Manual for Teachers for the Essential Health Care Program in Filipino Schools

7/31/2019 Manual for Teachers for the Essential Health Care Program in Filipino Schools

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Manual for Teacherso the I ple entation o the Essential

Health Ca e P og a in Schools


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The Third Edition o the Teacher's Manual or theEssential Health Care Program (EHCP) serves asthe showcase output o this laudable program othe Department o Education (DepEd) with localgovernments that earned prestigious international

awards.

This manual will guide you on the implementationo this program that reaches more than one millionpublic elementary school children in many provincesnationwide. You will be able to in uence tangiblehealth improvements to children who su er rom ahigh burden o preventable diseases - intestinal worms,diarrhea, and tooth decay. Through this program, wecan give each child bene ciary a way to better healthmaking them truly t or school and able to achieve theirmaximum potential in education and development.

Together with the support o the Department o Health,the German Development Cooperation (GTZ), Fit ForSchool Inc., other private sector and non-governmentorganizations, and stakeholders, we can be models ormulti-sector collaboration in giving good education andgood health to the Filipino children. Our partnership canbecome world standard as EHCP is already consideredthe best practice in oral health care.

Th o gh this p og a , e can give each child bene cia y aay to bette health aking the t ly t o school and able

to achieve thei axi potential in ed cation anddevelop ent.

Fo e o d | 3

Foreword

While at the helm o the department, I commit to urtherexpand and improve the implementation o this ground-breaking program. We will encourage more partners tojoin us in making our children healthier through cleanpractices o handwashing and toothbrushing.

We move on onwards in trans orming our schools intohealthy public places that bene t our school childrenand their community or a better start in li e or abrighter uture.

B . A in A. L ist o FSCSec eta y o the Depa t ent o Ed cationPhilippines


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DepED O de | 4 | DepED O de

Dep ED O deNo. 65, s. 2009

ImPLEmENTATION OF ESSENTIAL HEALTH CArE PrOGrAm EHCPFOr THE SCHOOL CHILDrEN

Education and health are interrelated. Academic per ormance o the pupils and instructional outcomes are1.

determined by the quality o health o the school children. Unhealthy children cannot develop their ull potentialwhich may result to high drop-out rates and low academic per ormance. The health status o public schoolpupils in public schools is alarmingly poorly. Dental caries, in ectious diseases (respiratory tract in ectionsand diarrhea) and worm in estations are the most common hygiene de ciency related in ectious diseases inpublic schools which are due to lack o water and unctional sanitary acilities. I unattended, these will lead tomalnutrition, poor physical growth and other diseases like anemia, toothache, among others.

To address these problems, the Essential Health Care Program (EHCP) or school children shall be2.institutionalized in all schools. Through this project, soap, toothbrush, toothpaste with uoride and dewormingmedicines will be provided or the conduct o daily handwashing, daily toothbrushing and bi-annual dewormingo all children. These are the most cost e ective, evidence-based preventive interventions to improve the healtho school children in public schools and thereby, improving their academic per ormance.

Recently, the Department o Education (DepED), League o Provinces o the Philippines (LPP) and Fit or School3.Inc., orged a Memorandum o Understanding (MOU) or a nationwide implementation o EHCP.

Regional directors, schools division superintendents shall establish linkages with LGUs and jointly participate4.in the planning while the regional/division health and nutrition personnel and Adopt-A-School Program (ASP)coordinators will be responsible or the orientation o school principals and teachers and monitoring andevaluation o the project.

School principals and teachers shall be oriented by the health and nutrition personnel or proper supervision/5.implementation o the daily handwashing with soap and toothbrushing with uoride toothpaste. Parent TeachersAssociations (PTAs) are encouraged to establish handwashing/toothbrushing acilities, toothbrush holders andother improvements o the schools.

Enclosed are the implementing guidelines o the project.6.

Widest dissemination and compliance with this Order is desired.7.

To: Undersecretaries

Assistant Secretaries

Bureau Directors

Regional Directors Schools Division/City Superintendents


ImmEDIATE CONSTruCTION OF wATEr AND HAND wASHINGFACILITIES IN ALL SCHOOLS FOr THE PrEVENTION OF INFuENZA A H1N1

To: DepED ARMM Regional Secretary

Regional Directors

Schools Division/City Superintendents

Regional/Division Physical Facilities Coordinators

Heads, Public Elementary and Secondary Schools

All Others Concerned

a. Assessment o the availability o water resources at the school level. The Division shall ensureavailability o running water and soap in all schools. I running water is not available, storage oclean water container/drum may su ce.

b. Construction or common handwashing acilities in schools to be sourced rom Maintenance andOther Operationg Expenses (MOOE) or school Building Repair and Maintenance Scheme (SBRMS)

unds or rom any available local unds. For this purpose, a special design o lavatory counter andcost estimates are enclosed or re erence. Implementation o this project shall be subject to theguidelines or utilization o MOOE and SBRMS unds.

Fully aware o con rmed In uenza A(H1N1) cases in the country and that schools can be a major source o1.transmission o the virus, immediate measures need to be undertaken to prevent its spread and other in ectiousdiseases in school.Relative to this, all schools, regional and division o ces are required to take immediate actions as ollows:2.

The acilities shall be made available immediately or within one week upon receipt o this Order.3.Immediate dissemination o and compliance with this Order is directed.4.

