Perspectives of spinal health within the school setting in a South African rural region: A qualitative study

BACKGROUND: Spinal pain is one of the leading causes of morbidity globally. There is an increase in the number of children and adolescents who experience spinal pain and the lifetime prevalence of adolescent spinal pain varies between countries. In Africa, one in two adolescents experiences spinal pain and the prevalence is increasing. OBJECTIVE: This study reports on the knowledge and perspectives of school-attending children, adolescents, teachers, and parents/guardians regarding spinal health. METHODS: We conducted a descriptive qualitative case study with an interpretative and phenomenological approach. Data coding, management and analysis was done using ATLAS.ti computer software. RESULTS: Ninety-three participants (66 women and 27 men) were enrolled in the study. The barriers associated with students' spinal health were multifactorial, including low levels of physical activity, dangerous gameplay, sports risks, poor ergonomics, school bags, insufficient knowledge, and pregnancy risks. Participants proposed strategies to improve spinal health including the provision of students' lockers, advice on appropriate school bag types, embedding spinal education in the curriculum, general adocacy for spinal health, and integration of technology in teaching and learning. CONCLUSION: There is a need for further engagement on school-based spinal health promotion programs that consider local socio-economic, educational, and cultural factors.