/ 20 District Health Boards

PUBLIC HEALTH SERVICES

SOCIAL ENVIRONMENTS and

HEALTH PROMOTING SCHOOLS

Tier LEVEL TWO

Service Specification
Status:
This service specification may be amended for agreements as required to meet local needs. / NON-MANDATORY

Review History

/

Date

Approved by Nationwide Service Framework Coordinating Group (NCG)
Published on NSFL
Review: Public Health Handbook (2003):
Amendments: inserted in standard service specification template, addedPurchase Unit table, Service linkages and Quality requirements, includes linkages to tier one Public Health Services tier three Refugee and Migrant service specification. / March 2010
Change of status to non-mandatory as an interim step before the specification is retired or replaced.
/ November 2016

Note:Contact the Service Specification Programme Manager, Ministry of Health, to discuss the process and guidance available in developing new or updating and revising existing service specifications. Nationwide Service Framework Library website

PUBLIC HEALTH SERVICES -

SOCIAL ENVIRONMENTS AND HEALTH PROMOTING SCHOOLS

TIER LEVEL TWO

SERVICE SPECIFICATION

This tier two Service Specification for Public Health Services - Social Environmentsand Health Promoting Schools service specification must be used in conjunction with the overarching tier one Public Health Services service specification.

Refer to the Public Health tier one service specification under the following headings for generic details on:

  • Service Objectives
  • Service Users
  • Access
  • Service Components
  • Service Linkages
  • Exclusions
  • Quality Requirements

The above heading sections are applicable to all Service delivery.

1.Service Definition

This Service includes:

  • social environment:

­healthy cities and communities

­healthy housing

  • health promoting schools (previously known as Healthy Schools/Kura Waiora) and
  • health impact assessment.

1.1`Social Environment

Social environment initiatives focus on strengthening community action to create environments that enhance social cohesionreduce health inequalities and achieve population health and wellbeing.

1.2Health Promoting Schools (HPS)

Health Promoting Schools refer to the Ottawa Charter-based community action approach to promoting health and wellbeing in the school setting. Community action for health refers to collective efforts by communities which are directed towards increasing community control over the determinants of health, and thereby improving health. The Ottawa Charter emphasises the importance of concrete and effective community action in setting priorities for health, making decisions, planning strategies and implementing them to achieve better health (WHO Health Promotion Glossary, WHO, 1998).

Community action utilises action and strategies to address local priorities. It is about finding ways to enhance the community and the environments that people live in. It relates to the concept of community empowerment where individuals and organisations in the community apply their skills and resources in collective efforts to address health priorities and meet their respective health needs (WHO Health Promotion Glossary, WHO, 1998). Community action is complemented by the implementation and enforcement of relevant national/local policies and regulations –together they form an important mechanism for increased control over determinants of health and for improving the health of disadvantaged people groups.

1.3.Health Impact Assessment(HIA) is defined as a combination of procedures, methods and tools by which a policy may be assessed and judged for its potential effects on the health of the population, and distribution of those effects within the population.

There are two levels of health impact assessment:

  • policy level HIA
  • project level HIA.

2.Service Objectives

2.1Social Environment

  • promote the health and wellbeing of communities and population groups through community initiatives and intersectoral action to enhance the social settings where people live, work and play
  • increase community participation in national, regional and local planning processes that affect community wellbeing
  • strengthen strategic alliances and interagency networks to promote supportive social environments.
  • Health Promoting Schools

Initiative objectives are to work:

  • in partnership with Māori, Pacific and other high needs groups to achieve Whanau Ora/community health and wellbeing
  • in partnership with schools and their communities to promote school social and physical environments that improve the health and wellbeing of young people, thereby contributing to positive learning outcomes and reducing barriers to learning
  • collaboratively with the education sector and school communities as they develop social and physical school environments, which promote, improve and protect the physical, social, cultural and emotional wellbeing of students and staff.

