» Topic List
	Thematic Group 1 – Policy
	Thematic Group 2 - Safe School Environment
	Thematic Group 3 - Skills Based Health Education
	Thematic Group 4 - School Based Health and Nutrition Services

During the Workshop, a large amount of time was allocated to group work and plenary discussion of each of the FRESH components and their supporting strategies. Thematic Groups delivered group presentations on Day 5 of the Workshop and their content is reproduced below.

THEMATIC GROUP 1 – POLICY » Up

Justification: A policy for School Health and HIV&AIDS is needed to ensure a national comprehensive framework allowing for all around development of children. Such a policy serves to improve quality and access to education, reduces drop-out and repetition rates and improves overall performance in school. It also addresses the achievement of international covenants such as EFA, Millennium Development Goals (MDG) goals, Convention on the Rights of the Child (CRC), etc.

Key Challenges

• Fragmentation of policies.
• Mainstreaming/ institutionalization/ scaling up.
• Collaboration/ harmonization of ministries.
• Lack of a policy framework based on holistic approach to child health and development.
• Lack of networking and regional strategies among countries in the region.
• Translation of policy (by teachers, administrators, health workers) into action.
• Influencing decision-makers to prioritize & mainstream; institutionalize school health, nutrition, HIV&AIDS and fund it
• Lack of national school health indicators and coordinated mechanism for monitoring.
• Sustainability of policy implementation through adequate human, financial, material resources.

Good Practice

• Participatory development of policy which includes monitoring system and is consistent with international covenants and in which elements and strategies are defined. Good coordination and collaboration between ministries of Education and Health and other relevant stakeholders with clearly defined Terms of Reference (TOR) at all levels
• Mainstreaming systems and processes for effective School Health implementation (e.g. HIV/AIDS, de-worming, etc)

Good Practice: Cambodia

How to turn Policies into Action: The Need for Systems and Structures to Mainstream School Health and HIV&AIDS in Sectorial Ministries: The Cambodian Experience of its School Health Department

The School Health Department (SHD)

• Education, Youth and HIV&AIDS are at the center of the Cambodian Development Strategies;
• The Ministry of Education, Youth and Sport (MoEYS) established in 1998 the SHD to contribute to improving better health conditions of Cambodian students. The SHD is also present and active in all 24 Provinces. It cooperates with line Ministries, National Health centers and their decentralized offices. SHD was also developed partnerships with Development partners.

Key Results of SHD:

• Basic Health Education is integrated in the national curriculum (eg: HIV&AIDS, Malaria, Dengue, Hygiene, etc);
• Over 90% of students are provided with deworming tablets, twice a year;
• School breakfast is provided to over 500,000 students, in 1,450 primary an secondary schools.

