Conceptual Framework of SHN/CHANGES Program

1. SCHOOL HEALTH AND NUTRITION (SHN) PROGRAMME IN ZAMBIA“Communities supporting health to improve learning.” PRESENTED AT CIES WORKSHOP22nd March 2005 BYJOSIAS E. ZULUCO-ORDINATOR,CHANGES PROGRAMME-EP,ZAMBIA

2. Conceptual Framework of SHN/CHANGES Program • Trainings • Community mobilization and advocacy • Community-based interventions • School-based interventions • Impact and outreach

3. The SHN activities • Baseline survey- biomedical, anthropometric and cognitive assessments • Micronutrients supplements (Iron tablets and Vit. A) and de-worming pills (Albendazole) once per year • Training teachers in Drug Administration and Life skills • Strengthening linkages between Health centres and schools • Providing small grants to schools and communities to support SHN and HIV/AIDS interventions • Community mobilisation to support SHN activities as a cross cutting activity

4. Mobilizing Institutions for School Health and Nutrition • Roles and responsibilities of Ministries of Education and Health agreed upon • School and health and nutrition policy developed • Multi-sectoral committees established • Link Schools to Health centres and communities (through School Health cards) • Characteristics of a Health promoting School-Multi-sectoral teams.

5. Mobilizing Communities for School Health and Nutrition. (SHN). • Use of Participatory Learning for Action (PLA) and Theatre for Community Action (TCA) • Public meetings • Training of teachers and health workers in HIV/AIDS and SHN activities • Training of communities and teachers: SHN concept, PLA and TCA • Sub grants to Community Based Organisations (CBOs) groups Supporting SHN activities • Develop and distribute IEC materials on SHN

6. Examples of Community Participation. • Molding of bricks and labour for construction of resource centres, wells and pit latrines and School gardens • Cooking on school feeding days • Dissemination of information to pupils and other community members • Parents provide snacks to their children to carry with them to school • Decision making and planning

7. Using the Media at National and Local Level Focus on benefits of SHN, Role of communities, How to make children healthy, Prevention of diseases-Water and sanitation Parents, pupils and teachers are involved in the discussions • Local and National Radio programmes • National TV programs • National Newspapers • IEC materials: newsletters, flipcharts, brochures, calendars etc.

8. Impact. • Pupils more alert and healthier • Absenteeism reduced • Communities more concerned about the health of their children • Cognitive functions of pupils improved • Health center attendances by pupils reduced • Cost effective

9. Challenges. • Teachers- extra duty vs extra pay, Competence, mouthful of activities • Health workers-Professional jealousy, are teachers competent? • Community- Competence, Not serious, Not sure of the benefit, Myths and misconceptions about drug administration to pupils. Is this Satanism. Does my religion allow? • Overcoming bad cultural beliefs and practices

10. Nyau Dancer- Eastern Province Zambia.

11. Lessons learnt • Popular drama is effective but expensive when professionals are used. However, equally effective are meetings and local drama groups • Training must go beyond teachers and health workers to include managers, policy makers and Community members with their opinion leaders • Poor infrastructure has no serious effect in implementation of the program • Health workers, Teachers and Communities can work together as partners to improve learning

12. Conclusions. • Involving teachers is the best practice; Teachers work closely with parents and exert influence on the welfare of school children; community members trust teachers ability to learn and adapt to new ideas • Teachers, Health workers and community members can work together to improve learning. Training teachers and health workers together builds team work.