The number of school children has been rising globally. But to ensure that children attend schools, their health has to be secured. In less developed countries school-age children are at risk of diseases due to poor health and nutrition and overcrowded classrooms that aggravate the transmission of communicable diseases. To mitigate the problem, the Ministry of Health (MoH) and the Ministry of Education (MoE) jointly launched in 2014 a program named School-based Health and Nutrition Services as part of a joint strategy.
The program led by the Department of Primary Care within the MoH and aims at improving the health of school children nationwide. The school based health and nutrition service is working in all regions through mobile clinics donated by partners including the German medical association, Archimed, the Eritrean Relief Association (ERA) and the Swiss Support Committee for Eritrea (SUKE) among others. Health workers travel with their mobile clinics to visit schools to make eyes-ears-teeth-skin and nutrition check-ups on school children from elementary to junior schools. Every year, a group of about ten health professionals go around the country to provide free-of-charge service in collaboration with their health teachers’ focal persons.
The continuity of the program depends on heavily on the commitment of teachers. For this reason, annually, training is organized and I attended one of them this last weekend in Asmara at the Godaif Elementary School. Besides the provision of screening of health problems, daily monitoring is key to successfully address health issues. As part of the project, every school established a health club where there is a director or person in charge who is in contact with the health focal person in charge of members of the school health club. Those teachers who voluntarily work as health focal persons have further responsibilities besides teaching. The refreshing training is an occasion to review and discuss different health issues related to eyes, ears, teeth, skin or nutrition to inform the teachers of any updates so that they could give quick response to a child’s health problem.
This innovative method creates a sense of responsibility to all members of the school as they are training in basic health check-up. They are equipped with direct delivery of interventions to the children in their schools by, for instance, providing iron tablets or vitamin A. During the two-day session, teachers and directors of schools in Asmara gathered together to listen to and interact with health professionals for each sector such as red-eye treatment, sight issue, dental care or skin problems.
“Teachers play a big role within the Eritrean society. Most pupils listen more to their teachers than to their own parents. They can pass on the message on health prevention easily”, said Mrs Leteberhan Ande, a nurse and an oculist who is a member of the team and hits the road annually with the mobile clinic.
Screening at school allows to bring quick response and, if needed, to refer children to the nearest local health facilities. As part of the strategic plan, the provision of safe water and sanitation in schools are likely to improve the health of school children. It decreases the level of absenteeism, and encourages practices of good hygiene such as hand washing and teeth brushing.
During the school-year of 2014- 2015, about 134,064 school children went through health screening in the Central region. Out of those screened, 5,859 had eye problems, 3,741 ear problems, 21,609 dental problems, 5,802 had skin problems and 5799 had nutritional deficits. In the school-year 2016-2017, there was a slight increase in the number of school children who visited the mobile clinics with 134,354 children in the Central region alone. Eye related problems were at 7,098, and 18,016 children with dental problems. The health screening in schools shows its relevance and importance in detecting any sign of health problems at an early stage.
The program provides health screening to school children free of charge and for those with refractory error, eyeglasses are given free of charge. On top of that, each year school kids are given free dental brush and toothpaste. “To ensure good health of the eyes, we have to push parents to send their kids for further exam to the Eye Hospital. We made sure that every Saturday, the hospital only accepts students and teachers except for emergencies so that they won’t be absent for their lessons”, said Mrs Leteberhan.
Screening for health problems provides a simple way to administer medication and treatment by teachers and only when cases are beyond their mandate, should a school child be referred to a health facility. It is cost-effective and ensures that all children are reached nationwide. Despite lack of separate budget specific to the program, the commitment of both teachers and health workers deserves recognition. Increasing the number of mobile clinics and human resources will make the work more efficient and more frequent nationwide. Raising awareness of parents about the program is important. “Some parents would come and ask us what we are doing or even tell their kids not to take the health screening in their school”, said Mrs Leteberhan.
This great initiative is key in ensuring the motto of education for all and a healthy society starting from the first year of schooling all the way to higher education.