Health status of school going children: a cross-sectional study in rural area of Lucknow

INTRODUCTION

Children of today are citizens of tomorrow. As Nehru “if we do not look after children today, we will be creating more problems for ourselves in future”. The health of children and youth is of fundamental value. Health services for school children are a must for building a healthy young India. Over one fifth of our population comprise of children aged 5-14 years and only about 80% of these children are enrolled in schools, of those enrolled 65-80% regularly attend school and easy to reach.¹

In a developing country like India due to poverty and prevailing socio-cultural milieu a substantial number of school children from paediatric age to adolescents suffer from various diseases. It is estimated that every third child has some sign if ill health manifesting in the form of dental, visual and hearing problems, nutritional deficiencies, respiratory infections, skin disorders, loco-motor disabilities etc. School age is a dynamic period where physical, mental and emotional growth of the child occurs, so that child can smoothly turn into an adult. It is also a critical period where child is vulnerable to many communicable and non-communicable diseases due to variations in the living conditions, immunity status, socioeconomic, and cultural factors. School health is an important branch of community health. School health services are an economical and powerful means of raising community health. It is more important, in future generations. The school health services are a personal health service. It has developed during the past 70 years from the narrower concept of medical examination of children to the present-day broader concept of comprehensive care of the health and wellbeing of children throughout the school years. Schools play a significant role in promoting the health and safety of students. Ideally, rural schools will strive to provide a healthy physical environment for students to learn, provide nutritious meals, and encourage physical activity.²

According to a study published in ‘The Lancet’, a survey across 10 Indian cities revealed that children suffer from a lack of immunity that result in an absence from schools. The survey conducted by IMRB research agency which involved 1500 mothers who had children in the age group of 6-14 years, also revealed that nearly 30% of mothers take their children to a doctor every month because of some nagging illness. For a country with the second-largest school system in the world, the figures can be more alarming if the money spent on physical travel to the doctor and lost hours of education are also taken into consideration. Even more concerning is the fact that a majority of the population of India resides in rural areas where access to healthcare is limited.³

Problem statement

Health status of school going children - a cross- sectional study in rural area of Lucknow.

Objectives

To assess the health and nutritional status of the school going children in rural area of Lucknow. And to determine the association of health problems with their socio demographic variables.

Hypothesis

The following hypotheses will be tested at 0.05 level of significance.

H1: There will be significant association between health status of school going children with their selected socio demographic variables.

Operational definitions

Health status in this study refers to physical functions of school going children’s which includes nutritional status, visual acuity, auditory function, and dental health. School going children in this study refers to children who studying 1^st to 10^th standard.

METHODS

Research approach

Quantitative research approach was used for the study.

Research design

Descriptive cross sectional research design was used.

Variables

Demographic variables

In this study demographic variables are age, gender, religion, class, food habits, and education of father, education of mother, occupation of father, and occupation of mother.

Research variables

In this study assessment of health status of school going children at Sarojini Nagar, Lucknow was research variable.

Research settings

The present study was conducted in Dabble Public School Banthra Sarojini Nagar Lucknow.

Population

The population for the present study was School Going Children at Lucknow. In this study the target population was school going children at Sarojini Nagar. The accessible population was School Going Children in Dabble Public School Sarojini Nagar, Lucknow.

Sample

In this study, the sample consisted of school going children in Dabble Public School Banthra Sarojini Nagar, Lucknow who met the inclusion criteria.

Sampling technique

The sample was selected through non-probability convenient sampling technique.

Sample size

Sample size was 150. The data collection started from 1^st April 2022 to 30 April 2022.

Inclusive criteria

In this present study inclusive criteria were all students present on the days of assessments from class 1st to 10th standard.

Exclusive criteria

In this present study exclusion criteria were student absent during all visits to school for assessment. Student who are not willing to participate.

Tool for data collection

A tool is the formal procedure that the researcher develops to guide the collection of data in a standardized fashion in most quantitative studies.

Description of tools

Based on the objectives and conceptual framework of the study, the following instruments were developed to collect data.

In this study tool consist of two sections,

Section A- Socio demographic variables

Section B- Checklist to assess health status of school going children.

Section A: Socio demographic data

This section consists of 9 items related to socio demographic variables such as age, gender, religion, class, food habits, education of mother and father and occupation of father and mother.

Section B: Checklist to assess the health status of school going children

This section includes nutritional status, visual acuity, auditory function and dental health.

RESULTS

Section I

Frequency and percentage distribution among school going children with their selected socio demographic variables.

Majority of the school going children 40% were in the age group of 9 -12 years, 26.7% were in the age group of 5-8 year, 28.0% were in the age group of 12-15 year and 5.3% were in the age group of 15 and above.

Out of 150 school going children 52.70% were female and 47.30% were male.

Majority of the school going children 88.70% belongs to Hindu religion.

