Community-Based Qualitative Study to Identify Challenges in Implementing Health Promoting Schools Framework in Government Schools of Khordha District, Odisha, India.

Abstract

The WHO asserts every school should be a Health Promoting School (HPS) and laid a framework. The WHO is constantly working on expanding the number of schools modelled on it. The status of the level of health promotion needs to be explored to understand the local issues to identify key priority areas for policy making towards positive health. The study aims to explore the challenges in implementing the HPS framework in Government-run schools in Odisha. Method: A qualitative study was conducted with grounded theory using an inductive approach. In-depth interview was done among nine teachers from six government schools in the Khordha district who were selected through purposive sampling. A semi-structured open-ended interview was conducted using an interview guide among school science teachers and principals (n=9) regarding the challenges in implementing the HPS framework. Codes were generated from the transcript using the inductive approach from the WHO-HPS framework. Thematic analysis by Braun and Clarke model was using Quirkos software. Five themes with 12 codes were identified with the transcript. The respondents had little knowledge about the WHO-HPS framework. Their perception of health promotion was restricted to organizing health camps for school children. The themes were School health policy (inconsistent teachers recruitment policy, partial implementation of tobacco-free schools, outdated science syllabus),Coordination with the local community, Healthy school needs (lack of interactive and repetitive health-related training for school teachers, first aid box in schools and lack of supplementation of micronutrients like WIFS), Sanitation (inadequate funding for maintenance of sanitation) and an emerging issue of increased use of social media were reported in our findings. Conclusion: Our findings suggest that implementation of health-promoting schools requires imparting the skills to teachers by orientation and expanding the existing health services, backed with adequate funding and a firm policy commitment at the state level.