School Health Program Research Articles

Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial

Background South African adolescents experience barriers to sexual and reproductive health (SRH) knowledge and uptake. This study provides insight into contraceptive and other SRH service knowledge, perceptions, and uptake among adolescents in high HIV prevalence settings. Methods A baseline cross sectional survey was conducted among 3432 grade 8s enrolled into the Girls Achieve Power (GAP Year) trial from 26 public high schools across three South African townships (Soweto, Thembisa and Khayelitsha) (2017 - 2018). An interviewer-led survey collected information on SRH knowledge and perceptions; an audio computer-assisted self-interviewing technique gathered SRH service uptake. Descriptive analysis indicates frequency distribution of socio-demographics and knowledge, uptake and perceptions of SRH services. Chi-square test tested for associations between age and sex and selected variables that measure SRH knowledge and uptake. Results In total, 2383 participants completed both survey components. Of these, 63.1% (n=1504) were female and 81.4% (n=1938) aged 12-14. Almost a fifth (18.3%, n=436) had ever had sex and less than 1% had accessed SRH services in the last year. Of the 157 females who had ever had sex, 50.9% had ever used contraception. Of those who had sex in the last three months, 59.0% reported using a contraceptive method. Condom use was inconsistent: almost all females said they had not used or could not remember if a condom was used at last sex. Conclusion This paper contributes to the evidence strengthening learner SRH education, including the national Integrated School Health Programme. Key themes include the need for age-appropriate, differentiated comprehensive sexuality education (CSE) for the range of ages found in the same grade in South African schools. Education on different contraceptive methods, informed decision-making, and emergency contraception is key. School-based interventions should embrace integrated HIV, STI, and pregnancy prevention messages. Closer links with health services need to be constantly fostered and reinforced.

A REALIZAÇÃO DO PROGRAMA SAÚDE NA ESCOLA COMO FERRAMENTA PARA PROMOÇÃO DE EDUCAÇÃO EM SAÚDE DURANTE A FORMAÇÃO EM MEDICINA DE FAMÍLIA E COMUNIDADE: UM RELATO DE EXPERIÊNCIA

Introduction: The School Health Program (PSE), announced by the Ministry of Health in 2007, aims to promote health in partnership with educational institutions to improve the quality of life of the population, specifically school-aged children. This involves collaboration between health and education professionals, providing appropriate knowledge to reduce vulnerabilities that may compromise the development and the future of children and adolescents. Objective: To report the experience of a family medicine resident, part of a family health team (eSF) in the Federal District (DF), primarily promoting sexual education for children and adolescents in two public schools within the team's area of coverage. Methodology: This is a descriptive and qualitative study, of the experience report type, conducted during the two years of residency in Family and Community Medicine, from 2023 to 2024, in the satellite city of Sobradinho, Federal District. Results: The students involved, aged between 9 and 12 years, showed great interest in the topics addressed regarding sexuality and hygiene habits, adopting a participatory attitude, engaging in the exchange of experiences, raising questions, and discussing the subjects covered in the meeting and topics detailed in the adolescent health booklet. Conclusion: The necessity of partnership between health teams and education professionals was evident to provide health promotion, especially focused on sexual education, aiming to reduce negative outcomes and minimize future social and health damages in the vulnerable population of the DF.

Risk factors for the gambling, smoking and alcohol consumption triad in Portuguese adolescents