Good Practice: Cambodia

How to turn Policies into Action: The Need for Systems and Structures to Mainstream School Health and HIV&AIDS in Sectoral Ministries: The Cambodian Experience of its Interdepartmental Committee for HIV&AIDS The Interdepartmental Committee for HIV&AIDS (ICHA) as a Coordination Structure To respond to the increase of the HIV&AIDS prevalence rate and the commitment of MoEYS to strengthen its contribution to the National HIV&AIDS Strategic Plan, the ICHA was created in 1999. It’s chaired by the Secretary of State and comprises of 15 MoEYS Departments. ICHA has an Annual Comprehensive Work plan (approx. USD 2,3 million/year) which is developed through a Joint Programming mechanism with Development Partners. The ICHA Structure: From Political leadership to Local implementation The 4 Pillars of the ICHA Strategy: A strategy focused that focuses on Strengthening Systems as well as Interventions Practical Recommendations Countries should take stock of current status of policies related to school health, nutrition, HIV& AIDS as a first step to developing a comprehensive school health policy. School health policies should be developed within framework of the national plans, policies, strategies, etc. Countries should ensure adequate resources to carry out the policies. Countries are encouraged to access regional networks and expertise to ensure quality of formulation and implementation of policies. THEMATIC GROUP 2 - SAFE SCHOOL ENVIRONMENT » Up Part 1: Creating a safe physical environment Justification Direct need for safe physical environment: Comfort and safety of students enabling them to enjoy their school experience (particularly girls and children with special needs) Indirect need for safe physical environment: Knock on effect within community (e.g. good practices being transferred to the home environment) If children are to apply lessons learnt in health education (e.g. hand washing) an enabling environment must be provided Both direct and indirect effects lead to improved education sector indicators (e.g. improved school attendance rates and decreased drop out) Key Challenges Limited resources (human and financial) Inter and intra departmental and sectoral coordination needs to be improved (e.g. first aid protocol) Guidelines exist in all countries, but not followed up through effective monitoring and evaluation (M&E) Lack of updated guidelines to respond to new emerging issues Good Practice: Cambodia Cambodian Child Friendly Framework Aim: To combine all known CFS into a single, specific approach to provide a safe school environment   Running since 2004 Partnership: MoEYS, UNICEF, UN Standing Committee on Nutrition (SCN), Kapuchean Action for Primary Education (KAPE) Operates at school level (included in in-service and pre-service teacher training) Committees have been established at central, provincial and district levels Focusing on providing clean and safe classrooms, playgrounds, proper sanitation, clean food and safe water Good Practice: Cambodia , Lao PDR and Thailand School Support Committee Aim: To ensure effective running and improvement of school performance through partnership with parents and communities   Running since 1994 Partnership between: MoEYS, schools, parents and communities Operates at school level with activities monitored by School Cluster Committee; District Education Officers; Provincial Education Officers; and MoEYS at Central level In Cambodia : National Annual Seminar on “Community Participation in Education” Main activities: Meetings when required by schools for problem solving; annual planning meetings for school development plan; collection of community contributions (cash or in kind) for maintenance and repair of school environment; school mapping and enrolment campaign; and linkage between school and community Good Practice: Cambodia Health and Hygiene Child Clubs   Aim: To enable students to maintain and improve their own school environment Running since 2001 Partnership between: Students, teachers, principals and School Support Committee Operates at school level with monitoring of activities by Principal and School Support Committee Main activities: Cleaning latrines, playground and classroom environment; making sure there is water and soap in latrines and classrooms; and use child to child approach to demonstrate good health and hygiene practices Part 2: Creating a safe socio-psychological environment Justification: Schools should be “sanctuaries” rather than “places of risk” for children, thus we need to: eliminate violence and abuse, sexual harassment and bullying address issues such as gender access and privacy promote overall health and psychological well-being Key Challenges: How to mainstream programs creating a safe socio-psychological environment given the: Limited resources (human and financial) Lack of guidelines Good Practice: Lao PDR Inclusive Education Program Aim: Promote inclusive education especially for children with special needs Activities: Train teachers, school principals and local administrators to implement the program. Regular monitoring of the program implementation Program started in 1993 and covers all provinces of Lao PDR Partners: UNESCO; Save the Children UK , UNICEF, Swedish International Development Cooperation Agency (SIDA), Save the Children Norway Lessons learned: To motivate teachers involved, regular meetings and exchange visits between schools are done The number of students should be limited (lower than in a regular class) to provide more time for interaction between teacher and students Good Practice: Cambodia Boarding Assistance Component of the Scholarship for Girls Project   Aim: Provide support and assistance to girls involved in the scholarship program in the boarding houses   The assistance provided include: Health and reproductive health Relationship within the school, the boarding house and families Participation in community activities Absenteeism Running since 2001 in 7 communes in Leuk Dek district, Kandal province Partnership between CARE International and the MoEYS Lessons Learnt: The project provided psycho-social support to girls in boarding houses, resulting in them staying in school longer Having female teachers in the committee contributed to the effectiveness of the project Practical Recommendations Develop a sub-Regional Policy and Guidelines (with strong M&E) on safe and healthy school environments to include emerging issues (substance abuse, game shops, motorbike accidents) for countries to adapt to their own context Effective sensitisation and mobilisation of students, parents and communities and facilitation of their involvement in the maintenance and improvement of the school environment is essential Despite some existing efforts promoting a safe psychosocial environment in schools far more work needs to be done Need to map existing problems and services related to psychosocial environment utilizing the CRC framework: types and extent of problems types and coverage of programs resources available that can be tapped to include partners gaps between problems and services/programs Develop/Expand psychosocial services/programs such as counseling to address identified gaps Good plan, good support and good money – a great school THEMATIC GROUP 3 - SKILLS BASED HEALTH EDUCATION » Up Justification