Assessment of the WHO Health Promoting Schools Framework among schools in selected villages of rural Puducherry, South India – a mixed method study

Abstract

Background The health of children and adolescents can be promoted through schools as they spend most of their time in school. The Health Promoting Schools (HPS) framework provides a set of policies to be followed in schools for improving the health status of school-going children and adolescents. The current study was done to assess this framework among schools in rural Puducherry. Methods Key informant interviews were done with the teachers under the six World Health Organisation (WHO) HPS framework domains to develop an observation checklist for the assessment of schools in the study area. After the survey, in-depth interviews were conducted as an approach to explore the existing health promotion activities, facilitating or hindering factors in the implementation of health promotion framework and suggestions for improving the same. Results A quantitative survey on nine schools showed that almost all the schools were lacking in domains such as health promotion policy, behaviour counselling and mental and social support. Physical education, facilities and policies for nutrition and community collaboration exist in only some of the schools. Qualitative interviews also showed similar findings and most of the teachers suggested to include training for general health emergencies and behaviour counselling. Conclusion The current study showed that most of the schools were lacking in almost all the domains under the HPS framework. Hence, stakeholders at all levels should be made aware of this framework and develop a strategy for uniform implementation of it in all the schools in the region.

Barriers and facilitators to implementation of nutrition-related actions in school settings in low- and middle-income countries (LMICs): a qualitative systematic review using the Consolidated Framework for Implementation Research (CFIR)

“…The most common reason was that no barriers and facilitators were found ( n = 82). A final 36 articles were included in this review [ 15 , 27 – 61 ].

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Implementation of “health promoting educational institute” strategies in the state of Himachal Pradesh, India: challenges, opportunities and the way forward

“…21 Apart from these initiatives, limited studies are available related to HPS concept in India, although some baseline assessments and surveys are available. [22][23][24][25]…”

A critical comparison of the Indian school food and nutrition guidelines with the WHO-nutrition friendly school initiative and the review of existing implementation scenario

“…Implementation outcomes of the HPS model. Five studies investigated the implementation outcomes of the HPS model (Joseph et al, 2019;Rajaraman et al, 2012;Thakur et al, 2014;Yuvaraj et al, 2019). Two of the five studies tested two different approaches (i.e.…”

“…Both approaches were successful (Rajaraman et al, 2012;Thakur et al, 2014). Three studies evaluated the compliance or adherence to the HPS model implemented in the schools (Joseph et al, 2019;Periyasamy et al, 2019;Yuvaraj et al, 2019). Overall, the compliance with the implemented HPS model was limited in all the schools.…”

“…A couple of studies identified the barriers to the implementation of the HPS model in schools. These included limited peer support for school children, a lack of teacher discussion with parents about their children's health outcomes, and a shortage of manpower at the school to support policy/ guideline implementation (Yuvaraj et al, 2019). Another • Nutrition service component-MDM scheme was functional in all the eligible schools and was monitored regularly.…”