UNESCO Chair Global Health and Education Health Education, Prevention, Health Promotion, Children and Young People

Intersectoral working in schools between education staff and primary healthcare professionals

Why is this study being done?

The pandemic has highlighted the importance of the relationship between health and education, and the need to increase schools’ resilience for any future health crises. Each student has to be equipped with a range of everyday skills to make independent and responsible decisions about their own health, which includes effective use of primary healthcare systems, and to live as a ‘good health citizen’ when the situation demands social public health strategies.

During the pandemic, our Chair published a commentary about schools as the foundation for healthy lives (Jourdan et al., 2021) where the potential for effective partnerships between health and education professionals was highlighted. Primary healthcare professionals could have key roles including advocacy in communities for school health, and capacity-building among teachers for delivering health-related curriculum material. This would help to reverse the widening health equity gaps the pandemic has precipitated in our schools and communities, including our youth’s future wellbeing.

The UNESCO Chair ‘Global Health & Education’ (UNESCO Chair GHE) launched a call for good practices with the objective of strengthening our collective understanding of effective intersectoral working between health and education professionals in – and for – schools.

How do we define intersectoral working?

Here are some examples of what we mean by ‘intersectoral working’:

  • Education and health professionals acting in synergy towards a common goal to improve the health of students in schools
  • The initiative contributes to creating links and coherence between professionals, thereby improving interventions and promoting more systemic change
  • Education and health professionals are involved in co-creation processes in schools, which may also involve students and parents, to ensure that health resources are tailor-made for that cultural and social context.

Presentation of the case studies collected

We were delighted to receive 20 interesting and relevant cases. The majority of the cases were from the diverse regions of Spain (n=12), and we thank our network there (Table 1); colleagues responded from Australasia, Europe and Latin America.

The professionals involved in the cases were diverse. Classroom teachers were common to all cases, of course, but Table 1 shows the wide range of other health and education professional disciplines taking part in intersectoral work.

Professional DisciplineNumber of cases (n=20)Professional DisciplineNumber of cases (n=20)
Classroom teaching20Pharmacy2
Council planning1Phonaudiology1
Disability specialist1Public health1
Emergency medicine1Research2
Hypnotherapist1School facility staff (Kitchen, caretaking)1
Medicine10School management (including principals)4
Nursing12Social worker1
Nutrition3Special educational needs1
Occupational Therapy1Speech therapy2
Table 1 – Professional disciplines involved in the cases

Most of the topics of the cases had a holistic focus on mental and physical well-being. Topics were very diverse and included autism, climate impact and even pharmacist input to subjects like maths and science.

The total number of students impacted by the initiatives was 892,340 – there was, however, a wide range of student group numbers across the cases (minimum 12, maximum 788,971). Regarding the stage of school where the initiative took place, many covered more than one stage of education (preschool, primary, secondary).

All the cases included students from public/free schools – 3 also included students from fee-paying schools. There was some diversity of location; most cases included urban schools (12/20), but there were also rural and suburban examples. The majority of cases involved students from all types of socioeconomic background, but some were targeted in areas of low deprivation.

Case studies

A Pharmacist in Schools (Yorkshire, England)

This case study describes the implication of a primary care pharmacist in schools to raise awareness of the pharmacist role, but also to support the curriculum and share how learning reflects true-to-life expériences. Sessions on different topics were provided : healthy eating and living, drug safety, Maths in the Everyday (ie. In the pharmacist role, by calculating a dose for a prescription).

To read the complete description
Contributor’s contact :
Laura Buckley, Primary Care Network Pharmacist and Lead for Primary Care, Guild of Healthcare Pharmacists​, laura.buckley10@nhs.net 

Active Travel 4 Climate Action (AT4CA): Co-Designing Solutions to Increase Active Travel for Climate Action in Schools and Communities (Australia)

The Active Travel 4 Climate Action project aimed to address the pressing issue of climate change through the delivery of an innovative co-design approach in one secondary school in 2022. A key focus of the co-design process was to identify the environmental barriers and enablers to active travel, and design solutions that promote active travel and mitigate climate change.

