HEALTH PROMOTION ACTION PLAN

The future of nations is determined by the energies, capabilities and well-being of their
youth. They are an essential natural resource, and key to socio-economic development. Pridmore
& Stephens (1999) state in their study that it is the very reason that there is an emphasis on
developing the quality of children’s life through improving health and education. In order to
response to the diseases that hinder achieving health and affect children’s achievement, health
promotion in schools has emerged world widely (Hubley, 1993).
In HPIS1 course, I learnt very first time about health promotion2 and Child-to-Child
approach3 to overcome the main causes of widespread diseases. Before this course, I had very
narrow idea about health; I considered it as an absence of any physical disease. Here, through
classroom discussions, benevolent input from facilitator and different readings, I learnt that it is a
state of complete physical, mental and emotional wellbeing (WHO, 1984: 1). Through active
participation in classroom discussions, I gained insight that health promotion emphasize the
importance of interventions to prevent diseases and promote wellbeing rather than relying upon
the remedial efforts to treat their damaging effects. After grabbing deep insight from different
classroom discussions and literature, I was encouraged to develop a health action plan for my
own school that may be implemented in future.
This paper highlights a health promotion action plan that I intend to implement in my
context. After analyzing my school context, this paper discusses the goals, objectives and
scheduled action plan, and it concludes with some expected challenges.

Background and Context of the School

The school where I work is Government Urdu Middle school New Saeedabad, district
Matiari. It is boys’ school with the enrolment of 200 students. There are 10 working teachers
with varies qualification such as B.A., B.Ed and M.A. The average age of teachers is 35 years

Health Promotions in Schools, a course taught in M.Ed. program at Aga Khan University-Institute for Educational 1
Development, Karachi
Health promotion is best thought of as a situated practice and it describes a relationship between state, market 2
economies and community groups. State regulates health opportunities, market economy creates both health
promotions and health hazards and community groups influence both the state and market economies as well as their
.own health
Child-to-Child approach aims to build children’s capabilities to take preventive health action. The approach also 3
recognizes that children have an extraordinary and unique power to act as agents of social change within their
.communities

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and the average experience is 17 years. Majority of teachers have rare opportunities for
professional development. The students are from low income and less educated families of the
locality. It is the main reason of less communication between school and parents (details are in
Appendix A).

Structure and Culture of the school

The school has four classrooms and one headteacher office. The school has a full
compound wall and possesses a small playground for students. Its hierarchal structure follows a
traditional government system, starting from EDOE4 to headteacher of the school. There is a
School management Committee that works as a bridge between school administration and
parents of the school. Due to the part of a hierarchal system, the school follows an authoritative
way of decision-making. The system lacks in proper check and balance mechanism from
administration side. The teaching and learning process follows a teacher-centered approach,
having fewer opportunities for the students to take part actively and independently.
I analyzed my school’s context and culture on FRESH framework5 and came-up with
following conclusion (details are in Appendix B);
• School has no written policy on health priorities. As for the health practices, there are no
proper measures for sudden accidents or injuries. Physical environment is not safe and
secure in terms of addressing issues such as school violence, corporal punishment,
bullying and harassment.
• School lacks in most of the basic health facilities, such as adequate sanitation facility,
school canteen, sickroom/ first aid facility, proper placement of dustbins and etc.
• Teaching and learning process is totally teacher-centered and students hardly get chance
to work independently. Teachers have very less expertise in delivering effective skill-
based health education. Child-to-Child approach aspect is missing from the scene.
• Due to hierarchal management system, there is lack of ownership among all stakeholders,
particularly; there is a big communication gap between school management and
community.

