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Integrated Health Services Delivery Networks

Fragmentation of health services is a major cause of poor performance of health services, and thus of the underperformance of health systems in general. Fragmentation can generate, on its own, or combined with others factors, difficulties in access to services, delivery of services of poor technical quality, irrational and inefficient use of available resources, unnecessary increases in production costs, and low user satisfaction with services received.

In response to the challenges posed by health services fragmentation and to various international mandates and commitments, PAHO/WHO is developing the initiative on Integrated Delivery Networks with a view to contribute to the strengthening of Health Systems and Services, and thus to the delivery of more accessible, equitable, efficient, and quality health services that better meet the expectations of the population.

The objective of this section is to support policy makers, managers and health services providers in the development and implementation of Integrated Delivery Networks through the dissemination of documents, lessons learned, and tools.


Agenda Regional para Hospitales en Redes Integradas de Servicios de Salud: Avances

Se presentan los avances de la Propuesta para una Agenda Regional para Hospitales en Redes Integradas de Servicios de Salud al mes de mayo del 2013. Documento está disponible aquí. (3.95 MB)

Experts Meeting. Barbados, October 24 – 25, 2012


Proposal for the Development of a Regional Agenda for Hospitals in Integrated Health Service Delivery Networks
Integrated Health Service Delivery Networks:The Challenge for Hospitals

Objectives: To validate the information from the series of managers’ meetings held in countries and provide a sub-regional perspective on the future of hospitals and the development of Integrated Health Services Delivery Networks (IHSDN); and to determine strategic lines for the Regional Agenda for Hospitals in IHSDNs from the perspective of the English-speaking Member States.


Taller de expertos. Panamá 25-26 de junio 2012

Taller de expertos en hospitales y servicios de emergencia médica efectuado en ciudad de Panamá el 25 y 26 de junio de 2012. Dicho encuentro se realizó como parte de un programa de trabajo que ha elaborado informes técnicos, ha generado talleres nacionales de gerentes hospitalarios y ha apoyado la elaboración de un libro sobre el desafío de los hospitales.


Pan American Health Organization
Integrated Health Service Delivery Networks: Concepts, Policy Options and a Road Map for Implementation in the Americas
Washington, D.C.: PAHO, © 2011
(SERIES: Renewing Primary Health Care in the Americas No.4)

This position paper focuses on the integration of the health services delivery function, and as a result it does not address mechanisms to integrate the health systems functions of financing and/or insurance.


Challenges of health services fragmentation and policy implications

Hernán Montenegro, Reynaldo Holder, Caroline Ramagem, Soledad Urrutia, Ricardo Fabrega, Renato Tasca, Osvaldo Salgado, Gerardo Alfaro, Maria Angélica Gomes.Combating Health Care Fragmentation through Integrated Health Service Delivery Networks in the Americas: Lessons Learned (2011) 

"This paper analyzes the challenge of health services fragmentation, presents the attributes of Integrated Health Service Delivery Networks (IHSDNs), reviews lessons learned on integration, examines recent developments in selected countries, and discusses policy implications of implementing IHSDNs." ... 


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