Project title: Strengthening the Integrated School Health Policy: Examining Coordination to Provide Sexual and Reproductive Health Services for Adolescent Girls in Public Secondary Schools in King Cetshwayo District, KwaZulu-Natal Province
In many instances, adolescent girls in South Africa do not access the services they need to prevent HIV, unintended pregnancy and gender-based violence (GBV); nor do they access psychosocial support. Additionally, research has established that there is a significant gap in linking adolescents who have newly acquired HIV to testing, treatment and care. Those who manage to test face additional challenges in initiating antiretroviral therapy. In South Africa, adolescents have larger gaps in the HIV continuum of care than adults, resulting in lower levels of viral suppression.
Schools offer platforms to identify vulnerable adolescent girls and unreached adolescents living with HIV, potentially linking them to services they need. School-going adolescents spend most of their time in school, making schools ideal places for reaching this vulnerable population group. In 2012, the South African government initiated the Integrated School Health Policy (ISHP), which aims to improve the health of school-going children and their communities. The goal of this policy is to contribute to the improvement of the general health of school-going children, as well as environmental conditions in schools, and address health barriers to learning to improve health and educational outcomes.
At the school level, implementation of the ISHP needs a coordinated and comprehensive approach. Coordination is specifically needed between the district-based support teams (DBSTs), school-based support teams (SBSTs) and learner support agents (LSAs). Schools, like other service sectors, are faced with an implementation gap where there is often slow adoption or uneven implementation of policy and evidence-based practices as part of routine service delivery; this limits efforts to promote improved learner health outcomes. However, implementation of the ISHP requires robust intersectoral collaboration on the part of key role players.
The implementation of successful school health programmes depends on strong partnerships between education and health sectors, teachers and health workers, schools and community groups and learners and persons responsible for school health programmes. Unfortunately, research in South Africa has revealed that there has been an absence of collaboration from key stakeholders, resulting in the poor adoption and implementation of the ISHP. This has resulted in a missed opportunity to reach vulnerable adolescent girl learners in the school setting for HIV prevention, treatment and care.
The IPHASA project
The aim of this study is to examine the role of the department of basic education-instituted coordinating bodies, including the SBSTs, DBSTs and LSAs, in facilitating access to HIV services, as mandated by the ISHP, in public secondary schools in the King Cetshwayo District, KwaZulu-Natal.
- To explore the role of the SBST, DBST and LSAs in identifying learner health needs and facilitating access to sexual and reproductive health services, including HIV services
- To explore learner health needs and engagement with SBST and LSAs and experiences of linkage to care
- To provide recommendations that will: (i) strengthen coordination between the DBSTs, SBSTs and LSAs in implementing the ISHP; (ii) strengthen the identification of vulnerable learners; and (iii) improve adolescent linkage to HIV prevention, treatment and care
- To improve linkage of vulnerable adolescents to HIV prevention, treatment and care