A Brief History and Key Aspects of the Evolution of the Health Promoting Schools Approach
School Health Promotion: An Enduring and Aspirational Approach
The frameworks used to promote health through schools emerged in the late 1980’s in several parts of the world. At their core, the different models were focused on key components such as over-arching policy, health/life skills education, school-based and school-linked services, a healthy physical environment and social support generated by involving parents, youth and the local community.
Different models (and some apparent confusion over purposes) emerged in the 1990’s, with some regions and countries opting to focus on a selected set of programs, others defining their work more as a planning framework to address all issues and others responding to their local contexts with slightly different components and combinations. At the same time, other sectors working with their school systems developed similar but different frameworks to promote inclusive child-friendly schools, safe and caring schools, community-school partnerships, education in countries facing conflicts/emergencies, development aid through basic nutrition, hygiene and infectious disease prevention and broad developmental issues such as social & emotional learning and life skills.
A 2007 WHO forum in Vancouver took stock of developments and issued a consensus statement that identified important gains and current challenges. These included the need to contextualize programs for different needs/strengths, to focus on educational as well as health benefits, to alleviate disadvantage, improve partnerships across several sectors, build capacity and improve implementation quality.
In 2010, an international school health symposium in Geneva focused on inter-sectorial connections between education, health & sustainable development. This connection between human and environmental health was a key part of the Ottawa Charter on Health Promotion, which was often a stimulus for developing school health models. The Geneva workshop also highlighted consensus statements and reports on two other equity-related contexts; disadvantaged communities in high resource countries and school health promotion within indigenous communities/nations.
Another international School Health symposium in 2013 concluded with a consensus statement and launched an educator-led, global dialogue and series of workshops on the need to integrate health and social programs within the core mandates, constraints and concerns of education systems. In some ways, this dialogue is the education response to the health sector call for Health-in-All-Policies (HIAP) initiative. Educators are calling for a fundamental change in how other sectors partner with the education sector.
In 2014, the FRESH Partners identified the core elements or pillars (FRESH Framework) that are common to the different approaches used by UN agencies when working with schools. In 2018, a Global Delphi consultation is finalizing what we know and need to know from the many compatible, similar but essentially different sector models for working within education systems to create a common base of knowledge and terms and to align efforts. Education and schooling is clearly recognized as a critical hub in the achievement of all the UN Sustainable Development Goals, so it is imperative that the non-education sectors stop working in competition or ignorance of each other.
A 2015 WHO Technical meeting in Bangkok identified several issues related to capacity-building within systems, including inter-ministry and multi-level, intra-sectoral cooperation, improved monitoring and reporting, sustainable funding and maintenance of approaches, workforce development and re-building of core health/life skills education programs and curricula.
About 2005 and increasingly thereafter, researchers began to catch up with practitioners in understanding that school systems are open, adaptive and complex ecological systems that cannot be subjected to multiple, competing projects and programs without creating an ecological, systems-based approach. Systems thinking and systems science concepts and tools are now being used to guide, plan and evaluate health promotion and social development approaches and programs.
Consequently, the school-based and school-linked health promotion of the 21st century must be and will be significantly different than the traditional, issue-focused, quickly find/develop the best (including consideration of costs, risks) program of the past three decades. The need to evidence-based and experience-tested programs will not disappear, but they will need to be nurtured within a dramatically new approach that includes the domains or dimensions described in these standards.
School Health Promotion: An Enduring and Aspirational Approach
The frameworks used to promote health through schools emerged in the late 1980’s in several parts of the world. At their core, the different models were focused on key components such as over-arching policy, health/life skills education, school-based and school-linked services, a healthy physical environment and social support generated by involving parents, youth and the local community.
Different models (and some apparent confusion over purposes) emerged in the 1990’s, with some regions and countries opting to focus on a selected set of programs, others defining their work more as a planning framework to address all issues and others responding to their local contexts with slightly different components and combinations. At the same time, other sectors working with their school systems developed similar but different frameworks to promote inclusive child-friendly schools, safe and caring schools, community-school partnerships, education in countries facing conflicts/emergencies, development aid through basic nutrition, hygiene and infectious disease prevention and broad developmental issues such as social & emotional learning and life skills.
A 2007 WHO forum in Vancouver took stock of developments and issued a consensus statement that identified important gains and current challenges. These included the need to contextualize programs for different needs/strengths, to focus on educational as well as health benefits, to alleviate disadvantage, improve partnerships across several sectors, build capacity and improve implementation quality.
In 2010, an international school health symposium in Geneva focused on inter-sectorial connections between education, health & sustainable development. This connection between human and environmental health was a key part of the Ottawa Charter on Health Promotion, which was often a stimulus for developing school health models. The Geneva workshop also highlighted consensus statements and reports on two other equity-related contexts; disadvantaged communities in high resource countries and school health promotion within indigenous communities/nations.
Another international School Health symposium in 2013 concluded with a consensus statement and launched an educator-led, global dialogue and series of workshops on the need to integrate health and social programs within the core mandates, constraints and concerns of education systems. In some ways, this dialogue is the education response to the health sector call for Health-in-All-Policies (HIAP) initiative. Educators are calling for a fundamental change in how other sectors partner with the education sector.
In 2014, the FRESH Partners identified the core elements or pillars (FRESH Framework) that are common to the different approaches used by UN agencies when working with schools. In 2018, a Global Delphi consultation is finalizing what we know and need to know from the many compatible, similar but essentially different sector models for working within education systems to create a common base of knowledge and terms and to align efforts. Education and schooling is clearly recognized as a critical hub in the achievement of all the UN Sustainable Development Goals, so it is imperative that the non-education sectors stop working in competition or ignorance of each other.
A 2015 WHO Technical meeting in Bangkok identified several issues related to capacity-building within systems, including inter-ministry and multi-level, intra-sectoral cooperation, improved monitoring and reporting, sustainable funding and maintenance of approaches, workforce development and re-building of core health/life skills education programs and curricula.
About 2005 and increasingly thereafter, researchers began to catch up with practitioners in understanding that school systems are open, adaptive and complex ecological systems that cannot be subjected to multiple, competing projects and programs without creating an ecological, systems-based approach. Systems thinking and systems science concepts and tools are now being used to guide, plan and evaluate health promotion and social development approaches and programs.
Consequently, the school-based and school-linked health promotion of the 21st century must be and will be significantly different than the traditional, issue-focused, quickly find/develop the best (including consideration of costs, risks) program of the past three decades. The need to evidence-based and experience-tested programs will not disappear, but they will need to be nurtured within a dramatically new approach that includes the domains or dimensions described in these standards.