Comprehensive School Health Programs delivered by community health workers in rural primary schools.

CHHIP is a health and education improvement program with three interrelated components, created for implementation in rural primary schools in the Darjeeling District of West Bengal, India. 

The Problem

Severe Lack of healthcare professionals

It is common for schools in rural India to lack basic infrastructure such as toilets, running water, and electricity. Students in control schools missed on average, more than 20 days of school per year due to diarrhea and dysentary alone. 1 out of 2 children were infected with intestinal parasites, nearly 40% of these children suffered from iron deficiency anemia, and many struggle with undiagnosed developmental delay, chronic illness, and behavioral issues.

The remoteness and the difficult terrain of rural India leaves a void in healthcare access with doctors and hospitals located in central cities hours away by car.  Populations of 50,000 or more people spread across a large region can at times be served by one doctor.

Logistically, an underlying problem is a severe lack of local healthcare professionals working in these remote communities.

The Opportunity

A public health priority

The Indian government acknowledges the problems prevelant in their rural schools and has identified school health programs as a priority public health program. In fact, local state government has even set aside significant amounts of funding for these programs. Unfortunately, over the course of ten years working in the rural communities of the Eastern Himalayas, we have yet to see one of these programs in action. 

Luckily, the government is actively seeking alternative models to address the problems in these communities. 


The Solution: Comprehensive Health and Hygiene Improvement Program

CHHIP is a health education and improvement program with three inter-related components, created for implementation in rural primary schools in the Darjeeling District of West Bengal, India.

CHHIP is an evidence based program designed to improve communities from the ground up by delivery health and education services to children in primary school.  Our key innovation is to use a different human resource delivery model by building a system of community delivered health care based on the idea that in every village there exists talented and committed individuals who, with proper support and training, can surmount tremendous poverty they face to ensure the health and well-being of the children in their communities. We call these health workers School Health Activists or SHAs.

Three Components of CHHIP

Improvements to School Health Environments

The first step is to ensure the schools that we work in our structurally sound and have basic infrastructure such as running water and working toilets. 

We work with our communities to complete the necessary construction projects at the schools before implementing the rest of our initiatives.

Health and Hygiene Education

We've created a teacher training program to improve in school learning and a health and hygiene education curriculum. 

Our curriculum and supporting materials and activities are delivered by our SHAs who teach their students about water, sanitation, hygiene, germs, and nutrition so they can stay healthy and in school.

Primary Health Services Intervention

We've developed a training, screening, and decision making program to empower our SHAs to not only provide primary health care services but also know when to escalate and refer issues and how to help families navigate and access the healthcare system.

SHAs are a local resource for our communities and provide health services such as:

  • Vision screening
  • Distribution of iron supplements and deworming tablets
  • Mental health and behavioral screening
  • Growth monitoring 

Our Reach

We're just getting started...

  • 4 Student Health Activists
  • 10 Schools
  • 500 Students

Our Impact

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