Executive District Education Officer 4

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Focusing Resources on Effective School Health (FRESH) which comprises four core components: Health-related
school policies, Provision of safe water and sanitation, Skills-based health education, and School-based health and
nutrition services

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Rationale
Analyzing the critical health issues that I found in my context, and relating and reflecting
on my experience, as a teacher, social worker6 and health promoter7, I realize that children need
to live in a healthy learning environment. They should be given opportunities to participate in
decision-making, developing their own learning and life-skills. In order to overcome the most of
the unhealthy practices, two stakeholders (teachers and students) are imperative to be focused,
teachers need to be trained and the students need to be engaged in health promoting activities.
Since, one of my brothers became victim of a contagious disease (hepatitis B) and
recently passed away; therefore, I intend to promote awareness about contagious diseases in the
community. My action plan will mainly focus on the training of the teachers to develop school
health policy and involve students in learning and to support them to develop good health
practices. Secondly, enhancing the capabilities of students and helping them to become ‘change
agent’ to fight against contagious diseases through CtC approach. The main rationale behind this
plan is to enable students to address the hazardous contagious diseases by themselves and to
educate other children to prevent themselves and their families. I consider children as a bridge
between community and school for spreading awareness about such health issues and CtC as a
strong medium for dissemination of health knowledge through schools into the communities.

Goals
• To facilitate teachers in developing their understanding and skills to promote health
education through CtC approach.
• Develop students as real ‘change agents’ through empowering them to promote basic
health education8 in their families and localities.

Objectives (for teachers)

By the end of academic year 2011-2012, teachers will gain deep insight;

.I worked with a local NGO (CBO) in its poverty and illiteracy alleviation program for more than 4 years 6
I worked with a national NGO, HANDS in its primary health care program (Mother-Child health care) for more 7
.than 5 years. Where, I learnt about first aid and immunization
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Students will be provided with basic knowledge of healthy food, cleanliness and ways to fight against contagious
.diseases

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 • To apply different innovative strategies to engage students in CtC approach to promote
basic health education; cleanliness, healthy food, prevention from contagious diseases,
etc.
• To convey basic health messages about hygiene and disease prevention, environmental,
community and social health to the families and communities through CtC approach.
(detail in Appendix C)

Objectives (for students)

By the end of the academic year 2011-2012, students will be able to;
• Identify basic health issues about hygiene, disease prevention, social and environmental
health.
• Develop positive healthy habits and attitudes.
• Actively participate to promote health and hygiene information in their surrounding
(school, family and community).
• Take possible actions against contagious health diseases at school and community level.
(details in Appendix C)

Input activities
In order to achieve the above-mentioned objectives, different activities will be
introduced. Teachers will be engaged in different training programs, workshops, presentations
and reflective practices. Students will be introduced to role-plays, poems, story-telling, debates,
presentations, surveys, poster displays, health mela and practical demonstration on cleanliness
and hygiene and disease prevention. (Details in Appendix C)

Outputs and Outcomes

Based on the above given inputs, following outputs and outcomes are expected:
• School implements an updated health action plan and adopts a new school policy
integrated health education in all subjects at least twice a week.
• All teachers are trained in using CtC approach.
• Friendly and collaborative learning environment in the school.

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 • Students are aware of different health issues and they can develop any disease-preventive
model.
• Students are encouraged and supported to be creative in initiating health promoting
activities.
• Students initiate activities to involve their parents and other community members in
health promotion.
• Students are capable enough to convey health messages in their homes and locality.
• Students are highly motivated to take possible actions against contagious diseases.

Monitoring and Evaluation

Some indicators (observation checklist) for health practices, school environment and
teaching and learning practices will be set to evaluate the outcomes (Appendix D & E).

Conclusion
In order to develop socio-economically, nations need to build their youth healthy in all
aspects (physically, socially and mentally). It is evident from the literature that high rate of death
among children is big threat for the welfare and productivity of the nations. To avoid big risks,
health education is considered as an imperative tool and health promotion in school has gained
immense response world-widely (Hubley, 1993).
In Pakistani context (particularly in rural areas), health promotion and CTC approach is
widely neglected factor in schools. School policies need to integrate health education with other
subjects for the holistic development of the child. There are many contagious diseases that are to
be addressed with the help of young generation. For that purpose, proper health action plans are
need to be developed and the students are to be encouraged to take possible actions. The
communication among all key stakeholders (school management, teachers, students, parents and
community members and government) is the guarantee for implementation of any action plan.

