The Healthy Learners Model
We recognized that if school-aged children aren’t accessing healthcare, then the entry point should move to where most children already are. Through our model, schools are able to monitor and respond to the health needs of children and facilitate preventative care. The result: better health for children.
Leveraging Existing Resources
We partner with the Zambian Ministries of Health and Education to implement, manage and monitor the model. We integrate programs into the existing infrastructure of local schools and health facilities, therefore reducing costs and promoting local ownership of the programs. As a result, we are able to sustain the program for less than $3 per child.
Training School Health Workers
We train and equip teachers to provide health education, monitor the health of students, assess unwell children, provide basic medical care and referrals to government health facilities.
Our School Health Workers are able to provide students with deworming medication and Vitamin A supplementation, and they help coordinate school-based vaccinations for the Ministry of Health.
Proactively finding sick children
Our model is uniquely able to provide timely feedback on sick children. We work with schools to actively monitor the health of their students as follows:
1. Buddy groups: All students are placed in "buddy groups," in which they are responsible for looking after their fellow classmates and reporting to their teacher when someone in their group is unwell. Teachers engage the buddy groups to obtain additional information about students absent from class.
2. Monitoring school attendance: Schools use class attendance to identify and follow up on the health status children who are absent from class.
3. Follow-up: School Health Workers contact parents of children suspected of being unwell. Students who are sick are encouraged to seek out care, while students who are otherwise healthy are encouraged to return to class.
Assessing sick children and monitoring health trends and outbreaks
Sick students are assessed by one of the trained School Health Workers (SHW's) using our mobile diagnostic tool. The screening algorithm was developed by ThinkMD, is based on international community case management guidelines and has been recognized by the World Health Organization.
Data collected by SHWs through the application enables us to monitor program quality, identify epidemiological trends and detect disease outbreaks throughout our network of schools. We provide real-time reports on program performance and health trends to our government partners.
Fast-track Referral System
If a student needs care from a health facility, the School Health Worker fills out a referral form while the student rests in the school’s sick bay. The student’s guardian is contacted to help take a student to the health facility. A SHW will directly intervene and take the student to the health facility if the student is found to require immediate professional medical attention.
Because they have already been triaged by a School Health Worker, students referred from the school enter a ‘fast-track’ at the health facility. These students are able to bypass queues at the health facility and receive care immediately. This fast-track system is highly regarded by our communities and has resulted in increased willingness by parents to bring their children for care when they are sick. Additionally, clinical officers report that the information provided by SHWs improves the efficiency and quality of care for school children visiting the clinic.
Improving continuum of care
Health facilities complete a ‘follow-up’ form for all children referred from the school. The form includes important information on the clinical diagnosis, treatment and advice from the health facility.
School Health Workers are required to follow up on all children they refer within three days, consulting further with students and guardians as necessary. If the condition has worsened, then the SHW will reassess and refer the student back to the health facility for additional care.
Preventing illness and promoting health
While schools are mandated to provide health education, in practice, lessons are rarely offered. We work with school administrators to establish designated times in the school schedule for health education. School Health Workers (SHWs) both teach the course themselves and help other faculty members to do so. The curriculum includes topics such as hygiene, HIV/AIDS, sexual and reproductive health, and common childhood illnesses. Data collected by SHWs enables us to tailor health education topics to community disease trends and emerging issues.
SHW support the deliver preventative medical interventions to school-aged children. For example, they provide students with biannual deworming and vitamin A supplementation, and they help to sensitize the community and organize students to receive immunizations from medical professionals at the school.
Local supervision and mentorship
We train both health facility staff and school administrators—the health staff to provide ongoing technical support to School Health Workers and the administrators to provide day-to-day supervision and management. Our active engagement of parent-teacher-associations has resulted in greater community awareness and support of student health.
We have found that by building strong links between the local schools and the health facilities, as well as engaging parents and community members, we can increase awareness among families and communities of the issues of school-aged children’s health.