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5th Nordic Health Promotion Research
Conference HEALTH AND INSTITUTIONAL CHANGE June
15-17, 2006 Esbjerg Denmark Charles Viljoen
Ph.D North West University. South
Africa sooctv_at_puk.ac.za
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• Acknowledgements
• Dr. Tiaan Kirsten Faculty of Education Sciences
  North West University South Africa
• Prof. Bo JA Haglund Karolinska Institute
  Stockholm
• The many students, teachers, principals, parents,
  community leaders, people from the private sector
  and departments of education

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• South Africa a few snapshots
• SA faces many challenges of development
• Reconstructing education to a system that brings
  equity to the education of all children is one of
  the most urgent
• The children are the future, and must be prepared
  to meet the demands of that future. The challenge
  cannot wait it must be faced now.
• The main problems in SAfrica's education system
  related to the troubled past, and in particularly
  to the policy of Apartheid and its consequences

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• What is needed to be understood is the nature of
  the educational challenges which face South
  Africa now, at this juncture in its history.
• Years of oppressive rule under the Apartheid
  system were laid to rest in 1994 when the nation
  elected its first multi-racial and democratic
  government.
• From holistic-societal point of view recent
  indicators give an insight into the challenges to
  be grappled with in education in South Africa.
• Crime, violence, and a variety of psychosocial
  problems continue to grow as the promise of a new
  life for many is too slowly to be realised.

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• Unemployment and low incomes are the
  after-effects of years of anti-apartheid
  international sanctions. And conflicts abound as
  both blacks and whites attempt to redefine their
  roles in the new society.
• Currently, more than half of South Africa's
  population is under the age of 20.
• Various problems continue to frustrate the
  effective delivery of education. Education is
  being characterised as inefficient, costly,
  unequal, and poor in quality the training of
  teachers is inadequate

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• there is a lack of basic materials
• communication between departmental officials and
  teachers is poor to non-existent
• rationalisation and redeployment of teachers is
  causing uncertainty and lack of motivation
• drop-outs and repetition of grades and subjects
  is more the rule than the exception
• misappropriation of funds is widespread
• chronic absenteeism of teachers and pupils as
  well as drunkenness while on duty cast a further
  dark cloud over the education sphere

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Health and nutrition the National Food
Consumption Survey (2000) survey eating patterns
South African children between the ages of one
and nine years old. One out of two children has
an intake of less than half the recommended level
of a number of important nutrients such as iron,
zinc and vitamins A and C. These deficiencies
cause undernourished children to suffer from
apathy, short attention span drop in learning
ability due to iron deficiency poor weight gain
and growth retardation poor cell functioning and
structure due to zinc deficiency, poor growth,
poor digestion, low mental alertness and poor
resistance to infection because of a lack in
vitamins.

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• Research amongst role players suggests various
  issues
• Education Department
• Dysfunctional schools
• Absenteeism of educators
• Mismanagement
• Lack of ethics
• Schools and teachers
• Demands from education department
• OBE
• School organisation
• Multicultural environments

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• Schools and teachers
• Parents/families
• Attitudes of learners
• Discipline
• Societal/community demands
• Physical ailments in educators and learners
• Learners
• Lack of learner support
• Disregard for human dignity
• Lack career orientation life orientation
• Observe stress in teachers
• Teaching learning not realised optimally

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• Parents
• Dysfunctional teaching
• Abuse of learners
• Perceive school as primary educator
• Schools should be safe routes to schools
• Social ills violence, drug abuse, etc.
• Inefficient parenting roles/skills
• Absent parents

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ORIGIN OF TOXIC CULTURE/SCHOOLS Negative views
of their work, their abilities, their students No
leadership to help staff to overcome adversity,
avoid negative rationalizations, no closure to
conflict Drift towards negativity slow, gradual,
new shared viewing of the school
counterproductive Pockets of negativity influence
whole school Keepers of negativity and cynicism
(rumourmongers, hostile storytellers,
antiheroines and antiheroes, harmful
exemplars) Use complaints to gain power and
attention

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• CHANGING A TOXIC CULTURE
• Schools with a negative, or toxic, culture
• lack a clear sense of purpose
• have norms that reinforce inertia
• blame students for lack of progress
• discourage collaboration
• often have actively hostile relations among staff
• In fighting such a negative culture, the staff
  must assess the underlying norms and values of
  the culture and then as a group activity, work to
  change them to have a more positive, supportive
  culture.

