During the COVID-19 pandemic, health workers in five African and Asian countries found new ways to combine different health programs—like vaccine campaigns, malaria prevention, and vitamin A distribution—into single events. Researchers interviewed 26 health leaders to understand what worked and what didn’t. They discovered that combining programs saves time and effort for healthcare workers and communities, but success depends on good planning, strong leadership, and making sure one program doesn’t overshadow another. This research shows how crisis can spark innovation in public health.

The Quick Take

  • What they studied: Whether health programs can work together more efficiently by combining campaigns into single events, and what helps or hurts this approach
  • Who participated: 26 health leaders and decision-makers from five countries (Côte d’Ivoire, Ethiopia, Guyana, Indonesia, and Nigeria) who manage vaccine programs, malaria prevention, disease control, and nutrition initiatives
  • Key finding: Health programs can be combined in different ways—from partial teamwork to fully merged delivery—and COVID-19 showed this is possible. Success requires good planning, teamwork, and strong leadership, but challenges include too much work for healthcare workers and disagreements about which program matters most
  • What it means for you: If you live in a low- or middle-income country, combined health campaigns could mean fewer visits to health centers and faster access to multiple health services. However, this only works if local leaders commit to making it happen and ensure healthcare workers aren’t overwhelmed

The Research Details

This was a qualitative study, which means researchers asked detailed questions and listened to people’s experiences rather than collecting numbers. The team interviewed 26 key stakeholders—people in charge of health programs—from five countries across Africa, Asia, and South America. These leaders worked on different health initiatives including vaccines, malaria bed nets, disease prevention, and vitamin A supplements. The researchers asked open-ended questions to understand what barriers and opportunities existed for combining these separate campaigns into coordinated events.

The study focused on learning from the COVID-19 pandemic, when many regular health programs were disrupted. This crisis forced health systems to think creatively about how to deliver multiple health services at once. By talking to program managers, partner organizations, donors, and government decision-makers, researchers could see the full picture of what works and what doesn’t from different perspectives.

This approach was chosen because combining health programs is complex and involves many people with different viewpoints. Numbers alone couldn’t capture the real-world challenges and solutions that these health leaders experience every day.

Understanding how to combine health programs matters because many communities in low- and middle-income countries receive multiple separate health campaigns throughout the year. Each campaign requires healthcare workers, volunteers, and community members to organize and participate. By combining campaigns, health systems could reduce this burden and reach more people more efficiently. This research helps policymakers understand what actually works in real communities, not just in theory.

This study has several strengths: it included perspectives from multiple countries and different types of stakeholders (managers, donors, government officials), which provides a comprehensive view. The researchers focused on real-world experiences during an actual crisis (COVID-19), making the findings practical. However, the study interviewed only 26 people, which is a relatively small number, so findings may not apply everywhere. The study is qualitative, meaning it describes experiences rather than measuring exact numbers, which is appropriate for understanding complex barriers and opportunities but requires careful interpretation.

What the Results Show

The research found that health programs are already being combined in different ways across the five countries studied. Some programs share planning and resources (partial integration), some deliver services together at the same event (co-delivery), and some are fully merged into regular health services. This shows that integration is already happening, not just a theoretical idea.

The biggest enablers—things that help programs work together—were joint planning (when different programs plan together from the start) and appreciation for healthcare workers’ time and effort. When leaders recognized how hard healthcare workers and community volunteers work, they were more willing to combine programs to reduce their burden.

The main barriers—things that get in the way—included differences in target populations (some programs serve children, others serve all ages), one program being prioritized over another, and healthcare workers becoming overwhelmed with too much work. When one program was seen as more important, it sometimes overshadowed others, making integration difficult.

An important theme emerged: leadership matters greatly. Success depended on country ownership (local leaders taking charge), political will (government commitment), and good relationships between different organizations. Without these elements, even well-designed integration plans failed.

The research identified that the COVID-19 pandemic created unexpected opportunities for innovation. When regular programs were disrupted, health systems had to think differently about how to deliver services. This crisis thinking led to new partnerships and creative solutions that might not have happened otherwise. The study also found that community context matters—what works in one area might not work in another, so solutions need to be tailored to local conditions. Additionally, stakeholder engagement throughout the process (keeping everyone involved and informed) was crucial for success.

Previous research has suggested that combining health programs could be efficient, but this study provides real-world evidence from actual health leaders about what works and what doesn’t. The findings align with earlier research showing that coordination saves resources, but add important details about the human and organizational challenges involved. This study goes beyond theory by showing that COVID-19 actually demonstrated these integration approaches are feasible, supporting calls for more permanent integration strategies.

This study interviewed only 26 people from five countries, so findings may not apply to all regions or health systems. The study relied on what people said about their experiences, which can be influenced by memory or what people think researchers want to hear. The research didn’t measure actual outcomes of integrated campaigns (like how many people received services), so we don’t know the real-world impact. Additionally, the study was conducted during or shortly after COVID-19, so long-term effects of integration remain unknown. Finally, the study didn’t include voices from community members or patients themselves, only health system leaders.

The Bottom Line

Based on this research, health systems should: (1) Plan campaigns together from the beginning rather than trying to combine separate plans; (2) Involve all stakeholders early and keep them engaged throughout; (3) Ensure strong leadership and political commitment from government; (4) Protect healthcare workers from becoming overwhelmed by monitoring workload; (5) Tailor integration approaches to local community needs rather than using one-size-fits-all solutions. These recommendations have moderate confidence because they come from experienced leaders’ perspectives, though more research is needed to measure actual outcomes.

Health officials and policymakers in low- and middle-income countries should prioritize this research. Healthcare workers and community health volunteers will benefit from reduced workload if integration is done well. Communities receiving health services may see improved access and convenience. Donors and international health organizations should consider these findings when funding programs. However, this research is less relevant for high-income countries with different health system structures, though some principles may apply.

If health systems implement these integration strategies, benefits could appear within one campaign cycle (typically 6-12 months). Healthcare workers should notice reduced workload relatively quickly. Communities might see improved access within the first year. However, building the relationships and systems needed for successful integration typically takes 6-18 months of planning before implementation begins. Long-term sustainability requires ongoing commitment and monitoring.

Want to Apply This Research?

  • Track the number of health services received per visit. Users can log: (1) Date of health visit; (2) Services received (vaccines, malaria prevention, vitamin A, disease screening); (3) Time spent at health center. Over time, users can see if combined campaigns reduce the number of visits needed to receive multiple services.
  • Users can set reminders for integrated health campaign dates in their community. When a combined campaign is scheduled, the app sends notifications about all available services at that event, encouraging families to attend once instead of multiple times. Users can also share campaign information with neighbors and family.
  • The app can track health service coverage over 12 months, comparing how many services users received before and after integrated campaigns begin. Communities can use this data to advocate for continued integration. Health workers can use the app to monitor whether integration is actually reducing their workload and improving service delivery efficiency.

This research describes opportunities and barriers to combining health programs based on interviews with health leaders. It does not provide medical advice about specific vaccines, malaria prevention, or vitamin supplements. Individual health decisions should be made with qualified healthcare providers who understand your personal health situation. The findings apply primarily to low- and middle-income countries and may not reflect health systems in other regions. While this research suggests integration could improve efficiency, actual implementation and outcomes depend on local context, resources, and leadership commitment. Always consult with your healthcare provider about which health services are appropriate for you and your family.