Background The global planetary health community increasingly recognises the need to prepare students to investigate and address connections between environmental change and human health. As we strive to support education on planetary health themes for students of all ages, understanding students’ concepts of linkages between the health of people and animals, and their shared environments might advance educational approaches. Children living in villages bordering Ruaha National Park in Iringa Region, Tanzania, have direct experience of these connections as they share a water-stressed but biodiverse environment with domestic animals and wildlife. Livelihoods in these villages depend predominantly on crop and livestock production, including extensive pastoralist livestock keeping. Through qualitative research, we aim to explore and describe Tanzanian primary school students’ understanding of connections between human health and the environment

Dauer, Jenny M.

Gustafson, Christopher

Komba, Elizabeth

Mlawa, Jesca

Mrema, Hilda

VanWormer, Elizabeth

English

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University of Nebraska - Lincoln
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Papers in Natural Resources Natural Resources, School of
5-28-2018
Using art and story to explore how primary school
students in rural Tanzania understand planetary
health: a qualitative analysis
Elizabeth VanWormer
University of Nebraska - Lincoln, liz.vanwormer@unl.edu
Jesca Mlawa
University of Nebraska- Lincoln
Elizabeth Komba
University of Nebraska - Lincoln
Christopher Gustafson
University of Nebraska-Lincoln, cgustafson6@unl.edu
Hilda Mrema
University of Nebraska - Lincoln
See next page for additional authors
Follow this and additional works at: https://digitalcommons.unl.edu/natrespapers
Part of the Natural Resources and Conservation Commons, Natural Resources Management and
Policy Commons, and the Other Environmental Sciences Commons
This Article is brought to you for free and open access by the Natural Resources, School of at DigitalCommons@University of Nebraska - Lincoln. It
has been accepted for inclusion in Papers in Natural Resources by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln.
VanWormer, Elizabeth; Mlawa, Jesca; Komba, Elizabeth; Gustafson, Christopher; Mrema, Hilda; and Dauer, Jenny M., "Using art and
story to explore how primary school students in rural Tanzania understand planetary health: a qualitative analysis" (2018). Papers in
Natural Resources. 850.
https://digitalcommons.unl.edu/natrespapers/850
Authors
Elizabeth VanWormer, Jesca Mlawa, Elizabeth Komba, Christopher Gustafson, Hilda Mrema, and Jenny M.
Dauer
This article is available at DigitalCommons@University of Nebraska - Lincoln: https://digitalcommons.unl.edu/natrespapers/850
Meeting Abstracts
18 www.thelancet.com/planetary-health
Published Online 
May 28, 2018
School of Veterinary Medicine 
and Biomedical Sciences 
(E VanWormer PhD), School of 
Natural Resources 
(E VanWormer, J M Dauer PhD), 
and Department of 
Agricultural Economics 
(C Gustafson PhD), University of 
Nebraska-Lincoln, Lincoln, NE, 
USA; Friends of Ruaha Society, 
Iringa, Tanzania (J Mlawa BS, 
E Komba MS); and Tanzania 
Veterinary Laboratory Agency, 
Southern Highlands Zone, 
Iringa, Tanzania 
(H Mrema MPVM) 
Correspondence to: 
Dr Elizabeth VanWormer, School 
of Veterinary Medicine and 
Biomedical Sciences, School of 
Natural Resources, University of 
Nebraska-Lincoln, Lincoln, NE 
68583-0961, USA 
liz.vanwormer@unl.edu
Using art and story to explore how primary school students 
in rural Tanzania understand planetary health: a qualitative 
analysis 
Elizabeth VanWormer, Jesca Mlawa, Elizabeth Komba, Christopher Gustafson, Hilda Mrema, Jenny M Dauer
Abstract
Background The global planetary health community increasingly recognises the need to prepare students to investigate 
and address connections between environmental change and human health. As we strive to support education on 
planetary health themes for students of all ages, understanding students’ concepts of linkages between the health of 
