Access to Health

The Access to Health Project (ATH) is an interdisciplinary health and human rights project in which students and faculty from Northwestern Pritzker School of Law's Center for International Human Rights (CIHR), the Center for Global Health, the Program in Public Health, the Kellogg School of Management, and the Feinberg School of Medicine work in consultation with marginalized communities across the globe to assess the health needs of the community, and to design a targeted, sustainable approach. ATH has worked with rural communities in the Mopti region of Mali to address female genital cutting, with urban communities in Nigeria on health rights, and with healthcare providers in the Dominican Republic to increase quality of patient service, among others. The project was founded by Professor Juliet Sorensen.

Students at the Law School, Feinberg, and Kellogg can join this experiential learning project through the Law School’s Health and Human Rights course. Each year the class is asked to form teams to act as ‘consultants’ to research and innovate a new approach to a common issue based on the feedback from community-based partners. Students from the class may apply to join an in situ health needs assessment, and to incorporate the information from this fieldwork into the final project for their team. Those who have taken the course and wish to continue supporting ATH are encouraged to assist with the projects implemented as a result of their in-class efforts.


Ongoing Projects

Mauritania

Access to Health has been working in Mauritania since 2022 with the Sahel Foundation for Health and Human Rights on programmatic interventions to support the Haratin community and disrupt traditional, hereditary slavery and discrimination based on work and descent (DWD). ATH and the Sahel Foundation developed interventions focused on the right to education and digital access, improving nutrition for pregnant and postpartum Haratin women, and researching access to patient services for Haratin people. The ATH Project and SF co-authored a report on barriers to accessing civil registration and identity documents for Haratin and the resulting impact on social determinants of health. The Executive Director of the Sahel Foundation, Brahim Bilal Ramadhane, is a longstanding Haratin anti-slavery activist and community leader and was the recipient of the 2024 Harvard Law School’s Global Advocacy Award.

Kenya

The ATH Project began working with Pamoja CBO, a grassroots, service-oriented organization in Kisumu, Kenya, in 2022 in support of their DREAMs, SheLeads, and Orphans and Vulnerable Children (OVC) projects. The scope of the partnership has included monitoring programmatic outputs around HIV/AIDs prevention and treatment for adolescent girls and young women (AGYW), as well as children, and a trauma-informed podcast focused on women’s empowerment and awareness-raising around sexual and gender-based violence (SGBV).

Past Projects 

Lebanon

Access to Health has been working in Lebanon since 2017. Since March 2020, the focus has been on the development of an interactive financial literacy curriculum for vulnerable Lebanese and a know your rights manual reflecting international, Lebanese and Syrian law for Syrian refugees.

Nigeria

Access to Health began working in Lagos, Nigeria in 2016, initiating a robust community-led health literacy and health access project that continues today. View the Nigeria Project website.

Opioids Roundtable and White Paper

Building on its 2016 Interdisciplinary Symposium on the opioid epidemic, on October 27, 2017, Northwestern University Pritzker School of Law hosted an invitational roundtable entitled “Identifying the Metrics of Success in Interdisciplinary Addiction Response.” The roundtable was convened to bridge the silos in Chicagoland working to curb the opioid epidemic. The event brought together a group of 35 stakeholders from the Chicago area across disciplines, including primary care physicians, law enforcement, NGOs, public health officials, and others, to bridge the disconnect and work toward an interdisciplinary approach to cresting the arc of the opioid epidemic. A white paper, largely derived from efforts at the roundtable, followed from that work.

Lake Tanganyika

Together with the Environmental Advocacy Center, ATH built an ongoing partnership with the Lake Tanganyika Floating Health Clinic to provide targeted, responsive research. The 2017 ATH team was asked to look at the complex issue of the negative environmental impacts of bed-nets on riverine communities. ATH and the Environmental Advocacy Center also worked with the Floating Health Clinic to assess the existing hydrocarbons law in the Democratic Republic of the Congo and to propose reforms based on best practices in environment and anti-corruption regulations.

Sudan

A feasibility study of the ongoing sustainability of a nonprofit health clinic in a peri-urban slum of Khartoum was conducted in 2015. Multiple ways to generate revenue to sustain the clinic were analyzed.

