www.schoolhealthpromotion.org
An Online Workbook for
countries, states, agencies, practitioners and researchers
to support Continuous Improvement
  • Home
  • About
    • Introduction to this workbook and new SHP Paradigm
    • How to Use, Contribute to this Workbook >
      • Format of Better Practices Pages
    • SH Promotion in the 21st Century
    • List of Better Practices in this Workbook
    • List of Partners, Contributors & Sponsors
    • Be the Lead on a topic/Contact Us/Sign-Up for Updates
    • Brief History, Key Aspects of SHP
    • Key Definitions & Terms
  • Better Practices (A-F)
    • Before You Start: Shared Vision & Goals
    • A. Understand Your Context >
      • A-1 Defined Country, Community Contexts
      • A-2 Conduct a Situation Analysis >
        • A-2-1 Understand the Organization, Structures, Laws for Education Systems
      • A-3 Exchanges with similar countries
    • B. Better Data, Focus Your Resources >
      • B-1 Agree on Priority Issues >
        • B-1 (i) Issues documented, Agreed, Communicated
        • B-1 (ii) Local, School Priorities Enabled
      • B-2 Focus Your Resources on these Issues
      • B-3 Select/Develop/Use Surveys on Child Health & Behaviours
      • B-4 Select/develop/use a SH Policy/Program Survey
      • B-5 Select/develop/use a HPSD student learning survey
      • B-6 Establish Reporting Format, Frequency
    • C Whole Child, All Children, Esp. Disadvantaged >
      • C-1 Define, Describe, Publish Your Values
      • C-2 Describe Impact on Access, Achievement in school
      • C-3 Describe Impact on Disadvantaged Students
    • D Choose Interventions, Build Multi-Interventions (MIP's) >
      • D-1 Select Populations to be served by priority interventions
      • D-2 Select core sets of interventions
      • D-3 Build Multi-Intervention Progrtams (MIP's)
      • D-4 Control Proliferation of Projects, Issues
    • E. Select & Align Multi-Component Approaches >
      • E-1 Select, descrtibe your Multi-Component Approach (MCA)
      • E-2 Align MCA's Used in your country
    • F Build, Maintain Core Components >
      • F-1 Over-arching SH Policy >
        • F-1 (i) The Policy-Making Cycle
        • F-1 (ii) Encourage/require multiple components/interventions
        • F-1 (iii) Emphasize Equity within the policy
        • F-1 (iv) Support the Policy with an Action Plan
      • F-2 Develop, maintain a strategic action plan >
        • F-2 (i) Health, Education, Other Ministry Service Plans
        • F-2 (ii) Local Health, Education, Other Agency Service Plans
        • F-2 (iii) School, Clinic, Professional Service Plans, Guidelines
      • F-3 Maintain a core HPSD Education Program >
        • F-3 (i) Core HPSD Curriculum/Class Instruction
        • F-3 (ii) Consider core Home Ec/Financial Literacy Curriculum
        • F-3 (iii) Consider Core PE Curriculum
        • F-3 (iv) Vocational Prep for Health Careers
        • F-3 (v) Planned, sequenced cross-curricular instruction
        • F-3 (vi) Use of school routines, organization
        • F-3 (vii) Correlate with School Climate, Discipline Practices
        • F-3 (viii) Use of Co-Curricular Activities
        • F-3 (ix) Use of Extra-curricular Activities
        • F-3 (x) School-linked Web Learning
        • F-3 (xi) School-linked Family/Parent Education
        • F-3 (xii) School Participation in Community Education Programs
        • F-3 (xiii) Teacher Education & Development
        • F-3 (xiv) Teacher Wellness
      • F-4 Define Set of SH Services, Waiting Times >
        • F-4 (i) Defined set of school-based/linked services
        • F-4 (ii) School Health Services Quality, Delivery
        • F-4 (iii) School-based Clinics
        • F-4 (iv) School-based Vaccinations/Immuization
        • F-4 (v) School Management of Students with Chronic Diseases
        • F-4 (vi) School Management of Students with Disabilities
        • F-4 Role, Training of School Nurses
        • F-4 (viii) Role, Training of School Psychologists
        • F-4 (ix) Role, Training of School Physicians
        • F-4 (x) Role, Training of Donor Funded Aid Workers
        • F-4 Role, Training of SH Coordinators
      • F-5 Social Environmnet, Support, Engagement >
        • F-5 (i) Maintain positive school social climate
        • F-5 (ii) School discipline/codes of conduct
        • F-5 (iii) Consult, engage students
        • F-5 (iv) Inform, educate, involve, support parents
        • F-5 (v) Inform, involve community
        • F-5 (vi) Awareness, safety, use of social media
      • F-6 Physical Environment, Practical Resources >
        • F-6 (i) School Construction, Retro-fitting
        • F-6 (ii) Clean Water
        • F-6 (iii) Clean, safe bathrooms, latrines
        • F-6 (iv) School Meals, Food Services
        • F-6 (v) Safe Routtes to School
        • F-6 (vi) Disaster/Emergency Risk Reduction
        • F-6 (vi) Strategy to "Green" School Grounds, Facilities
      • F-7 Reciprocal, Strategic Partnerships
      • F-8 Country/Community Ownership
      • F-9 Youth/Student Engagement
  • Better Practices (G-J)
    • G Implementing, Scaling Up, Sustaining Programs >
      • G-1 Are you distributing, disseminating or institutionalizing?
      • G-2 Scaling Up, Succession Planning
      • G-3 Intervention Mapping
      • G-4 Interventiion Fit with your Situation
      • G-5 Use of Effective Planning Mechanisms
      • G-6 Use a Tested Implementation Model
      • G-7 Anticipate local Barriers, Drivers
      • G-8 Identify Threshold/Levers for Sustaining Programs >
        • Calculate & plan for scale up/ongoing costs
    • H Build System/Organizational Capacity >
      • H-1 Start=up & Baseline Funding, Staffing >
        • H-1 (i) Transition from Project to Ongoing Program/Budget
        • H-1 (ii) Adequate Time in Curriculum/School Day
        • H-1 (iii) Minimum Waiting Times for Services
