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

Ghana

Girls Iron-Folate Tablet Supplementation (GIFTS)

The GIFTS Program is designed to improve the nutritional status of menstruating girls/women aged 10-19 years in Ghana. The program, which is supported through a collaboration with the Ghana office of the United Nations Children’s Fund (UNICEF), Ghana Ministries of Health and Education, Emory University Global Health Institute and The U.S Centers for Disease Control and Prevention, provides free weekly IFA supplementation delivered to in-school and out-of-school adolescent girls as well as health and nutrition education sessions for both boys and girls.

An evaluation of the GIFTS program assessed its impact in school-attending girls from the 2017-2018 academic year in four regions: Brong-Ahafo, Northern, Upper East, and Volta. The impact evaluation found that the prevalence of anemia among girls in the program dropped from 25% to 19.5%. Learn more about the GIFTS program and its impact by watching this webinar hosted by the Global Nutrition Coordination Plan.

Icon of a newspaper School Health and Nutrition in the News

| Webinar

Multisectoral Collaboration for Children

The Re-imagining the Package of Care for Children subgroup hosted a webinar on October 19 at 12pm EDT to share findings from interviews with USAID Africa Missions and other partners operationalizing school health and nutrition. Access the recording and presentation from the webinar here!

| Report

Operationalizing Health & Education Coordination

A new report has been published on the Child Health Task Force website sharing recommendations for operationalizing school health and nutrition that emerged from interviews with USAID Africa Missions. It answers the question: How do countries, practitioners, and development partners bridge the gap between knowing 'what to do' and 'how to do it' when it comes to school health? Read full report here!

| Blog

Getting School Health Right in Low- and Middle-Income Countries

Think Global Health published a blog on the COVID-19 disruptions to children's and adolescent's learning and access to school health and nutrition services. The piece also discusses the importance of school health programming and investments beyond COVID-19, challenges in implementation, and critical actions for individuals and organizations to promote and advocate for comprehensive health services in schools.