Mali

In 2014, ATH initiated several health interventions – including an album, a radio campaign, and a play about female genital cutting - in Douentza, a town in the Mopti region of Mali.

Dominican Republic

Guaymate, a town in La Romana Province, Dominican Republic, was the site of the Access to Health Project 2013, in which students partnered with the local public hospital, which serves primarily Haitian migrant workers, to do a patient care and service assessment.

Ethiopia

The Access to Health project sent an interdisciplinary team to Bonga, Ethiopia, in September 2011 and March 2012 to identify potential gaps in health care service delivery.

 

Reports

2024:

  • Civil Registration and Human Rights in Mauritania: A Focus on the Haratin Community
    • This report explores access to civil registration for people in Mauritania through a human rights-based approach. Civil registration is not merely a bureaucratic formality; it is a fundamental right that unlocks the door to various social, economic, and political rights. Without registration, children are barred from school; adults are precluded from employment, owning property, exercising political rights, and lack a legal security net; and individuals, especially women, are denied access to basic health services and insurance plans. The report focuses on regional and international standards relating to civil registration, domestic laws and enforcement gaps, and the impact of a lack of registration on voting rights and social, economic, and cultural rights, such as the right to health. The report concludes by offering recommendations based on the Sahel Foundation’s programmatic interventions to improve access to registration throughout the country.

2023:

  • Building Strategies and Tools for SheLeads in Kisumu
    • Despite the existence of a progressive constitution coupled with other legal and policy frameworks, adolescent girls and young women (AGYW) in Kenya continue to suffer marginalization in social, political, and economic life, limiting their opportunities to realize their full potential. The SheLeads program aims to empower women and girls and support survivors of gender-based violence. This report reviewed the organization’s current measurement tools for the SheLeads initiative and subsequently designed three new surveys: 1) a participant survey for activities, 2) a general participant survey, and 3) a volunteer survey.

  • Overview of Pamoja’s D.R.E.A.M.S. Initiative: Through a Stakeholders Lens
    • In the Spring of 2023, seven team members traveled to Kisumu, Kenya, to gather information related to Pamoja’s Orphans and Vulnerable Children (OVC) program, which seeks to serve families and children affected by human immunodeficiency virus (HIV). This report summarizes the team’s findings after interviews with members from Pamoja, Community Health Volunteers (CHVs), and the Ministry of Health (MOH). We then provide recommendations and a sample survey that Pamoja can adopt to gauge the experience of CHVs, Pamoja staff, and MOH personnel.

  • Measuring Programmatic Outcomes in Pamoja’s Orphans and Vulnerable Children (OVC) Initiative
    • While Pamoja serves roughly 16,000 community beneficiaries, their DREAMS initiative serves over 5,500 adolescent girls between the ages of 9 – 24 years old. DREAMS stands for “Determined. Resilient. Empowered. AIDS. Free. Mentored. Safe program,” and it serves to reduce HIV incidence among adolescent women and young girls (AWYG). The purpose of this report was to gather a deeper understanding of the DREAMS program and identify potential barriers from the perspective of members.

  • Community Participatory Health Assessment for Haratin Population in Mauritania
    • Given the lack of literature analyzing the accessibility and current needs to healthcare services of the Hharatin population in Mauritania, the ATH developed a community-based participatory health assessment to collect preliminary data from the target population to assist the Sahel Foundation seeking to assist the Hharatin population in gaining access to healthcare services.

  • How Education and Digital Access Can Help Abolish Modern Slavery in Mauritania
    • This report examines the right to digital information and the importance of internet communications in anti-slavery and human rights advocacy in Mauritania. The ATH worked with the SF to create a website for the organization.

  • Developing a Maternal Nutrition Education Program in Mauritania in Partnership with the Sahel Foundation
    • This project focused on creating a nutritional training and implementation guide to improve health literacy for pregnant and nursing Hharatin women.

