Abstract

ObjectiveTo assess school policies, built environment and practices for prevention and control of non-communicable diseases in schools of Delhi, India.MethodsSchool built environments and policies were assessed using a structured observation checklist in 10 private and 9 government schools which were randomly selected from all 184 co-educational schools with primary to senior secondary level education in Delhi, India. A self-administered questionnaire was also completed by teachers from each school (n = 19) to capture information specific to school policies. Surveys were also conducted with parent of students in class II (aged 6–7 years; n = 574) and student in class XI (aged 15–16 years, n = 755) to understand school practices.ResultsThe majority of government (88.9%; n = 8) and private (80%; n = 8) schools reported having comprehensive school health policy. In terms of specific health behaviours, policies related to diet and nutrition in government schools were mostly restricted to primary levels with provision of the mid-day meal programme. All schools had two physical education periods per week of about 45–50 minutes. Most schools were compliant with tobacco-free school guidelines (n = 15 out of 19) and had alcohol control policies (n = 13 out of 19). Parent and student reports of practices indicated that school policies were not consistently implemented.ConclusionMost schools in Delhi have policies that address health behaviours in students, but there was considerable variation in the types and number of policies and school environments. Government schools are more likely to have policies in place than private schools. Further work is needed to evaluate how these policies are implemented and to assess their impact on health outcomes.

Highlights

  • In terms of specific health behaviours, policies related to diet and nutrition in government schools were mostly restricted to primary levels with provision of the mid-day meal programme

  • Rapid changes in India’s demography, socio-economic profile, and lifestyles have led to the emergence of non-communicable diseases (NCDs) as a leading cause of morbidity and mortality

  • Signage of food and beverage companies were observed in private schools (10% and 30% respectively), but not in any government schools

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Summary

Introduction

Rapid changes in India’s demography, socio-economic profile, and lifestyles have led to the emergence of non-communicable diseases (NCDs) as a leading cause of morbidity and mortality. The onset of NCDs can be prevented or delayed by addressing key modifiable risk factors, including unhealthy diet, physical inactivity, tobacco use and alcohol abuse [2,3]. These lifestyle behaviours are often formed early in life, and track into adulthood [4,5,6,7]. Schools have been widely recognized as an important platform for delivering health promotion interventions [11,12] Despite recognition of their important role, little is known about existing initiatives and approaches to behaviour that are currently being implemented in the Indian context. The objective of this study was to assess existing school policies, built environment and practices regarding prevention and control of NCDs in private and government schools in Delhi, India

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