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School Health and Nutrition Manual
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BOXES AND FIGURES ii STEP 6 EVALUATION 35, ABBREVIATIONS AND ACRONYMS iiii STEP 7 LESSONS LEARNED 37. ACKNOWLEDGMENTS iv GLOSSARY 39, BACKGROUND 1 LIST OF USEFUL RESOURCES 42. SCHOOL HEALTH AND NUTRITION SHN PROGRAMS 1, THE INTERNATIONAL FRESH FRAMEWORK FOR SHN 2 REFERENCES 43. SAVE THE CHILDREN S SHN EXPERIENCE IN MALAWI 3, ANNEXES 45. INTRODUCTION TO THE MANUAL 5 ANNEX A KEY QUESTIONS TO GUIDE A SITUATIONAL ANALYSIS 46. ANNEX B RESULTS OF THE SITUATION ANALYSIS IN MANGOCHI DISTRICT 49. STEP 1 SITUATION ANALYSIS 7 ANNEX C SITUATION ANALYSIS SUMMARY TOOL TO COMPLETE IN STEP 1 51. CONDUCT A SITUATION ANALYSIS 7 ANNEX D KEY STRATEGIES MATRIX TO USE IN STEP 2 52. PREPARE TO MOBILIZE THE COMMUNITY 9 ANNEX E SAVE THE CHILDREN S SUMMARY IMPLEMENTATION. PLAN TOOL FOR MANGOCHI DISTRICT 57, STEP 2 PROGRAM DESIGN 11 ANNEX F SHN INDICATOR REFERENCE SHEETS TO USE IN STEP 3 58.
CREATE AN SHN RESULTS FRAMEWORK 11 ANNEX G SAVE THE CHILDREN S RESULTS INDICATOR. SELECT SHN STRATEGIES 12 PLANNING TOOL RIPT FOR MANGOCHI DISTRICT 63. COMPLETE A SUMMARY IMPLEMENTATION PLAN TOOL 13 ANNEX H PROCESS INDICATOR TOOL TO COMPLETE IN STEP 3 67. DEVELOP A COMMUNITY MOBILIZATION PLAN 14 ANNEX I STRATEGIES IMPLEMENTED BY THE SHN PROGRAM. IN MANGOCHI DISTRICT 68, STEP 3 MONITORING AND EVALUATION PLAN DESIGN 15 ANNEX J RAPID ASSESSMENT AND DECISION CHARTS FOR. COMPLETE THE RESULTS INDICATORS PLANNING TOOL 15 SCHISTOSOMIASIS AND SOIL TRANSMITTED HELMINTHIASIS 76. COMPLETE THE PROCESS INDICATOR TOOL 15 ANNEX K DOSAGE FOR CALCULATING THE NUMBER OF. ORGANIZE THE COMMUNITY FOR ACTION 16 PRAZIQUANTEL TABLETS NEEDED FOR DEWORMING 78. ANNEX L DRUG USAGE FOR IRON AND VITAMIN A, STEP 4 BASELINE DATA COLLECTION 17 SUPPLEMENTATION AND DEWORMING 79. COLLECT BASELINE DATA 17 ANNEX M VISION SCREENING USING AN E CHART OR. SUPPORT COMMUNITIES TO EXPLORE SHN PROGRAM ISSUES 19 SNELLEN S CHART 82. ANNEX N TYPICAL ITEMS REQUIRED IN A FIRST AID KIT, STEP 5 IMPLEMENTATION AND MONITORING 21 PUPIL TREATMENT KIT 84. PROGRAM IMPLEMENTATION 21 ANNEX O MEASURES TO ENSURE SAFE WATER SANITATION. Support the creation of a National SHN policy 21 AND HYGIENE WASH IN SCHOOLS 85. Support the formation of SHN committees 22 ANNEX P PROGRAM ACTIVITIES AND THEIR RELATED MONITORING. Support the community to plan and act together 23 ACTIVITIES TOOLS 86. Build capacity of all stakeholders involved in program delivery 24 ANNEX Q LESSONS LEARNED FROM THE STRATEGIES IMPLEMENTED. Implement the SHN program strategies 25 IN THE SHN PROGRAM IN MANGOCHI DISTRICT 87. IR1 Availability of SHN services 25, IR2 Quality of the school environment 30. IR3 Knowledge attitudes and interest 32, IR4 Community support and policy 34.
