Affordable Health Initiative (AHI) Health Promoting School (HPS) model: sample

 
 

Health Promoting School

As defined by the World Health Organisation, a health promoting school is one that constantly strengthens its capacity as a healthy setting for living, learning and working. Aligning the factors that affect a child’s health is the foundation of the AHI HPS model. Such factors include mental, emotional and spiritual influences. Therefore, key factors that influence a child’s health are addressed to help schoolchildren to change their personal behaviours centred around these areas of their life.  The AHI HPS model was designed to educate schoolchildren and their parents to take control over life's circumstances by improving their cognitive processes and life skills. The former includes attention, perception, memory, language, learning, and higher reasoning. The latter includes decision-making and problem-solving, creative and critical thinking, communication and interpersonal skills, self-awareness and empathy, assertiveness and self-control, resilience and coping with emotions and stress. Developing these attributes improves their health and educational achievements, social behaviour (e.g.: caring for oneself and others, trust, attachment, tolerance of others, reciprocity), social capital (e.g.: family ties, friends/friendship ties, and social networks), prevents violence and radicalisation, which in turn improve their wellbeing throughout the life course. In addition, it significantly increases their capacity for and future work opportunities.

The AHI HPS model moves beyond the dated believe that risk awareness raising programmes lead to behavioural change. Instead, we use a combination of interventions to facilitate behaviour change. The Affordable Health Initiative (AHI) offers a comprehensive whole-school approach that reaches out beyond the school to the community.

AHI Pedagogical approach

The AHI HPS model understands education in a broader way rather than is traditionally the case. We adopt a constructivist pedagogical approach. A traditional approach to teaching focuses on delivering information to students, while constructivism argues that school children cannot directly communicate this information. Only an experience can facilitate students to construct their own knowledge. AHI teaching approach is one where the schoolchild voice is placed at the centre, and a democracy is put into the classroom. Value is placed on discovering solutions together.

We understand that most school across the globe follows a behaviourism pedagogical approach and we respect their choice of pedagogical approach. AHI HPS model does not interfere to the way teachers deliver the content of the curriculum to a class. We believe that a combination of teacher’s guided and student’s centred approach as in the social constructivist pedagogical approach may bring benefits to the behaviourism pedagogical approach rather than to detract. We offer extra-curriculum activities that teaches skills that matter for life to schools running the AHI HPS model. The AHI HPS model provides support for the intellectual and emotional development of school children and their families. Therefore, we contribute to schoolchildren learning of the content of the school curriculum leading to improved school achievement. The AHI HPS model educational activities are based on the constructivism theory, in which people learn through experiences and reflection. Teaching is based on the belief that it is more effective to provide children with information to allow them to develop reasoning skills and make rational judgements than to give them the "right" solution to a problem. Furthermore, we understand that students feel that their teachers should model good interpersonal behaviours such as respect, calmness and rapport. In line with the constructivist pedagogical approach we incorporate project work and inquiry-based learning in our educational activities (e.g. the health detective project). We put the child at the centre of the learning. Our teaching takes into account the context that we teach in – low-income communities. We understand the relevance of the liberationist approach in schools serving low-income communities. “Liberationism” focus on removing the two major barriers to learning: poverty and hunger. We distribute healthy food to families of children enrolled in the AHI HPS intervention. We understand one cannot eradicate poverty proximately, therefore we facilitate access to schoolchildren to the necessary tools not available in low-income communities to maximise their chances to fulfil their potential and flourish throughout a number of interventions within the AHI HPS model.

Similarly, health education at the AHI moves beyond the dated believe that risk awareness raising programmes lead to behavioural change. Instead, it uses a combination of interventions that facilitates embracing a healthy lifestyle. The AHI HPS model consists of four interlinked components which are life skills and health literacy, health promotion activities, community engagement and also primary health care services at school to address the burden of diseases that could not be prevented. Activities complement each other and impact in a number of health and education outcomes.

Below is a sample of how we address transmission of germs.

