Improving paediatric quality of care through a Sweden-Uganda twinning partnership - reflections on implementation and early experiences from the child thrive project.

Despite major global progress in child health, significant inequalities remain between low- and high-income countries. In Uganda's Busoga region, child mortality is still high, largely due to preventable conditions and limited healthcare resources. In response, a paediatric health partnership was established in 2021 between the Busoga region and Stockholm, Sweden. Following a quality-of-care assessment in two Ugandan hospitals, the collaboration identified four priority areas: paediatric emergency care, neonatology, child neurology with a focus on epilepsy, and child rights. Over 3 years, 63 staff exchanges have taken place, enabling joint reviews of clinical practices and identification of improvement needs. A key achievement is the implementation of the WHO Emergency Triage, Assessment and Treatment Plus (ETAT+), supported by training 14 national facilitators who now serve as focal persons in their facilities. Initiatives in neonatology have strengthened early interventions for premature and low birth weight infants such as improved nursing care, infection prevention, and nutrition practices. In neurology, the introduction of an epilepsy registry and education programmes has reduced stigma and improved management. The child rights initiative has trained more than 80 ambassadors and fostered child-friendly hospital environments that promote participation. The in-hospital mortality dropped over the project period (2020-2025) from 26.4% to 21.7% for neonates (