Key findings:

Looking after the health and well-being of learners holistically, through multisectoral approaches is one of the most transformative and cost-effective ways to improve education outcomes and make education systems more inclusive and equitable. Realizing this potential will require a shift in thinking about the role of schools that goes beyond promoting academic outcomes to making the health and well-being of learners a core mission of education, as the consultations leading to the Transforming Education Summit in 2022 called for (UNESCO-OREALC, 2022).

School Health and Nutrition (SHN) programmes are central to tackling the global learning crisis, to education sector recovery from the impact of COVID-19, and to building resilience against future pandemics and other shocks. There is a pressing need to reopen schools safely and re-engage all learners. We must restore and scale up SHN programmes, including school meals, WASH, health and nutrition education, and services to address the adverse effects of the pandemic and other threats on learners’ physical and mental health. This is essential for learning recovery. This must be a priority for countries and the international partners supporting them.

Investment in SHN benefits the poorest and most disadvantaged children the most. However, the children and adolescents who could benefit most from these programmes are often those most likely to miss out. Strong country leadership and investment are required to ensure that all children and adolescents are in school and that SHN programmes reach those most in need in the poorest countries and the poorest and most marginalized households. Targeted action is needed to reach those at most risk of marginalization, poor health and malnutrition and this, in turn, requires that SHN programmes are designed to address equity, gender equality and inclusion.

Programmes must be comprehensive, implemented at scale and sustained by political and financial commitments from different sectors to maximize their impact. Global data suggest that SHN programmes are not always comprehensive in scope, that coverage of essential components remains low and fragmented, particularly in low-income countries, and that interventions are not consistently implemented at both primary- and secondary-school levels. More attention needs to be paid to the quality of programme design and implementation and to monitoring and evaluating delivery and impact. Implementing and sustaining comprehensive SHN programmes at scale calls for commitment, supportive national policies, innovative approaches to financing and coordinated efforts across sectors. In many countries, this will not happen overnight, and a pragmatic and gradual approach based on a clear set of priorities, better understanding of what works in different contexts, and lessons learned from experience will be required.

SHN policies and programmes must be relevant and responsive to country contexts and evolving needs. In practice, policies and programmes vary between countries, reflecting different priorities, available resources and capacity. Countries need to review and continue to adapt policy and programme design periodically to ensure that they meet the needs of school-age children and adolescents and respond to new evidence and emerging challenges, such as the impact of climate change. More attention needs to be given to mental health, promoting physical activity for all students, supporting students with disabilities, and effective approaches to address overweight and obesity.

Coordinated action is needed to better monitor SHN and address key evidence gaps. The process of developing this report has highlighted the wealth of existing data but also significant gaps in knowledge. These include limited information on SHN policies and coverage, quality and fidelity of programme implementation in many countries. There is a lack of data on delivery of specific aspects of SHN and on SHN programmes in schools outside the government sector, and limited evidence about effectiveness of programmes, particularly their impact on education outcomes. Generating reliable, comparable and timely data, disaggregated by sex and age, on policy, implementation and impact will be critical to assess progress and enhance programming. Data should also be improved on the health, nutrition and well-being of school-age children and adolescents, especially in low- income countries.

Zoom on School Health and Nutrition and SDGs 1 & 2