A Swiss-African initiative to promote health literacy

Physical inactivity, infectious diseases, imbalanced diet and high-stress levels are among the leading risk factors for disease and premature death. Particularly vulnerable are people from low- and middle-income countries living in underprivileged areas. Within these settings, children and adults alike are at an increased risk of a dual disease burden consisting of infectious diseases and non-communicable diseases. Under the auspices of the UNESCO Chair ‘Physical Activity and Health in Educational Setting‘, the KaziBantu project aims at improving and promoting health literacy as a means for a healthy and active lifestyle in collaboration with local partners. The KaziKidz toolkit, a school-based intervention, aims at improving learners’ health. It is complemented by the KaziHealth workplace health intervention for teachers. The respective educational system offers an opportunity to intervene and address the health challenges of children, as well as the children’s role models, their teachers.

All participating project schools are disadvantaged schools and situated in marginalised and socio-economically challenged areas. Schools have benefitted from the training, materials and resources provided for the Physical Activity, Health Education and Nutritional Intervention. Workshops were held with teachers, and teacher support was provided through the use of mentors throughout the intervention. Disease-positive children received treatment or were referred to local clinics for support and care.

Furthermore, students from the Nelson Mandela University (NMU) in Port Elizabeth, South Africa, and from the University of Basel, Switzerland, and Swiss Tropical and Public Health Institute (Swiss TPH, Switzerland) were trained as research assistants for the clinical, questionnaire and fitness components of the testing. Staff and postgraduate students from the Department of Biomedical Sciences at NMU were trained in the laboratory methods used in the study. Collaboration and exchange among involved researchers from South Africa and Switzerland became integral to all project related activities.

The KaziBantu project emerged from the joint research project ‘Disease, Activity and Schoolchildren’s Health’ (DASH) between the University of Basel, the NMU and Swiss TPH. The DASH project was initiated in 2013 through a grant fund under the Swiss South African Joint Research Programme (SSAJRP). The call was funded equally by the National Research Foundation (NRF) and the Swiss National Science Foundation (SNSF). In addition, based on the KaziBantu study, a follow-up study consisting of the at-risk population (children and teachers) for non-communicable diseases was funded by the SNSF. The links between the research foundations of both countries are conducive and the embassies of the two countries are responsible for political support.

So far, we have reached several thousand school children and several hundred teachers with our initiative. Since the first implementation of the health-programme in the DASH study, the teaching materials in the area of physical education and general health promotion for primary schools have been enhanced, expanded and further developed with the support of the Novartis Foundation. Under the auspices of the UNESCO Chair ‘Physical Activity and Health in Educational Setting’ the teaching material will be made available to other educational institutions in Southern Africa. All of these interventions are relevant for national interventions, which allow for the further support of the Swiss Embassy in Pretoria to demonstrate the societal impact of the SSAJRP. Hereby, the Swiss Embassy supports the roll-out of the interventions through (i) high-level engagements with the Departments of Health, Basic Education and Social Development for their support to ensure national roll-out; (ii) engagement with the country representatives of the United Nations Agencies in South Africa, including the World Health Organization; (iii) creating a platform for the research team to engage with relevant stakeholders; (iv) facilitate interviews for the research team with the South African Broadcasting Corporation (SABC); and finally (v) undertaking advocacy events through the hosting of showcase events for politicians and decision-makers. Furthermore, through the collaboration between principals, teachers, School Governing Bodies (SGBs), researchers and the Department of Education as well as the Department of Health, regular mass deworming schemes have been put back on track.

Presentations at national and international conferences were held and dissemination of the parasitological results of the study promoted to the local community, for example at the South African Association for Health Educationalists (SAAHE) conference, Department of Health and Anti-Poverty Steering Committee Meeting of the Port Elizabeth municipality was achieved.

Our activities aim at reducing the dual disease burden in disadvantaged community groups for both children and teachers alike and we further aim at providing the crucial evidence to facilitate change. The Children’s intervention focuses on deworming, health and hygiene measures, well-balanced nutrition, and regular physical activity. The three Short Learning Programmes (SLPs) that have emerged from the previous project activities ((i) KaziKidz Foundation Phase, (ii) KaziKidz Intermediate and Senior Phase, and (iii) KaziHealth, a teacher’s health promotion programme) are to be sustainably anchored in the South African Continuing Professional Development Programme (CPD) for teachers and will be accredited by the South African Council of Educators (SACE). It is in the interest of the SSAJRP to further support the programme to demonstrate the societal impact of bilateral research collaboration. It will be essential to ensure joint research projects’ sustainability through linkages and cooperation with existing structures and programmes. The support of the Swiss Embassy, politicians, health advocates and other important stakeholders will give us political leverage to tackle the next steps. The intention is to roll out the intervention nationwide and make it available to all schools in South Africa.