70407 School Health, Nutrition and HIV/AIDS Programming: Promising Practice in the Greater Mekong Sub-Region June 2009 Edited by: Donald Bundy (World Bank); Tara O’Connell (World Bank); Lesley Drake (Partnership for Child Development); Simon Baker (UNESCO); and Emmanuelle Abrioux (UNICEF). Contents Abbreviations and Acronyms ii Acknowledgments iii Executive Summary iv Programs and Initiatives 1 Chapter 1: Health-Related School Policies 3 Mainstreaming HIV/AIDS in the Education Sector – Cambodia Coordinating Implementation of School Health Activities – Lao PDR Resourcing School Health and Nutrition Activities through the “Sin Tax� – Thailand Chapter 2: Safe and Supportive School Environment 13 Promoting Gender Balance among Teachers: Scholarships for Girls – Cambodia Inclusive Education for Children with Special Needs – Lao PDR Chapter 3: Skills-Based Health Education 17 Pre-Service Teacher Training – Cambodia Health Education for Out-of-School Youth – Cambodia and Lao PDR HIV/AIDS Prevention Education for College Students – China Life Skills Education and Health Promotion Materials: Blue Box – Lao PDR Taking Life Skills-Based Education to National Scale – Myanmar Education Services for Out-of-School Youth – Myanmar Student Involvement in the Development of IEC/BCC Materials – Vietnam Chapter 4: School-Based Health and Nutrition Services 37 Deworming for Schoolchildren – Cambodia Educational Care Services for HIV/AIDS Affected Children – China Deworming for Primary School-Age Children – Lao PDR Deworming for Schoolchildren and Other High Risk Groups – Vietnam Boxes Box 1: School-Based Assessment in Thailand 9 Box 2: School-Based Assessment in Lao PDR 12 Box 3: Student Involvement in the Development of IEC/BCC Materials in Cambodia 36 Box 4: School Lunch Program in Thailand 44 Annexes Annex 1: School Health and Nutrition, including HIV/AIDS, in the Greater Mekong 47 Sub-Region: Questionnaire Responses Cover image: Tara E. O’Connell i Contents Abbreviations and Acronyms ACIPAC Asian Center of International Parasite Control MOU Memorandum of Understanding ADB Asian Development Bank NAA National AIDS Authority AICU Associazione Italiana Carlo Urbani NAAA Nucleo Assistenza, Adozione, Affido AIDS Acquired Immune Deficiency Syndrome NFE Non-Formal Education AIS Assistant State Inspectors NGOs Non-government organizations ASEAN Association of Southeast Asian Nations NIE National Institute of Education ATEOs Assistant Township Education Officers NIMPE National Institute for Malariology, Parasitology BCC Behavior Change Communication and Entomology CARE Cooperative for Assistance and Relief Everywhere NIN National Institute of Nutrition CBOs Community-based organizations NIT National Implementation Teams CMDG Cambodian Millennium Development Goal NRC National Rehabilitation Center CNM National Malaria Centre NRIES National Research Institute for Educational Science CPC Communist Party of China NSHP National School Health Policy CSCS Cooperation for a Sustainable Cambodian Society OSAVY Office of Social Affairs, Veterans and Youth DFID United Kingdom’s Department for International Rehabilitation Development PCD Partnership for Child Development DGE Department of General Education PDR People’s Democratic Republic DIT District Implementation Teams EFA Education for All PIT Provincial Implementation Teams ESP Education Strategic Plan PPAE Participatory Program Assessment and Evaluation ESSP Education Sector Support Program PRA Participatory rural appraisal EU European Union SCN Save the Children Norway EXCEL Extended and Continuous Education and Learning SEAMEO Southeast Asian Ministers of Education FFOCP Four Frees and One Care Policy Organization FRESH Focusing Resources on Effective School Health SHAPE School-Based Healthy Living and HIV/AIDS GMSR Greater Mekong Sub-Region Prevention Education HIV Human Immunodeficiency Virus SHN School health and nutrition HPS Health Promoting Schools SIDA Swedish International Development Cooperation HRDC Human Resource Development for Community Agency HSE Health Setting and Environment SMHF Sasakawa Memorial Health Foundation ICHA Interdepartmental Committee for HIV/AIDS STDs Sexually transmitted diseases IdCF Ivo de Carneri Foundation STH Soil-transmitted helminths IE Inclusive Education STIs Sexually transmitted infections IEC Information, Education, Communication TEOs Township Education Officers IMCI Integrated Management of Childhood Illness TFOSP Two Frees and One Supply Policy IMPE-HCMC Institute for Malariology, Parasitology and TOR Terms of Reference Entomology, Ho Chi Minh City TTCs Teacher Training Colleges IMPE-QN Institute for Malariology, Parasitology and TTD Teacher Training Department Entomology, Qui Nhon UN United Nations IQ Intelligence Quotient UNCRC United Nations Convention on the Rights of the JICA Japan International Cooperation Agency Child JSHC Joint School Health Committee UNDP United Nations Development Programme LSHE Life Skills for HIV/AIDS Education UNESCO United Nations Educational, Scientific and Cultural LSMC Local Scholarship Management Committee Organization M&E Monitoring and evaluation UNFPA United Nations Population Fund MDA Mass Drug Administration MoE Ministry of Education UNICEF United Nations Children’s Fund MoET Ministry of Education and Training US United States MoEYS Ministry of Education, Youth and Sport WFP World Food Programme MoH Ministry of Health WHO World Health Organization MoPH Ministry of Public Health YBoE Yunnan Provincial Bureau of Education MoSAVY Ministry of Social Affairs, Veterans and Youth YBoH Yunnan Provincial Bureau of Health Rehabilitation Abbreviations and Acronyms ii Acknowledgments This document is a product of the Greater Mekong Sub-Region (GMSR) Network of School Health, Nutrition and HIV/AIDS Ministry of Education Focal Points and their partners in the health sector and in civil society who participated in the Greater Mekong Sub-Regional Workshop on Strengthening the Education Sector Response to School Health, Nutrition and HIV/AIDS Programs, which took place in Siem Reap, Cambodia in March 2007. Development and coordination of the report was supervised by Donald Bundy (World Bank) and coordinated by Tara O’Connell (World Bank) with: Lesley Drake (Partnership for Child Development, PCD); Simon Baker (UNESCO); and Emmanuelle Abrioux (UNICEF). The report was edited by Anastasia Said (PCD), Tara O’Connell (World Bank), and Natasha Scolnik (World Bank Intern). The team benefited from the valuable input of three peer reviewers: Sheldon Shaeffer of UNESCO, Alexandra Valerio of the World Bank and Michael Beasley of the Partnership for Child Development. The team is also grateful to World Bank staff including Luis Benveniste, Jeffrey Waite, Simeth Beng, Boun Oum Inthaxoum, Helen Craig and Andy Tembon, who provided guidance and support at different stages and throughout the preparation process of this work. Useful comments, suggestions and contributions were also provided by colleagues from other international agencies and institutions: Patrick Duong of UNDP/DFID; Cliff Meyers, Niki Abrishamian, Tin Mar Aung and Noala Skinner of UNICEF; and Anthi Patrikios of the Partnership for Child Development. Various government officials and other individuals at the national level were involved in the development of the work and provided contributions that shaped its content. In Cambodia, they were: Soklay Khoun of CARE; Pen Sarouen and Chhay Kim Sotheavy of the Ministry of Education, Youth and Sport; Muth Sinoun and Duong Socheat of the Ministry of Health; Tracy Sprott of Friends-International; and Chum Thou of World Education. In Yunnan Province China, they were: Zhang Changan of Yunnan Provincial Office for AIDS Prevention and Control; Ma Na of the Foreign Languages School of Yunnan Normal University; and Ma Yanling of Yunnan Center for Disease Control. In Lao PDR, they were: Chitsavang Chanthavisouk and Vichit Santivong of WHO; Sutsaichai Duangsavanh, Anothay Kongsayasack, Sithath Outhaithany and Phoungkham Somsanit of the Ministry of Education; and Jun Kobayashi of JICA. In Myanmar, they were: Daw Tin Tin Shu of the Ministry of Education. In Thailand, they were: Supakorn Buasai of the Thai Health Promotion Foundation; Sirima Monmai of the Ministry of Education; and Usasinee Rewthong of PATH. In Vietnam, they were: Tran Cong Dai and Antonio Montresor of WHO; and Dang Thi Cam Thach of NIMPE. Acknowledgments iii Executive Summary In low income countries, poor health and malnutrition are health sector and in civil society participating in this critical underlying factors for low school enrolment, Workshop. The practices vary in focus, content and absenteeism, poor classroom performance and dropout; all process but, when taken together, a number of similarities of which act as important constraints in countries’ efforts emerge across the sub-Region, suggesting that the to achieve Education for All (EFA) and the education inclusion of specific characteristics in project planning and Millennium Development Goals (MDGs). In the Greater implementation increases the likelihood of effective Mekong Sub-Region (GMSR), the education and health implementation and sustainability. These common sectors have long recognized that school health and characteristics are explored below within the five broad nutrition programs can address the basic health problems programmatic areas of: faced by their schoolchildren. More recently, life skills modules and HIV prevention education are being • Health-Related School Policy; introduced to promote positive and healthy behaviors. • Safe and Supportive School Environment; The currently low levels of HIV infection in the GMSR make • Skills-Based Health Education; a focus on prevention all the more timely. Delivering • School-Based Health and Nutrition Services; comprehensive, scaled, systematic and sustainable school health and nutrition programs (that include HIV and prevention) based on the Focusing Resources on effective • Partnerships. School Health (FRESH) framework is becoming increasingly more common in the sub-Region. Health-Related School Policy: An area of convergence amongst those programs seen as promising practice is the The aim of this document is to share emerging promising existence of a comprehensive and established policy for practice in the field of school health and nutrition within school health and nutrition (SHN) including HIV/AIDS. the GMSR and to inform governments, development Those practices that were based on well-defined policy at partners and other organizations that recognize the need the national, provincial, district and school levels were to harmonize activities and align assistance. It aims to generally felt to be more widely supported by health and strengthen the Network of School Health, Nutrition and education staff, parents and students. Multi-level HIV/AIDS Ministry of Education Focal Points and further implementation was also found to foster much wider reach the establishment of a sound community of good practice and encourage sustainability by broadening the response in the sub-Region. The document includes descriptions a base. wide range of different activities from the six GMSR countries of Cambodia, China (Yunnan Province), Lao People’s Democratic Republic (PDR), Myanmar, Thailand Safe and Supportive School Environment: Programs and and Vietnam. activities were found more likely to meet with success when implemented within a supportive and inclusive The process of compiling the different accounts began school environment. The recognition of teachers as key during the GMSR Workshop in March 2007 on Strengthening implementers and the provision of capacity building in the the Education Sector Response to School Health, Nutrition and form of pre- and in-service teacher training were found to HIV/AIDS Programs in Siem Reap, Cambodia and was be critical elements in implementation of effective completed through remote correspondence