International journal of

ADVANCED AND APPLIED SCIENCES

EISSN: 2313-3724, Print ISSN:2313-626X

Frequency: 12
line decor
  
line decor

 Volume 5, Issue 4 (April 2018), Pages: 56-66

----------------------------------------------

 Original Research Paper

 Title: Identifying barriers to implementation of health promoting schools in Pakistan: The use of qualitative content analysis and fuzzy analytic hierarchy process

 Author(s): Sajid Haider *, Jamil Ahmad, Munir Ahmed

 Affiliation(s):

 Department of Management Sciences, COMSATS, Vehari, Pakistan

 https://doi.org/10.21833/ijaas.2018.04.007

 Full Text - PDF          XML

 Abstract:

Acknowledging government’s failure to implement health promotion approach in Pakistani schools, and recognizing the need for research in this area, this study was initiated with the purpose of providing exploratory insights into the barriers that are hindering implementation of health promoting schools. Both qualitative and quantitative techniques were used. Qualitative study involved interviews and content analysis. Quantitative analysis used multi-criteria decision-making (MCDM) method, called as Fuzzy AHP. Ten important barriers were identified in qualitative analysis. The quantitative analysis identified five most important barriers; little infrastructure, poor behavior of community, lack of govt. support, lack of health promotion skills, and lack of legislation and policy. Although the results of this research are promising for targeting some specific barriers to HPS, how these barriers can be overcome is less clear. Future researchers can approach the experts for identifying possible solutions to these problems. This research informs that any effort towards implementation of health promoting schools in Pakistan will require contemplating barriers identified in this research. This research contributes to school health promotion literature by identifying possible variables which can impede the implementation of HPS approach. Moreover, the application of Fuzzy AHP technique provides sophistication in determining the relative importance of barriers to health promoting schools. 

 © 2018 The Authors. Published by IASE.

 This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

 Keywords: Implementation, Barriers, Health promoting schools, Fuzzy AHP

 Article History: Received 15 November 2017, Received in revised form 30 January 2018, Accepted 2 February 2018

 Digital Object Identifier: 

 https://doi.org/10.21833/ijaas.2018.04.007

 Citation:

 Haider S, Ahmad J, and Ahmed M (2018). Identifying barriers to implementation of health promoting schools in Pakistan: The use of qualitative content analysis and fuzzy analytic hierarchy process. International Journal of Advanced and Applied Sciences, 5(4): 56-66

 Permanent Link:

 http://www.science-gate.com/IJAAS/2018/V5I4/Haider.html

----------------------------------------------

 References (30)

