Pan American Health Organization
Integrated Health Service Delivery Networks: Concepts, Policy Options and a Road Map for Implementation in the Americas
Washington, D.C.: PAHO, © 2011
(SERIES: Renewing Primary Health Care in the Americas No.4)

This position paper focuses on the integration of the health services delivery function, and as a result it does not address mechanisms to integrate the health systems functions of financing and/or insurance.

The World Health Organization (WHO) began promoting Primary Health Care (PHC) since before 1978, when PHC was adopted during the Alma-Ata Conference as a central strategy to achieve the "Health for All" goal. Recently, a process of PHC renewal was initiated by PAHO/WHO with the aim to strengthen countries’ capacity to implement a coordinated, effective and sustainable strategy to tackle existing health problems, meet new health challenges and improve health equity.
 
Multiple reasons justify the renewal of PHC: emerging epidemiological challenges; the need to correct weaknesses and inconsistencies in some of the different PHC approaches; the existence of new knowledge and tools that can increase PHC effectiveness; the growing recognition of PHC as a strategy to strengthen society’s capacity to reduce health inequalities; and the emerging consensus that PHC is a sound approach to address the causes of poor health and inequities.
 
The PAHO/WHO believes that PHC renewal must be an integral part of health systems development and, in turn, that health systems based on PHC constitute the best strategy to promote equitable and sustainable improvements in the health of the peoples of the Americas.
 
 A health system based on PHC is one that guarantees universal coverage and access to services that are acceptable to the population and equity-enhancing. It provides comprehensive, integrated and appropriate care over time that emphasizes prevention and promotion, and that assures first contact. Families and communities are the basis for planning and action.
 
 A PHC-based system requires a sound legal, institutional and organizational framework as well as adequate and sustainable human, financial and technological resources. It employs optimal organization and management practices at all levels to achieve quality, efficiency and effectiveness, and develops active mechanisms to maximize individual and collective participation in health. A health system of this nature promotes intersectoral action to address other determinants of health and equity.
 
 This section contains conceptual and theoretical developments, tools, guidelines and experiences related to PHC renewal that can support the process of building and strengthening PHC-based health systems in the Americas.

a. Documents
b. Declarations
c. Articles
d. Links
e. Videos 

Documents
	Servicios farmacéuticos basados en la atención primaria de salud. Documento de posición de la OPS/OMS. Washington, D.C.: OPS, 2013 (Serie: La Renovación de la Atención Primaria de Salud en las Américas No.6)
	Residencias médicas en América Latina. Washington, D.C.: OPS, 2011 (Serie: La Renovación de la Atención Primaria de Salud en las Américas Nº 5).
	Renovación de la atención primaria de salud en las Américas: documento de posición de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS). [2007] (2.47 MB) Renewing Primary Health Care in the Americas: A Position Paper of the Pan American Health Organization [2007] (3.23 MB) Renovação da Atenção Primária em Saúde nas Américas.[2008] (2.07 MB) Renouvellement des soins de santé primaires dans les Amériques. [2008] (2.1 MB)
	Sistemas de salud basados en la Atención Primaria de Salud: Estrategias para el desarrollo de los equipos de APS. (Serie la Renovación de la Atención Primaria de Salud en las Américas. No. 1) [2008] (469.85 kB) Estratégias para o desenvolvimento de equipes de Atenção Primária em Saúde. [2009] (602.79 kB) Strategies for the Development of Primary Health Care Teams. [2009] (605.27 kB)
	Redes Integradas de Servicios de Salud. Conceptos, opciones de política, Hoja de Ruta para su implementación en las Américas. (Serie la Renovación de la Atención Primaria de Salud en las Américas. No.4) [2010] (2.5 MB) Integrated Health Service Delivery Networks: Concepts, Policy Options and a Road Map for Implementation in the Americas. (Series: Renewing Primary Health Care in the Americas No.4) [2011] (2.45 MB)
	La Formación en Medicina Orientada hacia la Atención Primaria de Salud. (Serie la Renovación de la Atención Primaria de Salud en las Américas. No. 2) [2008] (1.06 MB) Medical Education for Primary Health Care (Series: The Renewal of Primary Health Care in the Americas No. 2). [2009] (1.3 MB)
	La Acreditación de Programas de Formación en Medicina y la Orientación hacia la APS. (Serie. La Renovación de la Atención Primaria de Salud en las Américas. No.3) [2010] .    [Only in Spanish]
	Informe sobre la salud en el mundo 2008 : La Atención primaria de salud: Más necesaria que nunca (4.08 MB) The World Health Report 2008 - PHC: Now More Than Ever (3.07 MB) Rapport sur la sante dans le monde, 2008 - Les soins de sante primaires: Maintenant plus que jamais (4.01 MB) Overview La Atención primaria de salud: Más necesaria que nunca - resumen (1.44 MB) The World Health Report 2008 - PHC: Now More Than Ever - overview (1.39 MB) Rapport sur la sante dans le monde, 2008 - Les soins de sante primaires: Maintenant plus.. - resume
	Aspectos generales del curso virtual de desarrollo de capacidades para la Renovación de la Atención (205.24 kB). [Only in Spanish]
Declarations
	Declaracion - Alma-Ata 1978 (39.44 kB)   Declaration of Alma-Ata : International Conference on PHC-1978 (25.47 kB)
	Declaración de Montevideo - Nuevas orientaciones de la APS - 2005 (33.01 kB)   Declaration of Montevideo - New Orientations for PHC - 2005 (30.94 kB)
	De Alma-Ata a la Declaración del Milenio - Buenos Aires 2007 (55.7 kB)   From Alma-Ata to the Millennium Development Declaration- Internat Conference - Buenos Aires 2007 (51.38 kB)
	Almaty: International Conference Dedicated to the 30th Anniversary of the Alma Ata Declaration on PHC (27.44 kB
Articles
	Regreso a Alma-Ata : Dra. Margaret Chan, Directora General OMS Return to Alma-Ata. Dr Margaret Chan Director-General of the World Health Organization
	Revista Panamericana de Salud Pública. Número especial sobre la atención primaria de salud en las AméricasFebrero-marzo 2007 Pan American Journal of Public Health.  Special issue on primary health care in the AmericasFebruary-March 2007
	Red para promover sistemas de salud basados en la APS en la Región de las Américas  [Only in Spanish]
Links
- Primary Health Care - WHO - Millennium development goals website - Curso del Campus Virtual de Salud Pública
Videos
- 25 years Alma Ata - Annual Report from PAHO Director 2009. Progress in Primary Health Care in the Ameicas - Dr. Margaret Chan - Dr. Halfdan Mahler   2009 - Annual Report from PAHO Director - Progress in Primary Health Care in the Americas