March 2006

Health Promoting Schools in China

EDC project is successful in changing attitudes in families and schools

The concept of health-promoting schools is taking hold in China, according to EDC’s Carmen Aldinger, project director in HHD (Health and Human Development Programs) Global Programs, who recently returned from an evaluation visit for the Health-Promoting Schools (HPS) project in China’s Zhejiang Province. She found many positive changes in the schools related to the four key HPS areas: school health policies, a healthy physical and psychosocial environment, skills-based health education, and school health and nutrition services.

“The HPS concept is now viewed as a means to achieving the government’s quality education policy, which requires broad development of the child, and it is being institutionalized. In addition, HPS is viewed as a co-responsibility of school administrators, teachers, parents, the community, and local government. The project is becoming sustainable because its content is becoming an integral part of the students’ education, rather than an add-on,” says Aldinger.

HHD’s role in this project has been to raise awareness of the importance of the health-promoting schools approach, provide technical assistance to schools, and assist with the evaluation. During this visit, Aldinger, another expert consultant, and a representative of the World Health Organization (WHO) held group interviews with school administrators, teachers, students, and parents in three HPS—one vocational, one elementary, and one junior high school—in different cities in Zhejiang Province. They then attended a summing-up conference in Hangzhou where representatives from schools in 11 participating cities (prefectures) across the province shared their experiences and project results and prepared for continuing and sustaining the HPS effort.

Significant changes are apparent in the expectations and standards for achievement. “The schools are increasing their focus on helping children and teachers to develop socially and emotionally as they focus on their academic goals,” said Jack Jones, School Health Group Leader, Department of Chronic Diseases and Health Promotion, WHO Headquarters. “As a result, teachers and students are communicating and working more constructively together.”

According to Dr. Zhang Xin-Wei, director of Zhejiang Province’s health education institute, “The expansion project pointed to several success factors, including that leaders in related departments worked together cooperatively, WHO and other agencies provided guidelines and technical support, more people were involved at all levels, and schools chose a key point as a focus and implemented comprehensive interventions.”

There have been tremendous achievements in how the concept of HPS has been put into practice in specific situations. Health is now becoming a priority in daily school life in practical ways. For example, in the vocational school visited, the incidence of injuries decreased from 5.9 percent during the year before implementation to 2.5 percent after. In the elementary school visited, of the nine teachers who smoked, eight quit smoking and one stopped smoking on the school grounds. In addition, some families reported increased communication between parents and children and that children were using their knowledge and skills to teach parents about health issues.

At the summing-up conference, WHO consultant Dr. Yu Sen-Hai noted that “cooperation of the health and education sectors is a strength in some cities and a weakness in other cities….(However,) better communication and closer cooperation between the education and health sectors are needed at all levels, particularly at the national level.”

Overall, the evaluation visits to the selected schools and the summing-up conference showed that the HPS project has been quite successful. All 11 cities decided to continue and expand the HPS project, although different cities will use different approaches. One of the next steps will be to bring the project to other provinces in China.

During the final stop on their trip, Aldinger, Jones, Yu, and Zhang attended the first International Symposium on School Health Education and Promotion in Beijing where Aldinger presented a paper titled “Research on School-Based Health Education.” They also learned about successful health-promoting schools in Beijing and Shanghai. In Aldinger’s view, “the symposium made it even more apparent that there is a movement developing in China to integrate health into the schools.”

This story originally appeared on the Web site of EDC's Health and Human Development

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