Introduction: To address the increasing burden of non-communicable diseases (NCDs), global commitments have been made towards an integrated care (IC) approach. The ‘SCale-Up diaBetes and hYpertension’ (SCUBY) project aims to provide implementation science-based solutions through co-creation, implementation and evaluation of roadmaps for scale-up of IC for diabetes and hypertension. We analysed macro-level barriers and facilitators to IC in: a developing health system in a lower middle-income country (Cambodia); a centrally-steered health system in a high-income country (Slovenia); and a publicly-funded highly privatised healthcare health system in a high-income country (Belgium). The results of this study will provide input in roadmap-strategies for scaling up IC in these contexts. Methods: To identify macro-level bottlenecks, documents review (scientific publications, policy documents and grey literature); practice observations; focus groups with patients, health workers and community-based actors; and in-depth stakeholder interviews with health facility managers, policy makers, civil servants (Ministry of Health and health insurance), representatives of professional associations, non-governmental organisations, implementers, academics, and patient platforms were conducted. Thematic analysis utilising the WHO global strategy on integrated people-centred health services, was conducted as a cyclical process including a deductive and inductive analysis approach. Country-specific codes were discussed and complementary literature review performed to get a comprehensive picture of the missing links. Results: We identified differences and similarities in macro-level barriers across the three contexts. The lack of political commitment regarding NCD investment in Cambodia and the limited policy coherence due to the fragmented political structure in Belgium weaken governance for IC. In Slovenia, a change in political leadership has interfered with IC implementation. In Cambodia, the limited financial resources and ...