WHO guideline on school health services

Research output: Book/ReportCommissioned reportpeer-review


Comprehensive school health services should be implemented.

Strength of recommendation: strong. Certainty of evidence: moderate.

Rationale: this recommendation is strong because:
• all evidence consistently points in a beneficial direction, including evidence related to acceptability and equity;
• the evidence suggests that – if school health services are implemented well – they will have lasting benefits for students;
• the overall certainty of the evidence in the systematic reviews is moderate;
• although there were no studies in low- and middle-income countries that provided highcertainty evidence, the observational studies that took place in low- and middle-income countries also identified benefits and did not identify significant harms; and
• schools offer a compelling, broad and relatively convenient opportunity to reach children and adolescents with needed comprehensive health services.

Implementation considerations
• This recommendation is for comprehensive school health services that have adequate resources and are implemented well.
• School health services need to be implemented with quality, fidelity and over the long term. The resource implications must be carefully identified, examined and met.
• In practice, implementation will be variable.
In some settings it may be difficult and/or not yet feasible to implement comprehensive school health services similar to those that the systematic reviews found were evaluated in controlled studies in high-income countries. Substantial resources, time and leadership may be needed to achieve this. In many low- and middle-income countries it may nonetheless be feasible to implement some aspects of comprehensive school health services now, even if not yet all aspects.
• Protecting student confidentiality is paramount, and school health workers are also obliged to prevent possible discrimination or stigma towards students.
Original languageAmerican English
PublisherWorld Health Organization
Number of pages73
ISBN (Electronic)9789240029392
ISBN (Print)9789240029408
StatePublished - 22 Jun 2021


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