School Health and Nutrition Manual: A guide for program planning and implementation in Malawi

In recent years, great progress has been made in improving child survival and increasing access to education for school-age children (aged 6 to 18 years) in the developing world.Though they suffer lower mortality than younger children, school-age children continue to face high levels of illness and malnutrition during their crucial growing years, decreasing their ability to pay attention and progress in school. It is estimated that 210 million school-age children suffer from iron deficiency anemia (IDA), 60 million from iodine deficiency, 85 million from vitamin A deficiency, and close to 800 million from soil-transmitted worms [1]. If left untreated, these diseases can cause permanent impairment to their intellectual capacity, chronic illness, and poor growth.

School health and nutrition (SHN) programs address the critical health and nutrition conditions that keep children out of school and inhibit their ability to learn, while creating a safe and supportive environment that promotes healthy behaviors. Simple interventions such as regular deworming and micronutrient supplementation prevent children from becoming anemic and thus, have a substantial effect on their school performance.The promotion of hygienic behaviors in schools, such as hand washing with soap is among the most effective ways to prevent diarrheal diseases and pneumonia, which together are responsible for the deaths of more than 3.5 million children under five.

The purpose of this manual is to guide Save the Children staff and its implementing partners in Malawi on how to implement a School Health and Nutrition (SHN) program in primary schools at the district level.The guidance comes from Save the Children’s program experience in Mangochi district and is mainly aimed at helping staff involved with the new SHN program in Zomba. In particular, the target audience for this manual is the SHN program manager (at the Save the Children national office) and SHN program officers and assistants at both field and national levels.The manual can be used for reference purposes during program design, planning, implementation, and monitoring, by field staff and program managers.