This paper is based on the experiences of Health Action Schools project and tries to look at issues surrounding the definition, choice and implementation of planned content of health education for primary schools in Pakistan. It argues that health education is a vital component to achieving quality because it links home with school; 'needs now' with 'needs later'. Yet it proves exceptionally difficult to plan and deliver such content effectively because curriculum planning bodies are geared to work with separate subjects rather than across the curriculum, with classroom content rather than wider learning experiences in and from school, and with textbooks and examinations rather than the physical and human environment of the school community.
There is confusion as to the definition and purpose of health education and a wide gap exists between what is planned centrally and what is actually delivered in a school. There is a need to rethink approaches aimed at improving content, methodology, materials and evaluation strategies. Yet, many fundamental problems remain in overcoming a restrictive and conservative culture of schooling. Issues raised in this paper have wide relevance, not only to health education but also to the planning of other themes, such as environmental education and inclusive education.