Jesli A. Lap sSec eta y o Ed cationPhilippines

Jesli A. Lap sSec eta y o Ed cationPhilippines


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| DepED O de


ImPLEmENTATION OF ESSENTIAL HEALTH CArE PrOGrAm EHCPFOr THE SCHOOL CHILDrEN

DepED Ad inis ative O de goes he e

IMPLEMENTING GUIDELINES

The ocus o EHCP is the institutionalization o evidence-based cost-e ective interventions, such as daily

handwashing with soap, toothbrushing with ouride toothpaste and bi-annual deworming as school activity.The program shall be implemented in all schools nationwide targetting preschoolers and Grade I-VI.

The project shall be nancially covered by the LGU depending on the number o children involved in the project

and should have a strong support rom Regional and Division O cials in establishing a linkage to LGU sans schoolsadministrators, teaching and non-teaching personnel.

Regional Directors School Divsion Superintendents:Issue a Regional/Divisional Memorandum or all regions/division schools to implement the EHCP

Oversee the overall implementation o the project

Inclusion o the school health programs into the per ormance ranking system or teachers and principals

Showcase Basic Education System Re orm Agenda (BESRA) and use the program to strengthen linkage with the

local government

School Principal:Call or PTA assembly or proper in ormation o parents and teachers on the EHCP

Ensure that handwashing and toothbrushing are done daily in schools

Link with LGUs and other stakeholders to provide the supportive environment

Ensure availability o supplies (soap and toothpaste)

Coordinate with the Chie o Health and Nutrition Section

School Health Personnel:Conduct a basic orientation on the EHCP to school administrators, teachers, PTA o cials/members and Barangay

Health Workers (BHW) during the PTA assemblyMonitor and give eedback to teachers and to the principal on the status o implementation and make suggestions

or improvementProvide teachers and parents with needed in ormation and address their questions, concerns and misconceptions

on dewormingProvide technical support to teachers and oversee/do deworming activities in their areas o responsibility

Seek assistance o the barangay health workers during the mass deworming activity


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Education and health go hand in hand. Children needto be healthy to be t or school. Sadly, too many childrenin the Philippines are aficted by everyday ailments thatimpact largely on their physical and mental developmentand limit them rom getting the most rom theireducation. The majority o Filipino children very o tensu ers rom worm in ections, severe tooth decay and

rom in ectious diseases. Toothaches have a huge impacton the quality o li e o children and on their ability tolearn. Diarrhea, stomachaches, and itchy skin in ectionsalso contribute to poor participation and schoolabsenteeism. Even the best education system cannotguarantee high academic per ormance when studentsare requently ill or in pain.

However, many o these diseases and ailments arepreventable. There are simple, scienti cally proveninterventions that greatly limit their occurrence andtransmission. The key is good hygiene.

The Essential Health Care Program (EHCP) or FilipinoChildren ocuses on three such interventions dailyhandwashing with soap, daily toothbrushing with

uoride toothpaste, and biannual deworming.

Handwashing with soap is regarded as more e ectivethan any other single health intervention, reducing theincidence o diarrhea by 42 to 47% and respiratory

Introduction

8 | Int od ction Int od ction |

in ections by up to 30%. Toothbrushing with uoride isrecognized by both the World Health Organization andthe FDI World Dental Federation as the most realisticway o reducing the burden o tooth decay in populations.Meanwhile, biannual deworming has been provenworldwide to reduce helminth in ections by up to 30%resulting in improved nutrition and body weight.

EHCP is cost e ective and can be easily implementedon a mass scale, even in under-resourced communities.How? Through an existing, well-organized institution the public school system. School is a second home tomost children. Because o the countrys widespreadpoverty, the school is also o ten the only environmentthat is equipped with the resources to expose childrento healthy practices.

By working closely with the Department o Educationand Local Government Units (LGUs), we haveincorporated EHCP into regular school activities thathave the potential to signi cantly improve the health oFilipino children.

The role o teachers is especially vital to the success oEHCP. Through their commitment to the program, theyensure that these interventions are correctly practicedby their students and become li elong, healthy habits.


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Hand ashing has been ecognized as the osti po tant step in avoiding illness and p eventingthe sp ead o ge s to othe s.

INFECTIOuS DISEASESIn ectious diseases are diseases that spread rom oneperson to another. Worm in ections, diarrhea, commoncolds, coughs, even bronchitis and skin in ections arethe most common in ectious diseases. Lack o cleanlinessis the root cause or the spread o these diseases. I weall take care to keep ourselves, our home and our schoolclean, we can guide children to cleanliness and stopmost diseases be ore they start.

FACTScienti c esea ch gathe ed in seve al st diessho ed that eg la hand ashing ith soapcan ed ce the ate o dia hea by 31% to 47%and espi ato y illness by 3 %.1

Hand ashing | 11

1. Handwashing

Yo sho ld al ays ash yohands ith soap a te singthe toilet, a te handlingpets, be o e handling oodand be o e eating.

1 | Hand ashing


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All children will wash their hands with soap at leastonce a day in school as a group activity.

The best time to do this is be ore eating at recessor at lunch time.

The teacher will assign and train students tohelp their classmates conduct the handwashingactivity in an organized manner.

A ter about a week, children get used to thisprocedure and the role o the teacher will belimited to supervision.

The teacher will remind the children to wash theirhands with soap a ter using the toilet, a terhandling pets, be ore handling ood and be oreeating.

