Putting the human into health systems: achieving functional integration of service delivery in Kenya and Swaziland

Background The Integra Initiative has evaluated different models of integrating FP/PNC and HIV testing and treatment services in Kenya and Swaziland. Human and physical resource integration (“structural” integration) is the usual outcome measure of “successful” service integration. Integra research has shown that in fact functional integration (clients actually receiving integrated care) does not necessarily follow. Much depends on the actions of individual providers and their managers in combination with systems and other factors. This paper provides a meta-analysis from a range of Integra data to investigate the human factors influencing successful “functional” service integration.