Intervention Links:

  • Health literacy

  • Life skills literacy

  • Basic hygiene practices

  • Community evening talk

  • Community quiz game night

  • Health detective game

AHI school Teaching Model (transmission of germs)

Two relevant topics are addressed each month, one in health and another in life skills. All follows the AHI teaching model as described below.

Heath topic: Spread of infection: hand hygiene

Teaching Time: 3 hours in total (4 sessions of 45 minutes)

Target Group: 6-8-year-old school children

Learning Objectives:

All students will:

·       Understand that infection can be spread through unclean hands.

·       Understand that handwashing can prevent the spread of infection.

·       Understand when and how to wash hands.

·       Understand why we should use soap to wash our hands.

Background:

Hygiene may be defined as conditions or practices conducive to maintaining health and preventing disease, especially through cleanliness. It refers to personal acts that can lead to good health and cleanliness. Personal hygiene includes body hygiene (skin care), oral hygiene (oral care), hand washing (hand care), face hygiene, fingernail and toenail hygiene (nail care), ear hygiene, hair hygiene (hair care), foot hygiene (foot care), armpit and bottom hygiene, clothes hygiene, menstrual hygiene (personal hygiene for women). Frequent hand washing, face washing, and bathing with soap and water are one of the most important ways to prevent the spread of infection and illness. Many diseases can be spread when hands, face, and body are not washed appropriately at the key times. Hands should be washed before eating or handling food; after using the toilet; blowing the nose, coughing or sneezing; touching animals or animal waste; handling rubbish; changing a nappy and before and after touching a sick or injured person. The prevention of communicable diseases, like diarrhoea, trachoma and many others are possible through the application of basic hygiene practices. Keeping hands, head and body clean stop the spread of germs and illness, thus minimise the incidence of communicable diseases. It benefits one own health and has a positive impact on the health of others in the locality. Good personal hygiene is a major determinant of health and an important public health action. Good personal hygiene also has aesthetic and social value. A schoolchild with poor personal hygiene might be isolated from friendship, be teased and bullied. Generally, cleaning oneself produces pride, comfort and dignity at home and in public places. Caring about the way one look is important to improve self-esteem.

 Activity:

·      E-learning is adopted to introduce the topic (Spread of infection: hand hygiene).

·      School quiz game is an informative feedback device (first session, 45 minutes).

·      Debate  focusses on a set topic around which the statements should revolve (second session, 45 minutes).

·      Group discussion allows arguments to take different flow and can lead to another view in between (third session, 45 minutes).

·      Set a goal helps schoolchildren change behaviour to travel safely throughout the life course (forth session, 45 minutes).

E-learning may be defined as any type of learning that takes place through or with a computer and is primarily facilitated through the Internet; but it can also be accomplished with CD-ROMs and DVDs, streaming audio or video and other media. AHI HPS e-learning model refers to electronically mediated learning in a digital format, using computers and/or the internet at school to enhance or facilitate teaching and learning. E-learning is a pedagogical approach that aims to be flexible, engaging and learner-centred. It encourages interaction (staff/staff, staff/student, student/student), collaboration and communication. E-learning is a pedagogical approach that aims to be flexible, engaging and learner-centred. It encourages interaction (staff/staff, staff/student, student/student), collaboration and communication. It may include storytelling, which is a proficient pedagogical approach that can be delivered through E-learning or used as an alternative to E-learning. Storytelling is what connects schoolchildren to their humanity. It links human to our past and provides a glimpse into our future. Since humans evolved into Sapiens, they have told stories, far before the written word was developed. Children like to hear stories, and good store has a beginning, a middle, and an end. Stories should have characters that look like the local schoolchildren or at least share characteristics they can relate to. A story should build up to a thrilling climax, followed by a satisfying conclusion. It should be moving, either emotionally or viscerally, like in a good action film. The AHI local team will develop a high-quality e-learning package appropriate to the local culture with appropriate content for children of school age.