10.70% were to belong to Muslim and 0.70% belongs to other and no one belongs to Christian.

Most of the schools going children 30% were I-III standard and VI-VIII standard, and 20% were IV-V and IX-X standard class.

Majority of the school going children 66.70% were vegetarian and 33.30% were non- vegetarian.

Out of 150 schools going children’s father 32% were completed secondary education, 31.30% were graduate and above, 30% were completed primary education, 6.7% were illiterate.

Majority of the school going children’s mothers 46.70% were completed primary education, 20.70% were illiterate, 20% were completed secondary education and 12.70% were graduate and above.

Most of the schools going children’s fathers 32.7% were involved in daily wages, and 30.7% were involved in private job and 24.7% were involved in business and 12 % were involved in government job

Majority of the school going children’s mother 89.3% were housewife, 6% were involved in government job, 4% were involved private job and 0.7% business.

Section II

Frequency and percentage distribution among school going children with their health status of school going children.

Reveal that majority of the school children had normal nutritional status 61.3% followed by 28.7% were underweight and 10% were overweight.

Reveal that majority of the school children had 69.3% normal vision and 30.7% had to abnormal vision in left eye.

Reveal that majority of the school children had 68.0% normal vision and 32% had abnormal vision in right eye.

Reveal that majority of the school children 99.3% had normal hearing and 0.7% abnormal hearing in left ear.

Reveal that majority of the school children 98.7% had normal hearing and 1.3% had abnormal hearing in right ear.

Reveal that majority of the school children 66.7% had no soft debris or stain, 24.7% had found less than 1/3 of surface covered, 8.05% found 1/3 to 2/3 of surface covered and 0.7% more than 2/3 of surface covered.

Reveal that majority of the school children 82.05% had no calculus, 10,7% found less than 1/3 of surface covered and were 7.3% found 1/3 to 2/3 of surface covered.

Section III

Association between the health status of school going children score with their selected socio demographic variables.

In order to determine the association between the levels of health status of school going children with their selected socio-demographic variables, the following hypothesis (H1) was formulated.

H1: There will be significant association between health status of school going children with their selected socio demographic variables.

Indicates as a significant

The data given in Table 3 shows that the Chi square test used to find out the association between nutritional status of school going children with their selected socio demographic variables. The finding of the Chi square test shows that there was no association between nutritional status score with their selected demographic variable. Here the p value in each case was more than 0.05 (level of significance).

Indicates as a significant

The data given in Table 4 shows that the Chi square test used to find out the association between vision (left eye) of school going children with their selected socio demographic variables. The finding of the Chi square test shows that there was no association between vision (left eye) with their selected demographic variable. Here the p value in each case was more than 0.05 (level of significance).

Indicates as a significant

The data given in Table 5 shows that the Chi square test used to find out the association between vision (right eyes) of school going children with their selected socio demographic variables. The finding of the Chi square test shows that there was an association between vision (right eye) score with their selected demographic variable like-class standard and education of father and mother. Here the p value in each case was less than 0.05 (level of significance). The finding of the Chi square test also shows that there was an association between the vision (right eye) with their specific socio demographic variables like: - class, education of father and education of mother. Hence, research hypothesis H1 was accepted.

Indicates as a significant

The data given in Table 6 shows that the Chi square test used to find out the association between hearing (right ear) of school going children with their selected socio demographic variables.

The finding of the Chi square test shows that there was no association between Hearing (right ear) score with their selected demographic variable.

Here the p value in each case was more than 0.05 (level of significance).

Indicates as a significant

The data given in Table 7 shows that the Chi square test used to find out the association between hearing (left ear) of school going children with their selected socio demographic variables. The finding of the Chi square test shows that there was no association between Hearing (left ear) score with their selected demographic variable. Here the p value in each case was more than 0.05 (level of significance).

Indicates as a significant

The data given in Table 8 shows that the Chi square test used to find out the association between dental (debris) of school going children with their selected socio demographic variables.

The finding of the Chi square test shows that there was no association between dental (debris) score with their selected demographic variable.

Here the p value in each case was more than 0.05 (level of significance).

Indicates as a significant

The data given in Table 9 shows that the Chi square test used to find out the association between dental (calculus) of school going children with their selected socio demographic variables. The finding of the Chi square test shows that there was no association between Dental (calculus) score with their selected demographic variable. Here the p value in each case was more than 0.05 (level of significance).

DISCUSSION

The major findings of the study are discussing as follows according to the objectives of the study and hypothesis:

Section I: Frequency and percentage distribution among school going children with their selected socio demographic variables.

Section II: Health status of school going children.

Section III: Association between the health status of school going children score with their selected socio demographic variables.

Section I: Frequency and percentage distribution among school going children with their selected socio demographic variables.