Children are encouraged to be advocates orhandwashing with soap and make it a routine in

amily li e.

1.wet hands ith nning ate .

4. r b pal s togethe ithnge s inte laced.

6. G asp th b and b ith a t istingotion. repeat o othe th b.

5. r b the backs o nge s againstthe opposite pal .

2.Apply soap, c eate lathe and

b all s aces o seconds.

3.r b ight hand ove le t and viceve sa.

Guidelines for Daily Handwashing

7. r b le t pal against the back o the ight hand and vice ve sa.

8. rinse hands ith nning ate . 9. D y hands in the ai .

Do not se a to el!To els beco e aso ce o in ectiona te the st se.

Hand ashing | 131 | Hand ashing


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Hand ashing | 114 | Hand ashing

when ashing hands, can I se any kind o soap?Yes. With proper use, all soaps, even laundry anddishwashing soaps, are e ective in cleaning our hands.However, laundry soaps have a stronger ormula thanother soaps.

Do e need to se antibacte ial soap?No. It is the action o rubbing and not the type o soapthat physically removes bacteria rom the skin.

Ho can yo i ple ent hand ashing ith soap inschools that have no access to ate ?Access to water is essential. Activities can be startedusing collected rainwater and tippy tap wash stations.It is important to make water an issue and lobby oraccess to water in the barangay council.

Can ain ate be sed o hand ashing?Yes. I water is scarce, water rom a well, rainwater andeven seawater can be used or handwashing, but it iso utmost importance that handwashing is always donewith soap.

why is it also i po tant to t i nge nails?The area under ngernails has the highest potential orharboring bacteria and viruses. Well-trimmed nails areeasier to keep clean.

Je Na isso, G ade III TeacheHonestly speaking, in the beginning I washesitant about washing hands with the kidsevery day because I eared it would inter erewith all my other duties as a teacher. But itturned out to be easy because children liketo take the lead or common activities and todevelop their leadership skills. I enjoy that thechildren are so much cleaner.

Pe lita del rosa io, mothe and Pa entTeache Association me beSince our school has the Essential Health CareProgram, we have a new p olicy. Each child hasto bring water to the school every day, becauseour school has no water. We appreciate thatsoap, toothbrushes and toothpaste are providedby our governor, but we really need waterin the school now. The barangay council haspromised to provide the necessary materialswhile our Parent Teacher Association (PTA) willprovide the labor. We are so happy about theimprovement o our school.

Frequently Asked Questions | Handwashing Experiences

I ate is sca ce, can t o o o e child en se thesa e ate o a basin o hand ashing?Children should not use the same water rom a basinwhen washing hands together as they will also sharetheir germs. Children should rinse their handsindividually and it is best to use owing water.

Is the p o otion o hand ashing only being done inthe Philippines?No, this is part o a global initiative to promote hand-washing. It is proven that handwashing with soap is thesingle most e ective intervention inreducing the spread o in ectious diseases and thussaving lives. Around the world, di erent stakeholderssuch as UNICEF, the World Bank, universities, industrypartners and governments have joined orces to promotehandwashing with soap on a mass scale. The Philippinegovernment is now part o this globalmovement.

Can I pa ticipate in the p o otion o hand ashingand ho ?Yes, everyone is welcome to join the global movement

or handwashing with soap. All you have to do is makeit a habit in your own personal and pro essional li e,talk about it among amily members, riends andcolleagues. Encourage your neighbors, your church andyour sports mates to join and carry out handwashingactivities. It eels good to be part o this importantglobal initiative.


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. Toothbrushing

Acco ding to the wo ld Health O ganization wHOand the FDI wo ld Dental Fede ation,toothb shing

sing toothpaste ith o ide is the ost ealisticay o ed cing tooth decay.

TOOTH DECAYTooth decay is the most common chronic childhooddisease worldwide. Tooth decay does not heal by itsel .In low-income countries, nearly all tooth decay remainsuntreated. Consequently, the decay will last a li etimeand will a ect the general health and quality o li e oa person.

Tooth decay hurts and deprives children o a goodnights sleep, making it harder or them to pay attentionin class, play with riends and enjoy li e. Ultimately, itmay hinder social development.

FACTThe e ectiveness o o ide in p eventingtooth decay has been ly established.resea ch has sho n that school-based o idetoothb shing p og a s lead to a 4 % to %

ed ction in ne toothdecay. ,3

Toothb shing | 17

Yo sho ld b sh yoteeth at least t icea day: once in the

o ning and al aysbe o e going to sleep.

1 | Toothb shing


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3.

6.

7. rinse yo toothb shith ate .

P ess the dispense once toapply a d op o toothpaste ontoa d y toothb sh. No ate isneeded, only saliva. I yo a e

sing a t be o toothpaste,sq eeze a pea-sized a o nt

onto the toothb sh.

Feel ith yo tong e i allteeth a e s ooth and clean.

B sh all teeth, especially yoola s, o t o in tes.

18 | Toothb shing

2.

1.Be o e sing, e ove the t olocks o the toothpastedispense and p p thepl nge ntil the toothpasteco es o t. replace one lockand p p. No the dispenseis eady o se.

Guidelines for Daily Toothbrushing

wipe yo o th ith so eate sing clean hands.

5.

8. ret n yo toothb sh to thetoothb sh holde .

Spit the toothpaste o t.Do not inse yo o th.

