Partnerships for Promoting Health and Education Donald Bundy
Partnerships for Promoting Health and Education Donald Bundy Human Development Network The World Bank Vancouver, Canada, June 7, 2007
IQ and schooling losses avoidable by school based SHN programs Condition Prevalence/ No. Cases IQ loss: Per Child Total IQ loss /mental retardation Years of schooling lost Stunting 52%/292 m 3 points 877 (21. 6 m) 284 m Anaemia 53%/298 m 6 points 1788 (45. 6 m) 524 m Worms 30%/169 m 3. 75 points 633 (15. 8 m) 201 m
Comparing returns to education Add years schooling p. a. SHN Programs Textbooks Cash transfer – Nicaragua Cash transfer – Progresa School Feeding -151 1. 2 – 2. 5 1. 1 0. 45 0. 66 0. 4 – 1. 2 Cost US$ <4 60 77 136 22
A FRESH Start: Focusing Resources on Effective School Health, Hygiene & Nutrition • Child Friendly Schools …. UNICEF • Health Promoting Schools…WHO • Education for All…UNESCO • Food for Education…WFP • School Health Initiative…World Bank
A FRESH Start: Focusing Resources on Effective School Health, Hygiene & Nutrition Core intervention activities • Effective health, hygiene and nutrition policies for schools • Sanitation and access to safe water facilities for all schools • Skills based health, hygiene & nutrition education • School based health & nutrition services
FRESH framework for action against worms • Policies in schools …that ensure well maintained sanitation and specific agreement that teachers can deliver treatment • Healthy environments in schools …. with effective sanitation and safe water to reduce transmission • Skills based health education …that promotes hygiene and healthy behaviors • School based delivery of anthelmintics by teachers …that follows WHO guidelines
FRESH Framework (UNESCO, UNICEF, WHO, World Bank, others) Health-Promoting Schools (WHO) Child-Friendly Schools (UNICEF) Pop. Ed (UNFPA) Global School Feeding Campaign (World Food Program) Policy Respects and recognizes the rights of the individual Respects and recognizes the rights of the child Creates an enabling environment for reproductive health and HIV education Focuses on those most at risk (girls, poorest communities, AIDS affected and infected) School Environment Healthy environment with opportunities for physical education and recreation Healthy, safe, secure. Is protective emotionally and psychologically Protects young people from unwanted pregnancy, STIs, sexual abuse and violence Serves as platform for other interventions Education Life skills education Promotes quality learning outcomes, provides skills based health education Strengthens HIV and reproductive health education programs Supports learning through good nutrition and promotes access to education Services Provides services, nutrition and food safety programs, counseling and social support programs and health promotion programs for schools. Includes community outreach components Promotes physical and mental health Ensures access to youthfriendly sexual and reproductive health services Provides food and promotes and supports deworming Supportive Partnerships Engages health and education officials, teachers, students, parents, health providers, community leaders Is child centered, family focused and community based Targets young people in and out of school and ensures participation from parents, youth, community leaders and organizations Promotes community and school partnerships
FRESH Partnership • Launched at the World Education for All Forum in Dakar, Senegal April 2000 • WHO, UNICEF, UNESCO, World Bank & Others
Directory of School Based Health and Nutrition Programmes: Findings from a survey of organisation support Updated Survey – October 2006 Partnership for Child Development Jan W de Lind van Wijngaarden Celia Maier Lesley Drake
Comparison of integrated SHN programmes in 2006 with 2000
Finding 2: Since FRESH, most agencies are moving towards Integrated SHN Programmes
Comparison of SHN activities in 2006 with 2000
Finding 3: Increasing partnerships between agencies
Accelerating the Education Sector Response to School Health and HIV&AIDS: Four Years On A Working Group of the UNAIDS Inter-Agency Task Team for Education and HIV/AIDS.