with ministry HIV/AIDS programming. Due in part to cultural taboos of education teams in each of the different countries. around sexuality, many teachers in the sub-Region are Analysis revealed that a significant amount of activity reportedly reticent and ill-prepared to broach the topic of around school health, nutrition and HIV/AIDS was already HIV/AIDS in the classroom. Pre- and in-service training underway in the education sectors of the sub-Region (see focusing on teaching techniques in relation to SHN Annex 1: School Health and Nutrition, including HIV/AIDS, including HIV/AIDS has proven a valuable primary step in in the Greater Mekong Sub-Region: Questionnaire implementing curricula addressing HIV/AIDS. Responses) by this time. The programs and initiatives presented here were identified as examples of promising Many of the programs documented here also include practice in comprehensive and contemporary school specific provisions to address the needs of all students, health and nutrition programs by members of the GMSR including those with special needs. In addition, the Network of School Health, Nutrition and HIV/AIDS document highlights the need to provide a supportive Ministry of Education Focal Points and their partners in the psychosocial environment for students and staff. Executive Summary iv Skills-Based Health Education: There is general peoples’ ownership and buy-in and ensures greater consensus that promising practice in SHN programming in relevance of programs to young peoples’ lives. the sub-Region involves the inclusion of a life skills component that includes HIV/AIDS in school curricula. While the exercise of developing this document has Promoting healthy behaviors related to nutrition, sexuality proven useful in creating a regional community of good and a healthy lifestyle in general is regarded as key, but practice in SHN and HIV/AIDS programming, it has also providing knowledge alone is not enough; young people aided in the identification of key challenges to successful also need to develop the skills necessary to affect behavior SHN and HIV/AIDS programming in the sub-Region. change. School systems present an established and efficient means through which to reach children and adolescents with information as well as training in life skills that provide the knowledge, attitudes, and values needed to make sound health-related decisions that promote a healthy lifestyle more generally. School-Based Health and Nutrition Services: The document presents a number of promising practice examples involving the delivery of health and nutrition services to school-age children. The examples demonstrate how simple, safe and familiar health and nutrition services such as deworming or micronutrient supplements can be cost-effectively delivered through the existing network of schools to address health issues that are prevalent among the target population. Photo: World Bank Partnerships: Creating and maintaining strong partnerships between governments and donor agencies; While few of the promising practice examples elaborated partnerships between the Ministries of Education and in this document include monitoring and evaluation (M&E) Health; and partnerships between schools and procedures, M&E is widely recognized in the GMSR communities has proven vital to successful implementation countries as a core component of the process and an area of school health, nutrition and HIV/AIDS programming. of challenge to which a much stronger response is needed. Partnerships generally proved most effective when Practitioners report that evaluation of programs has been established in the early planning stages of activities, hampered by the lack of an effective plan for M&E allowing widespread buy-in of and participation in the including: identification of measurable indicators to gauge planning and implementation processes. Such partnerships the level to which the program meets intended goals helped drive the collaborative process, promoting and objectives; a plan as to how data around these innovation at the community, national and regional levels, indicators will be collected and analyzed; and encouraged sustainability through shared responsibility an explanation as to how these data will be utilized in and ownership. A particular feature of partnerships in the impacting outcomes; and an estimation of resources region has been that of enabling young people to play a needed to support the M&E system. Efficient M&E systems role in the development of programs – and in particular of are critical in ensuring accountability and transparency of program materials. Such an approach increases young operations. v Executive Summary Programs and Initiatives The Greater Mekong Sub-Regional Workshop on The promising practice examples are presented within the Strengthening the Education Sector Response to FRESH1 (Focusing Resources on Effective School Health) School Health, Nutrition and HIV/AIDS Programs, framework, which outlines the four basic components of which took place in Siem Reap, Cambodia in March an effective school health program, namely: 2007, offered an excellent opportunity for practitioners to share experiences and to learn from existing promising practice within the 1. Health-Related School Policies: including Greater Mekong Sub-Region. those that address HIV/AIDS issues, and gender. In the lead-up to the workshop, participating country teams from Cambodia; China (Yunnan province, herein 2. Safe and Supportive School Environment: referred to as China); Lao People’s Democratic Republic including access to safe water, adequate (PDR); Thailand; Vietnam; and an observer team from sanitation and a healthy psychosocial Bhutan were asked to complete a pre-workshop environment. questionnaire in order to give a snapshot of the current situation in relation to school health, nutrition and 3. Skills-Based Health Education: including HIV/AIDS at country level. curriculum development, life skills training, teaching and learning materials. Responses revealed that a significant amount of activity around school health, nutrition and HIV/AIDS was already 4. School-Based Health and Nutrition Services: underway in the education sectors of the sub-Region (see including deworming, micronutrient Annex 1: School Health and Nutrition, including HIV/AIDS, supplementation, school feeding, malaria in the Greater Mekong Sub-Region: Questionnaire treatment/referral and psychosocial Responses). Discussion of this reality led to agreement by counseling. all participating countries and development partners that a publication documenting existing examples of promising practice in the sub-Region would be produced. School Health, Nutrition and HIV/AIDS Programming: Promising Practice in the Greater Mekong Sub-Region is a collaborative work documenting those activities and initiatives generally felt to be examples of promising practice in school health, nutrition and HIV/AIDS programming in the sub-Region. The program descriptions included in this document have been thoroughly vetted by government officials, practitioners, development partners and civil society groups active in school health in the GMSR. Drafts of the work were circulated widely on two occasions: the 8th International Congress on AIDS in Asia and the Pacific (ICAAP) held in Colombo, Sri Lanka in August 2007; and the UNAIDS Inter-Agency Task Team (IATT) on Education symposium on “Meeting the HIV Prevention Needs of Young People in Asia� held in April 2008 in Chiang Mai, Thailand. Useful feedback was collated and has been incorporated into this final publication. 1FRESH is an inter-agency initiative developed by United Nations Educational, Scientific and Cultural Organization (UNESCO), United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), Education International and the World Bank, launched at the Dakar Education Forum, 2000. The initiative now includes a large number of other organizations. The FRESH framework captures best practices from program experiences for the design and implementation of effective school health and nutrition programs. Programs and Initiatives 1 Chapter 1: Health-Related School Policies MAINSTREAMING HIV/AIDS IN THE EDUCATION SECTOR – CAMBODIA INTRODUCTION quality education – according to the latest estimates of the prevalence of HIV/AIDS in Cambodia, it is estimated that In Cambodia, the Ministry of Education, Youth and Sport some 2,000 MoEYS employees (teaching and non-teaching (MoEYS) is mainstreaming HIV/AIDS prevention education staff) could be HIV-positive. throughout its operations to ensure that students in public schools, out-of-school youth and its workforce can be HIV/AIDS Law protected from infection. This is an enormous undertaking: Article 3 of the HIV/AIDS Law states that the MoEYS is responsible for providing education services responsibility of the Ministry of Education, throughout the country to over 3,500,000 students and as Youth and Sport is to: the largest Ministry in Cambodia, it administers half of Cambodia’s civil servants (120,000 staff) in over 7,000 • Integrate HIV/AIDS education in the school public schools, ranging from pre-primary to tertiary levels. curriculum; As well as addressing staff and students in the formal • provide preventive education programs for sector, activities also aim to reach more vulnerable in- and out-of-school youth; children who do not yet access regular education. • train teachers as resource persons; and • cooperate with the civil society and non- AIMS AND OBJECTIVES government organizations (NGOs). • To protect and prevent students, out-of-school Cambodian youth and MoEYS labor force from being Program Implementation infected and affected by HIV/AIDS. • To contribute to increasing knowledge, skills and safe The Ministry’s HIV/AIDS program is coordinated through behaviors among Cambodian students and out-of- its Interdepartmental Committee for HIV/AIDS (ICHA, school youth, and the education sector’s employees. see diagram below) and implemented as part of the Education Sector Strategic Plan (5 years), its Education • To support the Royal Government of Cambodia’s Sector Support Program (ESSP) and the Ministry’s effort towards reaching Education for All (EFA), by HIV/AIDS Strategic Plan. strengthening the MoEYS capacity to respond to HIV/AIDS. The ICHA was established in 1999 in response to the decision of the Royal Government of Cambodia to strengthen Cambodia’s response to HIV/AIDS. The PROGRAM OVERVIEW committee is chaired by the MoEYS Secretary of State and Background comprises 15 departments and institutes. These include HIV/AIDS is a key priority for the Royal Government of School Health, Finance, Information and Association of Cambodia which considers that responding to HIV/AIDS is Southeast Asian Nations (ASEAN) Affairs, Personnel, critical to the socioeconomic development of the country. Teacher Training, Non-Formal Education (NFE), Education and Health are essential pillars of the Pedagogical Research, Primary Education, General Government’s strategic development plans; for example, Secondary Education, Higher Education, Planning, National Cambodian Millennium Development Goal (CMDG), Institute of Education, Student Physical Education and Rectangular Strategy and the National Strategic Plan for Sport, Youth and Inspectorate of Education. The ICHA Poverty Reduction. In February 2006, the Government structure is as follows: launched the new 5-year National HIV/AIDS Strategic Plan • Policy Board: composed of the Secretary of State (2006 to 2010), coordinated under the auspices of the and the 15 Directors in the departments. National AIDS Authority (NAA). HIV is likely also to be having an immediate impact on MoEYS’ ability to deliver • Technical Working Group: composed of 15 departments with 2 Focal Points per department. Chapter 1: Health-Related School Policies 3 • ICHA Secretariat: composed of 3 full-time and 5 Primary Target