Finalidades de la evaluación.

RESULTS

A total of three hundred and sixty questionnaires were distributed and three hundred and sixty were returned, giving a 100% response. All the checklists, 360 in number were also returned. Below are the results:

45

TABLE I: CHARACTERISTICS OF RESPONDENTS’ SOCIO-DEMOGRAPHIC VARIABLES CHARACTERISTICS PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Age at last birthday 21-30

31-40 41-50 51-60

>/=60

0 (0.0) 2 (1.1) 31 (17.2) 147 (81.7) 0 (0.0)

30 (16.7) 110 (61.1) 30 (16.7) 9 (5.0) 1 (0.6)

30 (8.3) 112 (31.1) 61 (16.9) 156 (43.3) 1 (0.3)

2.250 0.001

Sex Male Female

39 (21.7) 141 (78.3)

51 (28.3) 129 (71.7)

90 (25.0) 270 (75.0)

1.809 0.179

Marital Status Single Married

Separated/Divorced Widowed

5 (2.8) 152 (87.8) 3 (1.7) 14 (7.8)

31 (17.2) 144(80.0) 1 (0.6) 4 (2.2)

36 (10.0) 302 (83.9) 4 (1.1) 18 (5.0)

25.803 0.001

Religion Christianity Islam Others

155 (86.1) 24 (13.3) 1 (0.6)

158( 87.8) 20 (11.1) 2(1.1)

313 (86.9) 44 (12.2) 3 (0.8)

0.966 0.617

Ethnicity Hausa Ibo Yoruba Others

0 (0.0) 18 (10.0) 158 (87.8) 4 (2.2)

0 (0.0) 32 (17.8) 141 (78.3) 7 (3.9)

0 (0) 50 (13.8) 299 (83.1) 11 (3.1)

5.343 0.069

Highest Educational Qualification

Masters Degree University Degree

Certificate from College of Education

Teacher’s Training School Certificate

8 (4.4) 98 (54.4) 69 (38.3)

5 (2.8)

17 (9.4) 93 (51.7) 59 (32.8)

11 (6.1)

25 (6.9) 191 (53.1) 128 (^35.6)

16 (4.4)

7.417 0.060

How long have you been a Head Teacher

1-5 Years 6-10 Years 11-15 Years

>15 Years

93 (51.7) 35 (19.4) 20 (11.1) 32 (17.8)

98 (54.4) 47 (26.1) 19 (10.6) 16 (8.9)

191 (53.1) 82 (22.8) 39 (10.8) 48 (13.3)

6.804 0.078

The overall mean age of all the Head Teachers was 45.7± 9.9 years. The mean age of the Head Teachers in Public Schools was 53.0 ± 3.6 years while that for the Head

Teachers in the Private Schools was 37.4 ± 8.0 years. Majority of the Public School Head

46

Teachers, 147 (81.7%) fell into the 51-60 age group, while the highest number of the Private School Head Teachers, 110(61.1%) were in the 31-40 age group. The Private Head Teachers also had 30 (16.7%) members in the 21-30 age group while the Public Head Teachers had 0 (0%) members within that age group. There is a statistically significant difference in age between the Public and Private School Head Teachers (X²= 2.250, p=0.001).

Female Head Teachers outnumbered their male counterparts in both the Public and Private Schools. The Public Schools had a total of 141 (78.3%) Female Head Teachers while the Private Schools had 129 (72.7%) Female Head Teachers. This showed no statistically significant difference. (X²= 1.809, p= 0.179).

A high percentage of the total respondents numbering 302 (83.9%) were married. This was similar in both Public School Teachers, 152 (87.8%) and Private School Teachers, 144 (80.0%). However, 5 (2.8%) of the Public School Head Teachers were single, compared with 31 (17.2%) of the Private School Teachers. The marital status of both groups showed a statistically significant difference (X² = 25.803, p= 0.001).

Over 80% of the respondents were Christians: One hundred and fifty five (86.1%) of the Public School Teachers and 158 (87.8%) of the Private School Teachers. This had no statistically significant difference (X² = 0.966, p =0.617).

Most of the respondents were of the Yoruba tribe: One hundred and fifty eight (87.8%) of the Public Teachers and 141 (78.3%) of the Private Teachers. There was no statistically significant difference in the ethnicity of the Head Teachers in Public and Private Schools (X²= 5.343, p= 0.069).

About half of the Teachers in both groups had a University degree as their highest educational qualification: Ninety eight (54.4%) of the Public School Teachers and 93

47

(51.7%) of the Private School Teachers. However, 8 (4.4%) of the Public School Teachers had a Masters Degree compared to 17 (9.4%) of the Private School Teachers. This showed no statistical significance. (X²= 7.417, p= 0.060).

Ninety three (51.7%) and 98 (54.4%) of the Public and Private School Teachers respectively had between 1-5 years working experience as a Head Teacher. Whereas, 32 (17.8%) of the Public School Teachers and 16 (9.0%) of the Private School

Teachers had been working as a Head Teacher for over 15 years. This gave no statistically significant difference (X²= 6.804, p= 0.078).

48 SECTION B

KNOWLEDGE OF SCHOOL HEAD TEACHERS: The knowledge of the respondents regarding SHP was explored and the relevant findings are presented below.

