Bringing Public Health to a Public Place - Innovating School Health in Low- and Middle-Income Countries

Despite comprehensive policy frameworks and international guidelines on school health, the potential of schools as venue for health programs is often neglected. There is a gap between objectives and practical large-scale implementation. Building on the experience of the WHO-awarded national flagship school health programme of the Philippines, the Fit for School Program (FFS), the paper analyzes key elements of successful school health programs in general and gives 10 policy recommendations that are relevant for programs in any given setting. We postulate that success of a school health program is more likely if the following ten areas are addressed on a conceptual and process level: 1. Building on established international policy frameworks 2. Civil society involvement 3. Program relevance 4. Evidence and simplicity of interventions 5. Creating functioning intersectoral collaboration 6. Contribution to a broad development agenda 7. Capitalizing indirect effects 8. Including monitoring & evaluation 9. Stewardship & technical assistance 10. Political leadership & appropriate campaigning Responsibility for school health is traditionally split between health and education sectors; intersectoral collaboration is key for school health. The school as venue for health interventions is ideally suited to reach children in a receptive age, to initiate sustained behaviour change and to address determinants of health such as water and sanitation through involvement of communities and parents. With evidence-based interventions, tackling high-impact diseases, programs can make a significant contribution to achieving the health-related MDGs. The ten recommendations outline a roadmap to initiate or revitalise school-based health programs, particularly in low- and middle-income countries.