Group(s): Cambodian youth: primary part-time officers responsible for facilitating the schoolchildren, secondary schoolchildren and literacy implementation and coordination of the Ministry’s learners; vulnerable youth; out-of-school youth; orphans HIV/AIDS strategy and program. In addition, a finance and vulnerable children; and street children. MoEYS team oversees financial management, procurement teaching and non-teaching staff: central Ministry staff; and contractual matters. teachers and literacy trainers; and administrative and technical staff at provincial, district and school levels. The ICHA program is implemented by the Ministry’s 15 central departments, the Provincial and District Education Secondary Target Group(s): parents and community Authorities, contracted NGOs, and other development representatives; religious authorities; local authorities; partners and institutions. NGOs; community-based organizations (CBOs) and Target Groups political leaders in Cambodia. The ICHA program has nationwide coverage in the Program Activities Kingdom of Cambodia and operates with the following Program Components: The ICHA program consists beneficiaries: of 4 pillars (see diagram below). The 4 main Pillars of the ICHA Strategy MoEYS Process supported by Donor’s National technical Support for Preventive assistance Policy Institutional (4 Pillars) Mainstreaming Education Development Development HIV/AIDS Program and and GOAL: in the Strategic Performance Education and (Life Skills/ Planning Management MoEYS Youth Sector behavior contributes Change) to stabilizing and reducing HIV/AIDS infections in Cambodia. Pillar 1: Policy Development and Strategic Planning: Pillar 3: Support for Mainstreaming HIV/AIDS in the Policy and strategy are developed to ensure that HIV/AIDS Education and Youth Sector: Pillar 3 aims at (and other related topics) remains a priority for the mainstreaming HIV/AIDS across the MoEYS. It mainly MoEYS, and that relevant goals and aims are established. focuses on integrating HIV/AIDS in the national curriculum, pre- and in-service training of teachers, Pillar 2: Institutional Development and Performance developing curriculum and Information, Education, Management: Institutional development, capacity building Communication (IEC) tools, research, and monitoring and and training activities are organized to strengthen the evaluation (M&E). Ministry’s capacity to plan, implement and monitor HIV/AIDS programs. Financial management, procurement, Pillar 4: National Preventive Education Program (Life human resource management and merit-based incentive Skills/Behavior Change): Pillar 4 supports the planning schemes are also addressed. and implementation of the ‘National Life Skills for HIV/AIDS Education’ program that targets Cambodian in- and out-of-school youth (approximately 6 million youth). 4 Chapter 1: Health-Related School Policies Program Resources and Finance • HIV/AIDS is integrated in the National Examination plans. The ICHA annual budget is approximately US$2.3 million. • All pre-service teachers attend a 5-day training Besides national budget allocations, ICHA receives its main course on HIV/AIDS. support from DFID and from the United Nations • In-service teachers are progressively trained on Development Programme (UNDP), United Nations HIV/AIDS. Educational, Scientific and Cultural Organization (UNESCO), United Nations Population Fund (UNFPA), • HIV/AIDS manuals and IEC tools have been United Nations Children’s Fund (UNICEF) and other developed. development agencies. ICHA closely cooperates with • The ‘National Life Skills for HIV/AIDS Education’ international and local NGOs and coordinates its program program has been launched in 14 provinces. activities with NAA, other line Ministries and the donor • The Ministry reaches out to out-of-school youth and community. street children. Program Materials (MoEYS materials on • HIV/AIDS-related topics (such as reproductive health HIV/AIDS) and drugs) are integrated in the program. • Education Strategic Plan (ESP). • The DFID Monitoring and Advisory Team suggested • Education Sector Support Program (ESSP). that the model and experience of MoEYS in the area • HIV/AIDS strategic plan. of HIV/AIDS be used for other line Ministries and in • Workplace policy. other countries. • ICHA log frame. This holistic approach used by MoEYS to mainstream • Monitoring and evaluation plans. HIV/AIDS is today recognized as good practice in terms of • Manual for conducting ‘Participatory Program capacity building, political/individual commitments, Assessment and Evaluation’ (PPAE). sustainability and technical/managerial expertise. • Seven fact sheets: i. Education sector’s national response. Program Evaluation ii. Monitoring and evaluation. As a key cross-cutting issue, M&E is entirely integrated in iii. Life skills for HIV/AIDS education. the Ministry’s HIV/AIDS program. The MoEYS and M&E iv. Financial management. system address both process and impact(s). With the v. Institutional arrangements. support from DFID, MoEYS has opted for a combination vi. Staff performances (output-based incentive of quantitative and qualitative/participatory approaches. scheme). This dual system focuses on implementation and quality of vii. Contracting NGOs. processes/operations as well as on end results. In addition, • Teacher training manuals for primary, secondary while a centralized system was required in the early phase, and NFE. the Ministry is now moving towards greater • Life skills for HIV/AIDS manuals, with 2 separate sets decentralization and involvement of local authorities. Co- of manuals for teachers and students. operation with local actors (e.g. community leaders and • Set of IEC tools, including posters, games, television youth groups) and NGOs is therefore essential. spots, etc. • ICHA documentary film. PARTNERSHIPS FURTHER INFORMATION Support was received by DFID, UNDP, UNESCO, Mr Pen Sarouen Director, UNFPA, UNICEF, local NGOs and the donor community. Ministry of Education, Youth and Sport, Interdepartmental Committee for HIV/AIDS (ICHA), KEY OUTCOMES AND LESSONS #169, Preah Norodom Blvd, Phnom Penh, Cambodia. LEARNED Telephone: +(855-23) 218 408 Recent achievements of the MoEYS are: Fax: +(855-23) 212 512 • The new curriculum framework now integrates Email: icha@citylink.com.kh or icha@online.com.kh HIV/AIDS topics in primary, secondary and NFE. • HIV/AIDS is part of the new Students Performance Additional information can be obtained on the website Minimum Standards. www.moeys.go.kh. Chapter 1: Health-Related School Policies 5 COORDINATING IMPLEMENTATION OF SCHOOL HEALTH ACTIVITIES – LAO PDR INTRODUCTION for future activity between the Ministries of Education and Health. It includes both vertical and horizontal co- Effective coordination of different stakeholders is essential ordination mechanisms to encourage collaboration and co- if school health and nutrition activities are to occur within ordination between the education and health sectors. The countries. In Lao People’s Democratic Republic (PDR), concepts and vision of school health that support clear mechanisms have been established between the education outcomes were subsequently introduced education and health sectors that outline the roles and to provincial and district education and health responsibilities of each and their interaction with one administrators. another. Such coordination has enabled the establishment of a school health and nutrition program that is being implemented across the country. AIMS AND OBJECTIVES • To increase children’s knowledge on basic health issues. • To empower and motivate children to adopt basic healthy practices in daily life. • To strengthen collaboration between the Ministry of Education (MoE) and Ministry of Health (MoH). • To increase the capacity of the main partners in program management and in providing technical Photo: UNICEF support to program implementers. • To strengthen the capacity of schoolteachers in health More recently, a Joint School Health Committee (JSHC) messages that are delivered and implemented through was established in central and lower administrative levels a child-to-child approach using existing and new to oversee the school health implementation in certain materials. schools. A National School Health Policy (NSHP) was formulated by JSHC with key development partners. Both • To develop a package of school health materials. of these coordinating mechanisms serve to align efforts • To strengthen the system of monitoring and and to encourage the promotion of a common platform on supervision of the school health program. school health and nutrition activities and initiatives. PROGRAM OVERVIEW Program Implementation Background The program is implemented by the National School In Lao PDR, a number of agencies have been involved in Health Taskforce which consists of staff from related implementing health activities in schools. Previously, no departments of the MoE and MoH and plays multiple roles comprehensive or systematic process existed to in a cycle of school health implementation (see Figure 1: strengthen cooperation between the Ministries of School Health Education – Implementation Approach). Education and Health, or to introduce and expand health The approach follows a step-by-step process unique to subjects in the school curricula with effective, participatory developing a school health education intervention. The and interactive pedagogical systems. approach begins with the development of program materials, continues with the dissemination Since 2002, a number of steps have been taken to improve of materials and then proceeds to school self-assessments; coordination. The first was a meeting held among situation analysis; planning; implementation; monitoring education and health officials which drafted a and assessment; and review and re-planning Memorandum of Understanding (MOU) between the two of activities and materials. Finally, the ‘award’ intervention Ministries. It was agreed that the MoH would support the is carried out to recognize outstanding school MoE in institutionalizing, expanding and improving health achievements. Education and health staff were identified as promotion in schools. The MOU was a significant Focal Points to facilitate school health activities at achievement that created a basis for collaborative activity all levels. 6 Chapter 1: Health-Related School Policies Figure 1: School Health Education – Implementation Approach 1. School Health Policy CERTIFY: - Strategies/Accreditation Scheme Gold Level - Principal’s Guide Provincial Gold Level Evaluation NONE: Need Self- Improvement 2. School Health Taskforce (at each level) CERTIFY: 3. School Self-Evaluations Bronze/Silver Level District Bronze/Silver NONE: Evaluation 10b. Improvement Level Need Self- Improvement 10a. Awarding Need Special 9. Certifying 4. Prioritization Set-up NONE: Support from NONE Need Self- District and Improvement Provinces 8.Yearly Evaluation 5. Planning Volunteer Donors CERTIFY: NGOs Bronze/Silver 6. Implementation Level 7. Monitoring/Supervision (of created plan) Program Duration performed a national school deworming campaign for all primary school-age children throughout Lao PDR under The program will run from 2003 until 2007. the framework of school health. The task force also Target Groups enables the adoption of modern pedagogic systems and interactive participatory learning for health promotion. Primary Target Group(s): all primary schoolchildren in 450 ‘complete’ schools in 450 primary schools in 17 Program Resources and Finance provinces throughout Lao PDR2. In-service teachers in Data not available. targeted primary schools are also included as primary targets for improvement in a professional capacity. Each Program Materials province has decided to initially invest in ‘complete’ The materials for the program are: schools before expanding to ‘incomplete’ schools. It has • A National School Health Policy. been acknowledged that not all schools share the same • A National Strategic Implementation Guideline. point of departure towards reaching desired health • A Principal’s Guide on school health education standards and that some have little chance of gaining one interventions. of the programs ‘awards’. Rather than setting such schools • Educational materials such as the Blue Box. up for failure, they are therefore excluded, during the first • An advocacy kit for political leaders. few years, from the criteria of formally participating in the • A supervision checklist for implementation of Health school health program. Setting and Environment (HSE) and Health Promoting Secondary Target Group(s): pre-service teachers in Schools (HPS) activities. 