Comprehensive School Health inKenya: Moving beyondInfrastructureDecember 2012
Background and ContextTotal population 40,863,000School aged population 10,624,380School going children 8,661,333Children out of school 1,963,047Population at risk of STH 9,108,952School aged 2,368,237
Vision 2030 guides Kenya’s development path in the long-term. TheVision is being implemented through three pillars namely economic,social and political. The social pillar aims to create a just, cohesive and equitable socialdevelopment in a clean and secure environment. Education and Training; Health and the Economy; Water andSanitation are three of eight key sectors under the social pillar. Poor primary school infrastructure is one of the major barriers toimproving access to primary education in Kenya. Empirical data show that physical facilities are an important factor inboth school attendance and achievement. Currently, Kenya has over 18,000 public primary schools and a largenumber of non-formal schools.
The Challenges of School Health Infrastructure• Major backlog ofinfrastructure provision• Existing infrastructure aregenerally in poor conditiondue to lack of investmentcapital, poor constructionstandards and inadequatemaintenance.• FPE has added pressure onexisting infrastructure.• ASAL areas and urban slumsare worst hit.• Maintaining school healthinfrastructure and quality oflearning environment• Deepening knowledge onapproaches that work• Transmitting policy goals,approaches and action down tothe school level• Capacity at all levels• Recurrent costs are significant• Addressing comprehensivehealth needs for pupilsThe OldChallenges………..………….Newchallenges
In School Health, a major lesson from the past is that payingemphasis to infrastructure expansion is necessary but notsufficient…Goal: Ensure equityof access to basiceducationImproved participation, quality oflearning environment and healthfor pupils in primary schoolsFacilityexpansion..Governancesystems..Recurrentcosts..M&ESystems....there are manymore elements
Providing Policy Support7%49%22%75%69%33%Under Kenya’s new constitutional dispensation, improved water, sanitationand hygiene helps fulfill every child’s constitutional right to health andeducation.Devolution and emphasis on self-local government at county level is anew variable.Stand alone interventions in school health – WASH, nutrition, diseasecontrol, special needs etc is not sustainable and increases waste.Resources mobilization is still a major challenge at all levels.Despite the FPE initiative, an estimated 1.7 million children and youth forvarious socio-economic reasons are still unable to access education throughformal school delivery channels.The political and policy environment is therefore gettingincreasingly complex, untested and unpredictable, hencemore demanding.
An enabling policy environment for sustainableschool health interventions is an importantprerequisite for:7%49%22%75%69%33%• Strengthening coordination of school health interventions byrelevant Ministries, communities and other stakeholders• Ensuring mechanisms are put in place for sustainability of schoolhealth programmes• Facilitating effective monitoring and evaluation of school healthinterventions.• Adequate resources mobilization• Creating school environments that encourage pupils especially girlsto complete their education. This has far-reaching implications forwomen’s health and Kenya’s economy.
Current situation in School HealthInterventions7%49%22%75%69%33%WHO UNICEFPartnersGoK WB WFPNGOsSchoolSustainability??VerticalInterventionsPoorCoordination…No reports…DuplicationSchool Managers areoverwhelmed
The policy environment• Momentum behind education• Current and planned investments in schoolWASH• Interested development partners• Many excellent policies• Low capacity for implementing them
Key Challenges Poor coordination Duplication of activities Interventions not sustainable Wastage of resources Lack of sharing of information Poor reporting Increasing disease prevalence of otherhealth related conditions leading to poorschool performance.
Implementation Cycle of CSH atschool levelMonitoringPolicy andGuidelinesSMCImplementationSituation AnalysisMake ActionPlanEvaluationReview1. Values and Life-skills2. Gender3. Child rights, protection andresponsibilities4. Water, Sanitation andHygiene5. Nutrition6. Disease prevention andcontrol7. Special Needs, Disabilityand Rehabilitation8. School infrastructure andEnvironmental safety
Ministry of EducationNational School Health Inter-AgencyCoordination CommitteeNational School Health Technical CommitteeProvincial School Heath CommitteeMinistry of Public Health and SanitationDistrict School Health CommitteeDivisional Health CommitteeZonal School Heath CommitteeSchool Management CommitteeHealth FacilityCommittee
Advocacy3 High-Level Objectives:1. Increase funding for operations andmaintenance costs in schools2. Improved monitoring and evaluation foraccountability3. Increase knowledge and improve behaviors
Results to Date• Doubling of operations funds for school WASH ($840,000/year)with potentially more to come• Funds allocated for sanitary pads for school girls last year• Agreement to develop a school health sustainability charterinclusive of school WASH• Agreement on need to improve M&E systems, including onneed for unified monitoring tool between ministries• Adoption of WASH curriculum and materials by KenyanInstitute of Education