“ESTHER” – A European-South Health Institutions Solidarity Network

Norway has joined ESTHER, a modality for hospital-to-hospital collaboration. It is a mechanism to motivate hospitals and health institutions in Europe and in the Global South to establish cooperation e.g. twinning arrangements to help improve the quality of health care services in the South.

Norway has joined ESTHER, a modality for hospital-to-hospital cooperation - "Ensemble pour une Solidaté Thérapeutique Hospitalière En Réseau". It was initiated by France with a main focus on HIV/AIDS and joined by other European states in 2002 and 2004/2006, and by Norway in 2008. It is an instrument to motivate hospitals and health institutions in Europe and in the South to establish cooperation e.g. twinning arrangements. The expected effect will be improved quality of health care services to patients in the South.

The Norwegian ESTHER programme focuses on broader health system issues beyond but of course including HIV and AIDS, in particular activities linked to health workforce strengthening and the MDGs 4, 5 and 6 (children, mothers and HIV/AIDS).

Activity areas are

  • strengthening of primary as well as hospital care institutions
  • teaching and upgrading of education e.g. for nurses, midwives and technicians
  • specialization of health professionals
  • medical technical equipment and personnel
  • quality assurance and systems for quality improvement in service delivery
  • ICT and telemedicine
  • capacity development in management and administration

In Norway, ESTHER is administered by Fredskorpset on behalf of the Ministry of Foreign Affairs. The 2008 and 2009 budget is NOK 10 mill. annually (USD 1,5 mill.).

Already, several Norwegian health institutions undertake cooperation with sister institutions in the South, mainly in Africa. Enthusiasts among health professionals have engaged their institutions and educational facilities to join and support activities, and an increasing number of hospitals have established international units. Some relations have been long-standing, others fail to develop for various reasons.

The ESTHER approach will offer some funding to help ensure predictability and systematic, planned activities within the twinning arrangements. And linked to ESTHER, Fredskorpset together with Norad and the Directorate of Health will establish a platform for exchange of knowledge and experience in Norway, a "Norwegian Health Development Network". It will convene Norwegian institutions engaged in health development activities regularly, foster discussions and bring forward lessons learned and best practices. The first meeting will take place in February 2009.

An example of a Norwegian partner in health development is the Department of International Collaboration at Haukeland University Hospital in Bergen. It has over years been engaged with several partners in the South. In Malawi it has a twinning arrangement with Bwaila and Kamuzu Central Hospital, together with Ullevål University Hospital in Oslo and University Hospital North Norway in Tromsø. Activities are supported both by public and private financing. The activities are also supported by Fredskorpset and could eventually come under the ESTHER umbrella, once it is fully up and running.