PAN AMERICAN HEALTH ORGANIZATION Pan American Sanitary Bureau, Regional Office of the

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Pan AmericanHealthOrganization

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PAN AMERICAN HEALTH ORGANIZATION

Pan American Sanitary Bureau, Regional Office of the

WORLD HEALTH ORGANIZATION

PAN AMERICAN HEALTH ORGANIZATION

Pan American Sanitary Bureau, Regional Office of the

WORLD HEALTH ORGANIZATION

SCHOOLS AS ENGINE FOR DEVELOPMENT AND HEALTH, A NEW WAY TO PROMOTE COMMUNITY

DEVELOPMENT WITHIN THE FRAMEWORK OF THE SOCIAL DETERMINANTS OF HEALTH FOR THE

ACHIEVEMENT OF THE MDGs

Dr. Sofialeticia MoralesSenior Advisor Millennium Development Goals

Team Leader Education and Health

Unit of Health Determinants and Public Policies

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¿WHY ARE THE MDGs IMPORTANT?HEALTH OCCUPIES A CENTRAL PLACE

OF IMPORTANCE FOR DEVELOPMENT

GOALS, TARGETS AND INDICATORS ARE QUANTIFIABLE AND AMBITIOUS / MEASURE THE PROGRESS AND DEMAND PROGRESS

IT IS POSSIBLE TO CALCULATE THE COST OF ACHIEVING THEM, WHAT IS AVAILABLE VERSUS WHAT IS NECESSARY

HIGHEST LEVEL POLITICAL CONSENSUS ON MEASURES TO COMBAT POVERTY

MILLENNIUM DEVELOPMENT GOALS

Commitment to Action

• Consolidate progress, resolve problems

• Position health as a top public priority

• Reduce inequities

• Respond to national and regional needs

Inequity and Poverty

HIV/AIDS

Environmental Protection

GLOBAL PARTNERSHIP FOR DEVELOPMENT EMPHASIZES HUMAN SECURITY AND GLOBAL PROSPERITY SAFETY AND WORLD PROPOSPERITY

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The Millennium Development GoalsThe Millennium Development Goals• A set targets & indicators bound by a specific time frame for

completion (1990 2015) • A synergic and indivisible unit that requires intersectorial action for

their completion

• A set targets & indicators bound by a specific time frame for completion (1990 2015)

• A synergic and indivisible unit that requires intersectorial action for their completion

Eradicate extreme poverty and hunger

Achieve universal primary education

Promote gender equality and empower women

Reduce child mortality

Improve maternal health

Combat HIV/AIDS, malaria, and other diseases

Ensure environmental sustainability

Develop a global partnership for development

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OBJETIVOS DE DESARROLLO DEL MILENIO

• Highlight the challenge of inequity in the world’s Highlight the challenge of inequity in the world’s most inequitable region. most inequitable region.

• Go beyond advocacy and monitoring to become Go beyond advocacy and monitoring to become directly involved on interventions at the municipal directly involved on interventions at the municipal level. level.

• Carry out a regional mapping exercises of the Carry out a regional mapping exercises of the most vulnerable municipalities, based on MDG most vulnerable municipalities, based on MDG related local level indicators derived from related local level indicators derived from National Censuses and Population. National Censuses and Population. ((ECLAC/CELADE/PAHO AgreementECLAC/CELADE/PAHO Agreement))

PAHO’s STAND ON THE MDGsPAHO’s STAND ON THE MDGs

• Consider the social, economic, political, Consider the social, economic, political, environmental and cultural determinants and environmental and cultural determinants and their impact on health. their impact on health.

• Analyze and respond to the multi-dimensionality Analyze and respond to the multi-dimensionality and multi-causality of the poverty particularly. and multi-causality of the poverty particularly.

• Work at the municipal level to work on all the Work at the municipal level to work on all the MDGs respecting their indivisibility and synergy. MDGs respecting their indivisibility and synergy.