4.

Children should start their day with resh breathand clean teeth.

All children will brush their teeth at least once aday in school as a group activity.

The teacher will assign and train student leadersto help their classmates conduct the toothbrushingactivity in an organized manner.

Filipino children are very good at group activities.Daily toothbrushing will help make them evenbetter at per orming activities together. The roleo the teacher is to supervise.

A ter a week o training, the whole activity shouldnot take longer than ve minutes o each schoolday.

Children are encouraged to be champions o cleanteeth and resh breath, and to motivate theirparents and siblings to make a daily habit obrushing teeth, especially be ore going to bed.

Toothb shing | 1


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| Toothb shing

Is bad b eath ca sed by a lack o o al hygiene?I teeth are not cleaned, bad breath will annoy thepeople around you. Some people have bad breathbecause they have bacteria in their mouths, whichproduce sul ur compounds. It is help ul to brush thetongue intensively because this is where these bacteriareside. what can I do to keep y teeth healthy?Cut down on sugary snacks and drinks. Get into the habito eating resh ruits as snacks, replace so t drinks withwater and brush your teeth twice a day with uoridetoothpaste.

why is it i po tant to se o ide toothpaste?In many countries, the levels o tooth decay have allenby over 50% in the last 20 years. Leading experts aroundthe globe have agreed that this development is almostentirely due to the use o uoride toothpaste.

why is it i po tant not to inse the o th a tetoothb shing?Rinsing will reduce the positive e ect o the uoride onyour teeth. I you eel a need to rinse out the oodparticles, brush your teeth and rinse, then brush teethagain with luoride toothpaste, this time withoutrinsing.4

Frequently Asked Questions | Toothbrushing

Do I need to change toothb sh eve y th eeonths?

No. Research has shown that there is no di erence incleaning e ectiveness between an old and a newtoothbrush in the hands o children. 5

Can I se salt as an alte native to toothpaste?You can use salt or cleaning purposes, but you need

uoride to prevent tooth decay.

Can I se a g ava stick to clean y teeth?Yes, o course. In the absence o toothbrushes the guavastick is e ective in cleaning teeth, but do not orget toplace a drop o toothpaste on your guava stick.

Is toothpaste sa e to s allo ?Toothpaste is not intended to be eaten and children areencouraged to spit out the toothpaste. However, it isknown that children will always swallow sometoothpaste, but even when they do so, it is harmless.

1

La a, G ade V St dentI am Lara and I am a Grade V pupil. I am thepresident o the uoride patrol o ourschool.My role in the uoride patrol is to spread dentalin ormation to our classmates, to acilitate

the ormation o my classmates' lines duringtoothbrushing, to campaign or NO candies,to avoid dental caries and to report any o myclassmates' dental or medical related problemsto the teacher or the nurse. I like being inthe uoride patrol because it gives me theopportunity to serve my classmates and alsodevelop my sense o responsibility.

Experiences

Toothb shing | 1


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3. Deworming

No adays o in ections can be cont olledth o gh biann al de o ing ith inexpensive,highly e ective single-dose d gs.

COmmON wOrm INFECTIONSoil transmitted helminth (STH) in ection, also knownas worm in ection, and schistosomiasis are verycommon. School-age children in developing countriesare the most heavily in ected population.

Untreated worm in ections cause anemia and can leadto poor mental development. When in ected, childrenlose energy and their ability to concentrate. As a result,they are always tired and cannot actively participate inclass. Going to school becomes tiresome or in ectedchildren.

Heavily in ected children will not grow as expected ortheir age. Malnourished children become even moremalnourished.

In the Philippines, 7 out o 10 elementary school childrenhave worms, with 2 out o 10 being heavily in ected.

FACTAn eval ation o the i pact o school-basedde o ing evealed that de o ing child enin Kenya ed ced absenteeis by %.

Yo sho ld be de o ed eve y sixonths. De o ing d gs a e sa e

and can also be given to child en hoa e not in ected.

De o ing | 3 | De o ing


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4 | De o ing

Guidelines for Mass Deworming

Pa ents give thei in o edconsent.

2.School n ses o health

o ke s o ient teache s andpa ents.

1.

The DepED health personnel in collaboration withthe barangay health worker (BHW) will orient andeducate parents and teachers on mass dewormingto address all questions and concerns.

Parents need to sign a orm as a way o giving theirin ormed consent or the deworming o theirchildren.

The teacher will call ve children at a time andadminister the deworming tablets, which will bechewed by the children immediately under directobservation o the teacher.

The principal is encouraged to establish linkagewith the community and seek the presence o theBHW on the deworming d ay.

This procedure will take place every six months.

The data o deworming and the names o allchildren dewormed will be documented in theteacher's record book.

De o ing |

5.Teache inspects the child en's

o ths.

4.upon eceiving the tablet,child en st che ands allo it i ediately.

6.A pa ent ill assist in thedoc entation.

Teache calls ve child enat a ti e.

3.


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what a e the sy pto s o o in ection?Worms and other parasites live in people's intestinesand cause disease. Some worm types can be seen in thestool. Some worms lay their eggs outside the anus,which causes itching, especially at night, and interruptssleep. I the in ection is not treated, an in ected personmay experience loss o appetite, abdominal pain anddecline in energy levels resulting in decreased physicaland mental per ormance. An in ected person will alsoexperience a de ciency in vitamin A, which leads toanemia ( or hookworm cases only), dry eyes and evenblindness. The body o an in ected person cannot absorb

ood properly, which then leads to malnutrition andintestinal obstruction.

