Focusing Resources on Effective
School Health (FRESH)
Evidence has shown that investing
in school-based health and nutrition programmes results in
real advantages, including the five described below:
in school and better educational outcomes can
be obtained by boosting attendance and educational achievement.
For instance, provision of adequate water and sanitation facilities
in schools in Bangladesh increased girls' attendance by 15
per cent. Interaction with families and demand for sanitation
facilities at home were seen in 80 per cent of children who
acquired these practices at school. Studies have shown that
in Africa, more than half the schoolchildren are stunted in
height and are anaemic, and that in many areas most schoolchildren
are infected with worms, bilharzia and malaria parasites.
These highly prevalent conditions are all associated with
impaired cognitive ability.
New opportunities, unfulfilled needs: school health programmes
can help ensure that children are healthy and able to take
full advantage of what is often their first and only opportunity
for formal education.
Enhanced equity: school health and nutrition programmes particularly
benefit the poor and disadvantaged children, that is to say,
two groups with the worst health and nutrition status.
Contribution to youth development comes as a result of tackling
some major problems of adolescence: violence, substance abuse,
teenage pregnancy and sexually transmitted diseases, including
HIV/AIDS. For instance, in some countries in Latin America,
more than a third of adolescent girls leave school prematurely,
never to return, because of unplanned pregnancy.
A cost-effective investment in education (not just health)
can be reached by promoting learning and simultaneously reducing
repetition, absenteeism and dropout.
Launched at the World Education
Forum (Dakar, April 2000), FRESH aims at:
Promoting child-friendly schools and promoting quality EFA
by broadening the scope of school health programmes and improving
Helping identify and address health-related problems that
interfere with enrolment, attendance and learning.
Increasing awareness within the education community of the
value of school health programmes as a strategy to achieve
the EFA goals.
To achieve these goals, the
following four components are defined, which should be made
available together, in all schools.
Health-related school policies
as a means to:
promote the overall health, hygiene and nutrition of children,
ensure a safe and secure physical environment and a positive
psycho-social environment, and
address issues such as abuse of students, sexual harassment,
school violence and bullying.
Provision of safe water and
sanitation facilities the essential first steps towards a
healthy physical, learning environment. By providing these
facilities, schools can reinforce the health and hygiene messages,
and act as an example to both students and the wider community
Skills-based health education
- an approach to develop of knowledge, attitudes, values and
life skills needed to make and act on the most appropriate
and positive health-related decisions:
Changes in social and behavioural factors have given greater
prominence to such health-related issues as HIV/AIDS, early
pregnancy, injuries, violence, and tobacco abuse.
development of attitudes related to gender equity and respect
between girls and boys, and the development of specific skills,
such as dealing with peer pressure, are also central to effective
skills-based health education and positive psycho-social environments.
based health and nutrition services, both physical and psycho-social
Schools can effectively deliver some simple, safe and familiar
health and nutritional services, including counselling for
AIDS affected children and children traumatized by conflict
and address problems that are prevalent and recognized as
important within the community.
For example, micronutrient deficiencies and worm infections
may be effectively dealt with by (six-monthly or annual) oral
treatment and by changing the timing of meals, or providing
a snack to address short-term hunger during school.
To reach the expected outcomes,
strategies include effective partnerships between teachers
and health workers, the involvement and support of parents
and the community-at-large, and the active participation of
young people in the design and implementation of the programme.
The FRESH framework responds
to the specific needs of girls in the following areas: equal
enrolment and protection from harassment and the provision
of water and sanitation. The multi-country study on "young
people, gender, sexuality and HIV/AIDS in education"
drew the attention to the centrality of gender issues in the
lives of young people.
At the policy level, activities
consist of :
- Promoting inclusion of the
Fresh Framework into national EFA action plans or other education
reform documents through capacity-building and the training
of EFA coordinators from Ministries of Education.
- Provision of financial and technical assistance to Education
International to enable teachers' unions in Bukina Faso, Botswana,
Côte d'Ivoire, Guinea, Haiti, Malawi, Mali, Rwanda,
Senegal and Zambia to train teachers to use modern interactive
methods to help adults and young people acquire skills that
will help them avoid HIV infection and reduce related discrimination.
At the school level:
Campaigns launched to assist schools in planning and implementing
their own school health projects (Afghanistan, Burundi, Bolivia/Chile,
Timor-Leste, Kazakhstan, the Philippines, Samoa, Mozambique
Financial and technical assistance to primary, middle and
secondary schools in Zhejiang Province (China) to strengthen
nutrition and prevent tobacco use.
UNESCO, UNICEF, WHO, World
Bank and Education International
Section on Preventive
Education for an Improved Quality of Life
Division for the Promotion of Quality Education
7, place de Fontenoy
75352 Paris 07 SP,
Phone : +33 (0)1 45 68 09 31
Fax : +33 (0) 145 68 56 22