Health, safety and environment conditions in primary schools of Northern Iran.

BACKGROUND: People spend a considerable part of their childhood time in the schools, a phase that coincides with their physical and mental growth. A healthy educational environment is vital to student's health and wellbeing.
MATERIALS AND METHODS: This study is a descriptive study conducted in 100 primary schools (both state and nonprofit schools) from Sari's Districts 1 and 2 in Iran. Sampling was performed by census and data were collected using the standard questionnaire by direct interview. Data were analyzed by Excel and SPSS software (Version 20.0. IBM Corp, Armonk), NY: IBM Corp using independent numerical T2 testing.
RESULTS: Significant relationship was observed between the kind of schools (P = 0.045) and their locations (P = 0.024), however the health, safety and environment (HSE) ratings among boys only versus girls only schools were similar (P = 0.159). Interestingly private and nongovernment schools and primary schools from Sari's districts one had consistently higher HSE ratings.
CONCLUSION: The differential and higher HSE ratings in primary schools run by Private organizations and primary schools from Sari's districts one could be due to manager's awareness and implementation of recommended HSE standards, schools neglecting and overlooking these standards had lower HSE ratings. It is necessary that schools with lower HSE ratings are made aware of the guidelines and necessary infrastructures allocated to improve their HSE ratings.

INTRODUCTION

Educating in a safe, secure, necessary and stimulating environment for a Childs development. Access to high health care standards and professional teachers, are the basic rights of a growing child. As children's themselves cannot provide their needs for education and health care, the educational environment should be prepared to facilitate this and promote physical, psychological and social development of a child. This important responsibility should be mutually shared between parents, educational system and national health care system.[1]

Primary school students are at a critical age to impart good educational, health and environmental values. Undemanding health situations of the educational environment could impose a variety of devastating consequents to the students. Some of the consequences may appear after a relatively longer incubation time; hence health considerations at schools are not only necessary, but are also of priority. On the other hand, the school, as a second home, should be attractive and optimally demanding to promote interest of the students in the educational program. Although beautiful and sanitary school could provide a stand for learning and flourishing talents an unhealthy and inappropriate school could destruct learning opportunity. Unfortunately, a considerable amount of Iranian school is in an undemanding educational state. Broken tables, unclean walls, inappropriate toilets and heating system are among undemanding situations and attaining educational targets under these conditions is considerably unrealistic. Despite best efforts from Teachers’ achieving favorable output is impractical, hence improving health factors of the educational environment could lead to better outputs.[2]

The school is a vital place for learning, acquiring skills and basic attitudes, which are retained with the students all along their life. Flourishing maximum talents and requiring high levels of learning needs optimal levels of health and welfare environment. Hence investigating in education affairs is of most strategic investigation and the most important ways of increasing development and attaining maximum outputs. In the absence of optimal levels of healthy strategies, the education programs can fail resulting in academic failure and poor return of investment. Several health standards, national and international guidelines and frameworks are defined[3] and we aimed to benchmark these standards against prevailing situation of health environment and safety among sampled primary schools in Iran.

MATERIALS AND METHODS

We planned a descriptive study for which we selected 100 elementary schools (General and private schools) from Sari-Iran. Data were gathered using a standard questionnaire. We interviewed the school managers as participants and analyzed the data through SPSS and EXCEL software's. The following steps were adopted:

The questionnaire included 115 questions about assessment of Health, safety and environment (HSE) management systems in elementary schools of Sari city. The questionnaire was aligned to the most up-to-date recommendations on environmental, professional and environmental health.

We referred to the selected schools and filled the questionnaire through interview and observations.

Validity and reliability were estimated.

The observed characteristics were compared to the standards.

Data were analyzed.

RESULTS

As each question of the questionnaire could get the full score of 1, the rate of 100% shows the full score. We classified the estimated rates as follows:

Rates under 50% as poor.

Rates between 50% and 64% as moderate.

Rates from 65% to 79% as good.

Rates from 80% to 100% as perfect.

Comparing the two types of school management regarding HSE rating classes are presented in Table 1. Private or nongovernmental schools had relatively better HSE ratings.

Table 1

Relationship between HSE ratings and types of school management

In the other analysis, we compared the HSE ratings regarding the gender of students (as in Iran boys and girls study in separate schools). The HSE ratings of boys only and girls only schools were similar [Table 2].

Table 2

Comparing HSE ratings of the schools based on gender of students

In the third analysis, we compared the HSE ratings of schools in different regions (As Sari city has two regions based on municipal divisions). While the number of schools with perfect HSE scores were higher in region one, the good and moderate scores were similar in both regions [Table 3].

Table 3

Comparison of municipal areas based on HSE rating

DISCUSSION AND CONLUSION

Our study results indicate considerable differences between general and private schools and between schools of municipal region 1 and 2 based on HSE rating scores. However, differences between boys and girls school based on HSE rating scores was not statistically significant.

Ministry of health in Iran has provided a range of guidelines, standards and programs for health affairs in schools. Iranian schools are obliged to provide these standards to prepare a suitable environment for educational purposes and optimal development of the child. Unfortunately, financial resources are not enough to meet these standards, and it is also not possible to shut down the schools with poor standards. Iranian ministry of education has failed to supervise health standards and were currently maintaining the health care services at a working level.[4] Hence, efforts for estimating health risk levels in schools are necessary to better our knowledge and reach acceptable levels of HSE standards.[5] In addition, estimating cost-effectiveness of screening programs could illuminate processes to make better decisions on assigning financial resources for improving health situations of schools.[6] While ignoring health related issues of schools may lead in devastating consequences.[7] Our study highlights severe need for developing health systems and making permanent HSE programs in schools[8] such as developing general health training programs,[9] supporting health improving actions[10] and preparing standardized health protocols.[11] In addition, the health improving programs could enrich ongoing educational programs of schools,[12] nevertheless the financial issues must be aligned to meet the current needs.[13] School managers could play a critical contribution to this end[14] and take a systematic strategy to manage the situation.[15] Implanting of HSE health system in schools could organize divergent activities and policies regarding health issues and help make the schools better places for overall child development.[16]

We concluded that health management system could potentially improve the current health relate situations in schools and developing an organized HSE system is necessary to accomplish the following established objectives:

Developing a dynamic system in schools’ health affairs that prevent divergent actions.[12]

Encouraging students, teachers and parents to participate in health affairs.[12]

Encourage organizational participation from nongovernmental recourses.[12]

Differentiating between inter and intra-group participation.[12]

Creating a competitive environment between schools and school managers to get a better ranking on health issues.[10]

Provide a better background for financial assignment.[10]

Preparing a step forward to social equality in health issues.[10]

Improving physical environment and securing school via continual checking of health risks.[15]

Internalizing HSE training and culture for students and parents.[13] and

Optimal utilization of managers, teachers and parent's abilities and capacities.[13]