      • H-2 System & Organizational Capacities >
        • H-2 (i) Coordinated Policy & Leadership
        • H-2 (ii) Assigned Staff as Coordinators at all Levels
        • H-2 (iii) Mechanisms for Cooperation, Coordination
        • H-2 (iv) Ongoing Knowledge Exchange & Development
        • H-2 (v) Pre-service education, In-service development of workforce
        • H-2 (vi) Regular monitoring, reporting, evaluation, improvement
        • H-2 (vii) Identify, jointly manage emerging issues
        • H-2 (viii) Explicit plan for sustainability
    • I Integrate Health & Social Programs in Core Business of Education System >
      • I-1 New Partnership Models to Better Integrate Within Education >
        • I-1-(i) Negotiated roles, resources in SH partnership
        • I-1 (ii) All initiiatives through one SH structure/team
        • I-1 (iii) First Consider Learning Needs
      • I-2 Align SH work within education structures, concerns, routines >
        • I-2 (i) Understand constraints on schools
        • I-2 (ii) Understand teacher beliefs, norms, work lives, concerns
        • I-2 (iii) Recognize, support teacher autonomy in lessons
        • I-2 (iv) Use updated pedagogical models
        • I-2 (v) Build teams in constrained conditions
        • I-2 (vi) Fit within stages, models of teacher education./development
        • I-2 (vii) Invest in education/development of non-educators in SH
      • I-3 Avoid silos on diseases/problems >
        • I-3 (i) Be guided by integrative paradigms
        • I-3 (ii) Deliver interventions within your multi-component approach (MCA)
        • I-3 (iii) Advocate for HPSD education in a broad core curriculum
      • I-4 Re-align Health, Other Sectors Within Education >
        • I-4 (i) Use "no-blame", shared responsibility, incremental change strategies
        • I-4 (ii) Address the characteristics of education systems
        • I-4 (iii) Use systems change models used by educators
        • I-4 (iv) Work within education consultative, decision-making & management structures
        • I-4 (v) Describe how core health/other sector structures, functions will relate to education counterparts
        • I-4 (vi) Maintain long-term perspective when building partnership with education sector
        • I-4 (vii) Develop, maintain a joint monitoring & reporting system
      • I-5 Health/Other Sectors should commit to providing on-going financial & human resources within schools >
        • I-5 (i) Health/other sectors should build capacity within their system that work with schools
        • I-5 (ii) Be specific about outputs from your partnership with the education sector
        • I-5 (iii) Health/other sectors should define minimum service levels related to schools
    • J Use concepts/tools from systems science/organizational development >
      • J-1 Policies, practice guidelines require Ecological Approach, Systems-focused Actions >
        • J-1 (i) Discourage use of settings as way to reach captive audience, encourage strategies to build capacity, modify conditions
        • J-1 (ii) Position linear logic models for programs within complex, ecological models
        • J-1 (iii) Select or adapt a model of continuous improvement/quality management
        • J-1 (iv) Review, select concepts/tools from systems science
      • J-2 Address implications of systems characteristics >
        • J-2 (i) Address implications of Open Systems
        • J-2 (ii) Addresss imlications of decision-making in loosely-coupled systems
        • J-2 (iii) Address implications of "professional bureaucracies"
      • J-3 Address complexities of working across & within several systems, agencies >
        • J-3 (i) Address inter-organizational cooperation & competition
        • J-3 (ii) Plan for different types of cooperation
        • J-3 (iii) Implement, maintain a "whole of government" strategy
        • J-3 (iv) Understand contradictions of "Health in All Policies" initiatives
    • Addendum: Developing a SHP Knowledge Development/Research Agenda
  • Approaches & Contexts
    • Different Approaches
    • Different Contexts >
      • Low Resource Countries
      • Conflict/Disaster Affected Countries
      • High Resource Countries
      • Indigenous Communities
      • Disadvantaged Communities
      • Small Island Developing States
  • Calendar School Health & Development
  • New Page
A New Paradigm for School-based & School-linked Health Promotion:
Systems-focused, Incremental Continuous Improvement & Capacity-Building
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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:
  • Our introduction to this workbook and the new SHP paradigm for the 21st century
  • How to Use, Contribute to this Workbook
  • the List of Better Practices covered in this Workbook
  • The partners, contributors & sponsors in this Continuous Improvement program
  • Be the Lead on a Topic/Contact Us
  • A Brief History & Key Aspects of School Health Promotion around the World
  • Key Definitions & Terms used in this Workbook

[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
  • ISHN launched the global discussion of a New Paradigm for School Health Promotion in the 21st Century at the world Adolescent Health Conference in Delhi, India 26-29 October 2017.
  • The first of many webinars discussing aspects and elements of the new paradigm began with a presentation on the New Zealand Health Promoting Schools program on 17 October 2017. Their Health for Learning approach is integrated within the education system yielding academic benefits. Their HPS Coordinators focus on organizational development. Go to the ISHN webinars page for details.

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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”.         



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