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REFRENCES

Hubley, J. (1993). Communicating health: An action guide to health education and health
promotion. UK: TALC.

Pridmore, P. (2000). Children's participation in development for school health. A Journal of

Comparative Education. 30(1).

Pridmore, P. & Stephens, D. (1999). Education and health for development in children as
partners for health. London: Zed Books.

Ramachandran, L. & Dharmalingam, T. (1993). Health Education. A new approach. New

Delhi: VIKAS.

World Health Organization (WHO) (1985) Targets for All: Targets in Support of the European
Regional Strategy for Health for All. WHO Regional Office of Europe, Copenhagen.

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 APPENDIX A
Background of the school
The school where I work is Government Urdu Middle (6-8 grade) school New Saeedabad. The
school is located between Graveyard and Hala Branch Canal near Ward No.4, Saeedabad District
Matiari. It is boys’ school with the enrolment of 200 students. There are 10 working teachers
with varies qualification such as B.A, B.Ed and M.A. The average age of teachers is 35 years and
the average experience is 17 years. This school lacks in most of the basic facilities. Such as;
there is no staff room, no proper uniform for students, resource room, library, computer lab,
school canteen and sick room/fist aid facility. The school has no health education policy. There
is integration of HE in different subjects (such as science, Islamiyat and social studies) but
teachers do not focus on the health aspect.

Characteristics:

School timings:
The school timings in both winter and summer are from 8:00 a.m. – 1:00 p.m.; but due to lack of
check and balance teachers and students have their own timing to come to school.

Curriculum:
This school follows the national curriculum but uses books published by different publisher
covering the prescribed syllabus. The medium of instruction in the classrooms is Urdu.

Promotion:
The school has two terms of six month each in a year. Half yearly and final exams are held at the
end of each term respectively. Children have to get at least 33% marks in language (Urdu and
English), math and science to be promoted to the next class

Human resources:
The school has a headteacher, 10 teachers, 3 peons and one gatekeeper.

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School Facilities:
Classrooms
School has ventilated and big classrooms but with sturdy furniture (All classrooms have
chairs, desks, black board and a cupboard) and inappropriate lighting. There are two ceiling fans
in each classroom. The surrounding of the classrooms is not properly clean; there are bushes all
around that may become the cause of snake biting and malaria.

Playground:
• There is a small playground within the boundary wall of the school

Latrine:
The washrooms were available but lacked in the cleanliness. To keep washrooms clean a
bucket of water were placed in latrine. However, no soap was available for hand washing.

Drinking water:
No arrangement for pure water. Small water cooler without lid is placed in corridor at
ground. One contaminated plastic glass is placed on a water cooler. The school has hand pump
and water motor placed inside school premises but the purity of the water in terms of its access is
not kept in concern.

Health Services
The school does not have any health service. Even for any emergency, the school has no
measures. The injured students are rushed to nearby town’s hospitals. The school has no first aid
facility.

School events:
The school rarely celebrates any event. However, Eid Milad and 14th August are
celebrated within the school premises.

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 APPENDIX B
Need Analysis

• The school follows a traditional way of teaching and learning. Teacher-centered

