This article was originally published by WHO and is republished with permission.
Region Västra Götaland
A basic education is one of the most important social determinants of health and well-being, empowering people to live a healthy, independent life and contribute economically and socially to their communities. Acknowledging this, together with the strong impact that the education level of a population has on a region’s economic growth, Västra Götaland Region in Sweden has taken the lead on an ambitious cross-sector initiative entitled “Reducing School Failures”.
The Swedish school system is divided into two parts: the compulsory school, grades 0–9 (age 6–16) and the three year voluntary high school. A majority of children (about 90%) apply for high school. The goal of the initiative is to ensure that every child is able to fulfil the requirements of the curriculum (both at the lower and higher level) and thus become eligible for further studies.
The Swedish region, a member of the WHO Regions for Health Network (RHN), is a public institution whose main responsibility lies with the health sector and regional development. But while education may not be traditionally considered part of their remit, they recognized that the factors that enable children to attend and succeed at school often involve multiple welfare actors at various levels, making it challenging to effect change at the municipal school system level.
Crucial needs, such as providing access to high-quality mother- and childcare, parental support, preschools, youth clinics and sports and cultural clubs, as well as specific support to vulnerable families, could only be met through collaboration. Realizing that their role in both health and regional development put them in a unique position as a strong actor, both directly through health-care services and indirectly by taking responsibility for sustainable development through cross-sector collaboration, Västra Götaland chose to take action.
To increase opportunities for all students to complete their education, they integrated and linked the various strategies and stakeholders into a roadmap, comprising a whole-of-society approach to health and regional development. The roadmap incorporated not only activities that address children and adolescents in general, but also those specifically targeted to children and adolescents at risk, or experiencing particular challenges.
Five areas for joint action were identified and specific tasks formulated under each area, with responsibility for these tasks then allocated to the relevant departments or actors. The key areas for action were:
- promoting sustainable cross-sector cooperation
- promoting mental health and fighting the consequences of mental illness
- reducing the negative impact of migration on school achievements
- stimulating the joy of studying
- reducing the impact of social determinants and risk-factors.
While making the link between health and education is not a new concept, using it as common ground to lead a systematic cross-sector initiative with the purpose of improving education rates and closing the health gap, is a new mode of thinking and working.
With its Public Health Committee driving the process and taking responsibility for monitoring and evaluation, Västra Götaland is leading by example through what is not just a public health project, but systematic, long-term, cross-sector work embedded within the existing management and governance systems.
Steps for a successful development process for health and equity
The Reducing School Failures initiative was created in alignment with best practice guidelines for the successful development of processes for health and equity, as outlined in the RHN publication “Taking a participatory approach to development and better health”. The key steps presented in this report include:
- finding a common purpose for stakeholders and emphasizing the potential of the common good;
- creating ownership of the process through leadership and ambassadors;
- involving and empowering other sectors not only health;
- emphasizing governance processes involving people and power over constructing a formal framework of structures;
- achieving joint mobilization, requiring leadership characterized by courage and a willingness to take risks.
The goal of Reducing School Failures, to create opportunities for all students to fulfil the requirements of the curriculum, acts not only as a benchmark for improving the lives of individuals and the sustainable development of their region, but also as a call to action for all stakeholders involved, regardless of profession, organization or level.