Having made a clear link between education, health, wellbeing, and sustainability, Region Västra Götaland – responsible for regional health measures but not the local school system – is leading efforts to reduce school failures. Recognising that children’s educational progress is intertwined with health and welfare issues, it is developing cross-sectorial strategies to positively influence individual wellbeing and regional growth. All their actions are aligned with the Sustainable Development Goals.
By Elisabeth Bengtsson
There is no doubt that the population’s health is central to a country’s development. Health equity within and between countries is also recognised as being of vital importance to sustainable development. Health and well-being thus have both direct and indirect impacts on all the 17 Sustainable Development Goals (SDG) – and is one of the ultimate outcomes.
SDG number three ‘Ensure healthy lives and promote well-being for all at all ages’ is directly linked to health and health equity. In Region Västra Götaland, by targeting the social determinants of health, such as those described in SDG four ‘Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all’ a logical step between strategy and action has been taken in promoting and improving health and equity.
Region Västra Götaland has based its politics on the knowledge that there is a strong link between health and education. It has developed several strategies based on goals such as working towards better and more equal health, and combating segregation and exclusion. To make these strategies become reality for a large welfare actor such as a region, there is need for a common purpose, the creation of ownership, and the involvement and empowerment of different sectors.
Education is one of the most important social determinants of health and well-being both at the individual and the structural level. A basic education is crucial to be able to enter the labour market and to live an independent life. The level of education of a population also influences the economic growth of a region. The challenge of ensuring that every child leaves school with a good level of education is a welfare issue that involves several stakeholders.
Region Västra Götaland has therefore decided to work towards a common goal: Reducing School Failures. Creating opportunities for all children to fulfill their education depends on combining and linking different strategies and stakeholders, and offers a roadmap for a whole-of society-approach to health and regional development. It might seem strange that a public institution such as a Swedish Region, whose main responsibility lies within the health sector, takes the lead on a development process that belongs to the school system on the local municipal level. However, looking at the background factors for children to be able to come to school and to develop cognitively, you’ll find that several welfare actors are involved. High-quality childcare and parental support, specific support to vulnerable families, preschools, youth clinics and sports- and culture clubs, are some of factors which support children to fulfil their education.
If you make a deeper analysis you’ll realise that a region with a health care responsibility and a responsibility for regional development is a strong actor. Directly on the individual level within the health care services but also indirectly by taking a responsibility for a sustainable development in all its different dimensions through cross sector collaboration.
Five different themes have been identified as having the greatest impact on improving school achievements. Within each of these themes, actions have been prioritised based on evidence and according to their matter of urgency.
- Promote sustainable cross-sector cooperation.
- Promote good mental health and fight the consequences of mental illness.
- Stimulate the joy of studying.
- Reduce the negative impact that migration has on school achievements.
- Reduce the impact of social determinants and risk-factors.
Identifying the link between health and education is not a novelty but means taking the lead on a systematic cross-sector process to reduce school failures with the purpose of closing the health gap. It is a new way of thinking and working.
In the WHO-RHN report Taking a participatory approach to development and better health 2015 you’ll find key messages for a successful development process for health and equity:
- Find a common purpose for stakeholders and emphasise the potential of the common good.
- Create ownership of the process through leadership and ambassadors.
- Involve and empower other sectors not only health.
- Emphasise governance processes involving people and power over constructing formal framework of structures.
- Joint mobilisation requires leadership characterised by courage and a willingness to take risks.
The Swedish Commission for Equity in Health has made a similar analysis of how work for health and equality can become successful
- It must be through a life course approach and through different sectors.
- It must create ownership.
- It must be ongoing and systematic.
- It must have a clear focus on equality.
In the process of capacity building for reducing school failures in Västra Götaland these messages can be identified. The Regional Committee and the Regional Director has made it clear that this process involves the entire organisation and should influence partnership agreements. It is one of the most important cross-sector processes for sustainable development and the responsibility for succeeding is shared by many. The Public Health Committee has been given the responsibility for monitoring and evaluation and is seen as the driving engine of the process. It is clear though that this is not just another public health project, this is systematic long-term cross-sector work embedded within the everyday management systems.
The goal: Reducing School Failures is easy to understand, is possible to measure and you can feel accountable to it, no matter what profession you have or what organisation you belong to.
Elisabethis a senior Advisor in Public Health and Regional Developer in Region Västra Götaland Sweden. She has a masters degree in Social work and Public Administration. Elisabeth has been attached to the WHO European Healthy Cities Movement since 1998 and is currently and a member of the steering group for the WHO Regions for Health Network. She is strongly committed to public health promotion focusing on health equity and social sustainability through a-whole-government and whole-of-society approach.