Global School-based Student Health Survey. UNRWA Global School based Student Health Survey (GSHS)

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UNRWA Global School based Student Health Survey (GSHS) 21

UNRWA school Health services ü New entrant's medical examination ü Screening: for vision and hearing impairment, for thyroid enlargement and for oral health problems. ü Special medical attention for Children with special health needs ü Referral of students ü Immunization ü De-worming programme ü Vitamin A supplementation ü Regular inspection of school environment and drinking water ü Health education activities ü Training of Health Tutors

GSHS q The GSHS is a school-based survey conducted primarily among students aged 13-15 years. It measures behaviours and protective factors related to the leading causes of mortality and morbidity among youth and adults q Purpose To provide accurate base line data on health risk behaviours and protective factors To help in developing priorities, establish programmes, To establish trends in the prevalence of health risk behaviours and protective factors

Methodology Ø A two-stage cluster sample design was used to produce data representative of all students in grades 7th, 8th, and 9th. Ø At the first stage, schools were selected with probability proportional to enrolment size. Ø At the second stage, classes were randomly selected and all students in selected classes were eligible to participate.

Methodology (cont d.) Ø 2 girls and boys schools from each Field was selected according to standardized CDC sampling procedures Ø Students self-reported their responses to each question on a computer-scanned answer sheet Ø Students privacy was protected by allowing for anonymous and voluntary participation, Ø The questionnaires, answer sheets, school level forms and class level forms were gathered and sent to CDC/Atlanta for data entry, processing, and analysis.

GSHS Ques*onnaire Contained 75 ques*ons addressing the following topics: 1. Dietary behaviours 2. Physical ac*vity 3. Hygiene 4. Drug use 5. Mental health 6. Protec*ve factors 7. Sexual behaviours that contribute to HIV infec*on, other STI, 8. Tobacco use 9. Violence and uninten*onal injury 6

Percentage of students who were underweight (<-2SD )by age and sex) 1 8 6 2 5.2 6.7 3.8 6.1 4.7 4.9 QNUNWTG - Weighted Data

Percentage of students who were overweight (>+1SD ) by age and sex 1 8 6 2 23.1 23.5 22.7 24 24.8 2.6

Percentage of students who describe themselves as slightly or very overweight 1 8 6 2 15 14.2 15.8 12.6 15.3 17.1 Q59 - Weighted Data

Percentage of students who were obese (>+2SD) by age and sex 1 8 6 2 5.5 7 4 5.5 5.9 5.1

Percentage of students who are trying to lose weight 1 8 6 36.7 27.9 45.4 34.5 38.7 36.9 2 Q6 - Weighted Data

Percentage of students who went hungry most of the time or always because there was not enough food in their home during the past 3 days 1 8 6 2 7.4 7.8 6.9 8.9 7.3 5.7

Percentage of students whose main reason for not eating breakfast was there was not always food in their home 1 8 6 2 4.1 4.2 3.9 4.2 4 3.8 Q63 - Weighted Data

Percentage of students who usually ate fruit 2 or more times per day during the past 3 days 1 8 6 2 43.5 43.5 43.7 45.6 45.9 39.3

Percentage of students who usually ate vegetables three or more times per day during the past 3 days 1 8 6 2 17.7 18 17.5 19.4 18.5 15.3

1 21 Percentage of students who usually ate fruits and vegetables five or more times per day during the past 3 days 8 6 2 22.3 23.3 21.4 24.2 23.2 19.5

Percentage of students who were taught in any of their classes during this school year the benefits of eating more fruits and vegetables 1 8 68.1 62.5 73.4 71.5 65.8 66.7 6 2 Q69 - Weighted Data

Percentage of students who usually drank carbonated soft drinks one or more times per day during the past 3 days 1 8 6 52 53.2 5.6 54.3 53.7 47.5 2

Percentage of students who ate food from a fast food restaurant on three or more days during the past 7 days 1 8 6 2 18.7 22.2 14.9 2.9 18 16.9

Percentage of students who ate breakfast most of the time or always during the past 3 days 1 8 6 54.9 57.5 52.5 55.4 54.4 55.1 2 Q62 - Weighted Data

Percentage of students who ate a snack at school most of the time or always during the past 3 days 1 8 6 42 43.6.2.6.6 44.8 2 Q64 - Weighted Data

Percentage of students who usually drank energy drinks two or more times per day during the past 3 days 1 8 6 2 7.2 9 5 8.8 6.9 5.6 Q65 - Weighted Data

Percentage of students who usually drank tea or coffee two or more times per day during the past 3 days 1 8 6 45.8 53.3 38.5 42.6 47 47.9 2 Q66 - Weighted Data

Percentage of students who usually drank milk or ate milk products two or more times per day during the past 3 days 1 8 6 27.6 29.5 25.7 3 29.3 23.3 2 Q67 - Weighted Data

Percentage of students who were taught in any of their classes during this school year the benefits of drinking milk or milk products 1 8 6 56.7 51.7 61.5 61.5 53.6 54.7 2 Q7 - Weighted Data

Percentage of students who were taught in any of their classes during this school year the benefits of healthy eating 1 8 71.9 66.9 76.7 75.3 7.6 69.6 6 2 Q68 - Weighted Data

Percentage of students who were physically active for a total of at least 6 minutes per day on 5 or more days during the past 7 days 1 8 6 2 22.9 28.5 17.4 22.3 23.4 22.7

Percentage of students who did not walk or ride a bicycle to or from school during the past seven days 1 8 6 28.1 27.9 28.1 32 27.4 24.5 2 Q5 - Weighted Data

Percentage of students who were physically active for a total of at least 6 minutes per day on all seven days during the past seven days 1 8 6 2 17 21.8 12.4 17.7 17.3 16 QNPA7G - Weighted Data

Percentage of students who went to physical education (PE) class on three or more days each week during this school year 1 8 6 46.4 48.5 44.7 51.6 48.1 2 Q51 - Weighted Data

Percentage of students who went to physical education (PE) class on five or more days each week during this school year 1 8 6 38.4.7 36.6 43.1 39.4 33.2 2 QNPE5G - Weighted Data

Percentage of students who spent three or more hours per day during a typical or usual day doing sitting activities 1 8 6 28.7 3.6 26.6 25 27.3 33.6 2 Q52 - Weighted Data

Conclusions and Recommendations: A. Dietary behaviour 1. Boys were not aware about the problem of overweight or the risk of becoming over weight and they didn't try to lose weight as females did. 2. The prevalence of hunger among students reflects the low socio economic status of their families. 3. 7% - 8% of students ate fruits and vegetables, they were not aware about the importance of this kind of food which is a protective factor.

4. There is tendency to eat at a fast restaurant three or more days a week, and drink carbonated soft drinks which inhibit calcium absorption and at the same time the percent of students who take milk or milk products is low. 6. There is need design educational program to raise the knowledge of students about food, nutrition and food safety, balanced diet, importance of eating available food at home, and taking milk and milk products. 7. There is need to overview school canteens situation and develop school canteen policy, setting strategy, criteria and standards, safety measures, what food to be sold

Conclusions and Recommendations B. Physical activity 1. Most of students of both sexes were physically inactive and dealing sedentary life and practicing sitting activities such as computer games since computers are available now at home and at school. 2. There is need to activate and increase physical activity sessions in schools and not to be prevailed on by other sessions

3. Reviewing the present programs of physical activities for students on national days, races, marathons 4. Initiating some sort of incentives to encourage students to take part in physical activity classes at school such as some additional points or marks to their average score at school to facilitate entrance to higher education