2020:

  • Evaluation of the Effect of Medical Screenings on Asylum Procedures in Lesvos, Greece
    • This report examined the lack of medical assessments upon arrival and the impact this has on refugees’ legal procedure in Lesvos while providing recommendations on how these assessments should be conducted. 
    • Our partner, Fenix, is a humanitarian aid and legal organization that began operating in December 2018 to respond to the dire lack of legal representation and information available to refugees on the island of Lesvos. Fenix was first focused on providing legal assistance but quickly realized that a holistic approach was necessary.
  • Curriculum Guidelines for Female Cultural Mediators in Greece
    • This report developed guidelines for a cultural medication curriculum that is tailored to address the needs of refugee women and the barriers they face while seeking healthcare.
    • This report is in collaboration with SAO Association, an NGO for displaced women. Since 2017, SAO Association operates a day center in Lesvos called Bashira Center and one in Athens called Amina Center. Both centers provide emergency aid and protection services to women and are safe spaces.   
  • Data Protection and Privacy in Uganda: Exploring Data Privacy and Medical Stock Accountability in Uganda
    • This report examined issues related to collection, storage and processing of personal health data and cultural considerations related to privacy, confidentiality and consent.

  • Exploring the impact of User Fees on the Quality and Utilization of Health Services for Share Uganda
    • This report considered the optimal arrangement and policies for user fees for health services, to promote access and utilization, taking into consideration the cultural context. 
  • Both reports were written for Share Uganda a not-for-profit, community-based healthcare organization, working in the rural Kyotera District of Uganda. It began its operations in 2009, and its work focuses on providing quality and sustainable health services; supporting the education of local health professionals; and developing collaborative solutions to local healthcare challenges. Share Uganda is managed by Ugandan medical professionals and community leaders and is supported by an international network of volunteers.

2019:

  • Transgender Healthcare in China
    • This report investigated transgender people’s access to healthcare in China. It was written for the Psychological Team for Trans People in China, a non-profit established in 2018 which provides direct mental health services to transgender people, including counseling and operating a hotline. This report aimed at supporting the organization in its advocacy effort towards shedding light on the poor health outcomes of transgender people in China and support for the partner organization in its advocacy goals and objectives towards sensitizing Chinese society about its transgender population. 
  • Evaluation the Health and Human Rights for Incarcerated Women in Lebanon
    • In partnership with the Lebanese Center for Human Rights (CLDH), the aim of the report was to provide a mechanism for evaluating the health status and needs of incarcerated women, by developing a short survey tool to measure the key physical and mental health indicators, the provision of health care, and other prison conditions that can impact health. The survey tool allowed CLDH to identify firsthand data about the women’s health conditions in prisons.
    • A group of students then traveled to Lebanon to conduct meetings with key stakeholders, share their research findings and gain an understanding of the perspectives and challenges faced by government officials, lawyers, prison staff, NGOs, researchers, and health care providers in addressing the health needs for women in prison. 
  • New Technologies for Tuberculosis: R&D and Access
    • Tuberculosis (TB) is the leading cause of death from infectious disease and one of the top ten leading causes of death worldwide. There is a historic lack of research and funding for development of TB diagnostics and treatments, as well as a lack of universal access to the new medicines and diagnostics that do exist. TBpeople, founded in 2016, is a global network of activists who have been personally affected by tuberculosis.
    • TBpeople held a strategic planning meeting to update the organization’s goals. The result were four strategic priorities to be achieved between 2019 and 2022: 1) become the most influential network; 2) eliminate the TB funding gap; 3) demand innovation and accessibility now; and 4) end discrimination and fight stigma. This report, prepared for TBpeople by graduate students at Northwestern University, makes a series of research-based recommendations aimed to assist TBpeople in achieving these strategic priorities. 
  • Mental Health Stigma Among Youth in Nigeria
    • In partnership with the University of Lagos College of Medicine, this report examines mental health and mental illness amongst youths in Nigeria. The aim is to reduce stigma about mental illness by increasing awareness, evaluating how youths aged 18-24 perceive mental illness, and determining how resources can be utilized appropriately. To do this, a team of students traveled to Lagos to conduct qualitative research and organized an awareness seminar on mental health and mental health stigma with students at the of University of Lagos. The report serves to address gaps in research, examine the nature of mental health stigma, and to make recommendations for law and policy reform.