TABLE II A: KNOWLEDGE OF RESPONDENTS’ ABOUT SCHOOL HEALTH PROGRAMME

KNOWLEDGE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Definition of school health programme

(Poor) (Fair) (Good)

166 (92.2) 12 (6.7) 2 (1.1)

167 (92.8) 13 (7.2) 0 (0.0)

333 (92.5) 25 (6.9) 2 (0.6)

2.043 0.360

Knowledge of the components of school health programme

(Poor) (Fair) (Good)

164 (91.1) 15 (8.3) 1 (0.6)

167 (92.8) 9 (5.0) 4 (2.2)

331 (91.9) 24 (6.7) 5 (1.4)

3.327 0.189

Knowledge of the impact of medical record keeping in School Health Programme

Correct Incorrect

176 (97.8) 4 (2.2)

175 (97.2) 5 (2.8)

351 (97.5) 9 (2.5)

0.203

0.652 Knowledge of the role of school

health programme in the care of children with disabilities

Correct Incorrect

62 (34.4) 118 (65.6)

42 (23.3) 138 (76.7))

104 (28.9) 256 (71.1)

5.083 0.024

Knowledge of school feeding services among head teachers Correct

Incorrect

169 (93.9) 11 (6.1)

155 (86.1)) 25 (13.9)

324 (90.0) 36 (10.0)

4.562 0.033

Relevance of dental inspection and health in School Health Programme.

Correct Incorrect

169 (^93.9) 11 (6.1)

164 (91.1) 16 (^8.9)

333 (92.5) 27 (7.5)

1.133 0.287

Effective knowledge of First Aid among Head Teachers

Correct Incorrect

140 (77.8) 40 (22.2)

130 (72.2) 50 (^27.8)

270 (75.0) 90 (25.0)

1.398 0.237

49

More than three quarters of the Head Teachers in both groups could not provide a basic definition of the School Health Programme. While 166 (92.2%) of the Public School Head Teacher had a poor definition with scores between 0-1 out of a possible 4 marks, 167 (92.8%) of the Private School Head Teachers also had a poor definition with the same scores (X²= 2.043, p= 0.360). Again both sets of Head Teachers, 164 (91.1%) of the Public School Head Teachers and 167 (92.8%) of the Private School Head Teachers were unable to correctly list the components of the School Health Programme and scored between 0-1 (X²= 3.327, p= 0.189). The scores for definition and components of School Health Programme between the Public and Private Schools’

Head Teachers showed no statistically significant difference.

A high percentage 176 (97.8%) and 175 (97.2%) of the Public and Private Schools’

Head Teachers felt that Health records of school children must be consistently updated periodically and this did not show a statistically significant difference (X²= 0.336, p= 0.845). Sixty two (34.4%) of the Public School Head Teachers and 42 (23.3), of the Private School Teachers were of the opinion that School Health Programme made provision for physically and emotionally challenged children.

However, 118 (65.6%) and 138 (76.7%) of the Public and Private School Teachers felt it did not. This was a statistically significant difference (X²= 5.083, p= 0.024).

In response to the question, ‘school nutrition services will reduce hunger and malnutrition among learners’, 169 (93.9%) of the Public School Head Teachers and 155 (86.1%) of the Private School Teachers answered correctly and this gave a statistically significant difference (X²= 4.562, p= 0.033). One hundred and sixty nine (93.9%) and 164 (91.1%) of the Public and Private School Head Teachers were of the

50

opinion that inspection of children would also include both tooth decay and bad breath (X²= 1.133, p= 0.287). This was not statistically significant.

While 40 (22.2%) of the Public School Head Teachers and 50 (27.8%) of the Private School Head Teachers did not know if basic life support is an integral skill needed by the school’s first aider, 140 (77.8%) and 130 (72.2%) of the Public and Private School Head Teachers respectively responded that it was needed. However, there was not a significant statistical difference (X²= 1.398, p= 0.237).

51

TABLE II B: KNOWLEDGE OF RESPONDENTS ABOUT SCHOOL HEALTH PROGRAM

KNOWLEDGE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Knowledge of the role of advocacy and community participation for an effective School Health Programme Correct

Incorrect

148 (82.2) 32 (17.8)

149 (82.8) 31(17.2)

279 (82.5) 63 (17.5)

0. 019 0.890 Knowledge of environmental factors

and its influence on School Health Programme

Correct Incorrect

151 (83.9) 29 (16.1)

156 (86.7) 24 (13.3)

307 (85.3) 53 (14.7)

0.553 0.457

Knowledge of the sources of funding for School Health Programme activities

Correct Incorrect

50 (27.8) 130 (72.2)

54 (30.0) 126 (70.0)

104 (28.9) 256 (71.1)

0.216 0.642

Knowledge of the relationship between School Health Program and Millennium Development Goals Correct

Incorrect

147 (81.7) 33 (18.3)

152 (84.4) 28(15.6)

299 (83.1) 61 (16.9)

0.493 0.482

Knowledge of School Health Program as part of World Health Organization’s strategy to produce health promoting schools worldwide Correct

Incorrect

168 (93.3) 12(6.7)

156 (86.7) 24 (13.3)

324 (90.0) 36 (10.0)

4.444 0.073 Knowledge of the most important

personnel/ staff needed in the implementation of School Health Program activities

Correct Incorrect

18 (10.0) 162(90.0)

77 (42.8) 103(^57.2)

95 (26.4) 265 (73.6)

49.778 0.001

One hundred and forty eight (82.2%) of the Public School Head Teachers and 149 (82.8%) of the Private School Head Teachers were of the opinion that advocacy to community and the parents was necessary to have an effective School Health Programme (X²= 0.019, p= 0.890).