Ho can I p event the child en o beingin ected?Prevention o worm in ection requires improvement opersonal hygiene and sanitation acilities. First, use a

toilet whenever possible. Second, always wash handswith soap a ter going to the toilet and be ore eating.Rubbing hands with soap will get rid o microscopicworm eggs you or the child may have picked up. Third,wash vegetables thoroughly with clean water. Fourth,keep ngernails and toenails short. Finally, always wearshoes or slippers to keep eet rom direct contact withthe soil.

A e de o ing d gs sa e?Deworming drugs are sa e and can also be given to non-in ected children. They are sa e or all children above 1year o age.

Frequently Asked Questions | Deworming

| De o ing

why sho ld y child be de o ed again hen heas de o ed last yea ?

Children will easily be rein ected. There ore, dewormingis needed every six months. It will prevent chronicin ection and a heavy worm load.

Can e de o itho t a lab es lt?The World Health Organization recommends thedeworming o all children without prior laboratorytesting i the in ection rate in the area is higher than50%. The in ection rate in the Philippines has beenhigher than 50% in all areas surveyed. Deworming oall children is recommended in schools as the drugsused are sa e even or non-in ected children.

why as y child de o ed in school and in theco nity seve al ti es last yea ?In the past, there have been overlapping dewormingprograms. Collaboration among DepEd, DOH, DSWD,

respective LGU o ces and barangay health workers willassure coordination and mainstreaming o e orts.

why do child en have the highest isk o intestinalo in ection?

Most intestinal worms are so-called "soil transmittedhelminths," which means that the in ection is spreadthrough soil. Soil is easily contaminated with humanexcreta or waste. Children play on the ground then puttheir ngers in their mouths and get in ected. Thus,proper handwashing be ore eating is very important.

Boy mo ales, G ade III St dent"Our teacher told us how worms live and growin the body o children and why we can getin ected. I had o ten seen worms in my ecesand always wondered how they entered mybody. Our teacher told us that the eggs o wormsare on the ground where we are playing. Antsand beetles carry the eggs o worms rom the

eces o people who have worms and distributethem all over. The eggs are very small and ti ny.We cannot see them, but they are on our handsand under our ngernails. Now I always washmy hands be ore I eat because I do not want toswallow the eggs o the worms. In our school wewash our hand all together prior to recessbecause this is a school policy."

ma ia Gonzales, mothe , B kidnon"I was a raid to let my child be dewormedbecause I was told by my mother thatdeworming will make the worms come out othe mouth, the ears and the eyes, and the childmay be blind or dea a ter the deworming. Iwas too shy to ask about this, but the nurse inthe school told us that this is not true and justan old wi e's tale. I am well in ormed now andhappy because a ter the deworming, my childgained weight and is happily playing around."

Experiences

De o ing | 7


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4. Roles & Responsibilities

The Fit Fo School app oach identi es di e entoles to ens e the s ooth i ple entation o daily

hand ashing ith soap and daily o idetoothb shing. Child en a e not only thebene cia ies b t also the p i e acto s in schoolhealth p og a s.

THE rOLE OF THE CHILDrENremind the teacher when it is time or handwashing

and toothbrushing, and lead the ormation o studentlines during these activitiesmaintain cleanliness o the acilities

assist the teacher in implementation and

monitoringreport di culties to the teacher

remind parents to buy and use soap and toothpaste

at homeremind parents, grandparents, caregivers and older

siblings to wash their hands be ore preparing oodencourage younger siblings to wash their hands at

critical moments and remind them to brush their

teeth, especially be ore going to bed

roles & responsibilities |

THE rOLE OF THE TEACHErseek close partnership with parents in constructing

the handwashing acilities and in preparing toothbrushholdersorient the children on the activities

acilitate and supervise the daily activities

acilitate participatory learning in addition to

conducting lectures or lessonsempower children to take leadership roles and

responsibilityensure availability o water

organize the regular cleaning o acilities

ensure availability o toothpaste and soap

administer the deworming medicine a ter being

oriented by health personnel

8 | roles & responsibilities


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THE rOLE OF THE SCHOOL DIVISIONSuPErIN TENDENT (SDS)

issue a memorandum or all schools to implement the

EHCP, including the EHCP surveyoversee the overall implementation o the project in

the division and ensure monitoring o the program atleast once a year in all schoolsensure the distribution o soap, toothpaste and

toothbrushes according to DepED distributionsysteminclude compliance with school health programs in

the per ormance ranking system or teachers andprincipalsuse the program to showcase Basic Education Sector

