2002-12-31-世界卫生组织-2003_GSHS_Country_Report_Uganda_43页_543kb

Summary of the 2003 Uganda Global School-Based Health Survey (GSHS)

Core Content

The 2003 Uganda Global School-Based Health Survey (GSHS) was a comprehensive health behavior study conducted among secondary school students aged 13-15 years. The survey aimed to gather data on health behaviors and protective factors that contribute to mortality and morbidity in Uganda's youth and adult populations. It was designed to support national and international comparisons, inform policy development, and monitor the health and nutrition status of school children.

Main Purpose

The GSHS was initiated by the World Health Organization (WHO), UNAIDS, UNESCO, and UNICEF, with technical support from the US Centers for Disease Control and Prevention (CDC). Its primary objectives were:

• To provide accurate data on health behaviors and protective factors among students.
• To help countries develop priorities and programs for school and youth health.
• To monitor trends and support evaluation of health promotion initiatives.
• To enable comparisons across and within countries regarding health behaviors.

Methodology

The survey used a two-stage cluster sampling design to ensure a representative sample of students. The first stage involved selecting 50 secondary schools (25 urban, 25 rural) based on school enrollment size. The second stage included randomly selecting intact classrooms from each school. A total of 1878 students (880 boys, 963 girls) participated in the survey.

Each student completed a self-administered, anonymous questionnaire with 93 questions covering various health-related topics. The data was collected between July 30th and August 18th, 2003, and the survey was designed to ensure student privacy and voluntary participation. A weighting factor was applied to adjust for non-response and selection probabilities.

Key Findings

Demographics

• 44.2% of students were underweight (BMI < 19).
• 5.3% were at risk of becoming overweight (BMI > 25).
• 17.4% ate food containing animal protein daily.
• 57.1% ate breakfast daily.
• 16.5% never or rarely had lunch at school in the past 30 days.
• 8.1% rarely washed hands after using the toilet.
• 31.2% had no hand washing facilities at school.
• 40.7% of students reported that their parents checked their homework or knew their activities.

Alcohol and Drug Use

• 12.8% of students consumed alcohol on one or more days in the past 30 days.
• 9.0% of students drank one or more drinks per day on the days they drank.
• 2.2% of students usually obtained alcohol from stores, shops, or street vendors.
• 15.2% of students had been really drunk at least once in their lifetime.
• 8.5% of students had used drugs such as marijuana or sniffed petrol at least once in their lifetime.

Dietary Behaviors

• 67.2% of students usually ate fruits daily.
• 62.7% of students usually ate vegetables daily.
• 19.8% ate fruits and vegetables five or more times per day.
• 17.4% ate food with animal protein daily.
• 32.3% of students went hungry most of the time or always due to insufficient food at home.
• 5.3% were at risk of becoming overweight, with 8.8% of girls at risk compared to 1.5% of boys.
• 3% of students were overweight, with girls more likely to be overweight than boys.

Sexual Behaviors

• 21% of students had ever had sex.
• 29.4% of boys had ever had sex compared to 14% of girls.
• 10.9% had had sex before 13 years, with 16.8% of boys compared to 5.9% of girls.
• 8.6% had had sex in the past 12 months, with 11.7% of boys compared to 5.8% of girls.
• 3.3% had had sex with a same-sex partner.

Mental Health and Suicidal Thoughts

• 18.8% of students seriously considered attempting suicide in the past 12 months.
• 22.8% of girls compared to 14.5% of boys considered attempting suicide.

Physical Activity

• 15.3% of students were physically active for at least 60 minutes continuously on all previous 7 days.

Tobacco Use

• 4.3% of students smoked tobacco in the past 30 days.
• 6.2% of boys compared to 2.6% of girls smoked tobacco.

Violence and Injury

• 35.5% of students were involved in physical fights in the past 12 months.
• 45.5% reported being bullied in the last 30 days.
• 34.8% had been absent from school for one or more days in the past 30 days.

Conclusion and Recommendations

The survey highlights serious health and lifestyle issues among Ugandan secondary school students, particularly in terms of malnutrition, risky behaviors, and poor hygiene. The data shows that many students are underweight, lack proper nutrition, and are involved in behaviors that increase health risks, including alcohol and drug use, violence, and sexual activity at a young age.

The study underscores the need for Health Promoting School initiatives to address these issues. It recommends that the government and relevant stakeholders should:

• Develop and implement school health policies and guidelines.
• Improve nutrition education and access to healthy food.
• Enhance hygiene infrastructure and promote handwashing practices.
• Address peer influence and adult role models in shaping healthy behaviors.
• Strengthen parental involvement and awareness of children's activities.
• Increase school-based health programs focusing on mental health, physical activity, and prevention of substance abuse and risky sexual behaviors.

The data is representative of all students in grades S1, S2, and S3 in Uganda and was analyzed using 95% confidence intervals to account for the complex sampling design. This survey was the first of its kind in Uganda, providing critical baseline data for future health monitoring and policy development.