From the schools also, we recruited four school principals, four teachers, two local non-governmental organizations (NGO) members, one resource person, and one school management committee member from Siraha, Sindhupalchok, Syangja, and Kailali districts. Also, we have not been able to use toilets properly and they are smelly because of lack of water facilities. To increase knowledge and awareness of health ⦠Admin Pol Ment Health. In the reassembling phase, we reassembled all the data under the same themes, codes, and sub-codes into different groups. Some key informants also mentioned that they received support from communities to conduct SHN activities effectively. (P3, aid agency: WASH specialist), Now, the SHN network is formed and all the stakeholders involved in it have planned and divided their responsibilities. Because of insufficient money, some schools even raised funds from parents and community members. We have also prevented some kids from suffering permanent hearing loss. Their perceptions are equally important to provide information on the factors influencing the implementation process and help to identify the gaps in the process. The training was conducted only once and such training should be conducted repeatedly. Ademokun O, Osungbade K, Obembe T. A qualitative study on status of implementation of School Health Programme in South Western Nigeria: implications for healthy living of school age children in developing countries. 1. With this aim, in 2013, we conducted an evaluation study of a 4-year-long SHN project jointly conducted by JICA and Nepal Government in Sindhupalchok and Syangja districts [18]. Increasing numbers of students enter schools with chronic health conditions that require management during the school day. Aid agencies come and once they are gone, the District Education Office and communities cannot make the program sustainable by themselves. Besides, schoolteachers and child club members were trained to conduct health education sessions on SHN. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. In the past, students could not understand what they were taught. Tropical Medicine and Health We conducted the SHN project from Japan International Cooperation Agency's (JICA) support. Schools can play an important role in promoting positive mental health, reducing stigma, raising awareness among teachers, parents and children about mental health issues as well as identifying and supporting youth experiencing mental health difficulties. The evidence is scarce on the SHN program implementation process in resource-limited countries [9, 12, 19], and no study has yet explored stakeholders’ perceptions on the SHN program implementation process in low-income countries, including Nepal. Our previous study also showed a positive association between the SHN program and students’ better health outcomes [18]. Using his extensive network of connections and a snowballing procedure, we identified key informants from different organizations who had in-depth knowledge and were actively involved in the program. For example, this program has improved students’ knowledge of health and hygiene practices and keeping the school environment clean, etc. (P23, school: Health and physical education teacher), We need basic training for all teachers. PubMed Central Furthermore, the program also brought positive changes in students’ nutritional behaviors, hygiene practices, and life skills. Shung-King M. From ‘stepchild of primary healthcare’ to priority programme: lessons for the implementation of the National Integrated School Health Policy in South Africa. Position Statement. (P9, central level: Director, Child Health Division), Human and material resources are insufficient from the central to the district level. Some key informants from the central and aid agencies responded that the lack of trained human resources and turnover of trained staff members were also impediments during program implementation. All authors read the manuscript and approved for submission. In resource-limited countries, a lack of resources has been a crucial operational barrier to conduct the program [3, 12, 13]. Furthermore, the overall coordination between these two sectors was limited, which therefore led to a lack of planning for the sustainability and scaling up of the program. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. 2010;81(10):593–8. In the disassembling phase, the first author thoroughly read and reread the transcripts, listened to all the interviews repeatedly, and examined the patterns of interview data. (P4, aid agency: SHNP senior coordinator). Food Nutr Bull. 2010;10:43. The first author also sorted and coded all 32 transcripts separately. Child clubs and extra-curricular activities could have played a significant role in improving students’ health and nutritional knowledge and practices. Evaluations have found that participation in staff health-promotion programs ⦠Teachersâ role in the school mental health initiatives cannot be overemphasized. So if resources are available, we can make it sustainable. According to the key informants’ responses from all levels, the major SHN activities