Evaluation of the School Health Programme Among Primary Schools in Ilesa East Local Government Area of Osun State, Nigeria

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Evaluation of the School Health Programme Among Primary Schools in Ilesa East Local Government Area of Osun State, Nigeria EVALUATION OF THE SCHOOL HEALTH PROGRAMME AMONG PRIMARY SCHOOLS IN ILESA EAST LOCAL GOVERNMENT AREA OF OSUN STATE, NIGERIA A DISSERTATION SUBMITTED TO THE NATIONAL POSTGRADUATE MEDICAL COLLEGE OF NIGERIA, IN PART FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF THE FELLOWSHIP OF THE COLLEGE IN PAEDIATRICS. BY OLATUNYA, Oladele Simeon M.B.B.S. (UNILORIN 2000) MAY 2011 1 DECLARATION I hereby declare that this work is original unless otherwise acknowledged. The work has not been presented to any other college for Fellowship award nor, has it been published or submitted for publication elsewhere. Sign Date ----------------------- ------------------ Olatunya Oladele Simeon 2 CERTIFICATION We hereby certify that this study was done by Dr. OLATUNYA OLADELE SIMEON, of the Department of Paediatrics and Child Health Obafemi Awolowo University Teaching Hospital Complex Ile Ife and that the dissertation was written under our supervision. Supervisor Signature------------------ Name- Dr. SBA Oseni Status –Senior Lecturer/ Consultant Department of Paediatrics and Child Health OAUTHC Ile Ife Co- supervisor Signature-------------------- Name- Prof. O.A. Oyelami Status- Professor/ Consultant Department of Paediatrics and Child Health OAUTHC Ile Ife 3 DEDICATION This work is dedicated to the glory of God, my wife, my parents, Tijesunimi our child and all other children of the world. 4 ACKNOWLEDGEMENT I hereby acknowledge with profound gratitude the efforts of my supervisors; Dr SBA Oseni and Prof. O.A. Oyelami for their supports during the study. I also appreciate the assistance rendered by Professors G.A. Oyedeji, J.A. Owa and E.A. Adejuyigbe as well as Drs. N.A Akani, T. A. Aladekomo, J.A. Okeniyi, S. A. Adegoke and other consultants in the Paediatric department of our institution. I give special thanks to the secretary of Ilesa East Local Government Education Authority, Hon. Eniolabi Adeyeye, Mr Adeniyi, (Head of school services of the Local Government Education Authority), Pastor Ajijala (Chairman of Parents’ Teachers’ Association of primary schools in the Local Government Area), Pastor Akinyemi (the Chairman, Association of Private Schools Owners), all the primary school head teachers, pupils and their administrators for their patience and cooperation. I thank immensely Drs. Caleb Adegbenro, Kayode Olaleye and Olorunfemi Ogundele of the Department of Community Medicine OAUTHC Ile Ife, for their support especially in putting me through the data analysis. I am grateful to my wife and fellow residents for their supports during the study. Finally (and most importantly), I am grateful to God the Alpha and Omega. 5 LIST OF ABBREVIATIONS B.Ed – Bachelors Degree in Education CDC – Centre for Disease Control COPSHON – Conference of Primary Schools Head Teachers of Nigeria FRESH – Focusing Resources on Effective School Health GRADE II– Grade II Teachers Training certificate HND – Higher National Diploma HSE – Healthful School Environment IELGA – Ilesa East Local Government Area IELGEA – Ilesa East Local Government Education Authority LGA – Local Government Area MDG – Millennium Development Goal NCE – National Certificate in Education NEEDS – National Economic Empowerment and Development Strategy OAUTHC– Obafemi Awolowo University Teaching Hospital Complex OND – Ordinary National Diploma PTA – Parents’ Teachers’ Association SHCR – School- Home- Community Relationship SHI – School Health Instruction SHS – School Health Services 6 SHP – School Health Programme SPSS – Statistical Programme for Social Sciences UBE – Universal Basic Education UNESCO– United Nations Education, Scientific and Cultural Organisation UNICEF– United Nations International Children’s Emergency Fund USA – United State of America USAID – United States Agency for International Development WHO – World Health Organisation 7 TABLE OF CONTENTS PAGE Title page i Declaration ii Certification iii Dedication iv Acknowledgement v List of Abbreviations vi Table of contents viii List of Tables ix List of Appendices xi Summary xii Introduction 1 Literature Review 3 Relevance of the Study 25 Aims and Objectives 26 Methodology 27 Results 31 Discussion 60 Conclusions 76 Recommendations 77 Limitation 78 References 79 Appendices 89 8 LIST OF TABLES TABLES PAGE I The distribution of pupils and teachers in the schools 31 II Age distribution of schools 32 III Distribution of the qualifications of the teachers interviewed 32 IV Availability of trained first aiders, functional PTA, Extracurricular activities and School health committee 33 Va An outline of Healthful School Environment scores for each of the public schools 34 Vb An outline of Healthful School Environment