Experiences of school health nurses regarding the provision of the school health service delivery in the Tshwane district

School-based healthcare services in Cape Town, South Africa: When there's a will, there's a way

South African secondary schools do not deliver school-based healthcare services despite high rates of human immunodeficiency virus (HIV) infection, sexually transmitted infections, and unplanned pregnancies among adolescents, ongoing sub-optimal uptake of healthcare services from public healthcare facilities by adolescents, and national policy support for such services. A pilot school health nursing programme (SHNP) was offered to 44 secondary schools in a single health sub-district within the Western Cape, South Africa. The programme included fortnightly nurse visits that offered a standard package of healthcare services, including sexual and reproductive health services tailored according to school preference.Of the 44 schools, 42 gave permission for the SHNP to operate, with the majority of schools selecting the full comprehensive package of services. Programme implementation was truncated such that delivery only occurred over two school terms (20 weeks); however, 344 students attended the service. The majority of service users were female with a median age of 16 years, and over a half attended the service for sexual and reproductive health services.Contribution: A key challenge to school-based health service delivery arose from inadequate stakeholder support and differential views of adolescent healthcare needs among government officials, parents, guardians, school staff and governing bodies. These findings motivate for ongoing multi-level stakeholder engagement around the reality of adolescent healthcare needs and further opportunities to deliver school health services for longer time periods such that their feasibility, acceptability, and potential to impact healthcare outcomes can be assessed in this setting.

The role of community health nurses in promoting school learners’ reproductive health in North West province

Background

Reproductive health education is a major component in schools, which is delivered through Life Orientation and Life Science subjects. Providing sexual and reproductive health education and services remains a challenge in schools of many countries, as well as South Africa. Community health nurses have the responsibility to initiate and participate in reproductive health promotion initiatives in schools.

Aim

To explore the roles of community health nurses in the promotion of school learners' reproductive health in schools.

Setting

This study was conducted in the clinics of Madibeng municipality in North West province, South Africa.

Methods

An exploratory qualitative research study was conducted using in-depth interviews for data collection. The population included community health nurses who were sampled purposively.

Results

Community health nurses revealed that their primary role was to provide health education to learners, particularly in clinics. Furthermore, they revealed that they did not visit schools and had no communication with teachers regarding learners' reproductive health issues.

Conclusion

The Department of Education has opened a platform for the provision of reproductive health education in schools through various teacher-led initiatives. However, this has posed a significant challenge to teachers as they may not be willing to deliver sensitive and sexually themed information to learners. To ensure effective delivery of reproductive health education in schools, community health nurses, teachers and other relevant stakeholders must collaborate in schools.

Contribution

This article highlights the importance of community health nurses visiting schools to promote the reproductive health of school learners.

Factors affecting the provision of health service delivery in schools in Engela district, Ohangwena region, Namibia

Background

While health services have been offered at various schools in Namibia since independence in 1990, coverage has been limited and there has been a notable decline in recent years. This reduction of services is of great concern, with questions being raised regarding what factors are affecting the provision of these services.

Aim

To explore the factors affecting the provision of health services to schools in Engela district, Ohangwena region, Namibia.

Settings

Semistructured interviews were conducted at a public health care facility situated in the northern part of Namibia.

Methods

A qualitative, explorative, descriptive and contextual research design was utilised. Data were collected through semistructured interviews with 15 nurses from a health centre, of whom five were enrolled nurses and 10 were registered nurses. The data were then analysed thematically.

Results

The study revealed three themes: participants’ understanding of school health services; factors affecting the delivery of school health services; and corrective measures for improving the delivery of school health services.

Conclusion

The notable decline in health service provision to various schools within the district suggests that there might be factors affecting the provision of school health services, posing a serious challenge to the active implementation of the School Health Programme.

Contribution

These findings could be used to make adjustments to the provision of school health services and will also serve as an information baseline to elicit suggestions for future research related to school health services.

Public health nurses in Canadian schools: An opportunity to build capacity and nursing scholarship

Public health nurses (PHNs) in Canada have the potential to significantly benefit the health and academic outcomes of school age children with its impact lasting into adulthood. Unfortunately, cuts in government funding over the years have diminished the presence of PHNs in schools and their ability to practice to their full scope. In the midst of a pandemic, having a strong nursing presence in schools may facilitate public health efforts and reduce the burden on teachers and administration. This discussion paper will explore the current role of nurses in Canadian schools in relation to school nurses in other parts of the world. An overview of the literature looking at the impact of the school nurse on school health (i.e., student health and academic outcomes) will be presented to provide evidence in support of rebuilding nursing capacity in Canadian schools. Finally, the Framework for 21st Century School Nursing Practice will be introduced as a viable nursing theory to facilitate rebuilding PHN capacity in schools.

Community-Based Hearing and Vision Screening in Schools in Low-Income Communities Using Mobile Health Technologies

Introduction Globally, more than 50 million children have hearing or vision loss. Most of these sensory losses are identified late due to a lack of systematic screening, making treatment and rehabilitation less effective. Mobile health (mHealth), which is the use of smartphones or wireless devices in health care, can improve access to screening services. mHealth technologies allow lay health workers (LHWs) to provide hearing and vision screening in communities. Purpose The aim of the study was to evaluate a hearing and vision school screening program facilitated by LHWs using smartphone applications in a low-income community in South Africa. Method Three LHWs were trained to provide dual sensory screening using smartphone-based applications. The hearScreen app with calibrated headphones was used to conduct screening audiometry, and the Peek Acuity app was used for visual acuity screening. Schools were selected from low-income communities (Gauteng, South Africa), and children aged between 4 and 9 years received hearing and vision screening. Screening outcomes, associated variables, and program costs were evaluated. Results A total of 4,888 and 4,933 participants received hearing and vision screening, respectively. Overall, 1.6% of participants failed the hearing screening, and 3.6% failed visual acuity screening. Logistic regression showed that female participants were more likely to pass hearing screening (OR = 1.61, 95% CI [1.11, 2.54]), while older children were less likely to pass visual acuity screening (OR = 0.87, 95% CI [0.79, 0.96]). A third (32.5%) of referred cases followed up for air-conduction threshold audiometry, and one in four (25.1%) followed up for diagnostic vision testing. A high proportion of these cases were confirmed to have hearing (73.1%, 19/26) or vision loss (57.8%, 26/45). Conclusions mHealth technologies can enable LHWs to identify school-age children with hearing and/or vision loss in low-income communities. This approach allows for low-cost, scalable models for early detection of sensory losses that can affect academic performance.