1 Foreword
The Council of Ministers of Education, Canada (CMEC) is pleased to present this status report on the policies, programs and practices of school and public health systems. This report describes and discusses the existing policies, programs and practices of school and public health systems in Canada. A telephone interview survey was used to collect information on the activities of education and health ministries, school districts and public health units, schools and public health nurses and teachers. Eight focus groups were held with students and parents to clarify perceptions and problems. This report summarizes the findings from the analysis of the data from these two sources.
HIV/AIDS continues to be a major health risk for Canada’s young people. Recent data on the transmission of HIV shows that the teen years are often the time when the disease is contracted. Research on other sexually trans
mitted diseases reports similar findings. Evaluations of sexuality education programs, preventive health services and the coordination of instruction, health services and community support show that such programs do prevent the transmission of HIV and other health problems.Schools have more influence on the lives of children and youth than any other social institution other than the family. Schools form the "workplace" of over 20% of the Canadian population, including five million students and over 400,000 employees. Another 30% of the population, parents, have a direct stake in the school. In Canada, the role of the school has always included a concern for the health and social development of children since schools were started by churches and charities in the 19th century.
The public health system is the only public service with a primary mandate to prevent health and social problems in the population. While medical and social services respond to crisis and treatment needs, the public health system works with the available resources in the community and delivers services that prevent disease and promote the health of the population.
The education systems in all provinces and territories in Canada require that students receive instruction on sexuality issues and HIV/AIDS. All public health systems in Canada require that preventive sexual health services are offered to adolescents and that universal hygienic precautions are taken to prevent HIV. However, there has been no comprehensive report on the status and implementation of such programs. Indeed, there have been few reports on the status of policies, programs, services and practices for most health and social problems.
Consequently, this study will help to set a baseline for decision-makers to consider in reviewing the capabilities of their respective school and public health systems.
2 AcknowledgmentsThis study is part of a long tradition of cooperation between the Council of Ministers of Education, Canada (CMEC) and the AIDS Prevention and Community Action Programs of Health Canada.
Such cooperation has included the development and evaluation of a Grade Nine AIDS Education program that was integrated into the curricula of several provinces after the research showed that such programs have an effect on sexual behaviour.
The CMEC, with funding from Health Canada, has produced educational resources to fill identified gaps in the materials available to teach sexuality and HIV education and has compared the impact of different approaches to teacher education about HIV/AIDS. CMEC has also jointly funded workshops to disseminate HIV-related educational materials with the AIDS Prevention and Community Action Programs.
This study comes at a time when school systems and public health systems are undergoing rapid change. In the past three years, the number of school districts in Canada has dropped from over 1000 to approximately 640. Health ministries are regionalizing public health services and also reducing the number of health units and community health centres.
These two systems, schools and public health, are under considerable pressure from society to respond to many health and social problems that challenge students today. Youth unemployment, violence, technological change, literacy, immigration, gender equity, tobacco use, poverty, threats to the environment, family breakdowns, and decline in our collective sense of community and country are just a few of the issues that these two systems are now required to address.
It is a testament to the commitment and dedication of the professionals and government officials involved in the study that we were able to collect the data for this study in such turbulent times. HIV/AIDS continues to be a complex problem that is difficult to address by public systems serving publics that hold differing views and values. We salute and thank the many individuals that responded to our request for interviews.
Most studies about HIV and sexuality have focused on the behaviours of young people. This study is about the adult responses to those youth behaviours. We try to shed light on the implementation of the policies established by public authorities through the programs, services and practices of two, but not all, of the systems that need to respond to HIV/AIDS. We do not report on the impact of the media, nor of parents talking about these issues with their children. We do not examine the role of service or voluntary health organizations, nor of the AIDS organizations that deliver prevention programs in many communities. We do not report on the actions that can be taken by social service agencies, spiritual organizations, local businesses and young people themselves. Consequently, these findings should be seen as only part of a response to HIV/AIDS that needs to continue to come from the entire community.