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

Andrew Owusu Ph.D. & Angela Bowman M.A . Middle Tennessee State University Ghana GSHS & GSHPPS Country Coordinator

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

INTRODUCTION: HEALTH VS ACADEMIC PERFORMANCE  There is an association between school health  Improved health status of schoolchildren services and academic achievement (Castelli et al., 2015; correlates positively with learning abilities and Esteban-Cornejo, Tejero-Gonzalez, Sallis, & Veiga, 2014; Fedewa & Ahn,  Capitalizing on link retention (Hawley, Rosenholtz, Goodstein, & Hasselbring, 1984; Strolin- 2011; Murray, Low, Hollis, Cross, & Davis, 2007) between student health Goltzman, 2010; Taras & Potts-Datema, 2005). and academic performance requires comprehensive and integrated school health approach (Basch, 2011) .

INTRODUCTION: SCHOOL HEALTH EDUCATION PROGRAMME (SHEP) The School ool Healt lth h Educa cation tion Pro rogram ram (SHEP) P) establi ablished shed 1992. 2. • Ghana Poverty Reduction Strategy (GPRS) I & II • Free Compulsory Universal Basic Education (FCUBE) Scatt tteri ring ng of school ol healt lth h • National Community Water and Sanitation relat lated d poli licies s pre-20 2012 Programme (NCWSP) • The Education Strategic Plan (ESP), 2003 – 2015 Devel elopme opment nt of Natio ional al SHEP EP Polic licy y Guid idel elines ines  2012 What about t measurement asurement and evaluation luation of SHEP P • SHEP Poli licy y Guid idelines elines Sect ction n 6.2.7 .7 Poli licies es Im Imple lementa tation? n???

PURPOSE OF STUDY: RESEARCH QUESTION 1  What is the relationship* between school characteristics and the extent to which the SHEP recommended minimum package for school-level health services delivery is offered? * controlling for enrollment size

PURPOSE OF STUDY: RESEARCH QUESTION 2  What is the relationship* between school characteristics and the extent of implementation of SHEP policy guidelines on Water, Sanitation and Hygiene (WASH)? * Controlling for enrollment

METHODOLOGY: DATA SOURCE AND MEASURES  Data from the 2015 Ghana G-SHPPS  Identified Ghana GSHPPS items ; 1. Assessing components of the minimum recommended package (13 components) for delivery of school health services 2. Assessing WASH components  Measures  6 of 12 components of minimum package for health services delivery measure by SINGLE ITEM  Rest assessed using index created by combing 2 or more items.

METHODOLOGY: VARIABLES  Control Variable:  Enrollment size (≤ 200 vs >200)  Outcome Variables:  Minimum Recommended Health Service Delivery Package (<50% vs ≥50%)  WASH items (YES or NO)  Exposure Variable:  School Health Committee (YES vs NO)

METHODOLOGY: ANALYSIS PLAN  Complex Samples Cross-tabulations to examine prevalence estimates (95% CIs)  Individual health service minimum package components by school health committee (YES vs NO) layered by enrollment (≤ 200 vs >200) by  Logistic regression to predict the likelihood of offering minimum health services delivery package based on  enrollment size (≤ 200 vs >200)  health committee status (YES vs NO).

RESULTS: SAMPLE DESCRIPTIVE STATS  19,681 schools  375 sampled  82% response rate  307 surveys returned

RESULT LTS: SAMPLE DESCRIPTIVE STATS Descriptive Statistics % n * Enrollment Above 200 52.0 159 School Health Committee (YES) 53.2 161 Co-Edu i.e., Same School Boys and Girls 94.7 290 Public School 98.7 301 Day 94.9 291 Offers at least 50% of SHEP Recommended 32.8 100 Package for Health Services Delivery * Note: n = unweighted count

RESULT LTS: HEALTH SERVICES DELIVERY

RESULTS: HEALTH SERVICES DELIVERY Odds Ratio: Health Services (50%) by Enrollment / Health Committee OR 95% CI Enrollment Above 200 2.72 2.17 - 3.41 School Health Committee to guide policy 4.08 3.23 - 5.18 implementation Enrollment above 200 AND School Health 4.52 3.32 – 4.17 Committee to guide policy implementation Enrollment below 200 AND School Health 3.16 2.23 – 4.42 Committee to guide policy implementation * Regardless of enrollment, schools who have a health committee to guide policy implementation are more likely to offer at least 50% of the SHEP Minimum Health Services Package.

RESULTS: WATER, SANITATION, HYGIENE

RESULTS: WATER, SANITATION, HYGIENE Selected WASH Variables by Health Committee Status OR 95% CI Separate Toilet for Boys and Girls 1.24 1.01 - 1.52 Place for Girls to dispose sanitary pads 4.29* 3.09 – 5.95 Toilet paper provided 2.73* 2.00 - 3.72 Toilet cleaned everyday 2.19* 1.67 - 2.88 Hand washing area 2.25* 1.83 - 2.76 Soap provided 1.71* 1.18 - 2.52 Clean source of water 1.42* 1.13 - 1.78 Water tested for quality 1.70* 1.34 - 2.17 * Schools with a health committee to guide policy implementation are more likely to address WASH

IMPLICATIONS FOR SCHOOL HEALTH IN GHANA  Academic performance is associated with and causally linked to the health of students.  Since 1992, SHEP has help in delivery of school-level health services to millions of students.  But, lots of room for improvement .  GOOD NEWS!!! = School Health Committees  PRACTICAL  EFFICIENT  SUSTAINABLE!!!

Thank you!!!