|Public health; School Health and Nutrition; Evaluation; WASH; Peer-to-peer Education; Save the Children; Kenya
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Background: Kenya continues to face challenges with the health of schoolchildren due to poor management and dissemination of guidelines and services. The 2009 National School Health Policy provided a building block for improvements in health programming in schools, but much progress has been stymied due to lack of resources, a failure to focus on WASH as the root cause of many health issues, and programming that promotes unsustainable health activities and practices. School Health and Nutrition programs are essential to addressing these issues and improving children's abilities to learn effectively, stay in school, and contribute to their communities. Objective: This project evaluated Save the Children's School Health and Nutrition program implemented in Nairobi, Kenya from 2013 to 2015 to determine the success of indicators, goals, and objectives. The purpose of this project was to determine the potential effects of the SHN program on schoolchildren's knowledge, attitudes, and practices, as well as the state of health in schools in Nairobi. This project sought to use findings to make recommendations to all stakeholders, as this was the first complete endline evaluation done for a Save the Children SHN program in Kenya. Methods: The endline evaluation was performed using a cross-sectional study design. Endline data was collected at one point in time for each sampled school using student questionnaires, head teacher questionnaires, facility observations, and school records. The endline evaluation design measured differences between baseline and endline for stated objectives and indicators and stratified results to find correlations. The evaluation was carried out in the same fashion as the baseline evaluation conducted in 2013. Results: School attendance rate increased and diarrhea incidence decreased among schoolchildren in program schools over the two-year period. Gaps between knowledge and behaviors, such as handwashing, were still found to exist. Stratified results found correlations between rural or urban school location and certain measured factors. Further, results comparing students in School Health Clubs and those not in SHCs showed that while that status may play a factor in health, the peer-to-peer trickle down effect caused equality among many SHN elements. Discussion: Despite limitations due to issues with baseline evaluation and program implementation in 2013, this endline evaluation found positive effects of the program on a range of health topics. Students and teachers reported program activities as positive influences on overall school health. Lastly, sustainability efforts have provided an avenue for schools to continue SHN activities, and lessons learned will be used in the implementation of future Save the Children SHN programs in Kenya. TABLE OF CONTENTS – Chapter 1: Introduction 1 – 1.1 Introduction and Rationale 1 – 1.2 Problem Statement 1 – 1.3 Purpose Statement 3 – 1.4 Objectives 3 – 1.5 Significance 4 – Chapter 2: Literature Review 5 – 2.1 Background of SHN/WASH in Kenya 5 – 2.1.1… Advisors/Committee Members: Clasen, Thomas (Thesis Advisor).