In the serene meadows and forests of southern Lapland in Sweden, where the air is crisp and reindeers roam freely, local residents still face real-world challenges. Beneath its idyllic surface, the region has spent a century finding ways to deliver primary health care (PHC) to its ageing population, combat the loss of skilled health workers and professionals to urban centres, and overcome the vast distances that limit accessibility.
In the 1990s, Sweden reinvented their sjukstugor (also known as PHC cottage hospitals) to address these challenges, transforming them into the outstanding health-care delivery model they are today.
The success of Sweden’s PHC model in southern Lapland can be attributed to an approach that recognizes the connected nature of physical, mental and social health issues and addresses them through multidisciplinary teams, professional role development and task optimization. The collaborative efforts of local stakeholders, coupled with innovative organizational transformations, have positively impacted workforce development, recruitment and retention.
Expanding roles of medical staff
Since October 2022, Georgia, Kazakhstan and Latvia have sent delegations to Sweden to learn from this model. During a recent visit, Ieva Špironoka, a senior expert at Latvia’s Health Ministry, shared how empowering it is to expand the roles of nurses and support them in achieving their full potential: “This, coupled with the value of sharing experiences and learning from progressive practices, strengthens our belief that meaningful change is possible.”
The WHO European Centre for PHC and Västerbotten regional and local health authorities introduced a sjukstuga into a WHO PHC Demonstration Platform, which allows countries with similar challenges to gain insights into the solutions that can be adapted to different contexts. The Centre for Rural Medicine in Storuman Municipality, soon to become a WHO collaborating centre, is the main partner in organizing these visits. It leads research and innovation in rural PHC with a focus on serving remote communities and the indigenous Sami population. Sweden’s model stands as an inspiring testament to the transformative power of effective PHC delivery.
Innovative solutions
“Visits like this can truly make a difference because they ignite change,” stressed Melitta Jakab, Head of the WHO European Centre for PHC. “Reading about a country’s policies is one thing, but witnessing how they work in action is an entirely different experience.”
Västerbotten is a vast area located in southern Lapland, Sweden. It is one of Europe’s most sparsely populated regions, with just 5 inhabitants per square kilometre. Although larger than Denmark, the Netherlands or Switzerland, the landscape here remains largely untouched, with vast stretches of wilderness separating small, isolated villages. Despite these significant challenges, Västerbotten has implemented innovative solutions and become a model for delivering health care to remote villages.