Strengthening school health in Namibia: A framework for policy development, implementation and evaluation

Abstract

Background: Schools in rural Namibia face severe health challenges (malnutrition, infectious diseases, poor sanitation), leading to high learner absenteeism and poor academic performance. Current school health policies are often fragmented and insufficient to address these issues comprehensively.
Aim: This study aimed to develop an evidence-based, contextually relevant conceptual framework to enhance school health policies in Namibia and similar resource-limited Southern African settings.
Setting: The problem context is rural areas across Southern Africa. The resulting framework is specifically tailored for implementation in Namibia.
Methods: This study employed a convergent mixed-methods design. A systematic review (following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines) synthesised evidence on African school health policy. Qualitative data were collected through 15 key informant interviews and 3 focus groups (n = 30) with key stakeholders, including educators, healthcare professionals and community members, using purposive sampling and thematic analysis.
Results: The study developed a conceptual framework for Namibia. It integrates key components: evidence-based policy development, equitable resource allocation, capacity building and robust monitoring and evaluation. The framework emphasises stakeholder collaboration and addresses specific rural challenges, such as infrastructure gaps and inconsistent implementation.
Conclusion: The proposed framework provides an evidence-based, contextually relevant approach to significantly improve school health policies in Namibia. It directly addresses the unique challenges of resource-limited Southern African settings.
Contribution: The framework fills a crucial policy gap and offers a differentiated model focused on improving learners’ health and educational outcomes, moving beyond generic global approaches.