Abstract
Award schemes and self-evaluation systems have been developed to implement the 'Health-Promoting School (HPS)' concept in European and Asian countries. While there have been many successes in these regions, the implementation of HPS in African countries has been minimal. This study evaluated the impact of a self-evaluation system on school health in Niger. A school health activity guide was developed and distributed to 1999 primary schools in the Niger Tahoua region to raise awareness and solve problems related to school health and hygiene. The number of schools that planned or implemented health-related activities, and the budget and implementation status of their activities was compared over 3 years (before, soon after, and 1 year after distribution). Focus group discussions (FGDs) were also conducted targeting Conseillers Pédagogiques (CPs), who supervise primary schools and teachers, primary school principals and members of Comité de Gestion des Etablissement Scolaire (COGES), which is a type of school steering committee. The number of schools planning at least one health-related activity increased from 47% to 79% soon after distribution of the guide (p <0.001).The number of schools implementing activities increased from 44% to 65% one year after distribution (p <0.001). Health-related budget per school also increased after distribution (p <0.0001) and increases were maintained 1 year after the intervention (p=0.8414). Fulfilment or partial fulfilment rates for health-related activities were lower compared with other (non-health) activities in all three years (80%, 77% & 84% in health-related activities vs 88%, 90% & 91% in others; p <0.001, p <0.001, & p=0.004, respectively). Most FGD participants expressed a positive impression of the program and noted the usefulness of the guide. However, some respondents reported difficulties, especially in relation to budget. The introduction of a health activity guide for self-assessment was effective in increasing health-related activities in primary schools in Niger, where a simple monitoring system should be introduced to establish the HPS concept.
Highlights
Award schemes and self-evaluation systems have been developed to implement the 'Health-Promoting School (HPS)' concept in European and Asian countries
In Thailand, the award scheme is implemented with a self-evaluation system that aims to raise awareness and to solve health-related problems through school-related personnel using a comprehensive school health check list that lists the goals that must be achieved in order to become an HPS6,7
Some other Asian countries such as Lao PDR and Cambodia, use school health self-evaluation systems which were created by a simplification of the award scheme[9,10]
Summary
Award schemes and self-evaluation systems have been developed to implement the 'Health-Promoting School (HPS)' concept in European and Asian countries. Its core components are ‘school health policy’, ‘skills-based health education’, ‘health services’ and ‘healthy psychosocial and physical environment’ Another important implementation strategy for HPS is the collaboration between the health and educational sectors at three different levels: international, national and local (provincial, district, and schools)[3]. An award scheme for healthy schools as a means of implementing the HPS concept has been popular in European countries[4,5] It provides a structured framework, healthrelated targets and external support to help schools become HPS. In Thailand, the award scheme is implemented with a self-evaluation system that aims to raise awareness and to solve health-related problems through school-related personnel (teachers, pupils, parents and community) using a comprehensive school health check list that lists the goals that must be achieved in order to become an HPS6,7. Some other Asian countries such as Lao PDR and Cambodia, use school health self-evaluation systems which were created by a simplification of the award scheme[9,10]
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