If we were to talk of prevention, we find ourselves making invalid assumptions. For instance, we start with \’washing hands with soap regularly prevents disease\’. But the problem is, say a huge proportion of children and the community, \’there is not enough water even to drink, how do we wash hands with soap?\’ Next we say, \’you must eat green leafy vegetables\’. However, the response: \’hey, there isn\’t enough food to eat in the first place, let alone leafy vegetables\’. The list is endless. The bottom-line: poverty is at least as important a health issue as lack of health education.

On the other hand, emphasizing prevention has its own limitations. For example, when discussing scabies it is common to find the use of neem being advocated. Though neem is commonly available, it is not exactly always useful in all cases of scabies. Medical advice should be sought rather than relying only on such suggestions. As they say, it can be dangerous to be armed with half-baked information.

So what do we do? Not talk about health at all?

No, we do need to educate our children on health. But the emphasis has to be on educate rather than merely plying them with information. In concrete terms this implies helping children perceive the causal links between different factors in their immediate environment and their health. How the body works, what it is affected by and how it responds to different factors, and how our own actions (individually and collectively) impact upon it — these are some of the components of what contemporary health education should be like.

This would naturally require scope for exploration, projects and activities. The pedagogy involved should help children arrive at their own conclusions, especially in terms of actions they could take. Here\’s an example of what might be a good health education activity (for grade 3 students, assisted by their teacher):

Take two small plates — put a little dal water in one, and a little sweet tea in the other. Set these plates in the sun and let the fluids dry. After a while, touch both of them with your fingers – one of them feels sticky and the other doesn\’t. Why do you think this is so?

Next, take a knife (let your teacher do this!). Cut a cucumber and feel the knife edge carefully. Now cut a piece of jaggery and feel the edge again (carefully!). Which item left a more sticky knife edge? Why?

So when we eat, which items are more likely to continue sticking to our teeth? And what will happen if they remain there (discuss with your teacher)? So what do we need to do? 

That\’s it. There\’s no need really to give a long lecture of oral hygiene, full of facts and figures and information on exactly how to hold the brush etc. etc. All that sounds so platitudinous that children instinctively \’switch off\’ (as do adults when lectured!). The intention is that by helping children arrive at their own conclusions, we increase their stake in taking appropriate health-related action. And hence the increased chance that the understanding will actually translate into behavior!

Before you lynch me for raising blasphemous ideas and restricting girls to things such as reproductive health and sewing/knitting, let me explain. If we were to look at education only from the boys\’ point of view, we would find that everything we wanted is probably already there. But that is not the case when it comes to girls. Surely, education for both boys and girls would be much better off if the girls\’ perspective, experience and world view were, in fact, included.

Think, for a moment, of recipes, and how they would be wonderful material for learning mathematics (interesting, isn\’t it?). Or the kind of abilities girls have with fine motor skills and patterns. Or multi-tasking. Or giving value to emotions and relationships. Or being able to share rather than dominate. Or how to make use of meager resources. Or a range of other things which I\’m sure you can list (endlessly). Are we not depriving ourselves in not exploring this? There is no doubt that, on the whole, education is much the poorer from having been defined by the male perspective. Which then applies to the world itself as well.

1. The most important way to generate teacher motivation is to enable them to experience success in the classroom. Hence a set of minimum enabling conditions being in place make a huge difference. 
2. Teachers change when they experience the standards, rather than simply being told about them – towards this, the in-service courses themselves need to incorporate the standards expected of teachers. (A few of the states have begun this process of improving their own inputs to teachers.)
3. There is a sequence in which teachers learn (and indeed institutions and systems learn). It is also better to avoid overcrowding expectations. It would therefore be best to plan improvement in terms of stages of teacher development, broken down into three-month phases, each of which has a very limited number of indicators to be attained (4-8). As teachers attain one set of indicators, this motivates them as well as prepares them for the next, higher order, set. The support institutions, too, learn along with the teachers and grow phase-wise in turn.
4. Standards and indicators can tend to be vague! It is important to convert them into concrete steps that can actually be implemented by teachers. Thus, if an indicator agreed upon is ‘children ask questions freely, without fear’ there is a need to make clear exactly what the teacher needs to do for this to happen. Hence, as part of the roll out, all teams need to detail the concrete steps involved in converting the expectations into actionable steps.
5. Implementer choice and partnering with teachers is more likely to yield results than passing on a set of instructions. In sub-district meetings, teachers should get to choose the indicators they want to attain (from a given list of potential indicators for that stage, though) and identify / develop the steps needed to attain these. Their performance will be assessed against the indicators chosen by them. If possible, peer assessment will be introduced.
6. ‘Target setting’ in terms of the degree of improvement in performance can now be practiced. Teachers and their resource persons can use the standards document to fix the degree of change they seek to bring about over, say, a year or six months. They can then assess their progress against this. As this was not possible earlier, improvement efforts tended to lose their way very soon.
7. Taking a ‘low-interference’ approach helps – that is, there is no pressure on the system to change curriculum or textbooks or introduce new model of teaching. It is more a case of ‘doing the same as before, but a little differently’; this reduces systemic stress and enables rapid implementation.