Finnish School Health Care system & Health Education

Transcription

1 Finnish School Health Care system & Health Education Elina Hermanson MD, Ph.D, pediatrician, Special competence in adolescent medicine Chief Physician / City of Helsinki, School and Student Health Care

2 Proud to be a Finn! Free school meals since 1948 Comprehensive schools grades 1-9 (7 to 15 years) >> high school / vocational school Top results in OECD Programme for International Student Assessment (Pisa) : Literacy 1.st in Europe, 6.th in the world. Nearly free university education Low drop-out numbers

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4 School drop-outs in Finland 2014* Comprehensive school: 0,46% High schools: 3,4 % Vocational school: 7,6 % *

5 Teenage abortion rates in Finland 2015: 8.4 per 1,000* England and Wales: 11.7 * National Institute for Health and Welfare, Finland & Office for National Statistics, Britain

6 Abortions in the Nordic countries in 2014 per Danmark Finland Iceland Norway Sweden VL-Medi

7 Age standardised abortion rate per 1000 women aged in the Nordic countries , ,3 8,3 11,7 11,8 Danmark Finland Iceland Norway Sweden Age-standardised abortion rate per 1000 women aged Health Statistics for the Nordic Countries

8 Abortion rates by age groups in Finland, per 1,000 women in age-group

9 Daily smoking: 15-year-old Finns % BOYS GIRLS WHO

10 Weekly alcohol yrs, boys yrs, girls yrs, boys n high school yrs girls in high school yrs boys in vocational school yrs girls in vocational school

11 In Finland, the health and well-being of adolescents are well monitored and guarded 1. Preventive health care at schools Nurses with 4.5 years of college training School health physicians (GPs) 2. Other school welfare personnel Psychologists Social workers, Special education teachers 3. Sexual health/ family planning clinics at health centres 4. Health care at health centres (GPs) 5. Secondary health care with specialists F. ex. Adolescent psychiatry 6. Since 2001, systematic, mandatory health education at schools (teachers)

12 Health education in the National Core Curriculum FINLAND Grades Upper secondary School HE is an independent subject. 1 compulsory course, 2 optional courses Vocational School 1 compulsory HE course HE is an independent subject. 3 courses, 38 lessons of each. Alltogether 114 lessons. HE integrated into biology and geography and into physics and chemistry HE integrated into environmental and natural science studies

13 NINE STEPS OF SEXUALITY Sexuality = inside process Through the emotions and love Understanding own developmental stage Permission not to hurry Self knowledge and self-esteem Respecting others Informed choises

14 2 of 3 U.S. Parents Want Schools to Expand Health education beyond sex ed and substance abuse* 2/3 wish education to cover stress and bullying 1/3 tell that those are covered 70% wish the kids to learn first aid 63% wish the kids to learn CPR we have them all, plus: Mental health, nutrition, benefits of physical activity, safety in traffic, most common health issues etc. *University of Michigan C.S. Mott Children's Hospital, news release, Sept. 19,

15 School health services = Nurses and physicians at schools Preventive care Provided on school premises Part of the student welfare services

16 School health nurses 4.5 years of college training Vaccinations Individual health promotion 1. line screening: observation Recommendation: 1 nurse / 600 pupils 1 physician / 2100 pupils (reality: )

17 Preventive care includes: Health promotion, screening, counselling, referral, vaccination Health inspection performed by Comprehensive School Grades Public health nurse x x x x x x x x x x Doctor x x x Parent present x x x x

18 School health physicians The final part of the extensive health check-up 3 times during the 9-year primary school. broad view of the well-being of the pupil a parent and the pupil present screening for diseases, growth screening for psychosocial problems and mental health support for the health promotion (most work is done by nurses and teachers) 30 minutes /family Counselling for the nurse and school personnel Referrals for the secondary care

19 World Health Organization standards for health care services for adolescents* *M Nair et al. J Adol Health 2015:57; Adolescents health literacy 2. Community support 3. Appropriate package of services 4. Providers competencies 5. Facility characteristics 6. Equality and nondiscriminantion 7. Data and quality improvement 8. Adolescents participation

20 Current issues Nationwide health reform & the welfare personnel at schools Confidenciality vs collaboration Time allocation between the health checks, and the pupils in need for a physician - evidence for health checks?! Health education >< individual health promotion by nurses ADHD Education of school health doctors

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