Collection: Deciding When to Integrate

Integration is defined as the sharing of all or specific campaign components or functions by a specific program addressing a disease or health need with the broader health system and ongoing delivery of interventions through general health services. This approach is important because health campaigns often are implemented in silos with limited or no coordination with other public health programs in the same geographies or health domains, reducing potential efficiencies in achieving results or minimizing operational costs. Many public health professionals acknowledge the opportunities offered by integrating across health campaigns. The collection of resources below offer guidance on deciding when to integrate health campaigns and considerations for rolling out integrations. 

To contribute to the learning on this topic, the HCE program office has recently deployed 12 research awards, including 8 case studies and 4 IR awards, which focus on either collaborative planning or health campaign integration. Projects focus specifically on one of the following five health domains: malaria, neglected tropical disease, vitamin A supplementation, polio, and immunizations. Findings are expected to be shared in the fall of 2021 and 2022.

Two other resources that may be useful for public health professionals to consider are the Codelivered Campaign Tracker and the 2021 Codelivery Campaign Calendar, which shows campaigns that are currently integrating.


Technical Brief: Integration Between Health Campaigns: Intervention Co-delivery and Collaboration

This technical brief published by the HCE program office is targeted toward country and regional policymakers, health campaign organizers and implementers, as well as global organizations that support health campaigns. It is intended to provide an introduction to the evidence base on two approaches of health campaign integration (full integration or “co-delivery” of campaigns and partial integration or “collaboration” between campaign components), summarize the lessons learned from past experiences, and highlight the evidence gaps. It offers additional insights on integration under the context of the COVID-19 pandemic. Of particular interest may be the section titled “Which health campaigns are most appropriate for integration” as it offers WHO-suggested criteria for guiding decisions on integrated delivery of health campaigns.


Decision Guidance Toolkit for People-Centered Integration of Health Campaigns

The recently published Decision Guidance Toolkit for People-Centered Integration of Health Campaigns aims to assist stakeholders at country and global levels to identify and collect information on the potential opportunities for health campaign integration.

The objectives are to:

  1. Identify opportunities for initiating and continuing a discussion on campaign integration;
  2. Provide evidence-based criteria to help country health programs and stakeholders pair campaign interventions with strong promise for effective full or partial integration
  3. Highlight the factors that are potential facilitators and barriers to such combinations in each country context; and
  4. Facilitate the synthesis of global and national guidelines, standards, and criteria to inform campaign integration decisions in each country.  

While not exhaustive, the two appendices–Worksheet for Global and Country Standards on Planning Health Campaign Integration and Criteria across Health Domains and Specific Interventions for Selecting Potential Campaign Integration—can be particularly helpful for the pre-planning stages of campaign integration.


(WHO) Working Together: An integration resource guide for immunization services throughout the life course

This resource guide is intended for use by national managers from immunization, reproductive, maternal child and adolescent health and other related programmes. It may also be useful for global, regional and country level policy-makers and partners responsible for the design, implementation, monitoring and evaluation of integrated services, policies or health systems strengthening.


Opportunities and Barriers to Campaign Integration Across Vitamin A, Immunisation, Polio, NTDs, and Insecticide Treated Bednet Distribution: A Key Informant Interview (KII) Study in Five Countries 

This qualitative research study implemented in the last quarter of 2020 sought to understand the opportunities, barriers and facilitators that the COVID-19 pandemic brought for integration in health campaigns. Faced with delayed timelines, risks of expired commodities and mitigation efforts to prevent SARS-CoV-2 transmission, there was a need to find efficiencies in health campaigns in order to prevent losses to public health gains made over the last decades.

Results showed that the global pandemic has opened doors for new ways of working across health campaigns, including new forms of integration. Many of the enablers mentioned by participants across the health domains were also considered to be barriers, depending on the context. Of note were the following themes: importance of coordination across the different domains to be integrated; understanding the optimum combination of commodities; considerations regarding data management for integrated campaigns; coordinated logistics and timeline of activities and; the impact of campaign integration on human resources. Across all informants, there were also some factors that were identified as crucial to successful integration: strong leadership, supportive political will and positive personal relationships that support effective collaboration. Read more about nine of the key takeaways from the study here


Technical Brief Public Health Campaign Integration: Lessons Learned from 30 Years of Polio Campaigns in Ethiopia, India, and Nigeria 

This technical brief explores one of the longest-running health campaigns, oral polio vaccine, to draw lessons learned around how and which campaigns best integrate with one another and how campaign effectiveness can be strengthened. Insights focused on polio campaigns’ impact on coverage of interventions, impact on acceptability of campaigns, impact on program cost and population health outcomes.


Integration of immunization services with other health interventions in the developing world: what works and why? Systematic literature review

This article published in Tropical Medicine and International Health journal explores the “benefits, challenges and characteristics of integrating child and maternal health services with immunization programmes.” After conducting a literature review, the results showed that Integrated services were vitamin A supplementation, bednet distribution, deworming tablet distribution, Intermittent Preventive Therapy for infants and referrals for family planning services. Two key characteristics of success were compatibility between interventions and presence of a strong immunization service prior to integration. Overburdened staff, unequal resource allocation and logistical difficulties were mentioned as risks of integration, whereas rapid uptake of the linked intervention and less competition for resources were listed as two key benefits of integration.


Delivering on a Promise: Polio Eradication Strategy 2022 – 2026

The promise of a polio-free world has been a driving force behind the Global Polio Eradication Initiative (GPEI), contributing to critical health gains over the past three decades. Indeed, before the coronavirus disease (COVID-19), polio eradication signified to many what the world could achieve by joining together to protect and promote the health of all children. The Polio Eradication Strategy 2022–2026 reflects the kind of integrated approaches that will be required to deliver on the promise of eradication. Through this new strategy, we believe the GPEI has re-envisioned its relationship with governments, deepened its commitment to polio-affected communities, made changes to empower and safeguard the frontline workforce, and expanded its partnerships to achieve broader impact in polio-priority geographies, alongside key innovations that will improve detection and response. The strategy also sets clear goals for strengthening the programme’s gender responsiveness, in recognition that progress toward eradication will be made the more that women’s meaningful participation and empowerment becomes a cornerstone of GPEI efforts, as outlined in its Gender Equality Strategy.

This eradication strategy emphasizes the need for polio campaigns to integrate with other immunization delivery and PHC services. In particular, appendix C is specific on when to integrate.

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