THE POTENTIAL OF SCHOOLCHILDREN AS HEALTH CHANGE AGENT IN RURAL WESTERN KENYA

RUSITA NURWIDI ASTUTI

ü  From a public health perspective, primary schools offer an extraordinary opportunity to improve the health of students, their families and members of the community in a cost-effective way (Kalnins et al., 1994). Children are generally receptive to learning, and because many attend school, school-based programs are potentially cost-effective (WHO, 1992). When children acquire health-related knowledge and skills, they become well placed to pursue a healthy life and to work for the improved health of their families and communities (Patil et al., 1996).

ü  A broader view of children as health change agents captures children as individuals who make things happen in different social environments (OnyangoOuma, 2000). As agents, children are capable of strategizing and finding space to maneuver in situations they face as well as manipulating resources and constraints. Children can engage with health knowledge and skills in their own right and are not merely passive recipients of other people's care and interventions. Children's health agency has been reported in the literature (Christensen, 1998; Mayall, 1996; Prout & Christensen, 1996). More recently, Christensen (2004) has advanced the idea of the child as a health-promoting actor in the family context.

ü  The present study demonstrates children can be empowered to be health change agents in the community. Action-oriented and participatory health education intervention approaches have the potential to enable schoolchildren to assist their peers and parents to acquire health-related knowledge and changed practices. As health change agents in schools, children collaborated with other students to introduce and maintain changes in the school environment. In the home settings, they communicated health messages and introduced relevant health practices through which their parents/ guardians improved their knowledge and changed their behavior through their participation. The findings imply that despite several constraints children can be health change agents for their peers and parents/guardians in school and home environments.

ü  Public health programs should incorporate participatory, action-oriented methods which encourage individuals' full participation in the learning process since they produce more benefits with regard to improved knowledge and change of practice.

ü  Teachers and education policy makers should consider whether more didactic approaches should be replaced with participatory and action-oriented approaches in future health education projects. However, such approaches may require additional costs in terms of time, money and manpower. Where classes are big and teachers demoralized, effective implementation of action-oriented methods may have limited possibilities for success.

ü  Fostering school–community links is essential for the success of school health programs. A consequence of health education programs should be the establishment of good links between schools and communities. The sustainability of such programs will depend on the extent to which the two environments are conducive to children's actions and facilitate their ability to act.

Referensi :

Onyango-Ouma, W., Aagaard-Hansen, J., & Jensen, B. B. (2005). The potential of schoolchildren as health change agents in rural western Kenya. Social Science & Medicine, 61(8), 1711–1722. http://doi.org/10.1016/j.socscimed.2005.03.041

RUSITA NURWIDI ASTUTI

Kebijakan Dan Manajemen Pelayanan Kesehatan

Universitas Gadjah Mada Yogyakarta

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