CHAPTER ONE

INTRODUCTION

1.1      Background of the study

A communicable disease is an illness caused by a specific infectious agent or it's toxic products(1) .It arises through transmission of that agent or its products from an infected person or animal to a susceptible host either direct or indirectly through an intermediate plant or animal host ,vector or the inanimate environment (2). Infectious disease can be a major cause of illness among children and can affect a child's schooling by causing absenteeism .They may in turn, affect other children and staff, and can prevent parents careers ability to work, especially where both parents careers work (3) .School health programs could not be fully implemented without having staff and parent's cooperation and involvement .Parents, community leaders and teachers often can and do serve as role models for students. Students serve as a linkage with school and family while parents can and should cooperate with schools to help their children. (4)Communicable diseases spread quickly among students in the classroom, there must be gathered printable and advise for germ prevention in school (5). Recent years have seen a dramatic increase in public concern about communicable diseases in the schools all over the world .School administrations must find ways to strike a balance between protecting the general school population from exposure to dangerous communicable diseases and ensuring the infected student's right to privacy and to public education. This study focuses on evaluation of health education as a tool to the prevention and control of communicable diseases among primary school pupils, excluding immunization and harm reduction interventions, which are the subjects of additional evidence. It takes its lead from two meetings, one held by Interior Health in November 2005 and a second by Vancouver Health Authority in February 2006, which focused on population health and health promotion, including specific sessions on their relevance to communicable diseases. Both meetings demonstrated the gap between the rich discourse located in academic literature on health promotion and population health and its application on the ground. More so, these meetings confirmed that health promotion strategies have not been a priority focus of communicable disease prevention initiatives. This was reconfirmed through a search of the literature and discussions with a key informant that has been intimately involved with international reviews of the evidence base for health promotion. Health protection strategies important to communicable diseases include those relevant to safe food, drinking water and recreational water, and adequate community sanitation. Preventive intervention strategies, which impact on communicable diseases, include primary prevention initiatives such as immunization and vector control, and early secondary prevention strategies such as post-exposure prophylaxis, screening and treatment of communicable diseases and contact tracing and management. Health assessment and disease surveillance strategies important for communicable disease prevention and control include detecting disease clusters and outbreaks through community-based, hospital-based, and clinical epidemiology, and laboratory surveillance networks, health promotion strategies important for communicable disease prevention and control, which are the focus of this evidence study, include a set of strategies that enable people to increase control over and improve their health. Health promotion strategies are considered to be equally valid for the prevention and control of communicable diseases, 1 despite the focus of this approach on non-communicable diseases, especially in the developed world. The Bangkok Charter, developed in August 2005, explicitly mentioned communicable diseases in its revised definition of health promotion. This renewed interest is also evident in Canada and can be ascribed to the growing concern about the threats posed by a number of communicable disease trends, such as the persistence of AIDS and hepatitis C, the advent of new and emergent diseases, and the continuing development of antimicrobial resistance. These concerns have served to emphasize the important contribution of health promotion strategies to the prevention and control of these diseases. Before turning to review the evidence for effectiveness of health promotion strategies in tackling communicable diseases, let us briefly locate health promotion within the core functions framework and review its parameters and the continuing evolvement of its philosophical constructs. The need for this is dictated by the largely conceptual basis of the Ottawa Charterii and similar health promotion frameworks, and the fact that in relation to their conceptual and strategic development, health promotion and public health are customers of social, behavioral and other sciences. This leads naturally into a consideration of a model to guide the assessment of the evidence of health promotion strategies in tackling communicable diseases.