Map of South AfricaIn South Africa, inequalities in economics and health stem from a history of racial and gender discrimination. Since the end of apartheid in 1994, schools were target settings for addressing racial and ethnic divides by offering a healthy place that fosters learning. The primary target of intervention is a primary school that is situated in a semi-rural town about 50 kilometres outside of Cape Town. This community has a high level of ​unemployment, commercial sex work in teens, substance abuse, and gang activities. The value of education was suggested as a ‘social vaccine’ to prevent the spread of HIV. The Teacher Support System (TSS) was a program that identified policies to address teaching, learning and the school environment. A Health Promoting School (HPS) is one that engages health and education officials, educators, pupils, parents, and community leaders in efforts to promote health, a healthy environment, school health education, school health services, and school-community outreach projects. HPS links between the education, health, and the community sectors.

The HPS documented evidence of impact of learning and health outcomes before and after the HPS program was implemented into the school curriculum. The nurse and principal as well as other staff were key program implementers and evaluators in addressing various aspects of development and growth. The nurse documented health-related visits, the principle documented instances of violence, and teachers documented students’ performances within class. The evaluation utilised a quas​i-experimental approach with comparison schools. The target school reported better performances in the intervention for most outcomes (e.g., increased self-esteem in learners, increased positive relationships, and increased involvement of learners, teachers, and parents). There was also a new established vegetable garden within the school. Documentation of program components, new collaborations built, and program impacts highlighted improvements and gaps to be addressed. The development of formal evaluation structures and guidance is important to operationalise, manage the process, set goals, organise teams, evaluate progress, and improve practice.

[SOURCE: WHO (South Africa), WHO African Regional Office, Health Promoting Schools]

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