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School health nutrition for all

  A reality

SIMONE GALIMBERTI

The quest for an inclusive and accessible education can be effectively translated into reality if along the existing initiatives like scholarship for disadvantaged groups, multi lingual education, special provisions for differently

able children, the local schools are turned into hubs for health and hygiene promotion.

The latter option could be seen as a true game changer in the education and health sector thanks to the School Health and Nutrition, SHN model. The concept is simple, new and “Fresh” in the sense that is based on the internationally accepted model of “Focusing Resources for Effective School Health”. Imagine if certain basic health services, like vision, hearing and height screenings are offered at school level, think if a local teacher with the support of the local child club can monitor the hygiene status of the students, considers the benefits of offering simple oral health services to all students.All these could be done through periodic checkups, awareness making activities and involvement of the communities. We are not talking about schools replacing local health posts but rather extending the services of national health system through local schools.

The good thing is that this scenario is not a far dream but it is actually a reality in Nepal. Still we are very far from extending and scaling it up to all the student population of the country. Indeed the “National Strategy on SHN” approved by the Government in 2006 is facing a midlife crisis: no more in its initial stage, it has not been incorporated neither mainstreamed into the national education system yet.

Unfortunately the School Sector Reform Plan does not even mention SHN but it was heartening to know that the Department of Education very recently requested the Ministry of Education to formally include SHN in the School Sector Reform Plan.

Now we have a huge opportunity offered by the “Multisectoral Nutrition Plan” recently finalized by the National Planning Commission. This ambitious plan brings on the same board different stakeholders engaged in the nutrition sector and, if fully applied end mainstreamed, offers a fantastic platform for fighting malnutrition at all the levels.

It is still to be seen how SHN that offers interventions also beyond the nutritional sector can be fully incorporated and mainstreamed in this plan but the evidence is strong for suggesting flexibility in finding venues for incorporating the School Health and Nutrition Strategy into Multisectoral Nutrition Plan.

Water and sanitation components are vital too. Without adequate WASH infrastructures and conducive habits, the concept of child friendly school will remain unrealized, hampering the efforts of the Government and donor communities in improving the quality of learning at school level. In few words, SHN is a soft approach but so holistic, integrated and comprehensive that the health indicators of the nation can be improved because of it.

Malnutrition can be reduced, infections can be prevented, and hygiene can be drastically enhanced because of sustainable and doable SHN approach.

It is sustainable because it integrates already existing services being provided by the Ministry of Health and Population with the overall efforts of the Ministry of Education to provide inclusive and quality education for all. It is doable because the schools and local communities can be put in charge of the program and do the work. Technical health personnel can play an important role, but we should not forget how much the communities can do with a little guidance and help.

What they simply need is some technical knowledge that can be easily transferred through accessible trainings and a bit of more cooperation between education and health authorities at local level.On positive note, a “Minimum Package of Interventions on SHN” has been developed by the National Network on School Health and Nutrition. The Minimum Package goes side by side with the “National Joint Action Plan on SHN” that offers a fantastic opportunity to scale up in gradual and sustainable manner the program at national level. This plan, although incomplete as it does not properly address the early childhood development for example, needs to be fully disseminated and better mainstreamed.

Interestingly, the Plan foresees the establishment of a new section within the Department of Education for SHN and WASH related matter. This new institutional set up will facilitate the implementation of health and hygiene related activities while ensuring better technical cooperation from the Ministry of Health and Population.

Coordination is the most indispensible element for successful implementation of SHN. Both Ministries of Education and Health and Population have fruitful cooperation at central level. Many of the SHN activities are already being implemented by the Ministry of Health and Population like distribution of de-worming tablets, iron folic supplementation tablets, first aid kits. Encouragingly mid day meals are distributed in 35 districts. The final goal would be to have health posts establishing a working relationship with the local schools for effective implementation of SHN activities.Let’s empower and equip our schools to become agents of change also in the promotion of health and hygiene. It is value for money and it makes sense.

The author is the Coordinator of the School Health Nutrition Network

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