Evaluating the impact, investment case and scale-up of ‘Health Promoting Schools’ in Fiji

Background

In 2016, Health Promoting Schools (HPS) under the Fiji School Health Policy was launched as a joint program by the Ministry of Health and Medical Services and the Ministry of Education of Fiji. This is a ‘whole of school’ approach to improving health and wellbeing of Fiji’s children and youth by incorporating into the school curriculum resources to improve awareness and competency in promoting healthy behaviours. It has three key areas of focus: 1) diet and physical activity; 2) water, sanitation, and hygiene (WASH); and 3) mental health and wellbeing. In this initial phase of implementation, with support from the World Health Organization (WHO) and the Korean International Cooperation Agency (KOICA), HPS was delivered in 285 primary (ages 6-14 years, grades 1-8) and secondary schools (ages 14-18 years, grades 9-12).

There has been limited evaluation of the HPS program with important issues as yet answered: how the HPS program is being used across the participating schools, whether the program has been implemented as intended, how the program is being applied by teachers, students and families, what the students and families think of the program, how has it influenced behavioural, structural and environmental changes; and ultimately whether it is effective, represents value for money and is sustainable. The Fiji Government is committed to implementing HPS across all primary and secondary schools.

Aim

The goal of this research program is to evaluate the implementation processes, health outcome, cost-effectiveness and sustainability of the HPS program.

Research Methodology

The study will capitalise on the phased rollout of the HPS to generate real time evidence that successively informs implementation in its different stages: (1) a mixed methods process evaluation will be carried of the initial rollout to select number of schools from the 285 schools to understand the factors that influence implementation processes, and generate lessons for the subsequent phase of the rollout; (2) using the findings from (1) a series of co-design workshops will be held across Fiji to obtain community input into the next stage rollout; (3) a prospective evaluation of the effectiveness of the intervention on the three key areas (diet and physical activity, WASH and mental health, comparing outcomes at baseline and 12 months; (4) economic evaluation and budget impact and lastly; (5) sustainability analysis.

Significance

Data will inform individual schools and government of areas of improvement in relation to the wider implementation. Using this tailored adaptive approach to evaluation, we ensure that the HPS evolves into a program that has the best chance of realising its underlying potential for health, educational and social outcomes.