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Luận án thực trạng y tế trường học ở các trường tiểu học, trung học cơ sở của tỉnh tuyên quang giai đoạn 2007 2017 và kết quả một số giải pháp can thiệp

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MINISTRY OF EDUCATION &TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY MAC DANG TUAN THE CURRENT SITUATION OF SCHOOL HEALTH IN PRIMARY AND SECONDARY SCHOOLS AT TUYEN QUANG PROVINCE IN THE PERIOD[.]

MINISTRY OF EDUCATION &TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY MAC DANG TUAN THE CURRENT SITUATION OF SCHOOL HEALTH IN PRIMARY AND SECONDARY SCHOOLS AT TUYEN QUANG PROVINCE IN THE PERIOD 2007 - 2017 AND THE RESULTS OF SOME INTERVENTION SOLUTIONS Specialization Code : Public Health : 9720701 THE PUBLIC HEALTH DISSERTATION SUMMARY HANOI - 2022 THE RESEARCH WAS COMPLETED IN HANOI MEDICAL UNIVERSITY Supervisors: Assoc.Prof.Dr LE THI THANH XUAN Assoc.Prof.Dr CHU VAN THANG Reviewer 1: Assoc.Prof.Dr TRAN VAN DAN Reviewer 2: Assoc.Prof.Dr DAM KHAI HOAN Reveiwer 3: Assoc.Prof.Dr NGUYEN VO KY ANH The dissertation will be defended at the PhD Dissertation Judging Committee taken place at Hanoi Medical University At hour , date month year 20 The dissertation can be found at: - National Library - Library of Hanoi Medical University LIST OF PUBLISHED RESEARCH WORKS Mac Dang Tuan, Le Thi Thanh Xuan, Chu Van Thang (2017) The situation of school health care in secondary schools in Tuyen Quang city, Tuyen Quang province 2016 Vietnam Journal of Preventive Medicine Vol 27, No - 2017: 41 - 49 Mac Dang Tuan, Le Thi Thanh Xuan, Chu Van Thang (2020) Effectiveness of intervention measures for prevention of myopia among primary and secondary school pupils in Tuyen Quang province in 2017 Vietnam Journal of Preventive Medicine, Vol 30, No - 2020: 138 - 147 THE DISSERTATION SUMMARY Introduction School health (SH) is an important task in general care, protection and improvement of health for students Up to now, there have been many documents, directives and decisions issued by the Prime Minister, the Ministry of Health, the Ministry of Education and Training, directing and guiding its implementation in order to strengthen health work at schools Currently, as of September 30th, 2020, in Vietnam, there are 26,403 schools of all levels from primary to high school with nearly 17.5 million students (up 3.5% over the previous academic year and accounts for 17.9% of the country's population) This is the young generation, the future of the country, so taking care of, protecting and improving the health of students make a very important contribution to the comprehensive development of the young generation and improving the quality of life of the descendants of the nation in the future Meanwhile, the network of school health staff (SHS) is lacking in quantity and is not guaranteed in quality The number of schools with SHS accounts for only 74.9% of the total number of schools; the number of educational institutions without SHS is 25.1%; the number of schools with SHS in charge of primary health care with professional qualifications as mandated ( physicians and above) is only about 30% The majority of medical staff are part-time teachers who have not been trained in the specialty of general medicine, especially in disadvantaged rural areas, remote areas, very few schools have full-time SHS Tuyen Quang is a mountainous province in Nothern Vietnam, where education and health work has been invested in and paid much attention to, but healthcare work in schools still faces many difficulties and results are still limited Meanwhile, in order to clearly identify the situation of the above difficulties, to help propose feasible solutions, suitable to the local situation and to promote public health activities, there have not been many in-depthstudies on this issue From the (afore)mentioned fact, we have conducted a study on the topic "The current state of school health in primary and secondary schools in Tuyen Quang province in the period 2007 - 2017 and the results of some intervention solutions" with objectives: Describe the current situation of school health in some primary schools and secondary schools at Tuyen Quang province in the period 2007 2016 Describe the knowledge and practice of school health of students in grades and in the 2016-2017 school year at the above schools Evaluation of results after year of intervention to change knowledge and practice about school health of the above group of students New contributions of the dissertation: (1) The topic has provided an overview of the current state of school health in 18 surveyed schools with great difficulty in terms of human resources, facilities, funding, and ineffective school health activities (2) The students' knowledge and practice of school health are still limited, which is the basis for providing interventivesolutions to improve knowledge and practice (3) Research has developed and implemented intervention of health education-communication for students combined with training in school health work for SHS andteachers Initially, the study results have demonstrated the effectiveness of the intervention This result is scientific evidence to justify making further recommendations on maintaining communication intervention, health education for students, as well as improving the quality of school health activities by arranging staff to a fulltime medical professional, or contracting with a local medical facility; and organizing regular training Thus it is also the basis for replicating this intervention model to other localities so that school health activities get more attention, improvement and practicality The Dissertation Layout: The dissertation consists of 147 pages (excluding appendices), chapters including: Introduction: pages; Chapter 1- Overview: 35 pages; Chapter - Research subjects and methodology: 13 pages; Chapter - Results: 47 pages; Chapter - Discussion: 47 pages; Conclusion: pages, Recommendation: page The dissertation includes: 50 tables, charts, 16 information boxes, diagrams and 143 references Chapter INTRODUCTION 1.1 Model of organization and management of school health activities 1.1.1 In the world Today, in the world, school health is implemented based on many different models But in general, the models all have some similarities such as the community having a role in building services and activities inside the school, including physical and mental healthcare, educational communication, recruitment of medical personnel, sports and cultural activities, and social activities Some models of school health are as follows: Model content; Model content; Model of full-service schools; Health promoting schools 1.1.2 In Viet Nam From 2016 onwards, the assessment of public health work is carried out according to Circular 13/2016/TTLT-BYT-BGDĐT replacing the old circular 18/2011/TTLT-BGDĐT-BYT Currently, the management of SC is being coordinated by the Ministry of Health and the Ministry of Education and Training, and the management model of traditional health activities is increasingly consolidated and improved from the central to the grassroots level 1.2 Some studies related to school health 1.2.1 In the world Jones SE et al (2015) conducted a descriptive observational study that compared the outcomes of SH activities among countries in the United States that have policies requiring SH activities to be associated with the management of chronic diseases (asthma, diabetes) and requiring to have these conditions consulted with countries that not have the above policy The results show that in districts with the above policy, the number of students with chronic diseases managed is 53.8% compared with 29.9% in the districts without the above policy; physical activity and sports counseling (28.8% vs 12.6%); health status self-management education (51.3% vs 23.6%); and referral for chronic diseases (47.2% vs 19.9%) (p

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