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 Brief History and Key Aspects of the Evolution of the Health Promoting Schools Approach

School Health Promotion: An Enduring and Aspirational Approach

The frameworks used to promote health through schools emerged in the late 1980’s in several parts of the world. At their core, the different models were focused on key components such as over-arching policy, health/life skills education, school-based and school-linked services, a healthy physical environment and social support generated by involving parents, youth and the local community.

Different models (and some apparent confusion over purposes) emerged in the 1990’s, with some regions and countries opting to focus on a selected set of programs, others defining their work more as a planning framework to address all issues and others responding to their local contexts with slightly different components and combinations. At the same time, other sectors working with their school systems developed similar but different frameworks to promote inclusive child-friendly schools, safe and caring schools, community-school partnerships, education in countries facing conflicts/emergencies, development aid through basic nutrition, hygiene and infectious disease prevention and broad developmental issues such as social & emotional learning and life skills.

A 2007 WHO forum in Vancouver took stock of developments and issued a consensus statement that identified important gains and current challenges. These included the need to contextualize programs for different needs/strengths, to focus on educational as well as health benefits, to alleviate disadvantage, improve partnerships across several sectors, build capacity and improve implementation quality.

In 2010, an international school health symposium in Geneva focused on inter-sectorial connections between education, health & sustainable development. This connection between human and environmental health was a key part of the Ottawa Charter on Health Promotion, which was often a stimulus for developing school health models. The Geneva workshop also highlighted consensus statements and reports on two other equity-related contexts; disadvantaged communities in high resource countries and school health promotion within indigenous communities/nations.

Another international School Health symposium in 2013 concluded with a consensus statement and launched an educator-led, global dialogue and series of workshops on the need to integrate health and social programs within the core mandates, constraints and concerns of education systems.  In some ways, this dialogue is the education response to the health sector call for Health-in-All-Policies (HIAP) initiative. Educators are calling for a fundamental change in how other sectors partner with the education sector.

In 2014, the FRESH Partners identified the core elements or pillars (FRESH Framework) that are common to the different approaches used by UN agencies when working with schools. In 2018, a Global Delphi consultation is finalizing what we know and need to know from the many compatible, similar but essentially different sector models for working within education systems to create a common base of knowledge and terms and to align efforts. Education and schooling is clearly recognized as a critical hub in the achievement of all the UN Sustainable Development Goals, so it is imperative that the non-education sectors stop working in competition or ignorance of each other.

A 2015 WHO Technical meeting in Bangkok identified several issues related to capacity-building within systems, including inter-ministry and multi-level, intra-sectoral cooperation, improved monitoring and reporting, sustainable funding and maintenance of approaches, workforce development and re-building of core health/life skills education programs and curricula.

About 2005 and increasingly thereafter, researchers began to catch up with practitioners in understanding that school systems are open, adaptive and complex ecological systems that cannot be subjected to multiple, competing projects and programs without creating an ecological, systems-based approach. Systems thinking and systems science concepts and tools are now being used to guide, plan and evaluate health promotion and social development approaches and programs.

Consequently, the school-based and school-linked health promotion of the 21st century must be and will be significantly different than the traditional, issue-focused, quickly find/develop the best (including consideration of costs, risks) program of the past three decades. The need to evidence-based and experience-tested programs will not disappear, but they will need to be nurtured within a dramatically new approach that includes the domains or dimensions described in these standards.
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