Exploring the status of the School Health and Nutrition Programme in government-ddministered schools in Lusaka District, Zambia

Thesis (MNutr)--Stellenbosch University, 2018.ENGLISH SUMMARY: Introduction: School Health and Nutrition (SHN) programmes are implemented in schools with the objective to improve school children’s health and nutritional status. Ensuring the good health of school children leads to reduced absenteeism, improved classroom performance and reduced early school dropout rates. Currently the status of implementation of the SHN programme in schools in Zambia is not known. Aim: To explore the implementation of the School Health and Nutrition (SHN) programme in government-administered schools in Lusaka District in Zambia, from the SHN coordinators’ perspective. Methodology: A descriptive, cross sectional study design was used. The study population was the SHN programme coordinators (N=40) in government-administered primary schools in Lusaka District. Forty primary schools in Lusaka District were grouped into two strata, urban (n=16) and peri-urban (n=24) using probability proportion to size sampling. A self-administered questionnaire, based on the SHN programme in Zambia, was used as data-collection tool. Quantitative data analysis was done using Microsoft Excel and Stata. Qualitative data obtained from open-ended questions was analysed using content analysis and identifying major themes. Results: The study revealed that the majority of the participants (n= 25) received initial SHN programme training from the Ministry of Education (MOE) for one week, between 2004 and 2009. Twenty three schools (57.5%) indicated that they were not implementing the SHN programme. A comparison done on SHN implementation between urban and peri-urban schools, showed no significant difference (p=0.601). The SHN activities implemented in the schools resort under the domain of health and nutrition related activities. The schools also implement health and nutrition education, SHN record keeping and life skills activities, but none of the schools mentioned offering guidance and counselling services. The schools reported not receiving enough funds and materials from the MOE and a lack of consistency in following up on the implementation of the programme in the schools by the MOE as the main challenges and reasons for non-implementation of the SHN programme. There have been some positive outcomes from the programme, which include improvement in attendance and the pass rate of the school children. A reduction in the number of children suffering from ailments like diarrhoea and bilharzia were also reported. Conclusion: The findings of this study indicate that there are a large number of schools not implementing the SHN programme. The schools implementing the SHN programme are not implementing all the required activities mainly due to lack of funds and resources. The MOE should re-evaluate the SHN programme and ensure that all schools in Lusaka District are implementing the programme with all its activities, especially since positive results were observed when the programme is active.AFRIKAANSE OPSOMMING: Inleiding: Skool Gesondheid en Voeding (SGV) programme word in skole geïmplementeer met die doel om die gesondheid en voedingstatus van skoolkinders te verbeter. Deur die goeie gesondheid van skoolkinders te verseker, is die resultaat verminderde afwesigheid, verbeterde klaskamer prestasie sowel as verminderde vroeë skool uitsak syfers. Tans is die status van die implementering van die SGV program in Zambiese skole onbekend. Doel: Om die implementering van die Skool Gesondheid en Voeding program (SGV) in regering geadministreerde skole in die Lusaka-distrik in Zambië te ondersoek, vanuit die oogpunt van die SGV koördineerders. Metode: 'n Beskrywende, deursnit studie ontwerp is gebruik. Die studie bevolking was die SGV program koördineerders (N=40) in regering geadministreerde laerskole in die Lusaka-distrik. Veertig laerskole in die Lusaka-distrik is onderverdeel in twee groepe, naamlik stedelike (n=16) en buitestedelike (n=24) skole met behulp van ‘n waarskynlikheid verhouding tot die grootte van die studie monster. 'n Self-geadministreerde vraelys, gebaseer op die SGV program in Zambië, is gebruik as data-insamelings hulpmiddel. Kwantitatiewe data-ontleding is gedoen met behulp van Microsoft Excel en Stata. Kwalitatiewe data is verkry deur middel van oop vrae wat ontleed is met behulp van inhoudsontleding en die identifisering van belangrike temas. Resultate: Die studie het getoon dat die meerderheid van die deelnemers (n=25) het met die aanvang van die SGV program, opleiding van die Ministerie van Onderwys (MvO) ontvang vir 'n week, tussen 2004 en 2009. Drie-en-twintig skole (57.5%) het aangedui dat hulle nie die SGV program implementeer nie. 'n Vergelyking wat gedoen is tussen stedelike en buitestedelike skole in terme van die implementering van SGV, het geen beduidende verskil getoon nie (p = 0,601). Die SGV aktiwiteite wat in die skole geïmplementeer word val onder die domein van gesondheid en voedingsverwante aktiwiteite. Die skole implementeer ook gesondheids- en voedings opvoeding, SGV rekordhouding sowel as lewensvaardigheidsaktiwiteite, maar geen van die skole het genoem dat hulle voorligting en beradingsdienste implementeer nie. Die skole het gerapporteer dat ‘n tekort aan fondse en materiaal vanaf die MvO, sowel as 'n gebrek aan konsekwentheid in die monitering deur die MvO op die implementering van die program in die skole, die belangrikste uitdagings en redes vir nie-implementering van die SGV program is. Daar is wel positiewe uitkomste van die program gerapporteer, wat ‘n verbetering in skoolbywoning en die slaagsyfer van die skoolkinders insluit. 'n Afname in die aantal kinders wat ly aan siektes soos diarree en bilharzia is ook gerapporteer. Gevolgtrekking: Die bevindinge van hierdie studie dui daarop dat 'n groot aantal skole nie die SGV program implementeer nie. Die skole wat wel die SGV program implementeer, implementeer nie al die nodige aktiwiteite nie hoofsaaklik te wyte aan 'n gebrek aan fondse en hulpbronne. Die MvO moet die SGV program herevalueer en verseker dat alle skole in die Lusaka-distrik die program met al sy aktiwiteite implementeer, veral omdat positiewe resultate waargeneem word wanneer die program aktief is