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
Key Definitions and Terms Used in this Workbook
 
Capacity (of organizations, professionals, communities and individuals):

The concept of system/organizational capacity can be applied to school health, safety & social development programs at two levels, first in defining the baseline or minimum staffing, financial and policy requirements and secondly, by defining several operational capacities that promote effectiveness.
 
Baseline Capacity The basic capacity of health, school and other systems to promote learning, health, safety and social development requires essential number of staff, financial resources and legislative/policy authority to operate a minimally effective and coordinated school-based or school linked approach or to implement a defined number or type of programs, services and policies. These basic capacities include the physical aspects of the schools, social supports such as parent and community involvement, essential preventive health and other services, core instruction in health, family studies, physical education, environmental studies, social studies and moral/spiritual/religious instruction and essential policies requiring schools, agencies and ministries to work together.
 
Operational Capacity: From that baseline capacity, several operational capacities are required within schools, neighbourhoods, agencies, ministries and systems as well as among the professional and other staff assigned to work with or within schools to maintain their overall educational effectiveness, health, safety and social development as well as to implement and sustain programs. These capacities include the ability to coordinated policy, assign staff to coordinate programs and services, formal and informal mechanisms for cooperation, ongoing workforce development, effective knowledge exchange, regular monitoring & reporting, strategic management of issues and an explicit plan for sustainability of the system and core programs.
 
Components of School Health Promotion
(To be added)
 
Curriculum: refers to the required courses of study and sets of learning objectives/outcomes stipulated by national, state/provincial or local education authorities. These learning objectives can be achieved in formal classroom instruction as well as non-formal learning activities that are conducted on a regular and sequential basis.

Curriculum Supplement: refers to additional guidance, learning objectives, resources, suggested lesson plans and other advice produced to support the stipulated curriculum. Instructional Programs are similar, in that they address selected aspects of a mandated curriculum, but they have been published on a more specific set of topics, often accompanied by lesson plans, teacher training and other supporting information.
 
Continuous improvement strategies have emerged in educational administration as a complement to systems thinking. The steps in continuous improvement: include; identifying core beliefs, creating a shared vision, using data to determine data between the current reality and the shared vision, identifying the innovations most likely to close those gaps, developing & implementing an action plan and endorsing collective acceptability. Data-based decision-making is a big part of educational initiatives in continuous improvement. Continuous quality improvement (CQI) has been used in education decision-making for some time. It has been a response to the chaos and complexity of governing schools. It is posited that if staff are identifying specific attainable improvement goals and demonstrating that they are achieving them, then accountability and performance are being enhanced. If part of the challenge in school health promotion is to integrate the perspective of education and health leaders and researchers, then work should be done to determine if continuous improvement can be a unifying concept. In many ways, continuous improvement is very similar to the total quality management approach that evolved in the private, business sector.
 
Healthy Schools/Health-Promoting Schools: There are a variety of definitions and models of a healthy school or health promoting schools that are used school-based and school-linked health promotion (SHP). Here are a few examples with that emphasize different aspects.
Health Promoting Schools (WHO) -

School Health & Nutrition (World Bank) -


The Essential Package (World Food Program/UNICEF)


New Zealand – Health for Learning


USA – Whole School, Whole Community, Whole Child – added more components to their previous Coordinated School Health model

Australia – build around mental health/social emotional learning


ISHN – planning framework, responsibility shared at ministry, agency and neighbourhood/school levels by several sectors including education, health, child protection/social services, law enforcement, municipalities and others

Note: Our use of the term “school-based and school-linked” health promotion denotes that the actions in SHP are not limited to the school building or school grounds. The interventions can include various agencies and schools in the neighbourhood reaching into the school to provide timely, accessible and services, staff or volunteer time, funding and other forms of support. It also includes the school reaching out to their parents, youth-serving organizations and others in their communities to be engaged in community activities and supportive of the efforts of other agencies. In brief, the school can serve as the hub within the community to deliver several programs and services.
Implementation of a Policy, Program, Practice or Approach. The execution of a decision to adopt a program or approach, that is, the innovation or reform of a system suggested by research or experience is put into practice. The scope of the implementation will vary, according to the size, scope and complexity of the change. Innovations (i.e. specific interventions such as policies, programs, services, professional or organizational practices) are usually implemented without intending or causing a change or shift in emphasis among the basic functions of the organization. Reforms of the system, such as comprehensive or coordinated school health programs, do require a shift in the basic functions of school systems, public health systems and other systems.

Institutionalization or Maintenance Ongoing use or continued implementation of the innovation in practice by incorporating the innovation into the routines of an organization (part of sustainable health promotion actions) Other features include; features of “institutionalization” being a line item in the permanent agency budget; having a place in the agency’s organization chart; having personnel or full time equivalents (FTEs) assigned to specific prevention tasks; having position descriptions that include prevention functions and level of effort; having facilities and equipment for program operations; and developing an institutional memory for important agreements and understandings.
 
Intervention – a policy, instructional program, service, organizational or professional practice to prevent a problem behaviour/condition or promote a protective factor on a specific issue, behaviour or risk/protective condition

Multi-Intervention Program (MIP)– a set of different types (policy, instruction, services, social support, physical conditions) of coordinated interventions (programs, services, policies, practices) to address a broad education, health, social or economic issue such as sanitation/hygiene, child exploitation, school dropout, physical activity, bullying and others.

Multi-Component Approach (MCA) is a set of core components, pillars or Infrastructure that includes a macro-policy, mandatory health-personal-social development curriculum & instruction, minimum set of health, social and other services, minimum physical conditions and safety/sanitary standards, minimum social environment delivered in and with schools through education systems in cooperation with other sectors/ministries and sets of corresponding agencies/ authorities. To be considered a distinct approach here, they need to have a distinct primary partner sector. These include Healthy Schools with the health sector, Community Schools with the economic and social planning sectors, Safe Schools with the law enforcement, safety/accident prevention, military and emergency preparedness agencies/ministries, Eco-schools with the environment sector, Education in Emergencies working with relief aid agencies & donors, School Health & Nutrition working with humanitarian and development aid agencies & donors, Child Friendly Schools working with the human rights sector and others. Often the descriptions of the multiple components are accompanied by a list of system, organizational and professional capacities/standards such as leadership, work force development & training, coordination and similar concepts. Sometimes a multi-intervention program (MIP) such as nutrition is also considered as a key component An MCA should be “comprehensive” (delivered at multiple levels, in multiple systems, on multiple issues) and include several “coordinated agency-school district programs” at the regional level but is often focused only at the school level in “whole school strategies” that involve only educators as the delivery agents. MCA’s are often also used as planning frameworks to guide the development of multi-intervention programs (MIP’s). This use sometimes obscures the need for establishing and maintain a core set of components or infrastructure.
Organizational Development (OD) has been defined has been defined as “a planned, organization-wide, managed from the top effort to increase organization effectiveness and health through planned interventions in the organization’s processes, using behavioural-science knowledge. OD is a planned system of change”.

Sustainable health promotion, safety and social or sustainable development interventions are those that can maintain their benefits for communities and populations beyond their initial stage of implementation. Sustainable actions can continue to be delivered within the limits of finances, expertise, infrastructure, natural resources and participation by stakeholders.
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