Development of a community-specific health promotion plan to improve children's health in rural Guatemala

Abstract

The WHO Health Promoting School (HPS) approach embraces a comprehensive, integrated construct of a health promotion strategy aimed at the specific participation of the local school, health services and other stakeholders. The objective of this study was to initiate the development of a community-specific health promotion plan for the primary school in Llano Largo to reduce hygiene- and sanitation-related health problems among children. Participatory Rural Appraisal (PRA) techniques and Argumentative Policy Analysis (APA) were applied to assess the underlying causes of health-related problems and to initiate the process of social learning among stakeholders, including parents, teachers, the village committee and representatives from the local hospital, local NGO, local government, and the village church. Stakeholders defined five core problems: 1) serious lack of hygiene; 2) no doctor and a lack of medicines; 3) hunger and malnutrition; 4) absence in school as a result of child labor; and 5) no discipline in school. Lack of communication, organization and education seem to be the underlying causes of these problems. In line with the HPS concept, a community-specific health promotion plan was constructed. A "Social Communication Work Group" was elected to execute the plan. In conclusion, PRA and APA techniques were successful to implement a HPS plan in Llano Largo. Follow-up studies should determine the long-term efficacy of the plan.