The Problem
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.
Read our report on HealthStart 2
Download HealthStart 2 report (PDF)Goals
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.
The Latest
Introducing Child.org's School Health Training Guide
Posted on 11th Apr 2018
In a first for Child.org, Cherio and the team have created a comprehensive School Health Training Guide.
I wanted to share an awesome recent achievement from the Child.org team, the creation of our brand new School Health Training Guide. It's a hefty 136 page book that's designed to help our HealthStart schools to encourage peer-to-peer learning and create a culture of health and safety in their school.
Cherio had the idea for the guide when she was working closely with our Health Clubs at HealthStart schools in Kisumu. At Kenyan schools, it's national policy to create a school Health Club - a group of pupils who meet and take responsibility for creating a safe and healthy environment for all pupils.
In HealthStart schools, the Health Club work hard and take practical steps to improve their school - they clean toilets, refill water stations, ensure provision of hand washing facilities. But we also encourage them to learn about and promote healthy behaviour, and to champion the voices of their fellow pupils to school management. This new guide, Cherio envisaged, would be designed to support and encourage this kind of activity.
Creating a comprehensive guide like this was a big project for the team. It was particularly lovely for our UK and Nairobi offices to work so closely together on a creative project: Cherio and the programming team in Nairobi were drafting content for the book, and here in London, I was working on the writing style and structure, while Clare designed activities, proofed everything and sourced a monumental amount of photographs from our library to illustrate the book. We were working with designer Sam Walter, who had to create an entirely new visual style for the guide - this was the first time Child.org had ever actually had to design something for children to use and read!
What's in the guide?
At all points in the guide there are information sections to read out to a group or class, paired with activities to encourage the children to engage in games, exercises and active discussions around the topic they are learning about.
The guide is divided into three sections. The first helps the school to form their Health Club and teaches children about leadership, avocacy and good governance. The second section gives a comprehensive overview of school health, based on the priorities of Kenya's national policy. The third section of the guide teaches children specifically about sexual health and relationships.
These are some of my favourite learning topics and section titles from the guide, just to give you an idea of how comprehensive it is!
- How, and why, should pupils have a say in the running of your school?
- Life Skills: Decision Making. A six step approach to help you make good decisions, large and small.
- How to influence and communicate with people, without bullying them
- Children with special needs and disabilities: how can your school do more to be accessible for everyone?
- The difference between clean and dirty water, and how to make water safe
- Why you should wash your hands
- Nutrition and the value of eating a balanced diet
- Prevention of diseases including malaria, cholera, and pneumonia
- The male and female reproductive systems, and how they work
- Menstruation, and why it's important for both boys and girls to learn about it
- What to expect from puberty
- Prevention and effects of HIV/AIDs
- Healthy and unhealthy relationships: how to recognise when a relationship is unhealthy
Many of the topics covered in the book are very similar to those we would learn about in the UK. But there are some stark differences that reminded me of the very different problems children are facing in these schools: from "the signs and symptons of malnutrition" to "living positively with HIV".
Our HealthStart schools received the guide around the start of this year. In the gallery below are some photographs from Ayucha primary school, on the day Cherio visited all 25 of our HealthStart schools to give out the books.
Cherio visited Thurbie primary recently, and asked if they were finding the guide useful. She was pleased to see that it was already being used by the school, and the school health teacher, Linet, had this to say:
Providing a comprehensive school health programme like HealthStart is about so much more than the standard interventions that you might expect us to fund in schools, like deworming tablets or sanitary towels. It's about arming the school with the knowledge and structures they need to create their own improvements, long after Child.org have gone. Our new School Health Guide is a great example of this kind of work, and I'm very proud to have worked on it.
Evidence
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.
A few facts from the evidence linked to below:
- In western Kenya, 16% of primary children are underweight, 17.1% experience wasting, 18.3% are stunted and 20% are anaemic (Freidman 2005). Iron deficiency results in brain abnormalities and impaired cognition (Jukes 2008).
- Soil-transmitted helminth and schistosome rates are high in western Kenya and treatment improves attendance by 25% (Miguel 2004).
- Malaria causes 4-10 million days of school absenteeism a year in Africa (Brooker 2000). A study of 30 primary schools in western Kenya found that IPT of malaria improves health and cognitive ability (Clarke 2008).
Evidence based on:


Where we work
Currently HealthStart is working in Western Kenya. We are applying for funding to scale the programme in other areas of Kenya and Sierra Leone.

Methodology
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.
Systems strengthening
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.
Community involvement
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.
Health services
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.
Data
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."
- Archives of Disease in Childhood on HealthStart.
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.
