School Health Statement for Low-Income Countries

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Background

Vancouver conference:

• The Technical Meeting of Building School Partnerships for Health, Education Achievements and Development, Vancouver, Canada, 5-8 June, 2007, affirmed that schools make a difference to promote health and development for children, families and teachers. There is a strong association between good health and academic achievement and school completion. The meeting called for strengthening implementation processes and alleviating social and economic disadvantages [1] .
• A part of Track 3 of the Vancouver conference addressed the role of schools in health, learning and development in low-income countries. Health benefits of school health programs in low income settings primarily addressed infectious diseases. Educational benefits included increased enrolment, reduced absenteeism, reduced drop out and increased cognitive performance. FRESH (Focusing Resources on Effective School Health) was identified as a common framework for implementing successful school health programs. Partnerships at local level are vital, too, such as effective community partnerships, especially between teachers and health workers. – Challenges and Recommendations included: effective sectoral leadership of school health programs is needed. Effective coordination of all stakeholders must be carried out by Ministry of Health and Ministry of Education. Clear roles for all stakeholders including donors and implementers need to be stated. Effective targeting of interventions is vital. Effective monitoring and evaluation is necessary to achieve best practice [2].

Nairobi Call to Action

• The 7th Global Conference on Health Promotion, Nairobi, Kenya, October 2009, identified as urgent responsibilities: strengthen leadership and workforces, mainstream health promotion, empower communities and individuals, enhance participatory processes, build and apply knowledge [3].

Purpose of this Statement

• Describe strengths and needs of school health initiatives in low-income countries
• Focus our collective efforts
• Advocate for action at various levels, including fundraising, to meet the identified needs

Principles

This builds on the frameworks and successes of comprehensive approaches to school health:

• School health frameworks (developed more in tune with low income countries) include Focusing Resources on Effective School Health (FRESH) [4], Education for All (EFA) [5], Essential Package [6], child-friendly schools [7], health-promoting schools [8].
• Analysis of 26 case school health case studies from around the world showed that the most frequently utilized strategies for implementing school health initiatives included: vision and concept / international and national guidelines; dedicated time and resources (financial, human, technical, and material); stakeholder ownership and participation; team training and ongoing coaching / learning community; cross-sector collaboration; champions and leaders at all levels; data-driven planning and decision-making [9].

Strengths of low-income countries and their schools

(to start discussion: see http://www.health-equity-sustainability-schools.org/page/Addressing+Health+%26+Equity+through+Schools)

Needs of low-income countries and their schools

Access to and effective basic education, schools construction, clean water & sanitation, teacher training, basic literacy, completion of primary school, religious barriers, role of private sector (multi-nationals), basic hygiene [10].

(may also want to look at: http://www.health-equity-sustainability-schools.org/page/Addressing+Health+%26+Equity+through+Schools)

Areas for priority action

(structured along components of whole-school approach) [10].

• Policy
o Ensure access to basic education & completion of primary school
• Physical school environment (including sanitation)
o Construct schools; provide clean water & sanitation

Providers from the local government may offer social services, including sanitation. The school health team is charged also with the responsibility for the school environment.

• Psychosocial school environment
o Ensure good relations between teachers and students; no abuse
• Skills-based health education/instruction
o Teacher training
o Malaria prevention; girls education; trades education; basic literacy; basic hygiene

School health teams are expected to give health talks.

• Services (including health and nutrition)
o School feeding; reduction of parasites & malaria

There is a need to integrate health services in education since many of the students are faced with the harsh reality of disease and social challenge on a daily basis.

School health services might be an integral part of primary health care, and schools at central locations may house a school clinic staffed by qualified health workers, such as trained nurses, community health workers, and health educators, supplied by the local government. The school health team is charged with the responsibility for the growth and development of children. They may work together with other providers from the local government authority to offer health and social services on school premises, including immunization, TB treatment of learners, administering ARVs to thos who are infected with HIV, running a support group of volunteers for those infected with HIV.

• Outreach to families and communities
o Strengthen communities (schools are often the center of the community, teachers have a lot of respect, family and community ties are very strong, faith can be a positive force)

All social organs can play a big role in providing quality of life for all its citizens and in particular in countries that are economically challenged.

Schools can become a catalyst not only for positive educational change but broader community transformation.

We have to be creative in using all available resources to provide this quality of life to our people.

References

  1. Tang, K.C., Nutbeam, D., Aldinger, C., St Leger, L., Bundy, D., Hoffmann, A.M. et al. (2009). Schools for Health, Education and Development: A Call for Action. Health Promotion International, 24(1):68-77.
  2. World Health Organization & Joint Consortium for School Health. (2007.) Report of the Technical Meeting of Building School Partnerships for Health, Education Achievements and Development, Vancouver, Canada, 5-8 June 2007. Geneva: World Health Organization. (P. 28).
  3. Jukes, M.C.H., Drake, L.J., & Bundy, D.A.P. (2008). School Health, Nutrition and Education for All. Levelling the Playing Field. Wallingford, Oxfordshire, UK & Cambridge, MA, USA: CABI Publishing.
  10. Vince Whitman, C. & Aldinger, C. (eds). (2009). Case Studies in Global School Health Promotion: From Research to Practice. New York: Springer. Developed for 2007 WHO Technical Meeting Examples developed for 2007 WHO Technical Meeting
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