Re orm Agenda (BESRA) good practice and tostrengthen linkage with the LGU

3 | roles & responsibilities

THE rOLE OF THE SCHOOL PrINCIPAL

call or PTA assembly to properly in orm parents and

teachers about EHCPinclude group handwashing and toothbrushing

activities in the daily class programsinstruct all teachers in your school and ensure strict

compliance with the EHCP guidelines

link with LGUs and other stakeholders to provide a

supportive environmentensure availability and proper distribution o supplies

(soap, toothpaste, toothbrushes) within your schoolensure monitoring at least once a year and

communicate the results with the teachers and thecommunityrecognize achievements o individuals in their

per ormance ranking

THE rOLE OF THE SCHOOLHEALTH PErSONNEL

conduct a basic orientation on the Fit or School

EHCP or teachers, school administrators, PTAmembers and parents, establish linkage with thecommunity, especially with the BHWprovide teachers and parents with needed in ormation

and address their questions, concerns and

misconceptions about dewormingrequest the presence o the BHW during mass

deworming day to support the teacherstake the lead in coordinating the annual monitoring

with the PTA and a barangay o cialgive eedback and explain monitoring results to

teachers and to the principal

roles & responsibilities | 31

THE rOLE OF PArENTS AND THECOmmuNITY wITHIN THE PTA

acilitate the construction o washing acilities and

provision o toothbrush holderslobby or access to water and sanitation in the

schoolparticipate in annual monitoring

participate in PTA assembly, address questions and

concerns to the health personnel and sign consentorms or deworming

be a good role model by handwashing with soap at

critical moments, toothbrushing and reminding yourchildren to brush their teeth in the eveningprovide access to soap, toothbrushes and toothpaste

at home, so that children can grow up healthy


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THE rOLE OF LOCAL CHIEF EXECuTIVES(GOVErNOrS, mAYOrS, BArANGAYCAPTAINS)

support institutionalization o EHCP in provinces

through provincial ordinancestake the lead in programs or behavior change and

healthy habits

ensure budget allocation

ensure timely procurement o program materials

encourage community involvement

3 | roles & responsibilities roles & responsibilities | 33

THE rOLE OF PrIVATE PArTNErSengage in community partnerships

encourage community involvement

provide unds or capacity development

provide inancial support or pilot projects and

support the scale-up processuse mass media or health campaigns

engage in global partnership or development

assist the scienti ic community in research and

development e ortso er a ordable, mass market quality health care

products

THE rOLE OF THE ACADEmEconduct research to strengthen the evidence o the

e ectivity o the interventionssupport government agencies with research

advocate more a ordable health care solutions

devise and encourage simple and e ective health

habitsdisseminate in ormation on scienti c developments

trans er technology and know-how to private

companies, NGOs and LGUswork closely with the various development agencies,

aid agencies and departments in government topromote the general health and wel are o childrentake an active role in the advocacy process

THE rOLE OF NGOS, DEVELOPmENTAGENCIES AND OTHEr INTErNATIONALOrGANIZATIONS(wHO, wOrLD BANK, ETC.)

promote and advocate school health on a local,

national and global levelsupport communities and schools in their e orts to

improve water and sanitation acilities

strengthen school and village community action by

setting incentives and awarding outstandingper ormanceprovide technical assistance to government agencies

and support government agencies' ownership o theprogramspearhead ramework development

promote and strengthen global partnerships among

stakeholders and prevent program duplication andoverlapping


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The active pa ticipation o pa ents is needed o FACT


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. How to Create aSupportive Environment

Each child should have access to water, either roma tap or rom a water container (jug, canister,

tippy tap) in the classroom.

Schools without access to water should developways and means to ensure availability o water byencouraging the students and parents to bringwater to the school.

Access to water in the school should be a priorityo the barangay.

On the average, at least one liter o water is need-ed or every child per day.

The active pa ticipation o pa ents is needed othe s ccess l i ple entation o the EssentialHealth Ca e P og a . Involve ent o theco nity and the s ppo t o the b a angay co ncilis the key.

wATEr, SANITATION AND HEALTHIN SCHOOLSProviding access to sa e water and sanitation remains

a major challenge in Philippine schools. The EssentialHealth Care Program can serve as a starting point ormaking access to water and sanitation a priority inSchool Improvement Plans.

FACTThe es lts o a ecent s vey o ele enta yschools in misa is O iental sho that 71% o the toilets a e in despe ate need o epai andone o t o th ee toilets does not have nning

ate , hile 4 % o the assessed schools donot have ate at all.

Access to ate and i p ove ent o ashing acilities a e the esponsibility o

the hole co nity.

Guidelines for Access to Water

Ho to C eate a S ppo tive Envi on ent | 373 | Ho to C eate a S ppo tive Envi on ent

G id li f Ti T W h S i


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Guidelines for Tippy Tap Wash Stations

make a hole in the cap o eachate bottle.

2.Fix a st ing to the bottle and

e ove the label.

1.

Tippy taps o er a low cost solution or schools thatdo not have access to pip ed water.

As a temporary solution, the construction o a tippytap can be done in each setting, providing su cient

wash stations so that many children can wash theirhands at the same time in an organized manner.

Placing the bottles under the sun or at least sixhours will increase the water quality (http://www.sodis.ch). The UV light o the sun will disin ect thewater.

Building tippy taps is a un activity or children,parents and teachers.

5. 6.wet hands by sq eezing the bottleand lathe yo hands sing soap.

4.Fix soap in a stocking o a shnet nea each bottle.

rinse hands o toothb sh bysq eezing the bottle.

3. Fix the bottles to the ashstand so that they can be easilyt ned to an p ight position.

38 | Ho to C eate a S ppo tive Envi on ent Ho to C eate a S ppo tive Envi on ent | 3

G id li f th D ig d C t ti f


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4 | Ho to C eate a S ppo tive Envi on ent Ho to C eate a S ppo tive Envi on ent | 41

Guidelines for the Design and Construction of Handwashing and Toothbrushing Facilities

1.

7. 8.

