A New Paradigm for School-based & School-linked Health Promotion:
Systems-focused, Incremental Continuous Improvement & Capacity-Building
--------------------------------------------------------------------------
The concepts, purposes, underlying values, policies, practices and knowledge underlying school-based and school-linked health promotion (SHP) have evolved significantly since the term emerged in the 1980’s[1]. As countries, UN agencies and global organizations focus their attention on the achievement of the 2030 UN Sustainable Development Goals, with its emphasis on intersectoral action, it is fitting that we re-examine our fundamental approaches to uniting the efforts of the health, education and other sectors which have an interest in the health of children and adolescents.
This workbook is part of several activities undertaken by the International School Health Network that call for a new paradigm for school health promotion in the 21st century. While we must continue to focus on effective programs on specific health problems in schools, we strongly suggest that such programs are not sustainable unless we address several other dimensions to our work, including the contextualization of our strategies, better collection and analysis of data, more attention to maintaining and sustaining the core components of SHP, building organizational capacity, integrating within the core business of education and using the concepts and tools from systems science.

Attention to the intersection between health and education has returned once again, with the senior leaders of the World Health Organization (WHO) and the Global Partnership for Education calling for greater investments in health and education[i]. The recent adolescent component of the WHO global strategy on Maternal, Child and Adolescent Health[ii] includes a major focus on school health services and the UNESCO 2030 Framework for Action could be a catalyst for renewed attention to health education following the inclusion of health and life skills in the 2015 Incheon Declaration[iii].

The need for a new paradigm is urgent. While many countries are implementing excellent single intervention programs, very few have a stable SHP infrastructure of a Over-arching SH policy, a strong core health/life skills education program, a defined set of SH services, consistent ways of involving students, parents and communities and the social environment of schools in health, and a regulated, monitored set of physical conditions for school buildings, facilities and grounds.

Global organizations and UN agencies publish excellent guidance documents on specific topics but do not monitor the system/organizational capacities needed to deliver these recommended programs. In the health sector, the health promotion function and structures have been subordinated to a collection of physical health issues (NCD’s) rather than all aspects of health. Funding for programs, personnel and research for SHP is done by diseases and health conditions and further narrowed into time-limited projects in many cases.

However, we cannot simply renew what we have been doing for the past three decades[iv]. Yes, we need policy-makers to understand that education and health are inextricable. Yes, education and health sectors need to be partners.  Yes, education sector plans need to include health. But we have set these goals before and they are not sufficient. A pendulum goes back and forth on its same path but never affects its platform. We need to change our basic assumptions so that we can build, indeed, grow something that is more ecological, more systematic and more sustainable.   

Go to:
[1] Please refer to the brief history and discussion of the evolution of the Health Promoting Schools model in Appendix Two

Note: This web site is under construction. Comments and suggestions are welcome. Send them to info@internationalschoolhealth.org
Announcements
.
References:
[i] Julia Gillard, Tedros Adhanom Ghebreyesus (2018) Building a shared future in a fractured world starts with education and health. Davos 2018, DEVEX
[ii] World Health Organization (2017) Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation, Geneva, WHO
[iii] UNESCO (2016) Education 2030: Incheon Declaration and Framework for Action, Paris, UNESCO
[iv] The views stated in the recent 2018 joint article from the CEO's of WHO and the GPE are not new. WHO Directors-General and expert committees have underlined the education-health connection before. These include Margaret Chan, WHO Director-General in 2010, noting that “education and health go hand in hand”; Hiroshi Nakajima, in 1995 who stated that “Health is inextricably linked to educational achievements, quality of life and economic productivity” and a 1950 Expert Committee report that reported that “to learn effectively, children need good health”.