Accreditation of schools as Health Promoting Schools and Health Profile Assessment of Selected Accredited Schools in a Northern City of India

Abstract Background: Accreditation is a public recognition of the achievement of required standards by an organization. It certifies the schools for their efforts in implementing health promotion initiatives following an assessment, further helping them in redeveloping and implementing effective HPS strategies.Methods: The current study was conducted in 206 schools of Chandigarh with the objective of assessment and classification on accreditation level (bronze, silver, gold and platinum levels) as health promoting schools; intervention for one year for further quality improvement and reassessment after one year from 2016-2019. Interventions in the form of capacity building, technical visits, supportive supervision to schools, sensitization of policymakers and key stakeholders, implementation of policy initiatives, use of social media, technical support and monitoring of activities) were provided to all schools. Comparative health profile assessment was undertaken 754 children from higher and 700 children from lower accredited schools by GSHS questionnaire.Results : Out of 206 schools, 203 participated in the baseline and 204 in endline assessment. The response rate was 99 %.Two schools which refused participation were excluded and not assessed. Schools (N=17) which participated in the 2011-2013 study were excluded from analysis. There was a statistically difference (p=0.01) in the improvement of accreditation level of the baseline and endline assessment (p<0.05). Overall, the proportion of schools at the gold level increased from 1(0.5%) in 2016 to 71(38%).Silver level from 9(5 %) to 57 (31%) of schools after intervention. The response rate in health profile assessment in higher and lower accredited schools was 95.9% and 92.7% respectively. The health profile higher accreditation level schools (N=754) were found better in hygiene practices protective factors (peer support at school, parental or guardian supervision), handling stress and less prone to injury as compared to lower accreditation level schools (N=700),(p<0.05).Conclusions: The schools accreditation was feasible and lead to significant improvement in accreditation level as compared to baseline assessment (p<0.05).The Health profile assessment was also found to be better in higher as compared to lower accredited schools.Therefore, the accreditation system was found to be feasible, effective and beneficial in terms of improving health profile of children in the school setting.