Lessons learned in the implementation of strategies in schools: the case of Chile.

1. Lessons learned in the implementation of strategies in schools: the case of Chile. Marcia Erazo

3. BMI (Kg/m2) www.thelancet.com Published online February 4, 2011

5. School-based strategies • Chile, following the guidance of the World Health Organization, in 2007 implemented a series of strategies at schools (1000 schools nationwide).

6. Main strategies • Healthy kiosks: To reduce the exposure to “junk food” at school. • Physical education: To increase the total hours of physical activity • Health promotion: To introduce health topics on a regular basis at school

7. Objective • To analyze the barriers and facilitators to the implementation of strategies in schools. • Complete reports at: • http://www.minsal.cl/portal/url/page/minsalcl/g_proteccion/g_alimentos/prot_ego.html

8. First evaluation (2010) • Qualitative evaluation, aimed to evaluate the process of implementation at regional and community level. • Focus group and key stakeholders interviews.

9. Results • At regional level: • Horizontal articulation: • Technical orientations are applied al community level. • Metropolitan area, there is a lack of coordination. • There is inter-sectorial work between sports and educational institutions, that work together.

10. Results • Vertical integration: • There is intra-sectorial integration, especially when, at community level, there is a person designated to work the health promotion. • Monitoring, supervising and accompanying the implementation at community level

11. Results • Horizontal articulation at community level: • There is inter-sectorial work. • Only actions at school level, once a month. • “The school” sees this activity as an “extra”.

12. Second evaluation (2010) • Quantitave and qualitative methods • Weight, height • Interviews

13. Results

14. Results

15. Results

16. Results

17. Thirdevaluation (2011)

18. Facilitators • Principal’s will, by encouraging healthy habits. • Possitive assessment of students in more hours of physical activity.

19. Barriers • Selling unhealthy foods at school. • To give money to children • Lack of continuity of interventions. • Lack of intra-extra sectorial coordination • Managerial failure • Lack of “political agreement”

20. School-based intervention in one community • Presented in a seminar of successful practices to prevent childhood obesity, organized by PAHO, in Santiago-Chile, January 21-22, 2013. • Conducted by Municipalidad de Peñalolén • http://www.paho.org/chi/

21. School-based intervention in one community • Intervention: • Physical activity: • 3 hours a week, in different days, specialized teacher, active pauses. • Healthy eating and nutrition • Anthropometry • Healthy eating education to children, parents and school community. • Healthy kiosks • Health promotion

22. Results

23. Active pause

24. Healthy kiosks • Change in “terms of reference” to manage to kiosks

26. Lessons learned • Sustainability of the program is given by: • Central management • Coordinated Inter-sectorial work • Inclusion of the strategies in the community health plans and official documents.

27. Lessons learned • Successful of the program is given by • The leadership and commitment of the school principal, • Permanent monitoring of the correct implementation of strategies, • Fcus on promoting healthy habits to children and their families, • Reinforcement by regulation within and outside of the schools of junk food

28. Thank you!!