The FRESH initiative

FRESH ( Focusing Resources on Effective School Health) is an initiative which promotes the focusing of resources on the school-aged child.

The FRESH Start initiative was launched at the Education for all Conference in April 2000 in Senegal by UNICEF, WHO, UNESCO, and the World Bank (World Bank, 2001). It is also supported by a number of other agencies, including Education International, EDC, The Partnership for Child Development, WFP and partners from the private sector.

It has developed a common framework as a starting point for an effective school health component in a broader effort to achieve more child-friendly schools. This framework includes a core of simple and familiar interventions that capture the best practices from programme experiences. When they are supported by effective inter-sectoral and community partnerships they can even be implemented in the poorest schools and in hard-to-reach rural areas, as well as in more accessible urban areas.

The framework is increasingly popular around the world as the basis of both government policy and school-community practices. On the basis of the framework, the individual countries are encouraged to develop their own strategy to match local needs.

The four core interventions in the framework are:

Provision of safe water and sanitation
An essential step towards a healthy physical learning environment.

Skills based health education
This approach to health education focuses on the development of knowledge, attitude, and life skills needed to deal with health and social issues. The development of specific psycho-social skills and the opportunity to use and practice them are central to effective skills-based health education. When individuals have these skills, they are more likely to adopt and sustain a healthy lifestyle during schooling and the rest of their lives.

School-based health and nutrition services
Schools can effectively deliver a variety of health and nutritional services provided that the services are simple, safe and familiar, and address problems that are prevalent within the community and are recognised as important.

Health-related school policies
Health policies in schools can support the three interventions above. In addition, these policies could help promote strategies of inclusion and equity in the school environment if addressing issues like the further education of pregnant school girls and young mothers and of children (in)directly affected by HIV.

Besides the above noted four core interventions, the FRESH start approach defines three supporting activities that provide the context in which the interventions can be implemented. These supporting activities are:

• Effective partnerships between teachers and health workers and between the education and health sectors;
• Effective community partnerships: promoting a positive interaction between the school and the community is fundamental to the success and sustainability of any school improvement process; and
• Pupil awareness and participation - children must be important participants in all aspects of school health programmes and not simply the beneficiaries.