This paper was presented in a workshop for Head Teachers of Secondary Schools of Eastern region of Uganda which was held at St. Austin Catholic Community Centre in Mbale , Uganda on the Friday, 15th June 2012 organised by Eastern Region Secondary Schools Head Teachers’ Association , an Association of Head Teachers’ of Secondary Schools in Eastern Uganda.

1. HEALTH, SANITATION AND
ENVIRONMENT IN SCHOOLS
By:
Ilukor Geresom,
Msc.PH.
Academic Registrar

2. Performance Objective
By the end of the workshop...;
“The school leaders and managers should
be able to intiate and implement
programs and projects in their schools
to promote good health , sanitation and
environment in Schools to make them
conducive for teaching and learning to
take place.

3. By the end of the presentation, the Participants
should be able to....;
a.Define the terms;
 Health
 Sanitation
 Environment
 Environmental sanitation
b. Give a general overview of health, sanitation and
environmental issues in the world and in schools.
Presentation learning objectives

4. Presentation learning objectives
(cont.)
d. Explain what is meant by Health Promoting
School.(HPS)
e. Identify the qualities & characterisitcs of Health
Promoting schools.
f. Explain the components of a HPS.
g.Identify key health , sanitation and environment
activities that can be intiated and implemented in
schools.

5. Presentation learning objectives
(cont.)
h. Identify strategies that can be used to
promote health, environment in secondary
schools.

6. Definitions
a. Health;
 According WHO (1945), Health is defined as ; a state of
complete physical,social and mental well being of an
individual and not merely the absence of disease and
infirminity (disability).
 The definition of health health now is holistic i.e. It has
expanded to inlcude psychological , economical etc.
dimensions of life.
 It is a total sum of all the aspects that make up the life of a
person

7. Definitions (Cont.)
b. Sanitation
 World Health Organization (WHO) defines sanitation as
group of methods to collect human excreta and urine as
well as community waste waters in a hygienic way, where
human and community health is not altered.
 Sanitation methods aim to decrease spreading of diseases
by adequate waste water, excreta and other waste
treatment, proper handling of water and food and by
restricting the occurrence of causes of diseases.

8. Definitions (sanitation ..cont.)
 Sanitation is a system to increase and maintain healthy life
and environment. Typically health and hygiene education
is connected to sanitation in order to make people
recognize where health problems originate and how to
better sanitation by their own actions.

9. Definitions (cont.)
c. Environment:
 Is anything given by nature which exists as external
to man.
 The environment can be organic (biotic) or inorganic
(abiotic).
 Its composed of biological, physical, social,
economic etc. components/factors.

10. Definitions (cont.)
d. Environmental Sanitation
 Activities aimed at improving or maintaining the standard
of basic environmental conditions affecting the well-being
of people.
 These conditions include clean and safe water supply,
clean and safe ambient air, efficient and safe animal,
human, and industrial waste disposal, protection of food
from biological and chemical contaminants, and adequate
housing in clean and safe surroundings. Also called
environmental hygiene.

11. Overview of health, sanitation and
environmental issues in the world and in
schools.
 According to UN, A child dies every 15 seconds from
disease attributable to unsafe drinking water, deplorable
sanitation and poor hygiene.
 As of 2012, 2.6 billion people, approximately 41 percent,
are without improved sanitation. Even worse, many of the
world’s school children attend a school without water or
toilets.
 Not surprisingly, 40 percent of the world’s school-age
children have worm infections, predisposing them to
cognitive and developmental problems

12. Overview of health, sanitation and
environmental issues in schools.(Cont.)
 About 5,000 children die every day from diseases because
of lack of safe drinking water, inadequate sanitation, and
poor hygiene (WSSCC, 2004).
 In sub-Saharan Africa in countries such as Ethiopia,
Rwanda and Uganda, four out of five children who drink
unclean water are affected by diseases such as cholera and
infant diarrhoea.

13. Overview of health, sanitation and
environmental issues in schools. (cont.)
 According CHD –MUK , The latrine stance per pupil
stance is at 60:1 higher than the set standard of
40:1.
 Schools in eastern region (93:1) and northern (73:1)
had highest ratio but also least proportion of schools
(eastern-15% and northern-22%) meeting set
standards, compared to Kampala primary schools
(33% met standards). More private (42%) than
government primary (25%) and more secondary
(57%) than primary (25%) schools met set
standards.

