Lesson learned from health education in Japanese schools.

INTRODUCTION Qualitative improvement of school health education is required to improve health for school- aged children in developing countries. This study aims to clarify the factors that enable the provision of comprehensive and consistent health education in Japan. METHODS We reviewed the outline of health education in Japanese schools and the feature of curriculum revision and clarify the factors that enable the provision of comprehensive and consistent health education by literature review. RESULTS We identified the nine points as enabling factors: 1) clear description of the purpose of health education, 2) clear provision of teaching content and adequate time allocation, 3) comprehensive school health framework and positioning health education, 4) systems for surveying and screening children's health problems, 5) regular revising of the Courses of Study, 6) well-trained teachers responsible for health education , 7) health education specialists in higher education facilities, 8) various materials related to health education, and 9) collaboration with related health workers. CONCLUSION We proposed measures to enhance health education in developing countries; 1) clarifying the role of health education toward achieving goals set out in laws and policies related to education, 2) providing appropriate learning content and time allocation, 3) establishing a comprehensive school health framework, 4) establishing a system that continuously monitors children's health issues, 5) identifying the person responsible for health education in a school and establish a training system, 6) providing teacher's guide and teaching materials for facilitating child participatory learning, and 7) collaborating with guardians, community members and local health workers.