6.

9.

use o indigeno s ate ials isa lo cost option

3.

4. Conside sing a containe toens e constant ate p ess e

B ild the acility close to theclass oo

2. The acility sho ldacco odate at least 1 kids

5. P nched ate pipes ed cecost and ate cons ption

Tippy taps a e i ediate locost sol tions

Inclining the acility lets ateo s oothly

Ens e p ope d ainage Conside oo ng o g o pactivities, ain o shine

Assess the water and sanitation conditions in yourschool, discuss needed improvements and seeksupport orm the barangay council.

Think about immediate improvements and longterm improvement as part o the schoolimprovement plan (SIP).

To acilitate handwashing and toothbrushing asdaily school activities, each classroom should beequipped with its own washing acility.

I water pressure is too low or unreliable, do notuse aucets. Punched pipes will work much betterand consume less water.

Most important that the acility unctions no matterwhether concrete or indigenous material is used.

Ensure regular cleaning o the acility and be proudo your healthy school.

Use the experiences that others have made. Watchthe video on the DVD or on the website.

Guidelines for the Toothbrush Holder


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4 | Ho to C eate a S ppo tive Envi on ent

Guidelines for the Toothbrush Holder

Each child will receive one toothbrush with a coverper year. These are to be stored in a toothbrushholder inside the classroom.

The toothbrush holder will be xed to the wall so

that children can easily reach it.

The toothbrush holder should be easy to clean.

There should be spaces between the brushes toavoid cross in ection.

The slots should be designed in such a way thatthe head o the brush is exposed to the air. Thecover has little holes to prevent molding.

Each space and each brush should be clearlylabeled to avoid mixing up brushes.

Ho to C eate a S ppo tive Envi on ent | 43

using a pe anent a ke , toothb shesst be labeled individ ally acco ding to

st dent na e o n be .

The label st be apped ith tape to p eventit o being e ased ove ti e.

As an alte native to labeling, have thechild en pe sonalize thei toothb shes oeasy identi cation.

Neve let the child enb ing the b shesho e. A second b shis needed at ho e.

monito ing is necessa y o dete ining thest engths and eaknesses o the i ple entation


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. Monitoring

monito ing | 4

st engths and eaknesses o the i ple entationand identi ying a eas o i p ove ent.

mONITOrING AND EVALuATIONRegular monitoring and evaluation shows the status oEHCP implementation and whether handwashing andtoothbrushing have become a routine in daily school li e.It also helps to identi y challenges and needs or

additional support in managing the program. Sharing oresults encourages all local stakeholders to jointlydevelop solutions or urther improvements.

rEGuLAr SCHOOL SurVEYSA standardized School Survey Form is the key instrumentin monitoring and evaluation. The results rom thesurvey also serve as a basis or an award that recognizesthe best schools in each division and the best divisionsoverall. The survey orm can be downloaded rom theinternet. All criteria are transparent and all schools cantrain to ull ill the requirement and receive high

scoring.SEArCH FOr THE mOST OuTSTANDINGSCHOOL AND DIVISION

C ite ia o the co petition: Status of EHCP orientation Availability of program materials Status of deworming Availability of functional facilities for

g o p activities Frequency and orderliness of group

hand ashing and toothb shing

44 | monito ing

Schools sho ld p actice the s vey onthei o n to sco e high d ing ofcial

onito ing.

Guidelines for Monitoring


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g

Annual monitoring is carried out in every schoolin one randomly selected class.

The members o the monitoring team are theDepED Health Personnel, Barangay Captain or

Kagawad and the PTA President or O cer, whoeach represent one key local stakeholder.

An advance copy o the School Survey Form isdistributed to the principals o all schools in thedivision by the SDS. On the day o the actual schoolvisit, the team will use this orm as a guide in themonitoring process.

The SDS will assign the sta responsible to encodethe collected data rom the survey orms into anonline system that will be accessible to DepEDo cials at the divisional and regional level.

Please watch our Monitoring lm on the DVD or onthe website.

rando ly select the class andsection to be onito ed.

2.P epa e o the visit and b ingthe needed ate ials.

5. 6.Check de o ing eco ds andcove age.

4. Check the availability o EHCPate ials.

Obse ve and assess the g o pactivities.

7.Co pa e ans e s and ag eeon co on sco ing.

8. 9.Disc ss es lts ilth allstakeholde s.

Encode the data into the onlinesyste .

1. 3. Check the class p og asched le.

4 | monito ing monito ing | 47

Frequently Asked Questions | Monitoring

Experiences


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why does the monitoring team consist o three peopleho all have to fll out the orm?

Having each team member ll out an individual survey ormshows the involvement o all stakeholders. A orm signedby all key persons involved in the survey establishesaccountability and transparency. Filling out the orms is

only a part o the entire monitoring process.Each completed orm will be the basis or discussion oresults among the stakeholders and their respectiveconstituents, which is one o the most important aspectsin monitoring.

why sho ld the class oo teache and p incipal signthe o s?There is more to it than just signing a completed orm. Thisemphasizes the signi icance o their roles in theimplementation o the program and their par ticipation indiscussing indings, generating eedback, identi yingchallenges and inding solutions to improve the

implementation o the program and the status oacilities.

