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.

Check out our toolkit on school health and nutrition: a set of multimedia microlearning products for health and education policymakers, practitioners and donors.

Go to the toolkit

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?
Illustration of a school in the center of a community
© 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


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

| Special Update

International School Meals Day: Launch of New Animated Video

Learning while hungry is nearly impossible. In honor of International School Meals Day, the Child Health Task Force developed a new animated video on the benefits of school feeding programs for children. School meals are one of the most effective non-teaching interventions to improve learning. They encourage children to attend school regularly and foster equitable opportunities to learn. Making these programs effective requires the support and input of many sectors, including education, health, and agriculture.

| Webinar

Ready to Learn and Thrive: Sharing the School Health and Nutrition Global Status Report

The Child Health Task Force, UNESCO, and LSHTM co-hosted a webinar to mark the publication of the report Ready to Learn and Thrive: School Health and Nutrition around the WorldListen to the recording and access the presentation slides here on the website.

| Webinar

School Health and Nutrition: Reach and Relevance for Adolescents

The Global Financing Facility (GFF) is hosting a webinar to launch a suite of tools designed to guide program planners through some of the key questions that arise in program development and investment prioritization to support adolescents in achieving their full potential. The event will engage the World Bank Task Team Leaders, technical bodies, and external funding agencies to discuss how these tools can be widely applied in practice. The programmatic briefs and Zoom link are available on the GFF website.