This compendium is a supplement to the WHO guideline on school health services. It lists each of the 87 interventions that were identified by the Guideline Development Group (GDG) as essential or suitable for inclusion within school health services (SHS), either everywhere or in certain geographic areas only. Each intervention is shown with its GDG categorization, as well as its WHO source category and supporting WHO procedures or activities (PAs).
The sources cited in this compendium are from a literature review of global WHO publications focused on health service procedures or activities for 5-19-year-olds. For this review, a search was conducted through online WHO search engines, department website publication lists and other compilations of WHO recommendations. In total, 342 recent global WHO publications and WHO recommendation webpages were reviewed to assess their potential relevance for SHS, of which 149 publications had content used to produce a master list of 531 health service PAs that are relevant to 5-19-year-olds.
The 149 publications included global guidelines, strategies, standards for quality of care and guidance documents on adolescent health, school health and specific health conditions.
The 531 PAs included formal recommendations in guidelines that had been approved by the WHO Guidelines Review Committee (GRC), and other published interventions, such as those identified as evidence-based interventions, best practice statements, good practice statements, key actions, key areas for programming, priority actions, quality areas, quality statements, recommendations and standards. Most of the compiled PAs were quoted verbatim, but some were consolidated from many lengthy and highly specific WHO recommendations to create one brief, composite PA.
One unpublished global WHO report was included in the review and the resultant compendium (the February 2019 draft of the WHO universal health coverage (UHC) intervention menu). 1 This draft menu was a collaborative effort between different global WHO departments. It was included here to consider the SHS interventions within the context of broader, ongoing, high-level work at WHO, but the UHC menu did not influence the WHO source of any intervention.

# Compendium of interventions with WHO evidence

# Compendium key
For the 87 intervention tables in the compendium:
- each intervention is shown with its GDG categorization as essential or suitable within SHS, by location, as well as its WHO source and supporting WHO PAs;
- each intervention has its own table with intervention number and full wording in the top row, followed by supporting WHO PAs in subsequent rows; and
- column 2 of each intervention table provides additional notes for individual PAs, such as "GRC-approved" or WHO classification as a "Quality Statement" or "Good Practice Statement". No GRC-approved diarrhoea-prevention guidelines for the general population of children. However, WHO recommends interventions on access to safe drinking-water, household water treatment and safe storage, access to improved sanitation facilities and handwashing with soap for all populations to prevent deaths due to diarrhoea (7,8) I-03 -PA513. Strategies for successful promotion of hand hygiene in health-care settings: system change (make hand hygiene possible, easy, convenient; make alcohol-based handrub available; make water and soap continuously available; install voice prompts); hand hygiene education; promote/facilitate skin care for health-care workers' hands; routine observation and feedback; reminders in the workplace; improve institutional safety climate (general; promote active participation at individual and institutional level; avoid overcrowding, understaffing, excessive workload; institute administrative sanction/rewarding; ensure patient empowerment); combination of several of the above strategies I-04 -PA518. In a health-promoting school, depending on sociocultural conditions and resources, oral health promotion should target: maintaining good oral hygiene with daily toothbrushing drills supervised by teachers; the use of fluoride, including affordable fluoride toothpaste and fluoride rinsing programmes; promoting good nutrition; reducing the consumption and frequency of sugary snacks and drinks; promoting the consumption of fruit and vegetables; promoting water or milk fluoridation; promoting regular dental check-ups and care; preventing or reducing tobacco use, alcohol consumption and substance abuse; preventing accidents, violence and anti-social behaviours; and taking a wider responsibility at home and in society (12) I-04 -PA519. In a health-promoting school, oral health education should be regularly reinforced at home and further developed in school at key educational stages throughout the children's school career (12)

