Core educational goals in Flanders, Belgium require the inclusion of actions that promote students’ health as part of the school curriculum, according to the findings published in the Schools4Health policy mapping report. Among the educational goals, all primary schools must attain the objectives set out for physical education as well as individual and social competencies. Pupils in secondary schools in Flanders must demonstrate a minimum level of competencies in topics related to physical and mental health, social awareness, social relations, cultural awareness, digital competencies and sustainability. 

As of 2018, all schools have been required to abide by the Decree on “Student Guidance’’ (leerlingenbegeleiding) that sets out how they will monitor, protect and promote each student’s wellbeing and thereby promote their healthy lifestyles. This guidance covers four, broadly described domains: the educational trajectory, learning and studying, psychological and social functioning. Health policy is not explicitly outlined, and links to prevention can be interpreted differently. Education, Welfare, Public Health and Family policy areas also recommend that ‘whole school approaches’ be used in schools to promote health and wellbeing. According to the 2019 SHE Mapping Report, 51-75% of primary schools and a similar proportion of secondary schools are Health Promoting Schools. 

All schools must demonstrate that they have a guidance policy and comply with “minimum standards’’ to achieve core curricula requirements. The nature of their guidance policy, and how they achieve the minimum standards, is up to them. Education inspectors use the Framework for Educational Quality to ensure that schools meet these requirements. 

“During a school inspection, the education inspectorate examines the school’s quality of education as well as the quality of its policy on pupil guidance, including the health policy of the school. The difference with the past is that it takes the whole school approach into account. […] There is also more attention paid to the processes by which schools come to decisions, for example the way they provide for participation of pupils in the policy of the school.” SHE Mapping Report, 2019

Schools in Flanders can solicit the support of a wide range of resources to help them achieve educational goals and develop and implement the Student Guidance Decrees. Noteworthy, in this respect, are the Pedagogical Guidance Centres (PBD) and Student Guidance Centres (CLB) that are subsidised to provide support to schools working on the wellbeing of students. The Flemish School Association (VSK) and the umbrella organisations for parent associations also receive resources to support students and parents working on health policy themes and student guidance. An extensive range of organisations, including Gezond Leven, can implement programmes in schools, depending on their interests. The Flemish Education Council VLOR (Vlaamse Onderwijs Raad), is an advisory board on issues like discrimination, inequality, society in the classroom. Gezond Leven advises on the nutrition curriculum and guidelines for healthy and environmentally responsible food in the nutritional triangle, physical activity, mental health, smoking, vaping, health and inequality. Other organisations advise and provide schools with support on specific issues like alcohol, eating disorders, body image, obesity, and traffic safety. 

While there are many policy measures in Flanders to compel and encourage schools to take forward the objectives of the Health Promoting School approach, the Flemish report states that “implementation in particular requires adjustment.” While health policy at school is mandatory, through minimal core requirements and the student guidance policy, schools must “read this between the lines’’ because health policy was not explicitly included in the Student Guidance decree. The guidance policy contains few or no quality requirements and assessment frameworks specific to a health policy. Coordination with and full recognition of Student Guidance Centres (CLB) and Pedagogical Guidance Centres (PBD) is necessary, but they currently only intervene on a “demand-based’’ basis. The educational objectives relating to health for the 2nd and 3rd grades of secondary education have also recently been changed and reduced, and there is debate about the consequences of this reduction.

Further links to health-related policies and with municipalities
Broader health prevention policies in Flanders include a socio-ecological perspective on health and can give impetus to initiatives to create healthier school settings. The Flemish Prevention programme, for example, sets out specific goals in relation to “living healthier’’, that focus on healthy eating, sedentary behaviour, exercise, tobacco, alcohol, and drugs, that the regional government aims to achieve by 2025. It includes the following sub-objectives in the area of educational settings: 80% of primary schools and 80% of secondary schools will implement a preventative health policy of sufficient quality; by 2025 an increasing percentage of colleges and universities will implement a preventive health policy of sufficient quality. 

In attaining the educational objectives for primary and secondary schools, the Flemish prevention survey presented interim results on the percentage of schools meeting the minimal quality criteria for implementing a preventive health policy at school in 2019-2020. Over this period, 61% of elementary schools (in comparison to 57% between 2015-2016) and 73% of secondary schools (in comparison to 74% in 2015-2016) met in the minimum criteria. Initiatives like the Flemish Food Strategy also call for attention to education.

About the Schools4Health mapping of health promoting school policies in the EU
This article is an extract of the Schools4Health ‘Report on policy and practice to strengthen the Health Promoting School approach across the EU’. A key objective of the Schools4Health project is to encourage and enable public authorities and other relevant actors to move from health promotion in schools, towards applying more holistic Health Promoting School approaches. This is supported through the initiative’s policy component, which seeks to raise awareness, mainstream and scale up Health Promoting School approaches among policymakers and practitioners, and to engage them in efforts to integrate this approach in their national/sub-national contexts. It means bringing together different stakeholders in policy and practice, across levels of governance and sectors, to optimise the contribution that schools can make to the health and wellbeing of students, staff, and the wider communities.

As a first step, the Schools4Health consortium focused on scoping the current policy landscape across different participating municipalities, regions and countries influencing or impacting school wellbeing. This was done by identifying and bringing together key actors in the respective partner countries to discuss the broader policy context around health promotion in schools, and identify what is required, from a policy perspective, to introduce or strengthen the implementation of the Health Promoting School model in school settings.

Visit the Schools4Health website to access all resources from the project https://schools4health.eu/