7.4 Healthy lifestyles and healthy nutrition
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In the French-speaking Community, the decree of 20 December 2001 revised on 20 July 2006) organises health promotion at school. Health promotion at school consists of:
- the implementation of health promotion programme and of a healthy school environment ;
- the medical follow-up which includes individual medical check-up and vaccination policy ;
- early detection of transmitted diseases and preventive medicine ;
- the collect of standardised healthcare data.
Health promotion is free and compulsory. Each school is linked to a Service of Health Promotion or to a Centre for Psychological-Medical and Social Services. These centres are the main stakeholders regarding health promotion at school according to the 2015 activity report of the Birth and Childhood Office. Their role is to guarantee a healthy school environment and also make young people actors of their health. With the 6th reform of the state, these centres are now under the administrative supervision of the Birth and Childhood Office. Legal texts must be adapted according to the new institutional reality. A project of decree is in progress based on the decree of 20 December 2001 related to health promotion at school and the decree of 16 may 2002 related to health promotion in Higher Education except Universities. In Wallonia, the forthcoming Walloon Plan for health prevention and health promotion aims at improving health, quality of life and well-being of every Walloons including young people by 2030. The former Walloon Minister of Health presented the Plan’s main strategic directions to the Government in February 2017. See 7.8 Current debates and reforms.In the French Community Commission of Brussels, the Minister of Health has presented a Health Plan to the Government in April 2016. This plan covers the period 2018-2022. It includes priorities such as the promotion of health, healthy lifestyles, healthy eating and nutrition, preventing risky behaviour and substance abuse for the entire population including young people. The Minister of Environment, Life Quality and Agriculture implemented the strategy GoodFood “towards a sustainable food system in the Region Brussels-Capital” (stratégie GoodFood “vers un système alimentaire durable en Région de Bruxelles-Capitale”). This policy covers the period 2016-2020. The goal is to put food at the heart of the city with all its social, economic and environmental dimensions. This strategy aims at raising awareness on healthy nutrition and healthy production. It encourages and federates initiatives in the sector. The strategy includes as a priority the involvement of citizens from earliest childhood. One of the action relates to the awareness and the involvement of future generations through schools (pedagogical animations, cooking lessons, farm’s pedagogical visits, etc.). There is also the development of a vegetable garden at school: the strategy aims at supporting the creation of 10 school’s vegetable garden per year by 2020. Through this strategy, the Region encourages the exchange of good practices between schools and teachers, via the “Bubble” network. It also aims at strengthen the training of educative teams on these topics (health, nutrition, sustainable food, local food).
- APAQ-W, the Walloon Agency for the Promotion of a Quality Agriculture develops several schemes regarding healthy nutrition for young people. One of the Agency’s mission, as set out by decree, is to implement pedagogical actions and to develop the sense of taste according to the Agency’s activity report 2015.
- The Agency publishes pedagogical brochures such as “Julie and Martin’s farm” (la ferme de Julie et Martin), “Farm over seasons for children from 5 to 8” (la ferme au fil des saisons élèves 5 à 8 ans), etc.
- The Agency publishes and disseminates in every primary school on the French-speaking territory a list of “pedagogical farms in Wallonia”. This action is conducted in partnership with the association “Accueil Champêtre en Wallonie”.
- Financial support for “healthy snack and healthy breakfast” (Aide aux collations santé) The Agency grants financial aids to schools for the organisation of healthy breakfasts and healthy snacks at school. The support amounts 1.75 euros per person with a maximum of 350 euros per breakfast (per school per year) according to the Agency’s activity report 2015. For healthy snacks, the support amounts also 350 euros per event (0.20 euros per fruit and 0.50 euros for a dairy product). In 2015, 45 000 pupils have been touched by this action. This action is implemented for more than 15 years according to the Agency’s activity report (2015). The Agency requires to participants to associate the event with a pedagogical project on the topic of healthy nutrition or the discovery of agriculture.
- “Let’s eat walloon at the Scouting Camp” (Au camp, mangeons wallon!) Scouting movements may receive subventions from the Agency during their summer camp. The support amounts to 5 euros per participant per camp with a total amount of 400 euros per camp in order to buy local meat products according to the activity report 2015. The same support is granted for the purchase of local products from Walloon agriculture. In 2015, 528 scouting movements have introduced a request of which 258 have received the subvention.
