Interpersonal violence among adolescents is an issue of global public health concern, leading to adverse physical and psychological outcomes among children and young people under the age of 18 years. This article discusses the prevalence of interpersonal violence and identifies their associated factors among school-going adolescents of ages 13 to 17 years using the data from the Sri Lankan Global School-Based Health Survey conducted in 2016. Of the 3262 students who participated, 35.1% (95% confidence interval = 31.0% to 39.5%) were physically attacked and 44.2% (95% confidence interval = 39.2% to 49.4%) were in a fight with peers, one or more times during the 12 months prior to the survey. Being bullied by peers, male sex, 13 to 15 years age group, smoking and alcohol use, considering or attempting suicide, missing classes without permission, and parents not being aware of students’ activities were associated with violence. The study highlights the need for violence prevention programs to address the risk factors among school-going adolescents.

ObjectiveTo determine the risk of sedentary behavior during leisure time, physical activity and dietary habits on overweight among school children aged 14–15 years in Kalutara District, Sri Lanka.ResultsSchool based case–control study was conducted during September to November 2013 including 176 overweight children as cases and 704 children with normal weight as controls. Cases were defined as body mass index for age and sex of ≥ +1SD and controls as those in the range of −2SD to +1SD. Validated instruments were used for data collection. Multiple logistic regression was applied and results were expressed with adjusted odds ratios (OR) and 95% confidence intervals (CI). Risk factors for overweight were insufficient physical activity (OR 1.6, 95% CI 1.1–2.4), watching video/DVD ≥ 2 h (OR 3.1, 95% CI 1.8–5.3), watching television ≥ 2 h (OR 2.6, 95% CI 1.7–3.8) and doing homework ≥ 2 h, (OR 1.8, 95% CI 1.2–2.7). Consuming meat (OR 1.9, 95% CI 1.2–3.1), fish or other sea foods (OR 1.6, 95% CI 1.1–2.8), fast food/fried rice/oily foods (OR 1.9, 95% CI 1.2–2.9), carbonated drinks or sugary drinks (OR 1.9, 95% CI 1.2–2.8), sweets, cookies or ice cream (OR 1.8, 95% CI 1.2–2.9) were dietary risk factors for overweight. Consuming legumes and seeds (OR 0.50, 95% CI 0.3–0.7), vegetables and fruits (OR 0.6, 95% CI 0.4–0.9) were protective factors for overweight.

Background. Adolescence is defined by the World Health Organization (WHO) as “the transition period from childhood to adulthood”. Increases in autonomy during this period, willingness to experiment, and peer influence create an environment of taking high-risk decisions influencing adolescent health, such as substance abuse and smoking. The current study was conducted to estimate the prevalence of smoking, alcohol consumption, and illegal substance abuse and their determinants on in-school adolescents using data from the Global School-based Student Health Survey, Sri Lanka in 2016. Methods. A cross-sectional survey was conducted among 3,650 students using a self-administered questionnaire in government schools. Weighted prevalence was calculated, and logistic regression analysis was conducted to determine the correlates. Results. The prevalence of current alcohol, smoking, smokeless tobacco consumption, and substance abuse, 30 days before the survey, was 3.4% (95% CI 2.6 - 4.3), 3.6% (95% CI 2.5-5.0), 2.3% (95% CI 1.5-3.7), and 2.7% (95% CI - 1.7-4.2%). Male sex and involvement in physical fighting were independently associated with increased risk in all four substance categories assessed. Multivariate analysis using multiple logistic regression revealed that only the male sex and involvement in physical fighting were correlates for four substance categories assessed when confounding effects of other variables were accounted for. Being in the 16-17 age category, parents’ tobacco use and seeing actors consuming alcohol on TV increased the risk of alcohol consumption, smoking, and smokeless tobacco. Having ever attempted suicide was positively associated with increased risk for alcohol consumption, smoking, and illegal substance abuse. Conclusion. Alcohol use, smoking, smokeless tobacco use, and illegal substance abuse by students remain a concern in Sri Lanka and implementing life skills-based interventions at schools is recommended.

Background Unintentional injuries among adolescents is a major public health problem the world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; it is also the leading cause of death among adolescents in the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13–17 years using data from the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka. Methods A cross-sectional survey was conducted using a self-administered questionnaire, among 3262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected using probabilities proportional to school enrollment size, from all schools in the country that have classes in grades 8–12. Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. The weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates. Results During the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured one or more times. The injuries were more common among males, but were equally common among the two different age groups (13–15 age group vs 16–17 age group). The most common type of injury was cut or stab wounds (5.5%), followed by broken bones/dislocated joints (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as being of the male sex, being bullied, being physically attacked, and/or being in a physical fight. Conclusion This study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration when designing school-based interventions to prevent adolescent injuries.

Background Sri Lanka has one of the oldest school health programmes (SHP) in the region, which was started in 1918, and at present caters for 70% of adolescents in the country. This study assessed the implementation status of the Sri Lankan SHP. Methods This review was conducted by a panel of experts adopting a participatory approach. Policies and supporting documents were collected from the relevant sectors of the Ministry of Health and Ministry of Education using electronic and manual search and by visiting institutions/resource persons. The WHO’s ’4S’ Framework; consisting of strategic information (S1), supportive evidence-informed policies (S2), strengthening services for adolescents (S3) and strengthening collaboration with other sectors (S4); was used as the guiding framework to analyse the strengths and weaknesses of the SHP. Results Having a comprehensive national health information system was the main strength on S1, gaps in timeliness, completeness and accuracy of the data, and the lack of evidence on perceived health needs of school children were the main weaknesses. On S2, Sri Lanka has a strong unifying policy platform supportive of the SHP, but the timeliest need is to finalise the School Health Policy. More than 90% island-wide coverage of school medical inspection was the main strength on S3, while focusing more on physical health and less emphasis on promoting mental health in the existing service package and gaps in the referral/follow-up were the weaknesses. On S4, school staff focusing more on achieving academic-related outcomes and focusing less on health-related activities, undue media and industry influence hindering the promotion of healthy behaviours in school settings were the main challenges. Conclusions Despite several emerging challenges, the SHP in Sri Lanka is one of the best school health programmes in the region with more than 90% island-wide coverage of health services. Key messages The SHP in Sri Lanka, which is one of the oldest and the best school health programmes in the region, caters for 70% of adolescents in the country. Assessment of Sri Lankan SHP according to the WHO’s ‘4S’ Framework revealed multiple strengths such as comprehensive national health information system and high island-wide coverage.