Education Sector Funding of the Response to HIV/AIDS: Review of 38 Education projects in Africa Region 1997 -2004 • Only 42% specified a sectoral school health and HIV&AIDS program and budget • 33% did not mention school health and HIV&AIDS at all
Allocation of Multi-sectoral Health Resources to the Education Sector (survey of 22 projects) • 60% did not disburse to education • 18% disbursed >5% of budget to education
Key Correlates with an Effective Education Sector Response: • Strong education sector leadership • Inclusion of school health in the education sector plan • Support from a mix of resources – education and health sector • Technical assistance to the education sector in developing this new area
The Process Regional Analytical Work Sub-Regional Workshop Establishment of National Development Partners Group National Workshop and Follow Up
Fast Facts Since 2002: 37. . . the number of African countries in the Accelerate networks 76. . . the number of agencies, NGOs and development partners that have participated in the process 60. . . the average number of days between training events 120. . . the total number of training days to date 1, 350. . the number of education sector staff that have participated in training events 162, 000. . . the number of person training days conducted
Objective 1: To promote leadership by the education sector and create sectoral demand for an HIV/AIDS response. Participation of countries in the Accelerate Initiative since 2002
2002 Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops █ East Africa
2003 Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops █ East Africa █ Nigeria
2003 Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops █ East Africa █ Nigeria █ Central Africa
Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops 2004 █ █ East Africa Nigeria Central Africa Anglophone West Africa
Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops 2004 █ █ █ East Africa Nigeria Central Africa Anglophone West Africa Francophone West Africa (Madagascar observer)
Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops 2004 █ █ █ East Africa Nigeria Central Africa Anglophone West Africa Francophone West Africa (Madagascar observer) █ Lusophone Countries
Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops 2006 █ █ █ East Africa Nigeria Central Africa Anglophone West Africa Francophone West Africa (Madagascar observer) █ Lusophone Countries
Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops and National Follow-up 2006 █ Sub-regional participation only █ Countries with National Follow-up
Objective 2: To harmonize support among development partners, in order to better assist countries and reduce transaction costs. 25 Civil society Bilateral donors 20 UN agencies 4 6 7 8 11 8 15 8 4 2004 2 2005 3 1 4 2 4 8 2 6 5 3 3 Central Africa 3 2 Ethiopia Nigeria (5) 2 1 8 EAC 2 2 Senegal 2 EA Network Launch Lusophone Africa Francophone Africa 4 2 2 Sierra Leone 2 4 Burkina Faso 7 2 Nigeria 7 3 5 4 2006 United Republic of Tanzania 2003 Nigeria (1) Nigeria (2) 3 7 1 2 Nigeria (6) 7 5 2 4 Curriculum Workshop 8 5 East Africa Meeting East Africa 2002 5 2 2 4 Ethiopia 2 7 4 0 2 3 Nigeria (3) 5 1 2 2 Central Africa 5 1 5 3 Zambia 3 7 6 3 Anglophone W Africa 10 9 5 The Gambia 4 Level of representation of UN agencies, bilaterals and civil society organizations at the sub-regional and national level workshops and Network meetings held since 2002
Degree of participation of development partners in in subregional and national level workshops held since 2002
Objective 3: To promote coordination with the National AIDS Authorities, and enhance access to HIV&AIDS funds. Chronology of the initiation of Mo. Es accessing funds from their NACs
Objective 4: To enhance availability and sharing of information on HIV and AIDS that is of specific relevance to the education sector. Total number of website hits on www. schoolsandhealth. org each month, January 2003 – December 2006 Additionally, To date, approximately 250, 000 hard copies of 95 titles have been distributed in at least the three main languages.
The sub-Regional Networks of HIV and AIDS Education Focal Points • West Africa Network (ECOWAS and Mauritania) 16 countries: launched in 2004 • Eastern Africa Network 7 countries: launched in 2006 • Lusophone Africa (PALOPS) 5 countries: launched in 2006 • Central Africa Network (ECCAS/SEMAC) 7 countries: launched in 2006
Objective 5: To strengthen the technical content and implementation of the education sector response to HIV&AIDS. Progress made in the implementation of some activities in the area of policy against the number of activities carried out under the Accelerate Initiative. Progress made in the implementation of some activities in the area of prevention against the number of activities carried out under the Accelerate Initiative.
Key changes since EFA 2000 • More holistic approaches to school health, and increasing recognition of the need to work across the whole school • More harmonization among sectors and development partners – more cost-effectiveness, lower transaction costs and less confusion • More partnerships across sectors and among development partners around School health programs in low and middle income countries
Key issues going forward • FRESH framework does not reflect developments, eg, in health promotion, addressing violence etc…needs to be RE-Freshed • Accountability and monitoring of health issues by the education sector often the weakest part of the program…need for a common set of indicators • Focus on low income countries has missed opportunities for cross learning with high and middle income countries…. need for information sharing among networks
For more information, please visit: www. schoolsandhealth. org
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