Abstract Background Addiction to gambling, tobacco, and alcohol poses significant risks to mental, social, and physical health, particularly during adolescence, a critical period for habit formation. This study investigates risk factors linked to these habits among Portuguese adolescents. Methods This cross-sectional study used the 2019 ESPAD questionnaire, targeting 16-year-old adolescents. The sample comprised 4,365 responses. Descriptive analysis determined the prevalence of gambling, smoking, and alcohol use, as well as social, economic, and behavioral factors. Bivariate associations were assessed using the Exact Fisher test, and multiple logistic regression identified key predictors for the outcome of interest (cumulative presence of gambling, smoking and alcohol consumption). Statistical analysis was conducted with SPSS version 29.0, with a significance level of p < 0.05. Results Among adolescents, 6.2% presented probable problematic gambling according to the Lie/Bet test, with 3.7% spending at least 30 minutes a day gambling. In the past 30 days, 14.3% smoked, 42.7% drank alcohol, and 10.5% engaged in binge drinking. The behavioral triad was observed in 56 individuals. Male gender (OR = 2.024; 95% CI: 1.097-3.734; p = 0.024), problematic online gaming behavior (OR = 2.041; 95% CI: 1.005-4.144; p = 0.048) and going out at night at least once a week (OR = 1.439; 95% CI: 1.242-1.669; p < 0.001) significantly increased the risk of the behavioral triad. In contrast, parental control (parents knowing where the adolescent is on Saturday night) had a significant protective effect (OR = 0.162; 95% CI: 0.086-0.303; p < 0.001). Conclusions The study underscores the importance of parental supervision to curb risky behaviors in adolescents. It suggests implementing public health programs in schools, leveraging gaming for early screening, and tightening online gambling regulations to mitigate future health risks associated with gambling, smoking, and alcohol use. Key messages • Absence of parental supervision, male gender, problematic online gaming and frequently going out at night are risk factors for this behavioral triad. • Public health strategies are needed to prevent gambling addiction, emphasizing parental awareness, identification of at-risk students, and comprehensive school-based approaches.

The State of School Health Services of the School Health Programme in Nigeria: A Position Paper by the Paediatric Association of Nigeria (PAN) Sub-Committee on School Health Programme

The State of School Health Services of the School Health Programme in Nigeria: A Position Paper by the Paediatric Association of Nigeria (PAN) Sub-Committee on School Health Programme

Eye of the Beholder: Prevalence of Binge Eating Disorder among Youth in Urban Coastal Karnataka, India

Abstract Introduction: Eating disorders (EDs) are on the rise and can result in medical and psychiatric morbidities in children, adolescents as well as during adulthood. It is crucial to understand the disease burden for its early diagnosis, intervention, and prevention. Our study was thus conducted over 5 months to estimate the prevalence of binge ED (BED) among adolescents and young adults in Mangalore, Karnataka. Materials and Methods: A total of 300 participants between the ages of 15 and 24 years were administered the Questionnaire on Eating and Weight Patterns - 5. Responses were categorized into “possible diagnosis of BED” and “possible diagnosis of bulimia nervosa (BN).” Results: The mean age of the participants was 19.4 ± 3.1 years and their mean body mass index was 22.7 ± 3.9 kg/m2. Among 300 participants, 15 (5.0%) had a possible diagnosis of BN, while 4 (1.3%) had a probable diagnosis of BED, both were found to be more among females than males. Sixty participants reported having loss of control over their food intake, of which only 26 (43.3%) reported being upset about it. However, on multivariate logistic regression, none of the sociodemographic factors were found to be significant in our study. Conclusion: It is essential to encourage healthy eating habits and physical activity at an early age along with the inclusion of screening for EDs in school health programs. Raising awareness among parents and children is crucial in bringing about sustained behavior change.

The effect of national school health strategy components on the quality of health services: An Analytical research in Baghdad Governorate

Purpose: The research objective is to diagnose the extent to which the National School Health Strategy contributes to the quality of health services. Theoretical framework: The quality of health services can provide schools with benefits through building a healthy school community in line with the sustainable development goals, especially regarding quality education, good health, and well-being and through school health, we may be improving the health and well-being of elementary and secondary students, and the necessity of providing healthy foods reduction of fat content in school meals, and awareness to prevent the use of tobacco products and drugs. Design/methodology/approach: The research relied on the descriptive -analytical method and the research sample is a random sample of primary schools (governmental and private). The research tool is represented by using a questionnaire to collect data. Findings: Although there is a big school community represented by students compared to their society, studies in most countries of the world are still limited in discussing the quality of health services provided to them and the limited solutions. Research, Practical & Social implications: We suggest future research to evaluate the national school health strategy: a comparative study between two governorates. Originality/value: The results indicate that commitment to implementing school health programs positively affects the quality of health services provided to students of school age and that any defect in their application reflects negatively on the health of students currently and society in the future.