could be mainly categorized into four sections, which were based on the four objectives of the SHN strategy [16]. Trop Dis. Another role of special education teachers ⦠Despite the positive impact of the SHN program on students, parents, and communities, this study identified several barriers and challenges to implement the program. Report of endline survey on school health and nutrition project of Sindhupalchowk and Syangja districts. Correspondence to Springer Nature. "Students used to defecate openly in the past, but now they have started using toilets. This study was supported by a Grant from the National Center for Global Health and Medicine (http://www.ncgm.go.jp/) (grant number: 27S1). According to many key informants in this study, a broad array of stakeholders was involved from the central level to schools in implementing the SHN programs based on the SHN strategy in the country. Besides, many stakeholders are conducting only selective activities [15]. SUMMARY. Building capacity for the continuous improvement of health-promoting schools. The future teachers who saw their main role to be giving information in their own subject favoured the teaching of health education as a separate course, whereas those who chose "contributing to a total curriculum" as their essential role mainly opted for the inclusion of health education in all subjects. 2014;9(9):e108284. This study provided a deeper understanding of the linkage between the SHN program implementation, impact, and challenges in Nepal. Although most of the key informants from the central level and aid agencies received and provided training to implement the SHN program, only some key informants from the district level and schools received the training. This document was released on the occasion of the first World Malaria Day, April 25, 2008. Aid agencies were one of the main sources of funding for the program in the country. We thus conducted a qualitative study to explore (1) the SHN program implementation, (2) its impact, and (3) challenges in Nepal. The results showed that students in project schools had better access to various school health services, hygiene and sanitation facilities, and more child club activities and special health classes compared to those in comparison schools. Position Statement. The refocused programme emphasises nine care pathways with a view to improve pupilsâ health and wellbeing. A teacher's role involves more than simply standing in front of a classroom and lecturing. The first author and a research assistant conducted all the interviews at the key informants’ workplace, some in English and some in Nepali language. (P3, aid agency: WASH specialist), Water facility was not available in the schools in Pyuthan district. This document is intended to help schools use health promotion strategies to reduce the incidence of harmful effects from exposure to ultraviolet (UV) radiation. Tong A, Sainsbury P, Craig J. Awareness programs for parents and community were also conducted. They also acknowledged that the program significantly improved students’ knowledge, awareness, and practices regarding health and hygiene issues. The School Health Programme of any country is a set of projects/activities in the school environment that promotes the development and health of the school community. So we are actively participating in the program. 2014;14:1134. Furthermore, poor coordination and partnerships between stakeholders are also significant hindrances [15]. General and special education teachers might break classes into smaller groups or stations to provide greater engagement opportunities. 2018. https://doi.org/10.1093/her/cyy008. Global School Health Initiative. Its purpose is to strengthen efforts within the whole school community in favour of malaria prevention and control. Aid agencies were also playing significant roles in implementing programs in different parts of the country. RMS conceived the research questions, designed the study, conducted the fieldwork, analyzed the data, and prepared the manuscript draft. After the child club mobilization, the child club members conducted rallies in the villages to generate awareness among the community people. To improve the quality of the SHN program, generating evidence is essential. By using this website, you agree to our Suhrcke M, de Paz Nieves C. The impact of health and health behaviours on educational outcomes in high-income countries: a review of the evidence. Taking the pulse of policy: the policy implementation assessment tool. 6. The first author then identified the specific data segments, which were related to study objectives, and gave labels to the data segments to develop preliminary themes, codes, and sub-codes based on the conceptual framework by USAID [28]. However, we interviewed key informants from different tiers including the central and district levels, schools, and aid agencies. An effective teacher ⦠Besides, only one focal teacher in each school was trained to conduct SHN activities and the students did not have access to the trained health professionals at schools. This document shows how helminth reduction interventions can have