HEALTH

PROMOTING
SCHOOLS:
A m o n i t o r i n g t ool
 HEALTH
START DATE

PROMOTING
DATE AT 6 MONTHS

SCHOOLS:
DATE AT 12 MONTHS

A mo nito r ing to o l

WHO Library Cataloguing in Publication Data

Health promoting schools: a monitoring tool.

1. Health promotion 2. School health services 3. School health promotion

ISBN 978 92 9061 448 7 (NLM Classification: WA 350)

© World Health Organization 2009

All rights reserved. Publications of the World Health Organization can be obtained from
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2 1
distributed without warranty of any kind, either expressed or implied. The responsibility for
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 Purpose
This booklet contains a series of tables to help you assess your
school’s policies and programmes in its journey towards becoming
a health promoting school. Feel free to use this tool to identify
gaps and to track your actions. It is recommended that progress
be reviewed every six months.
How to use this guide?
Organize a group meeting of stakeholders ( e.g. students, teachers,
parents, school staff) who are interested in starting a health promoting
school initiative.
Set a meeting date.
Send out copies of the Health Promoting Schools Framework for Action
so that everyone will be familiar with the concept and proposed actions.
Assign some participants to lead the discussions on different “key
factors” of successful health promoting schools.
At the meeting of stakeholders, ask participants to introduce themselves
and give their ideas about a health promoting school.
Then ask the assigned participants to lead the discussions on the
different key factors of successful health promoting schools.
Put the health promoting school nurturing tree poster on the wall where
everyone can see it.
Using the Monitoring Tool, conduct a group review of policies and
programmes that are in place in the school.
Using the Monitoring Tool and following the instructions in the sticker
booklet, paste the relevant stickers on the health promoting school tree
poster.
2 3
Take a snapshot of the health promoting school tree at the start date.
If the school has a web site, post it on the site. Send the photograph to
hpr@wpro.who.int and it will be posted on the WHO web site.
On the Monitoring Tool, tick off the boxes to identify where the gaps
are. That is, identify which factor, attribute and action are not present in
the school.
As a group, discuss which factor, attribute and action needs to be
improved. One or more areas for action may be selected.
Develop a plan on how to improve on the areas for action. Think of
ways to involve all the students, parents, teachers, school staff and the
community.
Put the health promoting school tree poster in a visible and public place
where everyone can see it.
Throughout the year, use the Monitoring Tool and the health promoting
tree poster to track the school’s progress in the journey towards
becoming a health promoting school.
At 6 months, take a 2nd snapshot of the health promoting school tree
poster. Compare it with your 1st snapshot at the start date and see how
your tree has grown. If you have a web site, post it on the site beside the
first snapshot.
At 12 months, take a 3rd snapshot of the health promoting school tree
poster. Compare it with the previous snapshots and see how the tree has
grown.
 Getting Started
Materials & Legend
1. Health promoting school tree poster
a) Tree branch: Represents each key factor.
2. Monitoring tool
a) Column 1: Describes the attributes of each key factor.
b) Column 2: Describes the specific action points to achieve the
attribute.
c) Column 3: Place a check mark to indicate if a specific action
point has already been undertaken by the school at the start
date.
d) Column 4: Write down any new action undertaken by the
school since the start of the health promoting school initiative
and the date.
3. Sticker booklet
a) Orange fruit sticker: Indicates the key attributes under each
key factor.
b) Colored flower sticker: Represents the action points under each
key attribute and key factor.
c) Extra fruit and flower stickers: If your school comes up with
new key attributes and action points under each key factor.
4 5
Instructions
Step 1: As a group, review key factor 1 and the different attributes
under key factor 1.
Step 2: On the Monitoring Tool, put a check mark on the box across the
key attribute if this is present in the school. If the key attribute is not
present in the school, proceed to the review of the next attribute.
Step 3: Each attribute has an equivalent orange fruit sticker. If the school
has the attribute, peel off the sticker and put it on the branch for key
factor 1. If the school does not have the attribute, leave the sticker on
the booklet.
Step 4: From the Monitoring Tool, read through the action points of the
key attribute. For every action point that the school has undertaken, peel
off one flower sticker and paste it on the appropriate branch of the
tree.
Step 5: Continue in the same manner for key factor 2-6.
KEY FACTOR 1: 5. The school has a policy
and programme on first aid.
There are adequate first aid kits for the school population.
An appropriate number of teachers are trained in first aid
Does your school have healthy school policies? procedures.
At an appropriate age, students are offered training in first aid.
Emergency procedures are set out in the event that the urgent
referral of a student or a teacher to a hospital or clinic is indicated.
These policies are clearly defined in documents or in accepted practices1 which influence a school’s actions in
6. Where appropriate, Students are taught basic knowledge and prevention methods.
promoting the health and well-being of the students, staff, family and wider community and in enhancing the the school has policies and
educational outcomes of students. programmes on the control Treatment services are provided where appropriate, and in
of helminths and other consultation with health officials.
Instructions parasites.
7. Where appropriate, the Students are not permitted to play in the sun without protective
