School health services in the City of Zagreb - do we meet adolescents' needs?

BACKGROUND School health services (SHS) have in Croatia long tradition, established organizational structure, defined program and educated staff. The program is limited to the preventive activities. The aim of the study was to investigate the satisfaction of the children, school staff and parents with existing school health services in the City of Zagreb. SUBJECT AND METHODS The structured questionnaire was sent to the primary and secondary schools in the City of Zagreb, which were selected using random sample method. The questionnaires were anonymous and filled in supervised by class masters. In the secondary schools the structure of schooling was respected. Questionnaires were filled by 448 pupils from primary, 551 from secondary schools, by 596 parents and 595 teachers. RESULTS In primary schools pupils rated SHS more available and accessible, staff complaisant and responsible, counselling being useful and justified, confidentiality respected higher than pupils from secondary schools (p<0.001). Teachers from primary and secondary schools perceived SHS as valuable school partners (88.9% and 82.3%). Teachers from primary and secondary schools (88.9% and 88.1%) and parents (78.3% and 67.5%) stated that SHS could not be replaced by GPs or paediatricians. Primary school pupils felt that most common problems were injuries and vocational counselling, secondary school pupils assessed behavioural and sexual related problems as mostly challenging. Satisfaction with the SHS response to the most challenging problems was rated higher by teachers from primary schools (p<0.001 for learning difficulties, chronic diseases, bullying and vocational counselling), by parents for learning difficulties and vocational counselling, but no significance was found for pupils' satisfactions. CONCLUSION SHS in Zagreb are recognized as vital and necessary partners for schools, available and accessible for pupils, teachers and parents, especially for primary schools. Counselling is highly rated by all respondents, confidentiality considered as respected, and the problem of the most common challenges as successfully solved.