SCHOOL HEALTH:

HEALTH PROMOTING
SCHOOL
Gayatri Khanal
MPH
School health
◦School health refers to a state of complete
physical, mental, social and spiritual well
being and not merely the absence of
disease or infirmity among pupils, teachers
and other school personnel - k. k. gilani
DEFINITION OF SCHOOL HEALTH
SERVICES

◦School health service refers to need based

comprehensive service rendered to pupils,
teachers and other personnel in the school
to promote, protect their health, prevent
and control disease and maintain their
health.- k. k. gulani
History
The division of health promotion, education and
communication is charged with strengthening the
world Health Organization’s capacities to promote
health through schools.
WHO’s Expert Committee on Comprehensive School
Health Education and Promotion reviewed barriers to
the development of school health programmes as
identified by national , district and local education
education .
WHO expert committee find out that health
promoting school is a rich base of knowledge on
which to act to develop and improve school health
programmes.
They find out through research (developed and
developing countries) that school health
programmes can simultaneously reduce common
health problems, increase the efficiency of the
education system and advance public health,
education and social and economic development
in each nation.
◦ School health services are the first and the most accessible
point of contact with health services, with a potential to
regularly reach most school-age children with preventive,
curative and supportive health interventions.

◦ School health services are a very common model of service

provision in both high- and middle and low-income
countries – at least 102 countries have either school-based
or school-linked service provision.
◦ Global School Health Initiative launched in 1995. The
initiative supports countries to implement the four pillars
for Health Promoting Schools: 1) Health promoting
school policies 2) Safe and healthy learning
environment, 3) Skills-based health education, and 4)
School-based health and nutrition services.
WHO’S Global School Health
Initiative
◦ launched in 1995, seeks to mobilise and strengthen HP and E
activities at the local, national, regional and global levels.
◦ It designed to improve the health of students, school personnel,
families and other members of the community through schools.
◦ To increase the number of schools that can truly be called
"Health-Promoting Schools".
◦ Although definitions will vary, depending on need and
circumstance, a Health-Promoting School can be characterised
as a school constantly strengthening its capacity as a healthy
setting for living, learning and working.
◦ guided by the O C for Health Promotion (1986); the JD
Fourth International Conference on Health
Promotion(1997); and the WHO's Expert Committee
Recommendation on Comprehensive School Health
Education and Promotion (1995).
 Strategies of GSHI
◦ Research to improve school health
programmes: Evaluation research and expert opinion is
analyzed and consolidated to describe the nature and
effectiveness of school health programmes.
◦ Building capacity to advocate for improved school health
programmes: Each advocacy document makes a
strong case for addressing an important health
problem, identifies components of a comprehensive
school health programme, and provides guidance in
integrating the issue into the components.
https://www.who.int/school_youth_h
ealth/gshi/en/
◦ Strengthening national capacities: Collaboration between health
and education agencies is fostered and countries are helped to
develop strategies and programmes to improve health through
schools.
◦ Pilot projects implemented by the GSHI and partners include
Helminth Interventions with China in 1996, HIV/STI Prevention in
China in 1997, and Health-Promoting Schools/Health Insurance in
Vietnam in 1998.
◦ Creating networks and alliances for the development of
health-promoting schools: Regional Networks for the development of
Health-Promoting Schools have been initiated in Europe, Western Pacific
and Latin America.
◦ A global alliance has been formed to enable teachers' representative
organizations, worlwide, to improve health through schools.
◦ The alliance includes Education International, Centers for Disease Control
and Prevention, Education Development Center, UNESCO, UNAIDS and
NGTZ.
◦ WHO's Global School Health Initiative invites all governmental and
nongovernmental organisations, development banks, organisations of the
United Nations system, interregional bodies, bilateral agencies, the labour
movement and co-operatives, as well as the private sector to help all
schools to become Health-Promoting Schools.
 Health promoting school

