“facilitating the realization of the potential of individuals and communities” university of the...

“facilitating the realization of the potential of individuals and communities”

UNIVERSITY OF THE WESTERN CAPE

Health Promoting Schools Conference

14 - 16 September 2006


PROPOSITION

The next decade of the Health Promoting Schools Programme (HPS) must be spent focussing on implementation:

Identifying the barriers, Eliminating/militate against them, Building human capacity


RATIONALE

South Africa spends 9% of its GDP on Health and 20% on Education

And gets Health delivery in the lowest quartile

in the world (WHO), Last in grade 6 maths and science in

an international assessment,SOMETHING IS WRONG!


ART of WARSun Tzu (Circa 500 BC)

‘Know your enemy’

ALLOW ME, THEN, TO INTRODUCE YOU TO THE ENEMY


AN ANALYSIS

The country in transition since 1994 New constitution New structures

Provincial Line departments consolidated

New policies for almost everything Focus on reconciliation Affirmative action


ANALYSIS (contd)

Community participative decision making, Consultative road shows, Conferences Workshops and meetings,

Massive infra-structure deficit

“NO ACTION WITHOUT PERMISSION!”


Social Cluster Parliamentary Media Briefing – 26 August 2004

Dr.M.Tshabalala-Msimang reported: “R785m allocated for capital works in

provinces but only 15% spent after 4 months”,

“There are 1705 schools with classes in the open air, have mud structures or unsafe buildings!”,

“Not all provinces have been able to reprioritise their budgets (to correct this)”


EXECUTIVE SUMMARY:FACTORS DETERMINING EDUCATORS SUPPLY AND DEMAND (HSRC)

Mass of policies arriving over a short period of time has created exasperation and confusion,

Has meant extra administrative work, The identity of educators is challenged,

their role and functioning are changed.

These factors must be addressed or policies will lead to attrition


Climate at Schools

SEXUAL BEHAVIOUR (National statistics - MRC 2002)

41.1 % of Learners in Gr 8-11 reported having had sex

14.4% have had their 1st encounter by the age of 13rs

High prevalence in the use of drugs or alcohol before sex

High prevalence in using traditional healers for abortions

High prevalence of having STI


Climate at Home

1 in 3 mothers are HIV +. By year 2015 there will be 3.6 - 4.8 million orphans in SA - 9-12% of population (1999 Unicef Report)

20 000 cases of reported child rape each year in SA, one third of rapists are teachers (MRC)

Many children, especially the girl child, are left alone with unsuitable caregivers


EMIS: EDUCATION MANAGEMENT INFORMATION SYSTEM

The aim of EMIS is declared as: “To provide accurate statistical information enabling

sound education decision making “

Objectives & Performance measures include: Making EMIS information readily available Capturing 100% SNAP & ANNUAL SURVEY forms Ensuring data is accurate and reliable

NON RETURNS PLUS INCORRECT FILLED EMIS FORMS = 33% RATE OF EMIS FORMS RETURN = 85 %


EMIS INFORMATION / DATA FEEDBACK FROM SCHOOLS

2004/ 2005

ZEROs & BLANK DATA BLOCKS—(DATA – WISE)

% WATER 14 ELECTRICITY 15 SANITATION 28 ACCESS ROADS 14 CLASSROOMS 12 REPEATS, DROUPOUTS, NOT PROMOTED 17 LEARNERS PER GRADE INCORRECTLY FILLED IN 19 AVERAGE

18.45

BADLY FILLED IN SNAP& ANNUAL SCHOOL SURVEY FORMS 18%


AVAILABLE 7 TO 18 YRS

ATTENDING 7 TO 18 YRS

NOT

AT

SOUTH AFRICA SCHOOL SCHOOL AT SCHOOL

YEARS CHILDREN CHILDREN SCHOOL % %

2001 12 955 724 11 738 126 9.41 90.59

2002 13 150 059 11 917 012 9.38 90.62

2003 13 347 310 12 038 922 9.81 90.19

2004 13 547 570 12 176 391 10.12 89.88

2005 13 750 783 12 197 726 11.29 88.71

9.41 9.38 9.81 10.12 11.29

02468

1012

PERCENT NOT AT SCHOOL

NOT AT SCHOOL %

9.41 9.38 9.81 10.12 11.29

2001 2002 2003 2004 2005

SOURCE :STATS SA: SNAP SURVEY 2006 D O E


NO SCHOOLING BY PROVINCE 1996 VS 2001

21

16

10

23

37

29

22 23

7

19

23

16

8

22

33

28

18 2

0

6

18

0

5

10

15

20

25

30

35

40

EC FS GT KZN LP MP NC NW WC SA

PROVINCE --20 + YEARS

PE

RC

EN

TA

GE

%

1996 % 2001 %

SOURCE :SECOND EQUITY GAUGE 2004


A Z ELLSE Space-Time Research TABLE BTHE VALLEY TRUST 2001RESEARCH STATISTICIAN Table 112---AUGUST---2005 Geography by Education level recode

