RMCH School Health Project
Strengthening school health
services (Output 2A)
29th January 2015 NDoH Steer Committee Meeting
Sue Jones: School Health Advisor
Thoko Ndaba: Project Manager
Maredi Modiba: Field Team Co-ordinator
Outline of presentation
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Model of RMCH School Health TA
2 legacies
4 high level recommendations
DFID recommendations reviewed
Outstanding work to be done
Final document dissemination
Model of technical assistance
• National policy advocacy
– Health system strengthening: co-ordination structures, referral
system
– Clinical: Health promotion and ISHP family planning in schools,
• Capacity building
– Strengthen integration, partnerships, planning, reporting, coordination, M&E and increasing demand for ISHP
• Monitoring and evaluation
– District Reporting Tool adapted for the ISHP
• Knowledge management
– Documentation of lessons learnt and best practice
Legacies
Clinical:
1.
The ISHP (Policy) to change to “opt-out” for family planning services within schools.
Already planned to incorporate in the revised DBE HIV and STI policy soon to be
gazetted.
– provide greater access for adolescents to SRH services
– provide greater awareness to parents and school community that this is necessary
– ultimately to reduce high risk sexual behaviour and reduce teenage pregnancy (proxy
outcome measurements)
HSS interventions
1.
District ISHP task team and ToR existing in 20 districts
– Integration of 3 key departments DoH, DoE and DSD and external partners supporting ISHP
is the key to ISHP success
– Co-ordination structures strengthen implementation and effectiveness of ISHP
2.
The RMCH District Reporting Tool (DRT) can provide a structured method for monthly
monitoring of ISHP implementation, assessment of the enabling environment and a
tool for future planning and accurate, regular reporting.
Status of District Task Teams
Lewjeleputswa DM
Pixley ka Seme DM
Xhariep DM
T Mofutsanyane DM
Waterberg DM
Ngaka Modiri Molema DM
Uthungulu DM
Ekurhuleni MM
Uthukela DM
Amathole DM
eThekwini MM
Fezile Dabi DM
Ugu DM
Mangaung MM
A Nzo DM
O Tambo DM
J T Gaetsewe DM
Capricorn DM
G Sibande DM
uMgungundlovu DM
Siyanda DM
Frances Baard DM
Bojanala Platinum DM
Dr K Kaunda DM
Northern Cape
North West
Mpumalanga
Limpopo
KwaZulu-Natal
Gauteng
Free State
Eastern Cape
0
Presently there are 20 DTT that have been formed:
 14 are institutionalised
 3 are integrated into routine practice
 3 are in the process of implementation
 4 are pre-implementation
2
4
6
8
High level recommendation 1 (DFID 1)
The National ISHP Task Team will need to deliberate and motivate for effective
use of existing resources to ensure that District ISHP Task Team are
established and sustained in all districts to provide a sustainable District Lead
integrated structure to implement, plan, monitor and report in respect to the
ISHP. District ISHP task teams are clearly stipulated in the Integrated School
Health Policy to enable ISHP implementation.
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The Provincial Task Team is the key mechanism to continue the sustainability of
the District Task Teams.
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Critical success factors for sustainable action between departments: strong
leadership, accountability, commitment to action and better defined roles and
responsibilities. Dedicated ISHP co-ordinators for each department
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If this recommendation is adopted and taken to scale co-ordination structures will
be institutionalised, ISHP will be a consistent part of the district health plan
High level recommendation 2 (DFID 2)
To urgently revise the Integrated School Health Policy to an “opt out”
basis for SRH services and provide clear guidelines for the consultation
of SGB and parents.
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Strengthen advocacy for the ISHP and Family Planning services to the
School Governing Bodies and Parents. The National DBE document
“Guidelines for School Governing Bodies to consult parents on the ISHP”
has now been approved by the Council of Education Ministers enabling its
cascading to the Provinces, Districts and SGBs this year.