8 Teacher Training Colleges (TTCs) in Lao PDR. Program Activities See also Figure 2: Samples of Project Materials. Since 2005, the National School Health Taskforce has 2 In Lao PDR, a fully functioning ‘complete’ primary school is one that consists of grades 1 to 5. However, there are still many ‘incomplete’ primary schools (grades 1 to 2 or 1 to 3 only). Although good hygiene standards should be the goal for all schools in Lao PDR, it is understandable for ‘incomplete’ schools to first improve their scale of grades. Chapter 1: Health-Related School Policies 7 Figure 2: Samples of Project Materials PARTNERSHIPS KEY OUTCOMES AND LESSONS JSHC has received support from key development LEARNED partners such as Japan International Cooperation Agency The key outcomes to the program were: (JICA), United Nations Educational, Scientific and Cultural • Needs Assessment: In 2002, the ‘Rapid Knowledge Organization (UNESCO), United Nations Children’s Fund Attitude and Practice Survey’ was conducted to (UNICEF) and the World Health Organization (WHO). identify gaps and review project implementation. • Establishment of Focal Points: Focal Points consisted of education and health staff to facilitate school health activities at all levels. 8 Chapter 1: Health-Related School Policies • National School Health Policy (NSHP): The policy addressed several components such as improving the current health education curriculum on prevention FURTHER INFORMATION skill-orientation, school environment, health and Ministry of Education nutrition services, disease control and prevention, and Thanon Lane Xang, Ban Xiengyeun Tha, promoting partnerships and participation from the Muang Chanthaburi, community to school development. P.O. Box 67, Vientiane, Lao PDR. • National Strategic Implementation Guideline: The Telephone: +(856-21) 216 004 guideline contains the general strategy for co- Fax: +(856-21) 216 001 ordination, implementation, monitoring and evaluation, and reporting based on NSHP. Dr. Chitsavang Chanthavisouk WHO Co-ordinator for School Health & School Deworming, • Principal’s Guide: A guide to head teachers on school Quartier Phonxay, health education. The guide presents a worksheet to 23 Singha Road, P.O. Box 343, support head teachers in creating a school health Vientiane, Lao PDR. team and a school health plan. Telephone: +(856-21) 413431, 414264, 413023 • Teaching-Learning Materials: The materials used Fax: +(856-21) 413432 originated from UNICEF’s Blue Box (for further E-mail: chanthavisoukc@lao.wpro.who.int details on the Blue Box see pages 24 and 25). All materials (13 items) in the box were revised to create new materials so that they matched the health topics in ‘The World Around Us’ curriculum. A total of 20 items were now in the Blue Box (see Figure 3: Samples of Materials in the Blue Box). The materials are tools to support the implementation of the NSHP. The lessons learned from the program were: • In recent years, Lao PDR witnessed substantial BOX 1 progress in implementing school health programs. However, to translate the NSHP into effective action requires powerful leadership and a strong support system at the central, provincial and district levels School-Based Assessment to move the initiative forward and strengthen the in Thailand implementation of school health policy in primary schools. SUMMARY • To manage the school health program, JSHC needs to The Ministries of Public Health (MoPH) and improve leadership and identify clear mechanisms on Education (MoE) established an award system for coordination and collaboration with all related health promoting schools nationwide. According development partners for effective information to the results of the self-assessment conducted in sharing, planning and implementation, to avoid schools, supervisors have re-assessed school duplication and ensure effective sector-wide activities and upgraded their standards. In 2007, collaboration. more than 90% of schools maintained the highest • Strengthening the development of an initiative standard of health promoting schools. framework by supporting health promotion activities between schools and teacher training institutions is necessary. The limited support on school health activities for pre-service teachers in TTCs may FURTHER INFORMATION harm the sustainability of health promotion in schools. Since TTC students will become teachers in Ministry of Education the future, they must be familiar with issues on health Ratchadamnoen Nok Avenue, promotion in primary schools. Dusit, Bangkok 10300, Thailand. • Integrating appropriate monitoring and supervision Telephone: +(66-2) 281 9809 frameworks into the regular monitoring system in the Fax: +(66-2) 281 9241 education sector is advisable. Website: www.moe.go.th Chapter 1: Health-Related School Policies 9 RESOURCING SCHOOL HEALTH AND NUTRITION ACTIVITIES THROUGH THE “SIN TAX� – THAILAND INTRODUCTION including the MoE, for the financing of different health and nutrition activities. Attaining the resources needed to implement school health and nutrition activities is a major challenge in many ThaiHealth enjoys considerable autonomy as it is the only countries. In Thailand, an innovative “Sin Tax� levied on organization that reports directly to the Cabinet and alcohol and tobacco products enables the Thai Health Parliament, and the only organization that receives Promotion Foundation or ThaiHealth to disburse funds revenue outside of the normal budgetary processes. The needed to finance health and nutrition activities to a wide MoE is one of 21 members in the Governing Board, range of different actors, including the MoE allowing a wide chaired by the Deputy Prime Minister. The board has the range of different health problems to be addressed. role of: policymaking, general budgetary allocation, AIMS AND OBJECTIVES specification of important rules, provisions for project management and the assessment of expected results. • To reduce sickness and death and to promote general improvements in the quality of life of Thai people through the education sector. • To support, rather than replace, groups and organizations that are already working on public health issues. • To act as a catalyst, maintaining a neutral position that will allow ThaiHealth to promote collaboration between many different partners. PROGRAM OVERVIEW Background In Thailand, the major causes of death and health problems are due to preventable causes such as smoking, alcohol Photo: UNICEF abuse and road accidents. According to the World Health Organization (WHO), these issues should be addressed by public health organizations with the aim to achieve Program Duration complete physical, mental and social well-being. In The program is ongoing. response to international statements on public health, the Royal Government of Thailand created a strong public Target Groups health movement establishing, through the Health With respect to the education sector, ThaiHealth channels Promotion Foundation Act in 2001, the Thai Health its efforts to establish and promote health among young Promotion Foundation or ThaiHealth. The philosophy of populations in school settings. The program operates at all ThaiHealth is that “all Thais can attain better lives, in a self- education levels to children and young people aged reliant way, through increased cooperation.� The vision of between 4 to 18 years in Thailand of whom more than 8.5 ThaiHealth is “the sustainability of health for Thai people� million are currently enrolled in education from pre-school and its mission is to support and develop a movement to to high school levels. Under Thai law, every child has establish and promote health that will lead to a state of access to free compulsory education for 12 years. well-being among Thai people. Program Implementation Program Activities The program is implemented by ThaiHealth which receives ThaiHealth supports a wide range of different activities in revenue of US$35 million annually through a special excise schools undertaken by a number of different stakeholders. tax of 2% imposed only on tobacco and alcohol known as the “Sin Tax� (for further details about how this is collected, see “Program resources and Finance� below). ThaiHealth then distributes the monies collected to a wide range of different stakeholders, 11 10 Chapter 1: Health-Related School Policies Program Resources and Finance Program Materials Previously, producers paid a standard 30% excise tax on Not available. sale of tobacco and alcohol but, with the enactment of the ThaiHealth Bill, an additional 2% excise tax was added to PARTNERSHIPS the sale of these products. Products previously valued at The MoE receives support from various organizations and 100 Baht, for example, would have been subject to a 30 institutions. Baht excise tax but are now taxed to a total of 30.6 Baht. The 2% excise tax is only imposed at the sale of the KEY OUTCOMES AND LESSONS product, as no tax is payable if products remain in the LEARNED factories. The producers are required to buy the excise duty stamps from the Excise Office (under the Minister of Some key outcomes to the program were: Finance) and affix them to each bottle of alcohol and • The findings from the research, funded by ThaiHealth cigarette packets. The levy is collected when the producer on ‘the effects of increased exercise towards submits to the Excise Office documentation on how many increased bone mass in girls’ (2005) resulted in the units of alcohol or tobacco were distributed to the dealers implementation of a policy (by the MoE) of increasing and wholesalers. physical education in the school curriculum from 1 hour a week to 2 hours a week. The Excise Office sends daily summary reports to ThaiHealth and directly transfers the collected tax to • Networks of people who work with children/youth/ ThaiHealth’s account. The Customs Department collects families have vigorously started working on health the tax on imported products, for ThaiHealth. The Finance issues and have recognized around 1,000 model Department cross-checks the total amount transferred, at schools that teach approximately 500,000 the end of each month, from both the Customs and Excise schoolchildren. The networks have supported the Departments. ThaiHealth then allocates monies to the national censorship movement (2005) against the education sector as well as to other selected organizations portrayal of violence on children in the public media. and agencies. • Collaboration between the MoE and Thai Webmaster The budgetary provisions to the education sector, Association in 2006 launched a reliable knowledge- institutions and organizations were as follows: based website (www.panyathai.or.th) which serves both schools and public interest. • According to the annual report in 2006, ThaiHealth spent (in the fiscal year October 2005 to September 2006) a total of 2,233 million Baht (US$676 million, FURTHER INFORMATION with an exchange rate of 33Thai Baht for US$1). Ministry of Education The percentage distribution of funding according to target Ratchadamnoen Nok Avenue, organizations and institutions were as follows: Dusit, Bangkok 10300, Thailand • Government agencies and public