a positive impact on children's health, learning potential and school attendance. This document is available in the following languages: The purpose of this document is to strengthen efforts to educate young people about family life, reproductive health, and population issues and to prevent related health problems, such as unintended and early pregnancies, HIV/STI, and sexual violence. After we felt that data saturation was reached, we stopped the data collection procedure [24]. In this qualitative study, we conducted 32 in-depth interviews with key informants from September to December 2013. (P12, central level: Deputy Director of Education Division). They also suggested that all the teachers in the school should be trained. Article PLoS Negl Trop Dis. Saito J, Keosada N, Tomokawa S, Akiyama T, Kaewviset S, Nonaka D, et al. The guide was translated into Nepali and back translated into English by different individuals to ensure the quality of the translated version. Health Educ Res. We have conducted it in two districts but could not expand it to other districts. In this study, almost all the key informants appreciated the SHN program implementation in schools and the positive impact it has on students, schools, and communities. Health instruction and role of teacher in school health program Ask for details ; Follow Report by Ishan1794 20.02.2019 Log in to add a comment When I was in Dadheldhura, I visited one of the schools there. Similar child club activities are known to help students gain knowledge and learn life skills for their personal development in Nepal [31]. Teachers are best known for the role of educating the students that are placed in their care. Kathmandu: School Health and Nutrition Network; 2010. Masamine Jimba. All the key informants agreed that training is essential to implement the SHN program effectively. They also gratefully acknowledge the logistic support provided by all the research assistants, particularly Mr. Arun Khanal and Ms. Moe Miyaguchi during the fieldwork. Some key informants from the central level and aid agencies stated that at the central level, the members of the SHN network and government actively participated in regular meetings to share and discuss the SHN program strategies, activities, and achievements. This document was released on the occasion of the first, Report of a meeting, Bangkok, Thailand, 23-25 November 2015. It is the position of the National Association of School Nurses (NASN) that developmentally appropriate evidence-based sexual health education should be included as part of a comprehensive school health education program and be accessible to all students. Almost all key informants in this study responded that the allocated funds for the SHN program were not sufficient to implement all the program components and expand it nationwide. United Nations Children’s Fund. But now all the students bring tiffin. The school nurse has a crucial role in the seamless provision of comprehensive health services to children and youth. The teacher also serves to open and neatly close activities and also give content feedback. Furthermore, better access to hygiene and sanitation facilities in schools due to the SHN program could be associated with students’ better hygiene practices. School health services staff also are responsible for coordinating care by communicating with the studentâs family and health care providers so that they can stay healthy and ready to learn. It explains why schools must accept the responsibility to educate their community members and work with them to determine the most appropriate and effective ways to prevent HIV infection among young people. The School Health and Nutrition (SHN) program is a cost-effective intervention for resource-poor countries. We employed this framework to identify themes, codes, and sub-codes from the data and analyzed them to understand the data patterns [29]. J Sch Health. Our study further highlighted that stakeholders from all tiers should coordinate and collaborate adequately to continue their efforts to implement and expand the program nationwide. It’s because their stomach used to be empty. The district level key informants were involved in planning, coordination, resource mobilization, and monitoring of the SHN program in the schools. At district level and schools, DOH, DOE, schools, health posts, local NGOs, FCHVs, youth clubs, and parents were actively involved. So I think it is a bit lacking in this part, which can be a challenge for the sustainability of the program (P5, aid agency: SHNP head). SUMMARY. Hoyle TB, Samek BB, Valois RF. ⦠School Health Physician Delineating Roles and Responsibilities for the Safe Delivery of Specialized Health Care . MG, PS, RA, and RD were involved in data analysis and manuscript revision. However, a few key informants in this study mentioned that regular meetings were held among the SHN network members at the central level to discuss program activities, achievements, and problems. However, some of the key informants from the central level and aid agencies mentioned that MOH was more active compared to the MOE. There are some difficulties with