Organizational Models

“When thinking about integration, think vertizontal… a hybrid of vertical and horizontal, as both are needed.”

In this section you will find a review of vertical and horizontal models as they relate to health and development.  Because integration is a combination of the two models, it is important to understand what each of them are as separates.

The vertical model is where all levels of a system are working together to achieve objectives.  Vertical programs are effective when rapid responses and time-limited approaches are required for integration of programs into mainstream health services. The eradication of smallpox illustrates the success of a vertical approach. Despite its merits, arguments against a vertical approach to delivery include: a limited chance for sustainability; neglect of some of the underlying determinants; negative spinoff effects for health systems and non-targeted populations; potential duplication of services; and lack of pooling of funding or resources.  [i]

The horizontal model means working across sectors, departments or organizations to achieve objectives.  Horizontal approaches limitations: discussions remain at the policy level (intersectoral action) or at the service delivery sector without attention to differing levels of jurisdiction.