Integration of the fragmented vertical program is crucial for the efficiency and effectiveness of primary health care services. Therefore, identification of the strengths and challenges confronting the integration process through family medicine approach in some pilot project will give insight to the potential to capitalize on success of vertical programs. The study is an operations research post intervention study using a test (primary health care facilities implementing family medicine) and a control (Primary health care facilities operating according to the traditional primary health care–vertical programs) in urban and rural area. The sources of data were service statistics, structured exit interview in urban area and household survey in rural area as well as in-depth interview with service providers and programs planners and managers. The finding showed that , the volume of services delivered in the test groups showed initial increase. However the profile of utilization pattern did not show improvement especially for continuity of care, client and community satisfaction and referral. The study recommended the gradual introduction of the concept of integration at the education, training of service providers as well as the served community.