From leadership research to district action: School health policies and their implementation during the COVID-19 pandemic in the Philippines

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Introduction The COVID-19 pandemic has severely impacted the health and education of learners globally. However, there is a lack of information on enablers and barriers to the implementation of comprehensive school health policies during the pandemic. Methods This study utilized a case study design, and was conducted in the Division of City Schools of Navotas. A desk review of relevant school health policies released at the national level by the Department of Education and Department of Health during the pandemic was performed. The collected policies were classified if they were related to the Preparedness/Prevention Phase, Early Phase Response, and Chronic Phase Response. Focus group discussions and key a informant interview were conducted to determine the enablers and barriers in implementing school health programs during the pandemic. The identified themes were created deductively by using categories from Whitman’s Wheel of Factors influencing Implementation of Policy and Practice. Results Policies under the Preparedness/Prevention Phase focused on providing a comprehensive healthy school environment for learners, including Water, Sanitation, and Hygiene (WASH) in Schools. Early Phase Response policies included school closures and public health guidelines to prevent further spread of disease. The policies under the Chronic Phase/Response notably included guidelines for implementation of vaccination days and reopening of classes. Most of the factors identified were categorized under Whitman’s wheel of factors. Conclusions Despite COVID-19 restrictions, health policy implementation continued because of the collaborations, innovations, and leadership of various stakeholders. The vaccination of the public, including the pediatric population was implemented through the collaboration of various agencies. WASH in Schools was evident in policies regarding the guidelines on prevention of the spread of disease. The data provided in this study will serve as a guide to address the barriers and further strengthen the implementation of these policies. Keywords: School health, COVID-19, Pandemic, Policy, Policy implementation

Study methods

A literature review of relevant school health-related policies by relevant government agencies before and during the pandemic, especially those issued by the Department of Education (DepEd) and the Department of Health (DOH) was conducted. Documents were selected based on the US CDC’s definition of a policy [30]. The list of policies available in the DepEd [31] and DOH [32] online databases were used as the references for which policies were reviewed. School health policies issued from the year 2000 until May 5, 2023, when the WHO declared an end to COVID-19 as a public health emergency, were included in the review [33]. When certain policies were unavailable from these online database, other online sources were used, such as The Official Gazette, the official journal or repository of public policies of the Republic of the Philippines [34]. The keywords used include health, programs, hygiene, COVID-19, Mental Health, Food, Nutrition, Comprehensive, Inclusive, Sustainable development. All publicly available policies and selected policies related to school health, including Republic Acts (RA), Implementing Rules and Regulations (IRR), Administrative Orders (AO), Proclamations, Memorandums, and Department Circulars (DC) were checked and reviewed. The salient features of the policies such as their title, date of issuance, organization responsible, and main content, were summarized in a matrix.

Limitations

The findings of the study must be interpreted while taking into account several limitations. The FGD and KII were conducted in one school and one SDO only. These settings were chosen for the study due to their urban location and number of active COVID-19 cases at that time. Additionally, the FGD and KII were conducted during the early phase response to the pandemic and when the school was still implementing an online mode of learning. This probably has an effect on the comprehensiveness of our study as we were not able to get the perceptions of the learners and their parents. In line with this, the focus was given to the policy analysis, with the data from the FGD and KII providing insight into the real-life implementation of these policies.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Select one recurring district decision. Publish the decision owner, evidence requirements, consultation process and appeal route; test the process on a bounded low-risk decision. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Track decision time, unresolved objections, documented reasons, appeals and access differences. Review whether the process changes who can participate and who carries the burden. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Mikaela B Salanguit; Marian Danille C Santillan; Ernesto R Gregorio; Crystal Amiel M Estrada; Fumiko Shibuya; Akihiro Nishio; Jun Kobayashi. School health policies and their implementation during the COVID-19 pandemic in the Philippines. Tropical Medicine and Health (2024-12-23). https://doi.org/10.1186/s41182-024-00659-4

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.