Children in most less developed countries also complete far fewer years of schooling, and learn less per year of schooling, than do children in developed countries.
Recent research has shown that poor health and nutrition among children reduces their time in school and their learning during that time. This implies that programs or policies that increase children's health status could also improve their education outcomes.
This article provides highlights on synergy between good health, good nutrition and quality education outcomes. Majority of the content in this article is acknowledged to the online resources, including the 2005 Health and education working together’ report by Creative Associates International.
Poor health and malnutrition have been shown to be important underlying factors for poor performance, early drop out from school, low enrolment, and absenteeism, are some of constraints which are focused on various major global development plans such as the Education for All (EFA), the second and third Millennium Development Goals (MDGs) and the on-going Sustainable Development Goals (SDGs).
All of these global plans focus on achieving universal primary education and gender-based equitable access to quality education.
Why should we link health and education? In Africa, more than half of all school children are anemic, stunted, and in many countries the school aged children are chronically infected with worms. Stunting, illness, and worm infestations all have a negative effect on a child’s ability to learn.
Until the last few years, donor-funded health interventions often ignored the school-aged population, partly because it was believed that those who survived to age five had passed the most dangerous years of birth to five years and were now examples of “survival of the fittest”.
The emphasis in foreign aid for health was on child survival and early childhood development with focus on the child from fetus during pregnancy through five years of age, and later, on the reproductive-aged woman of 15 to 45 years. Little was actually known about health and nutrition of children from six to 15 years, and much still remains to be learned.
Further it was generally assumed that stunting acquired by age three from suboptimal breastfeeding practices and food insufficient nutrient density, could not be reversed, so it was futile to be concerned about stunting after the age of three years.
Research now shows that risk of poor health continues throughout childhood and children’s health status, especially of girls, actually worsens from age 5 to 15 years. Drake, L.J. and others in their 2002 report titled ‘School Age Children: Their Health And Nutrition’ argues that “carefully monitored school programs in health and nutrition have shown that stunting continues to occur during the school years and that this stunting can be reversed by appropriate health and nutrition interventions”.
There is now ample evidence that a very small investment in a few health interventions, particularly de-worming and micronutrients, along with skills-based health education, can have big pay-off in terms of better educational and health outcomes for children.
Healthier and better nourished children stay in school longer, learn more, and become more productive adults.
Girl children and adolescents are the key to health of future generations- girls who receive sufficient iron and grow adequately during adolescence have decreased rates of babies born with low birth-weight and birth defects, and a greater number of their children grow up to become adults.
Girls who stay in school longer have been found to delay child bearing longer than girls who drop out of school, which results in lowered birth rate, better birth outcomes, and better child health.
School children with lower levels of disease and infection also have the effect of reducing the transmission of diseases and infection also have the effect of reducing the transmission of diseases in the wider community.
Basing on the above findings, the education sector is now focusing on incorporating targeted health interventions into school-based programs, to improve children’s learning as well as their health.
Why school-based health interventions? The health system in most African countries has much less ‘reach’ than the educational system, whereby for every health facility there may be as many as 25 schools, and there are many more teachers than there are health personnel.
Recent efforts to achieve universal primary education have begun to increase the proportion of school-age children now enrolled in school. It is now clear that the school provide access to a much greater proportion of the population than do the health interventions.
School health and nutrition programs have been shown to make the greatest difference in terms of both health and cognition, with girls and the poorest, most disadvantaged children, and recently more of these children are enrolled in school.
Further, teachers can reach beyond the school facility and educators often work closely with parents and surrounding community.
With the advent of HIV/AIDS, the health sector is now considering the enormous potential to reach children in the schools before they become sexually active and before their attitudes and habits are completely formed.
Currently, school-aged children are the age group still largely free of HIV infection and are therefore referred to, by the 2002 World Bank report on Education and HIV/AIDS, as the ‘window of hope’.
The HIV prevalence and rate of spread among teens in many African countries, however, is very high, and the rate of infection among girls and young women is usually five times the rate of males due to physiological and cultural factors.
Ranking among the most cost-effective of all public health interventions, school health programs are increasingly seen as the best delivery system for certain health interventions and the ideal platform from which to launch HIV/AIDS prevention education and care for orphans and vulnerable children. School health programs are increasingly viewed as essential components of the education program.
Good health, good nutrition, and education are synergistic: good health and nutrition enable children to learn better, and a good education gives children the tools to grow up as healthy adults and lead productive lives. Given the importance of education for economic development, this link could be a key mechanism to improve the quality of life in less developed countries.
Masozi Nyirenda is a specialist in educational policy, planning, economics and finance. He is reached through +255754 304181 or [email protected]