Over the past two decades, many governments and organizations have renewed efforts to develop more effective school-based health and nutrition programmes in low income countries. In large part, this has resulted from the growing body of evidence linking children’s health and education; and the impact of school health and nutrition (SHN) programmes on improving these outcomes and contributing to Education for All (EFA) and the Millennium Development Goals (MDGs). A major breakthrough on the international consensus for SHN programming was achieved in April 2000 at the World Education Forum, where key international agencies agreed on a common framework for SHN programmes, called Focusing Resources on Effective School Health (FRESH). The FRESH framework promotes cost-effective programming by calling for the integrated implementation of a core group of four health-related approaches for schools in low income countries: 1. health-related school policies; 2. school-based delivery of health services; 3. safe and sanitary school environment; and 4. skills-based health education. The aim of this review is to form a starting point for discussions on how to develop and disseminate a future generic M&E framework. Such discussions are expected to be initiated at a meeting with the concerned 24 organizations to be held at the headquarters of the World Health Organization (WHO) in Geneva in September 2008.