2.3Health Impact Assessment

To ensure a systematic consideration of the potential health and well-being impacts of policies being developed by public policy makers to achieve improved health outcomes and reduce inequalities.

2.2Maori Health

Refer to the tier one Public Health Services service specification.

3.Service Users

3.1Social Environments

Social Environments initiatives are undertaken primarily to ensure inclusion of vulnerable population groups and promote social cohesion. Communities at risk of social marginalisation may be identified on the basis of ethnicity, geography (including both rural and urban communities), and age (youth and older people) and socio-economic status.

3.2Health Promoting Schools

Schools that express agreement and commitment to becoming a HealthPromotingSchool (particularly the school principal and Board of Trustees.

3.3Health Impact Assessment

Policy level HIA often focuses on the broader determinants of health such as urban planning and growth, transport infrastructure and social cohesion. Many of the policy decisions on these determinants are made outside of the health sector. The health system has an important role in indirectly influencing these broader determinants of health.

District health boards (DHBs), public health services, non-governmental organisations, iwi and local Māori communities, local authorities and other public policy making bodies can apply HIA methods and approaches.

4.Access

Refer to the tier one Public Health Services service specification.

5.Service Components

The following service component tables are in part two and part three of this service specification

  • social environment

­healthy cities and communities

­healthy housing

  • health promoting schools (previously known as Healthy Schools/Kura Waiora)
  • health impact assessment.
  • Process
  • Social Environment Service

Components of Service / Service Description/Activities
Increase community participation in national, regional and local planning processes that affect community wellbeing. /
  • Promote evidence-based research and programme logic to inform and support community engagement in national and local policy and planning processes in order towork towardsimproving social environments and population health outcomes.
  • Provide resources to support community capacity and capability to take action to improve population health and reduce inequalities in health outcomes.
  • Enable and facilitate Maori participation and partnerships at all levels of policy, planning, service delivery and evaluation of programmes with the potential to promote whanau ora.
  • Enable and facilitate participation of Pacific peoples and other minority population groups in programmes that may affect their health and wellbeing.

Strengthen strategic
alliances and interagency networks to promote supportive social environments /
  • Encourage researchers and planners across non-health sectors to promote healthy social environments as determinants of individual and community wellbeing
  • Work with non-health agencies to explore the extent that public healthissues are being addressed and the opportunity for these issues to be placed on their policy and planning agenda
  • Build collaborative relationships across health and other sectors, especially including local government, to address urban and other community concerns.
  • Support the development/maintenance of national, regional and local networks and intersectoral initiatives that address social determinants of health (e.g. HealthyCities/ Communities).
  • Enable Māori participation and partnerships at all levels of programmes promoting healthy social environment.

Increase the use of Health Impact Assessment as an inclusive approach to evaluating the impact of programmes across a wide range of sectors on health and wellbeing. /
  • Undertake HIA activities (screening, scoping, appraisal and reporting, evaluation) using current HIA tools available, including the Public Health Advisory Committee’s Guide to Health Impact Assessment and the Ministry of Health’s Whanau Ora HIA tool
  • Build partnerships across a range of sectors to support the development and effective use of HIA methods and approaches.
  • Promote an organisational commitment to the adoption of HIA (i.e. embedding HIA into organisational decision-making).

Monitor and assess the quality and
effectiveness of Social
Environment initiatives /
  • Encourage and/or support communities to assess health status and maintain profiles of vulnerable population groups.
  • Encourage and/or facilitate local research projects to determine community needs to guide the development of Social Environment initiatives.
  • Encourage communities to undertake evaluation of initiatives and strategies to assess programme effectiveness.
  • Identify, communicate and disseminate information about effective community action initiatives.