If your school already has an action point in place, please put a check mark [√] in Column 3. school has a policy on sun clothing (e.g. hats) covering the head and neck, and play times are
protection. not when the sun is at its strongest.
Teachers act as role models by wearing protective clothing while in
Count the number check marks (i.e., action points) in Column 3 and enter the total figure in the last row. the sun.
8. The school has a policy on Children are provided with routine health checks (including
Using the sticker booklet, paste the orange fruit and flower stickers onto your health promoting tree health screening. immunization) in line with local priorities and with a view to cost
effectiveness.
posters. [See steps 2 - 4 of the previous section.]
9. The school has a policy Classes are suspended and students asked to remain at home:
on closure in the event • if there is a continuing interruption to the supply of fresh water
If your school has undertaken a new action, please put a check mark [√] in Column 4. And enter the of emergencies or other • in the event of an outbreak of infectious disease
date the new action was undertaken. circumstances that would • if there are extremes of heat or cold from which they cannot
endanger students’ health. be protected adequately
• if sanitation arrangements are considered to be health
After every 6 months, assess new actions your school has undertaken. threatening by the school after consultation with local health
services.
10. The school has a safety The school has an evacuation plan in event of fire; students are
plan to be implemented in drilled in the implementation of this plan.
KEY FACTOR 1: does your school have healthy school policies? the event of emergencies or The school has emergency plans for other circumstances which could
crises. be expected in the local area and for which little forewarning is
IN PLACE NEW ACTION TAKEN
KEY ATTRIBUTES ACTION POINTS likely e.g. flood, typhoon, physical attack in the event of hostilities.
[√] AND DATE
11. Where relevant, the Issues of practical management such as blood spill procedures and
1. The school has a policy on The school has taken action to ensure healthy, and where possible school has a policy on the management of contaminated water are clearly documented and
healthy and safe foods and appropriate, locally grown food is available to students. control and management rehearsed and suitable equipment is available in the event that it is
Teachers and other school staff act as role models by eating healthy of infectious diseases (such required.
food in school. as HIV/AIDS, tuberculosis), Where appropriate, teachers and other school personnel are
Healthy food is made available at school social events like sports including their safe provided with training about the prevention and management of
days. management. HIV/AIDS, SARS, influenza and other infectious disease.
Healthy and safe food are readily available at the school canteen 12. The school upholds The school has a structured forum for students to voice their opinions
(if present), and options for unhealthy food are reduced. democratic and and ideas.
Food vendors selling or distributing food to students within the school participatory education Student-led activities are common across the school.
need to be approved by the school and relevant health authorities. by ensuring that students’ Where appropriate, the school facilitates student-initiated activities
2. The school is totally The school has developed a strategy for phasing out smoking opinions are considered. Also and student interaction with peers and relevant community members
tobacco-free and prohibits completely within the premises, with a deadline for being totally students have appropriate (under teacher guidance and supervision) in order to develop plans
harmful use of alcohol and smoke free; this policy applies to all staff, students and visitors. opportunities with guidance and actions to address relevant health issues.
illicit drugs in all activities. The school has prepared an appropriate action plan to eliminate and supervision to initiate
alcohol and illicit drugs in all school activities. and implement health
related activities
Where appropriate, the school community advocates for prohibiting
tobacco sales in the local area. 13. The school has a policy Care is taken to scrutinize all products to which the students are
that restricts and manages exposed in the school community.
3. The school upholds equity The school has reviewed customs and practices prevailing within the student exposure to media
principles by ensuring school with respect to the use of play space, equipment, teacher The school actively provides curriculum opportunities to enable
and marketing strategies for students to learn about how health related products are promoted.
that girls and boys have time and sanitary and other resources. Where necessary, it has also products and practices that
equitable access to school taken action to redress inequities between girls and boys. The school rigorously reviews any partnerships with external
pose a risk to health. organizations that may sell products and provide services which
resources and opportunities
in school activities. carry a health risk for the students .
4. The school has formal All medication distributed by the school is recorded. 14. The school has a The school has an action plan to enhance its physical and social
procedures in place relating Local health officials provide advice on the suitable storage and policy on the establishment environments, developed in consultation with students and parent
to the distribution of distribution of medication. and sustainability of a and where relevant, with local community leaders.
medication. healthy, friendly and safe
Where appropriate, the school community advocates for prohibiting environment.
tobacco sales in the local area.
TOTAL (ACTION POINTS) FOR KEY FACTOR 1:
1
Jones J and Furner, M. Health Promoting Schools: A healthy setting for living, learning and working. Geneva, World
Health Organization, 1998 (http://www.who.int/school_youth_health/media/en/92.pdf, accessed 10 September 2009).

