Our previous quantitative study also showed that child clubs and special health classes were positively associated with students’ higher health knowledge scores and identified a positive association between better health and sanitation facilities and students’ improved hygiene practices . http://www.euro.who.int/__data/assets/pdf_file/0004/134671/e94805.pdf?ua=1, http://www.who.int/school_youth_health/gshi/en/index.html, https://journals.openedition.org/factsreports/306, http://www.healthpolicyplus.com/archive/ns/pubs/hpi/1155_1_PIAT_Paper_Taking_the_Pulse_of_Policy_acc.pdf, http://www.healthpolicyinitiative.com/policyimplementation/files/1155_1_PIAT_Paper_Taking_the_Pulse_of_Policy_acc.pdf, https://cergnyc.org/files/2016/09/ChildClubsofNepal.pdf, https://www.unicef.org/publications/files/CFS_WASH_E_web.pdf, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s41182-019-0159-4. However, the key impediments in implementing the program included a lack of coordination between stakeholders, lack of resources, limited training opportunities, and doubts regarding the sustainability of the program. The authors would like to express their sincere gratitude to all the key informants who participated in this study. The school nurse has a critical role within this school health program and provides acute, chronic, episodic, and emergency health care. Our findings suggest that the SHN program in Nepal was not an exception. BMC Health Serv Res. After receiving the messages from the school children, the communities have been empowered. In the past, students could not understand what they were taught. Some key informants from the central level and aid agencies stated that at the central level, the members of the SHN network and government actively participated in regular meetings to share and discuss the SHN program strategies, activities, and achievements. 2014;4(1):9–17. This document is available in the following languages: This document includes a chapter on national strategies in the ten most populous countries and a chapter on collaborative efforts to strengthen school health promotion in countries with large school-age populations. Many key informants also mentioned that the program improved the attendance, enrolment, and retention rates in schools. In the interpreting phase, we wrote summaries to interpret the data and discussed important quotations. Washington (DC): World Bank; 2006. This finding is encouraging and suggests that mobilizing community members to generate resources at the local level and reduce over-dependence on external aid agencies  may be effective to sustain SHN activities in Nepalese schools. PubMed Google Scholar. This study provided a deeper understanding of the linkage between the SHN program implementation, impact, and challenges in Nepal. None of the organizations go directly for the implementation of SHN. Summary . Field Actions Sci Rep. 2009;3 https://journals.openedition.org/factsreports/306. Improving children’s health and education by working together on school health and nutrition (SHN) programming in Nepal. Data will be available from the first author upon reasonable request made. INTRODUCTIONâ¢ School health is an important branch of community health. Key informants from the schools implemented and self-monitored the SHN program in the schools. Health-promotion activities have been successfully implemented through the SHN program in resource-rich countries [1, 5, 11]. Awareness campaigns and advocacy for the program are indispensable to pull more resources from relevant stakeholders. Even if they forget to bring tiffin, their parents bring it to school. Basch C. Healthier students are better learners: a missing link in school reforms to close the achievement gap. A health promoting school is a school that constantly seeks to strengthen its capacity to promote healthy living, learning and working conditions. (P4, aid agency: SHNP senior coordinator). Regarding training on SHN program implementation, stakeholders at districts and schools who had received training on SHN program implementation once, suggested that such training should be more frequent and longer and also mentioned that it should be expanded to other parts of the country. Hardee K, Irani L, Maclnnis R, Hamilton M. Linking health policy with health systems and health outcomes: a conceptual framework. Aid agencies were also playing significant roles in implementing programs in different parts of the country. After the SHN program started, there have been many improvements. To increase knowledge and awareness of health â¦ We do not and cannot do all the activities of the SHN program. J Sch Health. (P3, aid agency: WASH specialist), In the past, proper coordination and communication did not exist between schools and communities, so the communities used to be dirty with open defecation. Healthier students are better learners: high-quality, strategically planned, and effectively coordinated school health programs must be a fundamental mission of schools to help close the achievement gap. All authors read the manuscript and approved for submission. Majority of key informants from all levels mentioned that they conducted activities such as school cleaning programs, access to safe drinking water, improving toilet and hand washing facilities, waste disposal pits in school, construction of classrooms, toilets, etc. Students can be effective advocates for creating a healthy school â¦ Their perceptions are equally important to provide information on the factors influencing the implementation process and help to identify the gaps in such processes [9, 21]. School health pomponent of WHO’s Mega Country Network for Health Promotion. The Research Ethics Committee of the University of Tokyo and the Nepal Health Research Council (NHRC) approved this study. Second, we did not include parents as key informants in this study though they are important stakeholders in SHN program implementation and their perceptions might have given additional insights. Position Statement. It provides practical guidance, tools and descriptions of and tips from Health-Promoting Schools around the world. Article During the 4-year SHN project in Sindhupalchok and Syangja districts, teachers and staff from the District Education Office and District Health Office were trained once to conduct SHN program activities . volume 47, Article number: 32 (2019) This study further showed that the lack of trained human resources to implement SHN was another key impediment. Epilepsy Behav. They also suggested that all the teachers in the school should be trained. 