Oct 27: A year-long school health education programme across 15 schools in Haryana, Delhi and Chandigarh recorded significant improvements in students’ health knowledge, alongside gains in self-reported health behaviour. The evaluation covered 1,513 Class VI students in 12 government schools in Haryana and three private schools in Delhi and Chandigarh.
According to Tarang Health Alliance’s 2025–26 impact report, average health knowledge scores increased from 42.87% to 75.06%, while average health behaviour scores rose from 0.77 to 0.88; on a scale where 1 represents the most desirable health behaviour and 0 the worst.
“Health education needs to go beyond awareness and equip children with the knowledge and skills to make healthier choices in their everyday lives. Our findings highlight the potential of a structured, school-based approach, supported by trained and motivated teachers, to strengthen health literacy among children,” says Dr Rahul Mehra, PhD, Executive Chairman, Tarang Health Alliance.
One of the key findings was the difference in outcomes between government and private schools. Students in government schools recorded a greater improvement in both health knowledge and behaviour scores.
Among government school students, average knowledge scores increased from 35.72% to 80.0%, while behaviour scores rose from 0.75 to 0.91. Both these improvements were statistically significant. In private schools, knowledge scores increased significantly from 55.70% to 65.65%. However, the average behaviour score remained unchanged at 0.84.
In government schools, Tarang Health Alliance employed teachers specifically to deliver the health curriculum and provided continued mentoring through staff meetings during the academic year. In private schools, the programme was taught by designated schoolteachers, typically Science teachers, who had other teaching responsibilities and did not participate in the same mentoring meetings.
Parent engagement also differed. Government schools conducted an average of 2.8 parent sessions during the year, compared with 1.7 sessions in private schools.
While these factors offer possible explanations for the differences, the report identifies them as hypotheses rather than established causes. The findings nevertheless point to the importance of motivated teachers with sustained teacher support and frequent engagement with the parents, when implementing a school-based health education program.
The programme was implemented in 12 government schools in Haryana and three private schools in Delhi and Chandigarh. Class VI students received two 40-minute health education sessions each week, using a curriculum and student workbooks titled ‘On the Way to Being Healthy’. Teachers received eight hours of training before the programme began, covering the curriculum and inquiry-based teaching methods.
Schools were also encouraged to conduct four sessions for parents during the academic year, focusing on nutrition, hygiene and other health-related topics.
To assess the programme, students completed knowledge and behaviour questionnaires before the first class and after the final class of the academic year. The questionnaires were administered using an Optical Mark Recognition system. The knowledge assessment measured correct answers to multiple-choice questions, while the behaviour assessment used a score ranging from 0 to 1.
The analysis included 1,028 students from government schools and 485 from private schools. Knowledge scores improved across all 15 schools, while behaviour scores improved in the government schools but did not show a statistically significant improvement across the three private schools.
The results indicate that improvements in health knowledge may not automatically translate into changes in behaviour. Reinforcement through teaching, opportunities to practise healthy habits and continued engagement with students and families may be important to help bridge that gap.
School-based health education offers an opportunity to introduce preventive health concepts early, when children are developing habits that may influence their health over time. Topics such as hand hygiene, balanced nutrition and physical activity can help students recognise everyday health risks and understand the steps they can take to reduce them.
The findings suggest that a structured school health curriculum can strengthen students’ health knowledge, but that gains in knowledge do not necessarily translate into changes in reported behaviour. While knowledge scores improved across all 15 schools, behaviour scores showed no statistically significant improvement in the three private schools. This difference highlights the need to examine how health education is delivered, supported and reinforced in different school settings.
For schools and policymakers, the implication is that health education needs to be more than a classroom subject. Regular lessons, ongoing teacher support and meaningful engagement with families may help students apply what they learn in everyday life. Further evaluation would help establish whether improvements in health knowledge & behavior are sustained over the long term.
