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Ghana: School health programs get students ready to learn

When Moses Nyaaba was growing up, he suffered from one ailment after another. But Moses considers himself lucky. His father, a farmer, sent him to school. He went on to become a principal at his former elementary school. For years as principal, he saw students fade in and out of school. Absences were often because of illness.

This is a familiar scene in the northernmost part of Ghana, which according to the Ghana Poverty Reduction Strategy II, suffers from extreme poverty. These northern regions have the highest levels of malnutrition and stunting among children, the highest child morbidity and mortality rates, the most recurrent cases of guinea worm and other water borne diseases, and not surprisingly, the lowest school enrollment and completion rates especially among girls.

Healthier Children Stay in School

To respond to these needs, CRS began a School Health Education Program (SHEP) in partnership with the Ghana Health Service (GHS) and the Ghana Education Service (GES).  The program, initially funded as part of a United States Agency for International Development Title II grant, is designed to improve the health and nutritional status of preschool and primary school children in northern Ghana. Providing these children with a safe, hygienic school environment and meeting their basic health needs increases the likelihood that they will enroll in, attend and complete primary school. This is a strategic priority of CRS’ education work: improving access and equity for vulnerable populations.   

One of the ways this is done is by reducing intestinal infections, such as Helminthes, that so often keep children out of school. UNICEF supplies de-worming medicine and CRS ensures the delivery and proper use of the medicine to over 190,000 children in program schools. Training parents and teachers so that they understand the purpose and importance of the medicine is an essential part of this process.

Fuseini Adama Bawa, the GES supervisor in charge of school feeding for Karaga District, reports that “worm infestation was the most common disease that was disturbing the people of Sung, especially children of school going age. With CRS introducing de-worming exercises into their program schools, Sung has been rescued from chronic worm infestations in their children — and on behalf of the people of Sung, I say a very big thank you to CRS.”

Behavior Must Also Change

Of course, delivering medicine is not enough. To keep children healthy it is important to also change certain behaviors and practices.  CRS recognizes this and trains teachers and peer educators in proper health and hygiene practices, such as having students use the latrine when they have to go to the bathroom and wash their hands before eating. CRS also distributes hand washing basins for the students, while the community does its part by providing the soap. In this way, students not only gain health information and skills, they also routinely put them into practice. In many schools, peer educators also form clubs that develop hygiene education messages, school health improvement plans, drama performances, and clean-up campaigns.

More Children Ready to Learn

All these efforts are working. Fewer children are absent due to sickness. Attendance at schools has increased. Behaviors have changed as well. At the beginning of the program, only 43% of students in program schools practiced appropriate hygiene behaviors; two years later at the mid-point of the program, 79% of children were practicing such behaviors. There is also evidence that students are now spreading the messages they hear at school and educating their parents about proper health and hygiene practices.

Moses Nyaaba, now the GES District School Health Coordinator, says “the program has galvanized school children and community members into action to change the sanitation situation in their schools and communities.” And those who ultimately benefit are the increasing numbers of children who remain healthy enough to stay in school.

For more information, contact Anne Sellers (, CRS Education Technical Advisor.

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