2016;57(Pt A):77–81. Elementary school teachers play an important role in the education and development of children. Psychol Health. A discussion about teach-ing health on the School Nurse Listserv during May motivated me to write this editorial. (P4, aid agency: SHN program senior coordinator). Health Educ Res. Int J Qual Health Care. 6 Centers for Disease Control and Prevention. This study provided a deeper understanding of the linkage between the SHN program implementation, impact, and challenges in Nepal. This study was supported by a Grant from the National Center for Global Health and Medicine (http://www.ncgm.go.jp/) (grant number: 27S1). Despite the challenges, all the key informants in this study unanimously agreed to make efforts to increase the program sustainability, given its positive impact on students, schools, and communities. This suggests that only one sector was actively involved in the implementation of the SHN program in Nepal. Many schools did not have sufficient physical infrastructures or facilities to implement the program efficiently. What is an adequate sample size? Teachersâ role in the school mental health initiatives cannot be overemphasized. 2005;262(Suppl 2):S186–92 PubMed PMID: 16075568. But we are facing difficulties to expand the program because of financial problems. (P26, school: Chairperson, School Management Committee), By using available funds, we can conduct activities that only meet the indicators proposed by our headquarters. Suhrcke M, de Paz Nieves C. The impact of health and health behaviours on educational outcomes in high-income countries: a review of the evidence. The teachers in the project schools were trained to conduct SHN activities. In Scotland, the Chief Nursing Officer recommended that the role should be refocused. Challenges in developing health promoting schools’ project: application of global traits in local realm. Similar findings were also reported in the end-line survey of the SHN project conducted in Sindhupalchok and Syangja districts . Later, an open-defecation-free zone was declared in school catchment areas. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. PubMed Besides, insufficient human resources and physical infrastructures were other major hurdles. An effective teacher â¦ Some key informants also mentioned that they received support from communities to conduct SHN activities effectively. We have also prevented some kids from suffering permanent hearing loss. The key informants were identified through personal network and snowballing procedure. In addition, the school nurse provides health education and health counseling and advocates for students with disabilities. The open defecation decreased and more toilets were built. By using this website, you agree to our Strategic Objectives. J Sch Health. We all go through SHN network, which has been a good mechanism where we can coordinate." These findings indicate that SHN program has helped to sensitize parents and community members about child health-related issues and promoting healthy behaviors; therefore, they also benefited from the program. Resilience is the ability to cope and thrive in the face of negative events, challenges or adversity. The authors would also like to thank Editage, Japan, for English language review. The key informants from the aid agencies were involved in supporting the MOE and MOH to implement the program as well as in monitoring and supervising the programs implemented in the schools. 2011;81(10):650–62. SCHOOLS AND teachers have an important role in the recognition of mental health â¦ USA and Canada: RoutledgeFalmer; 2002. These meetings might be helpful to improve program implementation . So this is about the behavior change among students as well as their parents. Starting in kindergarten and continuing through high school, it provides an introduction to the human body and to factors that prevent illness and promote or damage health. 2016;11(11):e0166001. To improve the quality of the SHN program, generating evidence is essential. According to many key informants in this study, a broad array of stakeholders was involved from the central level to schools in implementing the SHN programs based on the SHN strategy in the country. They further suggested that improved health has a positive impact on students’ academic performance. Our study further highlighted that stakeholders from all tiers should coordinate and collaborate adequately to continue their efforts to implement and expand the program nationwide. Health Educ Res. 3. We have obtained the ethical approval from The Research Ethics Committees of the Graduate School of Medicine at the University of Tokyo and Nepal Health Research Council. The seven districts were Siraha, Sindhupalchok, Syangja, Kailali, Kathmandu, Lalitpur and Bhaktapur. This finding may imply that healthy students attend school more regularly and stay longer in schools, which can have a positive impact on their academic performance [34, 35]. 8 The school is now included as an important â¦ BMC Public Health. Whitman C. Case studies in global school health promotion: from research to practice. California Privacy Statement, Despite these challenges, all the stakeholders acknowledged that the SHN program had positive effects on students, schools, and communities and provided some suggestions to improve the implementation of SHN program in the country. Many school nurses wonder about their role as health educators in schools. We found half of teachers have raised at least one mental health issue about a pupil in the last month. Teachers are increasingly being called upon to monitor the mental health and wellbeing of their pupils. (P18, district level: District Public Health officer, District Health Office), Physical screening has helped us to identify vision and hearing impairments. Many positive changes in the school nurse provides health education and health counseling and advocates students! Seeks to strengthen efforts within the whole school community in favour of malaria and. In most school districts, April 25, 2008 they also suggested that good coordination the. 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