Coverage of school health monitoring systems in China: a large national cross-sectional survey

Summary: Background: There is growing interest in the role that schools can play in promoting student health. The aim of this study was to describe the coverage of school health monitoring systems for infectious diseases, non-communicable diseases, and school physical environments in China, and to explore differences by geography, regional wealth, and school type. Methods: A cross-sectional study was performed using data from 2428 schools from 17 provinces in China in 2018. Data were collected using a questionnaire administered by the Ministry of Education through its monitoring system, and included infectious diseases (e.g., reporting system for student infectious diseases), non-communicable diseases (e.g., regular student health examinations), and school physical environments (e.g., monitoring of classroom light, microclimate and drinking water). Findings: Overall, the coverage rate of full school health monitoring systems was 16·6%. The coverage rates of school health monitoring systems for infectious diseases, non-communicable diseases, and school physical environments were 71·2%, 68·5%, and 24·9%, respectively. Coverage was higher in schools from urban rather than rural areas, in schools from areas with greater wealth, and in senior secondary schools rather than junior secondary and primary schools. Interpretation: Systems for monitoring infectious diseases in school students have been widely implemented in China. Systems for monitoring non-communicable diseases and physical environments need to be strengthened. Beyond greater attention in poorer and rural areas, increased investment in more comprehensive approaches to school health is indicated. Funding: This study was supported by National Statistical Science Research Project (2021LY052 to YS) and China Scholarship Council (201906015028 to PH). 摘要: 背景: 学校在促进学生健康方面可以发挥的作用越来越引起关注○ 本研究旨在描述传染病, 非传染性疾病和学校物理环境三方面的学校卫生监测制度在中国的覆盖情况, 并探讨其在不同区域, 地区经济发展水平和学校类型上的差异○方法: 数据来源于2018年在中国17个省 (市, 区)2428所学校进行的一项横断面研究○ 使用中国教育部指导下设计的调查问卷, 通过其在17省的监测站体系, 收集了学校卫生监测制度的覆盖数据, 包括传染病 (如学生传染病报告制度), 非传染性疾病 (如学生定期体检)和学校物理环境 (如教室采光照明, 教室微小气候和生活饮用水的监测)三方面○结果: 总体上, 全面的学校卫生监测制度覆盖率仅为16.6%○ 针对传染病, 非传染性疾病和学校物理环境的学校卫生监测制度的覆盖率分别为71.2%, 68.5%和24.9%○ 针对传染病, 非传染性疾病和学校物理环境方面的制度覆盖率表现较为一致, 均呈现城市高于乡村, 经济发达地区高于欠发达地区, 高中高于初中和小学的情况○解释: 在中国, 针对在校学生的传染病监测制度已被广泛实施.针对非传染性疾病和物理环境的监测制度尚需要得到强化○ 除了对贫困地区和乡村地区给予更多关注外, 还需要在更全面的学校卫生措施上增加投资○基金: 全国统计科学研究项目 (2021LY052 to YS)和国家留学基金 (201906015028 to PH)