Health Promoting Schools: Implementation Challenges, Barriers, and Lessons from a Case Study
The aim of this study was to evaluate the implementation process of the “Saúde na Escola” (“Health in School”) program in Manguinhos, a slum area in Rio de Janeiro, Brazil. Based on an analytical framework of theory-driven evaluation, an exploratory case study was developed involving normative document analysis, in-depth interviews, focus groups with teachers and students’ parents, and direct observation. The results reveal a poor articulation between health and education sectors, top-down decision making, and barriers to community participation. In addition, the focus strategy adopted weakened a more integrated approach, the evaluation process, and accountability.
KeywordsTheory-driven evaluation Implementation School health programs Intersectoral approach
The research presented here was guided by a respect for privacy and the right to interaction free of constraints. In addition to direct contact with participants, individual e-mails and phone calls were used. All participants in the study signed an informed consent form. The research was approved by the Ethics Committee of the National School of Public Health and ethics committee of the Municipal Secretariat of Education.
- Chen T (1990) Theory-driven evaluations. Sage, LondonGoogle Scholar
- Decreto N° 6.286, de 5 de Dezembro de 2007—Institui o Programa Saúde na Escola PSE. Disponível em http://www.planalto.gov.br/ccivil_03/_Ato20072010/2007/Decreto/D6286.htm
- Patton MQ (2008) Utilization-focused evaluation, 4th edn. Sage, LondonGoogle Scholar
- Salazar L (2011) Reflexiones y posiciones alrededor de la evaluación de intervenciones Complejas. Universidad del Valle, Santiago de CaliGoogle Scholar
- Silva C d S, Pantoja AF (2009) Contribuições da Avaliação na Identificação de Efetividade da Promoção da Saúde na Escola do Município do Rio de Janeiro. Bol Téc SENAC 35(2):36–49Google Scholar
- Villardi ML, Cyrino EG (2012) O cuidado à criança em idade escolar: percepções de equipes da Estratégia Saúde da Família. Bras de Med de Fam e Comunidade 7(24):177–183Google Scholar
- Weiss C (1998) Evaluation. Prentice Hall, Upper Saddle River, NJGoogle Scholar
- WHO Regional Office for Europe (1996) Regional guidelines: development of health-promotiong schools: a framework for action. WHO Regional Office for the Western Pacific, Health Promotion Schools, Manila, Series 5. http://whlibdoc.who.int/wpro/1994-99/a53203.pdf