RESUMO
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.
RESUMO
BACKGROUND: The World Health Organisation has reported that mental disorders are one of the leading causes of disability worldwide. Social phobia is one such mental disorder that can have significant impact on the livelihood of adults if not detected at an early stage. There have been very few studies done on social phobia among adolescents in South India. Hence, this study was done to determine the prevalence of social phobia and factors associated with it among the school-going adolescents in rural Puducherry. METHODOLOGY: A community-based cross-sectional study was conducted among 1018 school going adolescents from December 2017 to January 2018 in rural Puducherry. Information on socio-demographic characteristics was collected by a pre-tested semi-structured questionnaire and social phobia was assessed using the validated Social Phobia Inventory (SPIN) questionnaire. RESULTS: Among 1018 participants, 738 (72.5%) belonged to early adolescence (10-13 years); 520 (51.1%) were boys; 557 (54.7%) were studying in a middle class; 931 (91.5%) were Hindus; 978 (96.1%) had siblings.The prevalence of social phobia among adolescents was found to be 22.9% (95% CI: 20.4-25.5%). The prevalence of mild social phobia was 18% [95% confidence interval (CI): 15.7-20.4%], moderate social phobia was 4% (95% CI: 2.9-5.4%), severe social phobia was 0.7% (95% CI: 0.3-1.3%) and very severe social phobia was 0.2% (95% CI: 0.03-0.64%). Higher age, female gender, lack of counselling services and specialist visits at school were found to be determinants of social phobia. CONCLUSION: The current study showed that one in every five adolescents was at risk of developing social phobia. Health education for students, teachers and family members needs to be given to make them aware of the importance of social phobia.
