Poor nutrition diets and consequent rise of NCDs are population health challenges facing public health dietitians/nutritionists since they are charged with maintaining good health of the population through managing food and nutrition issues. By developing programs to tackle lack of food security, high pricing of healthy food and negative influences of food marketing, they can introduce nutritious diets and healthy eating habits to the community. They can do so effectively by collaborating with other health and non-health professionals and contributing to developing a more integrated health system. As noted by the WHO (2004), an integrated approach to the determinants of unhealthy diet would minimise future impacts of NCDs.
Integrated care has been attracting substantial attention as an imperative framework to develop better and more cost-effective health systems (Kodner & Spreeuwenberg, 2002). However, ...view middle of the document...
To patients an integrated system provides coordinated care with smooth and seamless transition between health, support, and social services provided by an array of health and other professionals (Cumming, 2011). To providers, integration indicates simultaneous or highly integrative provision, management, funding and assessment of technical services (WHO, 2008). To senior managers and policy-makers, integration means linking decisions and combining varying technical programs (WHO, 2008). With different expectations of integration, strategies are implemented for different reasons; some to lower costs and others to enhance quality, accessibility, and user satisfaction (Gröne & Garcia-Barbero, 2001).
Integration can occur at different levels. Both micro and meso level integration occur between individuals, but the former occurs in a single organisation (e.g. doctors and nurses working in a single general practice) while the latter occurs in different organisations (e.g. general practitioners and specialists) (Cumming, 2011). Contrastingly, macro level integration involves organisation-to-organisation collaboration (e.g. policy agreements or contractual arrangements) (Cumming, 2011).
Integration can be horizontal, vertical or inter-sectoral. Horizontal integration involves combining services on the same level to develop multidisciplinary teams (Gröne & Garcia-Barbero, 2001). Vertical integration entails integrating primary, secondary and tertiary care (Gröne & Garcia-Barbero, 2001). Inter-sectoral integration encompasses linking public health and curative services, health and support services and health and social welfare services (Cumming, 2011).
Developing an integrated health system is key to creating optimum health outcomes for patients and effective use of available resources (MOH, 2011). Integration improves services in relation to access, quality, user satisfaction, and efficiency, as they are cost-effective, client-oriented and equitable (Gröne & Garcia-Barbero, 2001; WHO, 2008). Integrating community dietitians/nutritionists promises improvement to health outcomes by effectively addressing the lack of nutrition in diets to reduce risk factors of NCDs.