Determinants Of Non-communicable Diseases Research Articles

A cross sectional study, for risk assessment of non-communicable disease in urban slum of South India

Background: Non communicable diseases (NCDs) contribute to around 5.87 million deaths that account for 60% of all deaths in India. India shares more than two-third of the total deaths due to NCDs in the south-east Asia region (SEAR) of WHO. Objective was to monitor the trends and determinants of non-communicable diseases (NCDs) in the study population in slum of Telangana. Methods: The cross-sectional community-based study, was conducted in the urban field practice area of Apollo Institute of Medical Sciences and Research, Hyderabad. Sample size was estimated, data was collected in WHO STEPS questionnaire (STEP 1 and STEP 2) after obtaining informed consent from the participants. The performa included anthropometric measurements, blood pressure and questions related to tobacco use, alcohol consumption, dietary pattern, physical exercise. Microsoft Excel 2007 was used for data entry, SPSS version 24 for data analysis. Results: Tobacco smoking use in any form was seen in 22.1% males of the study population and 1.8% of females. The means waist hip ratio amongst male is 0.92 cm. The mean waist hip ratio amongst 113 voluntary participants was 0.89. Conclusions: NCDs in the urban slum that requires appropriate early actions to prevent risk factors, reducing the disease burden. Health education among households through behaviour change, formulation and implementation of health policy for urban slums will go a long way in lessening the burden.

The prevalence and determinants of non-communicable diseases among Ghanaian adults: A survey at a secondary healthcare level.

The current epidemiological transition of diseases in Ghana necessitates understanding their burden and the associated context-specific risk factors to inform disease prevention strategies. To determine the prevalence and determinants of selected Non-Communicable Diseases (NCDs) among patients seeking healthcare services in a secondary health facility in Ghana. A facility-based survey was conducted among adult patients 18 years and above between May and July 2021, using a multi-stage sampling approach. Data regarding the prevalence of NCDs, participants' socio-demographics and lifestyle factors of NCDs were obtained using Modified STEPwise Approach to NCD Risk Factor Surveillance (STEPS). The Chi-square test and regression analysis were performed to identify the risk factors of NCDs at P < 0.05. The participants comprised 480 patients with a mean age of 37.7±16.5 years, and 57.7% (277/480) of them were females. The overall prevalence of the selected NCDs was 26.7% (CI = 0.23-0.31), of which hypertension (22.7%) was the most prevalent. More than half (54.2%) of the participants engaged in alcohol consumption and 54% were physically inactive. The odds of developing NCDs were higher in females (CI = 1.32-4.10, P = 0.004), older adults (CI = 4.11-20.68, P <0.001), overweight/obese adults (CI = 1.65-4.70, P < 0.001), family history (CI = 0.15-0.46, P<0.001), and alcohol consumption (CI = 0.12-0.40, P < 0.001). There was an overall high prevalence of NCDs, strongly influenced by the participants' age, sex, BMI, alcohol consumption, and family history. These determinants should be highlighted as part of the campaign for preventive action plans.

Determinants of Non Communicable Diseases: A Mixed-method Study on Its Prevalence and Perceptions among Rural Population of Muchisa, West Bengal

Introduction: Most people with Non Communicable Diseases (NCDs) are unaware of the problem because it usually does not have any signs or symptoms in the initial stages. The measures for prevention of NCDs are not well known to the rural population which results in a huge burden on the health system. Aim: To estimate the burden of NCDs, and its risk factors among the rural population residing in a village of Budge Budge II block, West Bengal. Also to explore their perceptions regarding determinants, complications and prevention of NCDs, and to look for the association of NCDs with the risk factors and sociodemographic characteristics. Materials and Methods: An observational study, with crosssectional design using mixed methods approach, was conducted on 160 residents of Muchisa, from December 2020 to March 2021. A predesigned, pretested and structured schedule, prepared on the basis of World Health Organization (WHO) STEPS framework, was used to assess the presence NCD and associated risk factors in the study population. Focused group discussion guide was employed to inquire about their perceptions. The participants were selected through cluster random sampling. The data were explored using Pearson’s Chi-square test, logistic regression and thematic analysis. A p-value of &lt;0.05 was considered significant. Results: Mean age of the participants was 45.0±16.8 years, and 69.4% participants were females. Total 75% of the participants suffered from at least one NCD. All the participants had at least one risk factor for NCD. Age group of 40-59 years (p-value &lt;0.001) and 60 years or above (p-value=0.002), female gender (p-valu=0.009), and preschool education or below (p-value=0.006) were associated with a higher risk of NCD. Qualitative data analysis revealed that lifestyle modification was not perceived to be effective against NCDs. Conclusion: Socio-demographic factors, like age, gender and education have a bearing on the risk of developing NCD. Lack of awareness about the prevention of NCDs is the challenge in addressing the problem.