# Categorization of interventions as essential, suitable or unsuitable within SHS, by location
Ranked "Effective" intervention I-06 -PA281. School health services should: 1. Collaborate with the physical education component of the school to regularly assess physical activity levels and fitness; 2. Collect medical information from students and parents that is relevant to participation in physical activity; 3. Provide such information (when necessary and in accordance with parental or guardian permission) to the physical education teachers and other appropriate staff members; 4. Identify inactive students and provide them with counselling; 5. Encourage active students to maintain their current activities; 6. Make recommendations about physical activity for students with disorders and conditions such as anaemia, diabetes, asthma, obesity and heart diseases and refer them, as necessary, to appropriate health services providers within the community; 7. Promote physical activity to students and their families through individual counselling, small group discussions and by distributing educational materials; 8. Collaborate with school policy-makers, teachers and administrators to develop safety standards and ensure that first aid is available for injuries that might result from physical activity  health workers could do the following: provide information and advice to students and school personnel; provide opportunities for school personnel, students and parents to ask questions and clarify any doubts or concerns they have about development during puberty, menstruation, pregnancy and methods of menstrual care and pregnancy prevention; serve as a confidant to whom students and school personnel can express fear and anxiety about physical and emotional changes during puberty or pregnancy without facing ridicule or judgement; provide health products (such as contraceptives or condoms) when they are permitted to do so by prevailing laws and practices or refer students and school personnel to an easily available source; identify and collaborate with organizations that can provide appropriate non-health services when required, such as legal or social support for children and adolescents who are being abused or neglected I-10. Promotion of responsible parenting skills for all students Suitable everywhere Other WHO support I-10 -PA437. Plan and implement a comprehensive education sector response to early and unintended pregnancy to support pregnant and parenting adolescents to continue and return to education. This includes curriculum-based interventions; eradication of policies and practices that result in the expulsion or exclusion of pregnant girls and adolescent mothers; promoting a safe school environment, free of gender-based violence, stigma, discrimination and bullying against pregnant adolescents and adolescent mothers; ensuring a supportive environment for adolescent mothers, such as parenting instructions or classes, breastfeeding space and counselling; engaging with teachers and school directors to ensure support to pregnant girls and adolescent mothers; and facilitating and promoting effective linkages between schools and adolescent-responsive health services, both within and outside the health sector (4)
Key area for programming I-10 -PA449. Parenting programmes are among the most common strategies to improve parent-child relationships. Programmes can be offered to groups or individuals through home visits (home-visiting programmes) or at designated centres in communities and they can be presented to all families or targeted at vulnerable families (e.g. disadvantaged or teenage mothers). They are usually delivered by a nurse, social worker or other professional (although sometimes this is done by experienced mothers) during the first two or three years of a child's life (some programmes begin prenatally) I-11 -PA243. One role of a SHS may be the provision of sunscreen, which should be available for all school activities. In deciding how to make sunscreen available, schools should consider five things: access, choice of sunscreen, skin reactions, management and correct use. ... A further role for SHS is in the treatment of sunburn and, if necessary, referral to other agencies (24) I- 12

#. Provision and promotion of use of insecticide-treated bed nets Essential/suitable in certain areas
Other WHO support I-12 -WHO UHC menu (2.19 Draft). Provision and promotion of use of insecticide treated bed nets for children (1) I-12 -PA336. Prevention and management of childhood illnesses including malaria, pneumonia, meningitis and diarrhoea (16) GSWCAH evidence-based CHD intervention I-12 -PA338. School nurses can help raise awareness of health problems among students, teachers and staff and play an important role in referring students to specialists. They are responsible for de-worming at regular intervals, managing health outcomes such as an asthma attack or injury and recognizing severe diseases such as malaria, severe diarrhoea and respiratory infections for correct referral. Ideally, they should receive training in environmental health issues prevalent in their community. School nurses should be responsible for tracking illnesses among students to help identify potential environmental health problems within the school (25)