- In the Community Commission of Brussels, the “GoodFood Homepage” provides initiatives and pedagogical tools to encourage healthy lifestyle and healthy nutrition for young people mainly through school.
- The website “mangerbouger” encourages healthy lifestyle and healthy nutrition for young people.
Sexual health The French-speaking Community, the Walloon Region and the French-Community Commission of Brussels have signed an agreement to spread the programme related to Education to relational, emotional and sexual life (EVRAS - Education à la Vie Relationelle, Affective et Sexuelle) in schools. This agreement sets out a common definition of “Sex and Relationships Education” in order to define a common framework in which actors take action (common definition, common objectives and principles of EVRAS). It also creates “EVRAS support points” inside “Local Centres for health promotion”. There are 10 “Local Centres for health promotion” in the French-speaking Community. They are created by the decree of 14 July 1997 organising health promotion in the French-speaking Community (organisant la promotion de la santé en Communauté française). They address the entire population including young people. Their main mission is to reduce social inequalities regarding health issues. The Agreement organises the insertion of “EVRAS support points” which are resources centres inside the “Local Centres for health promotion”. These resources centres support schools by providing pedagogical tools, facilitating partnerships with associations such as family planning centres (centre de planning familial) or health promotion’s associations. They also make inventories of school’s needs and available resources in EVRAS. This agreement has been signed in 2013 and is concluded for a permanent period. Its evaluation is planned 2 years after its effective date. The agreement defines EVRAS as [§1] an educative process which involves, among others things, a reflection (thought) in order to increase young people’s aptitudes to operate informed choices which will foster their fulfilment in their relational, emotional and sexual life and also to respect themselves and others. It’s about guiding every young people toward adulthood according to a global approach in which sexuality is understood in a wider sense and which includes relational, emotional, social, cultural, philosophic and ethic dimensions. […]. Actors operate within this common framework whether they depend from a level of power or another (family planning centres, teachers, youth workers, etc.).
The French-speaking Community implements an EVRAS label certification to ensure the quality of EVRAS service providers such as youth workers, family planning centres, etc.
A call for projects is also organised in the youth sector to fund EVRAS projects implemented by structures with the label certification. At Regional level The Regions recognise and fund “Family Planning centres” (Centre de planning familial). A multidisciplinary team (doctors, psychologists, social assistants, legal workers, etc.) welcomes families, couples, individuals and provides them with information, support and guiding regarding sexual and emotional life. At the French-speaking Community levelIn formal education, see sex education and personal relationship education. In non-formal education, the Minister of Youth has published in 2017 a circular which gives a legal framework to “label” associations which organise EVRAS activities for young people. This label aims at guarantying quality of the services provided by the labelled association, ensuring that animators have the right training, ensuring that activities match the objectives of EVRAS as defined in the circular. The Minister of Youth has also developed in this circular a call for projects to fund EVRAS projects. The projects must target young people from youth organisations and youth centres. The implementation of the circular reserves a total budget of 150 000 euros for the projects. The selected projects can receive a total amount of 5 000 euros. Preventing substance abuse In 2007, the Minister of Health and the Minister of Education have signed a convention (annex 1) with the 10 “Local Centres for health promotion” regarding the implementation of a pilot project creating “support points” to prevent substance abuse at school. The convention defines their missions and their funding. Their mission is to strengthen the collaboration between school’s actors (school, Health Promotion Services at school, Centres for Psychological-Medical-Social Services) and actors specialised in substance abuse prevention. The objectives are to:
- Strengthen the knowledge of school’s actors regarding the prevention offer of specialised structures ;
- Adapt the prevention offer to school’s needs ;
- Make easier collaboration between school’s actors and specialised structures ;
- Make them work in network.
The Walloon Government is responsible for this Convention. According to the Walloon Agency for quality of life which is the funder, the programme received 202 500 euros in 2016. The dispositive was evaluated in September 2015.