• Launch the initiative Faces and Places of the Launch the initiative Faces and Places of the MDGsMDGs

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EDUCATION

ENVIRONMENT LABOUR

HUNGER

POVERTY

HEALTH & DEVELOPMENT

AT SCHOOL

“The social determinants refer to the social conditions in which people live, study, work, and develop”

The MDGs recognize the interdependence of health and social conditions, and offer an opportunity to develop health policies that address the social roots of avoidable human suffering arising from unjust social conditions.

The Social Determinants, Health Promotion and the MDGs

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SOCIAL DETERMINANTS OF HEALTH

SOCIAL DETERMINANTS OF HEALTH

MILLENNIUM DEVELOPMEN

T GOALS

MILLENNIUM DEVELOPMEN

T GOALS

TWO WAY INTERACTION

WITH THE MUNICIPALITY

TWO WAY INTERACTION

WITH THE MUNICIPALITY

HEALTH PROMOTION

PROTECTING & RISK FACTORS

HEALTH PROMOTION

PROTECTING & RISK FACTORS

SCHOOLS ENGINES FOR DEVELOPMEN

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SCHOOLS ENGINES FOR DEVELOPMEN

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THE SOCIAL NATURE OF HEALTHTHE SOCIAL NATURE OF HEALTHTHE SOCIAL NATURE OF HEALTHTHE SOCIAL NATURE OF HEALTH

Health is not exclusively a bio-natural occurrence related to the individual, but the result of complex and changing relations and interactions between biological, individual, environmental, and living conditions of economic, environmental, cultural, and political order. We get sick and we die in relation to the way we live, We get sick and we die in relation to the way we live,

eat, reproduce, work, relate to others, educate, develop eat, reproduce, work, relate to others, educate, develop our capacities and face ours limitations . our capacities and face ours limitations .

This is the focus of This is the focus of SOCIAL DETERMINANTS OF HEALTHSOCIAL DETERMINANTS OF HEALTH

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Declaration on the New Orientations for Primary Health Care (Declaration of Montevideo)

Declaration on the New Orientations for Primary Health Care (Declaration of Montevideo)

Commitment to facilitate social inclusion and equity in health.

Recognition of critical roles of both the individual and community in the development of PHC-based systems.

Orientation toward health promotion and comprehensive and integrated care.

Development of intersectoral work.

Commitment to facilitate social inclusion and equity in health.

Recognition of critical roles of both the individual and community in the development of PHC-based systems.

Orientation toward health promotion and comprehensive and integrated care.

Development of intersectoral work.

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Renewing Primary Health Care in the AmericasRenewing Primary Health Care in the Americas

Values Right to the highest attainable level of health

Equity

Solidarity

Values Right to the highest attainable level of health

Equity

Solidarity

PrinciplesResponsiveness to people‘s health needs.

Quality – oriented

Government accountability

Sustainability

Participation

Intersectoriality

PrinciplesResponsiveness to people‘s health needs.

Quality – oriented

Government accountability

Sustainability

Participation

Intersectoriality

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The Causes of the CausesG

LO

BA

LIZ

AT

ION

HE

AL

TH

SY

ST

EM

S

BIOLOGICAL PROCESSES

HEALTH/ILLNESS

SOCIAL CONTEXT

STRUCTURAL DETERMINANTS

INTERMIDIATE DETERMINANTS

SO

CIA

L P

RO

TE

CT

ION

PR

IMA

RY

HE

AL

TH

CA

RE

HE

AL

TH

PR

OM

OT

ION

CULTURE, RELIGION, SOCIAL SYSTEM HUMAN RIGHTS, LABOUR MARKET,

EDUCATIONAL SYSTEM

PRODUCE SOCIAL STRATIFICATION AND INCLUDE TRADITIONAL FACTORS SUCH AS EDUCATION AND INCOME, AS WELL AS GENDER,

ETHNIC ORIGIN AND SEXULITY

ARISE FROM THE CONFIGURATION OF THE SOCIAL ESTRATIFICATION AND DETERMINE THE DIFFERENCES OF

EXPOSITION AND VULNERABILITY TO THE CONDITIONS UNHEALTHY CONDITIONS

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Millennium Development Goals 1990-2015

