Partnerships for Promoting Health and Education Donald Bundy Human Development Network The World Bank Vancouver, Canada, June 7, 2007

ConditionPrevalence/ No. Cases IQ loss: Per Child Total IQ loss /mental retardation Years of schooling lost Stunting52%/292m3 points877 (21.6m) 284m Anaemia53%/298m6 points1788 (45.6m) 524m Worms30%/169m3.75 points633 (15.8m) 201m IQ and schooling losses avoidable by school based SHN programs

Comparing returns to education Add years schooling Cost US$ p.a. SHN Programs 1.2 – 2.5 < 4 Textbooks Cash transfer – Nicaragua Cash transfer – Progresa School Feeding 0.4 –

A FRESH Start: Focusing Resources on Effective School Health, Hygiene & Nutrition Child Friendly Schools ….UNICEFChild Friendly Schools ….UNICEF Health Promoting Schools…WHOHealth Promoting Schools…WHO Education for All…UNESCOEducation for All…UNESCO Food for Education…WFPFood for Education…WFP School Health Initiative…World BankSchool Health Initiative…World Bank

A FRESH Start: Focusing Resources on Effective School Health, Hygiene & Nutrition Core intervention activities Effective health, hygiene and nutrition policies for schools Sanitation and access to safe water facilities for all schools Skills based health, hygiene & nutrition education School based health & nutrition services

Policies in schools …that ensure well maintained sanitation and specific agreement that teachers can deliver treatment Healthy environments in schools ….with effective sanitation and safe water to reduce transmission Skills based health education …that promotes hygiene and healthy behaviors School based delivery of anthelmintics by teachers …that follows WHO guidelines FRESH framework for action against worms

FRESH Framework (UNESCO, UNICEF, WHO, World Bank, others) Health-Promoting Schools (WHO) Child-Friendly Schools (UNICEF) PopEd (UNFPA)Global School Feeding Campaign (World Food Program) PolicyRespects and recognizes the rights of the individual Respects and recognizes the rights of the child Creates an enabling environment for reproductive health and HIV education Focuses on those most at risk (girls, poorest communities, AIDS affected and infected) School EnvironmentHealthy environment with opportunities for physical education and recreation Healthy, safe, secure. Is protective emotionally and psychologically Protects young people from unwanted pregnancy, STIs, sexual abuse and violence Serves as platform for other interventions EducationLife skills educationPromotes quality learning outcomes, provides skills based health education Strengthens HIV and reproductive health education programs Supports learning through good nutrition and promotes access to education ServicesProvides services, nutrition and food safety programs, counseling and social support programs and health promotion programs for schools. Includes community outreach components Promotes physical and mental health Ensures access to youth- friendly sexual and reproductive health services Provides food and promotes and supports deworming Supportive PartnershipsEngages health and education officials, teachers, students, parents, health providers, community leaders Is child centered, family focused and community based Targets young people in and out of school and ensures participation from parents, youth, community leaders and organizations Promotes community and school partnerships

FRESH Partnership Launched at the World Education for All Forum in Dakar, Senegal April 2000Launched at the World Education for All Forum in Dakar, Senegal April 2000 WHO, UNICEF, UNESCO, World Bank & OthersWHO, UNICEF, UNESCO, World Bank & Others

Directory of School Based Health and Nutrition Programmes: Findings from a survey of organisation support Partnership for Child Development Jan W de Lind van Wijngaarden Celia Maier Lesley Drake Updated Survey – October 2006

Comparison of integrated SHN programmes in 2006 with 2000

Finding 2: Since FRESH, most agencies are moving towards Integrated SHN Programmes

Comparison of SHN activities in 2006 with 2000

Finding 3: Increasing partnerships between agencies

Accelerating the Education Sector Response to School Health and HIV&AIDS: Four Years On A Working Group of the UNAIDS Inter-Agency Task Team for Education and HIV/AIDS.

