CHAPTER 7 SUMMARY, LIMITATION AND RECOMMENDATION
7.4 RECOMMENDATIONS
7.4.1 HPS practices of learners and health risks in High School
Developing partnerships between the education and the health sector policy makers. The Department of Basic Education, through the South African Schools Act, as the overall legislation that controls how schools should operate, should collaborate with the DoH, through the School Health Policy, in order to draw on the understanding and experiences of educators, health workers and other school community members to initiate a HPSI. The collaboration will assist high schools to address health risks among learners.
In contrast to the previous vertical model of delivering school health services, the School Health Policy should assist in the provision of school health services, integrated with other primary health care activities, allowing the HPSI to create a platform to control health risk practices. This include other different services provided at school to ensure that learners receive the required attention.The integration of these services and programmes in other sectors is particularly crucial to influence learners HPS practices in schools.
This study also recommends that interventions for learners at school should be included as part of service provision and to ensure Universal Health Coverage, to promote HPS practices and to address social determinants of health and wellbeing. This is similar to the recommendations of the Sustainable and Development Goals (SDGs) that show strong synergies encouraged among different sectors to implement strategies initiated, led and supported by both the DoH and the DBE.
143
Collaboration among different sectors can also assist in the reduction of the prevalence of risk behaviours, such as teenage pregnancy, in South Africa, which is currently at 47 births per annum per 1 000 girls aged between 15 and 19. This exceeds the prevalence of teenage pregnancy in high-income countries (Reddy et al., 2016). The HPSI is recommended as one of the initiatives which can assist the country to develop further by keeping the girl- child at school for a longer period of time, the practice recommended by SDGs numbers 3 and 4, although there is lack of understanding as to what constitutes best practice and how HPS implementation might vary, depending on context and traditions.
The outcome of this study is meant to encourage and assist the DBE, the DoH and other stakeholders to opt for the HPSI as one of the strategies that can still be used to reduce health risk practices among learners at school.
7.4.2 The HPS physical features and the environment in high schools
The Department of Basic Education should encourage that school environment must communicate messages through signs and billboards in order to prohibit health risk behaviours, such as substance use, smoking and carrying of dangerous weapons, on school premises. This could be achieved by assisting schools to adhere to the South African Schools Act and to develop school health policies that encourage putting up of “No Smoking” and “No dangerous weapons” signs in school premises. The HPS task team members could also come up with strategies to monitor the identified health risk behaviours learners are exposed to, especially in hidden corners of the school and to give thought to the implementation of planned strategies to deal with these risks.
Administrators of HPS should develop both a sense of direction in the goals of the school and clear and unambiguous leadership and administrative support for the implementers of the HPSI, providing resources that complement the fundamental role of the educators and which are of a sound theoretical and accurate factual base.
144 7.4.3 HPS training programme for LO educators
LO educators should be skilled on needs assessment among learners using reliable scientific methods to identify, prioritise the needs and to discuss priority issues leading to a strong foundation of HPS;
Since substance use is found to be a serious health risk among learners, both locally and globally and they use substances even during school hours, educators should be empowered, through the HPS training programme, to be confident to share their knowledge with learners and to create a supportive environment to control the risk behaviours. The control of risk behaviours among learners, physical and environmental factors, ethos and climate of the school, may improve the educational outcomes.
Educators should be confident to teach all the topics embedded within LO and make use of all the notional hours, as prescribed by the curriculum, to empower learners to resist challenges such as peer pressure and influence learners towards risk mitigation. They should provide adequate time for class-based activities, organisation and coordination, and out of class activities.
The school-based health risk prevention programmes based on theory and evidence, can also be developed as part of HPS initiative. The skills will enable educators to identify symptoms of health risks and how to address them.
The task HPS team should provide ongoing capacity building opportunities for educators and associated staff regarding HPS.
The training can bring educational changes for HPS implementation by demonstrating how the key features of HPS matched with effective schools, and how to build up educator capacity so they can be fully engaged during the process of establishing the paradigm shift in school health promotion.
7.4.4 The HPS climate/ethos in high schools
For HPS to thrive well, learners and parents should feel a sense of ownership in the life of the school;
As part of HPS initiative, schools should develop healthy school policies based on the existing South African Schools Act to strengthen health promotion practices and to control challenges that disturb teaching learning and the
145 educational outcomes at school. There should be coordinated mechanisms, budget, procurement, human resource management, data and audits for HPS to benefit schools that opt to initiate it.
The task team should develop and maintaining a democratic and participatory school community, exploring health issues within the context of the students’
lives and community;
Strategies that adopt a whole school approach should be utilised by the HPS task team, rather than primarily a classroom learning approach;
The implementers of the HPS initiative should create an excellent social environment which fosters open and honest relationships within the school community, ensuring a consistency of approach across the school, home and the wider community;
The schools should create a climate where there are high expectations of learners in their social interactions and educational attainments.
7.4.5 HPS Training Programme for LO Educators
LO educators should be first to undergo HPS training in Limpopo Province High Schools as they are responsible for a subject that relates to health topics.
LO educators only displayed knowledge of HPS activities during training, therefore a training programme is required to address all aspects of HPS initiative.
The training programme can create awareness of how health risks among learners can be addressed by LO educators whose skills should be developed during HPS training.
A knowledgeable LO educator can always improve learner’s educational outcomes.
Empowerment of all LO educators is recommended based on the fact that LO is a subject meant to assist learners to prevent health risks, address physical/environmental and school climate/ethos factors, assisting learners to achieve more academically.
7.4.6 HPS Training programme evaluation
146
Expectations of participants should be listed at the beginning of the training and be fully covered during training for HPS. This will assist the trainers to respond specifically to areas of concern and knowledge deficit regarding HPS.
Topics such as what Health Promoting School is, implementation and where can the school get funds to initiate it, should be included on the training programme as they were highlighted by most participants.
Participatory approach during training of educators is recommended as they learn more and share information during training.
The following quotes were taken directly from the educator’s comments:
The training should be empowering and technically correct to covered the content of what HPS is all about.
The training must be well planned to accommodate the busy schedule of educators.
Potential changes expected from HPS initiative in schools should be highlighted.