SDG 3- Good Health & Well-being: A summary of how the FRESH Framework and school programs can help to achieve and monitor this UN Goal

This summary explains how various school-based and school-linked programs support global actions to achieve this goal.

The achievement of this goal involves fourteen sectors that should be included in a broad, whole of government approach to promote health in all policies (HiAP). These include Health, Development Aid, Relief Aid, Welfare/Social Protection, Child Protection/Family Services, Finance/Taxation, Employment, Municipalities, Law Enforcement/Justice, Environmental Protection, Public Safety/Emergency Response Services, Early Childhood Care/Education, K-12 Education and Post-Secondary Education/Training, The FRESH Framework and other sources enables us to identify over 12 multi-intervention programs, numerous specific interventions and ten multi-component approaches as well as the indicators related to those school strategies, Five (TBA) global initiatives involving schools as a key partner in achieving this goal have also been identified in this summary.

The Organization for Economic Cooperation and Development (OECD) convened a symposium of experts to examine the relationship between higher levels of education and health. The report from that symposium (Feinstein et al, 2006) ststes that "Education does not act on health in isolation from other factors. Income is another very important factor that interacts in many important ways with education as influences on health. This makes it hard to assess their independent effects. However, empirical investigations often find that the effect of education on health is at least as great as the effect of income. Those with more years of schooling tend to have better health and well-being and healthier behaviours. Education is an important mechanism for enhancing the health and well-being of individuals because it reduces the need for health care, the associated costs of dependence, lost earnings and human suffering. It also helps promote and sustain healthy lifestyles and positive choices, supporting and nurturing human development, human relationships and personal, family and community well-being".

Excerpts from UN Description of this Goal:

Goal 3 seeks to ensure health and well-being for all, at every stage of life. The Goal addresses all major health priorities, including reproductive, maternal and child health; communicable, non-communicable and environmental diseases; universal health coverage; and access for all to safe, effective, quality and affordable medicines and vaccines. It also calls for more research and development, increased health financing, and strengthened capacity of all countries in health risk reduction and management.

Between 2000 and 2015, the global maternal mortality ratio, or number of maternal deaths per 100,000 live births, declined by 37 per cent, to an estimated ratio of 216 per 100,000 live births in 2015. Almost all maternal deaths occur in low-resource settings and can be prevented. Schools have always been a significant part of global and national efforts to improve child and adolescent health.

Preventing unintended pregnancy and reducing adolescent childbearing through universal access to sexual and reproductive health-care services are critical to further advances in the health of women, children and adolescents.

The incidence of major infectious diseases, including HIV, tuberculosis and malaria, has declined globally since 2000.

According to estimates from 2012, around 38 million deaths per year, accounting for 68 per cent of all deaths worldwide, were attributable to non communicable diseases.

Unhealthy environmental conditions increase the risk of both non communicable and infectious diseases, which is reflected in the strong integrated nature of the Goals. In 2012, an estimated 889,000 people died from infectious diseases caused largely by faecal contamination of water and soil and by inadequate hand-washing facilities and practices resulting from poor or non-existent sanitation services. School-based WASH programs (water, sanitation and hygiene) are widely used and demonstrably cost-effective in low resource and conflict/disaster-affected contexts. 

In 2012, household and ambient air pollution resulted in some 6.5 million deaths.

Substance use and substance-use disorders have also created a significant public health burden.

Mental disorders occur in all regions and cultures. The most common are anxiety and depression, which, not infrequently, can lead to suicide.

Around 1.25 million people died from road traffic injuries in 2013. Halving the number of global deaths and injuries from road traffic accidents by 2020 is an ambitious goal given the dramatic increase in the number of vehicles, which nearly doubled between 2000 and 2013.

Total official flows from all providers for medical research and basic health sectors were $8.9 billion in 2014.