Magnitude and Determinants of Non Communicable Disease and Its Contributing Factors in Medical Ward of Mettu Karl Referral Hospital, South Western, Ethiopia: A Prospective Observational Study

Background: Non-communicable diseases are defined as diseases or conditions, which affect individuals over an extended period of time (years, decades or even an entire lifetime) and for which there are no known causative agents that are transmitted from one affected individual to another. Noncommunicable diseases are a major global problem. Objective: To find out magnitude and determinants of non-communicable disease and its contributing factors in medical ward of Mettu Karl Referral Hospital. Methods: A prospective observational study design was conducted from April 23/2021 to June 24/2021. Data was collected through employing structured questioner, and then the collected data was coded and analyzed by statistical packages for social sciences 25.0-version statistical software. A test of association was done using binary and multiple logistic regressions. P value &lt;0.05 was considered significant. Findings: The overall prevalence of non-communicable disease in medical ward was 288 (68.2%).Hypertension was the commonest type of noncommunicable disease 41.71% followed by diabetes mellitus 41.5%. Regarding body mass index majority 153 (36.3%) of patients were normal (18.5-24.9 kg/m²) and least 57 (13.5%) of the patients were underweight (&lt;18.5kg/m²). Age, every khat chewers, every alcohol drinkers, BMI ≥thirty kg/m², biochemical risk factors (obesity, high blood pressure, high fasting blood sugar, low density lipoprotein, and comorbidity were significantly predictors of non-communicable diseases). Conclusion and Recommendation: Majority of patients had physical activity ten minutes per day, had sedentary lifestyle ten to thirty hours per week, were walking ten to thirty hours/per week, and above half of patients were use salt always/usually. Health care workers should have teach the patients how to prevent non-communicable diseases.

Prevalence, pattern and determinants of chronic disease multimorbidity in Nepal: secondary analysis of a national survey

ObjectivesTo assess the prevalence, pattern and determinants of non-communicable diseases (NCDs) multimorbidity in Nepal.DesignSecondary analysis of the data from the NCD survey 2018, which was conducted between 2016 and 2018.SettingThe...

PREVALENCE, PATTERN AND DETERMINANTS OF FAST FOOD CONSUMPTION AMONG SCHOOL AGE CHILDREN IN JOS METROPOLIS, PLATEAU STATE, NIGERIA: AN IMPLICATION FOR NUTRITION EDUCATION

Motivation/Background: In 2001, non-communicable diseases (NCDs) accounted for 60 percent of 56 million deaths worldwide and 47% of global burden of disease. In all countries, evidence suggested underlying determinants of NCDs were largely same. These include increased consumption of rapidly processed energy-dense nutrient-poor foods high in fat, sugar, salt and reduced levels of physical activity. The objective of this study was to determine prevalence, pattern and determinants of fast foods consumption among school age children in Jos metropolis.&#x0D; Method: In this study, we used descriptive cross-sectional study and included 347 mothers or care givers with children age 6 to 12 years in our sample size. We applied structured interviewer-administered questionnaire during data collection and analyzed the data with SPSS version 21.0.&#x0D; Results: Prevalence of fast food consumption among school age children in Jos metropolis in the last one week is 91.1%. Knowledge of health risk associated with fast food consumption was 86.5%. Flour based fast food were most commonly consumed. We established an association between meal skipping, fast food advertisement and fast food consumption.&#x0D; Conclusions: We recommend the need to focus public enlightenment on health risk associated with fast food consumption among school age children. Likewise, children should be encouraged to carry home-made food to school and legislation on fast food advertisement directed at children should be enacted.

Self-Perceived Health, Objective Health, and Quality of Life among People Aged 50 and Over: Interrelationship among Health Indicators in Italy, Spain, and Greece.