14. Overview of health, sanitation and
environmental issues in schools. (cont.)
 Close to 80% did not allocate separate toilet facility
for specific classes.
 Hygiene was poor especially in the Northern and
Eastern regions, floors in most secondary schools
(79%) were wet and dirty while walls were smeared
with faces in ¼ secondary schools visited.

15. The Health Promoting school
(HPS) concept.
 According WHO;-
 A health promoting school is one that constantly
strengthens its capacity as a healthy setting for living,
learning and working.
 A health promoting school is one that is based on a social
model of health. This model takes into account the
physical, and social and emotional needs of all members
of the school community. Schools are in an ideal position
to promote and maintain the health of children, young
people, school staff and the wider community.

16. The health promoting school
concept (cont.)
 The Health Promoting Schools concept is based on the
principles of the Ottawa Charter for Health Promotion
(Ottawa, 1986) and was initiated by the World Health
Organisation.
 Together, members work towards providing students with
positive experiences and structures that promote and
protect their health. These health needs are addressed
through the three components of the Health Promoting
Schools Framework.

17. Principles of health Promoting
schools.
 A health promoting school is one that;
a. Promotes the health and wellbeing of students.
b. Upholds social justice and equity concepts.
c. Involves student participation and empowerment.
d. Provides a safe and supportive environment.
e. Links health and education issues and systems.
f. Addresses the health and well being issues of staff.
g. Collaborates with the local community.

18. Principles of health Promoting
schools.(cont.)
 Integrates into the school’s ongoing activities.
 Sets realistic goals
 Engages parents and families in health promotion .

19. Importance of Health promoting
schools
 Helps to raise student achievement
 Helps to reduce inequalities in schools.
 It raises the status of the school.
 Learners’ personal, social , and health education is
enhanced.
 Supports’ children and young people in developing health
behaviour.

20. Components of a Health promoting
School.
 The Health Promoting School is based on the Ottawa
Charter for Health Promotion. It has a number of essential
components viz.
a. Healthy School Policies
 These are clearly defined in documents or in accepted
practices. The policies promote health and well being eg.
Policies which enable healthy food practices to occur at
school; policies which discourage bullying.

21. Components of a Health promoting
School.(cont.)
b. The School’s Physical Environment
 The physical environment refers to the buildings, grounds,
play space and equipment in and surrounding the school.
It also refers to basic amenities such as sanitation, water
availability and air cleanliness.
c. The School’s Social Environment
 The social environment of the school is a combination of
the quality of the relationships among and between staff
and students. It is influenced by the relationships with
parents and the wider community.

22. d. Individual Health Skills and Action Competencies
 This refers to both the formal and informal curriculum and
associated activities where students gain age-related
knowledge, understanding and experiences which enable
them to build competencies in taking action to improve
the health and well being of themselves and others in their
community and beyond
Components of a Health promoting
School.(cont.)

23. Components of a Health promoting
School.(cont.)
e. Community Links
 Community links are the connections between the school
and the students’ families plus the connection between
key local groups and individuals. Appropriate consultation
and participation with these stakeholders enhances the
HPS and provides students with a context and support for
their actions.

24. Components of a Health promoting
School.(cont.)
f. Health Services
 These are the local and regional health services which
have a responsibility for child and adolescent health care
and promotion, through the provision of direct services to
schools and in partnership with schools.

25. Key activities and requirements for
Health Promoting School
 The minimum requirements for health promoting schools
should based on the components below;
 Healthy policies
 Physical environment of the school.
 The school’s social environment;
 Community relationships;
 Personal health skills;
 Health services.

26. 1. Healthy policies
 School rules and regulations promoting health.
 Guidelines for maintenance of sanitation and environment
 Health, sanitation and environment Master and Prefect.
 School/staff health, sanitation, and environment
committee and also a students’ committee.
 School parades e.g. morning parades
 General cleaning day.
 Health, sanitation and environment competition day

27. 2. Requirements related to the physical
environment of the school.
 Buildings: Adequate well lighted and ventilated
classrooms, dormitories, office, teachers quarters, should
be accessible by both normal learners and those learning
barriers.
 Excreta: Adequate and clean facilities e.g. pit latrines,
water closets etc. for both sexes and for even children who
have differently abled (DA).
 Waste: Waste storage and disposal facilities e.g.
dustbins, refuse bins, incinerators, and sanitary pits.

