Transcript Document

Mainstreaming
Health and
Inclusion in
Education
in Uruguay
Sergio Meresman
VANCOUVER, June 2007
Uruguay
• 3.3 million people
• 4000 Primary schools (1000 rural)
• Strong and prestigious education
sector, nearly universal coverage
in primary education
• 98 percent of the population has
access to potable water
• Increasing equity and quality
issues: underprivileged schools
accumulating problems, demands
and services.
• Teacher training and practice
deteriorating
Impact of the 2002-03 crisis (selected
social indicators)
• 15% decrease of GDP
(estimated 2002)
• 55% of Uruguayan children are
poor
• 25% unemployment (April 2003)
• 18 million living under the
poverty line (50% of total
population)
• In 2002 Uruguay had a
population decrease: births
were 30.000, deaths 20.000
and migrants 30.000
Health situation for school-age
children in brief
•Deterioration of the living
conditions for many families
• Deterioration of the quality of
the environment especially for
children: exposure to “pretransitional” risks
•Epidemiologic regression: reemergence of pre-transicitional
morbidity, communicable diseases
Highlights of schools’ situation
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Schools are the last places where
state presence still exists
Aggregation of problems leads to an
aggregation of services. In
vulnerable areas schools have to
provide basic nutrition, health and
social services
In Montevideo, school feeding
program expanded from 40.000 to
90.000 children
That situation tend to reinforce
structural disadvantage of children,
who receive poorer education
After the Crisis: what is the situation?
•New government (left wing
coalition)
•A slow but steady
economic recovery
•Unemployment still high
(around 11 percent)
•Poverty close to 30
percent (National Institute
of Statistics, provisory
data, 2005).
School Health: future directions
Context
•Exclusion (youth)
•Poverty, Inequity
•Minimal public
sector
•Migration, loss of
human capital
•Descentralization,
democratization.
Opportunities for
local development
•Uncertainty,
political
unestability
Emerging Issues
• Food security
• Epidemiological
“accumulation”
(infectious + chronic
diseases)
• Violence
• Mental health problems
Challenges
Operational strengths and problems
Some Strengths
• Long standing tradition of
preventive health
interventions in schools
• Remarkable enthusiasm of
children and teachers about
environmental and health
education
• Increasing participation of
CSO on environmental
education
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Some Problems
Most school health activities have
traditionally “targeted” rather than
“engaged” schools (delivered vertically
from MoH, NGOs). Schools “used” as
a captive target.
Lack of educational rationale.
Dispersion of initiatives.
Limited training of teachers. Lack of
continuous training mechanisms
(supportive monitoring, systematization
of good practices, evaluation)
Tendency of intersectorial
collaboration to become too
bureaucratic, formal, restrictive of
participation.
Lack of supportive policy to assist
schools in networking, resource
mobilization.
Project Overview
•Education for Life and Environment (Educación para la
Vida y el Ambiente-EVA) introduced between 2002-04
as part of a World Bank-supported wider strategy to
improve basic education.
•EVA projects were piloted in 75 schools in the first
year and after that targeted 150 primary schools per
year.
•Resources were allocated as part of a demandoriented fund that provided small grants directly to
schools.
Education for Life and Environment
Educación para la Vida y el Ambiente (EVA)
The Objectives
– To strengthen and revitalize environmental and health
education in schools.
– To pilot inclusive education approaches
The approach
– To promote schools and communities active and
participatory learning of health and environmental topics
that where relevant to local development.
– Stimulate inclusive dynamics in schools and communities
Education for Life and Environment
Educación para la Vida y el Ambiente (EVA)
What did the project offered to schools
– Technical assistance to schools and teachers:
training,
supervision,
a teachers’ manual,
educational materials,
development of a “community of
practices”, electronic bulletin.
– Funding (between 3,000 and 5,000 dollars) in upto 100
schools every year
school infrastructure renovation and
development to create healthier, safer and
more inclusive environments
Education for Life and Environment
Educación para la Vida y el Ambiente (EVA)
Operational rationale
– All schools were invited to participate (quota was assigned
according to socio-educational profile)
– Participating schools were required to identify a specific
health and inclusion-related issue they wanted to change
– Selected schools received technical assistance and funding
to tackle their problem.
– Assistance comprised of resources that were meant to
benefit the quality of education in general, not just health
and inclusion objectives.
Education for Life and Environment
Educación para la Vida y el Ambiente (EVA)
Current
situation
challenges
desired
scenario
One example of EVA projects:
school bullrush gardens
. A natural solution to rural
sanitation
. A contribution to local development
. An entry point for environmental
and health education
. Bullrushes are natural purifiers of
sewage. They enhance soil´s aerobic
conditions and kill any pathogenic
organisms. At the end of the
treatment the water is usable for
irrigation or to refill toilet cisterns.
Education for Life and Environment
KEY IMPLEMENTATION ASPECTS
1 Educational focus
• The goal was to influence long term education policies,
institutions and leaders, mainstreaming HP concepts and
practice into the education sector objectives.
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Health, environment and inclusion projects have high
educational value. Help to address relevant and tangible
situation related to living conditions. Facilitate meaningful
learning.
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Active teaching and learning, school-family links, projectbased and life skills-oriented curiculum
are all
recomendations within quality education initiatives.
Education for Life and Environment
KEY IMPLEMENTATION ASPECTS
1
Education focus II
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Implementation strategy sought to collaborate as much
as possible with other components of the education
strategy and all technical teams involved.
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Avoid the perception that HP in school is an
“additional” programme which increases the
teachers´ workload.
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Active citizenship is important for personal
development and taking responsibility for the
determinants of health.
Education for Life and Environment
KEY IMPLEMENTATION ASPECTS
2 Multi-sectoral approach and permanent dialogue
• Moving from inter-sectoral collaboration to mobilizing all
possible parties and resources.
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Promoting
permanent
dialogue
and
“collaborative
management agreements” rather than establishing
bureaucratic partnerships/commissions.
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Engage teacher unions.
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Foster children representatives as
stakeholders in school health dialogue.
advocates
and
Education for Life and Environment
KEY IMPLEMENTATION ASPECTS
3
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Local ownership, autonomy, contribution to local
development:
The fact that schools had to administrate their funds,
prioritise problems and decide which one they wanted to
address, was in itself a learning and motivational
experience.
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The whole school community absorbed a methodology to
understand problems and challenges, made autonomous
decisions and planned responses on the basis of their own
culture, resources and skills.
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To optimise sustainability, the project encouraged schools
to identify and mobilize professional expertise that was
available in the local community.
Education for Life and Environment
KEY IMPLEMENTATION ASPECTS
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Participation:
The project firmly advocated on the educational
value of active involvement of children. A range
of specific opportunities were highlighted:
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Producing a situation analysis of school and
community through consultation with other children
and the community
Mapping issues affecting health and well-being
through problem trees
Identifying things that can be changed in their
school and planning strategies for change
Education for Life and Environment
KEY IMPLEMENTATION ASPECTS
4
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Participation II:
Still genuine participation didn't
go beyond sporadic and punctual
opportunities. Participation
brings additional complexity.
“When resources (personnel,
support, etc) are limited and
issues multiple, better keep
things under control as usual”.
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Teachers and headteachers
overwhelmed and time is limited.
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Are schools a good environment
for genuine participation?
How do you build a bridge?
What do you need to build a
bridge?
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Standing points
Plans, design
Materials
People, labour, dialogue
What´s progressive is not the
substance of an idea but rather
the dialogue of ideas…being very
clear that the results of such a
dialogue are always uncertain.
Edgar Morin