‘ Health Promoting Schools are schools

which display, in everything they say
and do, support and commitment to
enhancing the emotional, social,
physical and moral wellbeing of their
school community.’
(World Health Organisation)
Health Promoting Schools constantly
strengthen it’s capacity as a
◦A Health Promoting School focuses on how the
social, physical, cultural and spiritual
environment of a school can impact on
student’s health, wellbeing and ability to learn
effectively.
◦ It does this by using a Whole School Approach
to identify the health and wellbeing issues that
may create barriers to learning and
achievement, and develops strategies and
actions that address these.
 Rationale of Health Promoting
school
◦ Over 2.3 billion school age children spend one third of
their time in schools.
◦ Schools therefore constitute a unique setting to help
children and adolescents to develop a positive outlook
on life and help them establish healthy lifestyles.
◦ Global mortality and morbidity estimates suggest that
school aged children have significant needs for health
promotion, prevention and health care services.
◦SHS are the first and the most accessible point of
contact with health services, with a potential to
regularly reach most school-age children with
preventive, curative and supportive health
interventions.
◦SHS are a very good and cost effective model of
service provision in both high- and middle and low-
income countries – at least 102 countries have
either school-based or school-linked service
provision.
◦Constantly strengthening its capacity as
a healthy setting for living, learning and working
environment that influencing health-related
behaviors i.e. knowledge, beliefs, skills, attitudes,
values and support.
◦SHP can simultaneously reduce common health
problems, increase the efficiency of the
education system and advance public health,
education and social and economic
development in each nation.
 Activities of HPS
◦ Fosters health and learning with all the measures at its disposal.
◦ Engages health and education officials, teachers, teachers' unions,
students, parents, health providers and community leaders in efforts to
make the school a healthy place.
◦ Strives to provide a healthy environment, school health education, and
school health services along with school/community projects and
outreach, health promotion programmes for staff, nutrition and food
safety programmes, opportunities for physical education and recreation,
and programmes for counselling, social support and mental health
promotion.
◦Implements policies and practices that respect an
individual's well being and dignity, provide multiple
opportunities for success, and acknowledge good
efforts and intentions as well as personal
achievements.
◦Strives to improve the health of school personnel,
families and community members as well as pupils;
and works with community leaders to help them
understand how the community contributes to, or
undermines, health and education.
Components of health promoting
school
◦School Health Policies
◦The physical environment of the school
◦The school’s social environment
◦Community relationship
◦Personal health skills
◦Health services
 School Health Policies

The school has a policy on healthy food

Totally smoke-free and prohibits alcohol and illicit
psychoactive substances in all activities.
Upholds equity principles by ensuring that girls and
boys have equitable access to school resources.
Formal procedures in place relating to the
distribution of medication
◦A policy and programme on first aid.
◦The control of helminthes and other
parasites.
◦A policy on sun protection.
◦Policy on health screening
◦Closure(act) in the event of emergencies or
other circumstances which would endanger
student’s health.
◦A safety plan for implementation in the events
of natural or other disasters.
◦Where relevant the school has a policy on the
control of HIV/AIDS including its safe
management.
The physical environment of the school

◦ A safe environment for the school community.

◦ Adequate sanitation and water is available.
◦ The school upholds practices which support a sustainable
environment
◦ Students are encouraged to take care of the school facilities.
◦ Endeavors to enrich learning by ensuring the physical
conditions are the best they can be
 The school’s social environment
Supportive of the mental health and social needs of
students and staff.
Creates an environment of care, trust and friendliness
which encourages student attendance and involvement.
Provides appropriate support and assistance to students
who are at a particular disadvantage relative to their
colleagues.
Provides a fully inclusive environment in which all students
are valued and differences are respected.
The school is attentive to the educational needs
of parents and how these can influence the well-
being of students.
Community relationship
Family and community involvement in the life of
the school is fostered. The school is proactive in
linking with its local community.
 Personal health skills
◦ Curriculum approaches health issues in a coherent and
holistic way.
◦ The curriculum is designed to improve students’ theoretical
understanding of health issues and how to apply this in
practice.
◦ Teacher are adequately prepared for their role as key
participants in health- promoting school.
◦ Other key stakeholders have the opportunity to gain skills
relevant to health –promoting schools.
Health services
◦ Basic health services which address local and national
needs are available to students and staff.
◦ Local health services contribute to the school’s health
programme.
◦ Health services contribute to teacher training.
 Methods of developing health
promoting school in community
◦ Developing a school health policy
◦ Basing the health-promoting school on clear principles
and values
◦ Vision for health promoting schools
◦ The curriculum and methods of teaching and learning
◦ Staff’s own health and competences
◦ Teamwork, inside and outside of the school
◦ Involvement of parents and the community
Developing a school health policy