Majority of the school going children 40% were in the age group of 9 -12 years, 26.7% were in the age group of 5-8 year, 28.0% were in the age group of 1215 year and 5.3% were in the age group of 15 and above. Out of 150 school going children 52.70% were female and 47.30% were male. Majority of the school going children 88.70% belongs to Hindu religion and 10.70 % were to belong to Muslim and 0.70% belongs to other and no one belongs to Christian. Most of the schools going children 30% were I-III standard and VI-VIII standard, and 20% were IV-V and IX-X standard class.

Majority of the school going children 66.70% were vegetarian and 33.30% were non- vegetarian. Out of 150 school going children’s father 32% were completed secondary education, 31.30%were graduate and above, 30% were completed primary education, 6.7% were illiterate. Majority of the school going children’s mothers 46.70% were completed primary education, 20.70% were illiterate, 20% were completed secondary education and 12.70% were graduate and above. Most of the schools going children’s fathers 32.7% were involved in daily wages, and 30.7% were involved in private job and 24.7% were involved in business and 12% were involved in government job. Majority of the school going children’s mothers 89.3% were housewife, 6% were involved in government job, 4% were involved private job and 0.7% business. The above findings of the study were supported by Neeti Verma (2021) conducted a study. Health status of primary school children: study in urban slums of Lucknow. A community-based cross-sectional study was conducted among 760 students of primary schools.

A pre-designed, pre-tested, and semi-structured questionnaire was used as a study tool. The study result revel that the Most of the subjects 362 (47.7%) were in age group of 7-9 years, and were distributed almost equally in the classes from 1st to 5th standard. About one fourth (26.8%) school children were underweighted, whereas 5.6% school children were found overweight. Girls (34.0%) were found underweight more than the boys (20.8%). In contrast, more boys (8.8%) were overweight than girl students (2.6%). This finding is consistent with the others study.⁴

Section II: Health status of school going children

Most of the school children had normal nutritional status 61.3% followed by 28.7% were underweight and 10% were overweight. Majority of the school children had 69.3% normal vision and 30.7% had to abnormal vision in left eye. Majority of the school children had 68.0% normal vision and 32% had abnormal vision in right eye. Most of the school children 99.3% had normal hearing and 0.7% abnormal hearing in left ear. Majority of the school children 98.7% had normal hearing and 1.3% had abnormal hearing in right ear. Majority of the school children 66.7% had no soft debris or stain, 24.7% had found less than 1/3 of surface covered, 8.05% found 1/3 to 2/3 of surface covered and 0.7% more than 2/3 of surface covered. Most of the school children 82.05% had no calculus, 10,7% found less than 1/3 of surface covered and were 7.3% found 1/3 to 2/3 of surface covered.

This was supported by Nanditha G et al (2020) conducted a study on health and nutritional status of school children from a rural area of Andhra Pradesh. A cross-sectional study of 500 rural school children from 5 to 15 years was conducted to assess the nutritional status by anthropometry and health status by clinical examination. The study result revel that the Out of the 500 school children 33.4% were stunted. 25.6% and 27% were underweight according to weight and body mass index criteria respectively. Common health problems among school children in this study were anemia (31%), dental caries (27.2%), upper respiratory infections (13.4%), skin infections and scabies (12.6%), head lice infestation (6.8%), refractive errors (6%) and ear discharge (5.2%).⁵

Section III: Association between the health status of school going children score with their selected socio demographic variables

Based on statistical analysis using Chi square test for significant association was found only between vision (right eye) with their selected demographic variable like-class and education of father and mother only. There were no association found in nutritional status, hearing and dental problem with socio demographic variables. The above findings of the study were supported by Manal Matar Al Daajani, Dina Mohammed Al-Habib et al conducted a study on Prevalence of Health Problems Targeted by the National School-Based Screening Program among Primary School Students in Saudi Arabia. The result of the study shows that the most prevalent health problems identified were dental cavities (38.7%), eye refractory errors (10.9%), and overweight and obesity (10.5%); the less prevalent problems included ADHD (2.81%), auditory problems (0.6%), and scoliosis (0.48%) and there was an association between ADHA disorder and Auditory problems with their socio demographic variables. This finding is consistent with the others study.⁶

Limitations of the study

The study is limited to: Single setting, descriptive study did not use control group.

CONCLUSION

It was concluded that majority of the school children had underweight, vision problem and dental problems. So, school children need periodic health checkup and follow up. When family member participates in a effective school health programme, they may use the resources already in place to create a healthy environment for their children and provide them with the knowledge and skill they need to live healthy lives.

Nursing implications

Any research work has it’s worth when it is applied for the benefit of the public. The findings of the study have implication in the Nursing Administration, Nursing education, Nursing Practice and Nursing Research

Recommendations

On the basis of findings of the study the following recommendation have been made: a comparative study can be conducted both in rural and urban area among school going children. A study can be conducted with large samples. A similar study can be conducted on different group or subjects.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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