Progress in achieving the millennium development goals has been substantive but uneven , with its equity , effectiveness , and sustainability being often undermined by lack of integration into national health systems . Even where efforts have been made to embed services at the community level , such as in the roll - out of integrated community case management of childhood illness programmes , a lack of full integration and stewardship by national health systems has hindered service use and sustainability . 8 Disease specific approaches often fail to tackle the delivery of services for other diseases or to sustainably strengthen common delivery platforms . 9 Despite both methodological and data limitations in the evidence , 10 there are clear indications that working towards integrated service delivery can improve healthcare use and outcomes . 11 The desire for focus on specific conditions is understandable , but efforts need to be aligned with and steered by national health systems and must be accompanied by deliberate attempts to create synergies with other priorities of the health system .