Education Sector Funding of the Response to HIV/AIDS: Review of 38 Education projects in Africa Region Only 42% specified a sectoral school health and HIV&AIDS program and budget 33% did not mention school health and HIV&AIDS at all

Allocation of Multi-sectoral Health Resources to the Education Sector (survey of 22 projects) 60% did not disburse to education 18% disbursed >5% of budget to education

Key Correlates with an Effective Education Sector Response: Strong education sector leadership Inclusion of school health in the education sector plan Support from a mix of resources – education and health sector Technical assistance to the education sector in developing this new area

The Process Regional Analytical Work Sub-Regional Workshop Establishment of National Development Partners Group National Workshop and Follow Up

Fast Facts Since 2002: the number of African countries in the Accelerate networks the number of agencies, NGOs and development partners that have participated in the process the average number of days between training events the total number of training days to date 1, the number of education sector staff that have participated in training events 162, the number of person training days conducted

Objective 1: To promote leadership by the education sector and create sectoral demand for an HIV/AIDS response. Participation of countries in the Accelerate Initiative since 2002

Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops █ East Africa 2002

█ East Africa █Nigeria Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops 2003

█ East Africa █Nigeria █Central Africa Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops 2003

█ East Africa █Nigeria █Central Africa █Anglophone West Africa Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops 2004

Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops █ East Africa █Nigeria █Central Africa █Anglophone West Africa █Francophone West Africa (Madagascar observer) 2004

Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops █ East Africa █Nigeria █Central Africa █Anglophone West Africa █Francophone West Africa (Madagascar observer) █Lusophone Countries 2004

Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops 2006 █ East Africa █Nigeria █Central Africa █Anglophone West Africa █Francophone West Africa (Madagascar observer) █Lusophone Countries

Accelerating the Education Sector Response to HIV and AIDS: Sub-Regional Workshops and National Follow-up 2006 █Sub-regional participation only █Countries with National Follow-up

Objective 2: To harmonize support among development partners, in order to better assist countries and reduce transaction costs. Level of representation of UN agencies, bilaterals and civil society organizations at the sub-regional and national level workshops and Network meetings held since 2002

Degree of participation of development partners in in sub- regional and national level workshops held since 2002

Objective 3: To promote coordination with the National AIDS Authorities, and enhance access to HIV&AIDS funds. Chronology of the initiation of MoEs accessing funds from their NACs

Objective 4: To enhance availability and sharing of information on HIV and AIDS that is of specific relevance to the education sector. Total number of website hits on each month, January 2003 – December 2006 Additionally, To date, approximately 250,000 hard copies of 95 titles have been distributed in at least the three main languages.

The sub-Regional Networks of HIV and AIDS Education Focal Points West Africa Network (ECOWAS and Mauritania) 16 countries: launched in 2004 Eastern Africa Network 7 countries: launched in 2006 Lusophone Africa (PALOPS) 5 countries: launched in 2006 Central Africa Network (ECCAS/SEMAC) 7 countries: launched in 2006

Progress made in the implementation of some activities in the area of policy against the number of activities carried out under the Accelerate Initiative. Progress made in the implementation of some activities in the area of prevention against the number of activities carried out under the Accelerate Initiative. Objective 5: To strengthen the technical content and implementation of the education sector response to HIV&AIDS.

Key changes since EFA 2000 More holistic approaches to school health, and increasing recognition of the need to work across the whole school More harmonization among sectors and development partners – more cost-effectiveness, lower transaction costs and less confusion More partnerships across sectors and among development partners around School health programs in low and middle income countries

Key issues going forward FRESH framework does not reflect developments, eg, in health promotion, addressing violence etc…needs to be RE-Freshed Accountability and monitoring of health issues by the education sector often the weakest part of the program…need for a common set of indicators Focus on low income countries has missed opportunities for cross learning with high and middle income countries….need for information sharing among networks

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