Example of e-learning: “horrid hands” experiment video presentation to demonstrate how microbes can spread from person to person by shaking hands or touching surfaces.

School quiz game is a form of game, in which the players attempt to answer a series of questions correctly, to test their knowledge about specific subjects. AHI HPS model uses this game as a form of assessment that measures schoolchildren’s knowledge, skills, and abilities. Generally, an exam is a culminating assessment that evaluates a student over a large period of time and over a range of material. A quiz game is generally a frequent and short assessment that can gauge a student’s retention and comprehension of a small amount of information. A quiz can function throughout a course as an informative feedback device allowing both the instructor and the students to see where they are excelling or need more focus. Quiz games are a stress-free way to learn contrary to exams. Most children find that quiz games are fun. This is because it feels like playing, contrary to being evaluated, which often generates anxiety in most children. When a child plays quiz game, they keep their mind on what they are doing. Thus, it helps children to concentrate. Quiz games help the learning process. It helps to retain information and build confidence in addition to identify gaps in knowledge. Playing quiz games make children feel good and so, makes them enthusiastic to play more.

A quiz functions as an informative feedback device allowing both the teacher and the students to see where they are excelling or need more focus. Because this learning assessment takes the format of a game, the instructor will be able to identify knowledge gaps without the pressure on school children of being assessed. Assessing the effectiveness of specific educational methods is essential to ensure the highest level of learning possible. Similarly, identification of knowledge deficits facilitates subsequent intervention to improve learning.

School quiz game is played in pairs (cooperative learning). The pair works together to maximize their own and each other's learning. Cooperative learning differs from typical group work in that it requires interdependence among pairs to solve a problem or complete an assignment. At the end, the teacher gives the answer to each question, one by one, and the children mark their own answers. At the end the instructor collects the answers and assess gaps in knowledge that need further attention, as well as awareness of knowledge and skills that could be further developed. The AHI local team constructs quiz games that include ten questions on the learning objectives of the topic. Questions are appropriate to the level of education of the children and pertinent to the topic covered on the quiz. The quiz presentation may be made using PowerPoint (Microsoft Corporation). A number of quiz question is available on internet and the AHI local operational team may obtain questions from reviewing available resources.

Debating is an important part of children’s education, in particular to develop their cognitive processes. It helps them to become persuasive speakers and engaged citizens who are more informed about the world around them in a fun way. It helps them developing attention, perception, memory, language, confident communication, assertiveness, higher reasoning, analytical and critical thinking, interpersonal skills, empathy and self-control.

A debating activity requires a clear space where students can move around, some desks for writing notes, pens or pencils and paper. A ‘horseshoe’ or u-shaped set up is often best. This can easily be accommodated in a classroom. The teacher acts as the moderator and should have a stopwatch to control the time of speeches. School children need to practise and gain experience in fitting their ideas into a time limit. Phones can be used for this purpose. Debates involve two teams of 10-15 children. The teacher welcomes the students to the debate and explain the rules. The moderator starts the debate briefly introducing a statement (e.g.: ‘Dirt hands spread infections’) or setting a scene. The teacher acts as the moderator and allocates one side of the room as the “agree” side and the other as the “disagree” side. The children may have a say in which side they want to be, and the moderator should quickly and diplomatically create two groups approximately the same size. Children who are neutral can be allocated to the smaller group to balance the size of groups. The moderator asks each group to identify a summary speaker. This part of the activity lasts up to 10 minutes. Next each group prepares an argument for the summary speaker to voice. The moderator helps them to identify the major issue and asks them to focus their argument on it. He/she gives students an opportunity to discuss debate-statements from their own experience and also assures that arguments are evidence-based through data, facts, and statistics presented in the data show. This part of the activity should be completed in 10 minutes. Then, 10 minutes is allocated to preparing the argument. Following, each summary speaker will then have five minutes to present their group’s argument. Finally, all children involved in the debate will act as judges. The moderator asks them to leave the room and, when they return, to choose again one or other side of the room “agree” side or “disagree” side (5 minutes). Then the moderator closes the debate and thank you all for participating.

