Frontline organizations play a critical role in providing programs and services that support people living with or at risk for HIV, hepatitis C and other sexually transmitted infections (STIs). To do this effectively, services need to be organized and delivered in a way that best meets our clients' complex and evolving needs.
Creating comprehensive programs and services, based on clients' needs, is one way to ensure that programs offer the best combination of interventions to most effectively improve health outcomes and reduce new infections.
This article profiles some of the different approaches Canadian organizations have taken to map services as a way to move toward more comprehensive and integrated services.
The Right Services in the Right Places at the Right Time
We need to deliver the right services in the right places at the right time to improve client health outcomes and reduce new infections. But how do we do this?
First, we need to understand what "package" of services the community needs. This means having a good understanding of who our target audience is. We must also understand the complex and interconnected needs of clients, what health and social services are currently available to them, and how accessible and linked those services are.
Having a better knowledge of the services and programs clients use, need and want, allows service providers to see where existing programs are succeeding and where they are falling short.
How Do We Provide the Right Services in the Right Places at the Right Time?
Integrating prevention, testing, treatment and support services is one important way to provide the right services, in the right places at the right time. Client-centred care is the overall goal of an integrated approach.
Integrated services address a client's comprehensive engagement and linkage needs across the full continuum of prevention, testing, treatment, and care and support services, rather than working in "silos," which has traditionally been the case in many communities.
What Are Integrated Services?
Service integration allows clients to access a combination of programs and services that addresses their underlying health and social issues that are contributing to poorer health outcomes or ongoing risk for HIV, hepatitis and other STIs. Integrated approaches are a client-centred approach to program development through which multiple health and social issues are addressed in a coordinated way.
There are two broad approaches to integration -- service integration and program collaboration.
Service integration is an approach that provides clients with seamless access to programs and services within a single organization through a one-stop-shop approach. This approach aims to make it easier for clients to access services by providing a single point of entry. Most service integration models include some degree of health navigation, case management and referrals.
Program collaboration is an approach based on partnerships and collaboration across existing programs, services and organizations. Program collaboration can reduce duplication of services and increase participation in service delivery from a variety of programs and organizations. Strong integrated programs are collaborative and link to other service providers, such as those who specialize in mental health, substance use, housing, income assistance and food security. Such collaboration may be most useful in settings with limited resources, where community organizations develop strong linkages with other community-based and medical programs and services to provide navigation across the continuum of care.
Service Mapping: A First Step to Developing Integrated Services
Service mapping is one strategy to develop integrated client-centred programs and services. It provides service providers a way to situate the frontline services they offer in the broader landscape of the HIV, hepatitis C and STI work taking place in the community.
Through service mapping, you can examine what services and programs you offer; the services and programs that other agencies in your community offer; the links between these services; the services and programs your clients use, need or want; and identify any service gaps that may exist in the community that may need to be filled.
There is no one approach to service mapping; some Canadian examples are highlighted later in this article. However, service mapping should try to
- include participation from community members, other services providers and program planners
- evaluate whether current services are appropriate for the population being served (for example, LGBTQ friendly, culturally safe for Indigenous people, women, ethnoracial communities, and people of all abilities)
- assess whether services are underused, overused or simply don't exist.
Service mapping can be a launching point for a discussion about how to better collaborate with available services in your community. It may also help you determine which organization is best positioned to fill any service gaps.