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2.2.3. Comprehensive School Health Program (CSHP)
According to Allensworth et al. (2003): A Comprehensive School Health Program (CSHP) is an integrated set of planned, sequential, school affiliated strategies, activities, and services designed to promote optimal, physical, emotional, social, and educational development of students. The Program involves and is supportive of families and is determined by the local community based on community needs, resources, standards, and requirements. It is coordinated by a multidisciplinary team and accountable to the community for program quality and effectiveness (Allensworth et al., 1995:2).
The components of CSHP are eight in number, these are: (i) planned, sequential health education across the whole curriculum, from grade 1 to grade 12; (ii) school-based health services; (iii) the school environment; (iv) physical education at school; (v) food services;
(vi) counselling services; (vii) health promotion among school staff; and (viii) school/community integration of health promotion efforts (Allensworth & Kolbe, 1987).
Both the Health Promoting School (HPS) and the Comprehensive School Health Program (CSHP) initiatives have been promoted as a possibility of exceeding some of the restrictions related to school health initiatives, especially those that focuses on school-aged children. This consist of going further than sheer practices which is largely dependent on health education curricular, to a more comprehensive, integrated approach of health promotion which emphasizes both child attitudes and behaviours, and their environment.
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was to be found in the Declaration of Alma-Ata World Health Organization (Clay, 1988).
This statement came out of a major International Conference on Primary Health Care held in Alma-Ata, which called on all governments "to formulate national policies, strategies and plans of action, to develop a multi-sectorial approach to involve citizens in forecasting, organization, operation and control of Primary Health Care and to focus on education as a means of preventing and controlling health problems" (St. Leger, 1999; Wardell et al., 2003;
Strand et al., 2008; Oloukoi et al., 2014).
2.4.1. Some Major International Conference Declarations
The Declaration of Alma-Ata was the first international attempt at this high level to pinpoint the myriad of factors influencing health and thus, provides an emphasis for developing strategies by the member states of the WHO. The focus of the Declaration of Alma-Ata was that it brought the idea of health for all needs to be realized come the year 2000 (Ayila et al., 2014). This prompted a closer examination by governments and health authorities about how this could be achieved. The Ottawa Charter for Health Promotion and the Jakarta Declaration were other major milestones in influencing the direction of Health Promoting Schools (WHO, 2012). The Ottawa Charter focuses on creating: 1) healthy public policy; 2) supportive environments; 3) community action; 4) personal skills; and 5) a reorientation of health services. It also focuses the Initiative on creating health as well as preventing health problems by calling for actions that enable individuals to: care for themselves and others, make decisions and have control over their life (WHO, 1986). Complementarily, ‘the Jakarta Declaration emphasizes on creating sustainable health promotion programmes. Thus, the WHO Initiative calls for international, national, district and local actions to promote social responsibility, increase investments in schooling, consolidate and expand partnerships, build community capacity, empower individuals and secure an infrastructure for health promotion through schools. Such actions help to unlock the potential for health promotion that is inherent in all schools’ (Jones and Furner, 1998).
33 2.4.2. Challenges facing School Health Programmes
WHO’s Expert Committee on Comprehensive School Health Education and Promotion reviewed challenges to the development of school health programmes as identified by national, district and local education and health workers. Five broad problems are commonly identified at each organizational level, they are as follows:
1. Inadequate vision and strategic planning.
2. Inadequate understanding and acceptance of programmes.
3. Lack of responsibility and accountability.
4. Inadequate collaboration and coordination among persons addressing health in schools.
5. Lack of Programme infrastructure, including financial, human and material resources as well as organising mechanisms.
Despite the barriers, WHO’s Expert Committee found major reasons why school health programmes should be further developed. Therefore, the Committee concluded that there is a rich base of knowledge on which to act to develop and improve school health programmes. Furthermore, it concluded that research in both developing and developed countries demonstrates 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 (Department of Health &
Department of Basic Education,2012) DoH &DoBE, 2012)
2.4.3. Expert recommendations for School Health Programme (DoH&DoBE,2012) To strengthen each nation’s capacity to improve health as well as education, the WHO Expert Committee recommended two broad actions that must be supported at the local, national and international levels, they are:
• expanding investments in schooling
• expanding the educational participation of girls,
To promote health through schools, the WHO Expert Committee made three recommendations about what schools must do:
• provide a safe learning and working environment for students and staff
• serve as an entry point for health promotion and a location for health intervention
• enable children and adolescents to learn critical health and life skills,
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The WHO Expert Committee also recognized that schools clearly need to support health promotion; thus, they made the following five recommendations:
• policies, legislation and guidelines must be developed to ensure the identification, mobilization and coordination of resources at the local, national and international levels
• teachers and school staff must be valued and provided with the necessary support to enable them to promote health
• communities and schools must work together to support health and education
To strengthen each nation's capacity to improve health as well as education, the WHO Expert Committee recommended two broad actions that must be supported at the local, national and international levels, they are:
• expanding investments in schooling
• expanding the educational participation of girls,
To promote health through schools, the WHO Expert Committee made three recommendations about what schools must do:
1. Provide a safe learning and working environment for students and staff
2. Serve as an entry point for health promotion and a location for health intervention 3. Enable children and adolescents to learn critical health and life skills,
The WHO Expert Committee also recognized that schools clearly need to support health promotion; thus, they made the following five recommendations:
1. Policies, legislation and guidelines must be developed to ensure the identification, mobilization and coordination of resources at the local, national and international levels 2. Teachers and school staff must be valued and provided with the necessary support to
enable them to promote health
3. Communities and schools must work together to support health and education (DoH &
DoBE, 2012).
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