benefit Telephone: +(66-2) 280 0309 organizations – 38%; Fax: +(66-2) 280 0318 • community (temple and village) – 37%; • network organizations – 30%; Mr. Supakorn Buasai • schools and educational institutions – 16%; Chief Executive Officer, ThaiHealth, • private agencies – 9%; Thai Health Promotion Foundation, • community/civic organizations – 8%; 979, S M Tower, 34/Fl., Phaholyothin Road, Samsen Nai, Phaya Thai, Bangkok 10400, Thailand. • professional associations – 7%; • other organizations – 6%; Telephone: +(66-2) 298 0500 • hospitals and nursing homes – 4%; Fax: +(66-2) 298 0501 • the media – 4%; and • business and enterprises – 3%. Ms. Usasinee Rewthong (Mai) Associate Program Officer, The percentage distribution of funding on health issues Program for Appropriate Technology in Health (PATH), ranged from 1% to 9%. Among these were: 37/1 Petchburi 15, Petchburi Road, • Accident and safety promotion – 9%; Bangkok 10400, Thailand. • alcohol consumption – 8%; Telephone: +(66-2) 653 7563/64/65 • exercise – 6%; Fax: +(66-2) 653 7568 • tobacco consumption – 6%; Email: urewthong@path.org • narcotics – 2%; and • sexual relationships/behavior – 1%. Additional information can be obtained on the website www.thaihealth.or.th Chapter 1: Health-Related School Policies 11 BOX 2 School-Based Assessment in Lao PDR SUMMARY The Lao People’s Democratic Republic (PDR) School Health Taskforce established a system of self-assessment and an award system based on national policy and implementation guidelines. The standard level was set under the situation analysis in Lao PDR. The World Health Organization (WHO) Laos; the Japanese consulting team, Japan International Cooperation Agency (JICA); Tokyo University; and the Asian Center of International Parasite Control (ACIPAC) have offered support to expand this system FURTHER INFORMATION Ministry of Education Thanon Lane Xang, Ban Xiengyeun Tha, Muang Chanthaburi, P.O. Box 67, Vientiane, Lao PDR. Telephone: +(856-21) 216 004 Fax: +(856-21) 216 001 Photo: Tara E. O’Connell 12 Chapter 1: Health-Related School Policies Chapter 2: Safe and Supportive School Environment PROMOTING GENDER BALANCE AMONG TEACHERS: SCHOLARSHIPS FOR GIRLS – CAMBODIA INTRODUCTION Program Duration The program ran from October 2004 until September In many countries, the recruitment of female teachers to 2007. schools can be problematic. When female teachers are lacking, the impact on the school environment can be Target Groups substantial – both girls and boys are deprived of strong female role models, and girls in particular may be unable to The program is carried out in Hun Sen Kampong Phnum address health issues at school that they are reticent to High School in the Leuk Daek district, Kandal province and discuss with a male teacher. In Cambodia, the Human includes the following beneficiaries: Resource Development for Community (HRDC) project Primary Target Group(s): 65 scholarship girls who was begun in order to support human resource progressed from grade 10 through to grade 12. development in particular areas of Cambodia that lack Secondary Target Group(s): parents of the scholarship teachers. The project particularly focuses on females. As girls, local scholarship management committee members, part of this project, selected female students receive lower and upper secondary schoolteachers and scholarships for schooling in addition to training and community members in 7 communes of the Leuk Daek mentoring for capacity development, enabling young district in Kandal province. women to realize their full potential and contribute to the development of their communities. Program Activities AIMS AND OBJECTIVES The selection criteria used to decide who receives scholarships were based on girls who: • To support students, particularly females, to graduate • Have passed grade 9 school exams; from high school and to continue this support until • want to continue their studies; they obtain qualifications with which they can get a job • have families who support their education; to contribute to community development. • are from families of low socioeconomic status; • To ensure that scholarship students obtain knowledge • have high numbers of siblings; and skills necessary for community development. • are orphaned or from single parent households; and • have parents/guardians with little or no education. PROGRAM OVERVIEW The selection process involved 4 stages to decide Background scholarship recipients: The HRDC project is being implemented in an area of • Preparation of Scholarship Candidates List: The Cambodia that lacks teachers and other human resources, Local Scholarship Management Committee (LSMC) especially with regard to females. This is largely because announced the up- coming scholarships (organized by there are few female students who advance to higher the LSMC) in secondary schools. Directors of the education and have the skills necessary to obtain secondary schools obtained a list of students who had employment. Teaching and other professions have passed grade 9 and referred them to LSMC. attracted females from outside the communities involved, • Short-Listing of Candidates: LSMC organized but they do not stay long due to the difficulties of adapting meetings with village chief/elders to shortlist to village life far away from their families and support candidates by using the standardized selection criteria structures. To solve these issues, HRDC aims to develop above. Any candidates who failed to meet at least one female human resources within the communities of the short-listing criteria were disqualified from the themselves. candidate list. The LSMC organized interviews (based on the same selection criteria) when potential Program Implementation candidates were borderline or when LSMC were The program was implemented by the Ministry of uncertain as to whether the selection criteria had Education, Youth and Sport (MoEYS). been met. Chapter 2: Safe and Supportive School Environment 13 • Selection Process: LSMC review the scores from the • Promoting gender awareness campaigns on the short-list and select candidates. benefits and importance of education, the realities of trafficking, environmental protection • Public Announcement of Scholarship Recipients: and domestic violence. After the selection process, a list of successful candidates was posted in all public places, including secondary schools, commune council and local FURTHER INFORMATION markets. Successful candidates were then asked to complete an application form and sign a student/parent Ministry of Education, 80 Preah Norodom contract. Phnom Penh, Cambodia Once selected, girls who enter the program receive Telephone: +(855-23) 217 253 scholarship assistance such as tutoring payments, school Fax: +(855-23) 212 512 materials, lunch allowance and boarding allowances. In addition to scholarships, girls also receive training Ministry of Health beneficial for community development. This includes home 151-153, Kampuchea Krom, Phnom Penh, Cambodia economic life skills, gender awareness and peer educator training. Girls are also involved in various educational Telephone: +(855-23) 427 161 support activities such as ‘study clubs.’ Ms. Soklay Khoun Program Resources and Finance Project and Information Officer, Education Program/CARE Cambodia, The program has been funded by Cooperative for P.O. Box 537, Assistance and Relief Everywhere (CARE) Friends House 255, Corner Street 63 & Mao Tse Toung Bvld, Phnom Penh, Cambodia. Okayama and CARE Friends Tokyo, through CARE International Japan. Tel: +(855-23) 215267/8/9 Ext: 108 Fax: +(855-23) 426233 Program Materials • Awareness manual on facilitation skills The lessons learned from the program were: • Alcoholism • Girls staying at the boarding house were more • Safe migration and gender comfortable in sharing their concerns when a PARTNERSHIPS female teacher was assigned to welfare support. The program has been supported by CARE Friends • Study support provided through a ‘study club’ Okayama and CARE Friends Tokyo, through CARE activity (coordinated and encouraged by LSMC International Japan. members) resulted in girls’ improved understanding and academic achievement. KEY OUTCOMES AND LESSONS • Timely provisions of scholarship materials such as LEARNED notebooks, pens and school uniforms alleviated unnecessary financial burdens likely to jeopardize The scholarship program successfully implemented the the girls’ ongoing pursuits of formal education. following activities: • Awarding scholarships for vulnerable students in • Frequent monitoring of scholarship implementation upper secondary school, especially girls. through household visits, checking attendance lists, observation of tutoring classes and in-class • Establishing a Senior Management Team in performance facilitated higher levels of collaboration with MoEYS and provincial level achievement. authorities to monitor and support scholarship implementation, and establish the LSMC programs. • Strong support from both parents/guardians and members encouraged girls to perform well at • Creating local bases to manage boarding assistance school and to behave appropriately in the boarding and follow-up with teams at community level. house. • Delivering decentralization workshops at local, Program Evaluation provincial and national levels on community development support for girls’ education. An evaluation of the program was due to be conducted in August 2007. • Developing youth groups (i.e. ‘study clubs’) through their involvement in various aspects of the education program (e.g. planning, monitoring and management). 14 Chapter 2: Safe and Supportive School Environment INCLUSIVE EDUCATION FOR CHILDREN WITH SPECIAL NEEDS – LAO PDR INTRODUCTION minority children (who cannot understand the language taught in school); and children below average ability (who Many children with special needs have no access to basic need changes in pace and content). The IE program further education due to families not sending them to school or to seeks to ensure that children with disabilities are not non-acceptance from schools. In addition, there are many removed from their homes to attend special schools which children with special needs who attend schools but can violate children’s rights to their home, family and experience discrimination, bullying and failure. These involvement in the community, and where separation can children are eventually pushed out of the system where confirm society’s prejudice against children with exclusion becomes the norm. In order to address these disabilities. issues in Lao PDR, the MoE has introduced Inclusive Education (IE), a system through which children with Program Implementation special educational needs attend their local schools and study alongside their peers. The program seeks to address The IE program was initiated by the Ministry of Education the problem of exclusion by making changes needed in (MoE), with the Ministry of Health (MoH), through the schools, classrooms and the education system to enable National Rehabilitation Center (NRC). disabled children and all children with special needs to Program Duration learn successfully. The program is an important part Lao PDR’s efforts to achieve its Education for All The program will run from August 2005 until July 2008. (EFA) goals. Target Groups AIMS AND OBJECTIVES The program beneficiaries are: • To protect and ensure the right to quality education Primary Target Group(s): children with special needs in for all children in Lao People’s Democratic Republic Lao PDR. (PDR) by focusing on children with special needs. Secondary Target Group(s): non-disabled children, • To establish simple, effective systems of access for parents and community members in Lao PDR. quality education in designated schools nationwide for children with disabilities. Program Activities PROGRAM OVERVIEW Program activities included the following: Background • Establish Implementation