A school health policy should:

◦ Contribute to the implementation of the schools’ educational
mission;
◦ Promote the health and well-being of all school users;
◦ Include factors related to both lifestyles and living conditions;
◦ Promote a clear vision and provide a framework for solving
problems;
◦ contribute to pupils developing skills and action competences;
◦ be monitored and reviewed regularly.
A conceptual framework for
developing a school health policy
 Basing the health-promoting school
on clear principles and values
◦ Democratic practices and participation
◦ Equity and access
◦ Empowerment and action competence
◦ Sustainability
◦ Curriculum based health promotion
◦ Provision of teacher training
◦ The school environment
◦ Collaboration and partnership
◦ Involving communities
◦ Measuring success
 Develop vision of a health-promoting
school
◦ Clarify what you hope for in the future as well as a vision of
how you want the school to develop in relation to a selected
theme.
◦ Involved in health screening in your school.
◦ Reaching an agreement on what the term means and
deciding the principles and criteria on which your initiative
will be base
◦ ENHPS has given outline for developing vision (eg –setting
approach , whole approach , value based principles , whole
school, link with the community that should be focused .
 The curriculum and methods of
teaching and learning
◦ IMPORTANCE OF HEALTH EDUCATION : HPS focuses on all aspects of school life,
the learning and teaching in the curriculum is a still a key part of this
approach
◦ Integrated across the curriculum: It is vital that health promotion be integrated
right across the curriculum, throughout a whole range of subjects
◦ Taking a long term, developmental approach: Tailoring the approach to the
learner, for example their age, stage or emotional state.
◦ Active methods: Schools need to use a wide range of methods, with the
emphasis on those that are active and participatory
 Staff’s own health and competences
◦ Traditionally, taking the health and well-being of their staff for granted.
◦ This has never been a sensible assumption.
◦ Teachers and other staff cannot be expected to be enthusiastic about
health promotion if they do not feel their own health
◦ Need constant support, from staff development programmes, from
positive and helpful appraisal, and most of all by having a voice in school
management and organization.
◦ Need to be strongly valued, and to be given active and positive help to
promote their own health and well-being
Teamwork, inside and outside of the
school
◦ The whole school approach is necessarily based on teamwork.
◦ An initiative like the HPS cannot be carried out by one person
alone.
◦ The support of the school director or head teacher is crucial, as is
having someone who is clearly designated as the coordinator of
the programme.
◦ Identifying groups to take the initiative forward is very much
essential
◦ Teamwork is also essential to ensure that you make the best use
of everyone’s skills and strengths.
 Involvement parents and the
community
◦ The evidence for the supportive role of parents within the health-
promoting school is also accumulating.
◦ Parents are actively involved in their children’s health promotion,
good outcomes are more likely. Examples of this, such as in
healthy eating initiatives in schools.
◦ Where parents were involved it led to: more impact on pupils’
behaviors
◦ Action groups; co-operatives to provide healthy food for pupils in
the middle of the school day.
DEVELOPING NETWORKS FOR
HEALTH-PROMOTING
SCHOOLS/Coordination and linkages
with concerned stakeholders, health
education etc to
develop health promoting school
◦School communities learn from each other.
◦ Schools pursuing similar objectives, especially
those that are involved in pioneering new
developments, can provide significant support and
stimulus to each other and strongly reinforce each
others' efforts.
◦This type of productive interaction can involve
parents, teachers, students and support agencies.
◦ The establishment of networks of health-promoting schools is a
way of facilitating this interaction. Among the benefits that could
result are:
◦ pooling expertise
◦ sharing information, resources and experiences
◦ deciding on future directions
◦ providing the nucleus of a concerted "school voice" on health
issues
◦ reinforcing the health-promoting school concept
◦ ensuring a mechanism for monitoring the progress of health
promoting schools in the Region
◦ providing advice and support to new health-promoting schools
◦ organizations and individuals involved with and supportive of
health-promoting schools may benefit greatly by being linked into
a network.
◦ This would provide a structure for the exchange of information,
experiences and resources.