To read the complete description
Contributor’s contact :
Dr Lisa Young, Lecturer, Monash University, lisa.e.young@monash.edu
Dr Laura Alfrey, Monash University
Deana Leahy, Associate Professor, Monash University
Dr Tope Adepoyibi, Cancer Council Victoria

ARGOS – Community / educational program : Universal and environmental prevention model for consumption of alcohol, tobacco and cannabis in schools (Murcia, Spain)

Since 2012, the ARGOS program develops the prevention of addictions in the educational field by providing primary care health workers with basic training on effective interventions in addictions (counseling, motivational interview, …) and inciting them to collaborate to train adolescents. 

To read the complete description
Contributor’s contact :
Olga Monteagudo Poqueras, Head of the Health Education and Promotion Service (Addiction Prevention Unit), General Directorate of Public Health and Addictions, Ministry of Health, Autonomous Community of the Region of Murcia, Spain, olga.monteagudo@carm.es

Aula Educativo Terapeutica / structure designed to provide an extraordinary response to students with mental health problems (Cantabria, Spain)

Therapeutic educational classroom have been implemented in the 2022-2023 academic year to provide health support and educational attention to students who, due to their mental health situation, cannot attend school in a regular centre on a temporary basis. This initiative provides special resources and skills for their return in regular center.  

To read the complete description
Contributor’s contact :
Ana Belén Blanco Ferrero, Technical Teaching Advisor of the Unit for Attention to Diversity, Ministry of Education and Vocational Training of the Government of Cantabria (Spain), coordinacion.utadc@educantabria.es

Autism and Transdisciplinarity: can autism be cured? (France)

In response to a problem of violence, a cross-disciplinary team was formed around a teenager with an autism spectrum disorder. Working together enabled the pupil to be placed at the heart of her care, and fostered exchanges between professionals on the difficulties encountered and the relevant intervention tools.

To read the complete description in English and in French (original language)
Contributor’s contact :
Philippe Gaudry, Hypnotherapist, Jeunesanteethnomedecine.fr, philgaudry@wanadoo.fr

Co-constructing self-determination from primary school onwards, by implementing a polycentric approach in a project-based dynamic (Auvergne, France)

This case study explore the situation of a 10-year-old child with a recognised disability, specifically the construction of an intersectoral collaboration between the care service and the school. Their joint work made it possible to move from a monocentric approach to a polycentric approach in which the child is involved in the construction of his project, as a full partner.

To read the complete description in English and in French (original language)
Contributor’s contact :
Violon Nolwenn, coordinatrice dispositif ULIS, Éducation Nationale, ncubizolle@ac-clermont.fr

Description of community health activities carried out in a primary care centre in Elche: Health Week (Spain)

Throught a collaboration between the educational environment, the community and the primary care centre, the Health Week aims to respond to the expressed needs of the population from an interdisciplinary perspective, empowering people to increase control over their own health and adopt healthy lifestyles.

To read the complete description in English and in Spanish (original language)
Contributor’s contact :
Pablo Serna, Enfermero Salud Familiar y Comunitaria, Hospital Vinalopó Elche, psserna@vinaloposalud.com

Donate blood, donate life, IES Lomo de La Herradura. “We are part of the change” (Canary Islands, Spain)

This case study describes the experience of a school taking part in a blood donation program lead by The Canary Islands Blood Donation and Hemotherapy Institute. This service-learning project wants students to acquire knowledge, skills, moral principles and values, while providing a service to the community. As well as receiving training on the importance of giving blood, the students were also involved in the organisation and running of the collection.

To read the complete description
Contributor’s contact : Heriberto Báez Rodríguez, Director / Head teacher, IES Lomo de La Herradura, 35010154@gobiernodecanarias.org

Educating for health, educating for life (Spain)

This community health promotion project involves the coordination and commitment of multiple agents (school, socio-health, families, technicians, entities of the territory that work with children) in a child health promotion objective. It includes activities like developing videos and materials that can be used to work on different topics with children and training actions aimed at parents.

