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In this paper I attempts to discover the inter association of primary health care issues with the teaching-learning strategies of the school aiming for the children. I try to discover the needs of the children that would create them conscious about the primary health care both physically and mentally. Current practice of teaching has the deficient about creation the students aware about health and health care. However curriculum has recognized some of the objectives for achieving healthy behavior but the current teaching-learning situation and strategies are not enough appropriate to change the students' behavior for containable healthy body and mind. Moreover the children are not preparing accurately with the awareness that they have great tasks towards the society to build it aware regarding the healthy attitudes and behavior. Not only indicating the needs but this paper also paying attention some of the ideas (keeping in mind about the resource constrains) which could be efficient to gather the needs of the children as well as the society.Â
It is general when something begins it gets an aim.Â If we consider about education, it has also got some aims. Generally estimated by Chandra and Sharma (2004) education has two kinds of aims-the universal aims and the specific aims. Universal aims are likely to stay the same, irrelevant to the time and place. One of the commonly established objectives of education is the entire development of the human being. From the initial time to the current day and in every country of the world education has aimed to build up the abilities and tendencies of human beings in such a way that they may be able to get the highest change, both personal and social. To catch one example, the principle that a well mind needs a healthy body is a universal saying and a universal aim of education. For this grounds education everywhere consist of mental and physical training and education. In the other hand everywhere individuals build families after entering adult life and make sure new life. The human cycle goes such a system. But this all happens inside a formation which is called society and this cycle carries throughout the different social agencies. Education therefore must make sure that men and society build up in such a way that the occasions of clash and clash get reduced to a very minimum and cooperation enlarges extremely so that the cycle can circle efficiently. In the effort for survival, man needs a healthy and strong body. Beside with this, individual needs a sound thought annoying mind that can think significantly and examine the surroundings. A well mind in a healthy body is the key to continue to exist successfully in the difficult society.Â Over fifty years ago the World Health Organization described health as a state of total physical, mental and social good, not only the absence of disease and infirmity (WHO, 1948). Thus a child who has no touchable symptoms of ill health such as spots or pain may be considered as healthy. This kind of reasoning prevents us from identifying that health should involve a positive feeling of well-being. According to Hall and Elliman (2003) many factors which have the potential to badly harm a child's health may at best be disregarded and at worst stay unrecognized, if we fail to agree to that social, economic and environmental factors are as vital as biological disorders as reasons of poor health in children.Â
Children's of most cultures begin formal schooling during the primary years ages 6 to 8. The stress of schools in almost all the societies is on promoting academic education. Even in developed countries classroom teachers use the majority times given that instruction in traditional subjects especially language and reading, math and traditional science (Whiting and Edwards, 1988). What appears to be less important to parents' teachers and even child improvement researchers is physical growth and psychological improvement during the schooling years. Health consciousness is negligible highest in the poorer community like us where no one cares the true feature of consciousness structure through education to the society and among the children. Great anxiety has been uttered around the world about the nutrition and health care of every young child in poverty. Poor primary year of health status found to guess serious developmental problems later in life (pollit, 1994). In a large study of families in poverty Duncan, Brooks-Gunn and Klebanov (1994) report that elementary school children who do not have a sufficient diet or sufficient medical care suffer serious problems. The problems they face are very much connected to their daily life issues. For an example the children mostly suffer from malnutrition and this causes a lot of diseases to the children and by the time those problems turn into difficult ones such as skin diseases, dental problems, eye problems etc. children in poverty miss many more days of schools because of physical illness (Adams & Benson, 1991). Even in the rich countries it is seen that children suffer from malnutrition. In the United States, studies of eating habits in the elementary years show that American children have diets high in saturated fats, salts and sugar. (Berenson etal, 1982; J.E Brown & Pollit, 1996). Now if this is the condition then its need to find out where is the trouble lying. Apart from this as it is stated previously that World Health Organization described health as a condition of entire physical, mental and social well-being, not only the lack of disease and infirmity. So if there is no diseases in the body doesn't mean a sound health while the mind also need to be comfortable and ready for learning as the healthy mind is the key of winning learning. Now what does it indicate being sound for a child?