Year: 2010
Type: dissertation
Abstract: School-going children have unique health challenges that deserve a focused attention \nfrom policy makers, commonly done through the provision of school health \nprogrammes. The education system provides the most comprehensive existing \ninfrastructure for reaching school-going children and school health programmes \nenable health problems to be addressed at relatively low cost. The 2003 South \nAfrican National School Health Policy (NSHP) aims to deliver equitable and focused \nhealth services to school-going children in order to safeguard their right to optimal \nhealth and development. There is currently limited information on the process of \nimplementation of the NSHP, implementation context at different schools, as well as \nfacilitating and constraining factors that impact on the implementation of this policy. \nAim: The main aim of this study was to evaluate the implementation of the 2003 \nNational School Health Policy in two primary schools in Cape Town. \nMethods: This was a process evaluation that used qualitative methods primarily. \nTwo schools located in different education districts were selected via convenient \nsampling for an in-depth study. Within each school, participants were purposively \nselected based on their potential to provide relevant information. The final sample \nconsisted of seven individuals; five educators and two school health nurses. Data \ncollection tools included an in-depth semi structured interview schedule, selfadministered \nquestionnaire and document review. Interviews were recorded, \ntranscribed and later analysed to obtain key themes. \nv \nResults: The evaluation found that the NSHP has been implemented in a phased \nmanner, disadvantaged areas were prioritized, different staff-mix with regards to the \ncomposition of the school health team was used and the minimum requirements in \nterms of health assessment for Grades R and 1 learners (Phase 1 services) were met. \nEducators and school health nurses did not have the same level of knowledge and \nunderstanding of the NSHP, and educators were less informed about this policy than \nnurses. The policy context influenced working relationships between different actors \nor stakeholders. Challenges or constraints to policy implementation included broad \nsystemic problems such as poverty and staff shortages, lack of dedicated budget for \nschool health services and insufficient prioritisation of school health services by \nsenior departmental managers, all which constrained effective policy implementation. \nAlthough findings of this study cannot be generalized to other schools, they give \nimportant insights into the current implementation process of the NSHP. It is one of \nthe few studies focusing on the process of policy implementation in recent years and \nthe in-depth qualitative methods allowed the researcher to explore the complexities \nand contradictions of policy implementation in post-apartheid South Africa. \nConclusion: This policy has for the most part been implemented according to \nspecified policy implementation guidelines and minimum requirements for \nimplementing phase 1 services were met. It is recommended that a dedicated budget \nshould be allocated to school health services and existing structures within the school \nsystem such as School Governing Bodies be utilized effectively to encourage parental \ninvolvement in school health. Nurses should advocate for increased support for these services among all stakeholders, including managers in the Department of Health.
Author: Lebogang Ramma
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W178801045