Kenya + 6 more

Join Up, Scale Up: How integration can defeat disease and poverty


Executive summary

Despite the extraordinary advances of the 21 st century, the devastating impacts of poverty and preventable diseases continue to prevail. While major development efforts are ongoing in countries around the world, the vast majority of those programmes continue to be implemented through segmented divisions and budgets as dictated by institutional structures – such as health, education, nutrition or water and sanitation.

While these divisions can prove useful, they often create artificial divides in the lives of the individuals, families and communities that face the greatest challenges. Today, many stakeholders are recognising that, because the challenges of poverty and lack of access to health, nutrition, and education overlap in people’s lives, more effective and lasting solutions may be found in integrated, cross-sectoral programmes. For example, progress in child health can be accelerated through an integrated approach that coordinates a range of interconnected interventions. These include approaches aimed at reducing maternal mortality, solutions for tackling undernutrition, and efforts to address the environmental factors that contribute to poor health, such as lack of safe sanitation, clean water, and hygiene practices.

Today, interest in integrated approaches is increasing. Decision-makers at both the policy and programme levels increasingly acknowledge the importance of tackling poverty issues through integrated strategies and coordinated approaches. High-quality integrated programmes can prove cost-effective for donors, secure efficiencies for policy-makers, and provide more holistic services and greater impact for those who need them most.

At the same time, implementation of integrated approaches poses a challenge for development stakeholders. Myriad factors – for example, policy differences, lack of mechanisms for cross-sectoral and cross-institutional communication and collaboration, capacity gaps, and competition for limited financial resources – create imposing barriers to developing cross-sector approaches. Nevertheless, many governments and institutions are trying integrated approaches that are providing concrete examples of successful practice.

Successful models of integration are responsive to needs at the community and country level and include strong leadership from the responsible government agencies. The following success stories focus on three of the core areas – primary healthcare, clean water and sanitation, and nutrition – that are essential to achieving the Millennium Development Goals. These initiatives, and others like them, are generating important lessons and evidence for national policy-makers, donors and their NGO partners alike.