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Health Behavior and Protective Factors Among School Children in Four African Countries

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Increasing trends of non-communicable diseases is a worldwide phenomenon including in the developing countries. Few studies focus on adolescent’s positive health and their predictors.


The aim of this study was to investigate aspects of adolescent’s health enhancing health behaviors and their relationship with potentially protective factors in the home and school environment.


The sample included 12,740 students at the ages from 13 to 15 years from four African countries (Kenya, Namibia, Uganda, and Zimbabwe) chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The measure used was part of the Global School-Based Health Survey questionnaire including various domains of health behavior.


More than 70% of the participants scored positively for the items concerning non-tobacco use, limiting alcohol consumption, non-drug use, washing hands before eating, and were abstinent or had used a condom at last sex, while fewer than 50% fulfilled criteria for washing hands with soap, never bullied in the past 30 days, no passive smoking, condom use at last sex, physically active for at least 60 min per day for 3 days in a week, and walk or bike to school. Multiple logistic regression identified school attendance, parental or guardian connectedness, peer support at school, and parental supervision are important for adolescent health in this sample.


These findings enable health care professionals and researchers designing intervention studies to promote positive health practices.

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I am grateful to the World Health Organization (Geneva) for making the data available for analysis. I also thank the Ministries of Education and Health and the study participants for making the Global School Health Survey in the four African countries possible. The governments of the respective study countries and the World Health Organization did not influence the analysis, nor did they have influence on decision to publish these findings. Finally, reviewers are thanked for their useful comments.

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The authors declare that they have no competing interests to declare.

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Correspondence to Karl Peltzer.

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Peltzer, K. Health Behavior and Protective Factors Among School Children in Four African Countries. Int.J. Behav. Med. 16, 172–180 (2009).

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