Schools represent a cost-effective and convenient way to deliver regular but infrequent deworming to children. A major step forward in international coordination of school health programmes was achieved with the development of a global inter-agency initiative aimed at Focusing Resources on Effective School Health (FRESH). The FRESH framework includes the following core components:
- School health policies that advocate the role of teachers in health promotion and delivery.
- Safe water and sanitary school environments.
- Skills-based health education that promotes good health.
- Basic school-based health and nutrition services.
The FRESH framework has been adopted by a majority of countries in Africa as the organizing principle for school health programmes, including school-based deworming.
In addition to school-based programmes, deworming can also be successfully delivered through community campaigns, such Child Health Days. Whatever the delivery mechanism, identifying which schools and communities require treatment is an essential part of the process. There is a pressing need for reliable and up-to-date information on the geographical distribution of infection in order to (i) guide control to areas in greatest need and (ii) estimate drug requirements.