Andrew Owusu Ph.D. & Angela Bowman M.A . Middle Tennessee State - - PowerPoint PPT Presentation

Andrew Owusu Ph.D. & Angela Bowman M.A.

Middle Tennessee State University Ghana GSHS & GSHPPS Country Coordinator

Introduction Purpose of Study Methods Results Implications for school health in Ghana

PRESENTATION ROADMAP

 Improved health status of schoolchildren correlates positively with learning abilities and retention (Hawley, Rosenholtz, Goodstein, & Hasselbring, 1984; Strolin-

Goltzman, 2010; Taras & Potts-Datema, 2005).

INTRODUCTION: HEALTH VS ACADEMIC PERFORMANCE

 Capitalizing on link between student health and academic performance requires comprehensive and integrated school health approach (Basch,

2011).

 There is an association between school health services and academic achievement (Castelli et al., 2015;

Esteban-Cornejo, Tejero-Gonzalez, Sallis, & Veiga, 2014; Fedewa & Ahn, 2011; Murray, Low, Hollis, Cross, & Davis, 2007)

The School

• ol Healt

lth h Educa cation tion Pro rogram ram (SHEP) P) establi ablished shed 1992. 2.

• Ghana Poverty Reduction Strategy (GPRS) I & II
• Free Compulsory Universal Basic Education (FCUBE)
• National Community Water and Sanitation

Programme (NCWSP)

• The Education Strategic Plan (ESP), 2003 – 2015

Scatt tteri ring ng of school

• l healt

lth h relat lated d poli licies s pre-20 2012 Devel elopme

• pment

nt of Natio ional al SHEP EP Polic licy y Guid idel elines ines  2012

• SHEP Poli

licy y Guid idelines elines Sect ction n 6.2.7 .7 What about t measurement asurement and evaluation luation of SHEP P Poli licies es Im Imple lementa tation? n???

INTRODUCTION: SCHOOL HEALTH EDUCATION PROGRAMME (SHEP)

What is the relationship* between school characteristics and the extent to which the SHEP recommended minimum package for school-level health services delivery is

• ffered?

*controlling for enrollment size

PURPOSE OF STUDY: RESEARCH QUESTION 1

What is the relationship* between school characteristics and the extent of implementation

• f SHEP policy

guidelines on Water, Sanitation and Hygiene (WASH)? *Controlling for enrollment PURPOSE OF STUDY: RESEARCH QUESTION 2

Data from the 2015 Ghana G-SHPPS Identified Ghana GSHPPS items;

1. Assessing components of the minimum recommended package (13 components) for delivery of school health services 2. Assessing WASH components

 Measures

• 6 of 12 components of minimum package for health services

delivery measure by SINGLE ITEM

• Rest assessed using index created by combing 2 or more

items.

METHODOLOGY: DATA SOURCE AND MEASURES

Control Variable:

• Enrollment size (≤ 200 vs >200)

Outcome Variables:

• Minimum Recommended Health Service Delivery

Package (<50% vs ≥50%)

• WASH items (YES or NO)

Exposure Variable:

• School Health Committee (YES vs NO)

METHODOLOGY: VARIABLES

Complex Samples Cross-tabulations to examine prevalence estimates (95% CIs)

• Individual health service minimum package

components by school health committee (YES vs NO) layered by enrollment (≤ 200 vs >200) by

Logistic regression to predict the likelihood

• f offering minimum health services delivery

package based on

• enrollment size (≤ 200 vs >200)
• health committee status (YES vs NO).

METHODOLOGY: ANALYSIS PLAN

 19,681 schools

• 375 sampled
• 82% response rate
• 307 surveys returned

RESULTS: SAMPLE DESCRIPTIVE STATS

RESULT LTS: SAMPLE DESCRIPTIVE STATS

Descriptive Statistics % n*

Enrollment Above 200 52.0 159 School Health Committee (YES) 53.2 161 Co-Edu i.e., Same School Boys and Girls 94.7 290 Public School 98.7 301 Day 94.9 291 Offers at least 50% of SHEP Recommended Package for Health Services Delivery 32.8 100

* Note: n = unweighted count

RESULT LTS: HEALTH SERVICES DELIVERY

RESULTS: HEALTH SERVICES DELIVERY

Odds Ratio: Health Services (50%) by Enrollment / Health Committee OR 95% CI

Enrollment Above 200

2.72 2.17 - 3.41

School Health Committee to guide policy implementation

4.08 3.23 - 5.18

Enrollment above 200 AND School Health Committee to guide policy implementation

4.52 3.32 – 4.17

Enrollment below 200 AND School Health Committee to guide policy implementation

3.16 2.23 – 4.42

* Regardless of enrollment, schools who have a health committee to guide policy implementation are more likely to offer at least 50% of the SHEP Minimum Health Services Package.

RESULTS: WATER, SANITATION, HYGIENE

RESULTS: WATER, SANITATION, HYGIENE

Selected WASH Variables by Health Committee Status

OR 95% CI

Separate Toilet for Boys and Girls

1.24 1.01 - 1.52

Place for Girls to dispose sanitary pads

4.29* 3.09 – 5.95

Toilet paper provided

2.73* 2.00 - 3.72

Toilet cleaned everyday

2.19* 1.67 - 2.88

Hand washing area

2.25* 1.83 - 2.76

Soap provided

1.71* 1.18 - 2.52

Clean source of water

1.42* 1.13 - 1.78

Water tested for quality

1.70* 1.34 - 2.17

* Schools with a health committee to guide policy implementation are more likely to address WASH

Academic performance is associated with and causally linked to the health of students. Since 1992, SHEP has help in delivery of school-level health services to millions of students.

• But, lots of room for improvement.

GOOD NEWS!!! = School Health Committees

• PRACTICAL
• EFFICIENT
• SUSTAINABLE!!!

IMPLICATIONS FOR SCHOOL HEALTH IN GHANA

Thank you!!!