Association between availability and quality of health services in schools and reproductive health outcomes among students: A multilevel observational study

Simon Denny*, Elizabeth Robinson, Catriona Lawler, Sue Bagshaw, Bridget Farrant, Fionna Bell, Dianne Dawson, Diana Nicholson, Mo Hart, Theresa Fleming, Shanthi Ameratunga, Terryann Clark, Maria Kekus, Jennifer Utter

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

15 Citations (Scopus)

Abstract

Objectives. We determined the association between availability and quality of school health services and reproductive health outcomes among sexually active students. 

Methods. We used a 2-stage random sampling cluster design to collect nationally representative data from 9107 students from 96 New Zealand high schools. Students self-reported whether they were sexually active, how often they used condoms or contraception, and their involvement in pregnancy. School administrators completed questionnaires on their school-based health services, including doctor and nursing hours per week, team-based services, and health screening. We conducted analyses using multilevel models controlling for individual variables, with schools treated as random effects. 

Results. There was an inverse association between hours of nursing and doctor time and pregnancy involvement among sexually active students, with fewer pregnancies among students in schools with more than 10 hours of nursing and doctor time per 100 students. There was no association between doctor visits, team-based services, health screening, and reproductive health outcomes. 

Conclusions. School health services are associated with fewer pregnancies among students, but only when the availability of doctor and nursing time exceeds 10 hours per 100 students per week.

Original languageEnglish
Pages (from-to)e14-e20
JournalAmerican Journal of Public Health
Volume102
Issue number10
DOIs
Publication statusPublished - Oct 2012
Externally publishedYes

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