6 7
KEY FACTOR 2: KEY FACTOR 2: does your school have healthy physical environment?
IN PLACE NEW ACTION TAKEN
Does your school have a healthy physical environment? KEY ATTRIBUTES ACTION POINTS
[√] AND DATE
1. The school provides a In selecting any new play and sporting equipment, the school takes
safe, secure, and healthy safety into account and, if appropriate, ensures that guidelines for
The physical environment refers to the buildings, grounds, play space and equipment in and surrounding environment for the school their use are in place.
community. The school undertakes periodic safety audits of all buildings, plant
the school. It also includes basic amenities, such as sanitation, water availability, waste disposal and air and equipment and school surroundings.
cleanliness. In conjunction with the local community, the school takes action to
minimize local hazards, for example those related to traffic or drug
Instructions dealing.
Procedures for visitors are put in place to ensure the safety of stu-
dents and staff.
If your school already has an action point in place, please put a check mark [√] in Column 3. Where appropriate, the school undertakes regular checks and
undertakes necessary action to remove mosquito breeding grounds
Count the number check marks (i.e., action points) in Column 3 and enter the total figure in the last row. and other areas which may facilitate the reproduction of rats and
other pests.
2. Adequate sanitation and There are sufficient toilets connected to a functioning sewerage
Using the sticker booklet, paste the orange fruit and flower stickers onto your health promoting tree water is available. system, and where appropriate, separate facilities are provided for
posters. [See steps 2 - 4 of the previous section.] males and females.
Safe and clean water is available for drinking, hand-washing and
food preparation.
If your school has undertaken a new action, please put a check mark [√] in Column 4. And enter the
An adequate quantity of water is available for washing facilities
date the new action was undertaken. and sanitation.
3. The school upholds Materials, such as paper, glass and aluminium are recycled.
After every 6 months, assess new actions your school has undertaken. practices that support a The use of disposable plastic containers is discouraged.
sustainable and energy- Energy is conserved and renewable energy sources used where
efficient environment. appropriate.
The curriculum provides opportunities for students to learn
about global, national and local environmental issues, as well as
opportunities to develop actions which the school and students can
implement at school and in the local community.
4.Where food is provided, it Only healthy food is available at the school cafeteria.
is safe and nutritious. Food handlers apply the WHO Five Keys to Safer Foods or its
equivalent.
5. Students are encouraged The school has an adequate garbage disposal system that is
to take care of the school suitable to its circumstances.
facilities and the constructed Students participate in keeping the school clean.
and natural environments. Students participate in beautifying the school, for example by
painting murals and planting trees and shrubs.
6. The school endeavours to Adequate ventilation exists in all school areas where students
enrich learning by ensuring gather.
the best possible physical Adequate teaching and learning spaces are provided.
conditions. The lighting is adequate.
Provision is made for relief during extreme temperatures.
Measures are taken to reduce unnecessary sound disturbances.
The school should identify what standards already exist and explore
with relevant authorities how resources can be obtained to meet
those standards.
Furniture and other facilities cater to different sizes and needs of
students.

TOTAL (ACTION POINTS) FOR KEY FACTOR 2:

