In Tanzania, despite recent declines, malaria continues to contribute significantly to morbidity and mortality. The…
In 2016, when Stephen Dugbartey received his appointment as Municipal School Health Education Programme (SHEP) Coordinator, he was excited. Although Mr. Dugbartey had worked through the ranks of the public school system in his municipality of Nsawam Adoagyiri—from schoolteacher to Municipal SHEP Coordinator at the Ghana Education Services office—he did not feel fully prepared for the challenges of his new position.
He saw his new role of SHEP Coordinator as an opportunity to combine his passion for teaching with impacting the welfare of his community. However, he quickly realized that coordinating teachers to lead SHEP activities in their schools was no easy task. He saw that many of his colleagues did not have the same level of passion he had for health activities, but he could not fault them. He was well aware that more pressing structural challenges in the school system consumed the focus of teachers. “Some of these schools are village schools. Initially, they did not even have enough teachers,” So, it was no surprise that teachers prioritized these structural challenges, as opposed to focusing on SHEP.
VectorWorks kicked off its school-based malaria social and behavior change communication (SBCC) program in January 2017, and immediately the teachers were more engaged. VectorWorks trained SHEP coordinators and head teachers from all the schools in the municipality on how to conduct malaria communication through SHEP. VectorWorks recognized that SHEP was a key vehicle for school-based malaria education, thus held trainings to ensure better consolidation and prioritization of malaria education activities within overall SHEP activities.
Although malaria prevention was a main focus of the trainings, it was not solely prioritized. Trainings included a concurrent focus on the broader goal of improving the overall implementation of SHEP. VectorWorks provided attendees with guidelines for setting up health teams that are to oversee the implementation and routine monitoring of SHEP activities in their schools. VectorWorks also taught attendees how to develop action plans for implementation of SHEP activities during each term and provided them with a variety of strategies for communicating general health messages to students.
These trainings helped increase the credibility of a previously lackluster program. Mr. Dugbartey explained that prior to the workshops, “teachers had little motivation to engage in the program.” Furthermore, there was minimal accountability for monitoring the progress of SHEP activities in schools. Following the trainings, teachers were more interested and excited about the program. Mr. Dugbartey explained, “Automatically, teachers wanted to be a part of it!” In addition, action plans provided a mechanism for monitoring school staff engagement in the program. Mr. Dugbartey noted: “We now make sure that every term, they have an action plan. So, we just go to schools and ask for the plans.”
In addition to the trainings and subsequent implementation of SHEP activities, noticeable declines in malaria incidence and students’ absenteeism raised teachers’ spirits and they began to see the impact of the SHEP. In October 2017, VectorWorks, as part of its routine school SBCC monitoring, conducted a survey to assess the implementation progress of SHEP since the trainings. The survey found that 98% of schools reported fewer cases of malaria symptoms among students; 65% reported lower absenteeism; and 65% observed improvements in the use of insecticide-treated nets (ITNs). Malaria incidence was down for students and motivation sky high for teachers; it was a win-win for everyone at the schools.
The school SBCC efforts and activities focus on malaria education with a specific emphasis on malaria cause and transmission as well as effective tools for malaria prevention. Classroom lessons, school assembly discussions, and games serve as the primary methods/forums of education. The ‘Avoid the Mosquito’ game is a favorite among students and reinforces the message that when an individual sleeps under an ITN they avoid contact with mosquitos, thus preventing malaria. Additionally, Parent Teacher Association (PTA) and community outreach events provide other opportunities for teachers and pupils to educate the greater community about malaria prevention and ITN use through drama, poetry recitals, and discussions.
In the nine months between training and monitoring, SHEP activities increased much more than expected. At the time of the routine monitoring survey, 86% of schools in the Nsawam Municipality had set up their health teams and 86% had developed action plans, in compliance with the training directives. Finally, SHEP became the perfect platform for Mr. Dugbartey to fulfill his passion for improving the welfare of his municipality. The trainings gave him the tools he needed to supervise SHEP activities, and the guidelines from the training provided new incentives for schools to participate in the program.
Tamilore Areola was VectorWorks’ Global Health Established Field Placement from the Johns Hopkins Bloomberg School of Public Health placed in Ghana.