Experiences and Impact of Domestic Violence on Children: A Qualitative Study in the City of Tshwane, South Africa

South Africa has a high prevalence of domestic violence, and its impact is commonly limited to the partner, and not adequate attention is paid to its consequences on the children who experience such violence in their home. The purpose of this qualitative study was to explore the experiences of children who are raised in homes where there is domestic violence. The participants were 23 male and female children aged 12 to 16 years who were referred to one of the centres of Families South Africa (FAMSA) in the City of Tshwane because of domestic violence in their homes. A descriptive qualitative design, using in-depth interviews, was employed to collect data and NVivo version 12 was used to analyse the data. Three (3) major themes emerged from the data, these being the impact of domestic violence on children, the long-term social impacts of domestic violence, and coping strategies used by the participants to survive domestic violence. Additionally, seven (7) sub-themes emerged from the three major themes. The findings imply the need to acknowledge that children are direct victims of domestic violence that occurs between their parents. It is recommended that the school health programme in South Africa integrate screening for children who witness domestic violence.

Assessing the Dietary Practices and Anthropometric Outcomes of Students Consuming Mid-day Meals Versus Home-Cooked Meals.

Early childhood and adolescence are prime years that people spend in school. These formative years give the school ample opportunities to impart certain aspects of lifestyle and healthcare to the student, in addition to academics. School health programs are vital in providing comprehensive education and healthcare services. The objectives of the study are to enlist the socio-demographic factors affecting the nutritional level between students who enrolled for the mid-day meal scheme and those who did not. This is a cross-sectional questionnaire-based study, which was carried out between children who enrolled in the mid-day meal program and home-cooked meals for students from 3rdto 12thgrade in Faridabad. The study was conducted by the Department of Public Health Dentistry, Faridabad, from January to June 2024. It was determined that 162 (53.6%) males and 222 (74.9%) females were obese. 332 (55.3%) believed that social media had an impact on their dietary decisions, while 268 (44.7%) disagreed. When asked to rate how many healthy food alternatives were available at their school, 53 (8.8%) of them said it was great, 194 (32.3%) said it was good, 196 (32.7%) said it was fair, and 157 (26.2%) said it was poor. 236 (78.7%) parents of the mid-day meal group never had dietary supplemental education, which is why children have indigent nutritional status. The mean waist-to-hip ratio (WHR) was calculated as 0.92 ± 0.43 and 0.88 ± 0.69 with significant values of 0.00 (p≤0.05) in the home-cooked and mid-day meal-consuming groups respectively. Students consuming home-cooked meals showed a better WHR for age than those consuming mid-day meals. Children of parents with high education levels have good nutritional status and are healthier as compared to children with parents who have low education levels. Thus, there is a dire need to include school health programs to provide healthy and nutritious food to children, in need.

Burden and awareness of anemia among adolescent girls of residential school in Telangana.

Adolescence is an important transition phase and the burden of anemia among adolescent school-going children is not well explored. The present study was carried out to determine the prevalence of anemia among school-going adolescent girls and to explore their awareness on anemia. A cross-sectional study was conducted among 217 adolescent girls studying in a residential school of Bibinagar village, Telangana. A pre-tested, semi-structured questionnaire was administered to collect the data. Hemoglobin (Hb) was estimated using TrueHb. Data was entered into excel and was analyzed using SPSS software version 21. The mean (±SD) age of the adolescent girls was 13.8 (±0.99) years. About 74.2 % of the girls were in 12-14 years' age group. About 91.7 % had attained menarche. The prevalence of anemia was 81.6 % with a mean (±SD) Hb of 9.5 (±2.7) g/dl among adolescent girls. Among the adolescent girls, 32.7 % had severe anemia, 31.8 % had moderate anemia and 17.1 % had mild anemia. About 86.2 % adolescent girls had heard of anemia while 60.8 % adolescent girls felt that anemia is preventable and only 27.6 % were aware about iron-rich foods. About 38 % of adolescent girls were not aware of any causes of anemia. The prevalence of anemia was very high among the school-going adolescent girls of rural Telangana. The awareness regarding causes of anemia and iron-rich foods was low among study adolescent girls. Thus, there is a dire need to conduct frequent Test, Treat and Talk (T3) Anemia camps in schools through district school health program.

