Review of Major School Health-Related Policies Issued by Government Agencies Before and During the Pandemic
Preparedness/Prevention Phase (Before January 30, 2020)
In 2018, the Department of Education (DepEd) introduced OK sa DepEd, a comprehensive school health and nutrition program aimed at enhancing student well-being and academic outcomes. This initiative merged six flagship programs: School-Based Feeding, Medical-Dental-Nursing Services, Water-Sanitation-Hygiene in Schools (WASH), Adolescent Reproductive Health, National Drug Education, and School Mental Health.
To operationalize the WASH program, DepEd released policy guidelines in 2016 covering water, sanitation, hygiene, education, and deworming protocols. These guidelines detailed responsibilities of DepEd offices, schools, and partners, outlining performance metrics and evaluation criteria.
The passage of the Mental Health Act (Republic Act 11036) in 2018 mandated educational institutions to develop policies and interventions promoting mental health awareness, support, and services. Supplementing this was the Implementing Rules and Regulations of Republic Act 11036 in 2019, focusing on systematic procedures for counseling learners.
The Universal Health Care Act (Republic Act 11223) in February 2019 required all schools to adopt healthy settings based on WHO standards, emphasizing health policies, school environment, health skills, parental-community links, and access to health services.
Schools were also equipped to handle vaccination schedules, with immunization records screened for learners in Grade 1 and Grade 7. Free vaccinations would be administered if necessary, and informational campaigns were conducted to promote health literacy among families.
Early Phase Response—January 30, 2020 to December 14, 2021
The early phase of the pandemic saw the introduction of 40 policies aimed at controlling the spread of the virus and supporting school communities. Key policies included the Omnibus Guidelines on the Implementation of Community Quarantine in the Philippines, providing a framework for emergency responses.
Chronic Phase Response (On or After December 15, 2021)
As the pandemic evolved into a chronic phase, policies shifted focus to vaccination drives, safe reopening guidelines, and health education. Repeated Bayanihan, Bakunahan National COVID-19 vaccination days were scheduled, aimed at achieving herd immunity. Policies for safe reopening included the establishment of effective WASH facilities and hygiene campaigns to protect students and staff.
Enablers and Barriers of School Health Policy Implementation
While policies were strong, their implementation posed challenges requiring innovative strategies and stakeholder support. Key areas influencing policy success included leadership, resources, stakeholder engagement, cross-sector cooperation, and evaluation mechanisms.
Vision and Concept
Strong leadership was pivotal in motivating teachers and administrators to prioritize student health. Clear policy objectives were essential for guiding implementation efforts. However, misconceptions among parents, stemming from previous controversies, posed barriers to program acceptance.
The folic acid is for females. DepEd Order 2017, part of the Adolescent Reproductive Health program, menstruating females. This is still for the students, in preparation for them since they’re developing. They’re prone to iron deficiency because of their menstruation. Besides this, there is also nutritional imbalance in our adolescents because as they grow, they become weak because of the food they eat. They are prone to IDA, so we supplement them with folic acid. This also affects their outputs in their studies, they might become lethargic.
(Participant 2, FGD SDO)
Parents’ skepticism toward health services, exacerbated by the dengue vaccination controversy, impacted program participation.
Because before, when we distributed deworming tablets, they didn’t accept it, the parents rejected it. One of the reasons is the dengvaxia,
(Participant 1, FGD SDO)
Dedicated Time and Resources
Resource limitations were significant barriers to implementing school health policies. Teachers cited insufficient mental health professionals, guidance counselors, and facilities as major challenges. For instance, dental procedures couldn’t be performed due to the lack of dental facilities.
Just like what we mentioned earlier, we lack medical and dental facilities. That’s why, even if they wanted to perform procedures that they need to perform, oral treatment, they can’t do so because we don’t have the facilities.
(Participant 1, FGD SDO)
Moreover, the transition to online learning highlighted technological disparities among students, complicating education delivery.
On the other hand, as classes had to transition to an online setup, informants mentioned that learners experienced issues such as having unstable internet connection and a lack of gadgets to continue their studies.
Stakeholder Ownership and Participation
Stakeholder commitment was crucial for overcoming implementation challenges. Teachers, administrators, and parents recognized the importance of continuing health programs amid the pandemic. Parental support, particularly during online learning, was essential for distributing food packs, deworming tablets, and educational materials.
