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Here are just six of our favourite innovations that we’ve designed in HealthStart’s first year and a half of running in 25 schools.
This is how HealthStart ensures every pound you raise helps as many children as possible, for as long as possible.
1. Designing a new way to choose schools
One of the first things we had to design for HealthStart was a process of selecting schools! We had to identify schools that needed HealthStart, but also schools where HealthStart would work – where the school management were engaged and equipped with the right infrastructure to deliver on the aims of the programme. 
The process we designed to identify schools took four stages:
Desk based research using government and institutional publications.
Consultation with County level representatives from the Ministry of Health and Ministry of Education. At this point, we had identified two sub-counties to look at: Muhoroni and Nyando. Another sub-county, Seme, demonstrated high need but on further investigation and advice from the County Director of Education, a lack of infrastructure make it currently impractical.
Further research and consultation at sub-county and district level.
School interviews
This process was rigorous and exhaustive. We didn’t want to just visit a few schools recommended by local partners and pick the ones where the children looked most unhealthy! We needed to design this process so that we can be sure that the schools we’re working in need our support, and are schools where we have the opportunity to create lasting change. 
2. The HealthCard
Improving a child’s health and wellbeing through interventions at school is practical, but we also need to engage and involve the children’s parents if we are to have a long-term impact in the lives of the children and a wider impact in the community. 
It sounds extraordinary, but in Kenya, many children would be receiving health services, even medication at school that their parents might not even be aware of. One of the bright ideas we came up with while designing running HealthStart was the HealthCard. The HealthCard is like a school report card for health, and simply enables the school to communicate basic information about a child’s health with the caregiver at home!
The Department of Health in Kenya have asked us to measure the impact of the HealthCard and provide them with information about the difference it makes. If successful, there is potential for the idea to be rolled out to schools across Kenya. How’s that for a wider impact?
3. School health committees
In all 25 schools, School Health Committees have been set up. This means that each school will be able to assess their own performance against the government’s school health policy, and fill the gaps themselves – without outside interventions from 
For example, it is recommending in the school health policy that schools are surrounded by fencing, but this is not the case for many schools. In our initial audit, this was highlighted as a priority and so far 13 of our schools have built fences around their schools.
This activity was entirely driven from the committees within the schools, without additional prompting or funding from At St Joseph Ngula, the school health comittee sourced funding for the fencing poles and then the community all contributed towards the purchase of a chain to secure the gate. The committee then paid one of the parents, at a subsidised rate, to erect the fence. 
The new fencing makes it easier for schools to keep the children safe, and keep a closer track on their attendance. But it also makes it feasible for the school to invest in more resources in the school grounds, from toilets to food crops! 
4. Redesigning the government’s School Health Audit
When we began this phase of the HealthStart programme, we took an existing auditing system designed by the Kenyan Government in order to assess how well our schools were complying with national school health policy.
It soon became clear that the government auditing tool was over-complicated and under-used. None of our schools had ever seen the tool before, or been audited. So we designed a simplified version which was easy to use and made it simple for our partners to assess the schools’ adherence to health policy and the areas that needed addressing.
Just 8% of schools’ board of managers had received training on the government’s school health policy, only 4% had a copy of the policy and none of our schools had the guidelines or protocols they needed to implement the policy. 
The audit also helped us to find areas that specific schools need to focus on when it comes to health. We discovered that the biggest areas for improvement in the schools were:
Relationships with ministries and other stakeholders
Support for children with disabilities
5. School health clubs.
60% of HealthStart schools have active Health Clubs for pupils. However, many schools consider an active Health Club as one where the children manage basic hygiene and sanitation activities such as cleaning the latrines at the school. 
HealthStart school Health Clubs all include health education activities for pupils. The topics covered are highlighted by the surveys and information we have gathered about the priorities for that school. For example, at the start of last year only 39% of children could give us two examples of how to stay healthy and avoid disease, so there is a great opportunity to teach them simple strategies for staying well!
6. Sharing data to inform policy.
One of the best ways we can make a wider impact with HealthStart is by using our data and findings to inform government school health policy. 
For example, this month we are hosting deworming sessions in all HealthStart schools. Already there’s a national programme that provides the children with one distribution of deworming tablets per year. But in the areas that HealthStart is working in, it is recommended that children receive at least two per year.
So are working with the government to provide a second deworming distribution in our schools, and submitting all our data back to the government, so we can all assess what difference it makes to children’s health, attendance and academic achievement.
This is how you make change long-term. By working with the government, trialling and proving what works, can affect and support national policy.
In our first year of running the HeathStart programme, have worked with 8,918 children and 1,462 caregivers. We are making changes in these schools that will last for generations, with a programme that only needs funding from for 2.5 years. And we couldn’t do it without you, our supporters who are brave enough to fund complicated and necessary work like this.
Thank you for all your support. 


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