The biggest barrier to an education is ill health.
HealthStart breaks down that barrier.
Thanks in part to the Millennium Development Goals, 90% of children in the developing world now have access to school, but malnutrition, malaria, diarrhea, worms and other health issues stop those children from learning even if they make it to school. By tackling all of these issues, HealthStart means children actually get an education.
HealthStart 1, our pilot, saw school pass rates go from 40% - 87% in our two schools and proved the efficacy of a holistic and comprehensive approach to school health.
HealthStart 2, supported by Comic Relief, ran the programme in 25 schools from 2016-2018. We found that HealthStart could be delivered for less money and drive sustainable change - by strengthening systems within schools and engaging the whole community.
By phase 3 in 2020, we want to launch 100 HealthStart schools. That's 80,000 children.
HealthStart 2: a report
Posted on 02nd Nov 2018
It was Child.org's biggest, most ambitious and complex programme to date. Using our first ever Comic Relief funding, we scaled our comprehensive school health programme to 25 schools at a cost of £316,056. But did it work?
We've just finished creating a full report on HealthStart 2: what we spent, what we learned and what we achieved. The full report is available for anyone to download at the foot of this page, this blog will give you the headlines!
Where did HealthStart 2 come from?
HealthStart 2 is the second iteration of Child.org's school health programme, HealthStart. HealthStart advocates a holistic approach to child health, tackling a whole range of health issues for children at once, helping them get the most from their education.
The first version of HealthStart was a pilot, which we're now imaginatively referring to as HealthStart 1. This ran in two schools in Kisumu, Kenya for two years. We wanted to prove how effective this comprehensive approach to child health could be. It worked: we delivered a whole suite of health interventions at once, and the effect on the health of pupils in the schools, and their educational attainment, was transformational. HeathStart 1 was entirely funded by our visionary partners, Festival Republic.
The success of HealthStart 1 meant that Child.org were successful in applying for our first ever Comic Relief grant, to run HealthStart for another three years, this time in 25 schools. This time, HealthStart 2 would aim to deliver a comprehensive school health programme for less money and in a more sustainable way. Having proved the concept, we wanted to find ways for schools to deliver a similar holistic school health programme themselves. Here's what happened...
Schools delivered their own interventions
This iteration of HealthStart was all about strengthening systems within schools, their relationships with external bodies and their communication with their wider community. We wanted to show that schools could deliver their own health interventions, if they were provided with the right structures and health information about thier pupils.
This was a fantastic success, and it meant that schools received the interventions that they most needed. For example:
- Three schools built wells and created new water systems
- Five schools installed hand-washing facilities
- Four schools built additional classrooms
- Two schools built fences around the school grounds
- Two schools focussed on environmental protection, planting over 300 trees between them
- One school fundraised from the local community to build new latrines for the pupils
- Over 120 issues were dealt with that had been reported from the pupils to the school boards
None of these changes were funded by HealthStart. The schools identified their own solutions as a result of working together and applying to the government, the community or other organisations to help them to strengthen their weakest areas. (And our HealthStart school health audits helped them to identify the areas that needed improvements.)
We reached more children than ever before
The programme provided worming medication and health education to 11,690 children. In total, counting community members and parents, this programme impacted on the lives of 56,985 people.
We made HealthStart cheaper
HealthStart 2 was delivered at a cost of £25 per child. This low cost for such a comprehensive, three year programme is down to this iteration of the programme being designed with sustainability in mind. The biggest cost of HealthStart 2 was staff time, implementing the programme (you can read a full breakdown of what was spent in the report, below.)
We faced challenges
There were two key areas that presented particular challenges during HealthStart 2: digital data collection and management; and the political environment.
We initially planned to develop our own data collection tool for HealthStart 2, but before investing in this we decided to try an existing tool called SnapStory. (We had accepted that the majority of the data would need to be collected by hand, but wanted to introduce a digital system to speed up the process and to reduce opportunities for error.) While we had some success with this, it became clear that the app was slowing down our team. Whilst in the field, the team quickly reverted back to using their tried and tested method; writing the results down on paper. We managed to reach a compromise at later project sites by taking laptops and inputting directly into spreadsheets, therefore reducing the opportunity for error. We have recorded some key learnings from this experience that should enable us to improve the process next time.