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TOXIC SCHOOLS HEALTHY SCHOOLS Lack shared
purpose shared purpose Aggression in
workplace commitment team spirit Unhealthy
healthy Bullying care for each
other Unproductive productive Degenerative gro
wth Fragmented cohesion Not serving needs of
all all stakeholders important Negative
values collegiality, performance Disgruntled
staff professional community

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Hopelessness shared sense responsibility Attacki
ng new ideas network positive
communication Always
criticizing rituals/ceremonies that
reinforce core values School is
battleground/war interpersonal
connection Oppositional groups shared
sense respect and care Spreading
frustration for everyone Negative
conversations stories that celebrate Stories
of failure told successes Animosity against
principal professional relationship

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Poverty A combination of a lack of human assets
(health, skills, education, knowledge, etc.) and
physical assets (housing, land, food, water,
etc.) and presence of other aspects (risk,
vulnerability, insecurity, social exclusion, loss
of dignity, deprivation, lack of choice,
powerlessness).

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Health Health is not about the absence of
disease, but rather as the process by which
individuals, families, communities and societies
maintain their sense of coherence (i.e. the sense
that life is comprehensible, manageable and
meaningful) and the ability to function in the
face of changes in themselves and in their
relationships with their environment.

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Innovation in the school Key questions to be
answered Doing something I/we know about more
often? Doing something I/we know about
better? Doing something somewhat different? Doing
something altogether different?

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• Innovation in the school
• Conceptualisation and definition
• The ability to deliver new value to the customer
  (a new way of doing things or a new way to create
  customer satisfaction)
• Innovation utilises creative acts that must
  result in quantifiable gain
• Extending the utilisation of a product or process
• Any idea, practice, or material artifact
  perceived to be new by the relevant unit of
  adoption
• No innovation as long as the present course of
  action is considered to be satisfactory.
  Discrepancy between satisfactory and actual
  performance urges the need for alternatives

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or Innovation is process, involving multiple
activities, performed by multiple actors from one
or several organisations, during which new
combinations of means and/or ends, which are new
for a creating and/or adopting unit, are
developed and/or produced and/or implemented
and/or transferred to old/or new partners
(adapted from Gemuenden, 2004)

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• Innovation in the school
• The more open and willing an organisation is to
  accept and even seek out new ideas from its
  external environment, the more innovative it is
  (Zaltman Wallendoff, 1979).
• The tendency for large organisations to adopt
  more innovations has been attributed to critical
  mass (eg. the number of people convinced about
  the innovation number of people engaged in the
  innovation the amount of positive energy
  generated at the point of entry of the
  innovation the amount of success generated after
  the point of entry of the innovation (success
  stories)

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• Critical success factors of innovation
• Team/individual discensus
• Conflict properly managed is a positive force in
  innovative thinking
• Team/individual creativity
• Generation of ideas and new improved ways of
  doing things
• Team/individual commitment
• Willingness to transform intellectual in-puts
  into out-puts. It is about doing new things

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What is meant by health? Popular and general
meaning of health New Oxford Dictionary of
English (1998 864) the state of being free
from illness or injury A person being
restored to health would then mean a person
whom was ill or who had an injury, but is now
free from such problems. This general meaning
of health as a concept is loaded with the
connotations and denotations of health as only
being about the physical body, curative and very
medicalised in fact a very bio-medical approach

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World Health Organisation Definition The World
Health Organisation (WHO, 1948, 1999) defines
health as A state of complete physical, mental
and social wellbeing and not merely the absence
of disease or infirmity. Probably the most
often cited definition of health Definition
recognizes social wellbeing and therefore the
links between individuals and their social
world. Important for the role it has played in
highlighting that health is much more than the
absence of disease, and that it is much more than
a physical state (Wass, 2000 47)

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• Ryff Singers (19981) conclusion
• It also seems that in traditional everyday use,
  and because of the longstanding emphasis in human
  health on illness, and
• also because science has until now relegated
  health to the biological sciences,
• the state of the art conceptualization of health
  is that it is primarily concerned with the body.

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Wellness informed holistic definition of health
(Kirsten Viljoen (2004) Optimal states of the
domains of well-being in which an individual as a
biopsychospiritual being, is physically,
psychologically and spiritually integrated,
interrelated and in harmony with the total
living, non-living and symbolic environment,
conducive to living a life of quality and
actualising his/her potential in all the contexts
of human existence, based on sustainability and
for the common good.

