Context
Large numbers of school children in South-East Asia suffer from ailments such as diarrhoea, acute respiratory diseases, worms and dental caries, all of which are preventable and caused mainly by poor hygiene. These illnesses seriously impair a child’s physical and cognitive development and have a negative impact on their ability to learn and their prospects.
Although many countries in South-East Asia have recognised the value of school health programmes and developed their own national strategies, there is still a lack of realistic and affordable concepts, as well as the required expertise. Very few sustainable programmes run on a regional basis. Many are only carried out in a few individual schools and are thus far from reaching their full potential.
Objective
The health and academic performance of primary school children in participating countries are improved through the introduction of school health programmes.
Approach
The regional Fit for School programme works together with the Regional Center for Educational Innovation and Technology (SEAMEO INNOTECH), a regional office of the Southeast Asian Ministers of Education Organization (SEAMEO). The programme uses existing structures in the education sector to improve school washing and sanitary facilities. It also implements evidence-based preventative measures such as teeth brushing and hand washing with soap, promoting them as group activities and integrating them into the daily routine of state-run primary schools. Using Australian Government funding, the Fit for School approach is also being introduced in the Autonomous Region in Muslim Mindanao in the southern Philippines.
The Fit for School approach focuses on effective school health programmes that can be financed locally and implemented using the resources of the education sector. Thanks to high school enrolment rates, health programmes in primary schools reach the majority of school children regardless of their socio-economic background.
Daily teeth brushing with fluoride toothpaste and hand washing with soap are integrated into the children’s normal school day in the form of group activities. The children are also dewormed twice each year. These daily routines have a lasting effect on hygiene practices and supplement traditional forms of health education, which are based on knowledge transfer only. The programme also involves improving water supplies and sanitary services, in particular through the installation of hand washing stations. Improving access to water and providing sanitary facilities suitable for children in the participating schools create a healthy school environment which is essential for improving long-term health.
The programme’s success is mainly attributable to the following factors:
Simplicity. Implementing measures that are aimed at combating the most common illnesses and that can be carried out by the teaching staff at low cost.
Scalability. Developing realistic implementation models and using existing structures in the education sector in order to implement the programme nationwide.
Sustainability. Securing funding from local or national governments in order to ensure the programme’s sustainability; actively involving parents and local communities in order to strengthen ownership and transparency.
Results achieved so far
The Philippine Department of Education’s national school health programme currently targets more than 2.5 million of the country’s 12 million primary school children. Since 2008, it has used the Fit for School approach and has been supported by GIZ. A long-term study initiated in 2009 showed that the programme's measures were having a positive effect on the health of school children after just one year. In schools where the Fit for School approach was implemented, 20 per cent fewer children were underweight, the number of new cases of caries had fallen by 40 per cent, serious worm disorders had halved, and there were 30 per cent fewer illness-related absences than in control schools.
An initial impact study conducted in Cambodia, Laos and Indonesia in 2014 showed that the number of new cases of caries among children from schools involved in the programme was 20 per cent lower than that among children from control schools. The programme also helped to greatly improve access to water and sanitary facilities within the school environment. The functioning and cleanliness of school toilets and washing facilities had been significantly improved in the programme schools.