A second chance in the second decade

Working with other sectors


Education and health sectors share interests

The education and health sectors are partners in promoting adolescents’ healthy development.14 Adolescence is a time of growing capacity, including increasing skills and knowledge to enjoy life, to develop a livelihood for the future and to keep healthy. More years of schooling are associated with better health outcomes at the individual and population levels.

At the same time poor health compromises the education of children and adolescents. A range of health problems from malaria and worm infestations to trauma and HIV reduce school enrolment and retention and increase absenteeism; hunger and anaemia can impair cognition and learning.15 Diarrhoea and respiratory diseases also interfere with attendance and learning.

School retention

Learning to read, write, and use numbers, is the result of a considerable abstract cognitive exercise that transforms how people think, reason and solve problems.16 The cognitive impact of schooling is crucial for adolescents to be health-literate as well as to engage in health promotion.

Defining health

Health interventions and economic interventions to increase school attendance, such as conditional and unconditional cash transfers, can reinforce each other—for example, in preventing HIV and pregnancy among adolescent girls.17 18 With increasing enrolment in primary and secondary education in many countries, there will be more opportunities for the health and education sectors to work together to improve educational outcomes and promote health.

5 ways schools promote health with Vivian Barnekow

Collaboration for health education

In the WHO global consultation with adolescents, 41% of respondents state that they obtain health information at school, and 46% are influenced by such information when it comes from a school-based context. Skills-based health education19 is a key collaboration between the sectors. WHO strongly recommends health education, both to prevent health-compromising behaviours that arise during adolescence and to contribute to mental health.

to address SRH

Notable high-profile collaborations between ministries of health and ministries of education have taken place in Latin America and the Caribbean, and in East and Southern Africa, to promote comprehensive sexuality education and linkages to health services.

A recent statement from ministries of education in the Americas emphasizes the need to respond to problems beyond sexual and reproductive health.20 The statement highlights the importance of focusing on physical activity, healthy eating and prevention of addictions in addition to comprehensive sexuality education. Similar multi-health issue strategies are being promoted in other regions as well.

Comprehensive Ministerial Declaration Why adolescents and young people need comprehensive sexuality education and sexual and reproductive health services in Eastern and Southern Africa

Schools contribute more than health education. While skills-based health education is clearly important, there are concerns that, in isolation, these approaches have small effects.21 Schools are therefore, paying greater attention to the social environment. For example, recent findings confirm the important benefits of student participation in school activities to adolescent health and the positive effects of trusting relationships between school staff and students.22 Offering a physical environment that ensures safety, provides areas for physical activity and promotes healthy eating are other important ways that schools can contribute to adolescent health.23

Nutrition friendly school initiative

The provision of safe water and sanitation in schools24 is critical to the prevention of diarrhoea and parasitic worm infections. For adolescent girls the provision of running water, private toilet facilities separate from boys and hygienic materials for menstruation may discourage them from missing school during menstruation.

Puberty education and menstrual hygiene management

The social and physical environment, and the notion of school ethos, or culture, are all elements of “health-promoting schools”, an approach that WHO has encouraged for several decades. Evaluating this multi-component approach has been challenging. However, a recent systematic review that pools findings from a number of randomized controlled trials, largely in high income settings, shows benefits in terms of a reduction in body mass index and an increase in physical activity and fruit and vegetable consumption as well as a decrease in tobacco use and reports of being bullied. The review found little or no evidence of effect on body mass index z scores, fat intake, alcohol and drug use, violence, mental health and bullying others.25

School-based interventions can effectively influence common risk and protective factors for a range of health behaviours, even for marginalized groups of adolescents who are adversely affected by health inequities.26 In some instances they can do so over the long term coherently and efficiently.27 Schools can play this role in addition to providing a setting for the delivery of health services, as discussed in Section 6.

sector activities

Through school, as it is where we spend a lot of time, government initiatives of school wide health awareness should be somewhat compulsory, such as having speakers come to your school, organised by the government to choose from what organisation they come from, or your school, to speak about relevant health issues to students, from an understandable viewpoint. It is more effective than reading a pamphlet.

female, 15-17, Australia

Ensure sexual education in all schools and give out contraceptives for free, as sexual issues are the biggest health problems faced by adolescents, venereal diseases, unwanted pregnancies, HIV.

Gender not specified, 15-17, Chile

I don’t talk about my difficulties. I use sports as a way to feel relief from all the bad things that have happened and happen to me, etc.

male, 18-19, Chile

School stresses me out, and as a result I have been careless with my health, my diet, etc.

female, 18-19, Peru

I think that schools should do more than sport classes to improve their students health. Teaching the students how to cook healthy meals would be one of those things.

female, 18-19, Germany

I think the way we know about the issues that affect us should be much better done, like at schools and on internet instead of just on hospitals.

female, 18-19, Brazil

For me, to be in good health means above all to have a family. I think that health is not only a physical thing but also mental because if you are surrounded by family or by people who love you, that can allow you to always be in good health (to smile, to be in a good mood)

female, 18-19, Gabon

When someone in my family, especially my mother, or a close friend shows their support for me.

female, 15-17, Paraguay

Adolescents on what can be done to improve health services: Improve and create more facilities, such as more primary health care centres in schools, community centres (that work well); encourage sports and extracurricular activities to help adolescents clear their minds.

female, 18-19, Venezuela

Wide-scale action promoting sport: built-up of the network of bicycle paths and bicycle rents, discounts to sports centres, support from teachers to students who participate in sport competitions, varied and more inclusive physical education classes (overweight or disabled students too frequently find excuses to avoid exercises) 2) Increasing the awareness of importance of physical health and its relation to mental condition - by school education and social campaigns 3) Creating alternatives - youth needs to understand that getting drunk or taking tobacco/other drugs is not a good way to build up one's position among peers.

female, 18-19, Poland

I do not find enough time to perform sports and I find handy, unhealthy food in front of me

female, 18-19, Saudi Arabia

Through school, as it is where we spend a lot of time, government initiatives of school wide health awareness should be somewhat compulsory, such as having speakers come to your school, organised by the government to choose from what organisation they come from, or your school, to speak about relevant health issues to students, from an understandable viewpoint. It is more effective than reading a pamphlet.

female, 15-17, Australia

Life is difficult, especially when you’re young and you have to be sitting down all the time. I feel that my body is being destroyed at school because I am forced to stay seated all day.

male, 18-19, Canada