WASHINGTON, USA — To improve the response to the population’s health needs in the current context, the Pan American Health Organization (PAHO) updated the conceptual and operational framework of Integrated Health Services Networks (IHSN) with the purpose of strengthening the integration of health services and advancing toward more equitable and resilient systems. The new version incorporates regional learning and technical guidance to support countries in the progressive consolidation of their service networks.
In the region of the Americas, fragmentation and segmentation of health systems continue to affect timely access, continuity of care, and equity in health outcomes. Reducing these gaps requires integrating health care, priority programs, public health interventions, and the intersectoral approach to the social determinants of health. IHSN constitute a structural and operational response by reorganising care around principles of comprehensiveness, coordination across macro, meso, and micro levels, and a territorial approach, ensuring people-, family-, and community-centred care, while advancing the principles of primary health care.
The new framework proposes an operational structure based on four strategic domains: (1) organisation of care with a territorial approach; (2) integrated management of resources, digital transformation, and strategic processes; (3) governance, social participation, and intersectoral action; and (4) sufficient and sustainable financing. This architecture organises responsibilities and actions across different management levels, including macro, meso, and micro management.
The document also details attributes related to territorial organisation; people-, family-, and community-centered care across the life course; effective coordination mechanisms; and service delivery with resolutive capacity, as well as enabling components such as digital transformation, results-based management, and monitoring and health information systems.
For its application in the region, the Impulsa-RISS network has been established, an initiative promoted by PAHO to strengthen, accelerate, and innovate in the implementation of primary health care-based integrated health services networks through knowledge exchange and capacity development. This updated framework constitutes a technical reference to support national and subnational processes aimed at integrating services and strengthening the territorial organisation of care.
Learn more about the technical document: Integrated health service delivery networks: Updated conceptual and operational framework for the Region of the Americas (PAHO, 2025).
