Factors associated with perceived health of school-aged children in rural Rwanda: an opportunity to leverage community health workers to enhance school health promotion and primary healthcare systems linkages.

Autor: Manzi A; University of Global Health Equity, Kigali Heights, Plot 772, KG 7 Ave., 5th Floor, PO Box 6955, Kigali, Rwanda. mangano2020@gmail.com.; Partners In Health, Kigali, Rwanda. mangano2020@gmail.com.; Move Up Global, Kigali, Rwanda. mangano2020@gmail.com., Nguyen D; Move Up Global, Kigali, Rwanda.; Tufts University, Medford, USA.; Tufts University School of Medicine, Boston, USA., Katz B; Move Up Global, Kigali, Rwanda.; Tufts University, Medford, USA.; Warren Alpert Medical School of Brown University, Providence, USA., Michel CA; Hartwick College, Oneonta, USA., Nilingiyimana T; Ireme Education for Social Impact, Musanze, Rwanda., Sendarasi T; Ireme Education for Social Impact, Musanze, Rwanda., Niyonzima J; Ireme Education for Social Impact, Musanze, Rwanda., Nyiraneza O; Ireme Education for Social Impact, Musanze, Rwanda., Bimenyimana NB; Ireme Education for Social Impact, Musanze, Rwanda.; Ministry of Infrastructure, Kigali, Rwanda., Bloom E; Hartwick College, Oneonta, USA.
Jazyk: angličtina
Zdroj: BMC primary care [BMC Prim Care] 2024 Nov 08; Vol. 25 (1), pp. 393. Date of Electronic Publication: 2024 Nov 08.
DOI: 10.1186/s12875-024-02645-5
Abstrakt: Background: In many low-income countries, enhancing the health of school-aged children is often impeded by insufficient or limited knowledge regarding their health status. Further, hands-on health promotion interventions are nearly non-existent due to the lack of designated health workers. The disconnection between schools and primary care facilities further exacerbates this issue. To address these challenges, the World Health Organization has introduced the Health Promoting School (HPS) framework, a comprehensive model designed to integrate health into all aspects of school life and promote physical, mental, and social well-being. We sought to assess the perceived health status of school-aged children, identify associated factors, and explore the role of community health workers (CHWs) in public schools in rural Rwanda.
Methods: We carried out a convergent mixed methods study among teachers and community members in rural areas of Musanze, Rwanda. Data collection instruments were adapted from the World Health Organization's HPS framework and the literature. We conducted six in-depth interviews and three focus group discussions. We performed a logistic regression analysis to examine the factors associated with perceived health. Thematic analysis was used to analyze the qualitative data.
Results: A total of 479 individuals participated in this survey. Of these, 425 (89%) were community members, while 54 (11%) were employed as teachers at Nyabirehe or Rwinzovu public schools. Almost half of respondents 221 (46%) described the children's health as poor. Many factors were associated with perceived children's health, including having an established leadership team for school-based health promotion (OR = 1.97, 95%CI: 1.01,3,84), and being familiar with school-based health promotion (OR = 4.77, 95%CI: 2.27,10.0). Qualitative results described the CHW as a bridge between communities, schools, and primary healthcare centers.
Conclusion: This study revealed that the health of schoolchildren needs particular attention. In resource-limited settings, HPS presents a promising opportunity to address the health and well-being of children at rural public schools. However, adapted policies, the establishment of health promotion teams, and hands-on orientation for teachers and community members are necessary to ensure an effective implementation of HPS. In Rwanda and other low-income countries where public schools lack nursing staff, CHWs could play a vital role in enhancing HPS and the linkage between schools and primary healthcare facilities.
(© 2024. The Author(s).)
Databáze: MEDLINE
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