52

A high number of respondents, 151 (83.9%) of Public School Head Teachers and 156 (86.7%) of the Private School Head Teachers said that schools should not be sited close to the community market area to provide easy access to traders’ children (X²= 0.553, p= 0.457). This difference was not statistically significant.

While 130 (72.2%) of the Head Teachers in Public Schools felt that government must provide all the funding needed for School Health Programme activities, 50 (28.7%) of them felt funding should come from other sources. On the other hand, 126 (70.0%) of the Private School Head Teachers felt government should provide all the funding while 54 (30.0%) were of the opinion that there should be other sources of funding (X²= 0.216, p= 0.624).

One hundred and forty seven (81.7%) and 152 (84.4%) of the Public and Private School Teachers respectively were of the opinion that the School Health Programme plays a vital role in the attainment of Millennium Development Goals (X²= 0.493, p=

0.482).

That the School Health Programme is part of the World Health Organization’s strategy to produce health promoting schools worldwide was affirmed by 168 (93.3%) of the Public School Head Teachers and 156 (86.7%) of the Private School Head Teachers.

These last two parameters were not statistically significant.

Very few respondents that is 18 (10.0%) among the Public School Head Teachers compared to 77 (42.8%) among the Private School Head Teachers knew that the key personnel/ staff needed in the implementation of School Health Programme activities in school is the Head Teacher. Most 162 (90.0%) and 103 (57.2%) among Public and

53

Private Head Teachers, gave incorrect answers. This showed a statistically significant difference. (X²= 49.778, p= 0.001).

Overall the total knowledge score was 25. The mean knowledge score for both groups was 11.33±3.17. The mean knowledge score for the Public School Head Teachers was 11.78±2.83 while that of the Private School Head Teachers was 10.86±3.48 with a mean difference of 0.92±0.34. This result was statistically significant (t= 2.620, p=

0.01; 95%CI = 0.23).

54 SECTION C

The Practice of the various components of the School Health Programme among the schools was determined essentially with the Checklist. The findings are presented below:

SCHOOL HEALTH SERVICES.

TABLE III A: PRACTICE OF SCHOOL HEALTH SERVICES IN PUBLIC AND PRIVATE SCHOOLS.

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

PERSONNEL None

Health Assistant/Trained First-Aider Health Educator/Nutritionist Nurse/Midwife

Doctor

86 (47.8) 24 (13.3) 11 (6.1) 57 (31.7) 2 (1.1)

110 (61.1) 33(18.3) 10 (5.6) 27 (15.0) 0 (0.0)

196 (54.4) 57 (15.8) 21 (5.8) 84 (23.3) 2 (0.6)

17.122 0.002

HEALTH APPRAISALS

Routine (Teacher) Inspection Yes

No

Screening test for growth defect, Handicaps, Disabilities

Yes No

Periodic Medical Exams for Staff &

Pupils Yes No

Referrals to Health Centres/Hospitals Yes

No

Supervision of Health of the Handicapped

Yes No

168 (93.3) 12 (6.7)

14 (7.8) 166 (92.2)

13 (7.2) 167 (92.8) 82 (45.6) 98 (54.4)

14 (7.8) 166 (92.2)

175 (97.2) 5 (2.8)

10 (5.6) 170 (94.4)

31 (17.2) 149 (82.8) 88 (48.9) 92 (51.1)

7 (3.9) 173 (96.1)

343 (95.3) 17 (4.7)

24 (6.7) 336 (93.3)

44 (12.2) 316 (87.8) 170 (47.2) 190 (52.8)

21 (5.8) 339 (94.2)

3.025

0.714

8.398

0.401

2.478

0.082

0.398

0.004

0.526

0.115

There was no health personnel or a trained first aider in 86 (47.8%) Public Schools and 110 (61.1%) Private Schools. Also, a Nurse/ Midwife was present in 57 (31.7%) and 27 (15.0%) Public and Private Schools respectively. The findings on the

55

availability and the type of health personnel in the schools were statistically significant. (X²= 17.122, P= 0.002).

Periodic medical examination for staff and pupils was carried out in only 13 (7.2%) Public Schools and 31 (17.2%) Private Schools. This was a statistically significant finding (X²= 8.398, P= 0.004).