Teams at the National (NIT), Provincial (PIT), District (DIT) and school The IE program acknowledges the rights of all children to levels. receive education as enshrined in the United Nations • Build the capacity of the Implementation Teams. Convention on the Rights of the Child (UNCRC), and NIT trained PIT and DIT, while PIT trained head confirmed by the international agreements on EFA, and on teachers and schoolteachers. the Statement and Framework for Action on Special Needs in Education. • Build the quality of standard in classrooms, schools, districts and provinces. The program is based in the further recognition that most • Create an evaluation tool for school self- disabled children can study in ordinary schools which evaluations. should adequately provide education for all local children. In Lao, traditional systems have sought to limit access to • Annually plan review meetings and training for children with special educational needs, creating a teachers, supervisors and administrators including segregated system. They have also been found to ignore PIT. The NIT and DIT plan their own activities. children with special needs, excluding them from the • Integrate the UNCRC using appropriate methods education system. Barriers to learning have been found not such as the child-to-child approach. to occur because of disability but because of the methodology used in schools and organizations in the • Set parameters for inclusion by welcoming all education system. These barriers also affect other learners, regardless of their characteristics/ marginalized groups of children, such as poor children differences, background, disadvantages or (who have no books or time and space to study); ethnic difficulties. Chapter 2: Safe and Supportive School Environment 15 • Integrate UNCRC content in the IE training workshops at all levels. At present, integrated training on UNCRC in IE workshops is extended to 2 days. FURTHER INFORMATION • Ensure that head teachers and schoolteachers explain Ministry of Education to all schoolchildren the diverse backgrounds and Thanon Lane Xang, Ban Xiengyeun Tha, abilities of individual children and to discourage Muang Chanthaburi, children from discriminating against and bullying each P.O. Box 67, Vientiane, Lao PDR. other. Telephone: +(856-21) 216 004 Program Resources and Finances Fax: +(856-21) 216 001 Not available. Mr. Sithath Outhaithany Division of Primary Education, Program Materials Department of General Education (DGE), Not available. Ministry of Education, P.O. Box 67, PARTNERSHIPS Vientiane, Lao PDR. The IE program works in partnership between the MoE Telephone/Fax: +(856-21) 250 946 and MoH, through the NRC and Save the Children Email: ielao_st@yahoo.com Norway (SCN). The Swedish International Development Cooperation Agency (SIDA) is the major donor to the program. KEY OUTCOMES AND LESSONS LEARNED The program found that when children of different abilities grow up together and learn from each other, differences are acknowledged and accepted. Inclusion was believed to bring benefits to all children, not only children with special needs; when schools sought to be inclusive, they were enabled to increase responsiveness to the range of abilities, skills and learning styles of all children. Inclusion did not require high levels of resources and materials. Rather, what it needed most was changes in the relationship between teachers, children and communities. Essential to the smooth running of the program were found to be: • A long-term commitment from the MoE. • Good technical advice. • Excellent monitoring and support systems. • Sensitive and common sense approaches. • Flexibility. • Good practice in development, such as sustainability and local ownership. • Involvement by parents and community members. Photo: Tara E. O’Connell 10 16 Chapter 2: Safe and Supportive School Environment Chapter 3: Skills-Based Health Education PRE-SERVICE TEACHER TRAINING – CAMBODIA INTRODUCTION Target Groups HIV/AIDS has been integrated into the pre-service teacher Chapter 1 of this publication described Cambodia’s aim of training curriculum at all levels. For primary school mainstreaming HIV education among its 3,500,000 teachers it is taught through four subjects: Khmer, Science, students, 120,000 staff and 7,000 public schools. The sheer Maths and Social Studies. For the lower secondary school- scale of teacher training required to undertake this task is teachers, it is included in regional Teacher Training immense and the resources required to provide in-service Centers, and at the National Institute of Education (NIE) it HIV training for all existing teachers would be enormous. is included in training to become a secondary In addition, for existing teachers, the pedagogy required to schoolteacher. teach about HIV/AIDS in a participative fashion would be, in many cases, highly novel and, in certain cases, hard to acquire. Over time, a much easier way to ensure that all staff of the MoEYS is trained in HIV/AIDS would be to ensure that the subject is covered adequately in pre- service training – reaching both large numbers of trainees and also touching them at a time when their teaching approach has not been formed. In this chapter, Cambodia’s experience of providing such in-service teaching is described. AIMS AND OBJECTIVES Photo: UNICEF • To provide training for teacher trainees in primary schools (provincial Teacher Training Colleges), in lower secondary schools (regional Teacher Training Centers) and in upper secondary schools (National Program Activities Institute of Education). For 2 years the program was implemented in partnership between World Education Cambodia and TTD. After PROGRAM OVERVIEW endorsement from the Ministry, the program was Background implemented in 8 provinces and was later expanded to all 18 Teacher Training Colleges (TTCs) around the country. As has been discussed, pre-service teacher training in A training team consisted of 1 staff member from World HIV/AIDS is occurring as part of Cambodia’s efforts to Education Cambodia and 1 staff member from TTD. This mainstream HIV/AIDS throughout its education sector team designed the training plan and implemented the (see Chapter 1). program in the provinces. Continuous feedback was given within the team. This capacity building process made it Program Implementation possible for TTD staff to implement the program on their World Education Cambodia and the Teacher Training own after 2 years. Department (TTD) worked together to develop the Since the start of the 2005/2006 school year, TTD has curriculum and Information, Education, Communication implemented the pre-service program without technical (IEC) materials for a pre-service program. This also support from World Education Cambodia. During the included inputs from relevant departments in the Ministry 2006/2007 school year, 3,069 lower secondary of Education, Youth and Sport (MoEYS). schoolteachers (grades 7 through 9), 4,521 primary schoolteachers (grades 1 through 6) and 905 upper Program Duration secondary schoolteachers were trained in life skills for The program is ongoing. HIV/AIDS. Chapter 3: Skills-Based Health Education 17 Program Resources and Finances The MoEYS receives technical and financial assistance from FURTHER INFORMATION the United Kingdom’s Department for International Development (DFID) through a 5-year program Mr. Pen Sarouen, implemented by the ICHA (budgeted at US$2.3 million). Director, Ministry of Education, Youth and Sport, Interdepartmental Committee for HIV/AIDS (ICHA), Program Materials #169, Preah Norodom Blvd, Life skills teacher manuals have been developed for Phnom Penh, Cambodia. teaching HIV/AIDS and prevention of sexually transmitted Telephone: +(855-23) 218 408 infections (STIs), reproductive health and drug abuse. Fax: +(855-23) 212 512 PARTNERSHIPS Email: icha@citylink.com.kh or icha@online.com.kh The pre-service teacher training program started as a Additional information can be obtained on partnership between World Education Cambodia and the website: www.moeys.go.kh. TTD with funding from the United Nations Children’s Fund (UNICEF). KEY OUTCOMES AND LESSONS LEARNED Cambodia’s experience of undertaking pre-service training of teachers in HIV/AIDS is aiding enormously the country’s efforts to mainstream the issue throughout the education system. Pre-service training has a number of distinct advantages: • Over time, it results in the exposure of all teachers involved in the education system to training about HIV/AIDS. (In contrast, in-service training is seldom able to cover all members of the teaching population). • Teachers are trained in HIV/AIDS education and the participatory methodology this involves as they begin their teaching career and are open to taking on new pedagogical ideas. In contrast, in- service teachers may find it difficult to move from the "chalk and talk" methodology in which they were trained. • Pre-service training of teachers enables them to be informed about HIV/AIDS throughout their careers, enabling them from their first day in the classroom to avoid any risky behaviors and also to prevent stigma and discrimination where they see these happening. 18 Chapter 3: Skills-Based Health Education HEALTH EDUCATION FOR OUT-OF-SCHOOL YOUTH – CAMBODIA AND LAO PDR INTRODUCTION Program Activities The diagram on page 20 represents Mith Samlanh’s social Out-of-school youth, particularly those living on the reintegration process. Street children are provided with a streets, are amongst the most vulnerable to poor health, number of different opportunities and means of leaving the nutrition and infection with HIV/AIDS. Addressing the streets towards integration into safer and more supportive needs of such children is a complex activity; if vulnerable environments. As this occurs, careful monitoring and children are to benefit from health education they must be follow-up of children is undertaken on a weekly basis by enabled to be in a place where they can receive the project social workers to ensure that the young people education given. In Cambodia and Lao PDR, the receive necessary support at academic, emotional and organization Friends International runs a holistic program social levels. that enables out-of-school youth, particularly street children, to be helped out of situations of vulnerability and Once children/youth have reached a level whereby they to receive child-centered life skills education. The success are deemed ready for the public school system, it is of the program has depended on the collaboration of a essential that the reintegration is undertaken through wide range of different stakeholders. careful planning with the schools by working closely with the school directors and the teachers into whose classes AIMS AND OBJECTIVES the children/youth will be entering. Included within all Friends-International (Mith Samlanh) • To respond to the needs of out-of-school, programs are the life skills curricula: HIV/AIDS particularly street children, their families and their (Prevention, Care of HIV-positive, Support of Children communities, with the ultimate aim of supporting Affected by AIDS); Drugs (Prevention, Health, their social reintegration. Detoxification, Rehabilitation); Child Rights • To support the sustainable reintegration of street (Implementation of the United Nations Convention on the and out-of-school children (aged 5 to 24 years) into Rights of the Child, Monitoring and Evaluation); the public school system through the development Reproductive Health; Sexually Transmitted Diseases of Non-Formal Education (NFE) methodologies. (STDs); Nutrition; and Hygiene and Culture. The curricula for life skills as well as for basic education (e.g. literacy and PROGRAM OVERVIEW numeracy) are under constant evaluation and improvement, both in terms of content as well as in terms Background of methodology. All curricula are tested on the children In Cambodia and