Exploration of issues surrounding health education in Yerevan's schools

Abstract

Over the past decades chronic diseases of adulthood, which have been shown to be strongly correlated with unhealthy lifestyle, have become the leading causes of death in Armenia. While some success is achieved in the treatment of these diseases, nothing is being done for early prevention of them. Meanwhile culturally appropriate school health education programs could, in part, solve this problem. This paper presents the results of applied qualitative and quantitative research aimed at exploring issues surrounding health education in Yerevan’s schools in order to gain insight into the current situation and the possibilities for future school-based health education project. The topics to be described included: unhealthy behaviours of adolescents, causes for their developing, and the knowledge of adolescents about them; the current situation with school-based health education in Yerevan; attitudes of people in community towards the necessity of health education programs in Yerevan’s schools; the content of programs; feasibility of implementation of a program; and constraints for implementation. Qualitative techniques included in-depth interviews with purposive sample of six adolescents, tenparents, three teachers, two school managers, two officials from the Ministry of Education, and two officials from the Ministry of Health, and rating exercises with ten adolescents and ten parents. Structured questionnaires were administered to 11 boys and 12 girls of 15 year of age in one of Yerevan’s schools. The following high-risk behaviours were identified by respondents for in-depth interviews: smoking, lack of physical activity, low level of hygiene, unhealthy eating patterns and unhealthy diet, alcohol drinking, violence and stress, drug abuse, and unsafe sex. Frequencies of such behaviours as smoking, alcohol drinking, and lack of physical activity, although felt by key informants as being prevalent among adolescents, were recorded by respondents of questionnaire as very low. One of possible reasons for this finding might be the low validity of the instrument. Our data suggest, that there is a strongly perceive d needs for health education in community as a whole and in schools especially. Among reasons for developing unhealthy behaviours were mentioned: peer pressure, traditions, economic conditions, tension in society, lack of health education campaigns, negative influence of advertisements and some TV programs, lack of knowledge, lack of interesting things to do, curiosity, and desire to look like “adult” . At least some of them could be addressed by school health education programs. From the eleven topics for health education, formulated on the basis of identified high-risk behaviours, five, including physical activity, conflict solving, sexual development, hygiene, and drug abuse, were given the highest scores by adolescents and parents in rating exercises. However, although the need is clearly recognised, most conditions, such as availability of finances, manpower and time resources are found to be not favourable for introducing a health education program in Yerevan’s schools.