Action oriented health education in the context of kenyan primary schools
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Action-oriented health education in the context of Kenyan primary schools. W. Onyango-Ouma, PhD Senior Research Fellow Institute of Anthropology and Gender Studies University of Nairobi KENYA. Outline . Introduction – concepts in HPS, participation and action

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Action-oriented health education in the context of Kenyan primary schools

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Action oriented health education in the context of kenyan primary schools

Action-oriented health education in the context of Kenyan primary schools

W. Onyango-Ouma, PhD

Senior Research Fellow

Institute of Anthropology and Gender Studies University of Nairobi




  • Introduction – concepts in HPS, participation and action

  • Action-oriented and participatory health education

  • Experiences from the Kenya school health education program

  • Pupils’ ownership and participation

  • Teacher training and involvement

  • Findings

  • Conclusions and recommendations

The definition of health

The Definition of Health

  • Health is "...a state of physical, mental and social well-being, and not only the absence of disease and disability."

  • Health includes two different dimensions:

    • well-being, quality of life

    • absence of disease and disability

Overlapping concepts in hps

Overlapping concepts in HPS

  • Ottawa charter: enable people to increase control over and to improve their health

  • New Concepts: Empowerment, Action Competence, Health Literacy, Self Efficacy etc...

The concept of participation

The Concept of Participation

  • Participation – what is it about?

  • students have to be involved in decisions about content, process and outcome

  • Participation – why is it important?

  • ethical reasons

  • “learning efficiency” reasons – creating ownership

  • “educating for democracy” reasons

The action concept

The Action Concept

  • Action – what is it about?

  • target groups’ decisions

  • change perspective

  • Action – why is it important?

  • facilitating change (lifestyle and living conditions)

  • “learning efficiency” reasons (“learning by acting”)

  • Action can be both individual and collective

Components of action competence

Components of Action Competence

  • Knowledge/Insight

  • Commitment

  • Visions

  • Action experiences

  • Critical thinking

Action oriented and participatory health education

Action-oriented and participatory health education

  • A well-defined education approach developed among other places within the Danish network of HPS (Jensen 1997, 2000)

  • It is an integrated part of this aprroach that pupils should take action aimed at influencing ”real-life’ conditions as part of their learning processess

  • Action and participation are interrelated although participation may not always involve action

  • Facilitates the development of pupils’ ownership and processes leading to concrete change

The school health education programme

The School Health Education Programme

  • Conducted between 1999 - 2002

  • Involved 9 primary schools in Bondo district, Western Kenya

  • 536 of 2250 pupils directly involved

  • Aim: To explore, identify and improve the conditions for an action-oriented and participatory health education programme

  • Key concepts: Participation, Action and Action Competence

Key actors

Key Actors

  • Researchers

  • Pupils

  • Teachers and Education Inspectorate staff

  • Trainer of trainers in action-oriented approaches

  • Community members

  • Actors played different complimentary roles essential to program implementation

Study design

Study Design

  • Intervention design with pre- and post- intervention measurements/stages

  • Three interventions were implemented:

    • Use of flipcharts as an interactive tool in the school health education

    • Establishment of an extra-curricular health club

    • In-service training through continuous professional support

Distribution of schools by intervention

Distribution of schools by intervention

Pupils ownership and participation

Pupils’ ownership and participation

1)Use of Flip charts

  • Developed together with pupils

  • A strong notion of pupils’ participation in school and in the community

  • Content - transmission and prevention of worms

  • Teaching was action-oriented and participatory to develop pupils’ ownership

  • E.g., pupils got tasks to discuss what they could do to prevent worms at school and home

  • Teaching using flip charts created an enjoyable learning environment for pupils

Pupils ownership and participation1

Pupils’ ownership and participation

2) Health clubs

  • Pupils decided on membership while teachers acted as facilitators

  • Activities linked to concepts of action and participation

  • Pupils identified and took tangible actions to change their health conditions at school and home

  • Pupils were the main decision-maker s of when to meet and what to do

  • The informal climate in HCs motivated pupils to participate and take ownership

Teacher training and involvement

Teacher training and involvement

1) Initial training

  • Teacher training was an integrated part of the project

  • Aim: To develop teachers’ knowledge and commitment toward participatory and action-oriented teaching /learning

  • Two workshops of 2 days each conducted to build capacity to effectively participate in the project

  • Training involved – key health education concepts including action, participation and action competence

Teacher training and involvement1

Teacher training and involvement

  • Teachers were also exposed to different intervention types

  • Training enabled teachers to develop ownership of the form and content of the intervention as well as key concepts involved

    2) Continuous professional support

  • Provided to teachers in 3 schools as part of the intervention to strenghthen their skills and competencies for implementation

  • Researchers provided support through regular mini-seminars of 2-3 hrs on fortnightly basis

  • Teachers had the freedom to decide on their implementation time frame - ownership



  • A combination of health clubs and flip charts had the greatest impact on puplis’ competence and knowledge

  • Conditions that facilitated participatory teaching/learning include teacher attitude, availability of materials and teacher/pupil relationship

  • Changes in pupils’ environmental and hygiene choices

  • Actions encouraged and fostered creativity and resourcefulness among pupils



  • Genuine participation helps to build ownership (but in a dialogue with a professional)

  • Students’ own actions help to build ownership (but as integrated elements)

  • All ages and all socio-economic groups can benefit from participatory and action-oriented approaches

  • A genuine participatory approach implies a multidimensional concept of health



  • Teacher training: teachers need to develop competence to teach with participatory approaches

  • Collaboration between school and the community: ’Authentic ’ and action-oriented teaching approaches where pupils take action in the community builds closer links between school and community e.g. use of health clubs

  • Learning materials and models: The use of materials and models with a ”built in” participatory and action-oriented approach should be developed and disseminated to teachers

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