It is well known that self-perceived health (SPH), even if it is a subjective health indicator, is significantly associated with objective health and quality of life (QoL) in the general population. Whether it can be considered an indicator of cognitive functioning and quality of life in the elderly is still an open issue. This study used a data-driven approach to investigate the interrelationship among SPH, non-communicable diseases (NCDs), QoL, and cognitive functioning to answer this question. The study sample included information about 12,831 people living in Italy, Spain, and Greece, extracted from the Survey on Health, Aging, and Retirement in Europe, in the year 2015. The additive Bayesian networks methodology was used to identify the best directed acyclic graphs (DAG) for SPH, QoL, and NCDs. Results were given as posterior estimates of generalized linear models (GLM) coefficients, with 95% credibility intervals. Good SPH was associated with a decreasing number of chronic diseases in Italy (coeff = −0.52, 95%CI: [−0.59, −0.44]), Spain (coeff = −0.53, 95%CI: [−0.60, −0.46]) and Greece (coeff = −0.57, 95%CI: [−0.64, −0.50]). Age and Body Mass Index were determinants of NCDs in all countries. QoL of elderly was associated with SPH in Italy (coeff = 0.12, 95%CI: [0.10, 0.14]), Spain (coeff = 0.16, 95%CI: [0.15, 0.18]), and Greece (coeff = 0.18, 95%CI: [0.16, 0.20]). The number of NCDs was higher for people who were not employed in Spain (coeff = 0.45, 95%CI: [0.37, 0.53]) and was decreasing for a unitary increase in years of education in Greece (coeff = −0.12, 95%CI: [−0.14, −0.09]). As a general rule, the framework of the interrelationship among NCDs, SPH, and QoL was similar for Italy, Spain, and Greece. The connections found among indicators could be proposed to identify strategies for health promotion and healthy aging among people aged 50 and above, which are viable in general and at a country level. Reinforcing strategies targeted at some health indicators could have relevant effects on other related indicators.

Prevalence and determinants of non-communicable diseases in Saudi Arabia

Abstract &#x0D; Background&#x0D; Chronic diseases are considered the leading cause of mortality in Saudi Arabia. With a lack of national health surveillance systems, this study examines chronic disease prevalence and multimorbidity and their associated factors in Saudi Arabia.&#x0D; Methods&#x0D; Data was pooled from two cross-sectional national surveys conducted across the 13 regions of Saudi Arabia between March and July 2018. The study targeted Arabic speakers aged 18 years or older. The presence of chronic diseases was assessed according to self-reported medical diagnoses of chronic conditions. Multimorbidity was assessed based on the reported number of diseases (no condition, at least 1, and ≥ 2 conditions). Factors associated with chronic diseases’ presence were examined using regression analysis.&#x0D; Results &#x0D; Out of the total participants (N= 7,317), the most reported chronic conditions were cardiovascular diseases (15.1%) followed by respiratory diseases (14.16%). The multimorbidity prevalence (≥ 2 chronic conditions) was nearly 5.6% (n= 564). Factors found to be significantly associated with the presence of chronic diseases were age, gender, employment status, marital status, and smoking. The findings showed that those who rated their health as fair or poor were almost three times more likely to be diagnosed with at least one chronic condition (95% CI: 2.21 - 3.56, P &lt;0.001).&#x0D; Conclusions&#x0D; The study found a proportion of Saudis living with chronic diseases and multimorbidity with the highest risk among elderly people. The study findings are useful in building a sustainable health surveillance system and designing effective health policies and interventions to tackle the burden of chronic disease in Saudi Arabia.&#x0D;

An Epidemiological Study to Find Out the Determinants of Non-Communicable Diseases among Patients Visiting Chandi Daulatabad Block Primary Health Center, South 24 Parganas, West Bengal

An Epidemiological Study to Find Out the Determinants of Non-Communicable Diseases among Patients Visiting Chandi Daulatabad Block Primary Health Center, South 24 Parganas, West Bengal

Risk factors for non-communicable diseases in villages of Tamil Nadu - A survey

Background: Non-communicable diseases are among the leading causes of death in India, the rapid epidemiological transition as a consequence of economic and social changes is a major factor in the rise of patients suffering from non-communicable diseases (NCDs). Objectives: The objectives of the study were (1) to find out the prevalence of common risk factors among adults for NCDs, (2) to study the determinants of NCDs, and (3) to assess health-care seeking behavior and treatment adherence to NCDs. Material and Methods: The present study was undertaken in the field practice area of the Rural Health Training Center of the Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry. It was a community-based cross-sectional study. A representative sample of 590 respondents was selected by two-stage cluster sampling. Chi-square tests were applied to find proportions. Confidence intervals values were constructed around the prevalence ratio values. Multivariate analysis (negative binomial regression) was done to get the adjusted prevalence ratio and to select the variables that best predict the risk of development of at least one NCD among the study sample. Results: The prevalence of at least one NCD (hypertension and or diabetes) among respondents was 18.1%. Most of the patients with hypertension and or diabetes received treatment from a public health facility (68.2%) followed by private health-care services (31.8%) at village/ town level. The major perceived reasons for non-compliance to treatment among patients were related to the high cost of treatment (28%) from private services and sense of wellbeing without medication (28%). In multivariate analysis, two variables emerged as significant predictors for developing at least one NCD were alcohol consumption and obesity. Conclusions: Obesity was found be an independent risk factor for developing NCD. Hence, preventive measures should be applied to reducing BMI in obese individuals. Special efforts must be made to improve physical activity and dietary habits of these individuals from an early age so that the occurrence of NCD can be prevented. Awareness regarding physical activity and a healthy diet can be given in schools and colleges as it may have a better impact on the community. Opportunistic screening for NCD should be done for all adults in the outpatient department irrespective of their symptoms for early diagnosis of NCD.

