Objective: To assess the effectiveness of the FIFA 11 for Health programme in increasing children's knowledge about communicable and non-communicable diseases in five countries of Sub-Saharan Africa. Method: A prospective five-cohort study was implemented in schools in Ghana (17), Malawi (12), Namibia (11), Tanzania (18) and Zambia (11). The programme consisted of eleven 90-minute sessions consisting of two 45-minute halves of Play Football (football skills) and Play Fair (health issues). Participants were boys and girls aged 10-14 years: Ghana (906), Malawi (1098), Namibia (439), Tanzania (720), Zambia (651). The main outcome measures recorded were children's attendances at each session, their health knowledge (30-item questionnaire) before and after the interventions and the children's evaluation of the programme itself by means of a six-item questionnaire. Results: Mean attendance by children during the programme ranged from 88% (Malawi) to 99% (Tanzania) of participants. Increases in the children's overall level of health knowledge were recorded in all countries: range: 11% (Malawi) to 25% (Namibia). Children's overall evaluation-rating of the programme was very positive in all countries, ranging from 93% (Zambia) to 98% (Namibia, Tanzania). Conclusions: The FIFA 11 for Health programme produced significant increases in children's health knowledge and their awareness of disease prevention using an in-school, football-based health education programme. This success was most likely linked to the very high satisfaction rating given to the programme by the children involved. The success of the interventions also demonstrated the benefit of collaborating with the Ministries of Education in each country.