CHAPTER 5 INTERPRETATION OF FINDINGS
5.2 LEARNER'S HEALTH RISK BEHAVIOURS
5.2.1 Abuse of Alcohol by learners
The findings of this study show that alcohol use is the main health risk problem among learners, and this was confirmed by quantitative data from learners and qualitative data from key informants. Although young people are generally perceived to be of good health, substance use and abuse can increase their risk of injuries, violence, HIV infection, reduced concentration level and other diseases. According to Monitoring the Future Survey for High School and Youth Trends conducted by the National Institute of Drug use (2018) the overall, rates of vaping were second only to alcohol among substances surveyed, with 17.6% of the 8th graders, 32.3% of 10th graders, and
99 37.3% of 12th graders reporting past-year vaping. The survey findings were mixed, in terms of changes in the perceived risk of harm from using various substances. In this study, alcohol and other drug (AOD) use were found as most prevalent/common risks among learners by school, grade and gender as shown in Table 4.3. Alcohol use, was found to be one of the top three health risks among learners rating at 35.9% (n=297) in Mankweng area. According to Onya and Flisher (2008), cited by Tshiṱangano and Tosin (2016), alcohol use had a low prevalence rate among learners in Mankweng area. The low use of alcohol may be attributed to the African values regarding substance abuse, especially by young people, which indicated lack of proper child upbringing by parents. In the same study, the values also classify a substance user as a bad, unmannered and uncultured person.
In addition, most parents would discourage their children from associating with anyone using substances (Kann, McManus, Harris, et al. 2018). The key informants in the current study believed that their schools are in a semi-urban area, although most of the participants estimated at about 85%, said that their schools are rural. They come from rural areas far away from Mankweng, while a low proportion of the learners, about 15% come from urban area. Whether Mankweng is a rural area, semi-rural or urban area is still confusing to educators in this circuit. This uncertainty may be due to the gradual development that has occurred in this area over a period of years.
If the HPS goals and aim can be achieved, this age group can turn out to be a healthier generation in the coming decades. This is because a considerable body of evidence has emerged in the last twenty years to inform governments, schools, NGOs, teachers, parents and learners about effective school health programmes that are integrated, holistic and strategic. This evidence is more likely to produce better health and education outcomes than those that are mainly information-based and implemented only in the classroom.
The prevalence of most health behaviours varies by sex, race/ethnicity, and grade, and across schools and districts. A study conducted by Makwarela, Mammen and Adu, (2017) found that the schools previously had the most violent learners and they had no support from the parents and community members to deal with the challenge, however, after the implementation of the CFS programme, parents and community members were very supportive of the school and there was discipline. Some parents who participated in the CFS programme confirmed that there was a lack of co-
100 operation from the educators, parents and principal but that these attitudes changed after the implementation of the CFS programme, (an initiative similar to HPS by activities and principles), when they all worked as a team, including some of the learners (Makwarela, Mammen and Adu, 2017).
In this study, the top three most common risks which learners are exposed to, in descending order, were found to be alcohol 35.9% (n=297), followed by sexual intercourse 31.2% (n=258) and bullying [(bullied at school 20.9% (n=221); ever bullied anyone 14.8% (n=122)].
Substance use among learners was found to be a leading risk that requires immediate attention at school as key informants said that this risk behaviour causes learners to neglect schoolwork, to get involved in theft and physical fights among themselves and with educators. The findings of this study concur with findings of a study conducted by Tshiṱangano and Tosin (2016) in Cape Town which revealed that, in South Africa, substance abuse is extremely serious, and that drug use was reported as being twice the world norm, with over 15% of the population suffering from a drug problem. The SAPS published figures showing that drug abuse accounts for 60% of all crime in the country (Tshiṱangano & Tosin,2016). Key informants believe that some of these risks are attributed to the fact that learners come from families where parental control is inadequate and learners from such families apply peer pressure on others at school.
The findings also concur with the outcome of the study conducted by the CDC (2016), where the risks, such as not attending physical education classes, using smokeless tobacco and marijuana, remained at the same prevalence rate when compared to the previous studies (CDC, 2016).
The government of South Africa has put in place, and strengthened, policies on drug control, which this includes legislation such as the South African Drugs and Drug Trafficking Act 140 of 1992, which was subsequently replaced by the Prevention of and Treatment for Substance Abuse Act 70 of 2008, promulgated on 01 April 2013.
The Prevention of and Treatment for Substance Abuse Act focuses on new challenges related to the prevention of drug abuse and addresses gaps which existed in the Drugs and Drug Trafficking Act. The aim of the Prevention of and Treatment for Substance Abuse Act is to provide a comprehensive national response for combating substance use; providing mechanisms aimed at demand and harm reduction related to substance
101 use through prevention, and the provision of early intervention, treatment and re- integration programmes (Tshiṱangano & Tosin, 2016).
According to the National Institute of Drug Abuse (NIDA) (2018), alcohol use and binge drinking continued to show a significant five-year decline among all grades in schools.
Past-month use of alcohol was reported to 8.2%, 18.6% and 30.2% in the 8th, 10th, and 12th graders, respectively, compared to 10.2%, 25.7% and 39.2% in 2013. Daily alcohol use and binge drinking (defined as consuming five or more drinks sometime in the past two weeks) also decreased significantly in all grades between 2013 and 2018.
In the same survey, there were significant declines in lifetime, past month and daily binge alcohol use among Grade 12 learners between 2017 and 2018. In addition, the perception of risk associated with binge drinking significantly increased among 12th graders in 2018. The percentage of high school teens who reported ever using alcohol dropped by as much as 58% when compared to peak years. The survey found that 23.5% of 8th graders reported to have ever tried alcohol, which is a 57.9% drop from the peak of 55.8% in 1994.
Among 10th graders, lifetime use of alcohol fell by 40.3% from 72.0% in 1997 to 43.0%
in 2018, while there was a significant 28.4% drop in lifetime alcohol use among 12th graders, from 81.7% in 1997 to 58.5% in 2018.
The HPS could be one of the initiatives that could make use of existing policies to assist a school to develop programmes and control measures that could combat the substance use problem among learners at school. According to Reddy et al. (2010), surveys of schools in South Africa were conducted to look at risks that learners are exposed to, including sexual risks, infrastructure and nutritional patterns. Peu, Mataboge, Ladzani, Wessels, Mostert-Wenzel and Seane (2015) recommended that schools health promotion programs should respond to collaborative interventions, which is a strong principle of the HPSI.
Suicide attempts by adolescents are associated with early initiation of alcohol use before the 13th birthday and early initiation of drinking and smoking increased the risk of suicidal ideation. Suicide attempts among both girls and boys, occur where some learners are raised by a single parent, and have poor self-worth (Kim and Kim ,2010), .
102