Knowledge of dietary habit and behavior-related determinants of non-communicable disease in women of urban setting of Eastern Nepal

Background: The non-communicable diseases (NCDs) are one of the leading causes of death globally which accounts for 68% out of world’s 56 million deaths in 2012. Around 82% of the premature deaths due to NCDs occur in the low-and middle-income countries and 40% of global NCD-related deaths take place before the age of 70. The study aimed to assess knowledge of dietary habits and behaviour-related determinants of NCD in urban Nepalese women of Eastern Nepal.&#x0D; Materials and Methods: A cross-sectional study was designed by using interviewer-administered questionnaire regarding knowledge on NCD. The definitions used for the study adopted the WHO STEP wise approach to chronic disease risk factor surveillance (STEPS) survey. A total 706 women aged 20–59 years were selected randomly from Inaruwa Municipality of Eastern Nepal.&#x0D; Results: The overall knowledge scores was found to be 62.14% with standard deviation 14.93% and it build up that the diet- and behaviour-related causes (mean score 75.25%), diet quality (mean score 45.27%) fruit and vegetable link (mean score 30.02%), health consequences of obesity (mean score 76.82%), causes of cardiovascular disease (mean score 77.08%) and causes of certain cancers (mean score 36.10%) were calculated. The total score of knowledge regarding NCD was found to be significant with caste/ethnicity, education level, occupation, socioeconomic status, physical activity and fruit intake.&#x0D; Conclusions: Findings revealed the population had good overall knowledge concerning diet and nutrition related to NCD in the relatively new context of the obesity epidemic in urban set up of Nepal. However, there was poor knowledge of the benefit of eating fruit and vegetables and other preventable causes of certain cancers. Nutrition education messages need to be communicated within the general population of women. Education targeting the benefits of vegetables and fruit may have the positive impact on NCD prevention.

Reducing Inequalities in Oral Health in the Africa and Middle East Region.

Dentistry is facing many serious challenges and threats. Addressing them will require major changes in strategy. This work outlines the extent of dental disease in the Africa and Middle East Region (AMER) and suggests strategies to reduce inequalities in oral health. The main oral health challenges in the AMER relate to controlling the relentless increase in caries with age. A very conservative estimate of population caries levels suggests that a 5-fold increase in dental personnel would be required just to treat current levels of caries. Hence, we argue that current approaches to control caries in the AMER are both ineffective and unaffordable, and a new model to promote oral health is needed. Unless determinants of noncommunicable diseases are addressed and access to evidence-based minimal intervention dental care is improved, the burden of dental disease will persist. The new oral health promotion model calls for an integrated intersectoral common risk factor approach, namely, "oral health in all policies" (OHiAP). An OHiAP framework will initiate high-level policy initiatives and intersectoral partnerships. Oral health professionals have an important advocacy role in securing the fundamental changes in health strategy needed to control the growing, unjust, and unaffordable burden of oral disease.

Cardiovascular risk factor trends in the Eastern Mediterranean region: evidence from four countries is alarming.

Many Eastern Mediterranean countries are undergoing dramatic socioeconomic, demographic and life style changes and face noncommunicable disease (NCD) epidemics. We evaluated recent trends in major NCD risk factors in occupied Palestinian territories (OPT), Turkey, Syria and Tunisia. We searched published and unpublished sources for systolic blood pressure (SBP), diabetes, smoking, body mass index (BMI), and cholesterol trends for both men and women aged 35-84 in each country from 1995 to 2009. Smoking prevalence was stable over time in Tunisia and Syria, but decreasing in Turkey (annual change -0.9%) and OPT (annual change -0.7%). Mean BMI (annual change of 0.1% for Turkey, 0.2% for OPT and Tunisia and 0.3% in Syria) and diabetes (annual change of 0.3% for Turkey, 0.4% for OPT and Tunisia and 0.7% in Syria) prevalence increased in each country. SBP levels increased slightly in Tunisia and Syria but decreased in OPT and Turkey. Recent risk factor trends are worrying. Good quality data on the extent and determinants of NCDs are essential to respond the changing health needs of populations with burgeoning NCD epidemics.

