When children miss school due to health problems, the parent is also made to miss work so as to attend the child by taking them to the doctor. This translates to huge economic derailment on the side of the parent and the economy at large. An increasing number of school-based clinics have raised the question of how to fund the operation of the program. The number of school-based health care centers in the U. S. increased from 200 in 1990 to about 1,135 in 1999 (Dailard, 2000).
In 1998/1999 school year, approximately $30 million was spent by states in funding school-based health care. This indicates that expenditures on school-based clinics are quite high. Failure to provide school-based health care would be to some extent denying access to health care to children who cannot access quality health care. The political process is very important since the passing of bills that allow increased access and funding of the program are mainly politically influenced. Stakeholders
The school-based health care policy involves a number of stakeholders including the government (local, state and federal) as well as non-governmental bodies which fund and run the programs as providers. Among the major stakeholders is the NASBHC who are in the forefront of advocating for establishment of more school-based clinics, establishment of policies at the all levels of governance and the funding of the program. Funding foundations such as the Robert Wood Johnson Foundation (Stock et al, 1997) have been in the forefront of supporting the school-based health care programs more so in terms of funding.
To include children insurance coverage in the school-based health care program, President Obama signed the Children’s Health Insurance Program (CHIP) in 2009 (NASBHC, 2010). This indicates that the political process and governance are important stakeholders in the outcome of this policy. It should not be forgotten that students who depend on the school-based health clinics are great beneficiaries of the program and it affects their health and educational outcomes. While setting up school-based health center, the local community in addition to the state is also involved.
The contribution of the local community is vital since it is the community that decides the extent of scope of services and the terms on which the services will be offered. Failure to get community support may make it difficult to initiate such a program in a community. Stock et al (1997) identify that if the community does not endorse the program, then it becomes hard to establish a school-based health clinic. Other important players are the health professionals such as nurses who must be trained and equipped to operate school-based health clinics.
The media is also identified as an important participant in the policy process with Lundy, Lundy and Janes (2009) stating that the media can link schools with nurses, parents and political components of this program. Issue statement Provision of school-based health care is a pathway to ensuring school children are not denied access to health care. These efforts are however restrained by lack of consistent funding from the local communities and state and sometimes private resouces.
It is worth considering the establishment of more school-based health centers and federal funding of the same to ensure that academic and economic benefits are achieved by all children. The big question in this case is whether the NASBHC is in a position to influence the expansion of school-based health care to as many students as possible. In addition, it is also questionable whether this will be effective with the presenting challenge of unstable financing of the program and negative attitudes on provision of contraceptives to school children.