Health education Health promotion is compulsory at school. There is no separate subject in the school curriculum regarding specifically health education or health nutrition. However, the new compulsory subject “education to philosophy and citizenship” includes “education to well-being” in its objectives. It aims at developing the understanding of psychology and humans relations and of self-control, education to emotional relations and the acquisition of preventive behaviour as regards to health and security for oneself and others according to the decree related to education to philosophy and citizenship. The education ’s website, “enseignement.be”, provides information and pedagogical tools related to this subject. Sex education and personal relationships education There is no separate subject in the school curriculum regarding sex and relationship education. But the decree of 24 July 1997 “on the missions of school” has been modified in 2012 to introduce the following mission: “[…] each school must educate to [...] relational, emotional and sexual life […]”. This modification aims at introducing “EVRAS” (Education to relational, emotional and sexual life) in the school’s missions. It compels every school to take initiatives regarding this subject. But schools are free to choose the way they will take action regarding EVRAS according to their school’s project and their school’s reality. On September 2013, the Minister of Education has signed an informative circular related to EVRAS. It supports schools by informing about what is EVRAS and by providing ideas on how to implement it. According to this circular, EVRAS is a “life education” which has many dimensions (emotional, relational, social, cultural, biological, sexual,...). It gives some examples of objectives purchased by EVRAS:
- Promoting the respect between boys and girls, women and men ;
- Offering the possibility to anyone to make informed choices and to act by respecting oneself and others ;
- Preparing pupils to physiologic, psychologic and social changes linked to puberty ;
- Offering the possibility to everyone to get necessary aptitudes to face every aspects of sexuality and romantic relationships ;
- Promoting the capacity of everyone to communicate on sexuality, emotions, relations and to acquire necessary vocabulary to be able to communicate it properly ;
The circular also promotes the development of partnerships and synergies. Many actors are competent to support schools in their EVRAS project (Health Promotion Services, Family Planning Centres, associative sector or “EVRAS reference points” inside Local Centres for health promotion). “EVRAS reference points” inside Local Centres for health promotion provide schools with pedagogical tools. The Education Administration’s website, “enseignement.be”, also provides pedagogical tools.
Peer-to-peer education approaches are used by some associations. For instance, the yearly project “Festi-Team” offers peer-to-peer awareness campaigns in summer festivals about safe-partying. Young people are informed about risks linked to drugs, alcool abuse, safe sex, etc. Then they go in summer festivals to meet others young people and raise young partyer’s awareness about these issues. The young people targeted are between 16 and 25 years old. The Youth Council also uses peer-to-peer education approaches through the voluntary work of youth delegates. These ones meet young people in festivals, etc. and discuss with them about various topics including health.
The youth organisation OH YES ! has launched in 2021 an online channel on the social networks about sexual health: Moules Frites. It uses the peer-to-peer education approach and give a free and kindly space for every young people to share about their questions, experiences, etc.
To prevent school dropout, the decree of 21 November 2013 organises, among others things, the training of young people in the field of meditation in order to use peer-to-peer exchanges. See section 6.3 Preventing early leaving from eductaion and training.
Authorities of the French-part of Belgium cooperate to implement 2 dispositives to strengthen collaborations between school’s actors and specialised actors: - In 2007 regarding substance abuse prevention ; - In 2013 regarding the spread of Education to relational, emotional and sexual life (EVRAS). The decree of 21 November 2013 related to well-being of young people at school, preventing school drop-out, prevention of violence’s at school and school guiding is at the intersection of education and Youth Welfare sectors.
Raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people
Information providers Many actors are responsible for disseminating information about youth health:
- Birth and Childhood Office ;
- Health Promotion Services at school (the decree of 20 December 2001 related to health promotion at school and the decree of 16 May 2002 related to health promotion in Higher Education except Universities) ;
- Centres for Psychological-Medical-Social Services ;
- Local Centres for Health Promotion ;
- Schools ;
- Family Planning Centres ;
- Associations ;
- Youth information Centres.
Distribution of fruits and vegetables in schools The Regions participate to the European Programme “EU school fruit, vegetable and milk scheme”. It is designed to help promote the benefits of healthy eating to children and encourage them to increase their consumption of fruit, vegetables and milk according to the European Commission website.
- At the Walloon level, APAQ-W (Wallonia Agriculture) manages the scheme ;
- At the Brussels Regional level, the Public Service of Brussels is responsible for the scheme.
The Birth and Childhood Office participates as expert to the scheme. The new programme came into effect on 1st August 2017. It replaces individual schemes. All along the school year, pupils from primary school receive fruits, vegetables or dairy products during 30 weeks. This programme was first introduced in 2009. It is financed by the European Agricultural Guarantee Fund in the framework of the Common Agricultural Policy. For the school year 2017-2018, the Region of Brussels Capital launches for the first time its own strategy 2017-2023 in the framework of the European programme « School scheme ». Schools distribute fruits, vegetables and/or milk products for free to pupils.