Handwashing with soap training for elementary school children along the Martapura riverbank

Handwashing with soap, when practiced correctly, is the simplest and most effective way to prevent the spread of fecal-oral and other diseases among children. One of the national elementary school health programs is handwashing with soap (CTPS). Therefore, the purpose of this community service activity is to improve the handwashing skills of elementary school children living near the Martapura River. The methods used were lectures with question-and-answer sessions, demonstrations, focus group discussions, and practice. The results of this activity showed an increase in understanding and skills related to CTPS, so that children know the benefits and procedures.

Trailblazer in Health Education: The Legacy of Thomas Denison Wood.

Thomas Denison Wood, often regarded as the "Father of Health Education," was a pioneering figure in the early 20th century whose work laid the foundation for modern health education. His contributions were instrumental in integrating health education into the public school curriculum in the United States. Wood advocated for a holistic approach to health, encompassing physical fitness, hygiene, nutrition, mental health, and preventive care. His key achievements include the development of comprehensive health education programs, leadership in professional organizations, and the establishment of the New York City School Health Program. Wood authored several influential books, such as "Health by Stunts" (1901) and "A Textbook of Hygiene" (1915), which provided practical guidance on maintaining health and were widely used in educational settings. His work emphasized the importance of lifelong health education, beginning in childhood and continuing throughout life. Through his writings, teaching, and advocacy, Wood significantly shaped the field of health education, and his legacy continues to influence health education practices today.

Adesão ao uso da estratégia NutriSUS para fortificação alimentar infantil em municípios de Goiás

Introduction: The high demand for nutrients in children under five years of age, added to low nutritious diets, makes them vulnerable to micronutrient deficiencies. The NutriSUS Strategy, launched as part of the School Health Program (PSE) in 2014, aims to combat these deficiencies through the distribution of micronutrient sachets. The effectiveness of this strategy in Goiás, considering the weaknesses in the municipalities, needs to be evaluated. The objective of this study was to verify adherence to the NutriSUS Strategy in municipalities in the state of Goiás and the list of sachets used by agreed and added day care centers. Methods: A retrospective observational study analyzed data on micronutrient supplementation provided by the NutriSUS Strategy in the state of Goiás, between 2017 and 2019. The database available on the Ministry of Health website was used to identify adherence and coverage of the program in 10 regional health departments. The inclusion criteria were municipalities that implemented the strategy during the period studied, while those that did not adhere or did not show interest were excluded. The analysis was performed using absolute and relative frequencies in the EPI Info 7.2.6.0 program. Results: The NutriSUS Strategy was implemented in 35 (14.23%) of the total municipalities (n=246). Micronutrient supplementation targets were constant throughout the period from 2017 to 2019, with some cities, such as Araguapaz, Britânia, and Santa Helena de Goiás, exceeding their supplementation targets in some of the periods, while others, such as Aragarças, Hidrolândia, Piracanjuba, São Luís de Montes Belos, and Buriti Alegre, did not reach the expected targets. The analysis, by semester of supplementation coverage in daycare centers, showed significant fluctuations: a drop in 2017 from 45.44% to 32.60% from the first to the second semester. In 2018, the percentage was 34.43% in the first half of the year, but there was a significant increase to 52.37% in the second half of the year. In 2019, coverage rose to an average of 61.63% in the first half, followed by a drop to 35.74% in the second half. The data also revealed variations in standard deviation, reflecting fluctuations in program adherence. Conclusion: The NutriSUS Strategy showed a variable implementation in the municipalities of Goiás in the period studied, with fluctuations in supplementation coverage over time. The analysis highlighted both success in some locations and difficulties in others, highlighting the importance of continuously monitoring and adjusting supplementation strategies to ensure that all counties adequately benefit children from micronutrient supplementation.

School Perceptions and Attendance for Children With Medical Complexity During COVID-19 Over Time.

