Wash in schools davos 18 nov 2013


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GRF 2nd One Health Summit 2013: Presentation by Natalie Roschnik, School Health and Nutrition Advisor, Save the Children

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  • I am going to talk to you about WASH in schools, and School Health and Nutrition more generally which is a partnership between the health and the education sector to help advance the goals of both sectors.
  • But before that let me tell you about Save the Children and why I am here today:Save the Children which used to be made up of 29 separate organisations is now one organisation with a common mission and strategies, reaching 125 million children in nearly 120 countries with multisectoral programs which aim to bring positive lasting change to children and their families.Our strategy to bring lasting change (our theory of change ) is to build evidence, use the evidence to advocate for and then support scale up through partnership with governments and other implementing and research agencies
  • The reason Save the Children was asked to speak today is that we are one of the leading international agencies supporting the implementation of School Health and Nutrition programs. WASH in schools is one key element of School Health and Nutrition. Our SHN programs now reach nearly 30 countries around the world.Today I will talk to you about health programming within the education sector (SHN), specifically WASH in schools to show why it is important for both the health and education sector, yet is often not prioritized. And why it is important for girls education most importantly
  • School age children are not typically a priority for the health sector because they are less at risk of dying.. Yet they do representat a School age children represent a large portion of the population, which is mostly ignored by the health sector because they are not at a high risk of dying. They are the survivors.Yet they have amongst the highest burdens of disease (often invisible) which is preventing them from participating and learning in school and is contributing to disease transmission in the community. For example, school age children have the highest rates of intestinal worms, bilharzia and malaria, and high rates of anemia. They are least likely to seek and get treatment because they have developed immunity and are not ‘visibly’ sick. Here is a primary school class in Mali. Based on survey results in this area, in this class, 80% are likely to have malaria parasites in their blood (with no symptoms), 40% hookworm and 65% anemia. Many will also have diarrhea or may be hungry because they came to school without breakfast. All of which are not “visible’ But are preventing them from concentrating and learning.
  • Schools have a paid (usually) professional workforce and there are more schools than health centers. Schools therefore provide a great opportunity to bring behavior change amongst school chidlren and their non enrolled peers and families.
  • Bearing in mind a few challenges e.g. this first grade class in Malawi, wih 450 children enrolled and 200 present on this day – with one teacher!
  • Here is the situation in a country like Mali. These are the results from a baseline survey for the Dubai Cares funded WASH in schools project which is being implemented by 5 agencies, including Save the Children. The map shows the percent of schools with separate improved latrine facilities by region. Most schoolsactually have latrines, water points and evenhandwashingfacilities but they are inadequate. (seebullets)
  • Kids, especially small ones are often scared of using the latrines for different reasons e.g. the hole is too big and they are scared of falling in. There is nothing to hold onto, the latrine rooms are smelly and dirty
  • The impact on girls is particulary bad, especially when they are menstruating. Impact on education (notes from Brad Kerner Sarah Bramley presentation)Adolescent girls face particular challenges in the school environment. Poor water supply and inadequate sanitation facilities to allow girls to handle their menstruation with dignity, can all contribute to an uncomfortable learning environment for girls. Inadequate sanitary protection materials may lead to blood leaking and staining clothes causing stress and the fear of teasing by boys. Teachers, particularly male teachers, may not be aware of how to support girls to manage menstruation, and may even refuse girls’ requests to visit the latrine and making them stand up when answering questions. A number of studies report that such factors result in girls missing school during their menstrual periods and can even be a contributing factor to some girls dropping out of school. Recent studies have also indicated that child survival is more closely linked to their mother’s education level than their poverty level, so contributing factors which reduce educational opportunities for girls potentially have wide ranging implications to my sector, the health sector Gakidou, E, Cowling, K, Lozano, R, Murray, C.J.L (2010) Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis, Lancet 2010, 376: 959–74
  • 53 seconds: Tadala Interview explaining how she misses around 5 days per month of school when she menstruates
  • So what is the solution? How can the health and education sector work better together to improve the health situation in schools.At the World Education Forum in Darak in 2000, international agencies agreed that School Health and Nutrition (which includes WASH in schools) is essential for achieving education for all goals and improving learning outcomes.
  • The Dubai Cares funded WASH in schools program is a great example of a partnership to improve WASH in schools at national level. It reaches 6 out of the 9 regions of mali, 1400 schools and over half a milion children
  • With a strong community component through Community Led total sanitation, a highly effective method to get community commitment and action to improve the WASH situation both at school and community level. This has been particularly successful in Mali.
  • It’s about Puberty education
  • Starting before girls begin to menstruate
  • Wash in schools davos 18 nov 2013