Topical group discussion may be defined as an activity in which a small number of people meet face to face and exchange and share ideas freely or attempt to reach a common-sense decision on a specific theme. Participants bring up ideas, solve problems and give comments. This is a creative and dynamic activity which stimulates reflective thinking among the school children. Group discussion on study topics plays vital role in understanding the topic. Discussing a topic with classmates helps in learning the topic with perfection. Also, it facilitates addressing barriers and identifying solutions and facilitators to behavioural change. Group discussion differs from a debate. While in a group discussion, there are many people collectively putting in their thoughts, people can interrupt in between to put forward their views, whereas in a debate a set amount of time is given to two groups of people to prepare an argument for a summary speaker to voice the views of the group. A critical difference between a group discussion and debate is that in debate there is a set topic around which your statements should revolve, whereas, in a group discussion, the arguments may take different flow and can lead to another view or thoughts in between. The latter offers participants an opportunity to refine their own views in due course. This activity is a systematic exchange of information, views and opinions about the topic as well as an opportunity to identifying challenges, facilitators and solutions among school children. In the group discussion the teacher interacts with the children to address knowledge gaps identified in the quiz game and to identify solutions to the barriers identified in the debate.

Topical group discussion format includes a whole school class (20-25 children). The teacher will welcome the students to the group discussion and explain the rules. The teacher acts as a moderator and starts the group discussion briefly reintroducing the topic statement (e.g.: ‘(e.g.: ‘Dirt hands spread infections’). Next, the moderator will ask children to reasoning on their views on the statement and discuss among themselves. The moderator should motivate all participants to share their views and opinions with other participants and work as a team to identify solutions to a challenge (e.g.: ‘Washing hands prevent the spread of infections’). The moderator should encourage team approach, which requires cooperative problem solving, effective communication skills, and the ability to influence others by presenting ideas in an open, approachable, and non-threatening way.

Setting a goal is a powerful process for schoolchildren thinking about their lives, behaviours, attitudes and values, as well as, motivating them to develop life change behaviours. Without goals there is no plan or route in life. Many schoolchildren in low-income communities feel if they are adrift in the world and will not get anywhere worthwhile. A key reason that they feel this way is that they have not been aware of their potential or set themselves formal goals. Life is a journey similar to a trip. One needs to identify a destination, plan the journey and be fit to travel. The process of setting goals helps schoolchildren to travel safely throughout the life course.

By knowing precisely which behaviour a schoolchild needs to change, the child knows where to concentrate efforts. The e-learning, quiz game, debate and group discussion provides schoolchildren increase schoolchildren awareness of their behaviour and motivate them either to changing inappropriate behaviours or developing new behaviours that assist their life journey. The teacher may help schoolchildren to develop their own individual goals. This should not be done in an authoritarian way but through motivation. Goal setting is in the hands of the schoolchildren and they must set them. It may be that the teacher needs to elicit the goal through questions such as "what will you do?" or "what would you like to get out of this topic?" By listening actively and asking clean questions the teacher can help schoolchildren to identify a goal.

It is important to establish the difference between end goals and performance goals.  An end goal is the final objective and is usually something not completely in one's control.  A performance goal is something at a measurable level that gives one a good chance of achieving the end goal and is largely in one's control.  The AHI HPS model works with performance goals, which gives the schoolchildren the best opportunity for success and maximises ownership. With ownership comes motivation, underscored by choice and responsibility. Good goals must be SMART; specific, measurable, achievable, realistic and time bound. The teacher should support and help the schoolchildren to decide and articulate their own goals. Goals should be positively stated. Goals would provide a stretch, if they are too challenging there is no motivation, and it may take the schoolchildren into the "panic zone".  Goals must be ethical. The “goal setting session” considers individually what each schoolchild wants to achieve in relation to the topic addressed. Then, agree with the schoolchild that he/she will commit to it. Following, the teacher will help the schoolchild to set a SMART goal. The teacher should keep in touch with the schoolchildren and checking their progress towards achieving their goals.