Â Is it like feeling well same like an adult? Or it has got something different? These questions have got some easy answers. To a child it is very important to be activated. When it is seen that the child is very slow or silent the parents get concerned as they feel that there must be some problem. In nature we believe that children love to be active no matter if it playing or listening or speaking or dancing etc. the key point is their movement what shows the miter of their state of mind. While find out anything children have a tendency to show the interest or expression through movement as each of the learning whether it is positive or negative is a new knowledge for them. It is seen that when children listen something stimulating they tend to jump and clap. When children learn to talk then they ask so many question as each answer let them know something new and that is very important for them. They continue asking one after another question until we get tired answering them. Children like to contribute in everything whatever they see. They feel like they can do everything and they tend to try for it. They like to play the kind of game where they move things from one place to another they like to play like the elders, they like to draw things, they show interest in different objects specifically if it has some movement or if it colorful. When the question is about secondary level children they get the movement more and more maturely they perform the different types of play. They like to watch the cartoons as the cartoon characters never be settled in one place for long. There are some of the normal tendencies that the children show and we can guess that the kid is happy. But if we think a situation where they are bound to sit passively and quietly can we think that they are feeling fine and they are happy? Can we think that they have got the perfect environment for learning? Can we think that the mental health is balanced?Â
Children gain new motor skills in primary years. There are significant connections between motor improvement, brain growth, and learning. Children who implement during school may achieve greater brain organization and may be improved able to concentrate learning tasks. Unfortunately, motor play has turn down over time in modern society. (Jeffery Trawick-Smith, 2003). School reform efforts have reduced and in some cases abolished outdoor play time. There are trends toward deemphasizing physical growth and activity that have serious implications, including the rising rates of childhood obesity. Many schools in America have reduced the number of days children spend in physical education each week, and this includes reducing or eliminating recess periods and outdoor play altogether (Jeffery Trawick-smith, 2003). While this is the case of a modern industrialized country, being a representative of the developing country Bangladeshi system is unexplainable. We don't have even a ball in many schools so that the kids can move their feet. So how come we can think of reducing absenteeism or motivating children not to play in the street rather then be an attentive student inside the class said one of the head teachers from a rural district in Bangladesh. Now what's the solution is simple understandable. Children should provide sufficient time for playing. Its not that the recess time but they should be allowed for at least a class hour where sometime they would playÂ or sometime they would be involved in some creative things such as games, role play, debate, club activities or some project activities.
Data Collection and Interpretation
Children's education theoretically generally depends on the learning outcomes and competencies. Based on the learning competencies teachers attempt to focus their teaching to the class. The learning outcomes mainly focus the social needs, constitution, religious phenomena, developments issues, and personal needs, national and international needs. These needs are multidimensional and inter associated and all over the teaching learning circumstances it is predictable to get the competencies by the children. Now it needs to be judged whether our capabilities have the option to be conscious about primary health care? Is there anything so that the teachers get the possibility to make the children conscious about their health and health education? Teachers always tend to say traditionally that they don't have any other option to go beyond the learning outcomes as it is directed in the curriculum. Educational advisors or the policy makers try to say that being the poorest they don't have enough choice to add a new subject might be called health education. "It is not totally missing in the curriculum. We have some topics in the curriculum and in the texts which are connected to consciousness building to the children" said a science teacher. But is this so simple adding some of the text in the textbooks and make the students conscious about health?Â In the past it was thought that having knowledge would be adequate to change people's health behavior. Now it is known that behavior is subject to multiple and complex influences of which factual information is only one. What is needed is a mechanism to create the information personally relevant to the individual and present it in a form which is accessible. The goal is sustainable development in health, nutrition and family welfare rank of the people, mainly of the poor and defenseless groups, including women, children and elderly with ultimate aim of their economic and social emancipation and physical and mental well being. (National Health Policy--- An Update August, 2008). Steps will also be taken to reach basic health and reproductive health information through school curricula, is one of the strategy to reach the goal. One of the challenges within schools is to carry ways for children to participate, and allow them to make a measure of control over decisions relating to health (Hart 1992). The present curriculum has some crucial competencies already identified and given for the students. So from that context it is somehow ok but as it has been told before that it is important to let the students participate and create the ways to do it. One of the problems which are almost available in all the countries is to give the excess emphasis on recall and memorization of factual information. The environment in many schools one in which the teachers possesses knowledge which they pass on to children at their discretion. There children are seen as passive recipients and empty vessels (Freire, 1972) with little to contribute from their own experience. There are lots of ways to help children to be active and understand the fact rather then being passive and memories. When it's about the question of consciousness building and primary health care dealing with the children it needs to handle with care. There are simple ways of changing passive activities in the classroom to active learning experiences which are very familiar such as surveys, practical demonstrations, role play, and games. These changes have little or no resource implications. Some examples are given below-
