How about the Children?

Porträtt av Karin Karin Strömstedt Johansson och Tobias Alfvén

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Karin Strömstedt Johansson, Program and Advocacy Advisor at UNICEF Sweden and Tobias Alfvén, senior researcher in global health at Karolinska Institute, who are the coordinators for the Swedish Network for Global Child Health, which is part of Swedish Networks for Global Health. 

… Why do we need a network for Global Child Health?

“The short answer is that the implementation of the United Nations 2030 Agenda, in particular SDG 3, is not happening quickly enough for its objectives to be achieved by 2030. For this to happen many more parties need to meet, establish partnerships, and work together instead of separately,” says Karin Strömstedt Johansson, who is responsible for the 2030 Agenda program and global development at Unicef Sweden.

Tobias Alfvén, paediatrician and senior researcher in global child health at the Department of Global Public Health Sciences at Karolinska Institutet in Stockholm and chairperson of the Swedish Society of Medicine, agrees.

“Ideas for a network for global child health, and Sweden’s role in it, have been around for a long time. It’s clear that the need to work across sectors and to share experience can be identified within Unicef, NGO’s, research institutions, government authorities and society as a whole.”

According to Karin Strömstedt Johansson the focus in existing child focused networks is often on aid and NGOs are in one network and other actors have their network and we need to become better at meeting across sectors. A new approach is necessary. 

“This is the first network to include a wide range of actors such as academia, NGOs as well as government agencies  such as Sida (Sweden’s government agency for development cooperation), the Public Health Agency and the Swedish Foreign Office Ministry of Foreign Affairs. Now it’s only partners from the business/private sector which are missing,” she adds. 

“There can be no doubt that the business sector has influence on children’s health.”

So far Karin Strömstedt Johansson has found it positive that people working within and between networks have met to bring about change. 

“There’s a great need for people to share information and experiences. It’s useful to raise common issues to which we may have completely different approaches and attitudes,” she says. 

Another area where there is potential for development is research and innovation. Here, students and researchers could, for example, work to increase knowledge of child health on a global level through Masters’ degree programmes.

 “It would be very exciting if students and researchers in economics, the behavioural sciences, environmental studies and so on could meet and find different approaches to global child health,” says Tobias Alfvén.

Children’s health is linked to children’s rights, strengthened by the UN’s Convention on the Rights of the Child. Has the pandemic had any effect on the health and rights of the child?

“Children are not hit the hardest by the direct impact of the COVID-19 pandemic, but the indirect effects stemming from strained health systems, household income loss, and disruptions to care-seeking and preventative interventions like vaccination are clearly indirect effects.”

“The convention is very clear that, ‘All children have an equal value,’ and, ‘The best interest of the child should be taken into account in all decisions affecting children.’ Article 6 takes up the child’s right to life and development and Article 12 guarantees the child’s right to be heard,” says Karin Strömstedt Johansson.

She finds that the 2030 Agenda has many child health indicators crucial to children’s health and child survival. But she’d still like to see more participation from children themselves. This is clear in the UNCRC, but has not been fulfilled to any larger extent by any country. 

 “Children’s voices are heard too little in delegations and in important meetings about children,” she says.

Tobias Alfvén and Karin Strömstedt Johansson agree that children have been particularly badly affected during the pandemic. School closures have affected 1.6 million children, and around 77 million children have still not returned to school.

“The pandemic has shown that the child’s perspective must have a larger part in decision-making. Many children have had to lose two years of schooling, including girls, who haven’t returned to school because they’ve been married or started work. This is a catastrophe for children,” says Tobias Alfvén.  

“Now we need COVAX to succeed so we can stop the pandemic everywhere so children’s lives can go back to normal. We must prevent this from becoming a child rights crisis,” says Karin Strömstedt Johansson.

“We’re going to see the effects of the pandemic on children for a long time. Gender equality, for example, has taken a step backwards and child labour has increased for the first time for 20 years. But we must continue to implement our action plan, the 2030 Agenda.”

Even if child health has improved greatly, 5.2 million children under five die every year. That’s 15,000 per day. Do you have any comments?

“The pandemic threatens to reverse decades of progress made around the world toward eliminating preventable child deaths. While the full extent of COVID-19’s impact on economies, movement, and child health is still unknown, if life-saving interventions are disrupted, many more children could die of treatable and preventable conditions. But on the one hand, we have the know-how to turn this negative situation around. One positive outcome for the future of child health is the recent news about the long-awaited malaria vaccine for children. A true breakthrough for science, child health and malaria control,” adds Karin Strömstedt Johansson. 

 “How are the children? A lot of positive things have happened over the last twenty years. We see better interventions. Mosquito nets and treatment make a difference as do preventive measures for diarrhoea. Globally, child deaths have been halved,” says Tobias Alfvén.

”But, with lower vaccination coverage there is a risk that the mortality figures will rise. We don’t know yet.”

Lastly, what’s happening at the moment in the Child Health Network?

“We have a network meeting on November 8 where we will look at available UNICEF data on global child health and identify where data is missing. A specialist from UNICEFs Data and Analytics Section  will be visiting us . And that’s only the start,” says Karin Strömstedt Johansson.

Ps. If you would like to hear more from Tobias Alfvén on Global Child health (in Swedish), please go to the Karolinska Institute podcast, Medicinvetarna: Hur mår barnen?

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