South Africa case study: Building support and policy change for integrated school health (original) (raw)

2019, Training and Research Support Centre (TARSC)

This case study is implemented within the project 'Fostering policy support for child and family wellbeing-Learning from international experience'. Using a thematic and analytic framework for the project that draws on Kingdon's multi-streams theory 2 we are gathering and sharing evidence and learning on what has led to increased policy recognition of and policy change in family and child health and wellbeing (FCHW). In specific countries that have demonstrated policy recognition and change in FCHW post 2000, we are exploring within their context how different policy actors have come together to raise policy attention, develop policy options and promote their political adoption as processes for policy change, taking advantage of windows of opportunity for that change. The case studies were implemented with a local focal person with direct knowledge or experience of the policy process and include evidence from published and grey literature and interview of key informants involved in the policy processes. This case study explores how change was built for integrated school health in South Africa combining health, educational and social services to ensure the wellbeing of learners. In post-apartheid South Africa, the new political order made radical advances in child health and education introducing many affirmative health and education policies reflecting holistic, ecological views of child wellbeing. In this context, provincial health departments raised and framed the need for standardised school health services underpinned by national policy and strategy. A committed academic group facilitated a comprehensive policy development process with provincial actors, resulting in the 2003 National School Health Policy. Through this, relationships were built between government departments, researchers, policy makers and others. That the policy became a Department of Health initiative was seen as a missed opportunity to build the collective effort across health, education and social development needed to realise the vision and potential of school health. The main window of opportunity occurred in 2009, when a new administration with committed Ministers in Health and Basic Education advanced high-level inter-sectoral relationships and drove reforms that brought together local learning with regional and international experience, culminating in the Integrated School Health Policy in 2012. Regional and international organisations made important contributions to advancing integrated, holistic approaches to school health. This was accompanied by domestic learning and evaluations, which built support for a holistic, integrated view of school health services. Committed and influential academic groups, government officials and development partners collaborated to develop and implement policy options promoting this holistic view of school health and wellbeing within an increasingly receptive policy environment. The Integrated School Health Policy reconciled different modalities, facilitating its relevance in provinces, given the varying level of delivery of school health services across provinces.