Strengthening primary health care and health promotion in Sri Lanka’s schools: the need for a comprehensive national policy
Umanga de Silva A and Simon Barraclough A BA School of Public Health, La Trobe University, Vic. 3086, Australia.
B Corresponding author. Email: s.barraclough@latrobe.edu.au
Australian Journal of Primary Health 15(2) 123-131 https://doi.org/10.1071/PY08056
Published: 5 June 2009
Abstract
School children constitute ~20% of the population in Sri Lanka, making school health an important element in primary health care in this country. Sri Lanka faces severe economic problems, the challenge of reducing health inequalities within its society and a continuing ethnically based armed conflict. Historically, the school health program emphasised hygiene, screening for diseases and malnutrition and referrals to specialists. However, many interrelated factors influence the physical, mental and social health of school children. Schools should therefore provide not only a healthy physical setting, but also healthy social and emotional environments that promote better learning. This article uses both published and unpublished official documents, as well as a review of recent local research to present a comprehensive overview of school health programs in Sri Lanka, to identify problems with their content and implementation and to suggest ways for strengthening them. It is argued that there is a pressing need for a comprehensive national school health policy that not only addresses the essentials of planning and coordination, but also serves to reorient school health to embrace the promotion of physical and psychosocial health. Such a shift should be based on a whole-of-school approach, recognising the role of students, teachers and the wider community.
Acknowledgement
The authors wish to thank the anonymous reviewers of an earlier version of this article for their useful suggestions for its improvement.
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Appendix 1. The goal and the objectives of the School Health Program under the Ministry of Health (Family Health Bureau 2006)
Goal
To ensure that children are healthy, capable of promoting their own health and health of the family and community, and are able to optimally benefit from educational opportunities provided.
Objectives
(1) To strengthen the partnership between health and education sectors for promotion of the health of the school child
(2) To identify the range of needs of the school children for optimal development
(3) To provide appropriate health promotional activities to enable children to have control over and promote their own health
(4) To empower school children to act as change agents to improve health within the family and community
(5) To promote, healthful and safe school environment, that would facilitate learning
(6) To protect children, from communicable diseases including vaccine preventable diseases
(7) To screen school children for early detection and correction of health problems
(8) To improve nutritional status of school children by continuous monitoring and appropriate intervention
(9) To enhance community participation for the promotion of school health activities
(10) To provide a system of monitoring and evaluation to assess the effectiveness of the School Health Program.