To read the complete description in English and in Spanish (original language)
Contributors’ contact :
Maite Pascal, Ana Larumbe, Nuria Ibor, Mª Jesús Erice 
Trabajadoras Sociales, Centros de salud de atención primaria del Servicio Navarro de Salud ( España)
mpascalj@navarra.es; mericear@navarra.es; ana.larumbe.mutiloa@navarra.es; nuria.ibor.alduan@navarra.es

First aid and cardiopulmonary resuscitation workshop (Leon, Spain)

The initiative consists of a series of sessions with a theorical and practical part, with the aim of teaching students, parents and teachers about accident prevention, first aid and cardiopulmonary resuscitation maneuvers.

To read the complete description
Contributor’s contact :
Sandra Montoro Chavarrias​​, Pediatrician​, C.S. Villafranca Del Bierzo, Sacyl​, ​ Sandramontoroch@hotmail.com
Verónica Castro Alonso, Midwife and responsible for the health education and first aid working group, C.SVillafranca del Bierzo, Sacyl., vcastro@saludcastillayleon.es

Health Education Program For Schools (PESEI) – Programa de Educación para la Salud en las Escuelas e Institutos (Spain)

Since 2015, this program’s main objective is to increase health knowledge and improve students’ health behaviors through the promotion of healthy habits, risk prevention and general health education awareness. Health professional consultations, workshops, talks and sessions with the entire school community help students to take control over their present and future health.

To read the complete description
Contributor’s contact :
Gràcia Soler Pardo, President of ISNA (International Association of School Nurses and Health Promotion), isna.schoolnurses@gmail.com

Healthy Habits Workshop (Leon, Spain)

This initiative consisted in teaching and providing students with tools to increase their health : active life, eating healthy food, hands washing, tooth brushing, etc. Nurses and pediatricians have come in the schools to explain healthy habits, and prepare games and workshops to put into practice the new knowledge.

To read the complete description
Contributor’s contact :
Sandra Montoro Chavarrias, Pediatrician, C.S. Villafranca Del Bierzo, Sacyl, Sandramontoroch@hotmail.com
Verónica Castro Alonso, Midwife and responsible for the health education and first aid working group, C.SVillafranca del Bierzo, Sacyl., vcastro@saludcastillayleon.es

Healthy Life Project V (Spain)

This initiative instructs teachers in health subjects all the year through a course related to several health matters, in order to help them to incorporate health habits content during classroom activities. Complementary activities are given by professionals (policers, fire fighters, NGO’s members, etc.) and visits to food fairs, show cooking, 112 service, walk tours, etc., are organised.

To read the complete description
Contributor’s contact :
Alicia Sánchez Ortiz, Head of Studies, CIPFP Ciutat de l’Aprenent (Valencia, Spain), a.sanchez@edu.gva.es

Movimente Program: A school-based cluster randomized controlled trial aiming to increase physical activity and reduce sedentary behaviour among Brazilian adolescents (Brazil)

The Movimente Program is a school-based, cluster randomized controlled trial that aims to increase physical activity and decrease sedentary behaviour in adolescents in public schools in Southern Brazil. Three main actions were carried out during the school year 2017: Teacher training to provide insights on how to incorporate health topics during classroom activities; improvements in the physical activity school environment and educational strategies.

To read the complete description
Contributor’s contact :
Kelly Samara da Silva, Ph.D Professor, Federal University of Santa Catarina, ksilvajp@gmail.com 

Muovinsieme. School and community on the move (Italy)

This project proposes a best practice intervention on physical activity and outdoor education in elementary school. It supports children in exercising during school hours, combining physical activity (walking) with the opportunity to learn in a place other than the classroom (outdoor education), while also fostering and enhancing socialization and relational aspects.