learning environment is found in the school.
• There is no health education policy in the school.
• The term ‘health’ is still understood as 'being free from diseases', which is totally
different from the definition of World Health Organization (WHO, 1948) that, "Health is a state
of complete physical, mental and social well being and not merely an absence of disease or
infirmity". However, teachers are untrained in how to develop life-skills among students to build
their capacity for maintaining a healthy life.
• All the basic health facilities are missing in the school.
• There is no specific curriculum for health education. Even there is no integration
of HE in other subjects.
• Very rarely health messages are communicated by the teachers.
• Students’ social behavior and attitude is controlled through corporal punishment.
Very less moral education is kept in concern. Methods used are still teacher-centered, with a
focus on rote memorization, without allowing a space for developing students' critical thinking,
and problem-solving capacity.
• School has no canteen/tuck shop; therefore, students are to take snacks from
venders that are very harmful for their health.
• Students are not involved in decision making process.
• There is lack of communication between school management and community.
Majority of the parents have not visited school for more than two to three years. When they are
called for meeting about the performance sharing of their children but very few parents show up
and respond to teachers’ call.
• Students are totally unaware of contagious diseases and their consequences; they
have not adequate information about malaria, diarrhea, cholera or hepatitis. It is therefore, they
do not care for themselves and their family.

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 Situation Analysis of the Enabling Environments
School/Learning Place: Government Urdu Middle School Saeedabad

Date: 12-01-2011 Observer: CP M.Ed. 2011

Please circle one – YES or NO Notes: Please clarify criteria used to

define e.g. how did you decide something
was clean? What criteria did you use?
The Learning YES NO
Environment
(OBSERVATION)
Is the school or learning YES NO
place clean? 
Classrooms? 
Playground? 
Is the school or learning YES NO Please list hazards:
place safe from pests (eg. The surrounding of the school is full of
mosquito breeding places bushes that are the breeding places for
& snakes) road, electrical, mosquitoes and snakes
biological, chemical
hazards?
Are there latrines? YES  NO

Are the latrines clean? YES NO 

If there are no latrines what YES NO

do staff and students do?
Is there clean water to YES  NO Water is taken from hand pump and water
drink? motor but it is paced in a rough water
cooler
Is there soap (or ash) and YES NO 
water to wash hands?
The Learners (interviews and FGD)

Are the children in the YES NO Please describe

school or learning place Almost all children are not generally
clean? (nails, hair, nose, clean. They wear untidy clothes
clothes, shoes)
Are the children directly YES NO Please describe
involved in the CtC
programme clean (nails,
hair, nose, clothes, shoes)?

Do all the children in the YES NO

school know about the CtC
programme?

Are the children in the YES NO How do you know?

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school happy about the They do not know about CtC program
CtC programme?

Are those directly involved YES NO How do you know?

in the programme happy
about it?
Have changes occurred in YES NO
the school/learning place
because of the programme
since it started?
Do children believe they YES NO
can make in their own or
other health?
Attitudes towards CtC Programme

Is the school management YES  NO How?

supportive of the CtC Teachers and head shared their feelings
programme? during the discussion
Does the school YES  NO How?
management believe that They shared their feelings during the
children can promote discussion
health and well-being in
their homes and
communities?
Are the teachers happy to YES  NO How do you know?
be involved in the CtC They shared their feelings during the
programme? discussion

Do the teachers directly YES  NO How?

involved in the CtC They shared their feelings during the
programme believe that discussion
children can promote
health and well-being in
their homes and
communities?
Parents/Community Involvement (Interviews and FGD)

Are parents, guardians, YES NO  Awareness meetings with parents will be

carers aware of the CtC conducted
programme?
Are they supportive of the YES NO How?
CtC programme?
Do they believe that YES NO How?
children can promote
health and well-being in
their homes and
communities?
Health in the Curriculum

Is health education taught YES NO 

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in the existing curriculum?
Is there a separate health YES NO Please describe.
education curriculum?

Is there a health action plan YES NO Please attach or list topics covered
in place?

Is the health action plan YES NO How? By Whom? When?

being monitored and
evaluated?
Are there any co-curricular
health activities taking
place? (e.g. health clubs)
YES  NO Please describe.
Eid milad and 14th August
Sports

Health Services
Are there health services YES NO 
provided for the school?
Are there health services YES NO 
provided by the school?
Are children involved in YES NO 
basic health service
provision (e.g. First aid,
nutrition programmes)

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 APPENDIX C
Health Action Plan

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S:NO Tasks/Activities Actions Resources Timeline Remarks

1 Initiate health • To call and • SMC Once a Health

management conduct general members month management
Committee in meeting & PDT regularly committee will
school • To decide and • Meet from the meet parents and
ensure regular ing venue year other community
meetings (2011- stakeholders and

• To encourage 2012) will sensitize

members for them and

playing vigorous mobilize them to

role work
collaboratively.

