Community-Based Qualitative  Study to Identify Challenges in Implementing Health Promoting Schools Framework in Government Schools of Khordha District, Odisha, India.

BACKGROUND: The WHO asserts every school should be a Health Promoting School (HPS) and laid a framework. The WHO is constantly working on expanding the number of schools modelled on it. The status of the level of health promotion needs to be explored to understand the local issues to identify key priority areas for policy making towards positive health. The study aims to explore the challenges in implementing the HPS framework in Government-run schools in Odisha.  Method: A qualitative study was conducted with grounded theory using an inductive approach. In-depth interview was done among nine teachers from six government schools in the Khordha district who were selected through purposive sampling. A semi-structured open-ended interview was conducted using an interview guide among school science teachers and principals (n=9) regarding the challenges in implementing the HPS framework. Codes were generated from the transcript using the inductive approach from the WHO-HPS framework. Thematic analysis by Braun and Clarke model was using Quirkos software. RESULTS: Five themes with 12 codes were identified with the transcript. The respondents had little knowledge about the WHO-HPS framework. Their perception of health promotion was restricted to organizing health camps for school children. The themes were School health policy (inconsistent teachers recruitment policy, partial implementation of tobacco-free schools, outdated science syllabus), Coordination with the local community, Healthy school needs (lack of interactive and repetitive health-related training for school teachers, first aid box in schools and lack of supplementation of micronutrients like WIFS), Sanitation (inadequate funding for maintenance of sanitation) and an emerging issue of increased use of social media were reported in our findings.  Conclusion: Our findings suggest that implementation of health-promoting schools requires imparting the skills to teachers by orientation and expanding the existing health services, backed with adequate funding and a firm policy commitment at the state level.

Mental health implications of COVID-19 pandemic and its response in India.

INTRODUCTION: Mental health concerns and treatment usually take a backseat when the limited resources are geared for pandemic containment. In this global humanitarian crisis of the COVID-19 pandemic, mental health issues have been reported from all over the world. OBJECTIVES: In this study, we attempt to review the prevailing mental health issues during the COVID-19 pandemic through global experiences, and reactive strategies established in mental health care with special reference to the Indian context. By performing a rapid synthesis of available evidence, we aim to propose a conceptual and recommendation framework for mental health issues during the COVID-19 pandemic. METHODS: A search of the PubMed electronic database and google scholar were undertaken using the search terms 'novel coronavirus', 'COVID-19', 'nCoV', SARS-CoV-2, 'mental health', 'psychiatry', 'psychology', 'anxiety', 'depression' and 'stress' in various permutations and combinations. Published journals, magazines and newspaper articles, official webpages and independent websites of various institutions and non-government organizations, verified social media portals were compiled. RESULTS: The major mental health issues reported were stress, anxiety, depression, insomnia, denial, anger and fear. Children and older people, frontline workers, people with existing mental health illnesses were among the vulnerable in this context. COVID-19 related suicides have also been increasingly common. Globally, measures have been taken to address mental health issues through the use of guidelines and intervention strategies. The role of social media has also been immense in this context. State-specific intervention strategies, telepsychiatry consultations, toll free number specific for psychological and behavioral issues have been issued by the Government of India. CONCLUSION: Keeping a positive approach, developing vulnerable-group-specific need-based interventions with proper risk communication strategies and keeping at par with the evolving epidemiology of COVID-19 would be instrumental in guiding the planning and prioritization of mental health care resources to serve the most vulnerable.