Urban School Health Promotion Programme

Adolescence (10–19 years), as defined by the World Health Organization, is a critical stage of rapid physical, emotional, and behavioural change, during which schoolchildren are increasingly exposed to cardiometabolic risk factors related to unhealthy diets, sedentary lifestyles, psychosocial stress, obesity, family history, and insulin resistance.

 In Sri Lanka, school health promotion is delivered through the Medical Officer of Health (MOH) system and supported by initiatives such as the Clean Sri Lanka School Programme. However, these programmes are often insufficient to address behaviour-driven cardiometabolic risks and are not specifically tailored to the unique needs of adolescents.

To bridge this gap, the Urban School Health Promotion Programme, specifically designed for adolescents, was developed as a comprehensive, activity-based intervention focusing on health awareness and behavioural change communication within schools.

The programme is funded by the International Medical Health Organization (IMHO), with logistical support and administrative approval from the Jaffna Medical Association (JMA) for an initial two-year period, with continuation planned based on evaluation outcomes. It is guided by Dr. M. Aravinthan, Consultant Endocrinologist, as the Content Expert, and Prof. S. Kumaran, Consultant Family Physician, as the Implementation Expert.

Objectives

To promote healthy lifestyles among adolescents by improving dietary habits, physical activity, and psychosocial wellbeing through a structured, interactive, and school-based health promotion programme, while strengthening peer and family support systems and generating evidence to inform sustainable school health policies.

Target Schools and Beneficiaries

The programme is implemented in selected urban schools, namely Jaffna Hindu College, Jaffna St. John’s College, Jaffna Chundikuli Girls’ College, Jaffna Hartley College, and Jaffna Vembadi Girls’ High School, Jaffna Kokuvil Hindu College targeting students in Grades 9 and 10. Following one month of intensive facilitator training conducted by subject experts, ongoing capacity-building support is provided periodically in accordance with stakeholders’ feedback.

Baseline Assessment

A pre-assessment phase established baseline health status using BMI measurements and data on physical activity and breakfast consumption, collected via Kobo Collector and analysed using SPSS. Findings revealed a dual burden of undernutrition and overweight/obesity, irregular breakfast habits, and uneven participation in physical activity, highlighting the need for a structured, equitable, and sustainable school-based intervention programme.

Intervention Components

The intervention programme consists of 20 one-hour, theme-based sessions per school, delivered as one session per week to groups of 80–100 students using peer-based behavioural change strategies, social motivation and positive reinforcement strategies involving the family, school and peers. Sessions are group-based, competitive with marking system, highly interactive and include poster preparation, drama, role-play, debate, games, dance, music, poetry, and painting to promote experiential learning.

Core themes include: –

  • Healthy Diet (2 sessions) – Groupwise poster preparation and drama presentations
  • Physical Exercise (2 sessions) – Basic stretching, mobility exercises and traditional games such as Kummi and Koladdam, practised in groups.
  • The WhyTry module for psychosocial wellbeing (5 sessions) – Visual analogies, self-reflection, real-life scenarios, and team-building activities are utilized to address decision-making (‘The Reality Ride’), resilience (‘Jumping Your Hurdles’), self-worth (‘Tearing off Labels’), perseverance (‘Desire, Time, Effort’), and positive support systems (‘Getting Plugged In’).
  • Career Guidance (5 sessions) – Individual counselling, guest lectures by past pupils from diverse professions, and an educational excursion to expose students to real-world career pathways.
  • Combined sessions (6 sessions) – School cleaning initiatives, healthy food cooking competition, exhibition, canteen modification activities, sports day, and cultural day, with student work showcased to foster pride, confidence, and self-respect. Finally, a reassessment phase will evaluate the programme’s effectiveness in improving students’ cardiometabolic health, and positive findings will be shared with policymakers to inform strengthening of Sri Lanka’s existing School Health Promotion policy. Programme implementation was closely monitored, with feedback obtained from major stakeholders, including students, principals, teachers, facilitators, and evaluators. Students’ feedback was prioritised and consistently indicated high engagement, enjoyment of interactive and creative activities, and a preference for longer sessions. Overall stakeholder feedback highlighted strong participation, improved teamwork, and awareness of healthy behaviours as well as effective implementation and coordination. In conclusion, the Urban School Health Promotion Programme has successfully promoted healthy lifestyle practices through engaging, activity-based, and student-centred approaches. Strong student participation, positive stakeholder feedback, and early outcomes underscore its value as a sustainable school-based health promotion model, while reassessment findings will guide future refinement and support evidence-informed strengthening of national school health promotion strategies.

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