PROGRAM MONITORING 34, Boxes and figures, Box 1 Sources for primary and secondary data during the situation analysis in Mangochi district 8. Box 2 Interventions selected and implemented in Mangochi district 12. Box 3 Community orientation in Mangochi district 16. Box 4 Summary of the baseline survey report for the SHN program in Mangochi district 18. Box 5 Creation of the National SHN Policy for Malawi 22. Box 6 SHN committees that were formed in Malawi 23. Box 7 Capacity building in the SHN program in Mangochi district 24. Box 8 Definition of safe drinking water sanitary latrine and hand washing facilities 31. Box 9 Lessons learned in the SHN program in Mangochi district 38. Figure 1 The FRESH framework 2, Figure 2 The CASP program cycle and the community action cycle CAC for community mobilization 5. Figure 3 Save the Children s SHN Results Framework 12. Figure 4 Pictorial depiction of a possible training tree 24. SCHOOL HEALTH AND NUTRITION MANUAL A GUIDE ON HOW TO IMPLEMENT PROGRAMS IN MALAWI BOXES AND FIGURES. Abbreviations and acronyms, ACT Artemisinin Combination Therapy KAP Knowledge Attitude and Practice. ADC Area Development Committee MALDECO Malawi Development Cooperation. AIDS Acquired Immune Deficiency Syndrome MICAH Micronutrient and Health. BCC Behavior Change Communication MK Malawian Kwacha. BMI Body Mass Index NGO Non governmental organization. CAC Community action cycle NTU Nephelometric Turbidity Unit. CASP Common Approach to Sponsorship Funded PEA Primary Education Advisor. Programming, PTA Parent Teacher Association, CDA Community Development Assistant. PTK Pupil treatment kit, CHAM Christian Health Association of Malawi.
PZQ Praziquantel, CHN Community Health Nurse, RIPT Results Indicator Planning Tool. DHS Demographic and Health Surveys, SHN School health and nutrition. DM E Design Monitoring and Evaluation, SMC School Management Committee. DPD N N diethyl p phenylenediamine, SO Strategic objectives. EDC Education Development Center Incorporated, EFA Education for All SP Sulfadoxine and pyrimethamine.
FAK First aid kit SSP Safe School Policy, FPE Free Primary Education STH Soil transmitted helminths. FRESH Focusing Resources on Effective School Health STI Sexually transmitted infection. Hb Hemoglobin TIP Trials of Improved Practices, HIV Human Immunodeficiency Virus UNAIDS Joint United Nations Programme on HIV AIDS. HSA Health Surveillance Assistant UNDP United Nations Development Programme. IDA Iron deficiency anemia UNESCO United Nations Educational Scientific and. IEC Information education and communication Cultural Organization. IGA Income generating activities UNICEF United Nations Children s Fund. INGO International non governmental organization US United States. IQ Intelligence Quotient WASH Water sanitation and hygiene. IR Intermediate results WHO World Health Organization. IU International Unit WMA Water Monitoring Assistant. SCHOOL HEALTH AND NUTRITION MANUAL A GUIDE ON HOW TO IMPLEMENT PROGRAMS IN MALAWI ABBREVIATIONS AND ACRONYMS. Acknowledgments, This manual would not have been possible without the hard work and dedication of the. Save the Children Malawi staff members who implemented the school health and nutrition. SHN program in the districts of Mangochi and Balaka In particular we would like to. thank Mary Mukaka Humphreys Kalengamaliro Mathews Chavunya Oddoi Chimpembe. and Master Chitabwino for sharing their experience. The manual was drafted by Mohini Venkatesh the SHN Specialist at Save the Children with. editorial input from Anastasia Said and design support by Helen Waller Natalie Roschnik. Seung Lee and Dan Abbott from the Save the Children SHN team reviewed the manual and. provided critical inputs in making this a technically sound document This manual was also peer. reviewed by Mpumulo Jawati SHN Specialist Joby George Senior Health Manager and Prince. Kasinja Sponsorship Manager at Save the Children Malawi Celine Gustavson Sponsorship. Program Advisor at Save the Children and Gail Snetro Senior Africa Regional Capacity. Building Advisor for Health at Save the Children, We are very grateful to the Malawi Country Office Director Michael McGrath for approving. funds for this manual and its publication The manual was produced using funds from Save the. Children s child sponsorship program, A special thank you also goes to the schools and communities of Mangochi and Balaka.
