Swaziland: perspectives in school health.

Following major quantitative expansions of the educational system in Swaziland during the two decades since independence, the focus has shifted to improving efficiency. Efficiency of any educational system depends mainly on the characteristics of children entering school. Although Swaziland is not among the poorest countries, infant child mortality rates still reflect less than optimum living conditions and parental knowledge of child nutrition and disease prevention and management. Although access to primary schooling is universal, there is substantial waste during the early years of school through dropout and repetition, both associated with low socioeconomic status. School performance can be increased at little extra cost through increasing the nutrition and health status of students before school entry and through the early school years. In Swaziland, many activities are carried out to provide physical and mental health care to students. Coordinating these efforts and formulating clear policy on school health through cooperation among key ministries and nongovernmental organizations remains to be done.

PIP: Following major quantitative expansions of the educational system in Swaziland during the 2 decades since independence, the focus has shifted to improving efficiency. Efficiency of any educational system depends mainly on the characteristics of children entering school. Although Swaziland is not among the poorest countries, infant child mortality rates still reflect less that optimum living conditions and parental knowledge of child nutrition and disease prevention and management. Although access to primary schooling is universal, there is substantial waste during the early years of school through dropout and repetition, both associated with low socioeconomic status. School performance can be increased at little extra cost through increasing the nutrition and health status of students before school entry and through the early school years. In Swaziland, many activities are carried out to provide physical and mental health care to students. Coordinating these efforts and formulating clear policy on school health through cooperation among key ministries and nongovernmental organizations remains to be done. As of 1976, the school health system is part of public health activities. Primary schools and preschools are the main emphasis; secondary schools are visited by the health team by invitation. Only about 50% of the target schools are visited. The school nurse plays a supportive role. No regular dental service exists. Schools were used to train dental hygienists between 1981 and 1987. Many hygienists have continued to be in touch with the schools. Individual counseling services are provided for emotional disorders. A school nutrition program gives primary school pupils a hot mid-morning meal and a lunch to secondary school students. It is conducted by the nongovernmental organization Save the Children Fund in collaboration with the Ministry of Health and the World Food Project. Strong links exist between school and the community. Many nongovernmental organizations have started health and family issues programs. A Hearing Impairment Study, done in 1987, established baseline data and made recommendations leading to an action plan for management, prevention of hearing loss, and rehabilitation.

WHO Collaborative Study on Alcohol Education and Young People: outcomes of a four-country pilot study.

In 1985 the Division of Mental Health, World Health Organization, Geneva, convened a group of investigators from centers in four countries--Australia, Chile, Norway, Swaziland--to participate in a pilot study on the efficacy of school-based alcohol education. The goal of the educational program was to delay onset and minimize involvement of alcohol use among 13- to 14-year-old adolescents. Twenty-five schools in the four countries, representing middle- and lower-class populations, were randomly assigned to peer-led education, teacher-led education, or a control condition. The educational program was derived from social-psychological theory and etiological research on adolescent alcohol use. The program focused on the social and environmental influences to drink alcohol and skills to resist those influences. It consisted of five lessons over 2 months. Baseline and posttest data measured alcohol use knowledge, attitudes, skills, and friends' drinking patterns. Data were collected immediately prior to and 2 months following the educational program. The data converge on the finding that peer-led education appears to be efficacious in reducing alcohol use across a variety of settings and cultures.