Integration

What integration means 

Integration means each element, including prevention, diagnosis, treatment, monitoring, and care of neglected tropical diseases (NTDs), is a routine part of everyday healthcare services. This approach ensures that care for parasitic diseases becomes a regular part of a person’s journey through healthcare systems, rather than being delivered as separate programmes. 

Why integration matters 

Integrated health care plays a vital role in strengthening health systems, especially in low-income countries. It benefits both the person receiving the service and the healthcare professional delivering it. For the individual, there is person-centred care, where they receive a holistic package of health that is customised to their needs. For healthcare systems and professionals, healthcare can be delivered in a more coordinated, efficient, and effective way, saving capacity and resources. 

Despite affecting over 200 million people globally, schistosomiasis and other parasitic diseases often remain neglected within mainstream healthcare. Integration can bring together services such as maternal health and infectious disease management under a single system. This helps to improve access, support continuity of care, and make the most of limited resources. 

The WHO NTD Roadmap 2021–30 

The World Health Organization’s (WHO) NTD Roadmap for 2030 calls for greater integration of NTD interventions into national health systems, aiming to: 

• Strengthen primary healthcare and universal health coverage (UHC) 

• Improve access to diagnosis and treatment through existing platforms 

• Foster multisectoral coordination for sustainable impact 

What Unlimit Health is doing on integration 

Case study: FGS

Female genital schistosomiasis (FGS) is an underdiagnosed manifestation of schistosomiasis in women and girls. Without appropriate and timely treatment, it can lead to chronic pain, infertility, increased risk of HIV transmission, and stigma. But FGS is often misdiagnosed or missed entirely, because the symptoms can look like other infections, such as a sexually transmitted infection, and many health workers aren’t trained to recognise FGS. 

Integrating the prevention, diagnosis, treatment, monitoring, and care for FGS into routine healthcare can reduce the likelihood of misdiagnosis by ensuring women presenting with symptoms are recognised and cared for appropriately, thereby improving outcomes and ensuring dignity in care. Additionally, in health systems with limited resources, integration can facilitate the sharing of costs and human resources.  

From facilitating feasible solutions to providing missing services, this case study exemplifies how an integrated approach enables many women to access services that were not previously available to them. 

Find out more in this interactive case study from Côte d’Ivoire on integrating services for female genital schistosomiasis into routine healthcare.

Case study: child health days

Unlimit Health and partners are trialling new, resource-effective ways of delivering treatment for schistosomiasis. We have worked with the Ministry of Health in Uganda to deliver praziquantel, the medication that kills the adult worms, through their integrated child health days.  

An integrated child health day is a special outreach event where multiple child health services are delivered together in one visit, usually at the community level. These biannual campaigns are designed to improve access to essential healthcare for children, especially in areas where families may struggle to reach clinics regularly. Typical services may include routine immunisations, vitamin A supplementation (to boost immunity), growth monitoring, and deworming medication (to treat intestinal worms).  

Using an integrated approach enables families to access multiple services at once, which increases uptake of public health interventions and reduces the opportunity cost (for example, days out of work and travel costs) of attending the health service. 

With funding from Merck, The END Fund, and the Bill and Melinda Gates Foundation, we were able to evaluate this approach, including direct supervision of treatment activities, process and policy evaluation components, in addition to a coverage survey.