people and animals, and their shared environments might advance educational approaches. Children living in villages 
bordering Ruaha National Park in Iringa Region, Tanzania, have direct experience of these connections as they share 
a water-stressed but biodiverse environment with domestic animals and wildlife. Livelihoods in these villages depend 
predominantly on crop and livestock production, including extensive pastoralist livestock keeping. Through qualitative 
research, we aim to explore and describe Tanzanian primary school students’ understanding of connections between 
human health and the environment.
Methods Working with 26 village primary schools in Iringa Rural District, Tanzania, we adapted an art and story 
outreach activity to explore student perceptions of planetary health concepts. Following a standardised training session, 
a lead teacher at each primary school helped students aged 12–15 years form small teams to independently develop and 
illustrate a story centred on themes of how human health depends on water sources, wildlife, livestock, climate, and 
forest or grassland resources. Students were encouraged to discuss these themes with their teachers, peers, and 
families while developing their stories to gain broader as well as historical perspectives. The students generated stories 
that incorporated solutions to challenges within these themes. Written materials and illustrations were collected from 
each school along with data on sex and tribe of the group members. We translated all stories from Swahili to English 
for analysis. The primary outcomes of interest in analysing the students’ writing and illustrations were the relationships 
students identified between human health and wildlife, livestock, water sources, and forest resources.
Findings A total of 1043 students in 168 groups participated in the art and story activity between October and November 
2017, with groups containing a mean of six students (SD 1·5, range four to 11). In our preliminary review that we 
present here, students identified diverse beneficial and adverse connections between human health and environmental 
change through direct and indirect pathways, which included both ecological or biological and socioeconomic 
linkages. Preliminary themes noted in student work were clean air and water provision by forests, altered food, fuel, 
and medicinal resources, contact with animals and their waste, livelihood impacts, and cultural values. We are in the 
process of coding and analysing the student submissions to explore and describe their understanding of planetary 
health and to identify potential differences among student groups related to village, gender, and tribe.
Interpretation Through their art and writing, rural primary school students showed evidence of systems thinking in 
describing connections among human health and their surrounding environments. Focusing on links to wildlife, 
livestock, water sources, or forest resources, the students described both direct (eg, meat from wildlife or livestock to 
support human nutrition) and indirect (eg, funding for local human health clinics from wildlife tourism revenue) 
relationships between the environment and human health. Many student groups also interpreted relationships among 
people and components of their surrounding environment as beneficial or adverse, proposing specific solutions to 
enhance or mitigate these effects. Because responses varied widely among the included primary schools, future 
research on these gaps has the potential to improve planetary health educational approaches and student understanding.
Funding This study was supported with funding from the Agricultural Research Division of the University of 
Nebraska, Lincoln.
Copyright © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Contributors
All authors designed the study. JM and EK did the art and storyboard outreach activity with primary schools. All authors contributed to data analysis 
and writing of this report.
Declaration of interests
We declare no competing interests.


