A healthier nation starts with our children and health is vital for children to reach their full potential. Without proper healthcare, various medical problems could go undetected and untreated which could affect the development of a child.
Government has therefore prioritised the health of our children through the Integrated School Health Programme (ISHP) which aims to provide essential health services to pupils in especially in the country's neediest schools.
During the ISHP launch last year, President Jacob Zuma stated: “Currently it is only 16 per cent of the population, those with medical aids, who enjoy excellent all-round quality health care. We want to change that scenario and extend quality health care to all..”.
Schools provide Government with the ideal setting for health education and interventions, since most of the children spend up to thirteen of their formative years, from early childhood to young adulthood, in a classroom. Through implementing this programme at schools, we can reach the majority of our children and address various health and socio-economic factors which affect children in South Africa.
The ISHP, which forms part of the National Health Insurance (NHI) programme, aims to strengthen and expand existing school health services. The programme provides a comprehensive health package to improve the health of learners and remove health barriers to learning at every stage of their development. Also, it creates a safety net for children who did not access preventive health services during their pre-school years.
This programme is a joint initiative between various national departments. The Department of Health provides the relevant pupil healthcare, while the Department of Social Development assists those who are found to be vulnerable and need care and support. Additionally, the Departments of Basic Education and Sports and Recreation South Africa will promote physical education and sports to ensure healthy lifestyles.
The ISHC aims to individually assess every pupil once during each of the four educational phases namely foundation, intermediate, senior and the further education and training phase. Health information and education are age-appropriate and geared to serve the different needs of pupils in each of the four educational phases.
Assessments during the foundation phase focus primarily on identifying health barriers to learning, as well as long-term health, psychosocial or other problems. Services also cover environmental and personal hygiene, especially the importance of hand-washing; healthy eating habits; the promotion of physical exercise; and safety. Additionally, health professionals will check the ears, eyes, immunization and nutritional status of children.
In the intermediate phase, attention will also be paid to mental health including depression and suicide, as well as issues relating to substance abuse.
According to the Integrated School Health Policy document [pdf], there is no national representative data on the prevalence of psychiatric disorders among South African adolescents, but estimates suggest that approximately 17 per cent of youth between the ages of 6 to 16 years have poor mental health. The policy document adds that “poor mental health is associated with …educational underachievement, social disadvantage and poor health and well-being”.
In the more advance phases of ISHP, information on sexual and reproductive health will also be introduced to assist learners to make educated decision about their sexual behaviour.
President Zuma stated: “Equipping girls and boys with information on how to prevent unwanted pregnancies can thus play an important role in ensuring that all pupils reach their full potential”.
The President added that the subject of sexuality makes parents “uncomfortable”, but “we have to face the reality that some learners are sexually active, no matter how much this knowledge troubles us”. Therefore he said to deal with this reality and promote primary health care, “the school health nurse and team will provide sexual and reproductive health services including contraception as well as HIV Counselling and Testing, where appropriate”.
Another reality we as parents need to accept is that our children are at risk of contracting HIV infection. Figures from the 2011 Antenatal HIV prevalence survey showed that more than a fifth of pregnant young women between 15 and 24 years and, 12.7 per cent of the pregnant young girls aged 15 to 19 were HIV infected.
Hence through ISHP, we will educate pupils on how to prevent HIV infection and ensure that those who are infected, are identified and receive treatment, care and support. However, we would like to emphasise that the package of sexual and reproductive health services will be provided by a professional nurse in a one-on-one private and confidential consultation.
To render a high level of service, Government has trained 500 health professionals for this programme. The services will be provided by school health teams with each being led by a professional nurse. Every team will also include enrolled nurses, oral hygienists, and health promoters.
United Nations Children's Fund (UNICEF) Representative in South Africa, Aida Girma lauded the ISHP saying: “All children deserve the best start in life so they can grow up strong, learn and succeed in life – from birth, through childhood and into adolescence. This new school-based policy heralds a new collaborative era on child health and education in South Africa.”
The government believes an effective school health programme helps us capitalise on an invaluable opportunity for the healthy development of children. We urge parents to support our Integrated School Health Programme and to encourage their children to participate in this programme. Importantly, this programme can only thrive if the school governing bodies and the teachers provide an enabling environment for it to achieve its desired intention in their respective schools.
Phumla Williams is Acting CEO of the Government Communications and Information System (GCIS)