ImpactPositive

in the Healthand the Quality

of Life

= Resultsin the Health

VulnerabilityMaternal and

Child`Diseases

CommunicableDiseases

Chronicles

Mental Health ProblemsHIV-AIDS

+ Risk Factors

Hunger & Malnutrition

Limited Access

to health Services

& EducationQuality

UnemploymentContamination

and Climate Change

AddictionsObesity

+ Intermediate Determinants

Poverty andInequality

EnvironmentalDegradation

Styles ofLife notHealthy

Negative Impacts

On Health

Morbidity

Mortality

Reduce Life

Expectancy

LowQuality

ofLife

StructuralDeterminants

Economic

Political

Environmental

Technological

Biological

Social

Determinants of Health and the Millennium Development Goals

+Structural Determinants

Intermediate Determinants

=Reduction of

Factors ofRisk

BetterResults

in the Health

( - ) Negative

On Health

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POVERTYMARGINATIONMINIUMUM WAGEINCOME COMPENSATIONS

COMMITMENT TO HEALTH, SOCIAL POLICYL, LAWSREGULATIONS

FACES, FACES, VOICES & VOICES & PLACES PLACES

SCHOOLSSCHOOLS

FACES, FACES, VOICES & VOICES & PLACES PLACES

SCHOOLSSCHOOLS

•Bad Quality Bad Quality EducationEducation•Bad Quality Health Bad Quality Health Services Services • Morbidity and Morbidity and MortalityMortality•Materno-Adolescent Materno-Adolescent MortalityMortality

• Poor basic sanitationPoor basic sanitation•ParasitesParasites•Enfermedades infecciosasEnfermedades infecciosas•Respiratory InfectionsRespiratory Infections•Diahreal DiseasesDiahreal Diseases•Malaria, DengueMalaria, Dengue•Skin Cancer Skin Cancer •Lead PoisoningLead Poisoning

• Access to Access to education and education and health serviceshealth services•Social Security Social Security and Protection and Protection ProgramsPrograms•Health and Health and Education as a Education as a rightright

• DiscriminationDiscrimination• ObesityObesity• Prevention CulturePrevention Culture• StressStress• SedentarismSedentarism• Cardio Vascular and Cardio Vascular and metobolic pathologiesmetobolic pathologies• ViolenceViolence•

ECONOMICECONOMIC ECONOMICECONOMIC

SOCIALES Y SOCIALES Y CULTURALES CULTURALES SOCIALES Y SOCIALES Y

CULTURALES CULTURALES AMBIENTALESAMBIENTALES AMBIENTALESAMBIENTALES

POLITICALPOLITICAL POLITICALPOLITICAL

AIR AND WATER QUALITYSANITATIONCHEMICAL SUBSTANCES CONTAMINATIONOZONE LAYER DEPLETION,CLIMATE CHANGE

STRATIFICATION FACTORS ETHNIC GROUP, GENDER, SEXUAL ORIENTATION. HEALTH HABITSPERCEPTIONS HEALTH/ILLNESS

DETERMINANTES SOCIALES DE LA SALUD Y SU DETERMINANTES SOCIALES DE LA SALUD Y SU IMPACTO EN LA ESCUELA Y EN LA COMUNIDADIMPACTO EN LA ESCUELA Y EN LA COMUNIDAD

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ECONOMIC

• To what socioeconomic group the students belong to?

• What economic problems have and how these affect their education and health?

SOCIAL

• Are their parents are illiterate or university graduates?

• Do they have access to culture at home?

CULTURAL

• What is the value that their culture assigns to the education and health?

ENVIRONMENTAL

• Where is the school located?

• What are the environmental problems in the municipality?

• How do these problems affect their health?

ECONOMIC

• To what socioeconomic group the students belong to?