Distribution and determinants of non communicable diseases among elderly Uyghur ethnic group in Xinjiang, China.

BackgroundNon-communicable diseases (NCDs) are showing an increasing trend globally as well as in China. Elderly population are more prone to these NCDs. Situation in China is worse owing to the higher proportion of geriatric population. Burden of NCDs and the role of their socio-demographic and behavioral predictors among these elderly and more so among the ethnic minority groups among them, need to be investigated specifically, owing to their distinct genetic background, lifestyles and behavior.MethodsA cross-sectional study was conducted among 1329 randomly selected persons of Uyghur ethnicity, aged 60 years or more in Xinjiang, the largest administrative division in China to measure the burden of NCDs, understand the distribution of socio-demographic, behavioral and life event-related potential correlates of them and to estimate the association of the NCDs with these correlates.ResultsAmong these participants 54.2% were female, 86.8% were married and more than half had only attended elementary school or less. 41.46% was suffering from at least one NCD. 20.22% had one NCD, 12.11% had two and 8.58% had three or more. 27.3% had hypertension, 4.06% had diabetes, 6.02% had hyperlipidemia, 7.37% had angina, 14.52% had cardiovascular diseases, 11.59% had any kind of cancers and 9.78% had chronic obstructive pulmonary diseases. Rural residents (OR = 1.45, 95% CI: 1.17–1.80, AOR = 2.00, 95% CI: 1.53–2.61) and current smokers had higher odds of having more NCDs (AOR = 1.53, 95% CI: 1.00–2.34). Additionally not being satisfied with current life, not being able to take care of self in daily life, currently not being involved in farm work, less intake of fresh vegetables, fruits and garlic, too less or too much salt intake, not having hobbies were found to be positively associated with having more NCDs.ConclusionImplementation of effective intervention strategies to promote healthy life styles among the Uyghur elderly population of China seems urgent.

Data Resource Profile: The China National Health Survey (CNHS).

The China National Health Survey (CNHS) is the first nationwide multi-ethnic cross-sectional interview and health examination conducted from 2012 to 2017. The survey is designed to study reference intervals for physiological constants as well as determinants of noncommunicable diseases among different ethnic populations in different areas, so that the data can be used to enhance clinical diagnosis strategies and health promotion. CNHS used a stratified, multistage cluster sampling method to obtain a sample of 53895 people aged 20-80 years in 10 ethnic groups from 11 provinces or autonomous regions all over China. Blood samples were collected from each participant for the establishment of the China Multi-Ethnic Biobank (CMEB). CNHS collected data on demographic and socioeconomic information, lifestyle factors, anthropometric measures, laboratory tests and clinical profiles. These data provide a comprehensive resource for further study on risk factors of noncommunicable disease among different ethnic groups. Information about the CNHS database, including publication list, introduction of the survey design and methods, and guidelines for submitting electronic forms of data application, is available at [http://www.bmicc.cn/web/share/home].

Public policy, health system, and community actions against illness as platforms for response to NCDs in Tanzania: a narrative review

BackgroundMost low- and middle- income countries are facing a rise of the burden of non-communicable diseases (NCDs) alongside the persistent burden of infectious diseases. This narrative review aims to provide an inventory of how the existing policy environment, health system, and communities are addressing the NCDs situation in Tanzania and identify gaps for advancing the NCD research and policy agenda.MethodologyA literature search was performed on PubMed and Google scholar with full text retrieval from HINARI of English language articles published between 2000 and 2012. Documents were read to extract information on what Tanzanian actors were doing that contributed to NCDs prevention, treatment, and control, and a narration was written out of these. Reference lists of all retrieved articles were searched for additional relevant articles. Websites of organizations active in the field of NCDs including the Government of Tanzania and WHO were searched for reports and grey literature.ResultsLack of a specific and overarching NCD policy has slowed and fragmented the implementation of existing strategies to prevent and control NCDs and their determinants. The health system is not prepared to deal with the rising NCD burden although there are random initiatives to improve this situation. How the community is responding to these emerging conditions is still unknown, and the current health-seeking behavior and perceptions on the risk factors may not favor control of NCDs and their risk factors.Conclusion and recommendationThere is limited information on the burden and determinants of NCDs to inform the design of an integrative and multisectorial policy. Evidence on effective interventions for NCD services in primary care levels and on community perceptions on NCDs and their care seeking is virtually absent. Research and public health interventions must be anchored in the policy, health system, and community platforms for a holistic response.