Using art and story to explore how primary school students
in rural Tanzania understand planetary health: a qualitative
analysis

DigitalCommons@University of Nebraska

University of Nebraska - LincolnDigitalCommons@University of Nebraska - LincolnPapers in Natural Resources Natural Resources, School of5-28-2018Using art and story to explore how primary schoolstudents in rural Tanzania understand planetaryhealth: a qualitative analysisElizabeth VanWormerUniversity of Nebraska - Lincoln, liz.vanwormer@unl.eduJesca MlawaUniversity of Nebraska- LincolnElizabeth KombaUniversity of Nebraska - LincolnChristopher GustafsonUniversity of Nebraska-Lincoln, cgustafson6@unl.eduHilda MremaUniversity of Nebraska - LincolnSee next page for additional authorsFollow this and additional works at: https://digitalcommons.unl.edu/natrespapersPart of the Natural Resources and Conservation Commons, Natural Resources Management andPolicy Commons, and the Other Environmental Sciences CommonsThis Article is brought to you for free and open access by the Natural Resources, School of at DigitalCommons@University of Nebraska - Lincoln. Ithas been accepted for inclusion in Papers in Natural Resources by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln.VanWormer, Elizabeth; Mlawa, Jesca; Komba, Elizabeth; Gustafson, Christopher; Mrema, Hilda; and Dauer, Jenny M., "Using art andstory to explore how primary school students in rural Tanzania understand planetary health: a qualitative analysis" (2018). Papers inNatural Resources. 850.https://digitalcommons.unl.edu/natrespapers/850AuthorsElizabeth VanWormer, Jesca Mlawa, Elizabeth Komba, Christopher Gustafson, Hilda Mrema, and Jenny M.DauerThis article is available at DigitalCommons@University of Nebraska - Lincoln: https://digitalcommons.unl.edu/natrespapers/850Meeting Abstracts18 www.thelancet.com/planetary-healthPublished Online May 28, 2018School of Veterinary Medicine and Biomedical Sciences (E VanWormer PhD), School of Natural Resources (E VanWormer, J M Dauer PhD), and Department of Agricultural Economics (C Gustafson PhD), University of Nebraska-Lincoln, Lincoln, NE, USA; Friends of Ruaha Society, Iringa, Tanzania (J Mlawa BS, E Komba MS); and Tanzania Veterinary Laboratory Agency, Southern Highlands Zone, Iringa, Tanzania (H Mrema MPVM) Correspondence to: Dr Elizabeth VanWormer, School of Veterinary Medicine and Biomedical Sciences, School of Natural Resources, University of Nebraska-Lincoln, Lincoln, NE 68583-0961, USA liz.vanwormer@unl.eduUsing art and story to explore how primary school students in rural Tanzania understand planetary health: a qualitative analysis Elizabeth VanWormer, Jesca Mlawa, Elizabeth Komba, Christopher Gustafson, Hilda Mrema, Jenny M DauerAbstractBackground The global planetary health community increasingly recognises the need to prepare students to investigate and address connections between environmental change and human health. As we strive to support education on planetary health themes for students of all ages, understanding students’ concepts of linkages between the health of people and animals, and their shared environments might advance educational approaches. Children living in villages bordering Ruaha National Park in Iringa Region, Tanzania, have direct experience of these connections as they share a water-stressed but biodiverse environment with domestic animals and wildlife. Livelihoods in these villages depend predominantly on crop and livestock production, including extensive pastoralist livestock keeping. Through qualitative research, we aim to explore and describe Tanzanian primary school students’ understanding of connections between human health and the environment.Methods Working with 26 village primary schools in Iringa Rural District, Tanzania, we adapted an art and story outreach activity to explore student perceptions of planetary health concepts. Following a standardised training session, a lead teacher at each primary school helped students aged 12–15 years form small teams to independently develop and illustrate a story centred on themes of how human health depends on water sources, wildlife, livestock, climate, and forest or grassland resources. Students were encouraged to discuss these themes with their teachers, peers, and families while developing their stories to gain broader as well as historical perspectives. The students generated stories that incorporated solutions to challenges within these themes. Written materials and illustrations were collected from each school along with data on sex and tribe of the group members. We translated all stories from Swahili to English for analysis. The primary outcomes of interest in analysing the students’ writing and illustrations were the relationships students identified between human health and wildlife, livestock, water sources, and forest resources.Findings A total of 1043 students in 168 groups participated in the art and story activity between October and November 2017, with groups containing a mean of six students (SD 1·5, range four to 11). In our preliminary review that we present here, students identified diverse beneficial and adverse connections between human health and environmental change through direct and indirect pathways, which included both ecological or biological and socioeconomic linkages. Preliminary themes noted in student work were clean air and water provision by forests, altered food, fuel, and medicinal resources, contact with animals and their waste, livelihood impacts, and cultural values. We are in the process of coding and analysing the student submissions to explore and describe their understanding of planetary health and to identify potential differences among student groups related to village, gender, and tribe.Interpretation Through their art and writing, rural primary school students showed evidence of systems thinking in describing connections among human health and their surrounding environments. Focusing on links to wildlife, livestock, water sources, or forest resources, the students described both direct (eg, meat from wildlife or livestock to support human nutrition) and indirect (eg, funding for local human health clinics from wildlife tourism revenue) relationships between the environment and human health. Many student groups also interpreted relationships among people and components of their surrounding environment as beneficial or adverse, proposing specific solutions to enhance or mitigate these effects. Because responses varied widely among the included primary schools, future research on these gaps has the potential to improve planetary health educational approaches and student understanding.Funding This study was supported with funding from the Agricultural Research Division of the University of Nebraska, Lincoln.Copyright © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.ContributorsAll authors designed the study. JM and EK did the art and storyboard outreach activity with primary schools. All authors contributed to data analysis and writing of this report.Declaration of interestsWe declare no competing interests.