56

TABLE III B: PRACTICE OF SCHOOL HEALTH SERVICES IN PUBLIC AND PRIVATE SCHOOLS

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

TREATMENT FACILITIES First Aid Box

Yes No

Essential Drugs & Materials Yes

No

Sick Bay/Clinic Yes

No

Ambulance/School Bus Yes

No

167 (92.8) 13 (7.2) 114 (63.3) 66 (36.7) 26 (14.4) 154 (85.6) 5 (2.8) 175 (97.2)

162 (90.0) 18 (10.0) 140 (77.8) 40 (22.2) 67 (37.2) 113 (62.8) 44 (24.4) 136 (75.6)

329 (91.4) 31 (8.6) 254 (70.6) 106 (29.4) 93 (25.8) 267 (74.2) 49 (13.6) 311 (86.4)

0.882

9.039

24.371

35.931

0.348

0.003

0.001

0.001 EMERGENCY CARE

First Aid Treatment Usually given Yes

No

Treatment Given Recorded or Referral copy seen

Yes No

Notification of Parent Yes

No

Transport Child to nearest Health Post

Yes No

Transport Child Home Afterwards Yes

No

147 (81.7) 33 (18.3)

39 (21.7) 141 (78.3) 149 (82.8) 31 (17.2)

115 (63.9) 65 (36.1) 42 (23.3) 138 (76.7)

167 (92.8) 13 (7.2)

33 (18.3) 147 (81.7) 158 (87.8) 22 (12.2)

132 (73.3) 48 (26.7) 34 (18.9) 146 (81.1)

314 (87.2) 46 (12.8)

72 (20.0) 288 (80.0) 307 (85.3) 53 (14.7)

247 (68.6) 113 (31.4) 76 (21.1) 284 (78.9)

9.970

0.625

1.792

3.728

1.067

0.002

0.429

0.181

0.054

0.302 HEALTH RECORDS

No Records Available

Available but not Cummulative Cummulative but not transferrable Cummulative and transferrable

132 (73.3) 37 (20.6) 10 (5.5) 1 (0.6)

126 (70.0) 42 (23.3) 8 (4.5) 4 (2.2)

258 (71.7) 79 (21.9) 18 (5.0) 5 (1.4)

2.478 0.479

Wash hand basins and stands in class

Yes No

32 (17.8) 148 (82.2)

54 (30.0) 126 (70.0)

86 (23.9) 274 (76.1)

7.394 0.007

Dust bins and waste paper baskets available

Yes No

58 (32.2) 122 (67.8)

123 (68.3) 57 (31.7)

181 (50.3) 179 (49.7)

46.946 0.001

57

Essential drugs and materials were totally absent in 66 (36.7%) of Public Schools and 40 (22.2%) of Private Schools. (X²⁼ 9.039, P= 0.003). A sick bay/ clinic was present only in 26 (14.4%) and 67 (37.2%) Public and Private Schools respectively. (X²= 24.371, P= 0.001). While an ambulance/ school bus was present in 5 (2.8%) of the Public Schools, 44 (24.4%) of the Private Schools had an ambulance or a school bus.

(X² =35.931, P= 0.001). All these three parameters showed statistically significant findings.

First Aid of any type was unavailable in 33 (18.3%) Public Schools and 13 (7.2%) Private Schools. This was a statistically relevant finding. (X²= 9.970, P= 0.002).

Wash hand basins and stands were present in 32 (17.8%) and 54 (30.0%) Public and Private Schools respectively. This was however statistically significant. (X²= 7.394, P= 0.007).

Dust bins and waste paper baskets were available in 58 (32.2%) Public Schools and 123 (68.3%) Private Schools. This was a statistically significant finding. (X²= 46.946, P= 0.001).

58 SCHOOL FEEDING SERVICES

TABLE IV: PRACTICE OF SCHOOL FEEDING SERVICES IN PUBLIC AND PRIVATE SCHOOLS

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

School meals available Yes

No

Screening of Vendors /Food Handlers

Yes No

Training & Certification of Food handlers/ Vendors Yes

No

Cleanliness of food area Poor

Good

Nutritional Supplement Yes

No

151 (83.9) 29 (16.1)

124 (68.9) 56 (31.1)

122 (67.8) 58 (32.2) 143 (85.0) 27 (15.0) 36 (20.0) 144 (80.0)

139 (77.2) 41 (22.8)

81 (39.6) 99 (60.4)

71 (39.4) 109 (60.6) 113 (62.8) 67 (^37.2) 41 (22.8) 139 (77.2)

290 (80.6) 70 (19.4)

205 (56.9) 155 (43.1)

193 (53.6) 167 (46.4) 266 (73.8) 94 (26.1 ) 77 (21.4) 283 (78.6)

2.554

20.949

29.052

23.150

0.413

0.110

0.001

0.001

0.001

0.520

Food vendors/ handlers were not screened for any diseases in 56 (31.1%) Public Schools and 99 (60.4%) Private Schools (X²= 20.949, P= 0.001). No formal training or certification of handlers/ vendors had ever been done in 58 (32.2%) Public Schools and 109 (60.6%) of Private Schools (X²= 29.052, P= 0.001). These two practices under the School Feeding Services were statistically significant between Public and Private Schools.

The cleanliness of the food area was assessed and was seen to be poor in 143

(85.0%) of the Public Schools and 113 (62.8%) of the Private Schools assessed (X²= 23.150, P= 0.001). This finding was statistically significant.

59 SKILL BASED HEALTH EDUCATION

TABLE V: PRACTICE OF SKILL BASED HEALTH EDUCATION IN PUBLIC AND PRIVATE SCHOOLS

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

HEALTH INSTRUCTIONS None

One Period per Week Two periods per week Three periods per week

13 (7.2) 30 (16.7) 97 (53.9) 40 (22.2)

8 (4.4) 46 (25.6) 87 (48.3) 39 (21.7)

21 (5.8) 76 (21.1) 184 (51.1) 79 (22.0)

5.115 0.164

A total of 167 (92.8%) of Public Schools and 172 (95.6%) of Private Schools had varied periods of health education per week. However this was not statistically significant.

