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Efforts to integrate programmes have exacerbated the difficulties.
"The goal of universal access to HIV prevention, treatment, care and support," said Ms. Veneman, "provides momentum to comprehensively scale up and integrate programmes and services".
The approach was meant to be a way to integrate programmes to holistically address the development needs of children at the sub-national level.
The debate between delivering services through vertical or horizontal mechanisms has endured since the 1960's, with continued calls to integrate programmes and activities into existing services.
A key priority of the GMC will be to integrate programmes at the national and local level, linking to existing structures and networks, such as child rights clubs and local NGOs.
The desire to integrate programmes and thereby avoid the unnecessary duplication of resources led to the establishment of the National Control Programme for the Integrated Control of Neglected Tropical Diseases in Uganda in 2007.
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Recommendations based on these findings are to: modify Board agendas and prioritise safety; integrate programme targets into mission statements and strategic objectives; strengthen lines of accountability and introduce reporting mechanisms associated with programme outcomes; and incorporate programme approaches into other existing initiatives.
As a result, work around food security is increasingly about developing integrated programmes, working with more partners and standardising approaches.
An important step in improving household welfare and enhancing development will, therefore, be to adopt integrated programmes for the education and health sector.
According to the World Health Organization and ICM, integrated programmes are the least effective as they compromise development of competencies for both the nursing and the midwifery professions (41).
It should provide regular physical health screening and specific interventions (CBT, family interventions involving psychoeducation, and supported employment) through integrated programmes for service users with a diagnosis of schizophrenia.
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