◦ an appropriate coordinating and resourcing agency, a network

could provide an even more effective focal point for health
promoting schools in a district, or if appropriate, on a broader
front, such as nationally.
◦ They could in turn link with other networks both nationally and
internationally, creating considerable scope for the ongoing
development of the concept through pooling participants‘
experience
Management of health promoting
school
◦Evaluation of HPS COMPONENTS through the
checkpoints given in each components
◦The checkpoints propose ways in which it
could be demonstrated that action has
occurred in relation to a particular
component
Other techniques of Management
of health promoting school

◦ DEVELOPING A CHARTER FOR A HEALTH-PROMOTING

SCHOOL
◦ A Five-year plan for action.
◦ THE AWARD SYSTEM
 DEVELOPING A CHARTER FOR A
HEALTH-PROMOTING SCHOOL
◦ School communities learn from each other.
◦ Schools which are pursuing similar objectives, especially those
that are involved in pioneering new developments, can provide
significant support and stimulus to each other and strongly
reinforce each others' efforts.
◦ This type of productive interaction can involve parents, teachers,
students and support agencies.
◦ The establishment of networks of health-promoting schools is a
way of facilitating this interaction.
◦ Among the benefits that could result are:
◦pooling expertise
◦sharing information, resources and experiences
◦deciding on future directions
◦providing the nucleus of a concerted "school
voice" on health issues
◦reinforcing the health-promoting school concept
◦ensuring a mechanism for monitoring the
progress of health promoting schools in the
Region
◦providing advice and support to new health-
promoting schools
 A Five-year plan for action.
◦ Each country or area in the Region needs to work out the best
approach to initiating or advancing the HPS concept.
◦ Crucial to the success of HPS is the establishment of a Country
Coordinating Committee to oversee developments and to
ensure the essential cooperation and coordination of the
education and health authorities at all levels in supporting the
work of the schools.
◦ It also creates the vehicle for other key national agencies and
interests to be involved.
THE AWARD SYSTEM

◦ Schools should be acknowledged for their

achievements in becoming "a health-promoting
school".
◦ Category of awards are Bronze, Silver and Gold.
The bronze award
◦ To attain this level schools need to demonstrate that
they:
Have developed a "Charter for a health-promoting
school";
Have been active for over one year in the six areas
Meet the minimum requirements for the Bronze level.
The silver award
◦To attain this level schools need to demonstrate
that they:
have developed a "Charter for a health-
promoting school";
 have been active for over two years in the six
fields;
meet the minimum requirements for the Silver
level.
 The gold award
◦To attain this level schools need to demonstrate that
they:
have developed a "Charter for a health-promoting
school";
have been active for over three years in the six fields;
meet the minimum requirements for the Gold award.
supported another school to become a health-
promoting schools
Collaborations and partnerships
 SCHOOL HEALTH PROGRAM in Nepal

◦All of the health related causal factors can be

prevented through behavior change even in low
resources settings.
◦With this view Department Of Community Programs
is currently conducting regular school health
program in 24 schools around 14 outreach centers
of Kavrepalanchowk, Sindhupalchowk, Kathmandu
and Bhaktapur districts.
◦ Trained nurses of Department Of Community Programs visits
outreach centers to provide health education.
◦ Regular screening of school children in coordination were
conducted in coordination with the Departments of
Pediatrics, Dental, Ear, Nose and Throat, Ophthalmology,
Physiotherapy and other departments.
◦ The program is led by nurses who provide awareness programs
on different health issues such as adolescent reproductive
health, water, sanitation and hygiene (WASH) programs,
first aid training, and screening services.
https://www.dhulikhelhospital.org/in
dex.php/community-
programmes/public-health-
programs/school-health-program