Healthy Action: An Activity Book for Teachers and Learners Acknowledgements This Activity Book was written by Scott Pulizzi and Laurie Rosenblum of Education Development Center, Inc. (EDC), Health and Human Development Division (HHD). The authors worked in close partnership with the staff of the Solidarity and Development Unit coordinating the EFAIDS Programme at Education International (EI). The authors acknowledge the contribution of the World Health Organization (WHO). EI, EDC, and WHO would also like to acknowledge all the teachers’ unions affiliated to EI who have contributed to the EFAIDS Programme and thus to this Activity Book, specifically and the Zimbabwe Teachers’ Association. EI, EDC, and WHO are supported by the Dutch Ministry of Foreign Affairs’ Directorate- General for International Cooperation (DGIS) under the EFAIDS Programme. All photographs taken by Josephine Krikke. Acknowledgements 3 Table of Contents Introduction ................................................... 7 Tobacco Use and Prevention .......................... 11 Alcohol and Other Drugs................................ 27 Nutrition ......................................................... 37 Physical Activity ............................................. 55 Hygiene and Sanitation .................................. 69 Injury Prevention ........................................... 83 Violence Prevention ........................................ 95 Table of Contents 5 Introduction This toolkit is based on the premise that healthy students and teachers live better. The activities herein are designed to help learners and teachers develop healthy behaviours and lifestyles so they can reach their highest ability to learn and teach. It introduces the topics of tobacco, alcohol, and other drugs; nutrition and physical activity; hygiene and sanitation; and injury and violence prevention. All of these topics are connected through the theme of maintaining overall good health and a healthy lifestyle, that is, health promotion rather than just disease prevention. These health topics are being introduced through the EFAIDS programme because they fit with the Education For All (EFA) theme that good health improves the quality of education in terms of both attendance and ability to learn and teach when in school. In addition, these topics are being presented using the same approach (life-skills based) and methodology (participatory) that were used in developing the EFAIDS teacher toolkit and learner book on HIV and AIDS. Union affiliates are already training teachers how to teach about HIV and AIDS using this approach and methodology, so it makes sense to use the same approach and methodology to teach other health topics that are relevant to HIV and AIDS and affect the quality of education. Emphasizing overall health and teaching multiple health topics simultaneously are also useful because many health issues are connected by overlapping risk and protective factors and require similar skills to make healthy decisions and change behaviours. For example, the skills of critical thinking, decision-making, and risk assessment are necessary for addressing nutrition and physical activity; hygiene and sanitation; the use of tobacco, alcohol, and other drugs; injury and violence prevention; and HIV and AIDS. Communication and negotiation skills are particularly valuable for dealing with peers in relation to substance abuse, violence in relationships, and negotiating safer sex. Research has shown that when learners are (1) dealing with physical or emotional health problems, (2) do not have adequate nutrition and physical activity, or (3) are experiencing violence, they are not able to achieve as well in school. Nutritional deficiencies, lack of physical activity, and poor physical and emotional health, especially in primary school-age children, are some of the causes of low enrolment, high absenteeism, poor performance, and early dropout.1,2,3,4 Health problems and violence Introduction 7 clearly interfere with students’ ability to attend school, concentrate on their work, and participate and perform well. Furthermore, if obtaining a basic education is compromised by health problems, children will lack basic academic skills that can help them learn about health issues and maintain their physical, psychological, social, and spiritual well-being. These deficits can affect them through their adolescence and adult years. Research has also demonstrated that schools that protect learners’ physical, emotional, mental, and social health have been able to increase achievement.5,6 Therefore, programmes in schools that help learners achieve good health are crucial in enabling all children to receive a basic education, maintain their health, and have the best educational and life outcomes. The bottom line is that education and health are inseparable for healthy, successful development and reaching one’s full potential. Teachers and other school staff are also more likely to have higher absenteeism and poor work performance when they have physical and emotional health problems. They, too, need to learn how to develop healthy behaviours and lifestyles to enhance their own health and work performance, teach these issues more effectively to their learners, and serve as role models for their learners. Use of This Activity Book This activity book covers a range of common health topics that teachers and learners live with each day. These are as follows: • Tobacco • Alcohol and other drugs • Nutrition • Hygiene, sanitation, and infectious disease, including malaria • Physical activity • Injury prevention • Violence prevention For each topic, there are activities for adults followed by classroom activities for learners. The logic of the intervention is that first and foremost teachers need to protect themselves. Next, they can create healthy environments where they work and learners learn. With these conditions met, they can address health issues in the classroom. 8 Introduction The teacher section of this activity book provides information particularly relevant for teachers in addressing all of these health topics with their colleagues (i.e., other teachers and school staff), as well as with learners, and suggests ways to make changes in the school environment related to these health issues. For each topic, there is a discussion guide and additional information organised into the following three subsections: • The teachers’ personal relationship to the health topic and identifying factors that affect healthy behaviours • Taking action in the school setting related to policy, advocacy, and awareness on the health topic • Why it is important to teach the health topic in the classroom The approach used for teachers is inspired by the study circle method. Study circles have been used in diverse settings and purposes all with the aim of promoting human development and social change. Organised labour has used the techniques of study circles for more than a century and some teacher-union affiliates of Education International (EI) have conducted study circles to address issues such as HIV and working conditions. Study circles involve voluntary groups of persons to discuss issues of importance. Over several sessions the group unpacks complex issues, gains understanding, solves problems, and takes action when warranted. The methods build on adult learning principles: The topics are relevant to the participants and use their experience as the starting point for developing new knowledge. Effective study circles are informal, collaborative, participatory, and inexpensive to run. The facilitator can use the materials in this toolkit to convene a study circle. No special training is needed, and there are no medical qualifications for working with these health topics. It is important, though, that the facilitator establish a collaborative and participatory environment so that all participants have the space to discuss and learn. Ground rules, developed at the start, can help support a good learning environment. The aim is for participants to tell their stories and create new learning through dialogue. The competition found in some forms of traditional education is discouraged. The numbers of participants generally are 5 to 12, but more can be added provided that the circle can accommodate them. The health topics in this toolkit are ideal for this type of analysis because it encourages an examination of life and the understanding of individual behaviour in the context of environmental factors. For example, a healthy diet is the product of a person’s choices (individual) and the availability of healthy foods (environmental). Introduction 9 Each of the health topics is accompanied by activities that are geared towards learners but easily adapted for use with colleagues and community members. Each of the activities has been written to be used separately, but they can also be used as a group, focusing on just one or on several of the topics. They have also been written to be used in conjunction with the HIV and AIDS activities contained in the learner book, Learning for Life and the teacher toolkit Leadership in the HIV and AIDS Response: A Toolkit for Teachers’ Unions to Promote Health and Improve Education. As teachers, you are in a key position and have an important part to play in helping your learners and colleagues develop healthy behaviours and lifestyles. You can serve as role models and create change in your schools, as well as influence your community. So, we strongly encourage you to use the material