28. 2. Requirements related to the physical
environment of the school.(cont.)
 Water: A Supply of adequate wholesome water
 Food : A supply of adequate and wholesome food
 Playgrounds: Sufficient for the number outdoor games
and sports at the school.
 Environment: Compounds should be adequate and clean
and talking compounds with trees (wind breakers/shade
trees), flowers gardens, clearly marked foot paths,
protected green areas.
 Clean air: in relation to the sorroundings.

29. 3. Requirements related to the school social
environment.(cont.)
 These include:-
 Student-Teachers meetings on health issues. Inviting
students to participate in staff meetings, serve on staff
parties etc.
 Open days.
 Music and Drama shows on health, sanitation and
environment issues with both the staff and students in
attendance.
 Receiving of freshers, etc

30. 4.Requirements related to community
relationships.
Schools should involve the community:
 Inviting the community members to meetings to seek
ways of health problems where community is located.
 Involve the local leaders to participate in lobbying &
advocacy for school health services.

31. 5.Requirements related to
personal health skills
 Students must be examined regularly through inspections.
 Students should be educated of the importance of personal
health equipment such as tooth brushes, soap, panties,
pads, bras etc.
 Should need to be educated on personal health skills such
as how to take care of them selves during menestruation,
how to brush teeth etc.
 Curriculum oriented skills such prevention of diarrhoeal
disease.

32. 6.Requirements related to health
services.
 Have sick bay or a health facility close to the school.
Health services for students should include:-
i. Counselling services
ii. Reproductive health services
iii. Mental health services
iv. Immunisation services
v. Treatment of common ailments and infections.
vi. Accidents and injuries

33. 6.Requirements related to health
services.(cont.)
 School based programs.
 Health programs for employees i.e. support staff and
teachers. key areas to address can be stress, HIV/AIDS
etc.

34.  What strategies can be used to
good health, sanitation and
environment in school?

35. Strategies to be used
 Developing partnerships between education and health
sector policy makers.
 Ensuring students feel they have some sense of ownership
in the life of the school.
 Diversity of teaching and learning strategies.
 Adequate time for class-based activities, organisation and
coordination, and out of class activities.
 Exploring health issues within the context of the students
lives and community.

36. Strategies to be used (cont.)
 Teaching and learning strategies which adopt a whole
school approach rather than primarily a classroom
learning approach.
 Providing on going capacity building opportunities for
teachers and associated staff.
 An excellent social environment which fosters open and
honest relationships within the school community.
 Consistency of approach across the school and between
the school, home and wider community.

37. Strategies to be used (cont.)
 A sense of direction in the goals of the school and clear
and unambiguous leadership and administrative support
 Resources which complement the fundamental role of the
teacher and which are of a sound theoretical and accurate
factual base.
 A democratic and participatory school community.

38. Health Promoting Schools
(As drawn by S.1 student)

39. Sources for School health Information
a. Local Sources:
 District health Officer’s office
 Hospitals like Mbale regional hospital
 Organizations' within the district like TASO,UNICEF etc.
 Schools like School of Hygiene-Mbale
b. National sources
 Ministry of Health
 Publications like Straight talk

40. Sources for School health Information
(cont.)
c. International Sources
 UNESCO: (FRESH) initiative
 (http://portal.unesco.org/education)
 Schools & Health (http://www.schoolsandhealth.org)
 Centers for Disease Control and Prevention (CDC)
(http://www.cdc.gov/nccdphp/publications)
 Education Development Center, Inc.
(http://www.edc.org/HHD)

41. Sources for School health Information
(cont.)
 Education International: Education for AIDS
(EFAIDS) (http://www.ei-ie.org)
The Education for AIDS (EFAIDS) programme
(http://www.who.int/school_youth_health/hivaids_projec
Partnership for Child Development and nutrition:
 http://www.child-development.org

42.  Thanks for listening!

43.  The End