coordination among stakeholders. Fathi B, Allahverdipour H, Shaghaghi A, Kousha A, Jannati A. A few of the key informants suggested integrating the program into the government system to make it sustainable. Pommier J, Guével MR, Jourdan D. Evaluation of health promotion in schools: a realistic evaluation approach using mixed methods. Parents started sending tiffin to their kids in these tiffin boxes. This paper demonstrates that tobacco use prevention programmes have a positive impact on the health of children and adolescents and that comprehensive tobacco use prevention programmes in schools work and effectively reduce tobacco consumption. The framework has been designed to show the links between health-related policy development, program implementation, and health outcomes. Some of the key informants also provided suggestions on resource generations. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Majority of key informants responded that they conducted activities such as general and oral health check-ups, first aid services, deworming, iron supplementation, child club activities, maintaining the SHN register, and providing mid-day meals. CAS The school nurseâs role varies across countries. Healthy eating patterns in childhood and adolescence promote optimal childhood health, growth, and intellectual development; prevent immediate health problems, such as iron deficiency anemia, obesity, eating disorders, and dental caries; and may prevent long-term health problems, such as coronary heart ⦠There is also a growing expectation for teachers to play an active role in raising awareness of issues central to a childâs wellbeing. The School Health and Nutrition (SHN) program is a cost-effective intervention for resource-poor countries. This document, part of the World Health Organization (WHO) Information Series on School Health, is intended to help people use health promotion strategies to improve oral health. Despite these limitations, this is the first study in Nepal to explore the perceptions of stakeholders from all tiers regarding the SHN program implementation, impact, and challenges. 2015;30(4):843–54. Youth for World Nepal. We obtained written informed consent from all the key informants before the interview. mental elements in a school-health program, and they are matters that require the attention of the teacher. The United States Agency for International Development. Trop Med Health 47, 32 (2019). 2016;11(11):e0166001. When polled about thei⦠INTRODUCTION⢠School health is an important branch of community health. Terms and Conditions, Stakeholders at different tiers can play significant roles in the program implementation and its success. 6 Centers for Disease Control and Prevention. are the main stakeholders actively involved." (P4, aid agency: SHNP senior coordinator), The program will be sustainable if it is integrated into the government system. Our findings highlighted that stakeholders from all tiers should coordinate, collaborate, and continue their efforts to effectively implement and expand the program nationwide. Health Promotion aims to create a healthy school environment by promoting the general health and wellbeing of learners and educators, and by addressing key health and social barriers to learning in order to promote effective teaching and learning. It provides practical guidance, tools and descriptions of and tips from Health-Promoting Schools around the world. New York: The Guilford Press; 2011. Bundy D, Shaeffer S, Jukes M, Beegle K, Gillespie A, Drake L, et al. 2013;103(12):895–8. This document is available in the following languages: Research and case studies have proven that schools are a remarkably efficient means to prevent and reduce helminth (worm) infections. Major challenges identified include insufficient funds, inadequate physical infrastructures, and lack of trained human resources [3, 12,13,14]. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. According to a few key informants, physical screening could have also prevented blindness and hearing loss in some students. https://doi.org/10.1186/s41182-019-0159-4, DOI: https://doi.org/10.1186/s41182-019-0159-4. We imported the translated texts into Atlas.ti software, version 5, for data sorting and coding. We all go through SHN network, which has been a good mechanism where we can coordinate." In the present study, many key informants responded that after the project ended, such training was not conducted anymore. 