Intervention |
In 2002 the Government of Eritrea commissioned a National Situation Analysis of the health of Eritrean school children, which found a low prevalence of S. mansoni, but one that was highly focal and altitude dependent. In contrast to many African countries, the overall prevalence of intestinal nematode infections was found to be very low, but the lack of ecological pattern of infections and the variability of infection rates between schools suggests that poor school sanitation is likely to be responsible for infections.
Having identified poor health and nutrition as major constraints on the learning and educational achievement of its children, the GoE decided to establish a school health and nutrition program using the FRESH (Focusing Resources on Effective School Health) approach.
A strategic plan for implementation was written in 2002 which includes a detailed action plan for schistosomiasis control, prepared by the MoH and MoE with the assistance of the Partnership for Child Development (PCD) and the World Bank.
Identifying Priority Interventions
1. The strategic plan was developed by first reviewing the different health conditions affecting school children in Eritrea and identifying those which could effectively be addressed through school based health and nutrition services.
2. Having identified these particular conditions, ‘decision making matrices’ were constructed to enable the need, benefit, cost and feasibility of different services to be considered.
3. Using the data of the situation analysis and the MoH/MoE's knowledge and experience decisions were made on which health services needed to be delivered in each part of the country.
4. To maximize the cost-effectiveness and feasibility of delivery, the following recommendations were made regarding delivery:
• Maximize the input of teachers, and minimize the input of local health staff.
• Use mass treatment in schools where this is justified by the prevalence of a health condition.
• Involve teachers in screening for health conditions.
• Involve teachers in delivery of simple treatments.
• Refer all complex health issues to local health staff.
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