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This document includes information to create a healthy school environment, and to identify and modify aspects of the physical environment that jeopardize safety and health. However, physical interventions alone will not suffice. The document also contains guidance to ensure that positive changes in a school’s physical environment are supported, reinforced and sustained by school health policy, skills-based health education and school health services, the core components of an effective school health programme as called for in the international initiative to Focus Resources on Effective School Health (FRESH)