  1. Agmon M, Zlotnick C, and Finkelstein A (2015). The relationship between mentoring on healthy behaviors and well-being among Israeli youth in boarding schools: A mixed-methods study. BMC Pediatrics, 15(1): 11-22. https://doi.org/10.1186/s12887-015-0327-6   [Google Scholar]  PMid:25884174 PMCid:PMC4340683 
  2. Anuar NB, Papadaki M, Furnell S, and Clarke N (2013). Incident prioritisation using analytic hierarchy process (AHP): Risk index model (RIM). Security and Communication Networks, 6(9): 1087-1116. https://doi.org/10.1002/sec.673   [Google Scholar] 
  3. Arif S (2015). Effective school health program could promote child health in Pakistan. International Journal of Innovative Research and Development, 4(2): 47-49.   [Google Scholar]  
  4. Beard TC and Redmond S (1979). Declaration of alma-ata. The Lancet, 313(8109): 217-218. https://doi.org/10.1016/S0140-6736(79)90622-6   [Google Scholar] 
  5. Borade AB, Kannan G, and Bansod SV (2013). Analytical hierarchy process-based framework for VMI adoption. International Journal of Production Research, 51(4): 963-978. https://doi.org/10.1080/00207543.2011.650795   [Google Scholar] 
  6. Chakraborty N, Islam MA, Chowdhury RI, Bari W, and Akhter HH (2003). Determinants of the use of maternal health services in rural Bangladesh. Health Promotion International, 18(4): 327-337. https://doi.org/10.1093/heapro/dag414   [Google Scholar]  PMid:14695364 
  7. Chang DY (1996). Applications of the extent analysis method on fuzzy AHP. European Journal of Operational Research, 95(3): 649-655. https://doi.org/10.1016/0377-2217(95)00300-2   [Google Scholar] 
  8. Chen CT (2000). Extensions of the TOPSIS for group decision-making under fuzzy environment. Fuzzy Sets and Systems, 114(1): 1-9. https://doi.org/10.1016/S0165-0114(97)00377-1   [Google Scholar] 
  9. Deschesnes M, Martin C, and Hill AJ (2003). Comprehensive approaches to school health promotion: How to achieve broader implementation?. Health Promotion International, 18(4): 387-396. https://doi.org/10.1093/heapro/dag410   [Google Scholar]  PMid:14695370 
  10. Dey PK and Cheffi W (2013). Green supply chain performance measurement using the analytic hierarchy process: A comparative analysis of manufacturing organisations. Production Planning and Control, 24(8-9): 702-720. https://doi.org/10.1080/09537287.2012.666859   [Google Scholar] 
  11. Dooris M and Doherty S (2010). Healthy Universities: Current activity and future directions-findings and reflections from a national-level qualitative research study. Global Health Promotion, 17(3): 06-16.   [Google Scholar]     
  12. Dyer RF and Forman EH (1992). Group decision support with the analytic hierarchy process. Decision Support Systems, 8(2): 99-124. https://doi.org/10.1016/0167-9236(92)90003-8   [Google Scholar] 
  13. Ehiri JE (2009). An agenda for child health policy in developing countries. In: Ehiri J (ed.), Maternal and Child Health: 533-541. Springer US, New York, USA. https://doi.org/10.1007/b106524_29   [Google Scholar] 
  14. Evci KE, Ergin F, Okur O, Saruhan G, and Beser E (2012). Local decision makers' awareness of the social determinants of health in Turkey: A cross-sectional study. BMC Public Health, 12, 437. https://doi.org/10.1186/1471-2458-12-437   [Google Scholar]  PMid:22703525 PMCid:PMC3461478 
  15. Govender RD (2005). The barriers and challenges to health promotion in Africa. South African Family Practice, 47(10): 39-42. https://doi.org/10.1080/20786204.2005.10873303   [Google Scholar] 
  16. Haq AN and Kannan G (2006). Fuzzy analytical hierarchy process for evaluating and selecting a vendor in a supply chain model. The International Journal of Advanced Manufacturing Technology, 29(7-8): 826-835. https://doi.org/10.1007/s00170-005-2562-8   [Google Scholar] 
  17. Hills AP, Dengel DR, and Lubans DR (2015). Supporting public health priorities: Recommendations for physical education and physical activity promotion in schools. Progress in Cardiovascular Diseases, 57(4): 368-374. https://doi.org/10.1016/j.pcad.2014.09.010   [Google Scholar]  PMid:25269062 
  18. Jackson SF, Perkins F, Khandor E, Cordwell L, Hamann S, and Buasai S (2006). Integrated health promotion strategies: A contribution to tackling current and future health challenges. Health Promotion International, 21(suppl_1): 75-83.   [Google Scholar]    
  19. Karasek R and Theorell T (1992). Healthy work: stress, productivity, and the reconstruction of working life. Basic Books Publishing, New York, USA.   [Google Scholar]    
  20. Macnab A (2013). The stellenbosch consensus statement on health promoting schools. Global Health Promotion, 20(1): 78-81. https://doi.org/10.1177/1757975912464252   [Google Scholar]  PMid:23563782 
  21. Melo H, de Moura AP, Aires LL, and Cunha LM (2013). Barriers and facilitators to the promotion of healthy eating lifestyles among adolescents at school: the views of school health coordinators. Health Education Research, 28(6): 979-992. https://doi.org/10.1093/her/cyt077   [Google Scholar]  PMid:23861479 
  22. Mon DL, Cheng CH, and Lin JC (1994). Evaluating weapon system using fuzzy analytic hierarchy process based on entropy weight. Fuzzy Sets and Systems, 62(2): 127-134. https://doi.org/10.1016/0165-0114(94)90052-3   [Google Scholar] 
  23. Nutbeam D (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3): 259-267. https://doi.org/10.1093/heapro/15.3.259   [Google Scholar] 
  24. O'Neill M, Rebane D, and Lester C (2004). Barriers to healthier eating in a disadvantaged community. Health Education Journal, 63(3): 220-228. https://doi.org/10.1177/001789690406300303   [Google Scholar] 
  25. Prasla M and Prasla SA (2011). School health promotion–International perspectives and role of health care professionals. Journal of Ayub Medical College Abbottabad, 23(1): 150-153.   [Google Scholar] PMid:22830172     
  26. Pullig C, Maxham JG, and Hair JF (2002). Salesforce automation systems: An exploratory examination of organizational factors associated with effective implementation and salesforce productivity. Journal of Business Research, 55(5): 401-415. https://doi.org/10.1016/S0148-2963(00)00159-4   [Google Scholar] 
  27. Saaty T (1980). The analytic process: Planning, priority setting, resources allocation. McGraw-Hill, London, UK.   [Google Scholar]     
  28. Seigart D, Dietsch E, and Parent M (2013). Barriers to providing school-based health care: International case comparisons. Collegian, 20(1): 43-50. https://doi.org/10.1016/j.colegn.2012.03.003   [Google Scholar] PMid:23678783 
  29. Shaikh BT and Hatcher J (2004). Health seeking behaviour and health service utilization in Pakistan: Challenging the policy makers. Journal of Public Health, 27(1): 49-54. https://doi.org/10.1093/pubmed/fdh207   [Google Scholar] PMid:15590705 
  30. Shaw SR, Gomes P, Polotskaia A, and Jankowska AM (2015). The relationship between student health and academic performance: Implications for school psychologists. School Psychology International, 36(2): 115-134. https://doi.org/10.1177/0143034314565425   [Google Scholar]