Urbanization and International Trade and Investment Policies as Determinants of Noncommunicable Diseases in Sub-Saharan Africa

There are three dominant globalization pathways affecting noncommunicable diseases in Sub-Saharan Africa (SSA): urbanization, trade liberalization, and investment liberalization. Urbanization carries potential health benefits due to improved access to an increased variety of food imports, although for the growing number of urban poor, this has often meant increased reliance on cheap, highly processed food commodities. Reduced barriers to trade have eased the importation of such commodities, while investment liberalization has increased corporate consolidation over global and domestic food chains. Higher profit margins on processed foods have promoted the creation of ‘obesogenic’ environments, which through progressively integrated global food systems have been increasingly ‘exported’ to developing nations. This article explores globalization processes, the food environment, and dietary health outcomes in SSA through the use of trend analyses and structural equation modelling. The findings are considered in the context of global barriers and facilitators for healthy public policy.

Behavioural risk factors of non-communicable diseases among adolescents

Introduction: Cardiovascular and other chronic diseases are becoming the major causes of morbidity and mortality in most of the third world countries, including Nepal. Unhealthy diet, physical inactivity and consumption of tobacco, alcohol, drugs etc. are major global determinants of non-communicable diseases and contribute to the excess death and disability among the poor in terms of mortality. This study was done to estimate the prevalence of behavioral risk factors of NCDs among adolescent. Methods: A cross sectional study based on WHO stepwise approach for surveillance of Non- Communicable Diseases (NCDs) risk factors was conducted in Chitwan District to assess the risk factors of NCDs. Information was collected on substance abuse, dietary habits and physical activity through personal interview. Results: A bout 50% male and 30% female respondents were currently abusing one or other forms of substance. Male (39%) and female (26%) were using tobacco products. It was found that only 14% of respondents were doing satisfactory level of physical activities. Conclusions: Substantially high levels of the various behavioral risk factors among adolescents in Chitwan District suggest an urgent need for awareness raising programmes. DOI: http://dx.doi.org/10.3126/joim.v34i3.8916 Journal of Institute of Medicine, December, 2012; 34:39-43

Health-promoting schools: evidence for a holistic approach to promoting health and improving health literacy.

Chronic diseases are now the major causes of death and disability worldwide, and non-communicable diseases (NCD) account for the majority of the global health burden. About half of premature deaths are related to health-risking behaviours that are often established during youth and extend to adulthood. While these diseases might not be curable, they are preventable. Prevention is possible when sustained actions are directed at individuals and families, as well as at the broader social, economic and cultural determinants of NCD. A 'life-course' approach to promoting healthy behaviour should begin early in life. The aim of this article is to discuss the impact of the 'health-promoting school' (HPS) on improvements in youth health. HPS can be described as a holistic, whole-school approach in which a broad health education curriculum is supported by the environment and ethos of the school. HPS moves beyond individual behavioural change to consider organizational and policy change such as improving the physical and social environment of the school, as well as its curricula and teaching and learning methods. A positive culture for health would facilitate higher levels of health literacy by helping individuals tackle the determinants of health better as they build the personal, cognitive and social skills for maintaining good health. There is reasonable evidence to demonstrate that the whole-school approach using the HPS framework is effective in improving health, ranging from physical activities and healthy eating to emotional health. Schools adopting the HPS framework have demonstrated changes in culture and organizational practice to become more conducive to health improvement. These schools were reported to have better school health policies, higher degrees of community participation, and a more hygienic environment than non-HPS schools, and students in these schools had a more positive health behaviour profile. Health promotion and disease prevention is essential to reduce the healthcare burden of children and adolescents. HPS would help to combat the global burden of childhood obesity by promoting healthy eating behaviours and encouraging higher levels of physical activity. There are gaps in service provision for children and adolescents from both the health and education perspective; the HPS framework has the potential to develop a mechanism of closer integration with the primary healthcare system, making youth health services more school based and student centred. A new model of interconnection between HPS and different components of primary healthcare can be evolved to make services for disease prevention and health promotion more student friendly.