title: The interface between health systems and vertical programmes in Francophone Africa: the managers' perceptions.
abstract: OBJECTIVE
  To explores the interface between vertical programmes (VPs) and general health services (GHS) in sub-Saharan Africa.
  
  
  METHODS
  Using semi-structured interviews, we analysed the perceptions of a selection of experienced mid-level managers of health systems and of VP originating in francophone Africa on the nature and quality of this interface.
  
  
  RESULTS
  The respondents acknowledged that VPs lead to both positive and negative effects on the functioning of GHS. The overall result, however, cannot be viewed as a simple summation of the positive effects possibly compensating for the negative ones. Indeed, some of the negative effects have a profound impact on the management and operation of the health care delivery system and may undermine the long-term institutional capacity of the general health systems. The quality and the nature of the interface between VP and GHS strongly vary in time, between settings and programmes.
  
  
  CONCLUSIONS
  We argue for more systematic monitoring of the interface between VP and GHS, so as to identify and address, in a timely manner, significant disruptive effects and deficiencies in a perspective of systemic capacity building of health systems.
authors.affiliation: Ministry of Public Health, Yaounde, Cameroun. bkeugoung@itg.be
authors.forename: Basile
authors.initials: B
authors.lastname: Keugoung
authors.forename: Jean
authors.initials: J
authors.lastname: Macq
authors.forename: Anne
authors.initials: A
authors.lastname: Buvé
authors.forename: Jean
authors.initials: J
authors.lastname: Meli
authors.forename: Bart
authors.initials: B
authors.lastname: Criel
mesh_terms: D017954:Africa South of the Sahara; D001294:Attitude to Health; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003906:Developing Countries; D006302:Health Services Research / Q000379:methods; D006801:Humans; D007802:Language; D007857:Leadership; D008490:Medical Informatics / Q000458:organization & administration; D011314:Preventive Health Services / Q000458:organization & administration