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Here, we aimed to compare the design, promotion, and implementation of the national HIV programme a primarily vertical programme with that of NHI, a horizontal programme.
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Horizontal programmes in which community-based health workers are involved in all aspects of disease control have yielded very positive results in Ecuador [41].
The development of open-source EMRs for use in resource-limited settings reflects the long-standing tension in public health between vertical and horizontal programmes.
Integrated programmes (also known as horizontal programmes) "tackle overall health problems on a wide front and on a long term basis through the creation of a system of permanent institutions commonly known as general health services".[ 51].
IMCI advocates should highlight key benefits of implementing horizontal programmes, such as the potential of achieving long-term and comprehensive effects on health services, the capacity to adjust to changes in disease patterns (Gonzalez 1965) and the avoidance of unnecessary competition for resources between vertical programmes (Mills 2005).
However, few studies have explored how and to what extent the new external financing and organisational arrangements provided by global financial initiatives, such as the Global Fund and GAVI, have influenced the governance of vertical health systems and horizontal programmes in countries receiving financing from these agencies [ 17].
In 2014, the OECD Strategic Foresight unit piloted a globally, wide and deep horizon scan of multiple sources of data (a meta-scan) to help frame and inform a new strategic and horizontal work programme on the Next Production Revolution.
These disease-specific programmes lie horizontal in the organizational matrix of ECDC (figure 1).
The key policy documents concerning deconcentration and decentralization emphasize the need for horizontal integration of the programmes of the line Ministries at all levels.
Therefore, reaching healthcare workers through other healthcare system channels becomes an important action as TB care becomes decentralised and national TB programmes become horizontal rather than vertical.
Recommendation 5: More horizontal integration of vertical programmes There is a need to enhance integration among vertical components of the Health, Nutrition and WES Programmes and among different sectoral programmes of the CPC as well as enhance programmatic cooperation UNDAF partners with a potential for positive effects on interdepartmental cooperation within the Government.
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