Assessing and Improving Children's Rights in Hospitals: Case Studies from Kyrgyzstan, Tajikistan, and Moldova
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Ana Isabel Fernandes Guerreiro1, Aigul Kuttumuratova2, Kubanychbek Monolbaev3
1Independent Consultant on children's rights, Albufeira, Portugal, WHO Regional Office for Europe, Copenhagen, Denmark.
Insights
Implementing human rights-based approaches (HRBAs) to health improved children's rights in Central Asian hospitals. Assessments using the Convention on the Rights of the Child (CRC) identified gaps and guided quality of care improvements.
Area of Science:
- Public Health
- Human Rights Law
- Pediatric Healthcare Quality
Background:
- Growing need for evidence on implementing human rights-based approaches (HRBAs) in healthcare.
- Assessing the impact of HRBAs on children's rights within health systems is crucial.
Purpose of the Study:
- To assess and improve children's rights in hospitals across Kyrgyzstan, Tajikistan, and Moldova using a HRBA.
- To evaluate the effectiveness of the Convention on the Rights of the Child (CRC) as a framework for improving quality of care (QoC).
Main Methods:
- Application of a set of tools based on the CRC to conduct health facility assessments.
- Involvement of children and parents in the assessment process to ensure reliable data collection.
- Repeated assessments in Kyrgyzstan and Tajikistan to track changes over time.
Main Results:
- Common gaps identified across countries included adolescent-friendly services, privacy, play, infrastructure, and equipment.
- Second-round assessments in Kyrgyzstan and Tajikistan showed effective changes in several areas, with persistent gaps in others.
- The CRC proved to be a useful framework for improving children's quality of care, and the tools facilitated self-assessment.
Conclusions:
- HRBAs, guided by the CRC, can effectively improve children's rights and quality of care in healthcare settings.
- Involving children and parents is vital for accurate assessment and successful implementation.
- The developed tools are valuable for self-assessment and driving improvements in pediatric healthcare.
Abstract:
There is a recognized need to raise evidence on how to adopt human rights-based approaches (HRBAs) to health and to assess their impact. In 2013 and 2014, the World Health Organization (WHO) Regional Office for Europe used a set of tools to assess and improve the situation of children's rights in 11 hospitals in Kyrgyzstan, 10 hospitals in Tajikistan, and 21 hospitals in Moldova, by applying a HRBA to health, taking as a reference the Convention on the Rights of the Child (CRC). The assessment results show a similar situation across countries in some areas, and more or less significant variation in others. Common gaps include the need to improve adolescent-friendly health services, the rights to privacy and play; and infrastructure and equipment. In Kyrgyzstan and Tajikistan, a second round of assessment, was carried out, which showed an effective change in several areas, whilst other areas showed persistent gaps. Moldova did not carry out a second round of assessment. Involving children and parents in the assessment was crucial to obtain more reliable data; the project showed how to use the CRC as a framework to improve quality of care for children (QoC); and the tools were proven useful for self-assessment.
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