Creating health-promoting schools in rural China: a project started from deworming.

Intestinal helminth infection is highly endemic in rural areas of China. This project was implemented to determine if deworming efforts through schools could reduce helminth infections and successfully serve as an entry point for developing a more comprehensive approach to school health, i.e. the components of ‘health-promoting schools’. Six primary and junior secondary schools with 6188 students were involved in the project. Major interventions in four experiment schools included: examination and treatment of helminth infections; health education; improvement of school physical environment; establishment of relevant school policies and regulations; and strengthening relationship between school and community. The only intervention taken by the other two schools as controls was deworming. After 1 year of implementation, helminth infection in students and environmental contamination by helminth eggs in experiment schools decreased by ~80%, significantly higher than that in control schools. Remarkable improvements in students' knowledge, behaviour and skills of health protection, in school physical facilities, in school/community relationship, and in relevant policies and practices, were also observed in the experiment schools. The conclusions are that the concept of the health-promoting school has been well accepted by the students, teachers, parents and local government officers, and that helminth reduction is an effective and feasible entry point for establishing health-promoting schools in rural areas where helminth infection has been an important public health problem.