    1. 1. WASH IN SC H OOLS: Healthy to Learn and Learn to be Healthy Natalie Roschnik, School Health and Nutrition Advisor, Save the Children GRF, Davos, One Health Summit, 18 November 2013
    2. 2. Save the Children: Where we work Health and Nutrition Education & Child Development Child Protection & HIV AIDS Hunger and Livelihoods Humanitarian response In 2012, Save the Children helped more than 125 million children in nearly 120 countries
    3. 3. WASH in schools in 29 countries (School Health and Nutrition) Tajikistan Armenia Afghanistan United States (Domestic Programs) Egypt Pakistan Haiti Dominican Republic Guatemala Mali Sudan Yemen China Nepal Bangladesh Philippines El Salvador Burkina Faso S. Sudan Ethiopia Vietnam Kenya Malawi Bolivia Mozambique Indonesia
    4. 4. Outline  School age children and the education system  WASH situation in schools  WASH and girls education  The international FRESH Framework:  Healthy to learn, learn to be Healthy  Case study Mali  Menstrual Hygiene Management  Conclusion
    5. 5. Why focus on school age children?   They suffer from some of the highest burdens of diseases  80% have malaria School age children represent 26% of the population in Africa Which prevent them from learning and contribute to disease transmission in the population  School children are great agents of change within the community  They are the parents and leaders of tomorrow 65% are anemic 40% have hookworm
    6. 6. More children in school than ever before
    7. 7. What schools have to offer  There are more schools than health centers  A paid professional (usually) workforce in daily contact with school children and the community  Children with willingness and potential to bring change within their households and capacity  School Management Communities  Linkages with the health sector 7
    8. 8. With a few challenges…
    9. 9. ... And gender discrepancies exist
    10. 10. Discrepancies within and between countries and high drop out rates 69 million primary school-age children out of school (UNESCO) 75-101 million children in school are likely to drop out before completing primary school (UNESCO) 272 million school days lost each year due to diarrhoea alone (WHO) 2 out of 3 schools lack decent toilets in the developing world (UNICEF)
    11. 11. WASH situation in schools in Mali     Results from Dubai Cares funded WASH in schools project in 6 regions 80% of schools have latrines but only 12% have separate latrines that meet norms 48% have a water point but only 7% are functional and meet norms 32% have handwashing facilities but only 8% have water and soap Only 5% of students were observed washing hands after leaving the toilet
    12. 12. Latrines scolaires
    13. 13. Avoiding the hole
    14. 14. Open air defecation Latrines scolaires
    15. 15. Défécation en plein air
    16. 16. Défécation en plein air
    17. 17. A water point, but no water Points d’eau
    18. 18. A hand-washing facility, never used
    19. 19. Girls are most effected
    20. 20. 20
    21. 21. FRESH Framework: an international framework Focusing Resources on Effective School Health At the World Education Forum, Dakar, 2000 International Agencies agreed that School Health and Nutrition is essential for reaching Education For All goals and learning outcomes
    22. 22. The Four Pillars of FRESH Equitable School Health Policies WASH in schools (in 4 pillars) Safe Learning Environment Healthy to learn and learn to be healthy School based School Based Health and Nutrition health and nutrition services Services Skills based health education
    23. 23. WASH in schools in Mali • 1 400 schools • 6 regions • > 560 000 schoolchildren
    24. 24. Partnership and coordinator for scale up Interagency Steering Committee Coordination Unicef Care Oxfam - Interangency project coordinator - interagency MEL coordinator Save WaterAid - Project coordinator - Project coordinator - Project coordinator - Project coordinator - Project coordinator - Focal point ‘hard’ - Focal point ‘hard’ - Focal point ‘hard’ - Focal point ‘hard’ - Focal point ‘hard’ - Focal point ‘soft’ - Focal point ‘soft’ - Focal point ‘soft’ - Focal point ‘soft’ - Focal point ‘soft’ - Focal point ‘MEL’ - Focal point ‘MEL’ - Focal point ‘MEL’ - Focal point ‘MEL’ - Focal point ‘MEL’
    25. 25. Common infrastructure norms FAC ADE PR INCIPALE Norms:  Distance to the classrooms (20-30m), to waterpoint (minimum 15m) etc.
    26. 26. Common Materials
    27. 27. Community Led total Sanitation 27
    28. 28. Menstrual Hygiene Management
    29. 29. Hopes and Dreams
    30. 30. Very Young Adolescent Workbooks Puberty and MHM Gender Norms
    31. 31. Conclusions       School Health and Nutrition = Healthy to Learn and Learn to be Healthy WASH in schools is part of School Health and Nutrition It’s a partnership between education and health sector SHN important for Education and Health It is especially important for girls education Let’s not forget Menstrual Hygiene Management (MHM), part of WASH in schools
    32. 32. Thank You!