Integrated care: a fresh perspective for international health policies in low and middle-income countries

<b>Purpose:</b> To propose a social-and-democrat health policy alternative to the current neoliberal one.<br><br> <b>Context of case:</b> The general failure of neoliberal health policies in low and middle-income countries justifies the design of an alternative to bring disease control and health care back in step with ethical principles and desired outcomes.<br><br> <b>Data sources:</b> National policies, international programmes and pilot experiments—including those led by the authors—are examined in both scientific and grey literature.<br><br> <b>Case description:</b> We call for the promotion of a publicly-oriented health sector as a cornerstone of such alternative policy. We define ‘publicly-oriented’ as opposed to ‘private-for-profit’ in terms of objectives and commitment, not of ownership. We classify development strategies for such a sector according to an organisation-based typology of health systems defined by Mintzberg. As such, strategies are adapted to three types of health systems: machine bureaucracies, professional bureaucracies and divisionalized forms.<br><br> We describe avenues for family and community health and for hospital care. We stress social control at the peripheral level to increase accountability and responsiveness. Community-based, national and international sources are required to provide viable financing.<br><br> <b>Conclusions and discussion:</b> Our proposed social-and-democrat health policy calls for networking, lobbying and training as a joint effort in which committed health professionals can lead the way.

Abstract licence: CC BY

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