I-12 -PA357. Some schools provide health services related to the control and prevention of malaria. These services commonly include: mass treatment of fever when there are malaria epidemics; mass treatment of parasitological diseases such as lymphatic filariasis, onchocerciasis; immunization combining distribution of insecticide-treated nets; screening of health problems such as anaemia and malnutrition; school feeding in underprivileged and needy areas Health-related education is usually and most appropriately accommodated in a health-related subject area (variously termed healthy active living; health and family living; health and physical education; personal and social skills education; health and career education; life-skills education, etc.) (4)
Key area for programming I-24 -PA458. Review and adapt school buildings and grounds: Key actions: Involve students and staff in identifying hotspots for violence (including the way to and from school) and find practical solutions in these areas. Review the appearance and features of school buildings and grounds and identify areas that could be improved. Make sure schools have clean, separate toilets for boys and girls. Ensure that the annual budget includes a budget line for improving physical infrastructure of schools with the aim to enhance safety of children (32) Key action at school, district or national level I-24 -PA489. There are proven ways of reducing both the likelihood and severity of all types of child and adolescent injury. Prevention programmes that use a multidisciplinary strategy (i.e. a combination of education, environmental modification and legislation) have been shown to be particularly effective for reducing injury mortality in many high-income countries (39) I-24 -PA490. There are proven ways of reducing both the likelihood and severity of all types of child and adolescent injury. ... Drownings have been reduced by limiting access to obvious hazards such as pools, installing covers on wells and teaching older children to swim (39)  I-26 -PA419. Enforce a policy that in all cases -whether or not the consent of the parent or carer is required -an adolescent's voluntary, adequately informed, non-forced and non-rushed assent for services and participation in a datagathering activity is obtained. Adolescents should be given full, unbiased and clear information on the nature, risks and alternatives of a proposed intervention or data-gathering activity, to enable adolescents' participation in their own care and the communication of their choices. Information about an intervention should be provided to adolescents in a manner that is appropriate to their culture, education and level of understanding. While it is important to explain clearly to adolescents the potential risks, it is also important not to frighten them (4)
Key area for programming I-26 -PA420. Implement e-standards to automate the processes of data collection and analysis and to improve adolescent participation in providing feedback to facilities by using information technology (4) I-26 -PA515. All health-care workers should commit themselves to providing and using data to demonstrate the effectiveness and safety of the care (47) I-26 -PA516. Ensure effective use of health information systems, by: building reliable births and death registration systems and, from this, developing a national system of unique patient identifiers to support quality monitoring across pathways of care; moving away from paper-based records to a unique electronic health record that can be used across multiple health care settings; developing national legislation that protects individual privacy whilst enabling the use of personal health data for research and quality improvement; supporting clinicians, managers and policy-makers in collecting and analysing service data for quality improvement and communicating effectively with the public about how these data are used; encouraging transparency when things go wrong, by building a learning culture that focuses on understanding root causes rather than assigning individual blame; at global level, agreeing on standards to enhance data quality and comparability, particularly standardized terminology to classify, analyse and prevent adverse events; including measurement of patient outcomes and experiences as a standard element in facilities' quality assessment (47) Japanese encephalitis: Japanese encephalitis vaccination should be integrated into national immunization schedules in all areas where Japanese encephalitis is recognized as a public health priority. The most effective immunization strategy in Japanese encephalitis endemic settings is a one-time campaign in the primary target population, as defined by local epidemiology (typically children aged < 15 years), followed by incorporation of Japanese encephalitis vaccine into the routine childhood immunization programme.
Tick-borne encephalitis: in areas where the disease is highly endemic (that is, where the average prevaccination incidence of clinical disease is  5 cases/100 000 population per year), implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children. ... Where the prevaccination incidence of the disease is moderate or low (that is, the annual average during a 5-year period is < 5/100 000) or is limited to particular geographical locations or certain outdoor activities, immunization should target individuals in the most severely affected cohorts. People travelling from non-endemic areas to endemic areas should be offered vaccination if their visits will include extensive outdoor activities.