Disparities in school attendance exist for children with medical complexity (CMC) due to COVID-19. Longitudinal changes in family-reported school safety perceptions and predictors of full-time, in-person school attendance are unknown. This was a prospective, longitudinal cohort study with 3 survey waves (June 2021-June 2022) among English- and Spanish-speaking families of CMC aged 5 to 17 years and pre-pandemic school attendance. Changes in Health Belief Model perceptions and full-time in-person school attendance were estimated using multivariate generalized linear modeling with repeated measures. Among 1601 respondents (52.9% of 3073 invited), 86.8% participated in all 3 surveys. School safety perceptions improved with time; however, perceived susceptibility to COVID-19 increased. Full-time in-person school attendance rose from 48.4% to 90.0% from wave 1 to 3 (p < .0001), and was associated with motivation, benefits, and cues. For example, families with low compared to high motivation for in-person attendance had 76% versus 98% predicted probability for child's school attendance, respectively at wave 3 (p < .0001). Probability of full-time in-person school attendance was associated with several health belief model perceptions. School health policy and programs may benefit from promoting family motivation, benefits, and cues during future respiratory illness epidemics including COVID-19. In-person school attendance improved for CMC over time. Opportunities exist to continue optimizing in-person attendance and family-perceived safety for CMC at school.

Políticas públicas: O papel do Programa Saúde na Escola (PSE) como ferramenta para a integração entre saúde e educação

This research analyzed the School Health Program (PSE) as a tool for the integration between health and education, highlighting its importance and impact on the integral development of students. The objective was to evaluate how the PSE articulates the health and education networks to improve the quality of life and school performance of children and adolescents. A bibliographic research methodology was used, with a survey of articles on the SciELO, Web Of Science and Google Scholar platforms. The results showed that the PSE promotes an effective intersectoral approach, offering preventive and health promotion actions in schools, such as vaccination, visual screening, physical exercises, and educational campaigns. The analysis revealed that the program contributes to the reduction of social inequalities and improves the school environment by integrating health into the educational process. The conclusion reaffirms that the PSE is an innovative and essential strategy, as it combines health care and teaching to prepare students for academic and social challenges, demonstrating the effectiveness of public policies that promote intersectoral integration and the balanced development of the new generations.

A School Health Program to Foster Understanding of Sensory Processing Challenges.

School-age children experience sensory processing challenges, especially among children living with intellectual and developmental disabilities. As the modern classroom strives to be an inclusive environment, more schools are adopting measures to provide sensory processing support. School nurses can be at the forefront to spearhead this initiative and are well-positioned to promote support and inclusivity for students through increased education for this population, including their peers. This article explores a collaboration between local school health services and a college of nursing to provide school-age children the opportunity to learn about the challenges faced by children living with sensory processing challenges.

Prevalence, risk factors, and parental perspectives of dental caries in children in Odisha: A mixed-method study

Background/objectiveDespite numerous advances in dentistry, the frequency of dental caries remains high, especially among children. Therefore, the study's objectives were to assess the prevalence of dental caries in school-aged children between ages 6–14 years, to identify the risk factors associated with dental caries and to explore parents' understanding and awareness of preventing dental caries among children. MethodA mixed method study was conducted in the rural areas of Cuttack and Jagatsinghpur districts in Odisha, India. Children were chosen from schools using a multistage sampling process. Pretested and standardised questionnaires were utilized to collect data from children, while interviews with parents and teachers were employed to collect qualitative data. The DMFT/DEFT index was calculated for children. Data were analysed using frequency, percentage and binary multiple logistic regression analysis. The interviews were analysed using thematic analysis. ResultA total of 419 children, 14 parents, and 12 teachers participated in the study. The findings of the current study reported the prevalence of dental caries in 60 % of children. In addition, age, a high frequency of sugar and chocolate consumption, and poor socioeconomic status were found to be associated with a high risk of dental caries. Furthermore, the results of the thematic analysis indicated parent and teacher awareness and understanding of dental caries; however, it highlights the need for improved oral health practices. ConclusionThese insights from qualitative and quantitative findings can guide the development and improvement of preventive interventions to combat dental caries through implementing oral health programs in schools, thereby fostering better oral health and overall well-being among the younger population.

School health and nutrition services for children and adolescents in Tanzania: A review of policies and programmes.

