New partner initiative launched to protect refugee children’s health

We are facing an unprecedented displacement crisis. According to the World Health Organization's 2022 data, global migration figures stand at over 1 billion individuals, equivalent to approximately 1 in 8 of the global population. Conflict, climate change, instability, and economic deprivation have forcibly displaced over 114 million people as of September 2023. This includes over 40 million children, with nearly 2 million born as refugees. 

This humanitarian crisis is also a profound health crisis. In many host countries, which are predominantly low- and middle-income nations, existing health systems are already overburdened and struggle to meet the needs of both local and displaced populations.

Recognizing the urgency of this situation, the UN Foundation’s Shot@Life and United to Beat Malaria campaigns have joined forces to create Healthy Start for Refugee Children. The initiative aims to strengthen access to quality health care for refugee children in East Africa — specifically, Uganda, South Sudan, and Ethiopia — where the needs are acute yet often overlooked.

The goal, said Margaret McDonnell, executive director of United to Beat Malaria, is to ensure at least 1 million additional children will be provided essential health care services, including immunizations, malaria prevention and management, and nutritional support. Further, the initiative will work with the UN Refugee Agency, or UNHCR, to provide support to community health workers and strengthen health systems for refugees and host communities.

In an interview with Devex, McDonnell discusses the initiative's strategies to address health gaps for refugees, the importance of strengthening the network of community health workers, and how individuals and organizations can offer support.

This conversation has been edited for length and clarity.

We are facing a displacement crisis of historic proportions. How is this crisis impacting health systems and the health of refugees and internally displaced people, particularly children?

The number of people who have been displaced and have had to leave their homes around the world has doubled in the last decade. Currently, there are more than 40 million children displaced from their homes — that includes both refugees who have had to cross borders, and internally displaced people who are still living within the borders of their home country.

There are many reasons why refugees or displaced people aren't able to access the health care services they need, ranging from not being counted or prioritized, to insufficient funds and political will to ensure they’re reached and included. There are also other financial, legal, cultural, and practical barriers. Unfortunately, this means that oftentimes refugees and displaced people are excluded from critical health programs such as immunization drives or malaria prevention efforts. Children are particularly vulnerable to many diseases that are preventable and treatable, such as malaria, polio, and measles, but they lack access to critical health interventions and tools.

As we see displacement rates continuing to grow, it presents a big challenge for host countries and their health systems. We must figure out how to have shared responsibility between host countries, the international community, WHO, and U.N. agencies, to ensure that we can have long-term funding models and policies in place so that displaced kids and their families have equitable access to quality health care.

Can you talk us through the Healthy Start for Refugee Children initiative? How is it addressing current health gaps for refugee children?

Healthy Start for Refugee Children initiative is a collaboration between two sister campaigns at the UN Foundation: United to Beat Malaria and Shot@Life. Over the past 15-plus years, our two campaigns have collectively protected over 100 million children from malaria and other preventable diseases. The health of children and families has always been our mandate and our focus. However, given the significant displacement affecting children, the record high levels of unvaccinated children due to COVID-19 disruptions, as well as the ongoing challenges in fighting malaria, we decided it was time to join forces for the Healthy Start for Refugee Children initiative, or Healthy Start.

Healthy Start aims to ensure that at least 1 million more children will have access to essential health services like childhood immunizations; malaria prevention, diagnosis, and treatment, nutritional support; and community outreach.

We also see this as an opportunity to elevate the importance of ensuring refugees and displaced people around the world have access to health services and plan to use our platform to advocate for their inclusion in national health care policies and programs.

How are the current refugee crises in South Sudan, Uganda, and Ethiopia projected to develop in the coming years?

We chose to focus on South Sudan, Uganda, and Ethiopia because these countries have endured a lot of conflict, civil wars, and climate disasters like floods and droughts. Unfortunately, the conflict in the Democratic Republic of Congo has also led to significant displacement in countries, including Uganda. Together, these three countries have over 10 million displaced people, making up about a quarter of all displaced people in sub-Saharan Africa. Further, these countries are particularly vulnerable to other preventable and treatable diseases. In partnership with UNHCR, we identified a significant gap in health care coverage and in turn are aiming to help fill that need.

The good news is that the region has made a lot of strides over the last decade. Each of those three countries has seen a 20-33% decline in under 5 mortality since 2011. There has also been a lot of progress in border collaboration, including the East African Community, which is a seven-country consortium that has worked to improve economic cooperation and disease surveillance across the region.

How will the collaboration support Uganda, South Sudan, and Ethiopia to build resilient health systems for child refugees?

Our short- or medium-term goal is to include 1 million children in essential health services, focusing on malaria prevention, immunizations, and nutritional support. Providing lifesaving commodities like bed nets and vaccines will have the most immediate impact.

Beyond ensuring access to these interventions, we aim to make a long-term impact by investing in local community health workers and outreach agents. These workers will conduct community education about the tools and interventions necessary to keep kids and their families healthy and safe. Additionally, we plan to strengthen health systems by enhancing surveillance, tracking, and ensuring high participation rates among children and families.

How will community health workers and host country health officials come together to support each other in this initiative?

Healthy Start for Refugee Children aims to align health programs with national health care and displacement policies. Our front-line partners, such as UNHCR, are working in tandem with community and country health officials to realize this initiative and embed it within broader policies and objectives at community, country, and regional levels.

Community health workers and outreach agents are essential. They are the backbone of delivering health services in many communities, including among refugees and displaced people. They work to ensure that all families are counted and have access to health care and education. They also play a crucial role in promoting vaccines and malaria prevention, making families feel comfortable with health initiatives.

Most of these workers are women who are often underpaid or not paid at all and can be taken for granted despite their critical role and despite putting their lives on the line, especially during health crises like COVID-19 and Ebola. Healthy Start for Refugee Children is invested in strengthening the network of community health workers and outreach agents because they play such a critical role and are oftentimes among the trusted community members.

How can individuals or organizations support the initiative?

We need help to ensure that Healthy Start for Refugee Children can reach our goal of protecting 1 million kids with essential health services. We are looking for partners, donors, and advocates to raise awareness and to take action. Visit bit.ly/healthystart4refugees to donate, use our toolkit to spread the word on social media, and to learn how you can partner and get involved. We would very much welcome support, partnership, and voices to help promote inclusion and equitable access to health services for refugees and displaced people.