|Promoting Health Through Schools - Report of a WHO Expert Committee on Comprehensive School Health Education and Promotion (WHO, 1997, 104 p.)|
|3. Strengthening school health programmes at the international, national, and local levels|
|3.8 National-level strategies|
The objectives of the Network - which is a joint project of the WHO Regional Office for Europe, the Council of Europe, and the Commission of the European Communities - are to include health education in school curricula at all instructional levels in member states; encourage cooperation among member states; and disseminate the results of projects demonstrating the applicability of specific interventions under programme conditions. Each participating member state agrees to support intersectoral cooperation between the education and health authorities and establishes a national coordinator and a national support centre for activities to support the development of health-promoting schools.
In each nation, approximately 10 health-promoting schools are selected to participate in the Network. In each school, a project team (and manager) are appointed to help the school:
· provide a health-promoting environment for both working and learning through its buildings, play areas, and catering facilities, including the establishment of appropriate safety regulations;
· promote individual, family, and community responsibility for health;
· encourage healthy lifestyles and present a range of realistic health choices for students and staff;
· enable students to fulfil their physical, psychological, and social potential and promote their self-esteem;
· establish clear aims for the promotion of the health and safety of the school community (both students and staff);
· foster good staff-student and student-student relationships and efficient linkage between the school, home, and community;
· exploit available community resources for the promotion of health through schools;
· plan a coherent health education curriculum using methods that actively engage students;
· equip students with the knowledge and skills needed both to make sound decisions about their health and to preserve and improve a safe and healthy physical environment;
· take a broad view of school health services as an educational resource that can help students become effective users of health care services.
The Networks efforts clearly foster the development of national-level strategies for school health promotion, as illustrated by the example of Bulgaria. In 1992, the Bulgarian Ministry of Education and Ministry of Health requested a consultation with the Secretariat of the European Network of Health Promoting Schools to discuss Bulgarias possible entry into the Network. Bulgaria was undergoing rapid economic and social transitions. The education and school health service systems were in urgent need of reform, and school buildings needed repairs. Teacher training programmes and school curricula needed revision. Entry into the Network offered the opportunity to adopt at a national level a new concept of and approach to health education, and also a chance to interact with other Network participants in Europe.
As soon as an agreement was signed between the Ministries and the Network, a Bulgarian coordinator was selected for the Network; the existing National Centre for Health Promotion was designated the support centre for the Network; and a support team of educational psychologists and health professionals was established.
Together, the coordinator, support centre, and support team provided leadership, coordination, and technical input. They selected 10 schools for the Network on a competitive basis from among 68 schools. It was essential that these schools had demonstrated a commitment to and understanding of the aims of the Network. They also were required to have obtained approval for the project from their municipalities.
The 10 selected schools represented a spectrum of educational, social, and economic circumstances in Bulgaria. Some were located in mountain villages, some in small towns of less than 50000 people, and some in large cities. Because so many schools wanted to participate, a three-level system was created. Level 1 consisted of the 10 schools that became part of the Network. Level 2 consisted of the remaining 58 schools that were not chosen. These schools established a Bulgarian National Association of Health Promoting Schools and continued to work to develop school health programmes using the concept of health-promoting schools. Level 3 consisted of schools that wanted to work on a specific issue, such as drug abuse, sex education, or healthy eating, but did not implement the full health-promoting school concept.
Funding has been and continues to be a problem. Frequent changes of government in Bulgaria have limited the continuity and motivation of the national support team. However, the Bulgarian National Association of Health Promoting Schools has been recognized by the Bulgarian Government for the leadership it has provided in improving school facilities, curricula, and teaching. Moreover, during its first 2 years of operation, the Bulgarian National Association of Health Promoting Schools has:
· developed good working relationships and communication with the Ministries of Health and Education;
· created a national steering group made up of senior education and health officials to advise the national support team on technical and bureaucratic matters and to offer political endorsement of new initiatives;
· organized regular workshops for teachers to upgrade their training in areas such as planning and evaluation, project management, and specific curriculum topics (e.g. sex education, crisis intervention);
· organized lectures on different aspects of the health-promoting school concept for parents, members of local communities, and journalists from the print, radio, and television media;
· negotiated with national teacher training institutions for the inclusion of health education theory in training courses;
· developed a relationship with other health-promoting school networks in neighbouring countries; many schools share their knowledge and experience by participating in Albanian and Romanian national workshops organized by colleagues within the European Network;
· placed the concept of health-promoting schools firmly on the political agenda in Bulgaria.