The State Of Health Services And Needs Of Nursing School Children A Case Study Of Nursing Schools In Ile-Ife, Osun State

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Globally the number of children reaching school age is estimated to be 1.2 billion children (18 % of the world’s population) and rising. This study was therefore designed to determine the school health services available and its practices in primary schools in Ogun state, Western Nigeria.


The study was a comparative cross-sectional survey of private and public primary schools in Ogun state using a multi-stage sampling technique. Participants were interviewed using a structured, interviewer administered questionnaire and a checklist. Data collected was analyzed using the SPSS version 15.0.


A total of 360 head teachers served as respondents for the study with the overall mean age of 45.7 ± 9.9 years. More than three quarters of the respondents in both groups could not correctly define the school health programme. There were no health personnel or a trained first aider in 86 (47.8 %) public and 110 (61.1 %) private schools but a nurse/midwife was present in 57 (31.7 %) and 27 (15.0 %) public and private schools. (χ2 = 17.122, P = 0.002). In about 95 % of the schools, the teacher carried out routine inspection of the pupils while periodic medical examination for staff and pupils was carried out in only 13 (7.2 %) public and 31 (17.2 %) private schools (χ2 = 8.398, P = 0.004). A sick bay/clinic was present in 26 (14.4 %) and 67 (37.2 %) public and private schools respectively (χ2 = 24.371, P = 0.001). The practice of school health programme was dependent on the age (χ2 = 12.53, P = 0.006) and the ethnicity of the respondents (χ2 = 6.330, P = 0.042). Using multivariate analysis only one variable (type of school) was found to be a predictor of school health programme. (OR 4.55, CI 1.918–10.79).


The study concludes that the practice of the various components of school health services was poor but better in private primary schools in Nigeria. Routine inspection by teachers was the commonest form of health appraisal. This may suggest that more health personnel need to be employed to cater for the health of the school children in Nigeria and other similar developing countries.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-016-2006-6) contains supplementary material, which is available to authorized users.

Keywords: School health, Services, Practice, Primary schools, Nigeria


School health services refer to the health care delivery system that is operational within a school or college. These services aim at promoting and maintaining the health of school children so as to give them a good start in life. In addition, these services seek to enable children benefit optimally from their school learning experience []. Globally the number of children reaching school age is estimated to be 1.2 billion children (18 % of the world’s population) and rising []. In many homes across the world, children start to attend school from as early as 5–6 months because mothers have to wean early to return to their work place []. The purpose of the school health services is to help children at school to achieve the maximum health possible for them to obtain full benefit from their education.

School health services deal with health appraisals, control of communicable diseases, record keeping and supervision of the health of school children and personnel []. It is the aspect that concerns itself with the evaluating the health of an individual objectively. Health appraisals afford the school authorities the opportunity to detect signs and symptoms of common diseases as well as signs of emotional disturbances that could impede the learning activities of children []. School health services are both preventive and curative services and it helps in providing information to parents and school personnel on the health status of school children []. It also provides advisory and counselling services for the school community and parents. It include pre-entry medical screening, routine health screening/examination, school health records, sick bay, first aid and referral services. Other services rendered include health observation (which involves physical inspection of the physiology and behaviours of children), health examinations (screening tests and medical diagnosis) and health records (keeping of records of the health histories of children) [].

A National study of the school health system in Nigeria by the Federal Ministries of Health and Education revealed that only 14 % of head teachers indicated that pre-enrolment medical examination was mandatory in their schools and 30 % of the students had low body mass index (BMI). It further indicated that 30 % of students have low BMI and the common health conditions that contribute to absenteeism include fever (56 %), headache (43 %), stomach ache (29 %), cough/catarrh (38 %) and malaria (40 %) [] There is a dearth of school health clinics in Nigeria and where they exist, the services are not comprehensive enough or not organized to meet the needs of the pupils []. Studies have shown that primary school children in Nigeria were not provided with basic health examination services and pre-entrance medical examinations thus baseline health information about them was absent. There is also a lack of routine medical examination which would have picked up deviations from normal which make early referrals impossible and children vulnerable to preventable diseases [].

