PurposeThis paper aims to: analyze the challenge of health services fragmentation; present the attributes of integrated health service delivery networks (IHSDNs); review lessons learned on integration; examine recent developments in selected countries; and discuss policy implications of implementing IHSDNs.Design/methodology/approachA literature review, expert meetings, and country consultations (national, subregional, and regional) in the Americas resulted in a set of consensus‐based essential attributes for implementing IHSDNs. The analysis of 11 country case studies on integration allowed for the identification of lessons learned.FindingsStudies suggest that IHSDNs could improve health systems performance. Principal findings include: integration processes are difficult, complex, and long term; integration requires extensive systemic changes and a commitment by health workers, health service managers and policymakers; and, multiple modalities and degrees of integration can coexist within a system. The public policy objective is to propose a design that meets each system's specific organizational needs.Research limitations/implicationsThe analysis presented in this paper is qualitative.Practical implicationsSome policy implications for implementing IHSDNs are presented in the paper.Originality/valueThe research and evidence on integration remains limited. The paper expands the knowledge‐base on the topic, presenting lessons learned on integration and recent developments in selected countries, which can support integration efforts in the region.

There are similarities in the grounds, nature, and impact of litigation in the context of the countries studied. The studies included show weaknesses of health systems to ensure access to different services as well as in the introduction of new health technologies.

Los países de la subregión andina Bolivia, Chile, Colombia, Ecuador, Perú y Venezuela, integrados en el Organismo Andino de Salud – Convenio Hipólito Unanue (ORAS – CONHU) elaboraron y aprobaron mediante Resolución REMSAA XXXIII/474 del 23 de Noviembre de 2012, la Política Andina de Planificación y Gestión de Recursos Humanos en Salud y la implementación de su Plan de Acción 2013 – 2017.

In 2014, the Pan American Health Organization (PAHO) approved Resolution CP53.R14, which aimed to provide a framework for universal access to health and universal health coverage. It sets the stage for the inclusion of psychiatric practice within the provision of universal healthcare and highlights the fight against stigma. We propose to concentrate our efforts on changing the model of medical management. To that end, we are promoting the inclusion of mental health patients within the daily routine of primary care centres, thus allowing them to interact with other users of health services on a regular basis.