Lao, many thousands of children are out- and all educators receive on-going training and input into of-school. Some of these children live on the streets either delivery techniques to ensure child-centered learning at all with or without the care and support of their families. The times. A ‘toolbox’ of activities has been established to program of Friends International was developed to meet guide educators in this process. the needs of these children, enabling both their social The life skills curricula on Information, Education, reintegration, their education and their exposure to a wide Communication (IEC) materials are all produced in range of child-centered life skills education. picturecard form to ensure that those children who are illiterate within the program are fully able to understand Program Implementation the subjects being learned. Setting up child-centered IEC The program is implemented by Friends-International materials creates practical and accessible information for a (Mith Samlanh) in close collaboration with the Ministry of target group where delivery is difficult. For example, for Education, Youth and Sport (MoEYS), National Institute of the topic of hygiene, trying to get children to wash Education (NIE), and the Ministry of Social Affairs, themselves seems like a simple message, yet for street Veterans and Rehabilitation (MoSAVY). children who are either living or working on the street and who have no access to running water, practical options Program Duration must be found to provide access to drop-in-centers and cleaning facilities (including the river) in order to ensure The program commenced in 1994 and is ongoing. sustainable behavior change. Target Groups The primary beneficiaries are out-of-school children and youth aged 5 to 24 years. Chapter 3: Skills-Based Health Education 19 Working with children, however, is not enough. Health promotion needs to be reinforced by the parents. It also needs to be recognized that many of the children/youth have dropped out-of-school or have never been to school due to poverty and the need to work on the streets. For this reason, Friends-International (Mith Samlanh) has established ‘Home-Based Production’ as well as small business support and business creation for families. Program Resources and Finance Not available. Program Materials Not available. Photo: World Bank Mith Samlanh Social Reintegration Process 20 Chapter 3: Skills-Based Health Education PARTNERSHIPS Friends-International (Mith Samlanh) works in close FURTHER INFORMATION collaboration with the MoEYS and the NIE, especially for Ministry of Education,Youth and Sport, teacher monitoring and curriculum evaluation. To assist in 169, Preah Norodom, the reintegration and social follow-up of children/youth Phnom Penh, Cambodia. within a family structure, Friends-International has a Telephone: +(855-23) 218 408 Memorandum of Understanding (MOU) with MoSAVY and Fax: +(855-23) 212 512 works through the local departmental structures of the Office of Social Affairs, Veterans and Rehabilitation Ministry of Education (OSAVY) for social follow-up essential in ensuring Thanon Lane Xang, Ban Xiengyeun Tha, sustainable reintegration of formally marginalized and out- Muang Chanthaburi, of-school children. P.O. Box 67, Vientiane, Lao PDR. KEY OUTCOMES AND LESSONS Telephone: +(856-21) 216 004 Fax: +(856-21) 216 001 LEARNED The establishment of strong partnerships at all levels has Friends-International been essential to the success of the program. Not only Peuan Mit, Phai Nam Road, must partnerships be formed with relevant ministries (see P.O. Box 10688, above) but also with other key stakeholders. Vientiane, Lao PDR. An essential partnership within this process is also Telephone: +(856-21) 261 389 between the social worker and the child/youth. It is through this relationship that a mutual understanding of Tracy Sprott, the issues with which the ‘client’ is dealing can be reached Technical Advisor, and henceforth, the journey towards establishing future Friends-International, plans can be commenced. The reintegration process, 9a, Street 178, P.O. Box 597, Phnom Penh, Cambodia however, will not be successful if strong partnerships are Telephone: +(855-23) 986 601 not also fostered with the parents, in order to assist them in understanding the importance of education as well as Email: tracy@friends-international.org. ensuring sustainable income-generating options for the family. Additional information can be obtained from Friends- International in Cambodia, Laos, Thailand and Indonesia at Collaboration between children/youth, educators and the www.friends-international.org, and Mith Samlanh in Department of Non-Formal Education and the NIE Cambodia at www.streetfriends.org. (formerly the Faculty of Pedagogy) has also been important in ensuring the adoption of holistic and adapted curricula. Chapter 3: Skills-Based Health Education 21 HIV/AIDS PREVENTION EDUCATION FOR COLLEGE STUDENTS – CHINA INTRODUCTION Coordination of different stakeholders is undertaken by a Program Implementing Workgroup. A leading group has This program enables college students to gain knowledge been established at the provincial level with a program about HIV/AIDS, to change their attitudes towards life, and office established at the Physics, Health and Art to cultivate behavioral habits beneficial to their survival and Department of the Yunnan Provincial Bureau of Education. health. As part of the program, student volunteers raise The workgroup serves as the executing and operating unit awareness on HIV/AIDS prevention in the community, at the regional level for the Yunnan province. The ultimately benefiting the progress and development of the operational framework for the new 4-year program is whole population. illustrated in the diagram below. AIMS AND OBJECTIVES Propaganda & Education Germany Office of Propaganda Dept. • To safeguard college-age students from HIV/AIDS Program leader of CPC Yunnan Committee infection by empowering them with knowledge and Yunnan Provincial Bureau of Health life skills education that encourage healthy Chinese Program Cooperating Units behaviors. Program Leader YBoe Yunnan Provincial Bureau of Labor & • To raise awareness on HIV/AIDS prevention in the Social Security community by educated college students, ultimately Program Office YNCDC to benefit the progress and development of the Physics Health & Art whole community. Dept. of YBoE Yunnan Provincial DBAD Teachers’ Traning & PROGRAM OVERVIEW Researching Base PIW Yunnan Provincial Background Yunnan Normal University (YNNU) DBAD School Education Base Yunnan province is one of the areas in China that is Yunnan Provincial affected by HIV/AIDS. Because they are of an age of higher DBAD Youth Education Base sexual activity, college students are at a higher risk of infection by HIV/AIDS than other population groups. Program Duration There are 59 colleges and universities in Yunnan with 463,500 students. Therefore, offering an HIV/AIDS The program has been in operation for 6 years. The new educational course to college students in Yunnan is a key program will run for a further 4 years. measure in guarding against HIV/AIDS in the province. Target Groups Program Implementation University students in Yunnan Province. At first, the program operated in schools in bordering areas where poor, uneducated ethnic groups live. From Program Activities 2005, led by the Yunnan Provincial Committee of The diagram on page 23 illustrates the operational Education and partnered with the 3 educational bases framework for the program that has been in existence for (Yunnan Provincial Drug-Banning and AIDS-Preventing 6 years. Teacher Training and Researching Base; Yunnan Provincial Drug-Banning and AIDS-Preventing School Education Base; and Yunnan Provincial Drug-Banning and AIDS-Preventing Youth Education Base), the program has been in operation in universities throughout Yunnan province. The program operates with the support of representatives from the Propaganda and Education Office of the Propaganda Department of the Communist Party of China (CPC) Yunnan Committee; Yunnan Provincial Bureau of Health; Yunnan Provincial Bureau of Labor and Social Security; and Yunnan Provincial Center for Disease Control and Prevention. Photo: World Bank 22 Chapter 3: Skills-Based Health Education The program has undertaken the following activities: • Explore ways to maximize outcomes with current • Yunnan Provincial University AIDS-Preventing investments. Education Base was built by Yunnan Committee of • Promote the sustainable development on HIV/AIDS Education. prevention education in the Yunnan province. • Trainers were trained by key teachers in Kunming. In view of the background, this program has sought to: • Key teachers were trained by trainers, including • Receive support by all relevant departments. college teachers in Yunnan. • Establish a center for HIV/AIDS prevention education • Student volunteers were trained by key teachers. for colleges. • Student education was delivered by key teachers and • Train key teachers and student volunteers to educate student volunteers. college students. • Educated students became involved in advocacy within • Circulate HIV/AIDS prevention messages throughout the community. the community via the mass media. Program Resources and Finance Over the past 2 years the program has achieved the Not available. following: • A total of 330 key teachers have been trained. Program Materials • Approximately, 98% of colleges have established a curriculum for HIV/AIDS. Not available. • Around 3,300 student volunteers have been trained to educate other college students and to spread basic PARTNERSHIPS knowledge about HIV/AIDS throughout the whole The program was developed in partnership with relevant society. agencies and organizations including Save the Children; • The awareness rate of college students for HIV/AIDS United Nations Educational, Scientific and Cultural has reached 85%. Organization (UNESCO) and Southeast Asian Ministers of A further challenge is that whilst awareness of HIV/AIDS Education Organization (SEAMEO) for 3 subjects in 1999 prevention has developed rapidly, the knowledge fails to and 2001 respectively. match the skills and, as a result, life skills-based HIV/AIDS education needs to be developed. KEY OUTCOMES AND LESSONS LEARNED FURTHER INFORMATION The task of eradicating HIV/AIDS is substantial, but Physics, Health and Arts Department, education on HIV/AIDS prevention has been hindered in Yunnan Provincial Bureau of Education. Yunnan province by the lack of up-to-date information, AIDS Prevention Office,Yunnan Provincial Bureau of Health. equipment and training. The program has therefore met Ma Na both opportunities and challenges. Foreign Languages School, Yunnan Normal University, No 298, 121 Street, Kunming City, Yunnan Province 650092, P.R. China. The program aims at taking full advantage of college students’ enthusiasm for HIV/AIDS prevention, so as to: Telephone: +(86-871) 537 4846 • Create partnerships among the government, schools Email: timtina798013@yahoo.com.cn and society. Chapter 3: Skills-Based Health Education 23 LIFE SKILLS EDUCATION AND HEALTH PROMOTION MATERIALS: BLUE BOX – LAO PDR INTRODUCTION the indicators to measure the implementation of the National School Health Policy (NSHP). The Blue Box is The Blue Box is a toolkit of materials that enables teaching disseminated and used by schoolteachers in targeted and learning both in and out of the classroom about health schools. The contents of the Blue Box have been revised behavioral skills such as hand washing, personal hygiene, appropriately to match all existing health topics in the environmental sanitation, prevention skills against common curriculum by the local government, the World Health communicable diseases, and water and latrine usage Organization (WHO) and other development partners. through games and stories. Program