Wellness in Every Classroom: An Insight into School-based Health Programs
The essence of true health is not merely the absence of disease or infirmity; it also encompasses the state of complete physical, mental, and social well-being. Therefore, for a child, health goes beyond simply being disease-free but rather having a conducive environment where they can learn, grow, and thrive. Schools, as one of the most influential social institutions in a child’s life, provide a unique opportunity to promote both education and health. This is where school-based health programs play a transformative role.
School-based health programs are a set of planned strategies, activities, or services that are designed to promote positive health behaviours and practices among school children and staff. These initiatives range from essential services like vaccination, feeding programs, fund drives, and free medicine supply to more comprehensive efforts like counselling, health clubs, and safe spaces for emotional support. Globally, these programs follow an eight-component model, which addresses various aspects of student well-being. These include health education and instruction, as well as school health services, which ensure the provision of medical care. They also emphasise a healthy and safe school environment, along with nutrition programs that combat malnutrition. In addition, the model highlights physical education as well as mental health services such as counselling and social services. Finally, staff health promotion and school, parent, and community relationships ensure that everyone benefits from healthier lifestyles, reinforcing a culture of wellness within the community.
These programs reflect the growing global recognition that learning and health are interdependent. A healthy student is more likely to perform well academically, while education equips children with the knowledge to make better health choices.
Key components of school-based health programs in East Africa
1. Health education
Health education is the foundation of all school-based health initiatives. It equips students with knowledge about nutrition, hygiene, reproductive health, mental health, and disease prevention. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health, as well as sexual and reproductive health education.
Sexual and reproductive health remains a deeply contested issue in East Africa. Despite various policies being suggested and introduced, many schools have yet to implement them effectively. Meanwhile, mental health education, once an overlooked issue in East Africa, is emerging as a powerful tool for change. The success of mental health education in East African schools proves that empowering young people with knowledge and support can create lasting change while breaking the existing stigma.
Other initiatives focus more on the endemic diseases affecting the areas where the schools are located. For example, Ethiopia’s School Trachoma Program emphasises environmental health by teaching sanitation education, encouraging children to adopt healthy hygiene practices that prevent the spread of eye infections. Such targeted programs not only reduce disease but also instil lifelong health habits.
2. Deworming and vaccination
Soil-transmitted helminths (STH) remain a widespread issue, affecting more than one billion people globally, with roughly one-third of the world's population afflicted with at least one STH species. In East African countries like Uganda, Kenya, and Tanzania, these helminth infections, especially Schistosoma, affect millions of people in each country, presenting a huge problem.
These infections, caused by parasites such as roundworms and hookworms, lead to malnutrition, anaemia, and stunted growth. Deworming initiatives in schools, therefore, play a crucial role in ensuring that children are healthy enough to attend classes and learn effectively.
Similarly, school-based vaccination campaigns provide an efficient way to reach large populations, boosting immunity against preventable yet widespread diseases such as measles, tetanus, and polio in East Africa. With the presence of newer vaccines like the cervical cancer vaccine, there is growing interest in using schools as a platform for immunisation delivery. However, it remains crucial to obtain parental consent and ensure that schools are adequately prepared before implementing mass vaccination drives.
3. Feeding and nutrition
Good nutrition is important for learning. Hunger affects concentration, memory, and energy levels, making it difficult for children to engage in school. Recognizing this, many governments and NGOs have developed school feeding programs. For instance, Kenya’s Dishi na County program in Nairobi, launched in partnership with Food4Education, provides daily nutritious meals to thousands of students across over 200 schools. It has been very productive by boosting school enrolment and attendance, improving academic performance, combating malnutrition and food insecurity, while creating employment opportunities, showing that it is beneficial to the whole community at large. It stands as a testament to the power of innovative policy in transforming education and community well-being.
In Burundi, the Home-Grown School Feeding initiative was established to increase the proportion of locally produced school meals. It has led to an increase in the average number of school feeding days, providing an alternative to the centralised food procurement models. Since it sources food locally, it supports both student health and community farmers. Such programs demonstrate how nutrition initiatives can address both health and economic challenges.
4. Health activities/clubs
Health-related clubs are another innovative way schools encourage students to take ownership of their well-being. These clubs spread awareness about diseases, promote healthy behaviours, and often extend their influence into the wider community.
In Uganda, one such club is the 3C (Children Caring for Cancer) club. Started by the Uganda Child Cancer Foundation in 2010, it is a nationwide club, found in various schools, that is dedicated to educating young people and their communities about cancer and other related non-communicable diseases. It also tasks itself with providing both financial and emotional support for the numerous children’s patients and their families.
Similarly, Red Cross Clubs, Swiss-founded but present in many East African schools, for example, Kenya, promote values of humanity, independence, unity, voluntary service, and health awareness through student-led activities. These experiences empower young people to become agents of change beyond the classroom.
Government policies for school-based health programs in East Africa.
Across Africa, the importance of linking education and health is increasingly recognised. Governments, often in collaboration with organisations like the WHO, are implementing policies to ensure schools become platforms for delivering health services.
One of the notable examples of these is the School Health Program(SHP) of Ethiopia, which builds on the National School Health and Nutrition Strategy, whose development was led by the country’s Ministry of Education (MoE) of The Federal Democratic Republic of Ethiopia., Tthe School Health Program Framework was made to move beyond nutrition and close the gap on reaching children with health services by providing comprehensive school health service packages at all levels of schools, ranging from the pre-primary to the tertiary level of education.
This framework provides a broad package of services over ten areas intended to help schools offer broad health and support services to students. It begins with social and behavioural change communication and life skills development that address a child’s social well-being. The framework also ensures nutrition services, access to water, sanitation, and hygiene (WASH), alongside management of common infections, infestations, and disorders. It also includes routine and catch-up immunisation services, sexual and reproductive health services, HIV/STI prevention and control services, mental, neurological, and substance use disorder prevention and support, which emphasise prevention and management of non-communicable diseases. Finally, the framework highlights school health preparedness, response, and recovery during an emergency, guaranteeing resilience even in crisis.
By embedding these services into schools, Ethiopia shows how policy can bridge gaps in health service delivery.
Challenges faced in implementing school-based health programs
Although the benefits of school-based health programs are clear, their implementation faces numerous challenges. Despite the fact that financial hardships may be the greatest challenge in Eastern Africa, these programs are also affected by respondent bias, human resources, and the absence of government policies to support the programs.
Public-private partnerships as a solution
Many governments in developing regions lack sufficient funding to sustain large-scale initiatives. Public-private partnerships offer a promising solution. These collaborations allow private organisations to contribute resources, expertise, and infrastructure in exchange for long-term partnerships with governments. Beyond funding, such partnerships improve efficiency in program delivery while providing sustainability of the initiatives.
These partnerships play a significant role in the expansion and development of these programs, as they address one of the largest challenges faced by all government projects in Africa.
Conclusion
School-based health programs are more than just voluntary activities; they are essential investments in the future. By integrating health services with education, these programs break cycles of poverty, disease, and illiteracy. The evidence is clear: a child who is healthy is better able to learn, and a child who is educated is better equipped to live a healthy life. Expanding these initiatives through policy support, innovative financing, and community involvement ensures that schools continue to be places of learning, growth, and holistic well-being. For nations striving toward sustainable development, school-based health programs are not optional; they are indispensable.
