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TEACHERS AS AGENTS OF CHANGE: SCHOOL-BASED DIAGNOSIS AND TREATMENT OF MALARIA POSITIVELY IMPACTS CHILD MORBIDITY Ronald Mukisa; Andrew Macnab; Sharif Mutabazi; Rachel Steed
Proceedings of the International Conference on Applied Science and Health No. 1 (2017)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Teachers in developing countries traditionally send home children found sick in class. Yet infection due to malaria is the principal reason a child will miss school in sub-Saharan Africa and the leading cause of death in school-aged children. Rapid diagnostic testing (RDT) and treatment with artemesinin combination therapy (ACT) is the management for malaria recommended by the World Health Organization (WHO) but RDT/ACT are not available in schools. Aims: To evaluate the impact on child morbidity from malaria of engaging teachers to provide RDT and administer ACT in primary schools in rural Uganda, using duration of absence from school as a surrogate measure of morbidity. Methods: This was a 2 year project.Pre-intervention (year 1) we trained teachers to identify probable infectious illness, conduct RDT, and administer ACT; conducted baseline evaluation of malaria knowledge, and monitored days of absence from school. Intervention (year 2) trained volunteer teachers administered RDT to children found to be sick at school and treated those positive with ADT; data collection was ongoing. Results: Teacher administered RDT/ACT was implemented and sustained in 4 rural schools (grades primary 1-5). Teachers participated willingly. Year 1 (pre-intervention) 953 of 1764 pupils were sent home due to illness; mean duration of absence from class was 6.5 (SD 3.17) school days. Year 2: (intervention with RDT/ACT) 1066 of 1774 pupils were identified as sick, 765/1066 (67.5%) tested positive by RDT for malaria and received ACT and their duration of absence fell to 0.59 (SD 0.64) school days (p<0.001); and overall absence decreased to 2.55 days from 6.5 in year 1 (p<0.001). Conclusion: RDT/ACT use by teachers as a school-based health practice is novel and reduced child morbidity significantly. Our model of engaging and training teachers represents a community empowerment approach applicable to other low-resource settings worldwide where malaria is endemic and morbidity high.

HEALTH PROMOTION IN LOW AND MIDDLE INCOME COUNTRIES: ‘YOUTH CHAMPIONS’ AS AGENTS OF CHANGE Ronald Mukisa; Andrew J Macnab; Lynn Stothers
Proceedings of the International Conference on Applied Science and Health No. 2 (2017)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Health promotion includes a wide range of social and environmental interventions that enable people to increase control over their own health. The aim is to achieve health literacy, where people have the knowledge they need to make healthy choices and the skills and daily practices necessary to improve their health, and can access information that helps to reduce the risk of illness or injury. Health promotion programs traditionally use adult experts or teachers to deliver the information and practices promoted, but in school-based programs WHO advocates the involvement of youth to make program content and delivery relevant and interesting to school children. Aims: To summarize how youth leaders (‘champions’) can contribute to school and community based programs through their involvement in the design of school-based health promotion and by engaging and motivating the target population. Methods: Summary of the HPS literature and experience of youth involvement in our school programs in Africa Results: Schools are settings where important health knowledge and behaviours can be promoted. Teachers have a central role in creating an environment that fosters health learning, but the efficacy of health promotion is improved when youth are included in program design and delivery. Youth champions have a special ability to connect with the target audience in schools and by using the pupils ‘language’ and idioms make the knowledge and practices being shared relevant and accessible. Trained youth can champion individual messages or take on a variety of roles in health promotion initiatives. Youth champions have contributed to the success of programs that have promoted hand washing, oral health, improved nutrition, malaria prevention, sexual health and HIV/Aids prevention Youth involved as champions have an important opportunity to learn as well as to contribute; potentially, many educators, health care providers and leaders of tomorrow will emerge from among them.. Conclusion: Youth who act as champions and peer to peer counsellors have a unique contribution to make in school-based health promotion. As measured by long term retention of knowledge and sustained changes in behavior, school-based health promotion is improved when youth are included as ‘messengers’ and pupils help select the ‘messages’ promoted.

HOW TO ENGAGE A COMMUNITY AND IMPROVE CHILDREN'S ORAL HEALTH Andrew John Macnab; Ronald Mukisa
Proceedings of the International Conference on Applied Science and Health No. 3 (2018)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Globally, gingivitis (gum inflammation) and dental caries (tooth decay) have a negative impact on the health and quality of life of children. Those from disadvantaged populations suffer disproportionally from poor oral health, yet much of the pathology and associated pain and suffering is preventable if children are taught simple and inexpensive practices that can improve their oral health. The World Health Organization (WHO) has called for more programs to improve children’s oral health worldwide. Aims: To summarize how readily implemented school-based programs can provide knowledge and teach health practices that promote behaviors that can enable children to improve their oral health through better hygiene and a reduced incidence of gum disease and caries. Results: The WHO Health Promoting School (HPS) program model is well suited to address poor oral health. The model begins with community dialogue to establish understanding of the cause, adverse effects and approaches to prevention. Next teachers are helped to establish, sustain and evaluate an intervention in the local school. Intervention is based on the two core components of WHO HPS programs; first, teachers add health-related curriculum and visual aid production to classroom activities, and second, opportunities are added for children to participate in health-related practices while at school, for example tooth brushing or tooth stick sessions to clean their teeth after the lunch break. Conclusions: Poor oral health is an example of a worldwide public health issue of central importance to children where school-based intervention has been shown to have benefits, through changes in behaviors achieved through teaching a combination of simple factual knowledge and inexpensive health practices.

AN EVALUATION OF VIDEO MATERIALS WITH A HEALTH-RELATED MESSAGE AVAILABLE IN INDONESIA Ronald Mukisa; Doni Marisi Sinaga; Andrew Macnab
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: A core component of health promotion involves education. When we educate children and their parents about health, we need to use words that they can understand and ways to teach them that they find interesting. In schools in Uganda we have found that many children learn important facts from music videos recorded by celebrities that include a health message. This study looked at video material with a health message that is available on-line in Indonesia for those involved in health promotion to use to educate parents and children.Methods: A google question was generated and the videos the respondents suggested were then viewed on YouTube to identify the health topics that they contained. From this search, the availability of other videos with similar or related messages was evaluated.Results: Nine respondents suggested videos with a health message; 8 were female and 1 male, all had a bachelor’s or master’s degree. Four of the videos identified contained general health related messages, the remainder were specific to one of two areas, handwashing and hygiene (3) or tooth brushing and oral health (2). Importantly, when viewing these videos, a large number of related videos in various formats (message for adults/parents, message for children, educational material, songs, cartoons) were cross linked with the targeted video.Conclusion: In Indonesia, a broad range of videos exist that can be used either to educate parents and children about the key health topics that these videos cover, or to act as a model for producing similar materials for newly identified health promotion issues. Engaging and educating parents and children is an important health promotion strategy and community empowerment approach to improving the determinants of health.

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