1. 1 School Health in Cambodia Health Promoting School Ith Vuthy, MSc. MA. SEAMOLEC Deputy Director

2. General Education system in Cambodia: 2 NoFormal educationAge groupGrade 1Pre-school2-5 years3 2Primary School6-12 years6 (1 to 6) 3Secondary School12-15 years3 (7 to 9) 4High School15-18 years3 (10 to 12) 5Nursing3 years 6doctor7 years + 1-2 Year a as specialist Remark:. 1979-1986: 10 year educational system: 4+3+3. 1986-1996: 11 year educational system: 5+3+3. 1996-present: 12 year educational system: 6+3+3

3. General Education indicators 3 Education level School (Public) Students (Public) School (Private) Students (Private) TotalFemaleTotalFemale Pre-school3,184 157,28848.1% 2,62392,21150.1% Primary School 6,993 2,073,81148.0% 24354,82250.2% Secondary School 1,244 538,62649.7% 351,82856.5% High School 444 266,29347.7% 8727,64446.9% Total11,865 3,036,01848.8% 2,988176,50550.9% Tertiary: 105 (Public: 39, Private: 66), students: 271,503 (F: 29.6%)

4. 4 Current Structures Policies and Strategies School Health Department of MoEYS is an apex body to coordinate all kind of school health programs in Cambodia. Vertical structure are:  National level (School Health Department)  Provincial level (School Health Committee)  District level (School Health Committee)  School level (School Health Committee)

5. 5 Mission 1.To manage and develop health education programs and sanitation in schools 2.To manage the first aid corner in schools 3.To do health check up with the assistance of health professionals 4.To monitor, to research and to develop intervention measures when outbreak of diseases in schools 5.To report all intervention achievements to Minister

6. 6 How school health is implemented at school levels? 1.Integrate into National Curriculum 2.Integration into relevant teaching subjects 3.Integrate into regular school schedule (Physical and Health education, Home Economic...) 4.As part of the Local Life Skill Programs (every Thursday) 5.Daily practice at school 6.Schedule of health check up and deworming

7. Current policies and strategies (1)  Sub-decree 25, 1992  Sub-decree 84, 1998  Policy of de-worming of MoH, 2004 (2014?)  Policy of school health, 2006  Life skill education policy, 2006  Policy of child friendly school, 2007  HIV/AIDS work place policy, 2007  Guidelines of prohibition of tobacco in work place and school, 2000  Guidelines of flu prevention in school, 2008  Guidelines of prohibition of alcohol in school premises, 2011 7

8. Current policies and strategies (2)  Guidelines of process de-worming for all students 2013  Guidelines of strengthening security, safety, and hygiene in school, 2013  Guidelines of healthy and safety food for food sellers in school, 2013  Guidelines for celebration of global hand washing day in school, 2013  Guidelines of hygienic measure in school for school meal programme, 2014  National strategic plan of EFA 2003-2015  Education strategic plan 2014-2018 8

9. 9 School health policy health, nutrition Policy 1: Basic healthcare services: Health check up, First aid Vaccination, De-worming, Vitamin Counseling, school discipline School breakfast, Oral Policy 2: Health education services: Integration HE topics into national curricula Mainstream HE into existing events/training Capacity development for SH staff Training pre and in service teachers Encourage health promoting school and M&E

10. 10 Policy 3: Learning environment, hygiene and sanitation facilities: Improve Hygiene and sanitation in school (latrine and water supplies, washing hand station) Improve School environment (garden, trees…) Wastes management Physical education Policy 4: Stakeholder participation: Cooperation with line Ministries Link response with all sub-national levels Establishment school health committee Public private partnership and PTA Harmonization and align school plan into community development plan

11. 11 Current school health Programs

12. De-worming, Vaccination,.. School Feeding Water and Sanitation Communicable Disease Prevention Comprehensive Sexuality Education STH Education Oral Health First Aid Physical Education Non Communicable Disease Preventions Health Check Up

