A school is more than a place where children learn to read, write and count. It is also where they develop habits, build friendships and acquire skills that can shape their health and well-being throughout life.
In Kriva Palanka, North Macedonia, this understanding is driving a shift in how schools approach health promotion, turning a successful pilot into a municipality-wide initiative benefiting some 1766 students.
The Health Promoting School approach, which has now been expanded to include all schools in the municipality, goes beyond teaching children about healthy lifestyles. It creates an environment where health and well-being are reflected in lessons, relationships, school activities and cooperation with families and health services.
It is the latest stage in a national process that WHO has been supporting since 2022.
Making health part of school life
At the heart of the approach is I Learn for My Health, an elective subject for grades 4, 5 and 7. It was designed by teachers, working with psychologists and public health experts, and informed by the priorities of schools themselves.
“As a teacher, what pleases me most is that this approach helps us see how a child is feeling, what habits they are building and whether they feel they belong in the school environment,” notes Dobri Jovevski, teacher and author of the I Learn for My Health curriculum.
“Health promotion makes sense in everyday moments: when we link learning with movement and play, when we talk about healthy habits and organize a healthy food fair with students and parents, when children learn to ask for help and to support a friend. In this way, the school becomes a place where we learn how to care for ourselves and for others,” he adds.
The approach is approved by the Bureau for Development of Education, which also supports it together with the Ministry of Health, Ministry of Education and Science and the Institute for Public Health of the Republic of North Macedonia. In 2025–2026, it reached 520 students in 12 schools across North Macedonia.
What happens in schools?
A health-promoting school encourages students to try deep-breathing exercises and short guided meditations. In class, students put together a personal “calm-down box” of strategies, from breathing to talking to a friend or reading a book.
Lessons include walks where students learn about pacing and breathing, along with team games and fair play. Students play healthy food bingo, compile magazines of healthy family recipes and cook healthy meals together at school.
Groups of students might build a “bridge of friendship” from card, clay and straws, or design a friendship sign that the class votes on and displays in the classroom. Through role-play scenarios, children learn that asking for help is a sign of courage, not weakness.
Schools also strengthen links with local health services, including health examinations and immunizations, and students help teachers prepare and run health workshops.
“The Health Promoting School initiative is about supporting children at the earliest stage of life to gain skills and practices to live healthily, thrive and flourish. This can only be achieved when school leadership, teachers, parents and the government work together,” explains Dr Akeem Ali, WHO Representative to North Macedonia.
Building a model for broader change
Pilots in 4 municipalities helped inform the development of I Learn for My Health and the accompanying teachers’ manual. In June 2026, a national webinar introduced the programme to approximately 500 teachers, supporting wider implementation.
Building on the experience of the pilot school, Kriva Palanka has committed to designating school coordinators, monitoring implementation and, within available resources, exploring opportunities to integrate health promotion into future municipal planning and budgets, helping to create the conditions for long-term sustainability.
“In Kriva Palanka, we have seen for ourselves what the Health Promoting Schools pilot can do for our children. That is why we have decided not to stop there, but to make health and well-being part of how every school in our municipality plans and works, from this school year onwards. Investing in our schools’ health is investing in our children’s future and in the future of Kriva Palanka,” says Mayor Sashko Mitovski, who championed the expansion.
The experience in Kriva Palanka illustrates how health promotion can move beyond individual projects to become part of routine school planning and local policy. With municipal leadership, trained teachers and the participation of students and families, the initiative shows how communities can create healthier, more supportive environments where children can learn and thrive.