58. School–Based Health and Nutrition Programs

Abstract

The rationale for school–based health and nutrition programs and the approach to their implementation have undergone a paradigm shift over the past two decades. It has been increasingly recognized that ill health and malnutrition of school children have major impacts on cognitive development, learning, and educational achievement. While disease and malnutrition have significant effects on educational outcomes, current methods of estimating the burden of ill health and malnutrition often result in an underestimation of both the developmental consequences and the overall benefits for health and development of school health and nutrition programs.

Effective implementation of health and nutrition services within school–based programs requires integration of four key components: (1) nondiscriminatory and sensitive policies, (2) a school environment that is safe, (3) skills–based education for disease prevention, and (4) delivery of cost–effective health and nutrition services. Successful and equitable programs in low– and middle–income countries are characterized by a focus on school–based delivery, on a public health paradigm that minimizes the need for clinical intervention, and on the participation of the public sector and civil society locally.

Significant savings are realized by using the school system infrastructure rather than the health system to deliver health and nutrition to schoolchildren. Economic returns are also realized through the impact such programs have on improved adult health outcomes.