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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
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
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