During health program implementation, parents are usually the touchpoint for reaching the learners, especially during the pandemic when classes are usually held online. Thus, it was mentioned that a challenge experienced during program implementation was the inability of parents to visit the school due to work.
(Participant, KII Principal)
Team Training and Ongoing Coaching
Training programs such as Helping Fellows addressed teacher competency in mental health support. The program provided guidance on psychological first aid and referral procedures, ensuring students received appropriate care.
So we identified helping fellows from the schools, so they will provide what they learn during the training focusing on the mental health of the learners. These helping fellows, guidance counselors, others were health coordinators, it depends on the principal who they want to send or designate as participants.
(Participant 1, FGD SDO)
Cross-Sector Collaboration
Collaborations among government agencies, NGOs, health centers, and the private sector strengthened policy implementation. Partnerships facilitated the distribution of educational materials, health screenings, and mental health services. Collaboration with NGOs established informal referral systems, addressing the lack of professional mental health providers.
For us, we rarely encounter problems regarding that because it’s easy to collaborate with us.
(Participant 1, FGD SDO)
While partnerships were vital, formal referral systems remained inadequate, requiring ongoing improvements.
Compounding the lack of mental health professionals is the lack of a referral system and clear guidelines for referral. To address this challenge, informal referral systems in the form of partnerships with NGOs were established.
Data-Driven Planning and Decision-Making
Data collection and analysis played a vital role in refining health policies. Regular Program Implementation Reviews (PIRs) provided insights into strengths and weaknesses of health programs, guiding future actions. Quantitative measures such as module distribution rates, deworming tablet acceptance rates, and liquidation reports informed decision-making processes.
Actual there’s also the Program Implementation Review (PIR) that we accomplish. This is done quarterly in the division based on an operational plan…In the region also, we also have PIR with each coordinator.
(Participant 1, FGD SDO)
Monitoring tools included assessment forms cascaded from regional to division offices, ensuring consistent data collection and evaluation.
… the parents, they don’t want to accept so those are being monitored. How many accepted and how many rejected, how many were distributed to the parents. This is part of monitoring.
(Participant 1, FGD SDO)
Administrative and Management Support
Effective administration and management supported school health policy implementation. Clarity in policies, efficient resource allocation, and stakeholder engagement were critical. Communication channels and task delegation ensured smooth execution of health programs.
Quick approval, quick implementation.
(Participant 1, FGD SDO)
However, the shift to online learning necessitated flexible approaches, particularly concerning technology access and student engagement.
It seemed the programs even increased during the pandemic. Nothing was stopped. It intensified and was modified due to distance learning.
(Participant 3, FGD Teachers)
Attention to External Forces
Monitoring mechanisms ensured policy compliance and quality assurance. Regular evaluations by DepEd officials, partner NGOs, and local government units ensured effective implementation. Quality assurance certifications like ISO standards reinforced accountability.
There’s a tool cascaded from the division, there are also questions for the parents from the region.
(Participant, KII Principal)
Reward systems such as the “Region for Best Implementer of WASH” and the Seal of Effective School Governance acknowledged successful health initiatives, promoting continuous improvement.
Stage of Readiness
As the pandemic progressed, schools adapted to new realities, focusing on essential health programs like School-Based Feeding, deworming, mental health, and oral health. Online platforms like SDO Online Aralan facilitated information sharing and program management.
Since all of them are at home, we came up with SDO Online Aralan para sa Kalusugan and Dental Consultation.
(Participant 4, FGD SDO)
Integration of health content into regular school activities ensured consistent learning and improved student well-being.
Physical exercise was also integrated as a regular activity before the class starts for the day. School health and nutrition topics are also integrated into school modules when appropriate.
Despite challenges, the pandemic highlighted innovative approaches to health education, emphasizing the importance of flexible and responsive policy implementations.
Conclusion
The review of school health policies before and during the pandemic revealed a robust framework designed to protect student well-being. Comprehensive programs and guidelines addressed critical areas including nutrition, mental health, immunization, and hygiene. However, implementation challenges such as resource scarcity, technological disparities, and stakeholder skepticism required ongoing adaptation and innovation. Stakeholder commitment, cross-sector collaboration, and data-driven planning supported policy success, underscoring the importance of adaptive governance in health policy.
As schools continue to evolve in response to new challenges, the lessons learned from the pandemic offer valuable insights. Embracing flexibility, fostering stakeholder partnerships, and leveraging technology will be key to ensuring effective school health policies in the future.
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