HHD Conducts Rapid Assessment and Action Planning Process for School Health in Gujarat, India

Research tells us that healthy students learn better and educated students stay healthier. However, many countries have only limited school health programs. Often they are not aware of all the components of a comprehensive school health program. HHD’s Rapid Assessment and Action Planning Process (RAAPP) provides a method and tools to enable ministries of education and health and other national organizations to assess and strengthen their ability to promote health in schools.

Building on the successes of RAAPP in Indonesia and Nigeria, HHD, in collaboration with the World Health Organization (WHO), has recently been working with leaders in the state of Gujarat, India to carry out RAAPP. Gujarat is a very large and diverse state comprised of 65 million people of many different ethnic backgrounds in both urban and rural areas. It was chosen by government and WHO officials to be a site for RAAPP because it already had several elements of a comprehensive school health program in place to build on but was missing some others.

RAAPP is an evidence-based method that includes strategies, instruments, and professional development activities to prepare in-country teams to collect their own data, use the data to engage in a customized action planning process, and develop recommendations for improvements. It assesses the following five capacities in the area of school health as perceived by key national players:

• Knowledge base
• Leadership and management
• Collaboration among stakeholders
• Policy creation and implementation
• Monitoring and evaluation

The RAAPP in Gujarat has just been completed. A core team of education and health professionals learned participatory research methods and then collected data through key informant interviews, focus group discussions, secondary data sources, and observations. Several questions were asked about each of four components of comprehensive school health programs (health supportive school environment, school health policy, school-based health and nutrition services, and skills-based health education):

• What is your ministry doing now?
• What does the ministry need to do to improve what it is doing?
• What new activities should the ministry implement?
• What resources would be needed by the ministry to implement the new activities?

According to Scott Pulizzi, HHD project director, “The most important finding was that there is an extensive program for school check-ups and nutrition services, but skills-based health education is missing.” Many education and health leaders were not aware of the need for skills-based health education.

“The prevailing view has been that health education refers only to sharing knowledge and that that is the responsibility of health care providers,” says Pulizzi. “From the RAAPP, leaders learned the importance of a health education approach that develops skills for achieving behavior change and that this kind of approach can be provided to large numbers of children through school health programs. They then developed specific recommendations for implementing skills-based health education.”

Another key recommendation was that the health check-up and school health program should focus on prevention and health promotion. In addition, the health and education departments should work together in the planning, implementation, and evaluation of school health programs at the state, district, and block levels.

With the RAAPP completed, the next step is for leaders in Gujarat to implement its recommendations. HHD will continue to be a resource for the ministries of education and health, especially in providing technical assistance regarding skills-based health education.

June 15, 2005