Showcasing HEARD’s Work in School Health: Informing a Revised Integrated School Health Policy
HEARD continues to play a pivotal role in strengthening South Africa’s response to adolescent and youth health by contributing rigorous research to policy review processes. One such example is our recent evaluation of the Integrated School Health Policy (ISHP)—a collaborative initiative of the Departments of Basic Education (DBE), Health (DoH), and Social Development (DSD). First implemented in 2012, the ISHP provides a framework for delivering comprehensive health services to school-going children across the country.
Over a decade after its adoption, the ISHP is undergoing a critical review to ensure its continued relevance and alignment with both national priorities and evolving global standards for school health. HEARD led the independent evaluation process to assess how effectively the policy has been implemented, and whether it meets its goals of improving learner health, reducing health-related barriers to learning, and supporting educational outcomes.
What We Did
Our evaluation combined three key activities:
- Review of policy documents and literature to assess ISHP alignment with national strategies and global frameworks, including UNESCO/WHO standards.
- Quantitative indicator analysis using data from 2013–2023 to assess the reach and effectiveness of ISHP health services and screening.
- Multilevel consultations with government stakeholders from national, provincial, and district levels to gather qualitative insights into coordination, implementation, and resourcing challenges.
What We Found
- Policy Alignment and Literature Review:
South Africa’s children face multiple, intersecting health challenges—described in our findings as “colliding epidemics”—including HIV, mental illness, violence, and malnutrition. The ISHP remains a critical mechanism for addressing these issues, but must now evolve in line with national policies such as the Adolescent and Youth Health Policy, the Prevention and Management of Learner Pregnancy Policy, and the National Health Insurance (NHI) Bill. The revised ISHP should explicitly address gaps in sexual and reproductive health services, psychosocial support, and safe transport to health services. - Service Coverage and Outcomes:
Screening coverage—especially for Grade 1 learners—remains far below national targets, with significant variation across provinces. While there are promising signs, such as decreased obesity rates and high HPV vaccine uptake, the data also highlight persistent gaps. For example, sexual health behaviours among youth remain risky, and limited data on referrals and follow-up care hinder a full understanding of ISHP effectiveness. - Stakeholder Consultations:
Our engagements with provincial and district task teams revealed strong national commitment but inconsistent implementation on the ground. Clarifying the role of the DSD, enhancing resource allocation, and improving coordination across all levels were recurring themes. Notably, the evaluation called for improved monitoring and evaluation systems—including standardized data collection tools—and the addition of a pandemic preparedness component based on lessons from COVID-19.
Why It Matters
This evaluation comes at a pivotal moment. With the policy due for revision, HEARD’s work provides an evidence-informed foundation to guide the next generation of school health programming in South Africa. The recommendations aim to strengthen cross-sector collaboration, improve health service access and quality for learners, and ensure that the ISHP is better aligned with both local needs and international standards.
As South Africa works toward achieving universal health coverage and quality education for all, HEARD remains committed to supporting data-driven, equitable solutions that improve the lives of children and adolescents.
For more information on HEARD’s work in adolescent and school health, please contact Prof Gavin George georgeg@ukzn.ac.za