The Ministry of Health and Sports (MOHS) and the Ministry of Education (MOE) of Myanmar are jointly reforming school health programme with a greater emphasis on health promotion and health literacy, environmental health and sanitation, non-communication disease prevention, including mental health, injury and violence prevention.
Ministry of Health and Sports has been implementing health promoting schools under the slogan: “A health promoting school is a school constantly strengthening its capacity as a healthy setting for living, learning and working.” Myanmar has adopted the concept of health promotion in school settings since the beginning of Global School Health Initiatives in 1996. Health promoting school programme was introduced into existing school health services aiming to promote health standards for all students, skills and knowledge needed for adoption of healthy lifestyle. In principle, a health promoting school encompasses healthy school policies; school’s physical and social environment; health education, skills, literacy, and health services; and community engagement.
Current health status of school children in Myanmar
Myanmar Global School-based School Health Surveys were conducted twice, one in 2007 and another in 2016. The surveys showed overall health behaviour and risk factors across spectrums of health among students aged 13-15 years, ranging from dietary behaviours, hygiene, mental health, physical activity, alcohol and tobacco use, to protective factors, knowledge about HIV infection and AIDS and violence and unintentional injuries.
Generally, students’ personal hygiene in Myanmar, including hand washing before and after meals, as well as after using toilet, and teeth brushing, is in good coverage. Percentage of students who reported rarely washing their hands or cleaning their teeth is very low. Students who directly engaged risk behaviours are also low. However, they were exposed to tobacco as second-hand smokers from their environment. Regarding physical activity and dietary behaviour, most students are at risk of becoming overweight, as most students are not physically active or having fruits and vegetables on regular basis.
Concerning mental health indicators among students, considering suicide, planning suicide and attempted suicide are also increasing, about seven times in recent decade. Associating with nutrition and physical activity, 7.6% of students were at risk for overweight (>+1SD for BMI) and 18.0 % were under weight (<-2SD for BMI). The double burden of malnutrition is clearly present in this country. Sedentary behaviour, such as children who spent three or more hours per day, existed at 16.4%.
School Health Division of the Department of Public Health is responsible for planning and implementation of school health program in Myanmar. This division is headed by a Director, supported by a team of technical staff. State/Region directors are responsible for school health program activities at the respective state and region. A Township Officer for MCH/School/Nutrition is assigned to carry out school health activities in each township.
Comprehensive School Health Strategy (2017-2022)
. National Consultation meeting on Comprehensive School Health Strategy was conducted in December 2016, participated by approximately 70 participants from MOHS and MOE. The comprehensive school health (CHS) strategy (2017-2022) was developed, based on the context of National Health Plan 2017-2022 for younger generation, which comes from both education and health sectors. This Comprehensive School Health Strategy (2017-2022) is crafted to improve quality of education and health of students through holistic health promoting school approach, along with factors, influencing health of students especially from families and communities.
Major Comprehensive School Health strategies are:
Strategic 1: Strengthen and develop health promoting school structure and system,
Strategic 2: Improve health and well-being through health literacy and services, Strategic 3: Harmonize health and education through health promoting schools, and Strategic 4: Strengthen community partnership in Health Promoting Schools
Strategic 1 is fundamental to effective and successful interventions to improve child and adolescent health as well as promote health to the whole community through schools, students and teachers. It will also enhance coordination and mobilization of resources.
Strategic 2 is the key toward promotion of health in school settings that include school students, teachers, parents and community participation in children’s health and wellbeing, as well as providing multiple effects on health and sustainable development. Health services and health promotion in schools can be cascaded in different sets of activities that ensure health and well-being of students.
Strategic 3 provides linkage between health and education goals, as well as approaches that have been utilized, promoted, or advocated for schools in the past and for future programmes as potential partners are involved.
Strategic 4 includes cooperation not only by children’s parents but also by community people, because partnerships with local communities are indispensable factors for the effective implementation and success of health promotion schools. The health and education services through schools are included as well as cooperation of the local communities.
Recent developments in school health in Myanmar
1. Implementation of School Health Programme, as one of the three priorities of Ministry of Health and Sports, since 1 April 2016.
2. Dr Aye Zin Latt of Shwebo Constituency urged the Union Government to create a long term strategic plan with the Ministry of Health and Sports and other respective ministries to draft a national policy on school health and to allot a suitable amount of the national budget annually for the initiative, during the 25th day meeting of the seventh session of the Second Pyithu Hluttaw (7 March 2018). The motion was discussed by 15 MPs and the Pyithu Hluttaw approved the motion. Ministry of Health and Sports also approved the motion so that a suitable budget can be allotted to the School Health Programme, under the Ministry of Health and Sports after the Hluttaw’s approval.
3. Implementation of long term program for school nutrition and food safety in line with the Pyithu Hluttaw’s motion (2 February 2018).
4. Formation of new school health committees at central, state/region, district and township levels by the Office of the President Order No. 21/2018 (dated 8 February 2018).
5. With the objective to scale up and sustain comprehensive school health activities in Myanmar, Ministry of Health and Sports and Ministry of Education held a coordination meeting of Central Level School Health Committee (1/2018) on 12 June 2018.
2018 School Health Week
In collaboration with Ministry of Education, Ministry of Health and Sports will observe this year’s National School Health Week from August 13 to 17, 2018.
The primary goal of the National School Health Week is to spread the word regarding the importance of school health and how this not only affects the health and development of the students, but how it contributes to productivity, economic growth and ultimately, national development.
During this period, five health promoting school activities will be implemented in all basic education schools of the country. National-level School Health Week ceremony will be held in Loikaw, Kayah State, this year. The prioritized health promoting school activities includes school environmental sanitation, school medical examination and treatment, prevention of communicable and non-communicable diseases, school health education, school nutrition promotion and food safety. Ministry of Health and Sports will also launch its school deworming campaign across the country.
School Children’s Health, Tomorrow’s Wealth
In the era of Sustainable Development Goals (SDGs), health and its determinants cut across all sectors and require multi-sectoral coordination. Myanmar is one of the countries that has aspiration towards sustainable and inclusive development, that health and wellbeing of the people are at the centre of development. Best investment on health is for prevention and promotion. Promoting health through school setting is the most cost effective that produces viable outcomes. A synergic interface between the health service sector and the education sector from the central to the grassroots level is a foundation for promoting people’s health, enhancing health literacy, and enabling people to access health and education services at all levels.
That is One Step for Myanmar School Health, One Giant Leap for Myanmar People.