Haregu Tilahun Nigatu, Setswe Geoffrey, Elliott Julian, Oldenburg Brian
Monash University.
Glob J Health Sci. 2013 Oct 8;6(1):9-22. doi: 10.5539/gjhs.v6n1p9.
Although there are several models of integrated architecture, we still lack models and theories about the integration process of health system responses to HIV/AIDS and NCDs.
The overall purpose of this study is to design an action model, a systematic approach, for the integration of health system responses to HIV/AIDS and NCDs in developing countries.
An iterative and progressive approach of model development using inductive qualitative evidence synthesis techniques was applied. As evidence about integration is spread across different fields, synthesis of evidence from a broad range of disciplines was conducted.
An action model of integration having 5 underlying principles, 4 action fields, and a 9-step action cycle is developed. The INTEGRATE model is an acronym of the 9 steps of the integration process: 1) Interrelate the magnitude and distribution of the problems, 2) Navigate the linkage between the problems, 3) Testify individual level co-occurrence of the problems, 4) Examine the similarities and understand the differences between the response functions, 5) Glance over the health system's environment for integration, 6) Repackage and share evidence in a useable form, 7) Ascertain the plan for integration, 8) Translate the plan in to action, 9) Evaluate and Monitor the integration.
Our model provides a basis for integration of health system responses to HIV/AIDS and NCDs in the context of developing countries. We propose that future empirical work is needed to refine the validity and applicability of the model.
尽管存在多种综合架构模型，但我们仍缺乏关于卫生系统应对艾滋病毒/艾滋病和非传染性疾病整合过程的模型和理论。
本研究的总体目的是设计一个行动模型，即一种系统方法，用于在发展中国家整合卫生系统对艾滋病毒/艾滋病和非传染性疾病的应对措施。
采用归纳定性证据综合技术，应用迭代渐进的模型开发方法。由于关于整合的证据分散在不同领域，因此对来自广泛学科的证据进行了综合。
开发了一个具有5项基本原则、4个行动领域和9步行动循环的整合行动模型。INTEGRATE模型是整合过程9个步骤的首字母缩写：1）关联问题的严重程度和分布情况；2）梳理问题之间的联系；3）验证个体层面问题的共现情况；4）检查应对功能之间的异同；5）审视卫生系统的整合环境；6）以可用形式重新整理和分享证据；7）确定整合计划；8）将计划转化为行动；9）评估和监测整合情况。
我们的模型为在发展中国家背景下整合卫生系统对艾滋病毒/艾滋病和非传染性疾病的应对措施提供了基础。我们建议未来需要开展实证工作来完善该模型的有效性和适用性。
