Organizational models of school health services in the WHO European Region

J Health Organ Manag. 2013;27(6):733-46. doi: 10.1108/JHOM-08-2011-0084.

Abstract

Purpose: The purpose of this article is to produce a taxonomy of organizational models of school health services (SHS) in the WHO European Region, and to reflect upon the potential of each model to be effective, equitable, responsive and efficient.

Design/methodology/approach: The authors used data from the WHO survey to identify organizational models. To produce a taxonomy of organizational models, three features of SHS organization were analyzed--the presence of health personnel specifically dedicated to school health services provision (school nurse and/or school doctor); the statutory involvement of other health professions in SHS provision; and the proximity of service provision to pupils (school-based or not school-based).

Findings: There are five organizational models of school health services in the Member States of the WHO European Region: dedicated school-based, dedicated community-based, integrated with primary care, mixed school-based, and mixed community-based. Preliminary reflections show that school based models are more likely to produce better outcomes in terms of effectiveness, equity, responsiveness, and efficiency.

Research limitations/implications: The WHO European Region has 53 Member States; the data are therefore incomplete and conclusions are limited to the 37 respondent countries.

Practical implications: Knowledge on performance of various models of service provision may inform decision-makers in the process of reforms.

Originality/value: This is the first attempt to produce a taxonomy of organizational models of school health services based on data from 37 countries, and to investigate the potential of each model to achieve desirable health system objectives.

MeSH terms

  • Europe
  • Models, Organizational*
  • School Health Services / organization & administration*
  • Surveys and Questionnaires
  • Workforce
  • World Health Organization*