overview
Health-promoting schools (a school-wide approach to promoting health in schools) were conceptually developed in the late 1990s, but a fully embedded and sustainable system has yet to be realized. This study assessed the health status of school-age children (needs assessment) and the existing policy environment (landscape analysis) in the context of eight global health-promoting school standards in North Macedonia, collecting the necessary data to review implementation and develop an implementation plan. More than 95% of primary school-age children and more than 80% of secondary school-age children are enrolled in school. Non-communicable diseases are prevalent as causes of both mortality and morbidity, most of which are preventable (e.g. injuries). Priority behavioral risk factors (e.g. physical inactivity, inadequate nutrition, alcohol use, violence, bullying) can be addressed through school health interventions. Although health promotion is implemented in educational institutions and integrated into the curriculum, there is no separate national strategy or plan to scale up health promotion in schools. Suggested ways forward include a national strategy and standards for health-promoting schools, building on past positive experiences, better coordination among line ministries and stakeholders, increased parent and student involvement, adequate budgetary allocation, and building technical capacity in terms of human resources and training.
