Factors Enabling Systematized National School Health Services in Japan.

BACKGROUND Japan has consistently provided nationwide school health services since 1872. However, the system used and the factors enabling this provision have not been fully and systematically explored. This study therefore aimed to provide an overview of the system and identify enabling factors for the provision of the school health services in Japan, to support successful provision in developing countries. METHODS We reviewed research papers and related documents and identified factors likely to support successful provision of school health services in developing countries. RESULTS Six key factors were identified supporting systematized nationwide provision in Japan: 1) existence of a legal basis for school health services provision, 2) partnership between the education and health sectors, 3) a systematized supervision system at all administrative levels, 4) clear definitions of essential services and stakeholders' responsibilities, 5) securing skilled human resources for school health services at school level, and 6) regular assessment of children's health issues. CONCLUSION Five factors were proposed as essential for successful provision of school health services in developing countries: 1) formulation of national school health policies and guidelines with clear definitions of essential health services and stakeholders' responsibilities, 2) strengthening partnerships within and between sectors at all administrative levels, 3) building cooperation between schools and health professionals and the community at local and school levels, 4) establishing systems for sustainable human resource development for school health in the education sector; and 5) developing systems for collecting children's health data, assessing their health issues, and monitoring and evaluation of the implementation.