About SBHS

Improving the well-being and resilience of young people will give them a better sense of connection and help to ensure they are ready to learn and more likely to achieve at school. Young people should be supported to develop the confidence they need to reach out for help and support when they need it.

School Based Health Services (SBHS) take a holistic approach to supporting young people. The most common presentations include, but are not limited to, trauma-based health impacts, particularly family harm, mental health, addictions, and sexual and reproductive health. SBHS nurses provide clinical primary health care (both student requested and nurse initiated), referrals onto required services and support health promotion campaigns.

SBHS ensures that young people entering secondary schools meet the school nurse in person to develop a personal connection and have a private and confidential psychosocial assessment (Year 9 health check). A common form of the Year 9 health check is HEEADSSS: Home, Education/employment, Eating, Activities, Drugs, Sexuality, Suicide and Depression, and Safety from injury and violence).


Where SBHS are available

SBHS are available in lower decile (decile one to five) secondary schools, Teen Parent Units (TPUs), and Alternative Education sites (AE) nationally. This means SBHS are available to around 97,000 students across approximately 300 schools.

Other school health services may also be available in schools, for example, where schools pay for their own nurse, or where the district health board (DHB) or primary health organisation (PHO) have chosen to supplement services with a GP.

School Based Health Services Enhancements programme

The Ministry’s SBHS enhancements programme, is a five-year programme (2020-2024) to build assurance that the SBHS programme is effective and efficient in improving outcomes for young people and achieving equity.

The enhancements programme has a focus on populations currently not well served by the system, including:

  • rangatahi Māori
  • Pacific young people
  • rainbow young people
  • young people in care
  • young people with disability.

The enhancements programme is focussed on progressing the following enhancements to SBHS:

  • commissioning for equity and wellbeing (see below)
  • workforce development and support
  • improved linkages with other services and sectors
  • SBHS Year 9 health check model of care.

Commissioning for equity and wellbeing will include:

  • the aims and objective of the services
  • the quality and workforce expectations
  • the reporting and monitoring mechanisms
  • form the basis for quality improvement initiatives alongside an evaluation.

The commissioning work will:

  • reflect Te Tiriti o Waitangi (Te Tiriti) principles
  • ensure the needs and concerns of young people are central to the measures and indicators and are addressed by the services
  • link to the Child and Youth Wellbeing Strategy and other relevant government agency strategies. 

The implementation phase of the enhancements programme will begin in 2022.

SBHS updates

We'll update the SBHS enhancements programme webpage as new information becomes available. For more information or to ask questions about the SBHS enhancements programme, please email the SBHS inbox at SBHS@health.govt.nz.

School Based Health Services evaluation

The School Based Health Services (SBHS) evaluation will assist in developing a clear accountability framework for SBHS with a better reflection of te Tiriti o Waitangi principles and long-term system outcomes and performance measures for SBHS. This will support quality improvement and outcomes evaluation, to increase the contribution of SBHS to the health and well-being outcomes of young people.

The objectives of the SBHS evaluation are to:

  • ensure that SBHS contributes to achieving equity and improving outcomes for young people
  • set the standard for equitable, effective, and efficient SBHS
  • drive Quality Improvement
  • further build the evidence base for investment in and implementation of SBHS
  • inform any expansion of SBHS.

The evaluation approach

Malatest International is a New Zealand-based research and evaluation company. The Malatest team have carried out evaluations of health and social sector programmes since 2012.

The evaluation is guided by a kaupapa Māori model. The evaluation team is guided by tikanga Māori values and use indigenous pūrakau to inform an iterative approach. Through this kaupapa Māori lens, our evaluators reflect on the information, knowledge and insights gathered to create a feedback loop and learning cycle. The evaluation is designed to integrate into the wider SBHS enhancement work programme.

The evaluation timeframes

The evaluation team completed a formative evaluation in 2021. During 2022, the focus is on quality improvement activities and undertaking a process evaluation. In 2023, the evaluation team will complete an outcomes evaluation.


Te Tatau Kitenga: National Youth Health Leadership Group

Te Tatau Kitenga has been established to provide expert advice and recommendations to the Ministry of Health on youth-related topics and services, especially for our priority groups: rangatahi Māori, Pacific young people, rainbow rangatahi, rangatahi in care and rangatahi with disability.

Whakamaua, the Māori Health Action Plan 2020–2025 outlines a suite of actions that will help to achieve four high-level outcomes. These outcomes are:

  • iwi, hapū, whānau and Māori communities exercising their authority to improve their health and wellbeing
  • ensuring the health and disability system is fair and sustainable and delivers more equitable outcomes for Māori
  • addressing racism and discrimination in all its forms.
  • protecting mātauranga Māori throughout the health and disability system.

Te Tatau Kitenga includes Te Rōpū Mātanga o Rangatahi (Te Rōpū). Te Rōpū provides leadership and advice to ensure that the work of Te Tatau Kitenga supports achievement of these outcomes.

Youth Advisory Group, School Based Health Services

The Youth Advisory Group has been established to focus on quality improvement and enhancement activities of School Based Health Services (SBHS).

Our collaborative partnership with young people through the Youth Advisory Group means they can be involved in all stages of design, equal with adults. We are recognising the importance of including young people in leadership and governance, so they can educate and inspire other to act, demonstrate leadership skills, model positive behaviours for peers, communicate their opinions and ideas to others and contribute to positive development of young people and their communities.

The membership of the Youth Advisory Group is representative of our identified priority population groups for the SBHS enhancements programme.

The Youth Advisory Group will enhance youth voices, perspectives, knowledge and bring youth experience into the SBHS Enhancements programme and advise the programme partners on tailored communications material and channels for young.