None of the Schools within this study had any health promoting Information,

Education and Communication (IEC) materials in and around the school compound.

There was also no evidence of a health based or health promoting activity group, club or society among pupils and staff in any of the schools.

60 HEALTHFUL SCHOOL ENVIRONMENT

TABLE VI A: PRACTICE OF HEALTHFUL SCHOOL ENVIRONMENT IN PUBLIC AND PRIVATE SCHOOLS

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Water supply Pipe Borne

Bore Hole/Mono Pump Wells

Surface water None

17 (9.4) 90 (50.0) 14 (7.8) 3 (1.7) 56 (31.1)

34 (18.9) 97 (53.9) 30 (16.7) 0 (0.0) 19 (10.5)

51 (14.2) 187 (52.0) 44 (12.2) 3 (0.8) 75 (20.8)

33 0.001

Distance of water supply Within the school

<200 meters outside school

>200 meters outside school

72 (40.0) 67 (^37.2) 41 (22.8)

94 (52.2) 67 (^37.2) 19 (10.6)

166 (46.1) 134(^37.2) 60 (16.7)

10.982 0.004 Refuse Disposal

Open Dumping/Burning Controlled Tipping Incineration

162 (90.0) 12 (6.7) 6 (3.3)

128 (71.1) 44 (24.5) 8 (4.4)

290 (80.6) 56 (15.6) 14 (3.8)

22.56 0.001

Sewage Disposal Surface (Bush/Water) Bucket

Pit/Trench

Water Closet/Septic tank

20 (11.1) 6 (3.3) 114 (63.3) 40 (22.3)

3(1.7) 2 (1.1) 67 (37.2) 108 (60.0)

23 (6.4) 8 (2.2) 181 (50.3) 148 (41.1)

58.013 0.001

Gender Differentiated Toilets

Yes No

Toilet Rolls Available Yes

No

Soap for Hand wash available

Yes No

State of Toilet and Toilet area

Poor Good

61 (33.9) 119 (66.1) 135 (75) 45 (25)

23 (12.8) 157 (87.2)

158 (^87.8) 22 (12.2)

86 (47.8) 94 (52.2) 169 (93.9) 11 (6.1)

80 (44.4) 100 (55.6)

137 (76.1) 43 (^23.9)

147 (40.8) 213 (59.2) 304 (84.4) 56 (15.6)

103 (28.7) 257 (71.3)

295 (81.9) 65 (^18.1)

7.186

24.445

44.186

8.280

0.007

0.001

0.001

0.004 Toilet Pupil Ratio

None 1>90 1:61-90 1:46-60 1:31-45 1:<30

66(^36.7) 58 (32.2) 12 (6.7) 17 (9.4) 17 (9.4) 10 (5.6)

44 (24.4) 29 (16.2) 24 (13.3) 18 (10.0) 22 (12.2) 43 (23.9)

110 (30.6) 87 (24.2) 36 (10.0) 35 (9.77) 39 (10.8) 53 (14.2)

39.283 0.001

61

About half of the respondents in both groups, 90 (50.0%) and 97 (53.9%) in Public and Private Schools respectively use a bore hole or a mono pump as their source of water supply. However, 14 (7.8%) Public Schools and 30 (16.7%) Private Schools make use of well water (X²= 33, P= 0.001). Forty one (22.8%) and 19 (10.6%) of the Public and Private Schools respectively had their water source >200meters outside the School (X²=10.982, P=0.004). Most of the schools practiced open dumping/

burning of refuse with 162 (90.0%) Public Schools and 128 (71.1%) Private Schools (X²= 46.22, P= 0.001). These three practices were all statistically significant

Water closet/ septic tank was used by 40 (21.2%) of Public Schools and 108 (60.0%) of Private Schools. However 20 11.1%) and 3 (1.7%) Public and Private Schools respectively practiced surface (bush/water) method of waste disposal (X²= 58.013, P= 0.0001). Gender differentiated toilets were absent in 119 (66.1%) of Public Schools and 94 (52.2%) of Private Schools (X²= 7.186, P= 0.007). It was also observed that soap for hand washing was unavailable in 157 (87.2%) and 100

(55.6%) of Public and Private Schools studied (X²= 44. 186, P= 0.001). Again, these three practices were statistically significant.

State of the toilet area was good in only 22 (12.2%) Public Schools and 43 (23.9%) Private Schools (X²= 8.280, P= 0.004). Toilet to Pupil Ratio of 1< 30 was observed in just 10 (5.6%) Public Schools and 43 (23.9%) Private Schools. A ratio of 1 toilet to greater than 90 pupils was however observed in 58 (32.2%) and 29 (16.1%) Public and Private Schools respectively (X²= 39.283, P= 0.001). The differences in these findings were statistically significant.

62

TABLE VI B: PRACTICE OF HEALTHFUL SCHOOL ENVIRONMENT IN PUBLIC AND PRIVATE SCHOOLS.