To read the complete description
Contributor’s contact :​
​​Eleonora Tosco​​, ​​Health communication referent​, ​​Dors, Documentation Center for Health Promotion, Piedmont Region​, ​​eleonora.tosco@dors.it​ 

Neither Ogres Nor Princesses (Ni ogros ni princesas) (Asturias, Spain)

Based on a rights and gender approach, ‘Neither Ogres Nor Princesses’ is a sexuality education programme to improve the health and wellbeing of adolescents and increase self-esteem and personal autonomy, with a focus on gender equality as a transversal line, to achieve the empowerment of girls and the involvement of boys. The program addresses knowledge, attitudes of respect and training of social and specific skills in relation to sexuality and gender equality.

To read the complete description
Contributor’s contact :​
Jose Vázquez García, Proyect Lead, Consejería de Salud de Asturias, promocionsalud@asturias.org

Proxecta Educational Innovation Plan “Eat well” (Galicia, Spain)

This initiative responds to the need for students to acquire and consolidate proper eating habits and develop skills to make healthy choices. They are invited to get to know the food environment through sensory experiences, to value their traditional food heritage, to analyse the influence of the environment in which they live (advertising, food availability, food industry), in order to develop a critical behavior as responsible consumers regarding the current food offer.

To read the complete description
Contributor’s contact :
Silvia Suárez Luque, Sub-directorate for the promotion of healthy lifestyle programs, General Directorate of Public Health, San Lázaro s/n 15707. Santiago de Compostela. España

Red de Sonrisitas Programme (Argentina)

Since 2004, this initiative has been promoted an inclusive proposal to encourage healthy habits (nutrition and dental care) at the kindergarten and primary municipal schools, supporting the implementation of the strategy of the Health Promoting Schools. Actors from different health, social and university sectors are involved.

To read the complete description
Contributor’s contact :
Prof. Martín Zemel, PhD, Director, FASTA University Dental School, mzemel@ufasta.edu.ar

School Menu Review Programme (PReME) (Catalonia, Spain)

Since 2006, the School Menu Review Programme (PReME) offered a free review of menu planning in all schools in Catalonia in order to improve the quality of the meals offered in school cafeteria. Recommendations to facilitate the uptake of healthy eating habits were also produced and disseminated. A study to assess the evolution of compliance with PReME’s recommendations showed an improvement in the nutritional content of school meals.

To read the complete description
Contributor’s contact :
Maria Blanquer Genovart, Registered Dietitian, Public Health Agency of Catalonia, sec.promocio@gencat.cat

Student Assistance Policy of the Federal Institute of Education of Ceará, Brazil: contributions of nurses for health promotion (Ceará, Brazil)

Nurses inserted in multiprofessional student assistance teams in schools collaborate in the identification and resolution of problems related to the health of students, through promoting the integration of knowledge from different fields. The nursing activities aim to promote health, mainly through health education strategies and various projects and activities to respond to the students’ needs.

To read the complete description in English and in Portuguese (original language)
Contributors’ contact :
Emanoel Avelar Muniz, Nurse, Instituto Federal de Educação, Ciência e Tecnologia do Ceará, (IFCE), Enfermagem Escolar, emanoel.muniz@ifce.edu.br

Maria Veraci Oliveira Queiroz, Nurse and university lecturer, Universidade Estadual do Ceará (UECE), Saúde da criança e do adolescente, maria.queiroz@uece.br

Valter Cordeiro Barbosa Filho, Physical education professional and teacher, Universidade Estadual do Ceará (UECE), valter.filho@uece.br

Who is doing and supporting this study?

Nicola Gray, N.J.Gray@hud.ac.uk – Co-Chairholder for the UNESCO Chair GHE at the University of Huddersfield, UK – is leading the project, Shraddha Manandhar Shraddha.Manandhar@hud.ac.uk  is leading the qualitative data analysis, and Catherine Chabot catherine.chabot@unescochair-ghe.org  is in charge of the collection of the case studies.

The study is being funded by the Commonwealth Fund of New York City, USA, through their Senior Harkness Fellows Small Grants Program https://www.commonwealthfund.org/. It has received ethical approval from the School of Applied Sciences Research Integrity and Ethics Committee of the University of Huddersfield (SAS-SRIEC-20.04.23-1).