|Health & HIV/AIDS Education in Primary and Secondary Schools in Africa & Asia No. 14 (DFID, 1995, 94 p.)|
|Section 1 - An overview of the issues facing policy makers|
When one studies mortality and morbidity figures, the case for placing emphasis on the health of young people is not instantly compelling, since the 6-24 year age group tends to carry a relatively low burden of disease. On the other hand, the majority of death and disease in this age group is preventable. Work, particularly in terms of establishing a sound educational base, should bring future health gains, as young people grow up and become the parents and the workforce of the future.
With over one billion children in school, forming an easily accessible target group, the use of schools as an entry point for health activities is proving increasingly interesting to governments and donor agencies alike. Several key documents have stressed both health gains and cost effectiveness of organising health activities through the school system (e.g. World Bank 1993; Nakajima 1992). Other documents stress the educational importance of school health interventions. Much of this evidence is summarised in a major World Bank study (Lockheed and Verspoor 1991) entitled Improving Primary Education in Developing Countries. Taking evidence from a wide range of countries, they highlight protein energy malnutrition, temporary hunger, micronutrient deficiency and parasitic infection as important factors getting in the way of student learning in school. They recommend school breakfasts, deworming programmes, and micronutrient supplementation - combined wherever possible both with health education and with improved school sanitation resources - as cost effective ways of increasing learning achievement in schools.
Turning to the specific case of AIDS, it is acknowledged that the search for affordable vaccines and treatment therapies may take years. In the meantime, the main strategy for holding back the spread of the HIV virus is education, with consequent behaviour change on the part of individuals. Education must reach those who are at highest risk. Evidence suggests that a primary group for such education is teenagers and young adults:
"in many developing countries more than half the population is below the age of 25 years. In many countries over two thirds of adolescents aged 15-19 years, male and female, have had sexual intercourse. Adolescents and young adults (20-24 years of age) account for a disproportionate share of the increase in reported cases of syphilis and gonorrhea world-wide... In addition, at least one fifth of all people with AIDS are in their twenties, and most are likely to become infected with HIV as adolescents." (School Health Education to prevent AIDS and sexually transmitted diseases. WHO AIDS Series no. 10 p. 1.1992.)
What then are the most appropriate ways of reaching these groups? What potential do schools have to provide a base for AIDS education?
The aim of the study reported here is to provide insights into policy, practice and potential for health education within school systems in Africa and Asia, combining detailed case studies from four countries with a broader analysis of reported activities from the two continents. 1
1 For details of the literature and
document search see Section 2: Case