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

BUILDING Dilapidated

Old walls, leaking roofs Strong walls with minor cracks Strong walls & Roof

2 (1.1) 49 (27.2) 58 (32.2) 71 (^39.5)

2 (1.1) 14 (7.8) 29 (16.1) 135 (75.0)

4 (1.1) 63 (^17.5) 87 (^24.2) 206 (57.2)

48.995 0.001

FIRE PROTECTION All Prefab Buildings Some Prefab Buildings All Buildings with fire resistant Materials

29 (16.1) 92 (51.1) 59 (^32.8)

13 (7.2) 86(^48.3) 81(44.5)

42 (11.7) 178(^49.4) 140 (^38.9)

9.755 0.008

FLOOR Sandy

Worn Off, Broken & dusty Flat, Glossy

Flat, Non-Glossy

5(2.8) 57 (31.7) 22 (12.2) 96 (53.3)

0 (0) 19 (10.6) 38 (21.1) 123 (68.3)

5 (1.4) 76 (21.1) 60 (16.7) 219 (60.8)

31.595 0.001

VENTILATION I Not Adequate Adequate

27(15.0) 153 (85.0)

38 (21.1) 142 (78.9)

65 (18.1) 295 (81.9)

2.272 0.132

VENTILATION II Not Controllable Controllable

54 (30.0) 126 (70.0)

41 (22.8) 139 (77.2)

95 (26.4) 265 (73.6)

2.417 0.120

LIGHTNING Poor

Supplementary light Good

Good Plus Supplementary light

52(28.9) 0(0) 127 (70.5) 1 (0.6)

43(23.9) 3(1.7) 124(68.9) 10(5.5)

95 (^26.4) 3(0.8) 251 (69.7) 11 (3.1)

11.252 0.010 INSULATION

No ceiling Partially Ceiled Properly Ceiled

19 (10.6) 74 (^41.1) 87 (48.3)

14(7.8) 35(19.4) 131(72.8)

33 (9.2) 109 (30.3) 218 (60.5)

23.592 0.001

Old walls with leaking roofs were found in 49 (27.2%) Public Schools and in 14 (7.8%) Private Schools (X²= 45.995, P= 0.001). Floors were worn out, broken and dusty in 57 (31.7%) and 19 (10.6%) Public and Private Schools respectively.

However, in 96 (53.3%) Public Schools and 123 (68.3%) Private Schools the floors were flat and non- glossy (X²= 31.595, P= 0.001). The findings from these two practices were statically significant.

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It was observed that the ceilings of 19 (10.6%) Public Schools and 14 (7.8%) Private Schools were absent but 87 (48.3%) and 131 (72.8%) Public and Private Schools were properly ceiled (X²= 23.592, P= 0.001). This finding was statistically relevant.

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TABLE VI C: PRACTICE OF HEALTHFUL SCHOOL ENVIRONMENT IN PUBLIC AND PRIVATE SCHOOLS.

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

SITTING COMFORT Pupils

<100% seated 100% seated

52 (28.9) 128 (71.1)

7 (3.9) 173 (^96.1)

59 (16.4) 301 (83.6)

41.050 0.001

Teachers

No seats available

<100% seated 100% seated

0 (0.0) 21 (11.7) 159 (^88.3)

1 (0.6) 6 (3.3) 173 (^96.1)

1 (0.3) 27 (7.5) 332 (^92.2)

9.924 0.007

SAFETY MEASURES School Fence Yes

No

Fire Extinguisher Yes

No Fire Alarm Yes No

Safety Patrol Team Yes

No

63 (35.0) 117 (65.0) 2 (1.1) 178 (98.9) 1 (0.6) 179 (99.4) 11 (6.1) 169 (93.9)

148 (82.2) 32 (17.8) 31 (17.2) 149 (82.8) 3 (1.7) 177 (98.3) 21 (11.7) 159 (88.3)

211 (58.6) 149 (41.4) 33 (9.1) 327 (90.9) 4 (1.1) 356 (98.9) 32 (8.8) 328 (91.2)

82.732

28.057

1.011

3.430

0.001

0.001

0.315

0.064 NUISANCE &

HAZARDS Noise Pollution Presence in any form Absence

Flooding/Open Drainages

Presence in any form Absence

62 (35.0) 118 (65.0)

85 (47.2) 95 (52.8)

73 (35.3) 107 (64.7)

56 (31.1) 124 (68.9)

135 (37.5) 225 (62.5)

141 (39.1) 219 (60.9)

0.002

9.805

0.961

0.002

Less than 100% of pupils in 52 (28.9%) Public Schools and in 7 (3.9%) Private

Schools had seats provided for them in the schools (X²= 41.050, P= 0.001). This was statistically significant.

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School fences were absent in 117 (65%) of Public Schools and 32 (17.8%) of Private Schools (X²= 82.732, P= 0.0001). One hundred and seventy eight (98.9%) of Public Schools and 149 (82.8%) of Private Schools did not have a fire extinguisher available in their school premises (X²= 1.011, P= 0.0001). These findings were statistically significant.

Flooding/ open drainages were present in 85 (47.2%) and 56 (31.1%) Public and Private Schools respectively in one form or the other (X²= 9.805, P= 0.002). This was also statistically significant.