• What economic problems have and how these affect their education and health?

SOCIAL

• Are their parents are illiterate or university graduates?

• Do they have access to culture at home?

CULTURAL

• What is the value that their culture assigns to the education and health?

ENVIRONMENTAL

• Where is the school located?

• What are the environmental problems in the municipality?

• How do these problems affect their health?

SOCIAL DETERMINANTS OF HEALTH AND EDUCATIONDiagnosis and Context

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Education for freedom

With the community

With others

With themselves

Quality Education and teaching capacities for life

SELF UNDERSTANDINGHow to help students to understand themselves better?

EMOTION CONTROLHow to educate them to control their emotions?

HANDLING STRESSHow to teach them to control their stress?

CREAT AND SUSTAIN RELATIONSHIPSHow to educate to create and sustain healthy relationships?

EMPATHYHow to make students empathetic?

TRANSFORMING THEIR SORROUNDINGSHow to commit students to improving their social sorroundings?

DECISION TAKING

PROBLEM SOLVING

CRITICAL THINKING

CREATIVE THINKING

SEXUAL RELATIONSProviding relevant information and respect for themselves and others?

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They promote health through knowledge, understanding, and re-assessing the students immediate context.

The educational community is certain of the context where its everyday life takes place and can describe it by identifying the social determinants of health and analyzing how these social determinants play a key role in school life

An initial analysis takes place from the school and about the school to identify the interplay of the school and community and how its location limits or promotes educational quality and the school as motor for community transformation beyond classroom walls.

They promote health through knowledge, understanding, and re-assessing the students immediate context.

The educational community is certain of the context where its everyday life takes place and can describe it by identifying the social determinants of health and analyzing how these social determinants play a key role in school life

An initial analysis takes place from the school and about the school to identify the interplay of the school and community and how its location limits or promotes educational quality and the school as motor for community transformation beyond classroom walls.

What is the role of Schools in community development?

School Engines for Development play a key role in community transformation.

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The initial context analysis exercises is endogenous and centered around the school and mindful of the elements that promote or limit the provision of quality education.

The secondary level analysis is exogenous in nature and centered on the municipality as a geographical, jurisdictional and political entity. The analysis is based on the history, its peculiarities, and its cycles; sources of employment, economy, politics, and environment

The initial context analysis exercises is endogenous and centered around the school and mindful of the elements that promote or limit the provision of quality education.

The secondary level analysis is exogenous in nature and centered on the municipality as a geographical, jurisdictional and political entity. The analysis is based on the history, its peculiarities, and its cycles; sources of employment, economy, politics, and environment

What is the role of Schools in development, health promotion and addressing the determinants

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Social Determinants of Health

TARGET Children, Teenagers, Young

Adults,

Social Policy

Human Development: Sustainable / Equitable

Millennium Development Goals & other relevant national agendas

Health Promotion,

SCHOOLS AS AN ENGINE FOR DEVELOPMENTSCHOOLS AS AN ENGINE FOR DEVELOPMENT

Renewed Primary

Health Care

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Schools and Engines for Development base their strength in the pedagogy of development that has as its axiological foundation the value of human life as a fundamental right.

Takes on the paradigm of Education for Freedom, where education occurs through dialogue. This approach requires the development of alternatives and critical visions. Where the analysis of various points of view is essential for evaluating, transforming conceptions, attitudes, substantiate beliefs, and worldviews.

Schools and Engines for Development base their strength in the pedagogy of development that has as its axiological foundation the value of human life as a fundamental right.

Takes on the paradigm of Education for Freedom, where education occurs through dialogue. This approach requires the development of alternatives and critical visions. Where the analysis of various points of view is essential for evaluating, transforming conceptions, attitudes, substantiate beliefs, and worldviews.

The Pedagogy of Development

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The pedagogy of the development in the classroom where the educational act allows the transformation of the student’s understanding of community’s reality through dialogue and an analysis of the problems being faced.

