School health and nutrition: policy and programs.

This paper argues that there is now reliable evidence that ill health and malnutrition affect education access, participation, completion, and achievement, and that school-based health and nutrition programs can provide a cost-effective and low-cost solution. International coordination around this issue has been helped by a consensus framework to "Focus Resources on Effective School Health (FRESH)," developed jointly by UNESCO, WHO, UNICEF, Education International, and the World Bank, and launched at the World Education Forum in Dakar in April 2000 aspart of the global effort to achieve the goal of Education for All (EFA). The need for school health and nutrition programs as part of EFA actions is now recognized by both countries and development partners, and examples of successful practical sector programs that have gone to scale are presented for both low- and middle-income countries. This paper argues that, despite this progress, there are two key unresolved issues related to the targeting of nutrition interventions toward school-age children. The first concerns the role of food as an incentive for participation in education, and the second concerns the appropriate target age group for nutrition interventions. It is suggested that finding clear answers to these key policy questions in nutrition could profoundly influence the impact of future school health and nutrition programs.