Fragmentation of health services is a major cause of poor performance of health services, and thus of the underperformance of health systems in general. Fragmentation can generate, on its own, or combined with others factors, difficulties in access to services, delivery of services of poor technical quality, irrational and inefficient use of available resources, unnecessary increases in production costs, and low user satisfaction with services received.

In response to the challenges posed by health services fragmentation and to various international mandates and commitments, PAHO/WHO is developing the initiative on Integrated Delivery Networks (IDN) with a view to contribute to the strengthening of Health Systems based on Primary Health Care (PHC), and thus to the delivery of more accessible, equitable, efficient, and quality health services that better meet the expectations of the population.

The objective of this section is to support policy makers, managers and health services providers in the development and implementation of Integrated Delivery Networks through the dissemination of documents, lessons learned, and tools.

Hernán Montenegro, Reynaldo Holder, Caroline Ramagem, Soledad Urrutia, Ricardo Fabrega, Renato Tasca, Osvaldo Salgado, Gerardo Alfaro, Maria Angélica Gomes.Combating Health Care Fragmentation through Integrated Health Service Delivery Networks in the Americas: Lessons Learned (2011) 

"This paper analyzes the challenge of health services fragmentation, presents the attributes of Integrated Health Service Delivery Networks (IHSDNs), reviews lessons learned on integration, examines recent developments in selected countries, and discusses policy implications of implementing IHSDNs." ...