8 9
KEY FACTOR 3: KEY FACTOR 3: does your school have healthy social environment?
Does your school have a healthy social environment? KEY ATTRIBUTES
1. The school ethos promotes
the mental, spiritual, emo-
The social environment of the school fosters good relationships among and between staff and students. It is tional, financial and social
resources of students and
influenced by the relationships with parents and the wider community. staff.
Instructions
If your school already has an action point in place, please put a check mark [√] in Column 3. 2. The school creates
an environment of care,
trust and friendliness,
Count the number check marks (i.e., action points) in Column 3 and enter the total figure in the last row. which encourages student
attendance and involvement.
Using the sticker booklet, paste the orange fruit and flower stickers onto your health promoting tree 3. The school provides
appropriate support and
posters. [See steps 2 - 4 of the previous section.] assistance to students and
staff who are at a particular
If your school has undertaken a new action, please put a check mark [√] in Column 4. And enter the disadvantage relative to
their
date the new action was undertaken. peers.
4. The school provides a
After every 6 months, assess new actions your school has undertaken. fully inclusive environment
in which all individuals are
valued and differences are
respected.
5. The school is responsive
to the educational needs of
teachers and parents and
how these can influence the
well-being of students.
10
IN PLACE NEW ACTION TAKEN
ACTION POINTS
[√] AND DATE
The school promotes the self-esteem and resilience of students and
staff.
Teachers do not use harsh discipline and are supportive of and
respectful towards students.
Students are encouraged to participate in school decision-making
processes.
Students are encouraged to be active participants in the learning
process.
The school actively discourages physical and verbal violence, both
among students and by staff towards students; and encourages the
creative resolution of conflict and violence within the school.
The school provides appropriate monitoring and support to reduce
vulnerability and address special needs of students and staff.
The school and/or the education authorities recognize that some
students have special needs and ensure appropriate facilities,
learning aids and programmes are offered to students with special
needs and to students from less advantaged backgrounds
The school provides opportunities to celebrate cultural, religious
and tribal diversity, e.g. through food, art, costume, dance, displays,
festivals and exhibitions.
The curriculum provides opportunities for students to learn about
cultural, religious and racial diversity and customs; and where
appropriate, apply this learning.
Where appropriate, the school provides the setting for the provision
of specific educational services for parents, for example literacy,
parenting skills, helminth education, and encourages and facilitate
the formation of parent support groups.
TOTAL (ACTION POINTS) FOR KEY FACTOR 3:
11
KEY FACTOR 4: KEY FACTOR 4: does your school have community links?
IN PLACE NEW ACTION TAKEN
Does your school have community links? KEY ATTRIBUTES ACTION POINTS
[√] AND DATE
1. Family and community Families are involved in making decisions about suitable health
involvement in the life of the promoting activities, such as food policies, the development of a
Community links are the conections between the school and the students’ families plus the connection between school is fostered. school garden, physical activities and sexuality education.
The curriculum contains health-related activities which involve
the local groups and individuals. Appropriate consultation and participation with these stakeholders children working with their families.
enhances a health promoting school, facilitates partnerships and support for the school’s health promoting Local groups with an interest in child and adolescent health and
initiatives. health organizations providing services in the local community
participate collaboratively in school activities.
Where appropriate, the school seeks guidance and advice from
Instructions other agencies on specific emerging health-related issues.
2. The school is proactive Students and teachers participate in local events on a regular basis
If your school already has an action point in place, please put a check mark [√] in Column 3. in linking with its local such as culture, sports and festivals.
community. The school informs the local community of its health initiatives,
for example through the use of local media, school open days
Count the number check marks (i.e., action points) in Column 3 and enter the total figure in the last row. or community functions where students provide “healthy school”
displays.
Using the sticker booklet, paste the orange fruit and flower stickers onto your health promoting tree The school shares its facilities with relevant health promoting
posters. [See steps 2 - 4 of the previous section.] community members and groups.
The school works with the local community to reduce the impact
of media messages and marketing approaches which may be
If your school has undertaken a new action, please put a check mark [√] in Column 4. And enter the detrimental to the health and well-being of the students.
date the new action was undertaken. The school works in partnership with local media organizations to
enhance the media literacy of students and teachers to create a
communication environment that is supportive of health.
After every 6 months, assess new actions your school has undertaken.
TOTAL (ACTION POINTS) FOR KEY FACTOR 4:

12 13
KEY FACTOR 5: KEY FACTOR 5: does your school have action competencies for healthy living?
IN PLACE NEW ACTION TAKEN
Does your school have action competencies for healthy living? KEY ATTRIBUTES ACTION POINTS
[√] AND DATE
1. The curriculum approaches The health curriculum is designed to be interesting, engaging and
health issues in a coherent relevant to students and localized where relevant.
This refers to both the formal and informal curricula for health education. It also refers to associated and holistic way to build The learning process places an emphasis on student participation
competencies for students and empowerment.
activities where students can gain age-appropriate knowledge, understandings, experiences, and life skills from which they can take The curriculum content reflects issues that students can relate to their
that can enable them to build their capacity to take action to improve their health and well-being, and that action. community and experience.
of others in their community and beyond. The curriculum supports the students’ routine health-care
management.
Instructions The curriculum provides developmentally appropriate learning
experiences for children.
Sufficient time per week is allocated to health in the overall
If your school already has an action point in place, please put a check mark [√] in Column 3. curriculum.
2. The curriculum is designed Students gain a basic understanding, appropriate to their age
Count the number check marks (i.e., action points) in Column 3 and enter the total figure in the last row. to improve students’ and culture, of nutrition, WHO’s Five Keys to Safer Foods, disease-
understanding of health prevention and hygiene, physical activity, safety, mental health,
issues. Additionally, it should life skills, sexuality (including HIV/AIDS), tobacco and drug
Using the sticker booklet, paste the orange fruit and flower stickers onto your health promoting tree provide opportunities use prevention, accident and injury prevention, oral health and
posters. [See steps 2 - 4 of the previous section.] (that are both age- environmental issues.
and developmentally Students have opportunities to gain skills with respect to specific and
appropriate) for students relevant health issues, such as resistance to tobacco and drug use,
If your school has undertaken a new action, please put a check mark [√] in Column 4. And enter the to develop and apply their maintaining oral hygiene.
date the new action was undertaken. skills in addressing health Students are provided with authentic learning experiences, and
issues at the individual, supported to acquire skills in practicing protective behaviour and
family and community levels. avoiding risky behaviour.
After every 6 months, assess new actions your school has undertaken.
Students develop competencies in problem-solving, decision-making,
effective communication (including negotiation and refusal skills),
advocacy, coping with emotions and stress, and critical and creative
thinking, in order to enhance their own health and well-being, and
to be competent to take action to improve family and community
health.
Students develop competencies in working with peers as leaders,
educators and mentors.
3. Teachers are adequately Teachers are provided with pre-service and in-service programmes
prepared for their role as on health promotion and health promoting schools (such as short
key participants in health courses and workshops with refresher and update opportunities).
promoting schools. Teachers are provided with adequate information, on an ongoing
basis, about the availability and use of health resources to facilitate
learning and effective teaching and learning strategies.
School authorities enable all staff to gain the knowledge and skills
necessary to take action to improve their own health.
4. Teachers and students Students and teachers regularly analyse media (print, electronic)
gain knowledge and where health is portrayed and, where relevant, work together to
understanding of media take action to limit the potential health risks of such messages.
messages related to health,
and they develop the
competency to analyse these
messages.
5. Schools facilitate learning In addition to professional development programmes provided for
opportunities about healthy teachers, training sessions are made available for parents, key
living in the local community health and education personnel and local community members to
and society. equip these groups to take actions to advance the health and well-
being of students and their families and communities.

TOTAL (ACTION POINTS) FOR KEY FACTOR 5:

14 15
KEY FACTOR 6: KEY FACTOR 6: does your school have health care promotion and services?
IN PLACE NEW ACTION TAKEN
Does your school have health care and promotion services? KEY ATTRIBUTES ACTION POINTS
[√] AND DATE
1. Basic prevention, The school actively seeks immunization for its students.
promotion and protection Appropriate health screening is provided, for example for vision,
The school has access to direct service from, or can partner with, the local and regional facilities that are health services which hearing and physical development.
address local and national Appropriate basic oral health services are provided, for example
responsible for child and adolescent health care and promotion. needs are available to annual examination, sealant application and restoration of teeth.
students and staff.
Appropriate health records of children’s health status are kept by
Instructions the relevant authorities.
Counselling and support services are available for socially and
If your school already has an action point in place, please put a check mark [√] in Column 3. emotionally distressed students and those with health problems.
2. Local health services There is consultation between health services personnel and
contribute to the school’s teachers about the design and implementation of the health-related
Count the number check marks (i.e., action points) in Column 3 and enter the total figure in the last row. health programme. curriculum.
Health services personnel complement the work of teachers by
Using the sticker booklet, paste the orange fruit and flower stickers onto your health promoting tree collaborating with school staff in supporting curriculum initiatives.
posters. [See steps 2 - 4 of the previous section.] Health service agencies are proactive in approaching schools to
offer support for health promotion activities.
Local health services support schools by explaining and managing
If your school has undertaken a new action, please put a check mark [√] in Column 4. And enter the local health campaigns.
date the new action was undertaken. 3. Health services contribute Relevant health services personnel provide training programmes for
to teacher training. teachers in appropriate topics, for example helminth control or first
aid.
After every 6 months, assess new actions your school has undertaken.
TOTAL (ACTION POINTS) FOR KEY FACTOR 6:

16 17
Western Pacific Region

Health Promotion
P.O. Box 2932
1000 Manila, Philippines

www.wpro.who.int