2018:

  • Gun Violence, Employment, and Economic Development in Chicago’s North Lawndale Neighborhood
    • This report assesses the relationship between economic development, gun violence, and health in Chicago’s North Lawndale neighborhood. The work presented and proposed is tailored for the Restorative Justice Hub, which is a network of community partners in North Lawndale who collaborate with the goal of creating a safe space within the neighborhood.
    • The purpose of this paper was twofold: first, to evaluate the current research connecting gun violence and economic health, as well as the current landscape of gun violence and economic health within North Lawndale. The second goal was to evaluate the current opportunities within North Lawndale to increase economic health. The report provides three major categories of strategies to achieve this goal: incentivizing for-profit development, encouraging local entrepreneurship, and optimizing workforce development. 
  • Improving TB Diagnosis Access in India
    • Northwestern’s Access to Health project team researched and analyzed the TB diagnostic landscape in India, focusing specifically on drug resistant TB. Research uncovered three causes of inadequate MDR-TB diagnostics services—inadequate access to latest diagnostic technology, social disparities and stigma surrounding TB, and high reliance and trust Indians place on private sector healthcare. This report then analyzed the problem of technology and social disparities using publicly available data and qualitative research (consisting of focus groups and in-person interviews conducted in India).
    • This report provides recommendations for two different stakeholders—Global Coalition of TB Activists, a global platform of people affected by TB that amplifies community engagement and strengthens the capacity of TB activists at all levels and Touched By TB, a the Coalition of TB people in India that was formed with the goal to work towards a TB-free India. 
  • Barriers to Accessing Legal, Safe Abortion and Misoprostol in Kenya
    • Female victims of sexual violence in rural Kenya are unable to realize their full right to health due to their inability to access the life-saving drug misoprostol or safe abortion services.
    • Working with our partner the Kenya Legal and Ethical Issues Network (KELIN), a not-for-profit organization that creates country-based networks that intersect law, ethics and human rights.
    • The report describes the legal protections in place for women, the general characteristics of female survivors in Kenya, the context and support for misoprostol access in rural Kenya, and the structural, economic, and cultural barriers to accessing misoprostol. The report incorporates in-country research aimed at clarifying existing literature and the most up-to-date research in country. Due to a combination of explicit and implicit barriers, the Kenyan health system and penal code do not provide rural women, particularly those who are victims of sexual violence, with their constitutional right to health.

News

06/25/2020 - Trial Observation Report: Criminal Proceedings Against Diana in El Salvador

06/25/2020 - Trial Observation Report: Criminal Trial of Evelyn Hernandez in El Salvador

05/13/20 – Alexandra Tarzikhan receives a honorable mention for best project oral presentation during the Institute for Global Health’s Global Health Education Day 2020

02/26/2020 - Chicago to Nigeria and back again: How a local connection sparked an international journey with Slalom and Access to Health

Winter 2020 - Access to Health Project uses technology to improve community health education in Lagos

06/17/2019 - Access to Health in Lagos: An Interdisciplinary Partnership with the Community

01/08/2019 - America’s Opioid Epidemic: A Rights-Based Approach in Health and Human Rights Journal

10/23/2018 - Global partnerships lead to empathetic storytelling in Lebanon and Nigeria

09/26/2017 – Megan E. Schliep, Joseph M. Feinglass, Kenzie A. Cameron, and Juliet S. Sorensen are amongst the winners of the 2017 best paper awards during the International Conference on Sustainable Development

01/11/2017 - Juliet Sorensen Believes Interdisciplinary Collaboration is Key to Global Justice

10/18/2016 – NLawProud: Professor Juliet Sorensen

10/17/2016 - In Illinois, chasing the arc of opioid epidemic

04/26/2016 – The Role of Biomedical Visualization in Medicine and Health

04/26/2016 - Reducing premature deaths linked to environmental risks

03/09/2016 - In Remotest Mali, A Hero on International Women’s Day

11/02/2015 - Communities are Partners, not Beneficiaries

05/26/2015 - Courtney and Chris Combe Give $1 Million to NU’s Access to Health Project

04/23/2015 - Northwestern Law Experience:  Reinventing Interventions

04/15/2014 - What does it look like to be a socially conscious business person?

03/13/2014 - Juliet Sorensen Publishes “The University as Global Citizen” in Health and Human Rights Journal