Monitoring & Evaluating School Health Programmes

Core Indicators

The main purpose of the FRESH (M&E) School Health Core Indicators is to assess and monitor national-level progress in implementing a comprehensive school health program, specifically the four FRESH pillars recommended in the internationally-agreed FRESH framework.

Collecting data to evaluate the FRESH Core Indicators will allow countries to identify the strengths and weaknesses of their school health programming and to use the information to strengthen policy and implementation and monitor progress towards meeting the FRESH framework‘ standards’ over time.

There are eight Core Indicators, two per FRESH pillar. For each pillar, there is a national-level Core Indicator and a school-level Core Indicator:

  1. National-Level Core Indicators assess the existence and quality of national-level documentation to support the implementation of each FRESH pillar, e.g. water and sanitation standards to guide WASH (water, sanitation and hygiene) improvements or the health education curriculum to support skills-based health education. Data for these indicators is collected through a desk review of relevant documents (national policies, strategies, standards, and curriculums, etc.).
  2. School-Level Core Indicators assess the level to which elements of the pillar is implemented in schools: To what extent do schools have a safe school environment? What proportion of schools is implementing regular skills-based health education? These indicators are collected through a survey in a sample of schools representative of all schools in the country (pre-school, primary and secondary; private and public; different geographical areas and ethnic groups).

English, Pilot version in Spanish

Frequently Asked Questions

Eight checklists have been developed to support the collection of the eight Core Indicators along with data collection guidance.  


Thematic indicators

The main purpose of the FRESH Monitoring and Evaluation (M&E) School Health Thematic Indicators is to assess and monitor school-level progress in implementing a school health program. They attempt to answer the following question: To what extent are specific health topics addressed in your school? and are therefore focused on program-level M&E. They include around 150 thematic school health indicators, drawn largely from existing M&E guidance and organized by health topic (or thematic area).  The variety of health topics and indicators acts as a menu from which the user can select the most appropriate indicators to monitor.

Each thematic indicator page includes a short introduction to the health topic with a rationale for addressing this health issue in schools. A list of M&E indicators relating specifically to each health issue is then provided as is the data collection method. The indicators are either drawn from existing documents (e.g. the deworming indicators) or were developed by thematic expert groups (e.g. the HIV and AIDS indicators).

The health themes covered are:

  • Water, Sanitation and Hygiene
  • Worms
  • Food and Nutrition
  • Physical Activity
  • Malaria
  • Oral Health
  • Eye Health
  • Ear and Hearing
  • Immunization
  • Injury Prevention
  • HIV and AIDS
  • Sexual and Reproductive Health
  • Substance Use
  • Violence in Schools
  • Disaster Risk Reduction

Click  here to download the PDF in English





Chinese version available here




Russian version available here


For feedback and comments on the indicators, please contact us at info-iatt(at)

The development of the FRESH Monitoring and Evaluation Guidance for School Health has been a multi-agency effort, guided by the FRESH Monitoring and Evaluation Coordinating Committee.

Back to top