for Person weighted, Age 20+

No schooling Some primary Complete primary Some secondary Std 10/Grade 12 Higher TotalKZ286: Nkandla 28266 9652 2395 9429 5639 1429 56810PERCENTAGE % 49.75 16.99 4.22 16.59 9.93 2.52 100 Ward 1 1203 885 270 1018 397 91 3864 Ward 2 2028 786 136 478 272 96 3796 Ward 3 1288 862 186 867 311 68 3582 Ward 4 859 589 155 611 281 71 2566 Ward 5 1772 958 259 1370 1152 200 5711 Ward 6 1520 274 58 311 156 49 2368 Ward 7 2750 448 105 384 166 89 3942 Ward 8 1935 910 230 773 558 192 4599 Ward 9 2610 853 195 585 371 80 4695 Ward 10 2754 802 217 748 319 194 5034 Ward 11 2296 483 131 609 444 63 4025 Ward 12 1742 793 233 668 644 72 4153 Ward 13 3187 541 137 561 325 83 4834 Ward 14 2322 468 83 444 244 79 3640

Figures greater than 0 and less than 4 are randomised to preserve confidentialityUsers of these data should refer to the extract from the SA Stats Council Censussub-committee report at http://www.statssa.gov.za/extract.htmCreated on 11 August 2005SuperCROSS. Copyright © 1993-2005 Space Time Research Pty Ltd. All rights reserved.


SOURCE: StatsSA & General Household Survey July 2005

21.922.

721.

621.

1Grade 12

2005200

4200

3200

2Percent with Matric / **

SOUTH AFRICA

POPULATION 20+ YEARS =25 472 769 ( M + F ) 2001#

10.211.

111.412.1

(%) 20052004200

3200

2SOUTH AFRICA NO. of persons aged 20 +( M + F)

years – no formal education

POPULATION ( 13 TO 19 YRS ) =3 522 434 ( 2001 ) ( F )*

13.2517.413.4

11.8

because of Pregnancy ( % )

20052004

2003

2002

an Educational Institution

SOUTH AFRICA

( 13 to 19 yrs ) not in

NO. of Teenage Girls


SCHOOLS WITHOUT TOILETS BY PROVINCE 2000

13.1

1.1

5.86.6

2.5

7.5 8.1

0.1

9.2

18.8

0

2

4

6

8

10

12

14

16

18

20

EC FS GP KZN MP NC LP NW WC SA

PROVINCE

PE

RC

EN

TA

GE

%

WITHOUT TOILETS 2004 = 10.1% SA


TOILETS NOT WORKING BY PROVINCE 2000

19.9

15.9

12.4 12.314.1

11.1

19.8

8.9

15.5

23.3

0

5

10

15

20

25

EC

FS

GP

KZ

N

MP

NC

LP

NW

WC

SA

PROVINCE

PE

RC

EN

TA

GE

%

NOT WORKING 2004 = 20 % SA


NKANDLA WARDS -- LEARNERS BY GRADES BY WARDS 2005

0

100

200

300

400

500

600

700

800

900

1000

1100

1200

1300

1400

1500

1600

pre r 1 2 3 4 5 6 7 8 9 10 11 12 lsen

GRADES

NU

MB

ER

OF

LE

AR

NE

RS

CHWEZI EKHOMBE GODIDE SIBHUDENI SIGANANDA


0.0

50.0

100.0

150.0

200.0

250.0

300.0

350.0

400.0

1992/93 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03

Eastern Cape

Free State

Gauteng

KwaZulu Natal

Limpopo

Mpumalanga

Northern Cape

North West

Western Cape

Source: An evaluation of Public PHC Financing 1992/3 and 2002/3By Health Economics Unit - Cape Town

PHC Expenditure per capita by Province


HIV and AIDSHIV and AIDSMANAGING A COHERENT RESPONSEMANAGING A COHERENT RESPONSE

National Education Policy Act,1996Notice 1926 of 1999

National Policy on HIV/AIDS, for Learners and Educators in Public Schools, and Students in Further Education and Training Institutions

Tirisano – 2 June 2002 – Declaration of Intent


NATIONAL POLICY ON HIV AND AIDS FOR NATIONAL POLICY ON HIV AND AIDS FOR LEARNERS AND EDUCATORSLEARNERS AND EDUCATORS

PREMISES

Each school must have a planned strategy to cope with the epidemic

Educators to be prepared to handle disclosure of HIV status

Infected learners and educators must lead full lives – no discrimination

Good hygiene and infection-control practices must be in place


SCHOOL IMPLEMENTATION PLANS

A provincial education policy for HIV and AIDS, based on the national policy, can serve as a guideline for governing bodies when compiling an implementation plan

Major role players in the school community should be involved in developing an HIV and AIDS implementation plan

NATIONAL POLICY ON HIV AND AIDSNATIONAL POLICY ON HIV AND AIDSFOR LEARNERS AND EDUCATORSFOR LEARNERS AND EDUCATORS


HEALTH ADVISORY COMMITTEE (HAC)

Each school should establish a Health Advisory Committee as part of the SGB, where possible

Community health workers should be involved and be assisted by the local clinics.