Prof. M.V.C Jeffreys writes, " the school can do nothing better for the education of citizens than to make its boys and girls members of a true community in which are combined liberty and order, freedom and responsibility" The phrase member of a true community is important in terms of the responsibility of education, school and children. School needs to get ready its children in such a way so that the children can behave positively inside the society and also can contribute for building a better society.Â
Being a developing country we have so many aspects to think about like educating people, making the environment for better living, developing the humans as resource etc. these all are inter connected and it is widely recognized that education can serve this responsibility. Recently we have maximum of our children enrolled in the primary schools but it's important to remember that still most of the parents of those young children are not educated. So when we would think about living in a community the children need to think about their responsibility towards their society. For an example when a child can come to know about balanced food and different food with different essentials then he or she can let his or her parents know about that. When the child would be strong with the attitude of taking balanced diet then it won't be tough for making a balanced and healthy society. As an agricultural based country our children shouldn't be left with mal-nutrition. When a child would know the information, how to prevent mosquitoes to lay their eggs in the stored water around then he or she can look after his or her surroundings for checking if there are any stored water in the garbage or ditched broken bottles. But it's very important to change the children's behavior first. Our teachers teach the students how to make the dehydration solution but it is seen that with some exceptions parents tend to buy the oral saline (dehydration solution) from the shops. It is seen that, there's a huge number of children among the dengue victim. It seems surprising when it happens in the urban communities as well. But children should know the preventive measures of dengue mosquitoes. The school and the teaching -learning strategy should have that quality of capacity building. There is a common story which can be a very relevant to this issue---
Once the authority of a country got very worried as the local games were getting lost by the over played game Cricket and Football. So they took a decision to make a rule. They fixed some marks and they also fixed some time so that the children could play those games.Â After some days it was seen that children play those native endangered games only in that specific time but when they get recess they play Football and Cricket.Â
It is important to let the students know the information of healthy behavior while it is more important to make them aware and habituate to use the information in their behavior otherwise the result can be similar to the story. The task can be identified in two ways. If one can be achieved in a proper manner then another can be achieved by itself very easily. When children would be aware then the society would be aware as each child would aware its parents. Recently it is a very popular idea of making all, scientifically literate but isn't it equally important, to make all literate about health? Traditionally it is seen that when there is a question of awareness building no formal education always take the lead to give some sudden impact. As for example campaigning the negative impact of early marriage resulted some positive influence preventing the early marriage. But the time has come to think that, making aware about the cause-effect relationship in the formative age of a child is much better then to aware in other time through other medium.
It is very significant to assess the children's opinion regarding any issues. While the children would feel that their opinion is judged by the elders for any decision making then it is natural that they would feel their significance in the family as well as inside the society and that's very vital. WhenÂ a child come to know that whatever he is telling good or bad doesn't mean anything to the decision makers though they know something better butÂ remain unwilling rather than letting others to know. As it is mentioned above that knowing something is not enough while behavior towards anything is necessary. So the children need to get that possibility to act inside the school. They need to practice their knowledge or information through by their behavior. There are some other significant factors such as family, home environment, traditional and cultural patters of life, the media, the peer groups etc. it is seen that sometimes children start smoking by the influence of their fellow-mates while they know that smoking is bad but they do it to avoid stigmatism.Â Peer group relation act very strongly while the school should use this force towards the positive behavior.Â There is a very common believe that prevention is better the cure for any country whether it is a developed country or developing. It is more relevant for the developing country as the people can't afford sufficient money if theyÂ
Passive learning activities
Active learning activities
Lecturing: Teachers normally read the names of the healthy foods and tell the students to eat them. Traditionally the teachers read the definition of the balanced diet and tell the students to memories it.
