A School Health Project Can Uplift the Health Status of School Children in Nepal.
BACKGROUND
School health is effective in helping students achieve health literacy, enhance their health-related behaviors, and thereby improve their health status. However, in resource-limited countries, evidence is limited to show the impact of school health. We determined the association of the school health and nutrition (SHN) project activities on students' a) health knowledge, b) hygiene practices, and c) health outcomes, one year after the project completion.


METHODS
This is a cross-sectional study conducted among the schools with the SHN project and without the project in four districts of Nepal. We recruited 604 students from six schools in the project group and 648 students from other six schools in the comparison group. We used a self-administered questionnaire to collect the data, and analyzed them using regression models and a structural equation model (SEM).


RESULTS
Students from the SHN project group reported the decreased odds of worm infestation (AOR = 0.50, 95% CI: 0.34 to 0.75) and diarrhea/ dysentery infection (AOR = 0.67, 95% CI: 0.47 to 0.97) compared to those in the comparison group. Furthermore, the SEM analysis also showed that the students in the project group were more likely to have better health outcomes (β = 0.03, p< 0.05).


CONCLUSIONS
Students in the SHN project group were more likely to have better health outcomes compared to those in the comparison group, even after one year of the project completion. As it can bring about sustainable changes for students, it should be scaled up in other parts of the country.
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Rachana Manandhar
RM
Shrestha
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Moe
M
Miyaguchi
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Akira
A
Shibanuma
Tritunga Development Society (Tritunga Bikas Samaj), P. O. Box 8162, New Baneshwor, Kathmandu, Nepal.
Arun
A
Khanal
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Junko
J
Yasuoka
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Masamine
M
Jimba
D000293:Adolescent; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D006920:Hygiene; D008297:Male; D009390:Nepal; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D012572:School Health Services