13. 13 Current school health programme (1) NoProgramsMilestones 1De-worming> 90% of students and pre-service teachers 2School meals (school breakfast) 392,077 students in 1,349 schools (20%) in 12 provinces 3First aid kits16% of primary schools in 24 provinces 4Life skill on comprehensive sexuality education (new curricula) 25% of primary and secondary schools (7 provinces)

14. 14 Current school health programme (2) NoProgramsMilestones 5Health check up For all pre-service teachers of all teacher training center, oversee students, and some primary schools 6Malaria education 16 provinces (zone 1 and 2 of malaria transmission) 7STH educationAbout 20% of all primary schools in Cambodia 8Hygiene and first aid education Nearly 90% of primary schools in Cambodia

15. 15 Current school health programme (3) NoProgramsMilestones 9Eye health education All primary schools in 5 provinces (30% of all primary schools) 10Fit for school10 pilot schools (7,500 students in 5 provinces) 11Health promoting and Healthy city 9 schools in Phnom Penh 12Safety and healthy food, and Market tour 6 primary schools in Phnom Penh (7,755 students and 1,480 parents participated)

16. 16 10.New co-curricula on health education have been introduced to target schools:. Eye health education,. STH education,. LSE-CSE (4 curricula). Safety and healthy food. Malaria education (3 curricula). Dengue education manual. First aid education manual,. Hygiene and sanitation manual, Current school health programme (4)

17. School health partners (1) 1.Ministry of Health 2. Ministry of Rural Development 3.National AIDS Authority 4.National Combating Drug Authority 5.UN agencies: UNFPA, UNESCO, WHO, WFP, GFATM, WB, UNICEF, 6.NGOs: HKI, CWW/Johnson & Johnson, Fhi360 (USAID), Fred Hollow Foundation, Brien Holden, RHAC, OneWorld, Inthanou, URC, One to One, WVC, BORDA, RWC 7.Bi-lateral: GIZ, KOICA, Colgate, 17

18. School health partners (2) 18 NoProgramPartner 1School mealsWFP 2Life skill on comprehensive sexuality education UNFPA, GF, UNICEF, RHAC, UNESCO, OneWorld, Intha 3Eye health education and eye screening FHF, BH, KOICA 4Soil-transmitted helminthes education CWW, JJ, HKI, Fhi360

19. School health partners (3) 19 NoProgramPartner 5Malaria educationGF, URC, PFD 6Fit for school (hygiene and sanitation) GIZ, WVC, UNICEF BORDA 7Safety and healthy food, hygiene and sanitation education WHO, NB (PB) 8Health check up and first aidNB (PB), WB, KOICA

20. School health partners (4) 20 NoProgramPartner 9Oral healthColgate, One to One 10De-wormingJJ, MoH 11Vitamin A and VaccinationMoH 12Sanitation and Hygiene facilities UNICEF, NB, MoRD, BORDA, RWC, KOICA

21. 21 Gaps and next step (1) A. Legislation: Revision of school health structure at sub- national level (sarachhor #03) Revision of sub-decree 25 on school health (stand alone? how any hours/week?) Inter-Minitry Prakas on Health check up Guidelines to implement the policy on school health New guidelines “minimum package on WASH”

22. 22 Gaps and next step (2) B. Programme: Provision of suitable equipments and materials for water supplies and sanitation including hand washing facilites in schools Provision of health care services in school especially first aid kits and materials for doing health check up (grade 1) including capacity development at school levels Scaling up the primary health care of eye and ear including access health services of low vision and low hearing

23. 23 Gaps and next step (3) Continue the de-worming to all target students include STH education, vaccination and vitamin supplementation for students at high risk groups Expansion of the life skill education on comprehensive sexuality education for young people which includes HIV, Drug, goal setting Scaling up the health education focusing on non communicable disease and season diseases Scaling up school daily practices on hand washing and tooth brushing (primary school)

24. 24 Gaps and next step (4) Continue school meal programs for students at vulnerable areas C. Capacity development: Strengthening the capacity of food sellers and food makers at school on food safety and healthy food Strengthening capacity of school health personnel on effective implementation programs of school health including exchange visits

25. Thank You