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TABLE VII: PRACTICE OF PHYSICAL HEALTH EDUCATION AMONG PUBLIC AND PRIVATE SCHOOLS

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

PHYSICAL HEALTH EDUCATION Sports field available

Yes No

Other Sports Facilities Yes

No

129 (71.7) 51 (28.3) 17 (9.4) 163 (90.6)

92 (51.1) 88 (48.9) 64 (35.6) 116 (64.4)

221 (61.3) 139 (38.7) 81 (22.5) 279 (77.5)

16.043

35.189

0.001

0.001 Adequate Emotional Climate

Yes No

98 (54.4) 82 (45.6)

148 (82.2) 32 (17.8)

246 (68.3) 114 (31.7)

32.029 0.001

Sports field were found in 129 (71.7%) Public Schools as against 92 (51.1%) Private Schools. This difference was statistically significant. (X²= 16.043, P= 0.001). Sixty four (35.6%) of the Private Schools had other sports facilities while 17 (9.4%) of the Public Schools had other sports facilities outside a football field. This difference was statistically significant (X²=35.189, P=0.001).

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TABLE VIII: PRACTICE OF SCHOOL HOME AND COMMUNITY RELATIONSHIP AMONG PUBLIC AND PRIVATE SCHOOLS

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Functional parents-teachers association?

Yes No

167 (92.8) 13 (7.2)

165 (91.7)

15 (8.3) 0.155 0.694

Functional school health committee?

Yes No

76 (42.2) 104 (^57.8)

88 (^48.9) 92 (51.1)

1.613 0.204

A functional Parents-Teachers Association was found in 162 (94.4%) of the Public Schools and in 160 (94.7%) of the Private Schools. This was not statistically significant. (X²=0.039, P= 0.694).

TABLE IX: PRACTICE OF COUNSELLING AND PSYCHOLOGICAL SERVICES AMONG PUBLIC AND PRIVATE SCHOOLS

PRACTICE PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Presence of Counselling and psychological services?

Yes No

58 (32.2) 122 (67.8)

90 (50.0)

90 (50.0) ^11.749 0.001

Counselling and Psychological Services were present in 90 (50.0%) of the Private Schools and in 58 (32.2%) of the Public Schools. This difference in the availability of Counselling and psychological services was statistically significant (X²=11.749, P=

0.001).

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SECTION D: FACTORS AFFECTING IMPLEMENTATION.

TABLE X A: INFLUENCE OF POLICY ON IMPLEMENTATION OF SCHOOL HEALTH PROGRAM IN PUBLIC AND PRIVATE SCHOOLS

CHARACTERISTICS PUBLIC SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Awareness of the National School Health policy (NSHP) in Nigeria?

Yes No

99 (55.0) 81 (45.0)

79 (43.9) 101 (56.1)

178 (49.4) 182 (50.6)

4.445

0.035

CHARACTERISTICS PUBLIC SCHOOLS N=99 (%)

PRIVATE SCHOOLS N=79 (%)

TOTAL N = 178 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Copy of NSHP ever seen?

Yes No

9 (9.1) 90 (90.9)

17 (21.5) 62 (78.5)

26 (14.6) 152 (85.4)

5.441 0.020

CHARACTERISTICS PUBLIC SCHOOLS N=9 (%)

PRIVATE SCHOOLS N=17 (%)

TOTAL N = 26 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Copy of NSHP in School?

Yes No

4 (44.4) 5 (55.6)

9 (^52.9) 8 (47.1)

13 (50.0) 13 (50.0)

0.170 0.680

It was observed that 99 (55%) Public School Head Teachers and 79 (43.9%) Private School Head Teachers were aware of the existence of the National Policy on School Health in Nigeria (X²=4.445, P=0.035). This was statistically significant.

However, out of the 99 Public School Head Teachers who were aware of the

existence of the National School Health Policy, only 9 (9.1%) of them had ever seen a copy of it. Similarly, out of the 79 Private School Head Teachers who were aware of the existence of the National School Health Policy, only 17 (21.5%) of them had seen a copy of it (X²=5.441, P=0.020). This was also statistically significant.

Out of the 9 Public School Head Teachers who had seen a copy of the School Health Policy, only 4 (44.4%) of them reported that they had a copy in their Schools. On the other hand, out of the 17 Private School Head Teachers who had seen a copy of the Policy, 9 (52.9%) reported that they had a copy of it in their Schools (X²=0.170, P=0.680). This finding was not statistically significant. Overall, 4 (2.2%) Public School Head Teachers out of 180 and 9 (5%) Private Head Teachers out of 180 reported that they had a copy of the National Policy in their schools. However, when

69

asked to produce the copy, it was observed that none of the Head Teachers in both the Public and Private Schools were able to do so.

TABLE X B: INFLUENCE OF POLICY ON IMPLEMENTATION OF SCHOOL HEALTH PROGRAM IN PUBLIC AND PRIVATE SCHOOLS

CHARACTERISTICS PUBLIC

SCHOOLS N=180 (%)

PRIVATE SCHOOLS N=180 (%)

TOTAL N = 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Awareness about the

“Implementation guidelines on National School Health Programme” (IGNSHP)?

Yes No

59 (32.8) 121 (^67.2)

55 (30.6) 125 (69.4)

114 (31.7) 246 (68.3)

0.205 ^0.650

CHARACTERISTICS PUBLIC

SCHOOLS N=59 (%)

PRIVATE SCHOOLS N=55 (%)

TOTAL N = 114 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Copy of IGNSHP seen?