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School Approaches and Programs that address this Goal:

There are several school multi-intervention programs and single interventions that promote health and well-being. These programs are often grouped and coordinated in these multi-component approaches:

• The health promoting schools approach is used primarily in high and middle resource countries but can be adapted to all settings
• child-friendly schools, derived from a childs rights perspective, is also applicable to all settings
• school health & nutrition programs, developed and used primarily in low resource contexts, 
• full/wrap-around services schools is used primarily in high resource countries by the welfare/social services sector when working with schools
• education in emergencies is used in countries and regions affected by conflicts, disasters and epidemics
• integrated early childhood education/care programs are used primarily in high and middle resource countries but can be applied to all contexts
• safe schools models are used to prevent crime and bullying with the law enforcement sector in high and middle resource countries, with emergency and protection services in conflict affected contexts and with the private sector/construction sectors in earthquake risk regions
• community schools are used for guiding school work with community and economic development agencies deprived communities in high and middle resource countries. Community-led schools often develop in low resource countries for religious purposes or because public funding is insufficient
• inclusive schools were established primarily so that students with disabilities were able to participate in regular schooling and are applicable to all contexts
• eco/green-schools/education for sustainable development include a concern for human health, particulalry in regard to climate change, pollution and environmental hazards

These school-based and school-linked  policies, programs and practices (FRESH topic/problem-based themes) are effective in supporting this goal:

• Schools promote sexual and reproductive health in a variety of low resource, high resource and conflict/disaster-affected settings. 
• Comprehensive approaches to HIV education are established as a mainstay of global and country efforts. School-based immunization and vaccination programs are cost-effective and extend the reach of such programs significantly on health issues such as malaria, tuberculosis, HPV, meningitis and other infections diseases, including soil-transmitted and neglected tropical diseases.
• School-based and school-linked multi-intervention programs on school feeding, healthy eating/diet, physical activity, tobacco use, accidental injuries and other risk factors related to NCD's have been proved effective by intervention studies, evaluation reports and administrative/survey data.
• School-based programs on indoor air quality, moulds, radon, lead poisoning, pesticides and other environmental hazards are effective in all contexts.
• School-based and school-linked programs to engage/develop young people and to involve parents to prevent substance abuse, misuse of medications, gambling, Internet overuse and other addictions have also been reviewed and evaluated to be effective.
• School-based and school-linked early identification/referral and school participation in managing individual support programs on depression, and anxiety, As well, multi-intervention programs have been developed and found to be effective on autism, intellectual and learning disabilities, FASD, ADHD, behaviour disorders, compulsive behaviours and other afflictions are part of comprehensive school mental health programs that include the promotion of positive mental health, increasing awareness/reducing stigma, addrsssing mental health problems related to trauma, child abuse & neglect, sexual abuse, living with chronic diseases, bullying, bereavement, divorce and other issues. 
• School-based and school-linked road safety, fire safety, water safety, CPR and other aspects of comprehensive multi-intervention safety/accident prevention programs are effective and adaptable to different community and country contexts.

Intervention research, administrative and survey data, and evaluation reports on school-based and school-linked programs represent a significant and valuable source of knowledge about population health, health promotion, prevention and preventive health services. Often schools are the collection points for studies of child and adolescent health and behaviours. Nevertheless, much of the this knowledge is trapped on disease-focused compartments and silos. Please refer to this brief summary and follow the links to learn more about the current knowledge and gaps.

The components (pillars) of the FRESH Framework also address this goal in these ways:


The cross-cutting themes within the FRESH Framework can be applied to this goal in these ways:


Schools help students to develop these skills, beliefs, attitudes and values related to this goal:

Current & Recent Global/UN Initiatives to Achieve this Goal:

Current & Recent Global School Initiatives related to this Goal:

Overview of UN Targets for this Goal:

3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents

3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination


3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all

3.c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

School-Related Indicators from the FRESH Framework & School Programs/ Approaches

The following indicators are included in the FRESH Framework, its thematic applications on various health, social, safety and economic problems and other sources or updates on the FRESH Monitoring and Evaluation Guidance. The indicators describe the type, frequency and data sources of monitoring that can be done. As well, the FRESH Framework provides suggestions for monitoring at the national and school levels.


As well, the progress being made in relation to the implementation and maintenance of these core compontents and cross-cutting themes in the FRESH Framework can be monitored in relation to this goal:

These school-related organizational and systems capacities should also be monitored in relation to this goal: