Sustainable School Health Promotion Strategy For Migrant Children In Shanghai

BackgroundIn recent year, size of migrant children has expanded rapidly. According to the data from sixth nationwide population census, the number of migrant children aged6to14years old has reached378,000by2010in Shanghai, accounting for4.2%of the total migrants. Compulsory education for migrant children in Shanghai relies on both public schools and schools for migrant children. In2008, Shanghai government launched a three-year action plan on compulsory education for migrant children, which aimed to include all eligible schools for migrant children into private education system. Then those private schools can get students’average budget expenditure from the government. In2011, a total of501,700migrant children received compulsory education in Shanghai and368,900migrant children were accepted by public schools while others were accepted by158private schools for migrant children.Shanghai ranks the top in implementing the policy of the conversion of schools for migrant children, which is still in the exploratory stage. School health promotion strategy should be changed after schools for migrant children are included into private education system. So the study tries to explore sustainable school promotion strategy for the schools for migrant children in the different periods through in-depth analysis of the school health promotion case.ObjectiveTo explore sustainable school promotion strategy for schools for migrant children through the case study of school health promotion in the schools for migrant children in Minhang and Songjiang District, Shanghai.MethodsThe study is based on a case of school promotion for the schools for migrant children. The research sites are3schools for migrant children and2public schools in Minhang and Songjiang District.The study uses the questionnaire data of the baseline survey in2009. The participants included634students in Grade4to6from3schools for migrant children. School health promotion intverwentions were conducted in the3schools for migrant children during two years after baseline survey.The terminal evaluation was conducted in2009. Stratified cluster sampling method was used in quantitative survey. Questionnaire survey was conducted among1252students in Grade4to6in the3schools for migrant children, including416students in Grade5, and164students in Grade5in the2public schools. Purposive and snowball sampling methods were used in qualitative survey. In-depth interviews were conducted with4government managers of these two districts,3leaders in charge of health,3health teachers and6students of these3schools for migrant children.Results1. The differences in health related knowledge and behaviors among migrant children from schools for migrant children, migrant children and local children from public schools:Both health related knowledge and behaviors scores of migrant children from schools for migrant children were lowest among three types of students, while there was no significant difference between migrant children and local children from public schools.2. The relevant factors of health related knowledge and behaviors among migrant children from schools for migrant children:Multiple linear regression analysis showed the total scores of health knowledge were associated with the schools, grade, educational level and career of mothers while the total scores of health behaviors were associated with educational level of fathers and schools.3. The effectiveness of school health promotion in the schools for migrant children: The schools were equipped with standard school clinics. The sanitation, such as toilets, was renovated. The system of school health care was built and normalized. The school promotion policy was driven to be launched, and then the main intervention measures were implemented in all private schools for migrant children in Shanghai. The score of health knowledge improved significantly (P<0.05) after the intervention. However the change of health behavior was not statistically significant.4. Sustainable school promotion strategy for schools for migrant children:The issues of weak-targeted school health promotion interventions, insufficiency of full-time health care workers in schools, shortage of health knowledge and health education skills among teachers in charge of classes, and management of private schools for migrant children have limited sustainable improvement of school health promotion. Relevant authorities should devote much attention to intervention strategy for individuals, to increase full-time health care workers in schools, to train teachers in charge of classe, and to turn private schools for migrant children into public ownership.Conclusion and suggestionTargeted strategies should be taken according to the characteristics of schools for migrant children in the different periods. Relevant authorities in Shanghai should devote much attention to intervention strategy for individuals, to increase full-time health care workers in schools, to train teachers in charge of classe, and to turn private schools for migrant children into public ownership.