Educating children and adolescents can instill positive health behaviours in the early years and prevent risk and premature death To make responsible and healthy choices, children/young people need to know how to seek out relevant, accurate information Explicitly including social, emotional skills building has a positive impact on important health promoting behaviours Key Challenges Curricula which continues to emphasise knowledge, with limited opportunities for skills development Little systematic application of assessment tools, particularly in relation to social & emotional skills Challenges in the teaching of sensitive, controversial issues (such as sexuality and reproductive health) Participation of children/young people Challenges with partnerships and disparate, project-based interventions Poorly defined roles and responsibilities of educators Ensuring pilot initiatives have the stamina to go to scale with quality (sustainability) Lack of resources (human, financial, material) Good Practice: Lao PDR Curriculum Development & Delivery: Blue Box   Aim: To provide a comprehensive package for teaching-learning on health issues to primary schools and Teacher Training Colleges (TTCs)   Process: Programme is based on research outcomes from Knowledge, Attitudes and Behavior/Knowledge, Attitudes and Practice (KAB/KAP) surveys and an understanding of local needs Materials were developed through collaboration between Ministry of Education (MoE), Ministry of Health (MoH) and specialists Consists of teachers’ guides, posters, card stories, comics/story books, games, cassettes/video compact disks (VCDs) at a minimal cost A comprehensive capacity development system: teachers, school directors, parents Good Practice: Cambodia Professional Development Systems: Pre Service Teacher Training Aim: Strengthen delivery of health education through pre-service teacher training   Process: Various decentralised teacher training institutions are involved both formal and non formal (ie Community Learning Centers, primary, lower secondary, upper secondary) Development of skills based health education materials with teachers on HIV/AIDS, substance misuse, STD’s, etc An institutionalised Monitoring & Evaluation System Key Results: Shift from partnership to ownership Good Practice 3: China Partnerships with Young People, Parents, Communities and Local Organizations: Peer Education   Aim: HIV prevention through peer education   Process: Initiated by the Yunnan Provincial University in 2001 through the training of teacher trainers and subsequent training of peer educators who engage in outreach within their communities Key Results: Significant number of teachers trained on HIV prevention and most colleges delivering HIV prevention curriculum. Approximately 3300 peer educators have been trained to educate other students the wider community. As a result, 85% of college students have increased their knowledge on HIV/AIDS Note: Whilst increased knowledge on HIV/AIDS has been reached rapidly, more emphasis needs to be placed on developing the necessary skills for HIV prevention Practical Recommendations Strengthening health education assessment/M&E systems (ie holistic standards/ benchmarks) Investing in research for more effective programmes Applying a life skills based methodology to achieve health education outcomes Developing policies which outline expectations, responsibilities and support for/within the provision of health education (including coordination mechanisms) Improving professional development systems and support for health educators, administrators and managers Providing flexibility for programmes to address local health issues Explicitly including mental health, sexuality & reproductive health issues within curriculum Identifying mechanisms by which out of school young people can be provided with skills based health education Ongoing sharing of practice THEMATIC GROUP 4 - SCHOOL BASED HEALTH AND NUTRITION SERVICES » Up Justification Care of children is a government priority Improved health and nutrition leads to improved learning capacity, enrolment and retention Health and nutrition services promote the physical, mental and psychological development of children Education system is an effective means of delivering services Practical action complements health and nutrition education Strengthening social adaptation increases motivation for self health care Addresses key development indicators Key Challenges Ensuring political commitment and leadership at all levels Ensuring effective inter-sectoral collaboration and co-ordination Ensuring commitment at the school level Capacity and resource issues Moving from piloting to scale level implementation Good Practice: China Educational Care Service for Children Affected by HIV&AIDS   Aim: To support education of all children affected by HIV&AIDS   Program operating time: 4 years Program Developers: Yunnan Provincial Bureau of Education in cooperation with Women’s Union , Red Cross, UNICEF Levels at which program operates: All educational levels (kindergarten, primary, secondary, tertiary) Services: Free Education, Counselling, Exchange activities, Health check-ups Changes over time: Original concern for free education. Other services (e.g. counselling) added later Partnerships: Yunnan Provincial Bureau of Education, Yunnan Provincial Bureau of Health, Yunnan Provincial Drug-Banning and AIDS-Preventing Youth Education Base, School Education Base and Education Base, Yunnan Center for Disease Control ( CDC) Good Practice: Thailand School Feeding   Aim: To provide school lunch to all children in Thailand Program operating time: 26 years Program developers: MoE, Local Government Authorities Levels at which the program operates: kindergarten, primary and secondary schools Services: Daily lunch funded by government, cooked by parent volunteers, using locally produced food (school garden and community sourced) Changes over time: Regional direction and ownership of the program becomes stronger Malnutrition rate has declined from 30% at beginning to 1% now Partnerships MoE, MoH Local Government Communities and temples Parents Students Local businesses Good Practice: Cambodia Deworming   Aim: To reduce worm infection prevalence in pre-school and primary school children   Program operating time: 4 years Program developers: MoE, MoH, other partners Levels at which program operates: Pre-school and Primary schools country-wide Services: Deworming (mebendazole) 2x per annum Changes over time: 2003 – 11 provinces 2004 – entire country (24 provinces) Partnerships: MoE MoH Development partners Community Teachers Students Practical Recommendations 1 Ensure commitment and leadership at all levels Ensure roles and responsibilities of different stakeholders are clear National task force can help activities to move quickly Search for synergy – deliver services as part of comprehensive package Monitoring and evaluation based on good, few and simple indicators are essential Identify good technical support Practical Recommendations 2 Wherever possible, integrate complementary activities into existing programs e.g. Micronutrient supplementation, School Feeding, HIV& AIDS Prevention, etc. How? Strengthen partnerships wherever possible Seek good community partnerships Evidence based Develop human resources Share experiences