Health Promotion in Schools: When will we take the step forward?

Article in local newspaper “Peloponnisos”

Apostolos Vantarakis, Professor of Public Health, Medical School, University of Patras

According to the 1986 Ottawa Charter on Health Promotion: “Health is a goal of daily life, not an object of life itself. It’s a positive concept that emphasizes social and personal resources as well as physical capabilities”.

No education system is effective unless it promotes the health and well-being of students, staff, and the community. These strong links have never been more visible and compelling than in the context of the COVID-19 pandemic. An approach to school health promotion was introduced more than 25 years ago and has since been promoted worldwide. However, the ambition of a fully integrated, sustainable School of Health Promotion system has not yet been achieved, and very few countries have implemented and maintained this approach on a large scale. A health promotion school, according to the World Health Organization, is a school that continuously enhances its capacity as a healthy living, learning, and working environment.

A holistic school approach brings together school principals, students, staff, families, and the wider community to work together to support and promote the health and well-being of the school community. It integrates what is taught through the curriculum with the natural environment, culture, policies and procedures of the school and with the collaborating organizations and services that they and others can offer. These programs are specialized by the school as they are likely to reflect the school’s priorities and have the support of creating sustainable change. The framework for health-promoting schools is a model that takes into account the broad health needs of all members of the specific school community (students, parents / carers, school staff and the wider community). These health needs are addressed collectively using a combination of strategies linked to the three interrelated elements of the framework illustrated in the figure below: Curriculum, teaching and learning. School organization, ethos, and environment and finally collaborations and services.

Why cooperate at a school community level to promote health?

Over the past two decades, health promotion has evolved from a focus on changing individual behavior to a broader view that includes social, economic, and other determinants of health. It is clear that health education alone has a limited effect on the health of the population. People’s health behaviors are determined by the context of their daily lives. Changes in health behaviors are more likely to occur when supported by changes in the environment, public policy, community support, and community action. For example, sun protection behavior is more likely to apply when a school has adequate shading for children, teachers reinforce and support sun protection messages, sports activities take place during periods of lower sun exposure, and the school has a children’s policy to wear protective clothing.

The World Health Organization describes environments, such as schools, as places where “people live, work and play.” Recommends the use of a holistic approach towards improving health. This view has become increasingly important, leading to the development of the World Health Organization’s School Health Promotion framework. Schools have been shown to have a significant protective effect on a wide range of health issues for young people. Researchers have found that teens who feel that their schools care about them and think they belong in their school are less likely to engage in risky activities than those who feel excluded from school. The health benefits of working with schools have been well documented. The school environment and the community are more likely to lead to an improvement in the health of school-age children. One-off sessions and talks on health education and strategies that do not recognize the interconnectedness of health issues are less effective. It has been confirmed that piecemeal efforts in health education are unlikely to have a significant impact on student health behavior.

A school for the promotion of health according to the WHO:

• It must promote health and learning by all means at its disposal.
• Involves health and education executives, teachers, teachers’ associations, students, parents, health professionals and community leaders in efforts to make the school a healthy place.
• Strives to provide a healthy environment, adequate school health education and school health services along with school / community projects and promotion, staff health promotion programs, nutrition and food safety programs, physical education and leisure opportunities, and counseling programs; social support and mental health promotion.
• Implements policies and practices that respect the well-being and dignity of an individual, provide multiple opportunities for success, and recognize good efforts and intentions as well as personal achievements.
• Strives to improve the health of school staff, families and community members, as well as students.

Collaborates with community politicians to help them understand how the community contributes to, or undermines health and education.

Important levers for transforming a school into a Health Promotion School

1. Strengthen cross-sectoral cooperation and coordination of many actors.
2. Development and improvement of health policies.
3. Empowerment of the school’s administration and administrative practices.
4. Financial resources.
5. Apply documented practices.
6. Empowerment of the school’s collaborations.
7. Investment in school infrastructure.
8. Development and support of knowledge.
9. Access to the education of the school community.
10. Access to health services at school.
11. Involvement of students.
12. Involvement of parents and local community health staff.
13. Evaluation and improvement.

iLearn4Health in the service of Health Education

With the above mindset, and considering the need for education to move towards a more digitalized path, iLearn4Health came to life. An Erasmus+ project, which focuses on providing high-quality health education in Primary Schools. By implementing the Game-Based Learning Method (DGBL), while at the same time developing digital training programs for teachers, iLearn4Health puts itself in the service of Primary Education; Students will have the chance to become educated on the values of health and personal hygiene, and at the same time teachers will be empowered, and their educational arsenal expanded, via the courses and tools focused on them.

iLearn4Health is rolling! Stay near!