Procesamiento y análisis de los resultados

Website: <www.hki.org>

Contact person(s): Chad MacArthur at [email protected]

Introduction and background

The mission of Helen Keller International (HKI) is to save the sight and lives of the most vulnerable and disadvantaged. HKI combats the causes and consequences of blindness and malnutrition by establishing programmes based on evidence and research in vision, health and nutrition.

School health is seen as a key intervention in the life cycle approach of HKI to improve nutrition and thus improve school attendance and improve learning. The promotion of eye health is also essential to allow students to achieve their full potential. HKI views schools as a doorway to the community allowing students to share their knowledge and positive health behaviours with parents, siblings and out- of-school peers.

The HKI school health strategy is based on the FRESH framework. In the countries HKI works in, the agency makes a point of promoting this framework to HKI counterparts and particularly those working in the Ministries of Health and Education.

Activities and programmes

HKI has worked with a number of Ministries of Health and Education to have school health included in the primary level curriculum to ensure that health knowledge and practices are routinely taught. Tanzania has recently integrated trachoma into its curriculum as well as Burkina Faso. In Mozambique, nutrition and trachoma are taught in a number of schools in the Manica province capitalizing on the flexibility provinces have to include a certain percentage of province-specific curricular components.

Many of HKI’s school health programmes focus on trachoma of which water is essential. In Tanzania, HKI has worked with communities to install rain-harvesting systems at schools to extend water availability to allow for face washing. In Burkina Faso, Mali, Nepal and Niger HKI has also installed water wells at schools. Latrines are another important component of trachoma control and are the predominant school health programme HKI has been working in. Latrine construction due to budgetary constraints has been limited though the organization promotes their construction among national and international partners. Gender segregated latrines are critical. Face washing and latrine usage are the two primary components in HKI’s trachoma school health programmes. The development of curricular activities, lessons and teaching materials constitute the major thrusts of HKI. Trachoma school health programmes are being implemented in Burkina Faso, Mali, Nepal, Niger, and the United Republic of Tanzania.

In HKI programmes that focus primarily on nutrition, most notably in Mozambique, hygiene education is also critical particularly to complement deworming efforts. Litter disposal and maintaining a clean school environment is also an integral part of the programmes.

In Bangladesh and Indonesia, HKI in collaboration with local governments promotes the inclusion of visually impaired children in the classroom. Furthermore, HKI has a number of programmes in the United States and Mexico to screen schoolchildren for refractive error and to provide spectacles where needed.

In Mozambique, HKI has developed class-specific teaching guides and student workbooks for nutrition. In Burkina Faso, HKI has been working with the community and school gardens to increase nutritional knowledge and to promote a diversified diet. In its Mozambique school health programme, iron/folate supplements are provided to adolescent boys and girls. Deworming is a key component for HKI’s programme in Mozambique where mebendazole is the antihelminth drug used. In Burkina Faso, a consortium of NGOs such as CRS and Save the Children,US (SC-US) with HKI are beginning a school health project under the auspices of the Ministry of Basic Education and Literacy for a comprehensive school health project which will include iron and vitamin A supplementation.

In most HKI school health programmes, teacher training is a key component where particular emphasis is placed on participatory methodologies. In Burkina Faso and Tanzania, HKI has been working with the Ministries of Education to include trachoma in the curriculum of teacher training institutes.

In the school health trachoma programmes, screening services are provided for the students and communities. Topical antibiotic ointment is distributed in a number of the programmes to treat those infected and their families.

HKI has both domestic and international refractive error programmes in which eyeglasses are provided to students in need of them. More complex cases related to eyes are referred to near hospitals.

Topics on policy and advocacy work

Topic Topic

Human rights, discrimination and stigma

reduction Services for students with special needs ✔ School feeding programmes Violence prevention

Immunization, vaccination Gender and sexual diversity _✔ Ethnic and religious diversity Environmental concerns

Skills-based health education including

reproductive health/HIV&AIDS prevention ✔ Access to safe water ✔ Tobacco, drugs, alcohol prevention Promotion of adequate

sanitation/latrines ✔ Health and nutrition services, including

deworming ✔ Partnerships and participation ✔

Promotion of a safe school environment _✔ Malaria care and prevention

Work place issues Other:

Partnerships, advocacy, research and participation

HKI’s school health programmes promote partnerships between the Ministries of Health and Education. Other critical partners are those representing the water sector and agriculture. This takes place both at the national level as well as the

provincial/district levels. Information dissemination, periodic workshops and sharing of results are the main means of fostering these partnerships.

In developing curriculum, HKI takes into account the teachers’ experiences and their needs refining efforts accordingly. In Tanzania, teachers have been instrumental in the design of curricular activities. In a number of countries, teachers have also been surveyed to identify their levels of comfort with the teaching materials and their reactions have also been used to improve the materials to ensure effective teaching. Students’ reactions are also taken into account in curriculum design as a means of ensuring effective learning.

HKI has been working with a number of NGOs, most notably CRS and SC-US, as well as local NGOs and community volunteer groups. As a technical assistance organization, governmental partnerships at all levels of the health and education systems are considered critical to successful implementation and sustainability. HKI uses whatever opportunity possible to advocate to in-country partners and particularly governments and to donors the importance of school health for improved health for the students and for improved educational outcomes. The inclusion of trachoma into the primary level curriculum in Tanzania has been the most notable result in this regard.

Future plans

Funding for HKI school health programmes has for the most part been decreasing though several country programmes such as Burkina Faso, Mozambique and the United Republic of Tanzania have either maintained or slightly increased their levels.

While the majority of HKI school health programmes have been conducted in Africa, increased programming in the Asia-Pacific region beyond the current programmes in Indonesia and Nepal are being explored as well as expanding programmes in Mexico.

Technically, HKI strives to develop a broad-based integrated school health package, which builds on on-going nutrition, trachoma and refractive error programmes currently being implemented in schools.

Partnerships are recognized as being essential in terms of maximizing resources and allowing for greater technical expertise.