scores for each of the private schools 35 VI Methods of sewage disposal 36 VII Toilet to pupil ratio 37 VIII Quality of buildings/structures of the schools 39 IX Sitting comforts, food service area and maintenance 40 X Healthful living in the schools 42 XIa An outline of School Health Instruction scores for each of the public schools 43 XIb An outline of School Health Instruction scores for each of the private schools 44 XII Contents / scope of health teaching in the schools 45 XIII Methods of health instruction 46 9 XIV Preparation of teachers for teaching health education 47 XVa An outline of the public schools scores on School Health Services 48 XVb An outline of the private school scores on School Health Services 49 XVI School health personnel in the schools 50 XVII Health appraisal services in the schools 50 XVIII Treatment/Health facilities in the schools 51 XIX Contents of the First Aid box 52 XX Care of emergency illness in the schools 53 XXI The mean scores attained in the various components of SHP by group 55 XXII Independent sample t – test to compare mean scores between the private and public schools in the various components of SHP 56 XXIIIa Total scores of public schools in the various components of SHP 57 XXIIIb Total scores of private schools in the various components of SHP 58 XXIV Age distribution of the schools and their total mean scores on SHP 59 10 LIST OF APPENDICES APPENDIX PAGE I The School Health Programme Evaluation Scale 89 II Letter of consent from the Local Government Education Authority 96 III List of primary schools in Ilesa East Local Government Area 97 IV Letter of appreciation from Ilesa East Local Government Education Authority 98 V Electronic copy of sensitization seminar on school health Programme by the researcher to Ilesa East Local Government primary school community 99 VI Hard copy of sensitization seminar on school health programme by the researcher to Ilesa East Local Government primary school community 100 VII Pictures 104 11 SUMMARY School Health programme (SHP) is a group of coordinated activities which promote the health and development of the school community. It is a veritable tool for the achievement of education and health related Millennium Development Goals (MDG) as its effective implementation helps to prevent various illnesses that greatly impair learning among school children. Although there exist a National School Health Policy of the Federal Ministry of Education, Nigeria, the level of compliance by primary schools in Ilesa East Local Government Area has not been evaluated. The overall aim of the study was to assess the status of School Health Programme as available in primary schools within Ilesa East Local Government in the aspects of School Health Instruction, School Health Services and Healthful School Environment. A cross sectional descriptive study of the School Health Programme in all the 64 primary schools in Ilesa East local government area was done with the use of respondent interview and direct observation. Relevant data was obtained from each school’s head teacher, health teacher and first two pupils (a male and female) on the attendance register present on the day of data collection selected randomly from the most senior classes. The responses were scored using the School Health Programme Evaluation Scale. The 64 primary schools studied were made up of 34 public and 30 private schools. Only three (4.7%) schools (all private) attained up to the minimum acceptable score of 19 in the aspects of School Health Services while only one (1.6%) private school attained up to the minimum acceptable score of 57 in the aspects of Healthful School Environment. None of the schools attained up to the minimum acceptable scores of 27 in the aspects of School Health Instruction nor the minimum total cumulative score of 103 in these three major aspects of SHP assessed. The total mean scores of 63.23 ± 14.57 and 57.50 ± 6.59 obtained 12 by private and public schools respectively, showed a statistical significant difference with the private schools performing better (t= 2.068, df= 62, p=0.043). The overall status of School Health Programme among primary schools in Ilesa East Local Government Area was very poor especially in public schools. There is need for implementation of the National Guidelines on School Health Policy and Sanitation by the agents of the ministries of Education, Health and Environment in the study area. 13 INTRODUCTION School health programme (SHP) is a group of coordinated activities which promotes the health and development of the school population.1,3,4 It uses a multidisciplinary approach and fosters inter sectorial collaboration to enhance sustainable human, economic, community and national development.1,3,4 It encompasses many procedures that are carried out by teachers, health workers, counsellors and school administrators in conjunction with the children’s
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