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This will facilitate standardised consultations between SGB and parents in
respect to increasing the awareness of the need for SRH services in the
school community (and so the parental community can “opt out” if agreed)
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The implications are full roll out of SRH services in schools, greater access
for adolescents, reduction in teenage pregnancy.
High level recommendation 3
To improve the quality of care through the ISHP by
strengthening the referral system through the ISHP to PHC
• Standardise a tracking system from schools to PHC/other
sources. The 3 streams of PHC re-engineering can be linked
effectively to support learner referrals and follow up (SHT,
WBOT and DCST), and the link should also be strengthened
to the SBST.
– Incorporate the 3 streams into the extended SBST network
• Implications if adopted: improved outcome of ISHP
interventions, barriers to learning treated/rectified, SRH
service accessed  longer term better educational outcomes.
High level recommendation 4
Improve the quality of data capturing and recording at
local level and ensure districts gain access to DHIS
and utilise data for planning and reporting
• Capacity building for districts where data capturing is poor quality
• Ensure all districts have access to the National ISHP recording and
reporting system, and standardise data collection tools
• The District Task Teams adopt District Reporting Tool
• The implication is that the quality of ISHP implementation, M&E,
planning and reporting will be improved and greater coverage will be
reached.
DFID review October 2014 recommendation 1
Recommendation 1 2014
Status
Response
Task teams have been established as part of a
strategy to implement the ISHP nationally.
These teams are jointly staffed by DoH and
DoE. At present responsibility for leading and
coordinating these teams is unclear. This
creates a risk to the sustainability of the school
health work. RMND to work with relevant
government departments to clarify
responsibility for leadership of these teams.
Pending
To provide recommendation
to the final SteerCom on
29th January 2015 for the
Provincial ISHP Task Teams
to continue strengthening
the District ISHP Task Teams
and motivate for clearly
defined roles for the
respective department ISHP
co-ordinators from DoH,
DoE and DSD.
DFID review October 2014 recommendation 2
Recommendation 2 2014
Status
Response
RMND to work with NDoH and DBE to
galvanise support for an opt-out approach
(instead of opt-in) to providing sexual and
reproductive health services in schools.
Achieved
National DBE has approved
this change which will be
effected through the revised
DBE HIV and STI policy.
RMCH has advocated for the
Integrated School Health
Policy to be updated to
specify the school SRH
services will be “opt-out”
only and clearly define the
process for consultation for
SGB and parents to opt out.
DFID review October 2014 recommendation 3
Recommendation 3
2014
In the final year of the programme the focus
of school health and WBOT work should
move from achieving coverage to measuring
quality and impact. Measures of quality,
performance and impact should be
developed with NDoH and put into use
before the end of the programme. These
measures are not primarily to assess the
performance of the RMND programme but
to aid the future development of the
national strategy. Indicators could be added
to the RMND log-frame for the extension
period related to this recommendation.
Status
Response
Pending
To be recommended to the
final SteerCom on 29th
January 2015.
Analysis of the status 50
HPS has been conducted
and available in the PCR
and Provincial Profiles
Outstanding work to be done
What?
Why?
• WC did not receive RMCH
School Health TA
• Priority for Provincial ISHP
task team support to NW, NC
and GP
• ISHP DRT capacity building
and full launch across districts.
DRT champions are needed at
all levels government
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WC PDoH requested RMCH to
work in another district
Challenges to access district
and implementation ended Nov
2014. Ideal would be 1 RMCH
school health facilitator for each
Province
ISHP DRT is now being finalised
and presented to NDoH M&E
In hindsight need all systems
in place at the end of the
inception phase (eg DBE
approval, DRT)
All systems are now
developed now ready to use
Product dissemination February 2015
Documents for National, Provincial and District task
teams:
• School Health Baseline summary and
recommendations
• RMCH School Health Manual
– Accompanying CD with all presentations and
documents produced by RMCH
• Case studies
• Policy brief (for National only)
• Provincial ISHP profiles (for Provinces)
THANK YOU