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Reform programs which enhance clinical integration and continuity of care include innovative models for integrated service delivery and care [ 3, 4]; establishment of new "cross-border" roles for care coordinators to improve transitions across healthcare settings [ 1, 5]; and case managers such as community 'matrons'[ 6].
Our finding suggests that even with high levels of provider knowledge, benefits of integrated service delivery are limited if providers are unable to deliver elements of integrated care.
If these other areas of health system functioning are not coordinated in order to support integrated service delivery, nurses will continue to be frustrated in their attempts to provide integrated care.
However, to date there is very little evidence available concerning the feasibility of integrated service delivery, or on the impact on imbalances in staff workload when integration is implemented at scale.
The challenge with integrated service delivery is that it reveals organisational, logistical and technical deficiences shortcomings.
Building on this work, she investigates how HIV platforms can be leveraged to effectively address NCDs, focusing on an integrated service delivery model in rural Malawi.
Since that time, investigators affiliated with PGNCDSC have evaluated the outcomes of integrated service delivery models for complex chronic conditions such as rheumatic heart disease and type 1 diabetes in resource-poor setting in Rwanda, Haiti, and Malawi.
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Multidimensional Treatment Foster Care (MTFC) is an especially effective example of an evidence-based, community-integrated service delivery option that advances positive child outcomes.
Some of the more established areas of healthcare such as cardiac care or administration are rather advanced in terms of the application of information technologies such as clinical knowledge bases and computer-integrated service delivery models.
Designing a consistently positive, rewarding experience across all those touchpoints takes system-wide thinking and an integrated service-delivery approach.
Moreover, the body of work describing operational models of integrated service-delivery in context remains thin.
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