School Health and Nutrition

Investments in school health are a strategic win-win for a country’s education and health sectors - and more critically - a win for children and adolescents.

Girls washing hands
Photo: Madagascar, Crystal Thompson, USAID
For the health sector, schools represent a cost-effective platform for reaching school-aged children with the interventions they need to achieve their human capital potential. For the education sector, delivery of health services and health sector investments ensures that a child’s poor health is not a bottleneck to learning, growth, and cognitive formation. For these reasons, investments in school health and nutrition are synergistic and essential to other educational investments focusing on quality and access. Moreover, school health sets the stage for children to thrive and become transformative agents in their communities.

What is School Health?

Broadly we can think about school health in terms of what is required for children to be healthy. One of the most well-known frameworks for making school health concrete and parsing it into major component areas is UNESCO’s Focusing Resources on Effective School Health (FRESH) framework. In this framework, there are four pillars of school health:

  • Policies. Are there national, sub-national as well as school policies that make children safe and signal a commitment to every child’s health?
  • School environment. Is the school environment safe and free from hazards? Is there clean water and other sanitation services?
  • Services. What sort of routine health services are offered at the school to students and are those appropriate and adequate for the students’ needs? Services vary and examples include school feeding, deworming, HIV/AIDS prevention education, treatment for malaria and routine screenings for vision and hearing, among others.
  • Education. Are students provided with age-appropriate information to empower them to take ownership over their health and well-being?
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© Partnership for Child Development. Used with the permission of Partnership for Child Development. Further permission required for reuse.

Icon of a book and brain What We Know About the Benefits of Strong School-Health Programs

Quite simply, healthy children learn better. For instance, certain conditions that are prevalent among school-age children and adolescents can impair cognition, attention span, and learning. To take one example, the average IQ loss for children with untreated worm infections is estimated to be 3.75 IQ points per child, and the average IQ points lost due to anemia is even higher. The good news is that most of these conditions are easily treatable. School-based health interventions in areas where these conditions are prevalent could result in 2.5 additional years of schooling for affected children.

Although the relationship between healthy children and able learners has been well-established, in practice many children remain inadequately supported. Prior estimates in low- and lower-middle income countries have found annual public spending for health for ages 5-20 is less than 3 billion USD. In comparison, public expenditure for education during the same age range is estimated to be more than 200 billion. Because health is a prerequisite for learning, these substantial educational investments likely fail to realize their true dividends as inadequate health serves as a constraint to learning and development.

The inadequacy of health investments for school-age children is being recognized more broadly. Furthermore, interest in SHN is more pronounced due to COVID, and school health has become a major priority action for building back schools, and not only in low- and lower-middle income countries.

Icon of spotlights Practitioner Spotlight

Kenya

Ministry of Public Service, Youth and Gender Affairs

In 2017 and 2018, the Ministry of Public Service, Youth and Gender Affairs established a national program to procure and deliver sanitary towels to 3.7 million girls in primary, special primary and secondary schools. The motivation for this large-scale effort came from the Republic of Kenya’s Constitution which enshrines a commitment to gender equality as well as the country’s Basic Education Act and Goal 4 of the SDGsResearch conducted by the World Bank estimated that adolescent girls in low and middle-income settings may be absent up to four school days out of every 28 days due to inadequate menstrual hygiene management (Mooijman et al., 2005). Not all research has found a clear link between provision of sanitary towels and school days missed. However, when attendance data are missing from school registries, simply excluding the missing data incorrectly minimizes any program effects. A recent randomized controlled trial that corrected for these problems in data collection from Kenya estimated a reduced effect while nonetheless confirming that provision of sanitary towels reduces absenteeism among adolescent girls by more than 5%. Despite some dispute on the magnitude of the effect, this program is clearly critical to to improving school attendance.

Icon of a newspaper School Health and Nutrition in the News

| Webinar

Global Launch: Making every school a health-promoting school

The World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO) are hosting a global launch event to introduce the Health-Promoting Schools initiative and newly developed guidance. Join the call on Tuesday, June 22 at 1pm CEST/7am EDT by registering here!

| Press Release

Research Consortium for School Health and Nutrition

The London School of Hygiene and Tropical Medicine launched a research consortium on school health and nutrition on May 27th, 2021. Watch recordings from the launch event here! The Research Consortium is a global, multi-sectoral partnership of academic, scientific and technical institutions and individuals, to promote quality research on the health, nutrition, well-being, education and development of school age children and adolescents. You can learn more about the initiative on their website.

| Webinar

Webinar on Global Standards

WHO organized a webinar (February 2021) to debut its updated global standards for health promoting schools.