Discussion: Teacher can ask the students, what are the foods they normally ea?Â Then he can give them some examples what the different food (represents the different category of food) works different essential task for the body and then can ask them if someone don't take a particular food then what type of problem he or she can face? This way the teacher can ask, to be fit which are the food they should take everyday? And this is how he can go for the definition for balanced diet. In continuation of this teacher can say that the food they eat everyday somehow represents different category of food that make a balanced diet and can tell them about Protein, Carbohydrate Vitamin etc.
Lecturing: The teachers normally read the symptoms of different skin diseases and tell the students to memories the characteristics and their precautions.
Project method :Teacher can tell the students to have a project which would identify a single skin diseases which a student have in any of his relative or in aÂ known person and would describe different aspects of it including the symptoms and probable precautions that he or she( the victim) could and should take to overcome from it.
Lecturing and discussion : Teachers tell the students about the importance of cleanliness and ask them to wear clean cloths and to cut their nails regularly, to use soap after coming from the toilet etc.
Physical activity: the teacher can motivate the students to be clean not only by their cloths (the poorest country like us some of the students only have one shirt which they wear the whole week) only but by nature. Teacher can tell them not to through papers here and there inside the class or not to spit inside the class. The teacher can get involved the students to clean their own class once or twice in a week.Â
Lecturing: The teacher tells children how to make oral dehydration solution.
Practical demonstration: the teacher can demonstrate how to make oral dehydration solution and help each child to make it.
Lecturing: The teachers tell the students to be positive about the nature andÂ tell them to plant trees,
Practical activity: teachers can arrange a tree plantation week or ca fix a day in every month as a plantation day while the students would plant a tree. This task could be merged with cleanliness activities as well.
There are lots of vital issues still we have left for discussion or to let the children to know such as some diseases which are very common now a days, some environmental issues which are counted as vital need, some life skills which required to achieve to survive. But there is nothing we have for our child in our present teaching-learning environment. While if there is some information (as mentioned above in the table) in the competencies and in the textbook the teachers can change their method and can make the students conscious about those issues but while no information is in the curriculum about the issues (just told before) then it makes a huge gap for building consciousness. For an example recently, Dengue is a very common fever in Bangladesh and taking some actions can prevent this disease along with some other risky fevers. But there's a missing of text regarding this consciousness building concept. Along with the text it is vital to get some strategy so that the students get themselves involved to get some behaviors such as they can remove mosquito breeding grounds by removing unused plastic pools, old tires, or buckets; by clearing clogged gutters and repairing leaks around faucets; by regularly changing water in bird baths; and by filling or draining puddles, swampy areas, and tree stumps. Eliminating such mosquito breeding areas can be a very effective and permanent way to reduce mosquito populations without resorting to insecticides. It needs to make the students conscious and beside this they need to be ready to habituate some behaviors (as discussed above) which would prevent diseases. While Defining education it's been simple told, education is the positive change of behavior, now the question is about a child's health then how far we are doing it?Â
Prevention always depends mostly on consciousness and healthy behavior. Education needs to be that much capable so that it can construct the children conscious and healthy behaving. When they would achieve these qualities they would try to conscious their parents if they (the children) feel that their voices are also important inside the family and in the society. Teachers should be conscious that they have a big role here making the students prepared for this challenge. They need to reorganize their thoughts about the children and their teaching style so that the students get enough chance to be active both mentally and physically as these two aspects are closely related to a healthy human being. Sufficient timing to play, role-playing, project work, mentoring etc are very necessary to generate the speed inside the children. Teachers need to find out new ways, how to involve the children more. If we succeed to make a healthy mind inside a healthy body among the children then for sure these children would make a better world for the next generation.