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Indicators for Health Promoting Schools

• Indicators of the HPS
• The health promoting school a choice to be made
• Policies and practice
• Formal curriculum
• Environment
• Social environment
• School, home, community links partnerships
• Community and health agencies

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Indicators for Health Promoting Schools

• The health promoting school a choice to be made
• Evidence
• Staff members aware of HPS concept
• HPS framework is used in school
• HPS promoted in school community
• HPS supported by school policies
• HPS concept supported by school leadership

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Indicators for Health Promoting Schools

• 2. Policies and practice
• Evidence
• HPS plan/framework agreed upon for all to see
• Promotion discussion school policies
• Clear policies and procedures needs students
  (mental, health, welfare, safety, risk management
  local issues, environmental sustainable)
• Teachers informed trained to meet
  responsibilities needs learners
• Teachers encouraged to promote sense of community
  well-being

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Indicators for Health Promoting Schools

• 2. Policies and practice (cont.)
• Evidence
• School undertake health promoting activities
• Trained and active health worker nurse,
  occupational therapist

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Indicators for Health Promoting Schools

• 3. Formal curriculum
• Evidence
• Curriculum based on holistic model of health
• Teachers convinced the content/delivery support
  schools health and well-being
• Staff have access to professional development for
  curriculum development
• Teachers seek student input and feedback in
  relation to teaching, assessment and content
• Teachers encouraged and supported to design
  effective learning experiences for all students

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Indicators for Health Promoting Schools

• 3. Formal curriculum (cont.)
• Evidence
• Teachers want student participation in learning
  and use methodologies that consider student needs
  and learning styles
• Processes in place that students do not slip
  through
• Teachers have high achievable expectations of
  learners
• Learners have meaningful opportunities to
  participate and contribute

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Indicators for Health Promoting Schools

• 3. Formal curriculum (cont.)
• Evidence
• Curriculum informed by current health issues of
  learners in community
• School informed by parents, learners and teachers
  in terms of health issues

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Indicators for Health Promoting Schools

• Environment
• Evidence
• Welcoming safe for learners, staff, all visitors
• Protection from rain, sun, etc
• Classrooms ventilated and well-lit
• Safe and adequate play areas
• Hygienic adequate toilet facilities, soap,
  hand-drying facilities, ample sanitary disposal

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Indicators for Health Promoting Schools

• 4. Environment (cont.)
• Evidence
• Access to hygienic water
• Appropriate and secure places to store belongings
• Appropriate areas for sick learners
• Regular safety audits of grounds, classrooms,
  with parent, learner and staff representatives

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Indicators for Health Promoting Schools

• 5. Social environment/ethos
• Evidence
• School community share values
• Ownership and pride promoted amongst learners and
  staff
• Community experience school as welcoming place
• School/classroom atmosphere warm, open and mutual
  respect
• Learners/staff feel comfortable and safe
• Staff members model caring relations
• Variety of structured student forums where issues
  can be raised

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Indicators for Health Promoting Schools

• 5. Social environment
• Evidence
• Variety of structured staff forums where issues
  can be raised
• Encourage, value and recognise achievement by
  learners and staff
• Teachers aware of roles as significant people
  that learners can approach for help and guidance

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Indicators for Health Promoting Schools

• 6. School, home, community links partnerships
• Evidence
• Established varied communication strategies with
  parents/caregivers in regard to policies and
  practice
• Clear communication to parents/caregivers on the
  ways they can support learners school-based
  learning
• Sharing of physical resources with community

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Indicators for Health Promoting Schools

• 6. School, home, community links partnerships
  (cont.)
• Evidence
• Use local media to communicate school activities
  and events to wider community
• Use the expertise of community agencies, groups
  and individuals in complementing the curriculum

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Indicators for Health Promoting Schools

• Community and health agencies
• Evidence
• Linking with local health and other local
  community agencies
• Teacher/counselor have latest information on
  health and related services (type provided,
  referral procedures, waiting lists, charges,
  etc.)
• Training opportunities for staff on
  health-related issues available by local health
  and community agencies
• Local health and community agencies help and
  support curriculum delivery (sex education,
  STDS, HIV Aids, etc.)

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Thank you for your attention!

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