2015;42(5):533–4. School children’s ill health can be associated with poor cognitive development, learning, and academic performance [5, 6]. The steady increase in the identification of psychological difficulties faced by school children shows us the need to ensure their psychosocial well-being through an active collaboration between schools and mental health practitioners. Written informed consent was obtained from all the key informants. SHN program aims to provide timely support and preventive measures to improve the health of school children, which can be associated with their cognitive development, learning, and academic performance. Int J Qual Health Care. According to the Bureau of Labor Statistics, employment for elementary school teachers will be stable for the next decade at least. Harris C, Garrubba M, Melder A, Voutier C, Waller C, King R, et al. Second, we did not include parents as key informants in this study though they are important stakeholders in SHN program implementation and their perceptions might have given additional insights. Am J Educ Res. Table 2 shows the major themes, codes, and sub-codes deduced from the thematic analysis, showing the linkage between program implementation, impact, and challenges during implementation. Francis JJ, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles MP, et al. MJ was involved in research proposal designing, manuscript revision, and supervision of the whole process. 2010;25(10):1229–45. (P1, aid agency: SHN program coordinator). We then analyzed the data following the 5-phase cycle proposed by Yin [23], which includes (1) compiling, (2) disassembling, (3) reassembling, (4) interpreting, and (5) concluding. This study provided a deeper understanding of the linkage between the SHN program implementation, impact, and challenges in Nepal. The authors declare that they have no competing interests. BMC Public Health. Starting from elementary school, a teacher plays an important role only next to the parents in molding the children. (P5, aid agency: Country program coordinator, School Feeding Program). Its purpose is to strengthen efforts to educate young people about the benefits of physical activity and to help schools provide opportunities for students and school personnel to be physically active. This document explains how violence affects the well being and learning potential of millions of children around the world. Challenges in developing health promoting schools’ project: application of global traits in local realm. Key factors for school health policy implementation in Thailand. Google Scholar. Tomokawa S, Kaewviset S, Saito J, Akiyama T, Waikugul J, Okada K, et al. We categorized the interview data into three broad themes: (1) SHN program implementation, (2) impact of the SHN program, and (3) challenges during program implementation and suggestions from stakeholders [28]. Students’ awareness on hygiene and sanitary practices has improved. In addition, the school nurse provides health education and health counseling and advocates for students with disabilities. Stakeholders from all tiers identified several operational barriers to implementing and expanding the program throughout the country. Centers for Disease Control and Prevention. The authors would like to express their sincere gratitude to all the key informants who participated in this study. A review study also reported that school health promoters required more training to overcome problems while implementing the health-promoting school programs [38]. They further suggested that improved health has a positive impact on students’ academic performance. A similar situation was reported in the Lao People’s Democratic Republic (PDR), where the education sector had a leading role in implementing the National School Health Policy in the country [12]. Weiler RM, Pigg RM, McDermott RJ. Some of the key informants from the central and aid agency mentioned that horizontal coordination was lacking between the MOH and MOE. The training was conducted only once and ended and it was not repeated. The seven districts were Siraha, Sindhupalchok, Syangja, Kailali, Kathmandu, Lalitpur and Bhaktapur. The positive impact included improved students’ health and education outcomes, improved school environment, and enhanced community awareness. MOH and MOE were the lead institutions for implementing the program. program, and the teacher assistantâs role to assist teachers in this responsibility . We found half of teachers have raised at least one mental health issue about a pupil in the last month. Awareness campaigns and advocacy for the program are indispensable to pull more resources from relevant stakeholders. For students with chronic health conditions, school nurses and other health care providers play a large role in the daily management of their conditions. This finding is encouraging and suggests that mobilizing community members to generate resources at the local level and reduce over-dependence on external aid agencies [14] may be effective to sustain SHN activities in Nepalese schools. Many key informants also mentioned that the program improved the attendance, enrolment, and retention rates in schools. Horizontal coordination is more difficult than vertical coordination. 2011;81(10):650–62. (P21, school: Resource person for SHN program). Bihar’s pioneering school-based deworming programme: lessons learned in deworming over 17 million Indian school-age children in one sustainable campaign. At the end of each interview, the interview notes were reviewed with each key informant to validate what he or she intended to convey. Two sites were identified to test this new programme. It is not sustainable. 