University of Nebraska - LincolnDigitalCommons@University of Nebraska - LincolnPapers in Veterinary and Biomedical Science Veterinary and Biomedical Sciences, Department of2018Using art and story to explore how primary schoolstudents in rural Tanzania understand planetaryhealth: a qualitative analysisElizabeth VanWormerUniversity of Nebraska - Lincoln, liz.vanwormer@unl.eduJesca MlawaFriends of Ruaha SocietyElizabeth KombaFriends of Ruaha SocietyChristopher GustafsonUniversity of Nebraska-Lincoln, cgustafson6@unl.eduHilda MremaTanzania Veterinary Laboratory AgencySee next page for additional authorsFollow this and additional works at: https://digitalcommons.unl.edu/vetscipapersPart of the Biochemistry, Biophysics, and Structural Biology Commons, Cell and DevelopmentalBiology Commons, Immunology and Infectious Disease Commons, Medical Sciences Commons,Veterinary Microbiology and Immunobiology Commons, and the Veterinary Pathology andPathobiology CommonsThis Article is brought to you for free and open access by the Veterinary and Biomedical Sciences, Department of at DigitalCommons@University ofNebraska - Lincoln. It has been accepted for inclusion in Papers in Veterinary and Biomedical Science by an authorized administrator ofDigitalCommons@University of Nebraska - Lincoln.VanWormer, Elizabeth; Mlawa, Jesca; Komba, Elizabeth; Gustafson, Christopher; Mrema, Hilda; and Dauer, Jenny M., "Using art andstory to explore how primary school students in rural Tanzania understand planetary health: a qualitative analysis" (2018). Papers inVeterinary and Biomedical Science. 311.https://digitalcommons.unl.edu/vetscipapers/311AuthorsElizabeth VanWormer, Jesca Mlawa, Elizabeth Komba, Christopher Gustafson, Hilda Mrema, and Jenny M.DauerThis article is available at DigitalCommons@University of Nebraska - Lincoln: https://digitalcommons.unl.edu/vetscipapers/311Meeting Abstracts18 www.thelancet.com/planetary-healthPublished Online May 28, 2018School of Veterinary Medicine and Biomedical Sciences (E VanWormer PhD), School of Natural Resources (E VanWormer, J M Dauer PhD), and Department of Agricultural Economics (C Gustafson PhD), University of Nebraska-Lincoln, Lincoln, NE, USA; Friends of Ruaha Society, Iringa, Tanzania (J Mlawa BS, E Komba MS); and Tanzania Veterinary Laboratory Agency, Southern Highlands Zone, Iringa, Tanzania (H Mrema MPVM) Correspondence to: Dr Elizabeth VanWormer, School of Veterinary Medicine and Biomedical Sciences, School of Natural Resources, University of Nebraska-Lincoln, Lincoln, NE 68583-0961, USA liz.vanwormer@unl.eduUsing art and story to explore how primary school students in rural Tanzania understand planetary health: a qualitative analysis Elizabeth VanWormer, Jesca Mlawa, Elizabeth Komba, Christopher Gustafson, Hilda Mrema, Jenny M DauerAbstractBackground The global planetary health community increasingly recognises the need to prepare students to investigate and address connections between environmental change and human health. As we strive to support education on planetary health themes for students of all ages, understanding students’ concepts of linkages between the health of people and animals, and their shared environments might advance educational approaches. Children living in villages bordering Ruaha National Park in Iringa Region, Tanzania, have direct experience of these connections as they share a water-stressed but biodiverse environment with domestic animals and wildlife. Livelihoods in these villages depend predominantly on crop and livestock production, including extensive pastoralist livestock keeping. Through qualitative research, we aim to explore and describe Tanzanian primary school students’ understanding of connections between human health and the environment.Methods Working with 26 village primary schools in Iringa Rural District, Tanzania, we adapted an art and story outreach activity to explore student perceptions of planetary health concepts. Following a standardised training session, a lead teacher at each primary school helped students aged 12–15 years form small teams to independently develop and illustrate a story centred on themes of how human health depends on water sources, wildlife, livestock, climate, and forest or grassland resources. Students were encouraged to discuss these themes with their teachers, peers, and families while developing their stories to gain broader as well as historical perspectives. The students generated stories that incorporated solutions to challenges within these themes. Written materials and illustrations were collected from each school along with data on sex and tribe of the group members. We translated all stories from Swahili to English for analysis. The primary outcomes of interest in analysing the students’ writing and illustrations were the relationships students identified between human health and wildlife, livestock, water sources, and forest resources.Findings A total of 1043 students in 168 groups participated in the art and story activity between October and November 2017, with groups containing a mean of six students (SD 1·5, range four to 11). In our preliminary review that we present here, students identified diverse beneficial and adverse connections between human health and environmental change through direct and indirect pathways, which included both ecological or biological and socioeconomic linkages. Preliminary themes noted in student work were clean air and water provision by forests, altered food, fuel, and medicinal resources, contact with animals and their waste, livelihood impacts, and cultural values. We are in the process of coding and analysing the student submissions to explore and describe their understanding of planetary health and to identify potential differences among student groups related to village, gender, and tribe.Interpretation Through their art and writing, rural primary school students showed evidence of systems thinking in describing connections among human health and their surrounding environments. Focusing on links to wildlife, livestock, water sources, or forest resources, the students described both direct (eg, meat from wildlife or livestock to support human nutrition) and indirect (eg, funding for local human health clinics from wildlife tourism revenue) relationships between the environment and human health. Many student groups also interpreted relationships among people and components of their surrounding environment as beneficial or adverse, proposing specific solutions to enhance or mitigate these effects. Because responses varied widely among the included primary schools, future research on these gaps has the potential to improve planetary health educational approaches and student understanding.Funding This study was supported with funding from the Agricultural Research Division of the University of Nebraska, Lincoln.Copyright © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.ContributorsAll authors designed the study. JM and EK did the art and storyboard outreach activity with primary schools. All authors contributed to data analysis and writing of this report.Declaration of interestsWe declare no competing interests.

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Using art and story to explore how primary school students in rural Tanzania understand planetary health: a qualitative analysis

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