Schools should draw on the local expertise within the health system – HEALTH PROMOTING SCHOOLS

NATIONAL POLICY ON HIV AND AIDSNATIONAL POLICY ON HIV AND AIDSFOR LEARNERS AND EDUCATORSFOR LEARNERS AND EDUCATORS


TIRISANO – June 2002TIRISANO – June 2002HIV and AIDS and the SYSTEMHIV and AIDS and the SYSTEM

Strategic objective to ensure a multi-partner Education Sector response to the pandemic: Develop an advocacy strategy to bring key

partners such as parents, teachers and traditional leaders on board the DoE’s HIV and AIDS response

Strengthen and maintain strategic partnerships with other government departments (social cluster) and NPOs


Student populationsurvey

220 students from the high schools, grade 8-11

Randomly selected fifty students from each school

Equal representation of grade level and sex, based on presence at schools

Males and females separated during survey when possible

To ensure confidentiality, students never wrote their name on the survey


Behaviour Change Continuum

Awareness

Knowledge

Under-standing

Belief

Change in

Behavior

Advocacy


Interpretation The data demonstrate

that students do have a good understanding of both the facts concerning AIDS and the ways that HIV can be transmitted

Thus, we can say that the majority of students are at the level of UNDERSTANDING (See left)

AwarenessAwareness

KnowledgeKnowledge

UnderstandingUnderstanding

BeliefBelief

Change in Change in BehaviourBehaviour

AdvocacyAdvocacy


Interpretation That 74% of sexually experienced students

considered themselves at risk of contracting HIV demonstrates that the students must believe in the existence of HIV and AIDS

Considering that students have a good understanding of HIV and its transmission, one would assume that students protect themselves from risky, sexual behaviour.

However…


Interpretation Students understand HIV,

have a proven fear of it, yet participate in risky sexual behaviour

62% of students have had more than one sexual partner

Only 27% claim to wear a condom every time

39% admit that they NEVER wear a condom

Students are stuck at Understanding. Their knowledge does not effect their behaviour

AwarenessAwareness

KnowledgeKnowledge

UnderstandingUnderstanding

BeliefBelief

Change in Change in BehaviorBehavior

AdvocacyAdvocacy


Why do students refuse to change behaviour?

• Fatalism: students feel that dying is inevitable or that the future is too bleak. Students are less likely to protect themselves if they have no positive hope in their lives

• Self-esteem: Students grow to depend on a partner for confidence and fear rejection – then no sex!!

• Mistrust: Students associate condom use with unfaithfulness. “If she wants me to wear a condom, it means she doesn’t trust me…”


SEX-MAD SOUTH AFRICA DOES ‘IT’ WITHOUT PROTECTION

Natal Witness

64% of South Africans have had unprotected sex without knowing their partner’s sexual history an increase on last year

59% of South Africans had sex with a stranger

Durex Global Sex Survey - 2005


‘We are what we repeatedly do’ Aristotle

The single most destructive impact of apartheid - loss of self worth

Education systems and the policies of the previous government constantly reinforced a sense of inadequacy

The condition is perpetuated by many of the educators in rural schools


Emotionally Safe Schools Recognition that:

“Our lives begin to end the day we become silent about things that

matter” Martin Luther King

Principal and SMT committed to the Health Promoting school concept – in action,

Educators caring and reinforcing life skills in all classes and their own personal behaviour

Care and support programmes for educators and learners, including ART,

Community development stimulated through conversations with parents re their rights,“


EVALUATION

THERE ARE GOOD POLICIES IN PLACE

BUT, WITHOUT IMPLEMENTATION,

THEY ARE POOR POLICIES.

ACCOUNTABILITY IS NOT IN PLACE


RECOMMENDATIONS

Accept existing policies as adequate, Prioritise a maximum of five key

policies, Identify the barriers obstructing

implementation on a larger scale Political will – absentee collaborative action Information management Culture of ‘no action without permission’


RECOMMENDATIONS (contd.)

Develop implementation plans including the elimination of the barriers Accept that education is ‘business as

unusual!’ Lateral thinking involving business and civil society,

Build, Build, Build human capacity Self esteem and decision making Utilise retired skilled personnel of all colours

Carpe diem ASGISA and R370 billion 2010


NON NEGOTIABLE ACTION

Intersectoral collaboration

Clear lines of accountability must be established with strict time lines,

Acceptance from the highest level downwards in all of the ‘social cluster’ departments of the consequences of non performance


A DESIRED OUTPUT OF THIS CONFERENCE

A PLAN OF ACTION FOR THE EFFECTIVE IMPLEMENTATION OF AN HEALTH PROMOTING SCHOOL

(HEALTH AND WELLNESS) PROGRAMME INBEDDED IN THE SCHOOL DEVELOPMENT PLAN INCLUSIVE OF TIME LINES AND

ACCOUNTABILITY


SUMMARYSUMMARY

WE HAVE MANY POLICIES.

EFFECTIVE HEALTH AND EDUCATION DELIVERY IN SOUTH AFRICA REQUIRES URGENT AND AGGRESSIVE ACTION LEADING TO THE IMPLEMENTATION OF THE EXISTING POLICIES THEREBY MAKING THEM GOOD POLICIES.

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