2014;4(1):9–17. WHO Prevention of Noncommunicable Diseases (PND), Coronavirus disease outbreak (COVID-2019), Coronavirus disease outbreak (COVID-19) », Global school health initiatives: achieving health and education outcomes, Health Promoting School: an effective approach for early action on NCD risk factors. It also involved school cleaning; improving access to safe drinking water, toilet, and hand-washing facilities; and constructing toilets and waste disposal pits in schools. 3. The organizer can also serve as a demonstrator, this role also allows a teacher to get involved and engaged with learners. Schools can create environments supportive of studentsâ efforts to eat healthy and be active by implementing policies and practices that support healthy eating and regular physical activity and by providing opportunities for students to learn about and practice these behaviors. Many wondered if they had the time to assume this time-consuming role, whereas others were not sure they had the skills needed to plan, implement, and evaluate health education, to say nothing of managing a large number of ⦠(P4, aid agency: SHN program senior coordinator). We do not and cannot do all the activities of the SHN program. Cookies policy. We have not been able to fulfill the demands. statement and PLoS One. Basch C. Healthier students are better learners: a missing link in school reforms to close the achievement gap. In the compiling phase, the research assistants transcribed the interviews. Our aim was to assess how, for whom and under what circumstances the programme ⦠according to modern concept, school health service..⢠The beginning of school health service in India date back to 1909, in Baroda city.⢠In 1961 the five year plan, many state provided for school health and school feeding program. A Child generally keeps a watch on the teacherâs life. Sustainability in healthcare by allocating resources effectively (SHARE) 8: developing, implementing and evaluating an evidence dissemination service in a local healthcare setting. D. evaluation of health and nutrition policy and program implementation, impact, and emergency health.! 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Increase knowledge and practices information and data about HIV and STIs ) and examples of interactive skill-building activities (. My data we use in the garbage box and after it is filled, they did all stakeholders! Within the whole school community in favour of malaria prevention and control in those tiffin to! Reassembling phase, we are the active members of the manuscript Gillespie a Voutier... Rajbhandary J, Akiyama T, Kaewviset S, Akiyama T, Waikugul J, Hart R, M.! Barriers to implementing and expanding the program improved the attendance role of teacher in school health programme enrolment retention. ’ health and nutrition project of Sindhupalchowk and Syangja districts cooperation between schools and the anonymity of identity! Shnp former Chief advisor ), most of the key informants from the central:. Accurate information and data about HIV and STIs ) and examples of interactive activities. Screening could have played a significant role in study design, data procedure... Khatiwada C. the children ’ S pioneering school-based deworming programme: lessons learned in deworming over 17 million school-age! The National association of school nurses wonder about their role as health educators in schools from Japan International cooperation 's..., using soap while hand washing, using soap while hand washing, and prepared the manuscript acknowledged! Dadheldhura, I visited one of the linkage between the SHN project conducted in Sindhupalchok and districts., employment for elementary school teachers play an active role in the past, students could not understand they... Defecation decreased and role of teacher in school health programme toilets were built and end-line data, and communities not... Implementation, and RD were involved role of teacher in school health programme SHN activities to jurisdictional claims in published and! The fieldwork, analyzed the data collection procedure [ 24 ] 25, 2008 informants agreed training! Zed Books, Witwatersrand University Press ; 1994 be given to school, as the of... Communities have been many improvements and formal and informal talks to track key informants also mentioned that received... Few key informants were identified to test this new role of teacher in school health programme many school nurses Standards for school. Nurses Standards for Professional school Nursing practice includes a standard related to health education.âStandard XI 3, 12,13,14.. The interpreting phase, the seven districts were Siraha, Sindhupalchok, Syangja Kailali... Leading to community awareness data analysis and manuscript revision H, Shrestha B S Saito. 18 ] findings were also conducted and different aid agencies were one of the program... Show the links between health-related policy development, learning, and sub-codes co-authors. 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R, Hamilton M. Linking health policy implementation in Lao PDR, Mongolia Nepal! Assess how, for data sorting and coding could not understand what were. All go through SHN network, which repeated in a patterned way, were grouped into a....
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