2 Workshops and Making plan, Human Twice in a -Teachers apply

refresher courses inviting participants, resources month: new teaching
for teachers arranging required such as June and methods like
related to new material for trainers/ July 2011 (child-centered
pedagogical trainings and trainees, approach,
skills) ensuring venue for PDT. inquiry-based
training Training teaching,
material cooperative
learning,) etc.
3 Presentations on Conducting PDT/trainer Two * Teachers apply
FRESH presentation about (multi- sessions new teaching
framework & FRESH framework media, in July methods.
Child-to-Child & to teach them writing pads, 2011
approach how to use CtC in handouts, *Students are
school and how to pens, pencils involved in &
integrate health etc) interested in
related topics with learning.
others subjects
4 To enhance Story telling & role Props, story 3 months -Students initiate
awareness and plays on healthy book, charts, August- some activities:
importance about food (avoiding pencils, October (Displaying and
healthy food in unhealthy food), color boxes, 2011 conveying health
students poems, making blackboard, messages in 14
slogans regarding chalk, school premises
healthy food, poster charts, through slogans
 APPENDIX D
Classroom Observation Checklist of Teaching & Learning Practices

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S# Indicators Y N Comments
1 Planning
• The teacher has unit/daily plan
• Objectives are SMART
• Strategies/activities are clearly mentioned
2 Subject Knowledge
• Teacher has sufficient understanding of the
subject knowledge
• Explains concepts in a simple and clear way
• Gives examples from daily life
3 Method of teaching
• Teacher gives clear instructions
• Involves students in pair/group work
• Pays individual attention
• Facilitates the students during group and pair
work
• Manages time properly for each activity
• Voice is clear and audible to all the students
• Keeps proper eye contact with students
( focusing all student)
• Asks creative questions to develop students
thinking skill
• Uses Child-to-Child Approach
4 Setting and checking home work
• Gives homework (HW) and check on regular basis
• writes comments on students HW journals for
improvement
• writes letters to parents to help children in doing
HW
• has developed HW time table and follows it
• HW is challenging and creative
• Gives individual/group feedback
4 Lesson evaluation
• Checks students learning to see whether the
objectives were achieved or not
• Reflects on the lesson delivered and students 16
learning
• Focusing on slow learners
 APPENDIX E
Health Improvement Observation Checklist

AREAS Y N COMMENTS

School has clear health policy

Is there any health action plan?

Health education is integrated with other subjects

What health topics are covered?
Is school/learning place clean?

Are the learners/students and staff clean? (nails, hair, nose,

cloths, shoes)
Classrooms are airy with sufficient sunlight
Classrooms are clean and organized

School assembly
Physical exercise
Lecture sessions on health
Students avoid uncover and unhealthy food
Students bring their home-made food

School has own canteen/tuck shop

Access to pure drinking water

Washrooms are in good condition

Washrooms possess all necessitates (water, soap, etc.)

Students effectively participate in sports periods

Students reduce noise pollution

Students artifacts are displayed in the school

Students show respect for others (students, teachers & other

staff)

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Students participates in competitions and win prizes

Students participate in health activities inside/outside school

Good relationship among students

Students conveying health messages through school
assembly
Students follow school regulations
Discipline in classrooms and school premises

Corporal punishment

School play-ground is safe

School has sick room/first aid

Dustbins or thrash bin available

Flowers and trees are planted by students, teachers and
others in the school and the near surroundings
Free-smoking school (nor students nor teachers are smoking)

Low average of absenteeism in classes

Accommodation of special children

Encouragement to shy and hesitant child

Increased numbers of students wearing safety helmets when

riding their motor-bikes

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