Table 2.
Strategies that may enhance TCA integration for essential health services delivery, based on our findings | Strategies that promote Facilitators |
Strategies that remove Barriers |
||||||
---|---|---|---|---|---|---|---|---|
Collegiality | Stature | Personal initiative | Personal experience | Fragmentation | Isolation | Lack of trust/awareness | Inadequate infrastructure/resources | |
High-level political will required for all strategies | ||||||||
Case documentation and sharing across systems, and in the academic literature | ✓ | ✓ | ✓ | ✓ | ✓ | |||
Routine opportunities for interaction and collaboration across systems (eg, health camps, health promotion drives) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Routine opportunities for interaction within co-located facilities (eg, staff meetings) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Rewards for the integrative initiative of individuals (eg, challenge grants or institutional recognition) | ✓ | ✓ | ✓ | ✓ | ||||
Rewards for the integrative initiative at the systems or facility level (eg, joint targets such as the number of monthly referrals, number of cases resolved jointly) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Guidelines for collaboration (criteria and conditions for cross-referral, jointly developed by practitioners, non-clinical aspects of work together, including health promotion and managerial duties) | ✓ | ✓ | ✓ | ✓ | ✓ |