The right to equal health is undoubtedly a matter of democracy. Ensuring access to healthcare and reducing inequalities is a central task to guarantee universal human rights.
“Children’s needs and rights are often neglected in healthcare settings, and through this collaboration, we hope to contribute to improvements,” says Talla Alkurdi, Regional Councilor for Health and Medical Care in the Stockholm Region and also one of the participants in the partnership cooperation between Stockholm and Jinja.
About the partnership
The Stockholm Region, through Astrid Lindgren Children’s Hospital, collaborates with Jinja City Council in Uganda in a municipal partnership on the theme of Equal Health with a focus on children and their rights. The two non-profit organizations, Pediatric Health Initiative in Sweden and Busoga Health Forum in Uganda, are also associated with the partnership collaboration to implement the proposed improvements as effectively as possible.
The partnership collaboration has been granted four parallel projects, all with clear democracy and rights aspects. The four projects are about:
- Care for newborns,
- Children in need of emergency/critical care,
- Children with neurological diseases and disabilities, and
- Children’s rights in health care
Although the projects are independent, they all benefit from each other.
The right to timely access to healthcare
A clear focus on children’s rights permeates all the projects. It is also about the right to receive the right care in a timely manner. Child mortality in Uganda is high: 43 out of 1,000 children die before their fifth birthday. The main causes are birth complications, as well as treatable infectious diseases such as pneumonia, diarrhea, and malaria. Malnutrition also contributes to illness and death among many Ugandan children. At the same time, there is a severe shortage of healthcare personnel, as well as a lack of equipment and sometimes even medication.
Small changes can bring significant improvement
The project teams have identified how significant improvements can be made with simple means and changed routines.
“We cannot do anything about the significant resource shortage, but we can contribute to strengthening routines for pediatric care in the country!” says Helena Hildenwall, a researcher in global health, a pediatrician at Karolinska University Hospital, and the Swedish project leader for the collaboration with Jinja.
Helena explains that they actively work in the project to support healthcare personnel in Uganda in identifying small changes that can be made to create improvements and facilitate the implementation of new routines and methods for better quality care. One of the projects has conducted an evaluation of pediatric emergency care in hospitals throughout the Busoga region to identify the main barriers to providing quality care, and the Jinja main hospital is intended to serve as a future “training hub.” The project has already organized an interactive course in emergency care for healthcare personnel in Jinja.
Helena Hildewall together with Dorothy Akongo, who coordinates the projects for Busoga Health Forum.
Increasing knowledge to reduce stigma
One of the projects focuses on children with neurological diseases, especially epilepsy. In Uganda, children with neurological diseases are at risk of increased vulnerability due to societal stigmatization and lack of access to the care they need. There is a need to raise awareness about pediatric neurological diagnoses, both among healthcare personnel and in society at large. The Swedish team has already conducted educational initiatives to increase knowledge among healthcare professionals, and efforts targeting the general public are planned.
“The neonatology and neurology team and healthcare personnel have acquired significant skills and knowledge that improve the quality of care for children in the region,” says Dorothy Akongo, a social worker who coordinates the projects for the Busoga Health Forum.
Increased participation for caregivers
Involving caregivers is also an essential factor for increased participation.
Helena explains that Sweden has made significant progress in this area. Both in involving parents in the care of their children and in implementing approaches that consider children’s rights. Helena believes that this is largely due to the well-established management routines in Sweden, together with non-hierarchical communication within the healthcare system.
In Uganda, the work is more hierarchically organized, and there are fewer established routines for how parents can participate in the care of their children.
“By providing caregivers with knowledge about their own and their children’s rights, they will also be able to demand the care their children need,” says Dorothy Akongo.
Several educational initiatives have been carried out, including within the child rights project. An education on children’s rights and pedagogical methods has been held for over 30 caregivers. The Ugandan project group will undergo extensive training to then function as child rights ambassadors and support both within their own hospital and the staff at other healthcare facilities in the region.
Relying on technical aids
For the Swedish project teams, the partnership collaboration enables competence development. The teams are exposed to conditions that are becoming increasingly rare in Sweden but still require maintained expertise in an increasingly globalized world. Likewise, the teams practice working with severely limited resources.
“In Sweden, we rely heavily on technical aids in healthcare. Colleagues in Uganda often have a fantastic clinical eye for the patient, something we should not lose within the Swedish healthcare system,” says Helena Hildenwall.
The project between Jinja and Stockholm continues until 2025.