districts for allowing Save the Children to address their health and nutritional needs over the. period of the SHN program Last but not least we extend our heartfelt gratitude to the. Ministries of Education and Health and our partners in country without whose cooperation. Save the Children would not have been able to successfully implement its SHN program in. Malawi We hope that this manual will assist the Malawian Government as they continue to. implement SHN at the national level, SCHOOL HEALTH AND NUTRITION MANUAL A GUIDE ON HOW TO IMPLEMENT PROGRAMS IN MALAWI ACKNOWLEDGMENTS. Background, School health and nutrition programs, In recent years great progress has been made in improving child survival and increasing access to education. for school age children aged 6 to 18 years in the developing world Though they suffer lower mortality. than younger children school age children continue to face high levels of illness and malnutrition during. their crucial growing years decreasing their ability to pay attention and progress in school It is estimated. that 210 million school age children suffer from iron deficiency anemia IDA 60 million from iodine. deficiency 85 million from vitamin A deficiency and close to 800 million from soil transmitted worms 1. If left untreated these diseases can cause permanent impairment to their intellectual capacity chronic. illness and poor growth, Ensuring that children are healthy and able to learn is essential for an effective education system Good health. increases school enrollment and reduces absenteeism and brings more of the poorest and most disadvantaged. children to school many of whom are girls It is these children who are often least healthy most malnourished. and who will gain the most educationally from improved health Once healthy and well nourished they not. only stay longer in school they also learn more and become healthier and more productive adults. School health and nutrition SHN programs address the critical health and nutrition conditions that keep. children out of school and inhibit their ability to learn while creating a safe and supportive environment that. promotes healthy behaviors Simple interventions such as regular deworming and micronutrient. supplementation prevent children from becoming anemic and thus have a substantial effect on their school. performance The promotion of hygienic behaviors in schools such as hand washing with soap is among the. most effective ways to prevent diarrheal diseases and pneumonia which together are responsible for the. deaths of more than 3 5 million children under five. Schools are also a cost effective option to identifying and addressing priority health and nutrition problems in. children School based micronutrient supplementation and mass deworming do not require diagnosis and. selective treatment and cost anywhere between 4 and 30 US cents per child They have been shown to. improve school performance and restore losses of up to 21 IQ points 1 2 Because there are generally more. schools than health centers school based health interventions reach more homes and more children including. non school going children and their families, SCHOOL HEALTH AND NUTRITION MANUAL A GUIDE ON HOW TO IMPLEMENT PROGRAMS IN MALAWI BACKGROUND. The international FRESH framework for SHN, At the Dakar World Education Forum in 2000 international organizations including the World Health.
Organization WHO the United Nations Children s Fund UNICEF the United Nations Educational Scientific. and Cultural Organization UNESCO and the World Bank agreed that SHN was essential to reaching the. Education for All EFA Goals A framework was thus developed outlining the key elements of SHN. programming FRESH or Focusing Resources on Effective School Health is the framework for a common. approach to SHN programming see Figure 1 below It forms a starting point for program design and. establishes the basis for country programming The four components of the FRESH framework are. 1 Safe school environment This includes provision of safe portable water adequate sanitation and the. promotion of good hygiene practices for a safe and healthy school environment. 2 School health and nutrition policy This includes advocacy support and promotion of national and. school level SHN policies, 3 School based delivery of health services This includes micronutrient supplementation deworming. vision and hearing screening school based management of minor illnesses and injuries. 4 Skills based health education This component is centered on a behavior change approach to the. promotion of good health nutrition and hygiene and prevention of HIV. In addition the success of the program and sustainability of its achievements hinges on some key. supporting strategies, 1 Effective partnerships between teachers and health workers and between the education. and health sectors, 2 Effective community partnerships. 3 Pupil awareness and participation, Figure 1 The FRESH framework. SCHOOL HEALTH AND NUTRITION MANUAL A GUIDE ON HOW TO IMPLEMENT PROGRAMS IN MALAWI BACKGROUND. Save the Children s SHN experience in Malawi, Save the Children is one of the leading international non governmental organizations INGOs in the.
field of SHN SHN is one of the main program areas of Save the Children s efforts to support marginalized. communities with quality education Implemented in 20 countries across the globe Save the Children reached. nearly 1 5 million with its SHN programs in 2008 Other program areas of Save the Children s education work. are early childhood development basic education and adolescent learning. In Malawi Save the Children has served children since 1983 beginning with child sponsorship programs in 39. government schools in Mangochi district Over the years it has built a strong partnership with the Government. of Malawi Ministries at both national and district levels It has supported the government through implementing. village based schools strengthening the quality of education in government schools and a partnership project. to enhance child survival and reproductive health, In 1994 the Government of Malawi took an important step of introducing Free Primary Education FPE With. this move primary school enrollment increased almost by 50 as families who previously could not afford to. send their children to school could do so with the introduction of FPE However one of the key challenges. School health and nutrition SHN programs address the critical health and nutrition conditions that keep children out of school and inhibit their ability to learn while creating a safe and supportive environment that promotes healthy behaviors Simple interventions such as regular deworming and micronutrient supplementation prevent children from becoming anemic and thus have a substantial

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