The pedagogy of the development in the school implies a collegiate action that leads the students and the educator to develop a school project that involves the whole school.

Learning will take place by doing and the transformation of an aspect of the school.

The pedagogy of the development in the community through an action of co responsibility between the educational community and the key actors of the community.

The pedagogy of the development in the classroom where the educational act allows the transformation of the student’s understanding of community’s reality through dialogue and an analysis of the problems being faced.

The pedagogy of the development in the school implies a collegiate action that leads the students and the educator to develop a school project that involves the whole school.

Learning will take place by doing and the transformation of an aspect of the school.

The pedagogy of the development in the community through an action of co responsibility between the educational community and the key actors of the community.

The Pedagogy for Development and Education

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Arises from the analysis of the social determinants of health and aims advancing toward the achievement the Millennium Development Goals and other pertinent agendas with the understanding that schools are the engine for development.

The commitment implies first creating or consolidating the national, provincial and local networks of schools and later to promote the international networks.

The national Networks become solid foundations for the sharing of experiences, success stories and challenges in making that schools become promoters of development. It is necessary to link the schools with the first level of care within the framework of Primary Health Care to ensure that the local development is consolidated through the partnerships between schools and health services.

Arises from the analysis of the social determinants of health and aims advancing toward the achievement the Millennium Development Goals and other pertinent agendas with the understanding that schools are the engine for development.

The commitment implies first creating or consolidating the national, provincial and local networks of schools and later to promote the international networks.

The national Networks become solid foundations for the sharing of experiences, success stories and challenges in making that schools become promoters of development. It is necessary to link the schools with the first level of care within the framework of Primary Health Care to ensure that the local development is consolidated through the partnerships between schools and health services.

Schools Engines for Development and Health

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Social Protection and Education Workers Health

UNESCO/OREALC/ PAHO/ILO

Health and Occupational Health

Virtual Network

Health Promotion and Prevention Primary Health Care

Provision of Health Services Training and Education Strategies

•Health Promoting Schools(1995), •Programs Responding to Violence in Schools settings•HIV/AIDS prevention

Educational Environments

Healthy and Violence Free

Network of Healthy Environment For

Children

SUPPORTING TECHNICAL PARTNERSHIPS

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Other methods to promote health within the framework of the

determinants

The promising introduction of programs that combine financial assistance with the human resources development and the improvement of health and living conditions

Bolsa Familia - BrasilOportunidades - MéxicoChile Solidario/ Chile PuenteBarrio Adentro - VenezuelaFamilias en Acción - ColombiaBono de Salud - BoliviaBeca escolar - EcuadorPrograma de Asignación Escolar - HondurasBono Alimentario y Escolar -Nicaragua.Red de solidaridad y oportunidades - El Salvador Plan Familia - Argentina

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EMPHASIS:

CAPACITIES FOR LIFE AS A TEACHING-LEARNING PROCESS

AND EDUCATION’S 4 DIMENSIONS: LEARNING TO BE, LEARNING TO KNOW, LEARNING TO DO, AND LEARNING TO CO-EXIST

IN TERMS OF LEVELS THE EMPHASIS IS PLACED ON INITIAL EDUCATION, PRE-SCHOOL, PRIMARY, SECONDARY, AND VOCATIONAL OR TECHNICAL. THE ROLE OF HEALTH AND DEVELOPMENT PROMOTING UNIVERSITIES

EQUITY IN THE RESPONSE TO THE SOCIAL DETERMINANTS Education with gender and intercultural perspective

SCHOOLS ENGINES FOR DEVELOPMENT IN RELATION TO THE SCHOOL PROYECT AND THE MUNICIPALITY TO ADVANCE THE MDGs

THE PEDADOGY OF DEVELOPMENT

PAN AMERICAN HEALTH ORGANIZATION Pan American Sanitary Bureau, Regional Office of the

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Transcript of PAN AMERICAN HEALTH ORGANIZATION Pan American Sanitary Bureau, Regional Office of the