AHI health promotion activities (transmission of germs)

Basic Hygiene Practices

Basic hygiene practices aim to provide a training exercise associated with health coaching to consolidate good personal hygiene. AHI HPS model implements the UNICEF Wash, Sanitation and Hygiene (WASH) in schools,  a well-established health initiative designed to improve the effectiveness of hygiene behaviour change programmes, supported by UNICEF.  Supervised tooth brushing with fluoridated toothpaste was added to WASH practices in the AHI HPS model, as recommended by the WHO. Hygiene may be defined as conditions or practices conducive to maintaining health and preventing disease, especially through cleanliness. It refers to personal acts that can lead to good health and cleanliness. Personal hygiene includes body hygiene (skin care), oral hygiene (oral care), hand washing (hand care), face hygiene, fingernail and toenail hygiene (nail care), ear hygiene, hair hygiene (hair care), foot hygiene (foot care), armpit and bottom hygiene, clothes hygiene, menstrual hygiene (personal hygiene for women). Frequent hand washing, face washing, and bathing with soap and water are one of the most important ways to prevent the spread of infection and illness. Many diseases can be spread when hands, face, and body are not washed appropriately at the key times. Hands should be washed before eating or handling food; after using the toilet; blowing the nose, coughing or sneezing; touching animals or animal waste; handling rubbish; changing a nappy and before and after touching a sick or injured person. The prevention of communicable diseases, like diarrhoea, trachoma and many others are possible through the application of basic hygiene practices. Keeping hands, head and body clean stop the spread of germs and illness, thus minimise the incidence of communicable diseases. It benefits one own health and has a positive impact on the health of others in the locality. Good personal hygiene is a major determinant of health and an important public health action. Good personal hygiene also has aesthetic and social value. A schoolchild with poor personal hygiene might be isolated from friendship, be teased and bullied. Generally, cleaning oneself produces pride, comfort and dignity at home and in public places. Caring about the way one look is important to improve self-esteem.

Community engagement (transmission of germs)

Community engagement is a key part of the AHI HPS model. Educating a parent by including them in the school educational activities significantly increases the likelihood of success of the AHI HPS model in educating children. Therefore, the AHI HPS model places great value on engaging parents/community in the school life. Parents are the most important role model to their children. Community engagement is a way of developing a working relationship between public bodies (such as schools) and community groups, as well as, of ensuring that community members have access to valued social settings and activities, feel that they are able to contribute meaningfully to those activities, and develop functional capabilities that enable them to participate fully. AHI HPS model include the families of schoolchildren in key areas of education to help the whole family to take control over life's circumstances and their health.

AHI HPS model engages parents in a number of school activities aiming to reach out to the community to educate the children and also their parents. At least one child-parent activity is run monthly. Good community engagement means that both schoolchildren and parents/community can fully benefit from the AHI HPS model helping all to achieve positive personal and community values.

This includes an evening role model talk and a community quiz game night, ideally on a Friday evening to facilitate parents’ attendance. These activities aim to help the community to improve their cognitive processes and life skills. The evening role model talk motivates children and their parents to strive to uncover their true potential and overcome their weaknesses. The community quiz game night consolidates health knowledge and life skills among children and disseminate them to the community.

AHI HPS model also involves parents in the health detective game, which is an epidemiological exercise. This game consolidates health knowledge among school children and disseminate health knowledge to the community. Importantly, these educational activities attended by schoolchildren and their parents promote higher reasoning, decision-making, problem-solving, creative and critical thinking, communication and interpersonal skills, self-awareness and empathy, assertiveness and self-control, and resilience and coping with emotions and stress. Developing these attributes improves health and social behaviour (e.g.: caring for oneself and others, trust, attachment, tolerance of others, reciprocity), social capital (e.g.: family ties, friends/friendship ties, and social networks) prevents violence and radicalisation among community members. All values addressed in these activities are conducive to better mental and physical health and well-being.