The biggest setbacks and difficulties we faced during the programme were due to the political climate. Kenya has a relatively stable potitical environment, but big events like the elections and political unrest last year impacted on the programme. To mitigate this next time, we'd prefer to run the programme over a longer time frame, to give everyone more time to catch up after short term disruptions.
We reached beyond the schools
As we learned in our HealthStart 1 pilot - community engagement beyond the schools is key to making sure we deliver long-term change. We wanted to make sure the messages that children were receiving about their health at school were reaching home and being reinforced int he wider community. It was also very important to provide parents and caregivers with health information about their child.
- 25% of parents told us they had applied knowledge learned from HealthStart to improve the health of their families
- We witnessed improvements to hygiene practices in pupils' homes
- 45% of parents used the new Health Cards we introduced to improve their knowledge of the health of their children
- Caregivers reported improved knowledge on nutrition and communicable diseases
- Community sessions strengthened communication between the schools and the community
We improved health education
By ensuring schools were familiar with Kenya's schoool health policy, providing educational materials and by creating and training up school Health Clubs, we increased understanding of a whole range of health issues and behaviour.
- 87% of School Health Club members feel that they are having a positive impact on the health of pupils
- There was a 42% increase in pupils reporting they are given information at school about how to stay healthy and avoid sickness
- 94% of older children now know how to protect themselves from unwanted pregnancies
- We noticed improvements to children’s confidence about reporting sexual harassment
We're seeking funding for two further iterations of the HealthStart programme. Having previously run HealthStart in and around Kisumu, HealthStart 3: Narok will bring HealthStart to a new area of Kenya, where children face different health difficulties. This will help us test the flexibility of HealthStart, and build contacts and relationships in a new area of Kenya. HealthStart 4 will be a huge project, where we work with government agencies to scale the programme to run across an entire county. This has the potential to reach 200 schools, and over 50,000 children.
It costs Child.org a significant amount of money to apply for funding to deliver a huge programme iteration like HealthStart 3 and 4. (It also costs us money to write blogs and produce reports, which we do because we believe in being transparent about the fantastic work we're achieving with your donations, and to encourage further support!) We rely on your donations to make this happen. If you believe in what we do, and you want to donate money that could have an enormous impact, do something amazing. Donate.
Read the full report
Download the full report as single pages or in spreads (whichever is easiest to read on your device.)
If you would like to request a printed copy of the report, drop Francine an email at firstname.lastname@example.org.
The whole is greater than the sum of the parts
All the evidence points to the fact that when tackling health problems - you need to do them all. Just providing clean water, or malaria nets, or deworming tablets can help, but it can also exacerbate the other problems. You need to do a comprehensive intervention. The FRESH framework from the UN and WHO makes this very clear, but it’s also expensive and complicated. We wanted to prove that it can be done, and that it works.With our partners in Kenya we ran a pilot in two schools, to 2,000 children, over three years. We tackled malaria, malnutrition, worms, diarrhoea and waterborne diseases. By tackling them all together we showed the impact can be huge. We’re building on that evidence now.
Where we work
Currently HealthStart is working in Western Kenya. Over the next three years we hope to expand a version of the programme to Sierra Leone.
One simple intervention (water/malaria nets/deworming tablets) doesn’t work - or if it does, it doesn’t last. We are determined to change the way health and education intertwine for good.
HealthStart works with schools, local government and the community to put in place a system that will have a sustainable impact on every pupil.
We work with each school to ensure they are embedding health services and teaching health skills. It’s the school that will deliver the services in the long term - so we need to work with them.
We set up health clubs within the schools for both children but also parents and other members of the community. Communities hold the school to account.
We help the schools ensure they get the malaria nets and deworming tablets they’ve been promised by the government. We work with each school to see what other services they need - nutritional supplements, clean water, sanitation and help find ways to deliver those sustainably.
It is essential we know what works and what doesn’t. We teach the schools to capture and share their results so that we can continue to learn and monitor which schools need further support.
How you can help
"These results are encouraging and demonstrate that complex schools health programmes can lead to positive gains in health, nutrition and importantly academic performance.
"There is a need for further evaluation of comprehensive school health interventions in poor communities."
A monthly donation is the best way to help us fund HealthStart. We won’t tell you that your monthly donation of £100 saves 100 children. It’s not as simple as that. Read why we need Child.org core.
If you want to help us spread HealthStart and get rid of the barriers stopping children from getting an education, take a look at our Do something page and take your first step.