Ho can a school improve its score?Monitoring will be done regularly; hence, there is enoughtime, a whole school year, to prepare and apply thenecessary improvements based on the eedback obtained

rom the survey and solutions agreed on as result o thecollaboration o all stakeholders involved. Engaging thePTA and barangay to support in making the program betterwill be a big help to achieve this. Also, the survey orm willserve as the schools guideline or the diferent pointersthat need to be observed and monitored.

Does a school itho t ate access have lessechances o inning the a a d?The questions in the survey pertaining to water access arenot included in the rating so it will not afect the schoolsoverall score. However, this provides important in ormationabout the schools in rastructure. Awareness o this act

could lead to the development o long-term solutions. Thissetting also shows that the local community must beworking hard to nd solutions to compensate or the lackcompared with schools that have reliable water access.

Ho can a division i p ove its sco e?A division can improve its ranking by supporting ALL theschools under its wing. The SDS could help rein orce thecooperation o LGUs or the timely provision o su cientmaterials and or helping improve water access and

acilities in the schools. Also, i all the schools in thedivision are monitored, this will add to the divisionsoverall average score. A non-reporting school automatically

gets zero score.

why should all schools be monitored?There are schools without EHCP materials yet, but theymay have taken an initiative to start implementing EHCPon their own so these eforts and best practices should beidenti ied. Monitoring will also orient them about thepossibilities and bene ts they might have with additionalsupport rom the diferent stakeholders. The competition

or the GSK Award could greatly encourage these schoolsto ully implement EHCP.

48 | monito ing monito ing | 4

Nilo meneses, PTA OfceThe role o the parents is essential or thesuccess o the program. As a parent, I wantto see that my child has a chance at school todevelop healthy habits. I also want to make surethat the acilities that we built are put to gooduse. I am proud to be part o the monitoringteam and I am looking orward to work with ourprincipal and the barangay to make the programeven better.

Ge a masiclat, P incipalI think it is very important that we regularlymonitor the EHCP. It encourages our teachersto give their best and is a chance or our schoolto shine and to show our good per ormance.The eedback rom the monitoring team is veryvaluable because it helps us to improve theprogram urther . It clearly proves that this is ajoint project by parents, the barangay and theschool.

monito ing | 4

Checklist for Teachers PHASE I: PrEPArATION PHASE II: ImPLEmENTATION


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| Checklist

O Primary assessmentO Read the manualO Watch the videos provided with the manualO Set a Homeroom PTA members and o cers

meetingO In orm the barangay o cials o the meetingO Encourage their participation

O Include health personnel in the meetingO Discuss the program with the PTAO Show the manual and videos to the parentsO Discuss how the parents contribute to the

construction o the handwashing acility andthe toothbrush holder

O Supervise the construction o thehandwashing acility together with parent-volunteers or barangay o cials

Daily Toothb shing ith Fl o ide ToothpasteO Put the holder in an area where children

can easily reach or their toothbrushesO Request toothbrushes, toothpaste bottles and

soap rom the principalO Label the toothbrushes individually according

to student name or number using a permanent

marker, or have the children personalized theirtoothbrushes or easy identi cation

O Label one toothpaste bottle GIRLS and theother BOYS

O Remove ONLY one lock/stopper rom thedispenser

O Assign and train a student leader to help his/herclassmates conduct the toothbrushing activityin an organized manner

O Time the whole activity; a ter a week otraining, the procedure should take less than

ve minutes

Daily Hand ashing ith SoapO Have at least two soap dishes readyO For soap bars: cut each soap bar into three

piecesO For liquid soap: Mark one bottle with GIRLS

and the other BOYSO Keep the soap dish or liquid soap bottle in a

dry place in the health cornerO Assign and train a student leader to help his/her classmates conduct the handwashingactivity in an organized manner

O Time the whole activity; a ter a week, theprocedure should not take longer than veminutes

O Per orm the activity daily

Checklist | 1

Bibliography


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| Bibliog aphy

1 Curtis V and Cairncross S (2003). E ect owashing Hands with Soap on Diarrhoea Risk in theCommunity: A Systematic Review. Lancet In ect Dis3 pp 275-281.

2 Adyatmaka A et. al. School-Based PrimaryPreventive Programme or Children: A ordable

Toothpaste as a Component in Primary Oral HealthCare. Experiences rom a Field Trial in KalimantanBarat, Indonesia.

3 Curnow M M et al (2002). A Randomised ControlledTrial o the E cacy o Supervised Toothbrushing inHigh-Caries-Risk Children. Caries Res vol 36 issue 4pp 294-300.

4 Chestnutt IG, Scha er F, Jacobson AP, Stephen KW.1998. The in uence o toothbrushing requency andpostbrushing rinsing on caries experience in a caries

clinical trial. Community Dent Oral Epidemiol. 26(6):406411.

5 Palenstein Helderman WH van, Kyaing MM, Aung MTet al. Plaque Removal by Young Children Using Oldand New Toothbrushes. J Dent Res 2006 85: 1138-1142.

6 Miguel E and Kremer M (2004). Worms: Identi yingImpacts on Education and Health in the Presence oTreatment Externalities. Econometrica Vol 72 No 1pp 159-217.


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FIT FOr SCHOOL INC.Head Ofce4F mothe s Ho se B ildingmo tola-Hayes St eets

Cagayan de O o CityPhone/Fax: + 3 88 8 7 1 4in o@ t o school.ph

. t o school.ph

Documents

Manual for Teachers for the Essential Health Care Program in Filipino Schools