Yellow fever: preventive mass vaccination campaigns are recommended for inhabitants of areas at risk of yellow fever where there is low vaccination coverage.
Vaccination should be provided to everyone aged  9 months, in any area with reported cases. ... Vaccine should be offered to all unvaccinated travelers aged  9 months, travelling to and from at-risk areas, unless they belong to the group of individuals for whom yellow fever vaccination is contraindicated (62) Dengue vaccination: vaccination should be considered as part of an integrated dengue prevention and control strategy. Countries should consider introduction of the dengue vaccine CYD-TDV only if the minimization of risk among seronegative individuals can be assured. ... The optimal age group to be targeted is the age before which severe dengue disease incidence is highest; this can be ascertained from national and subnational routine hospital laboratory-confirmed surveillance data.
Hepatitis A vaccination: hepatitis A vaccination is recommended for inclusion in the national immunization schedule for children  1 year if indicated on the basis of incidence of acute hepatitis A, change in the endemicity from high to intermediate and consideration of cost-effectiveness. In highly endemic countries almost all persons are asymptomatically infected with hepatitis A virus in childhood, which effectively prevents clinical hepatitis A in adolescents and adults. In these countries, large-scale vaccination programmes are not recommended. Countries with improving socioeconomic status may rapidly move from high to intermediate endemicity. In these countries, a relatively large proportion of the adult population is susceptible to hepatitis A virus and large-scale hepatitis A vaccination is likely to be cost-effective and therefore is encouraged. For individual health benefit targeted vaccination of high-risk groups should be considered in low and very low endemicity settings. Those at increased risk of hepatitis A include travellers to areas of intermediate or high endemicity, those requiring life-long treatment with blood products, men who have sex with men, workers in contact with non-human primates and injecting drug users. In addition, patients with chronic liver disease are at increased risk for fulminant hepatitis A and should be vaccinated.
Meningococcal vaccination: meningococcal polysaccharide vaccines can be used for those  2 years of age to control outbreaks in countries where limited economic resources or insufficient supply restrict the use of meningococcal conjugate vaccines. Polysaccharide vaccines should be administered to individuals  2 years old as one single dose. One booster 3-5 years after the primary dose may be given to persons considered to be a continued high risk of exposure, including some health workers.
Rabies vaccination: there are two main immunization strategies for the prevention of human rabies: (i) post-exposure prophylaxis (PEP), which includes extensive and thorough wound washing at the rabies virus (RABV)-exposure site, together with rabies immune globulin administration if indicated and the administration of a course of several doses of rabies vaccine; (ii) pre-exposure prophylaxis (PrEP), which is the administration of several doses of rabies vaccine before exposure to RABV. PrEP is recommended for individuals at high risk of RABV exposure. These include subpopulations in highly endemic settings with limited access to timely and adequate PEP, individuals at occupational risk and travellers who may be at risk of exposure. I-55 -PA116.
health workers could: 1. Be alert to the possibility of the presence of health problems, (such as sexually transmitted diseases) and/or unhealthy practices (such as injecting drug use) and detect them early, if and when they arise. 2. Appropriately manage STI and/or HIV-related problems, to the best of their abilities and based on the facilities available at their disposal. This could include providing medical treatment, responding to the child's/adolescent's psychological needs and helping them deal with the social implications of their conditions. 3. Refer students and school personnel to the next "level" of health service delivery and/or to organizations which provide relevant support services, such as counselling and social support in the areas of adolescent development, sexuality, peer pressure, identify formation, illness and death, if and when available. 4. Answer questions of students and school personnel about the need for and value of HIV-antibody testing. As necessary and if available, refer students and staff to an appropriate and confidential facility that provides pre-and post-test counseling. Counselling about HIV-antibody testing requires the services of support staff and professionals who are trained and experienced in dealing specifically with the issues involved. 5. Observe confidentiality with respect to infected students and school personnel and disclose information to staff on a need-to-know basis only. 6. Support the education and employment rights of HIV-infected students and staff by assuring concerned officials and others that HIV infected students and staff pose virtually no health threat to students and school personnel when they attend classes or work in the school (35) I-57-PA20. We recommend the use of syringes with a sharps injury protection feature, as opposed to syringes without a sharps injury protection feature, by healthcare workers delivering intramuscular, subcutaneous or intradermal injectable medications to patients. We recommend the use of syringes with a reuse prevention feature (RUP devices), as opposed to devices without, by health-care workers delivering intramuscular, subcutaneous or intradermal injectable medications to patients School nurses can help raise awareness of health problems among students, teachers and staff and play an important role in referring students to specialists. They are responsible for de-worming at regular intervals, managing health outcomes such as an asthma attack or injury and recognizing severe diseases such as malaria, severe diarrhoea and respiratory infections for correct referral. Ideally, they should receive training in environmental health issues prevalent in their community. School nurses should be responsible for tracking illnesses among students to help identify potential environmental health problems within the school
I-59 -PA343. Low-osmolarity oral rehydration salts (ORS) is recommended for the treatment of dehydration or intravenous electrolyte solution in cases of severe dehydration, in HIV-infected and -exposed infants and children with diarrhoea. This recommendation is the same for all children (100)
GRC-approved I-59 -PA344. Elemental zinc supplementation for 10-14 days is recommended, with increased fluids and continued feeding, for all HIV-infected and -exposed children with diarrhoea, at 10 mg/day for infants 2-6 months of age and 20 mg/day for infants and children > 6 months. This recommendation is the same for all children (100)
GRC-approved I-59 -PA345. Children with diarrhoea and blood in stool (i.e. dysentery) should be treated with ciprofloxacin as a first line treatment. Ceftriaxone should be given as a second line treatment in severely ill children where local antimicrobial sensitivity is not known.... Where local antimicrobial sensitivity is known, local guidelines should be followed (95) GRC-approved I-59 -PA357. Some schools provide health services related to the control and prevention of malaria. These services commonly include: mass treatment of fever when there are malaria epidemics; mass treatment of parasitological diseases such as lymphatic filariasis, onchocerciasis; immunization combining distribution of insecticide-treated nets; screening of health problems such as anaemia and malnutrition; school feeding in underprivileged and needy areas (26)   Assessment and management of adolescents who present with unintentional injury is necessary not only to provide appropriate medical care, but also to identify accurately the cause of the injury to ensure it does not occur again. For example, burns are one of the few forms of injury that have a higher burden in adolescent females than males, because worldwide approximately 2 billion people in LMIC -the vast majority female -cook on unsafe open fires or very basic traditional stoves. ... Careful assessment of the cause of adolescent injury is also important because some adolescents or their guardians may falsely state that an injury was due to an accident when in fact it was due to self-harm or interpersonal violence.
In some countries, for example, so-called honour killings and death by fire account for a significant number of reported cases of familial or intimate partner violence against adolescent girls and survivors of such assaults may be compelled by the perpetrators to claim the injuries were accidental (4,40) Assessment and management of adolescents who present with unintentional injury is necessary not only to provide appropriate medical care, but also to identify accurately the cause of the injury to ensure it does not occur again. For example, burns are one of the few forms of injury that have a higher burden in adolescent females than males, because worldwide approximately 2 billion people in LMIC -the vast majority female -cook on unsafe open fires or very basic traditional stoves. ... Careful assessment of the cause of adolescent injury is also important because some adolescents or their guardians may falsely state that an injury was due to an accident when in fact it was due to self-harm or interpersonal violence. In some countries, for example, so-called honour killings and death by fire account for a significant number of reported cases of familial or intimate partner violence against adolescent girls and survivors of such assaults may be compelled by the perpetrators to claim the injuries were accidental (4,40)  health workers could do the following: provide information and advice to students and school personnel; provide opportunities for school personnel, students and parents to ask questions and clarify any doubts or concerns they have about development during puberty, menstruation, pregnancy and methods of menstrual care and pregnancy prevention; serve as a confidant to whom students and school personnel can express fear and anxiety about physical and emotional changes during puberty or pregnancy without facing ridicule or judgement; provide health products (such as contraceptives or condoms) when they are permitted to do so by prevailing laws and practices or refer students and school personnel to an easily available source; identify and collaborate with organisations that can provide appropriate non-health services when required, such as legal or social support for children and adolescents who are being abused or neglected  health workers could provide information and advice  to students and school personnel; provide opportunities for school personnel, students and parents to ask questions and clarify any doubts or concerns they may have about HIV/AIDS/STI and methods of prevention; serve as a confidant to whom students and school personnel can express fear and anxiety about HIV/ AIDS/STI without facing ridicule or judgement; provide health products (such as contraceptives and condoms) when they are permitted to do so, by prevailing laws and policies; and identify and collaborate with organizations, which can provide appropriate non-health services when required, such as legal support for adolescents who are being abused (35) I-73 -PA174. Where children are exposed to intimate partner violence at home, a psychotherapeutic intervention, including sessions where they are with and sessions where they are without their mother, should be offered, although the extent to which this would apply in low-and middle-income settings is unclear (7,85) GRC-approved I-73 -PA298. Assessment and management of adolescents who present with unintentional injury is necessary not only to provide appropriate medical care, but also to identify accurately the cause of the injury to ensure it does not occur again. For example, burns are one of the few forms of injury that have a higher burden in adolescent females than males, because worldwide approximately 2 billion people in LMIC -the vast majority female -cook on unsafe open fires or very basic traditional stoves. ... Careful assessment of the cause of adolescent injury is also important because some adolescents or their guardians may falsely state that an injury was due to an accident when in fact it was due to self-harm or interpersonal violence.
In some countries, for example, so-called honour killings and death by fire account for a significant number of reported cases of familial or intimate partner violence against adolescent girls and survivors of such assaults may be compelled by the perpetrators to claim the injuries were accidental (4,40)
Good Practice Statement 1 I-73 -PA473. Before starting to obtain the medical history or forensic interview, any urgent medical and/or safety needs must be addressed. In line with the principle of "do no harm", when the medical history is being obtained and, if needed, a forensic interview is being conducted, health-care providers should seek to minimize additional trauma and distress for children and adolescents (3)
Good Practice Statement 2 I-73 -PA474. Health-care providers should seek informed consent for all decisions and actions to be taken as appropriate to the child's or adolescent's age and evolving capacity and the legal age of consent for obtaining clinical care. Where the child or adolescent is below the legal age of consent, it may still be in the child s or adolescent s best interests to seek informed consent. Moreover, in accordance with evolving capacities, children and adolescents have the right to access confidential counselling or advice and information without the consent of their parents or legal guardians. In situations where it is assessed to be in the best interests of the adolescents who are in need of care and based on their preferences, health-care providers may consider whether to involve the parents or legal guardians (3)
Good Practice Statement 5 I-73 -PA477. Promoting and protecting the physical and emotional safety of the child or adolescent must be the primary consideration throughout the course of care. This means that, with the participation from the child and adolescent (and their nonoffending caregivers, as appropriate,) health-care providers need to consider all potential harms and take actions that will minimize the negative consequences to the child or adolescent, including the likelihood of the maltreatment continuing (3)
Good Practice Statement 6 I-73 -PA478. The interaction with caregivers when child maltreatment is suspected is complicated by the fact that the caregiver might be the perpetrator or may have allowed the maltreatment or felt powerless to stop it or may also be victim of violence in the home. Good interaction will influence outcomes for and safety of the child or adolescent (3)  For more information, please contact: mncah@who.int