TAILIEUCHUNG - School-Based Health and Nutrition Programs

Approximately 75% of COPD cases are attributed to cigarette smoking (5). Occupation-related exposures may account for another 15% of COPD cases (6) and genetic factors, asthma, respiratory infections, and indoor and outdoor exposures to air pollutants also play a role (6,7). hus, COPD largely can be prevented. Prevention of COPD begins with reducing and/ or eliminating smoking initiation among teenagers and young adults and encouraging tobacco cessation among current smokers. More than 20 million workers in the United States have been exposed to gases, vapors, fumes, and dusts that may cause COPD (6). Public health programs and policies that focus. | Chapter 58 School-Based Health and Nutrition Programs Donald A. P Bundy Sheldon Shaeffer Matthew Jukes Kathleen Beegle Amaya Gillespie Lesley Drake Seung-hee Frances Lee Anna-Maria Hoffman Jack Jones Arlene Mitchell Delia Barcelona Balla Camara Chuck Golmar Lorenzo Savioli Malick Sembene Tsutomu Takeuchi and Cream Wright The paradigmatic shift in the past decade in our understanding of the role of health and nutrition in school-age children has fundamental implications for the design of effective programs. Improving the health and nutrition of schoolchildren through school-based programs is not a new concept. School health programs are ubiquitous in high-income countries and most middle-income countries. In low-income countries these programs were a common feature of early particularly colonial education systems where they could be characterized as heavily focused on clinical diagnosis and treatment and on elite schools in urban centers. This situation is changing as new policies and partnerships are being formulated to help ensure that programs focus on promoting health and improving the educational outcomes of children as well as being socially progressive and specifically targeting the poor girls and other disadvantaged children. This evolution reflects five key changes in our understanding of the role of these programs in child development. First ensuring good health at school age requires a life cycle approach to intervention starting in utero and continuing throughout child development. In programmatic terms this requirement implies a sequence of programs to promote maternal and reproductive health management of childhood illness and early childhood care and development. Promoting good health and nutrition before and during school age is essential to effective growth and development. Second operations research shows that the preexisting infrastructure of the educational system can often offer a more cost-effective route for delivery of simple health .

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