School health has been described as the neglected component of Primary Health Care in Africa []. Since almost every small community has a primary school, in those communities without health centres, it should be possible to use the primary school as a centre for primary health care delivery not just for the pupils but also for the community []. A well organized and properly executed school health programme can be used to create safe environment for school children []. School health programme can become one of the strategies for promoting primary health care services []. All efforts at addressing the school health programme in Nigeria have remained largely at policy level, with minimal implementation. Where implementation has been attempted the emphasis has been on outside rather than within the schools [].

This study was therefore designed to determine the school health services available and its practices in primary schools in Ogun state Nigeria. This has implications in the primary health care of the school children and reduction in incidence of preventable diseases early in life.


Study area

The study was carried out in Ogun state, South West Nigeria. Ogun state was created on February 3rd 1976 out of the defunct Western Nigeria. The state is named after Ogun River which runs right across it from North to South. Ogun state is situated on latitude 7.00° N and longitude 3.35° E in the Greenwich Meridian. It covers a total land area of 16,409.26 km2 within the South West region of the country. It is bounded in the north by Oyo and Osun states, in the east by Ondo state, in the west by the Republic of Benin which makes it an access route to the expansive market of the Economic Community of West African States (ECOWAS) and in the south by Lagos state and the Atlantic Ocean. The state Capital Abeokuta, lies about 100 km north of Lagos state, Nigeria’s business Capital [].

The projected population of the state as at 2012 is 5.1 million. The people of the state belong to the Yoruba ethnic group of South–West Nigeria. The main ethnic groups of the state are Egbas, Ijebus, Remos, Yewas, Eguns and Aworis. Major occupations in the state are farming trading, artisan and white collar jobs. The three major religion of the people are Christianity, Islam and traditional religion. A greater proportion of the state lies in the tropical rain forest zone []. The state has twenty (20) Local Government Areas (LGA). Each LGA is headed by an Executive Chairman. It has three (3) Senatorial Districts and is divided into four (4) geo-political zones.

Study population

The study population consisted of all the head teachers in public and private primary schools in Ogun state and their schools. The Ogun State Universal Basic Education Board (SUBEB) is in charge of primary school education and activities within the state under the Ministry of Education. The state operate a 6-3-3-4 system of education which means 6 years in primary school, 3 years in junior secondary schools, 3 years in senior secondary school and 4 years in the University. There are One thousand, four hundred and forty nine (1449) registered public primary schools and one thousand, six hundred and ninety four (1694) registered private primary schools within the state making a total of 3143 primary schools [].

The schools have an Administrative Head known as the head teacher and he/she supervises all school activities and the activities of the teaching and non-teaching staff. The head teacher and other staff within the public schools are employed by the State’s Ministry of Education while the private school Heads and Staff are employed by a Proprietor/Proprietress who may also function as the head teacher. All the public schools run the six (6) year programme but some private schools run a five (5) year programme. The private schools usually have an attached Crèche and Nursery Units.

The Zonal Education Office (ZEO) is responsible for compliance and adherence to the Educational standards as specified by the Ministry of Education for all public and private schools within each Zone. In each Local Government, the Local Government Education Authority (LGEA) is directly responsible for the supervision and human resource management of public primary schools. The three (3) Local Government Areas where the study was carried out are Sagamu, Abeokuta South and Ado-Odo/Ota [].

Study design

The study design was a comparative cross sectional study that assessed the school health services in public and private primary schools in Ogun state. All fully registered public and private primary schools in the selected LGAs were included in the sampling frame while all unregistered schools were excluded.

Sample size

A prevalence of 40.4 % of private schools compared to 31.0 % of public schools [] was used to estimate the sample size using the formula for comparative study proportions between two groups.

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