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The relationship between academic achievement and the status of student health is acknowledged by the National Education Policy and Goals of the Kingdom of Saudi Arabia. Among its directives are the following: (1) Students are to start school with healthy minds, bodies and mental alertness necessary for learning. (2) There should be safe and disciplined school environment to ensure a physical and psychological well being of students. (3) An opportunity for all students to acquire healthy life skills and health education. (4) The maintenance of the development and the growth of the students “psychosocially, mentally and physically” in the school set-up, should be in circumstances similar to the home situation governed by Islamic teachings. (5) Free health care (preventive and curative) should be provided to all students.
Today's children are the citizens of tomorrow's nation. Their survival, protection and development are, therefore, the prerequisite for the future development of this country. Empowerment of the younger generation with knowledge and resources to meet their basic human needs and enable them to grow to their full potential should be a primary goal of national development. As their individual development and social contribution will shape the future of the country, investment in children's health, nutrition and education is the vital foundation for national development.
It is evident that good health improves learning potentials, so for students to be able to attend school regularly and take full advantage of opportunities provided by schools, they must be in a state of health that enables them to do so. Also, the improvement of the ability to learn and the performance at school requires school-based effort to improve health. However, it is also obvious that schooling improves health. The impact of schooling is evident in the benefits to maternal and child health by the marked reduction of mortality among young women who had had some schooling.
In 1993, the World Bank and WHO made a comparison of the cost effectiveness of various public health programmes and concluded that a school health programme that provided safe and low cost health services, such as deworming treatments, and health education was one of the most cost-effective investments a nation could make to improve health. Programmes to expand immunization and micronutrient supplementation, increase knowledge about nutrition, and health care, reduce the consumption of tobacco, alcohol, and drugs, and prevent AIDS and STDs are of great value and were listed among the most cost-effective investments in health. Clearly school health plays a major role in these programmes. Consequently, investment in school health programmes is perhaps the “very best of the best”.
Although schools have the potential to improve health through education, all too often, they do not take advantage of, nor utilize that capacity. Indeed, many schools in diverse ways put the health of the students and school personnel at risk. These dangers could be eliminated altogether or reduced with better resources.
The goals “Health for All” and “Education for All” express The United Nations’ commitment to health and education. Because these goals are inseparably linked and must be worked at concurrently for their realization, much cooperative and concerted effort are required from health and education organizations at all levels. The impetus for action resides with individuals. Both young and old can play a vital role in supporting school health by asking and trying to resolve questions such as these: Does our school promote health? Is our school a healthy environment for work? Does our school help students, school personnel and their families address their health needs? What can I do both personally and with others to bring about the needed change?
Schools can serve as a means for coordinating, integrating, implementing and sustaining a variety of ways that promote good health, prevent disease and injury, and reduce risk. They can assist with programmes that help to improve health, education and the well being of the nation. Today, the concept of school health goes well beyond providing health instruction and screening for students. It consists of multiple inter-related aspects including health education, the provision of health services, a healthy environment, physical education and recreation, school and community health projects and outreach programmes, psycho-social counseling, health promotion programmes for staff, nutrition and feeding programmes as well as other programmes for the improvement of the health of the nation. The different aspects of school health can be planned and organized and implemented in a coordinated manner, with an eye on the prevailing health needs and problems. This planning helps to avoid irrelevant, duplicative or conflicting interventions, reduces competition for time and attention for the various facets and maximizes the use of the available resources.
School health programmes should be organized to address a wide range of health issues, and include broad holistic approaches. Evidence demonstrates that a comprehensive approach to school health is a cost-effective means for promoting health and reducing health problems. The findings of cost-effective studies for some aspects of school health suggest that the potential benefits are many.
It is hoped that in measuring the effectiveness of school organization, the school authorities would include indicators of student health. A more active support and commitment from the Ministries of Health and Education and coordination of their effort with school officials and school health staff are of the utmost importance. A part of the support will be to provide more resources in terms of skilled personnel, training and materials. Research is needed on how to influence schools to adopt and maintain good health programmes, and on the problems envisaged in the implementation of school health programmes at the local and national levels.1–5
School health has been and should remain a priority investment in health of the nation. In the wake of health planners’ keenness on cost-effectiveness, school health has recently received increased emphasis in health planning and finance. For our region, where health challenges have become a blend of problems of ‘developing’ and ‘developed’ countries, re-orienting efforts and resources towards school health has become a necessity. In this edition of our journal, and at a time when an important school health conference is being convened in Al-Hassa, we devote a guest editorial and an article on school health to mark our keeping up with this important aspect of family and community medicine.