Implementation AIMS AND OBJECTIVES • Ministry of Education: National Research • To provide a comprehensive package for teaching Institute for Educational Science, Department and learning in both primary schools and Teacher of General Education, Department of Teacher Training Colleges (TTCs). Training, Faculty of Medical Sciences, Representatives from provincial education services • To train teachers on the use of the Blue Box and teachers from a number of primary schools materials as well as life skills education and child- and TTCs. centered methods of teaching. • Ministry of Health: Department of Hygiene and • To help teachers guide students to use materials Prevention, Department of Curative, Department through a child-to-child/peer education approach. of Personnel, Center for Health Education Information, Center for Malaria, Center for Water and Sanitation. Program Duration The program has been in operation for 1 year. Target Groups The program targets primary schools in all 17 provinces and in 8 TTCs in Lao PDR. Program Activities The resources contained in the Blue Box enable the use of child-to-child and child-to-adult teaching about health and Photo: UNICEF nutrition. In turn, educational messages are spread by the children to their homes, villages and districts through PROGRAM OVERVIEW word-of-mouth and through the media. Background Blue Box materials have been distributed and pre-service teachers have been trained in all 8 TTCs, so that teachers The Blue Box originated with the United Nations are well trained in using the materials for teaching health Children’s Fund (UNICEF) and was developed to support education before they are assigned to schools. children’s hygiene and sanitation. The materials in the Blue Box (see Figure 3: Samples of Materials in the Blue Box) Program Resources and Finance compose a comprehensive toolkit to support health education teaching and learning activities and are part of Not available. 24 Chapter 3: Skills-Based Health Education Figure 3: Samples of Materials in the Blue Box Program Materials The Blue Box contains the following 20 items related to health education: • Two teacher guideline books. • Five posters on: the transmission of hookworms; the transmission of roundworms; food groups; key hygiene practices that prevent diseases; and instructions on hand washing. • Three games: Snakes and Ladders; Prevention of Parasites; and word card games. • Four comics/stories on: parasites; HIV/AIDS; hygiene and sanitation; and malaria prevention. • Five Kamishibai, or story telling cards on: the encouragement of latrine usage; a safe environment; dental health; safe waste disposal; and clean and safe drinking water. • A complete set of songs about hygiene and sanitation. To certify quality and appropriateness, the materials had been pre-tested in schools for 2 months by schoolteachers who used them as a tool for teaching ‘The World Around Us’ curriculum. PARTNERSHIPS The international partners who supported the program stimulate learning, not only for the learners but also for were Japan International Cooperation Agency teachers and literacy trainers. Observations further (JICA/KIDSMILE), Lao Red Cross, UNICEF and WHO. revealed improvements in the health and safety of the environment. KEY OUTCOMES AND LESSONS LEARNED Schoolteachers, members of United Nations (UN) FURTHER INFORMATION organizations and non-government organizations (NGOs) National School Health Taskforce were strongly involved in the development of the Blue Box Ministry of Education, materials through the use of workshops and discussions. Vientiane, Lao PDR. All stakeholders shared ideas as well as resources to Telephone/Fax: +(856-21) 213 161 develop the package of materials for use in schools. Email: nries@laotel.com Prior to publication, the materials were piloted in a Mrs. Phoungkham Somsanit number of schools. As the Blue Box was disseminated to National Research Institute for Educational pilot schools, the need for trained schoolteachers in using Science (NRIES), the materials became apparent. Ministry of Education, Lao PDR. Mrs. Sutsaichai Duangsavanh Feedback from the users revealed the benefits and effects Department of General Education (DGE), to schoolchildren and people in the community. The use of Ministry of Education, Lao PDR. the Blue Box in schools and communities was found to Chapter 3: Skills-Based Health Education 25 TAKING LIFE SKILLS-BASED EDUCATION TO NATIONAL SCALE – MYANMAR INTRODUCTION Program Implementation Many countries around the world have seen smaller scale With technical and financial support from UNICEF, the HIV/AIDS activities occurring in schools through the work MoE started in July 2004 the revision process of the of nongovernmental organizations or through the piloting National Primary Life Skills Curriculum (mainly a teacher of approaches by governments and other agencies. Taking guide for all primary grades). The need to revise the 1998 such small-scale approaches to national scale is a major curriculum was due to changing trends in HIV/AIDS, challenge – what has been effective in just a few schools emerging issues, and the need for using a life skills-based may not be so readily implemented amongst many. In approach that would encourage children’s participation Myanmar such a transition was achieved as a pilot project, and critical thinking. A taskforce was formed consisting of the School-Based Healthy Living and HIV/AIDS Prevention the curriculum developers, who also served as trainers for Education (SHAPE) program, became the basis for a primary teachers and educators from education colleges. nationally delivered life skills curriculum. Personnel from the National AIDS Program and personnel from the Department of Health, including School Health, AIMS AND OBJECTIVES were also involved from the onset. • To promote and build the knowledge, Program Duration competencies and psychosocial skills that primary schoolchildren need for healthy living. The program is on-going and is expected to have primary teachers in all schools trained in the new curriculum by • To empower primary schoolchildren to adopt 2009. positive behaviors and make informed decisions that will enable them to deal effectively with the Target Groups challenges of everyday life. The beneficiaries to the program are: • To empower primary schoolchildren to protect themselves against HIV/AIDS. Primary Target Group(s): primary schoolchildren in Myanmar. Secondary Target Group(s): primary schoolteachers PROGRAM OVERVIEW (including pre-service teachers), school principals, parents Background and communities in Myanmar. With the increase in HIV/AIDS infections, the need for Program Activities intensified prevention efforts for children and young people became evident in Myanmar in the early 1990s. The following 4 key strategies were used: Myanmar Health and Education Ministries recognized the importance and need for a life skills-based education 1. Strategies to Improve Quality of Life Skills program to be introduced in schools to combat HIV/AIDS. Curriculum: The lessons learned during the With technical and financial support from the United implementation of the (SHAPE) project provided the Nations Children’s Fund (UNICEF), the Ministry of basis for the revision of the national life skills Education (MoE) developed a primary and secondary curriculum increasing its relevance. curriculum and implemented a pilot project entitled SHAPE in one-third of schools in the country between The program taskforce looked at several life skills 1997 and 2003. In 1998 the Ministry introduced the life curricula, including the national life skills curriculum, skills education as a separate core subject (with exams) at SHAPE and the Japanese International Co-operation the primary level using the main contents from the SHAPE Agency’s (JICA) pilot life skills program, which provided curriculum. In 2004, based on lessons learned from the the base material for the revised version. Each of the 5 SHAPE project and based on the changing trends in revised areas was given to a group within the taskforce to HIV/AIDS and emerging issues, it was decided to revise the develop appropriate lessons. The 5 revised areas life skills-based education curriculum to address the new were: Social Skills (self-awareness, safety and protection); and emerging issues facing the Myanmar children. The Healthy Living; Diseases and Prevention of Drugs; revision of the national primary life skills curriculum began Environment (green issues and cleanliness) and Mental in early July 2004 and included revision of the teacher Health. A series of workshops, discussions and meetings guides and student books for all primary grades. was set-up to finalize the lessons. Special support was provided by the UNICEF Regional Office in Bangkok 26 Chapter 3: Skills-Based Health Education through the HIV/AIDS project officer. In total, 74 lessons At the workshop a 2-hour ‘study time’ was planned in the were produced and field tested extensively both in urban evenings to help teachers prepare for demonstration and rural schools as well as in ethnic schools. Drafts of the lessons, where training teams were formed with inputs lessons were revised to incorporate the inputs received from the next level of trainers to help strengthen the from children during field testing. The whole process of capacity of the team members. Follow-up monitoring visits development, review, revision and finalization of lessons were made to townships during and after training to took more than a year. The printed materials were piloted provide necessary support to different levels of education in 315 schools in 3 townships by the end of 2005. personnel and focus group discussions were conducted with children, teachers and head teachers at randomly 2. Strategies to Build the Capacity of Teachers and selected schools to assess program implementation. Education Officials in the Life Skills-Based Learning Approach: Teacher Learning in Schools: The prescribed teaching The strategies include: periods for life skills subjects in Myanmar are as follows: • Provision of awareness training to Township • Lower Primary School: 3 periods per week, 108 Education Officers (TEOs) and Assistant State periods per year, or 54 hours for 40 lessons. Inspectors (AIS) for supervision of life skills-based • Upper Primary School: 2 periods per week, 72 preventive education. periods per year, or 42 hours for 34 lessons. • Provision of sufficient and free life skills teacher guides and student books to all schools. Selection of Resource Personnel for Trainings: The recruitment • Systematic pre- and in-service training for teachers of the trainers from zonal trainings was taken into of life skills to ensure quality delivery of the consideration to prevent a shortage of central trainers curriculum. from the start of the SHAPE project. The core trainers • Ensuring that sufficient numbers of life skills (Curriculum Developers) carefully identified the potential trained teachers are placed in all schools. teachers during zonal training workshops and during their field monitoring visits to schools. They selected and gave Advocacy and Orientation of TEOs: With life skills being refresher training to those potential teachers to help them a fairly new subject, the program focused heavily on the become central level trainers. The core trainers also training of teachers at the state and division levels, as well received frequent refresher training by the UNICEF as advocating to township education officials, who received regional life skills and HIV/AIDS project officers, who The table below represents the target and attainment of the revised life skills curriculum. Revised Life Skills Curriculum Target and Attainment Basic Target Attained (2005/06/07) Education Townships Year Townships School Teacher* Student Primary 325 2009 238 31,351 83,067 4.05 Level (73% total) (77% total) (71% total) millions