5.1.2Health Promoting Schools

Components of Service / Service Description/Activities
Support the development ofschool infrastructuresthat promote the health and wellbeing of students and staff / Provide a Health Promoting Schools (HPS) advisory service to schools and kura kaupapa
Introduce the concept of the HPS initiative to schools and Boards of Trustees
Invite schools to commit to developing a HPS and establishing a HPS team
Identify schools as .Active Health Promoting Schools, Towards Health Promoting Schools and StandardServiceSchools, according to defined criteria, and provide defined levels of service to each category
Encourage and assist schools to:
  • identify a staff person or community member to co-ordinate the HPS team
  • undertake a school needs assessment
  • identify health promoting priorities (being mindful of Ministry of Health priorities)
  • develop and implement an action plan
  • review and evaluate initiative, identifying areas of need and setting goals for future action.
Encourage a workforce development plan to be implemented for HPS teams that include principal, staff, parent/caregiver, student representation
Assist schools to establish school health teams to drive the HPS initiatives. These teams could include principals (or school managers), health education teachers or other teachers, students, parents/caregivers/whanau, public health nurses, other community/agency members
Encourage schools and communities to give particular attention to partnership with Māori and addressing Māori health and wellbeing needs
Encourage schools to address health and wellbeing issues for Pacific people, Asian, refugee/migrant and other groups with high needs
Encourage schools to focus on and address health inequalities, mental health issues, and nutrition and physical activity as part of their HPS work.
Increase adoption of policies and environments that promote the health and wellbeing of students and staff / Encourage and assist schools to develop and implement health promoting policies, eg, Smokefree, SunSmart, Healthy Eating Healthy Action, mental health promotion, environmentally safe schools, behaviour management policies, bullying and non-violence policies
Promote the use of the national Health Promoting Schools resources (available through authorised health education resource centres in public health units), including Guidelines for Mentally Healthy Schools, and HPS resources for Māori and Pacific communities.
Increase schoolcommunity awareness and knowledge abouthealth and wellbeing / Support workforce development for school managers, HPS teams, Boards of Trustees and students involved with HPS
Encourage the school to comprehensively implement the Health & Physical Education Curriculum
Assist schools to identify and access quality health education programmes, agencies, resources and information to support the delivery of the Health and Physical Education Curriculum
Develop and provide support/information/resources to schools and their communities to address health priorities and needs
Encourage health promotion practitioners and researchers to raise the profile of HPS through the media and through conferences, workshops, and other community forums (eg, injury prevention, mental health promotion, sexuality education and nutrition educators/health promoters)
Develop and/or participate in developing and disseminating newsletters, fact-sheets, website information and sharing information regionally and nationally
Provide advice to the sector and the public on HPS.
Increase the levelof community action topromote health and wellbeing in schools / In conjunction with schools, work with Iwi and local Māori communities to identify health and wellbeing issues and implement appropriate strategies to encourage schools to be positive environments for students and whanau
Provide opportunities for and encourage the involvement of parents/caregivers and famil and whanau in HPS
Implementing programmes that build on factors that positively influence whanau ora such as:
  • programmes that strengthen ties with whanau resulting in shared and informed problem-solving
  • Building community cohesiveness through activities that make Māori and key stakeholders effective in their respective roles.
Encourage, initiate or provide input to community events or programmes that aim to promote health and wellbeing of school communities.
Strengthen strategic alliances and interagency networks to promote health and wellbeing in schools /
  • Foster the development and maintenance of interagency networks to ensure there is liaison and coordination between schools and providers of health, social and education services
  • Foster relationships with Iwi and Māori organisations and work collaboratively to create supportive school and community environments
  • Enable Māori participation and partnerships at all levels of public health services
  • Facilitate collaboration between sectors/agencies involved in the school social environment and health promotion initiatives to achieve cooperation, coordination and collaborative action
  • Develop and monitor the implementation of intersectoral strategic action plans to deliver HPS initiatives in geographic localities
  • Support the development of HPS regionally and nationally
  • Work with education sector stakeholders at Ministry, national and regional levels to facilitate greater partnership in the implementation of HPS.