School health and nutrition programmes are effective strategies to address the health problems among school-going children and adolescents. We examined the policy environments, successesand bottlenecks associated with school health and nutrition programmes in Tanzania. We used the 'policy triangle framework' to examine 22 national and regional school health and nutrition policies and programmes in Tanzania. We also interviewed 16 key informants to gain further insights into school health and nutrition programmes. Several school health and nutrition policies in Tanzania outline the basic elements of school-based health and nutrition services. Yet, these documents neither recognise vulnerable groups, recommend age-appropriate strategies to address children's and adolescents' varied and transient needs, nor provide a framework for implementing and tracking recommended activities. In these documents, underweight and infectious diseases, including humanimmunodeficiency virus/acquired immunodeficiency syndrome, are frequently identified as major concerns of young people, with little or no consideration of social determinants. Diverse strategies including school feeding, water and sanitation services, health and nutrition educationand promotion of healthy behaviours are identified. In doing so, these documents adequately define the roles and responsibilities of all government actors, but young people and their guardians are not actively engaged in design and implementation. Additionally, there are several challenges to implementing these policies including budgetary constraints, limited resources, a lack of inter-sectoral coordinationand insufficient capacity within targeted schools. To improve the health and nutritional status of school-going children and adolescents in Tanzania, adequate budgets, strengthened coordination and implementation efforts, the development of school-based stakeholders' capacity, as well as the involvement of all other stakeholders, including adolescents, are imperative.

Analysis the Healthy School Campaign in Indonesia: A Health Policy Triangle Approach

The School Health Program policy was initiated by the Indonesian government in 2014. However, by 2021, student health service coverage was still suboptimal. The Healthy Schools Campaign Program was introduced in 2022 as an alternative policy to revitalize the School Health Programme. The study aimed to analyze the Healthy School Campaign Program using the health policy triangle framework, which includes actors, content, process, and context. This research uses qualitative methods with secondary data sourced from electronic document searches. The main actors in this policy involve official government institutions, supported by collaboration with non-government partners. Policy selection is based on situational, structural, cultural and international contextual factors. The program content focuses on physical health, healthy nutrition, and student immunization. The conclusion is that the selection of content is influenced by how actors identify health problems in the early stages of policy preparation. Implementation of this program requires a clear collaboration system as a reference for its implementation in educational units. Teacher and parent involvement is also very important to increase the effectiveness and sustainability of the program.

Healthier School Systems for Learners: Government Role in Fostering Holistic Interventions

Background: School health is a key component of school reform, and it is essential to address health issues that are relevant to education and incorporate key actors such as the government and other relevant stakeholders. This review article aimed to examine the role of governments in fostering healthier school systems for learners. Methods: This paper examined existing literature, policies, and programs and identified effective approaches to promoting holistic well-being within educational settings. Scientific databases, including Google Scholar, PubMed, and Web of Science, and the websites of international organizations including the WHO, UNESCO, and UNICEF were searched. Results: Through case studies and best practices from different regions including Nepal, Japan, United Arab Emirates, Ghana, and Kenya, this review illustrated the potential impact of government-led initiatives in promoting school health. In this regard, health impact assessment can help policymakers understand the health implications of their policies and identify ways to improve health while minimizing harm. The government’s role includes enactment and assessment of policies that improve school programs, establishing accountability and regulatory framework, facilitating decision-making, collaborations with other stakeholders, and coordination. Conclusion: This article provided insights and recommendations for policymakers seeking to prioritize the health and development of students in their jurisdictions. Implementing the school health program is essential for achieving both the nation’s goal of health for all and the sustainable development goals.

School Nurses' Perceived Role and Capacity to Support School Behavioral Health Programs in DC Public and Public Charter Schools.

School nurses (SNs) practicing in DC public and public charter schools were surveyed to assess their perceived role and self-reported preparation to provide behavioral health prevention, early identification, and treatment services in schools. A total of 154 SNs completed a questionnaire about their role in the delivery of behavioral health services and supports. SNs reported they are primarily involved in the identification and referral of students to other school behavioral health professionals. Respondents also reported a lack of training in behavioral health and a desire for more information on related programs and services. This study offers recommendations for educating future SNs and highlights how the DC School Health Services Program utilized study findings to build capacity for SNs employed in practice. This study can help tailor educational opportunities for SNs to maximize their role in school behavioral healthcare process flows and ultimately improve outcomes for students and families.