Systematic review on school health program and health-promoting schools in Southeast Asian region countries

Abstract

Introduction: Studying the process and impact of interventions like Health Promoting Schools (HPS) is important for sustenance and policy changes. This calls for gathering evidence on the current status of school health programs at a larger level so as to identify barriers and opportunities to strengthen their implementation. Methodology: Systematic research using selected databases led to identification of 18 eligible studies (from 1979 to 2019). Results: The studies were from India (n = 12), Indonesia (n = 3), Thailand (n = 2), and Nepal (n = 1). Collectively, studies have assessed health services under domains of health education (n = 2), health services (n = 3), nutrition services (n = 6), healthy school environment (n = 4), disease control and prevention (n = 6), school and community collaboration (n = 5), risk factor management (n = 6), life skills education, mental health and well-being (n = 7), and health promotion for school staff (n = 1). Health promotion services provided under similar domains were not similar kind in all studies. Five studies reported student, teacher, administration, and parental level facilitators and barriers to service provision under school health/health-promoting interventions/programs. Lack of time, overburdening, poor support by parents, unhealthy behavior in schools, etc., were some of the barriers. Cooperation by stakeholders and behavior reinforcement and parental trust in school activities reflected potential facilitators. Conclusion: Implementation of global standards of health-promoting schools (HPSs) is variable. Service provision is not essentially under the school health program and is mostly restricted to school children only. The study can serve as baseline for the implementation of standards in Southeast Asian Region countries. Countries should build on this information. Recommendations: Policies may be framed to include global standards of HPSs, understanding that little change can bring about a larger impact.