Strengthen skills and knowledge of the health sector and other change agenciesto promote health and wellbeing in schools. /
  • Ensure health provider staff are thoroughly inducted to HPS and receive ongoing HPS workforce development training
  • Create training opportunities for other relevant health and social service providers working with HPS.

Monitor and assess the quality and effectiveness of HPS initiatives /
  • Monitor and evaluate health provider HPS activities and ensure these are consistent with Ministry of Health priorities and strategies
  • Support schools to monitor and evaluate their respective HPS initiatives. For example, schools may:
­develop baseline data for the purposes of monitoring progress made towards the schools achieving their HPS objectives
­include evaluation components in the design of programmes delivered as part of a HPS initiative to assess their ongoing effectiveness
­undertake and support local research projects to determine needs and to guide programme development.

5.1.3Health Impact Assessment

Components of Service / Service Description/Activities
Undertake HIA activities (screening, scoping, appraisal and reporting, evaluation) using HIA tools available in New Zealand and internationally. /
  • Carry out HIAs by systematically applying the steps in health impact assessment methodology:
­screening including judging whether the policy has the potential to affect the health of the population
­scoping including establishing the foundations and boundaries for undertaking the HIA
­appraisal and reporting including describing the potential benefits and risks to health, and determining their nature and magnitude
­evaluation including process, impact and outcome evaluation.
  • Document the outcomes of each stage of the HIA process, even if a complete HIA does not proceed.
  • Enable Māori participation and partnerships during each stage of an HIA.
  • Identify and facilitate the participation of health and non-health sector agencies in an HIA process to reflect the determinants of health or policy decisions that are being considered.
  • Identify and consolidate opportunities for integrating HIA methods with other impact assessments (such as social impact assessment, cultural impact assessment, and environmental impact assessment) that are being undertaken on the same policy proposal.
  • Identify and include current local or regional indicators for monitoring health outcomes social, economic, environment, cultural wellbeing in the appraisal and reporting stages of an HIA.
  • Develop regional or local HIA networks that include health and non-health sector agencies to build the capacity and increase the evidence base for HIA.

Build partnerships across a range of sectors to support the development and effective use of HIA methods and approaches. /
  • Identify appropriate regional or local partners or services that have programme goals, objectives, resources and people necessary to apply health impact assessment methods and activities.
  • Work with iwi and local Māori communities to identify how HIA tools, including the Whanau Ora HIA tool, can be applied to assess the impacts on whanau ora of a proposed policy
  • Participate in policy-making process led by non-health sectors to promote and apply HIA methods and approaches.
  • Identify resources required to develop, negotiate, implement, evaluate and sustain the planned HIA activities.
  • Develop and evaluate measurable HIA outcomes that are meaningful to all partners involved.

Develop an organisational commitment to the adoption of HIA (ie. embedding HIA into an organisation’s decision-making). /
  • Identify and enhance opportunities to embed HIA methods and approaches into the core business of the service or organization.
  • Establish or reorient positions to focus on HIA activities including embedding HIA within organizational practices, providing technical advice and support on HIA, commissioning HIAs and identifying and delivering opportunities for HIA training.
  • Establish an organizational database of completed HIAs, including literature reviews and recommendations, and HIA practitioners to support the local and regional capacity and evidence-base for HIA and provide this information to the Ministry of Health’s HIA Support Unit to assist in capturing the overall development of HIA across the country.

Provide awareness raising presentations, training sessions in the use of HIA, its value and benefits within and across organisations. /
  • Promote the HIA tools and guidelines available in New Zealand, including the Public Health Advisory Committee’s guidelines on HIA (2nd edition, 2005) and the Ministry of Health’s Whanau Ora HIA tool (2007).
  • Identify and explore opportunities to resource HIA local and regional training needs.
  • Develop, distribute and update locally-relevant information about the use and benefits of HIA, including the resources available at a national and local level.

5.2Settings