Yes No

13 (22.0) 46 (78.0)

19 (34.5) 36 (65.5)

32 (28.1) 82 (71.9)

2.207 0.137

CHARACTERISTICS PUBLIC

SCHOOLS N=13 (%)

PRIVATE SCHOOLS N=19 (%)

TOTAL N = 32 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Presence of IGNSHP copy in School?

Yes No

6 (46.2) 7 (53.8)

12 (^63.2) 7 ^(36.8)

18 (^56.2) 14 (43.8)

0.907 0.341

It was observed that 59 (32.8%) Public School Head Teachers and 55 (30.6%) Private School Head Teachers were aware of the existence of the Implementation Guidelines on National School Health Programme in Nigeria (X²=0.205, P=0.650).

This was not statistically significant.

However, out of the 59 Public School Head Teachers who were aware of the existence of the Implementation Guidelines on National School Health Programme, only 13 (22.0%) of them had ever seen a copy of it. Similarly, out of the 55 Private School Head Teachers who were aware of the existence of the Implementation Guidelines on National School Health Programme, only 19 (34.5%) of them had seen a copy of it (X²=2.207, P=0.137). This also was not statistically significant.

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Out of the 13 Public School Head Teachers who had seen a copy of the

Implementation Guidelines on School Health Programme, only 6 (46.2%) of them reported that they had a copy in their Schools. On the other hand, out of the 19 Private School Head Teachers who had seen a copy of the Guidelines, 12 (63.2%) reported that they had a copy of it in their Schools (X²=0.170, P=0.680). This finding was not statistically significant. Overall, 6 (3.3%) Public School Head

Teachers out of 180 and 12 (6.7%) Private Head Teachers out of 180 reported that they had a copy of the Implementation Guidelines in their schools. However, when asked to produce the copy, it was observed that none of the Head Teachers in both the Public and Private Schools could produce it.

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TABLE XI: CHALLENGES REPORTED BY HEAD TEACHERS IN IMPLEMENTING SCHOOL HEALTH PROGRAMME.

S/N CHALLENGES PUBLIC

SCHOOLS N= 180 (%)

PRIVATE SCHOOLS N=180 (%)

1. Lack of infrastructures 93 (51.7) __

2. Lack of Funds 77 (42.8) 44 (24.4)

3. Inadequate Health Personnel 56 (31.1) 37 (20.6) 4. Lack of cooperation between Parents

and the School Management

__

29 (16.1)

The Public School Head Teachers had reported that lack of infrastructures (51.7%), lack of funds (42.8%) and inadequate health personnel (31.1%) as the three most important challenges that they faced in running the School Health Programme. On the other hand, the Private School Head Teachers had listed lack of funds (24.4%),

inadequate health personnel (20.6%) and friction between parents and the school management (16.1%) as the three major challenges faced while trying to implement the School Health Programme.

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TABLE XII: CROSSTAB OF PRACTICE SCORES AGAINST SOCIO-DEMOGRAPHIC VARIABLES

CHARACTERISTICS

Grade of Score: (Poor)

Grade of Score: (Good)

TOTAL – N= 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Age at last birthday 21-30

31-40 41-50

>50

15 (8.0) 45 (24.1) 30 (16.0) 97 (51.9)

15 (8.7) 67 (38.7) 31 (17.9) 60 (34.7)

30 (8.3) 112 (31.1) 61 (16.9) 157 (43.6)

12.53 0.006

Sex Male Female

46 (24.6) 141(75.4)

44(25.4) 129 (74.6)

90 (25.0)

270 (75.0) 0.33 0.855

Marital Status Single

Married

Separated/Divorced Widowed

16 (8.6) 159 (85.0) 2 (1.1) 10 (5.3)

20 (11.6) 143 (82.7) 2 (1.2) 8(4.6)

36(10.0) 302 (83.9) 4 (1.1) 18 (5.0)

0.971 0.808

Religion Christianity Islam

124(66.3) 63 (33.7)

104 (60.1) 69 (39.9)

228 (63.3)

132 (36.7) 1.485 0.223

Ethnicity Ibo Yoruba Others

23 (12.3) 162 (86.6) 2 (1.1)

27 (15.6) 137 (79.2) 9(5.2)

50 (13.9) 299 (83.1) 11 (3.1)

6.320 0.042

Highest Educational Qualification Masters Degree University Degree Certificate from College of Education Teacher’s Training School Certificate

9 (4.8) 101 (54.0) 68 (36.4) 9 (4.8)

16(9.2) 90 (52.0) 60 (34.7) 7 (4.0)

25 (6.9) 191 (53.1) 128 (35.6) 16 (4.4)

2.803 0.423

Length as a Head teacher?

1-5 Years 6-10 Years 11-15 Years

>15 Years

99 (52.9) 43 (23.0) 19 (10.2) 26 (13.9)

92 (53.2) 39 (22.5) 20 (11.6) 22 (12.7)

191 (53.1) 82 (22.8) 39(10.8) 48 (13.3)

0.267 0.996

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The study revealed that the practice of School Health Programme was dependent on the age (X²=12.53, P= 0.006) and the ethnicity of the respondents (X²=6.330, P=0.042). It was however not dependent on sex, marital status, religion, highest educational qualification and how long they had been a Head Teacher (P>0.05).

TABLE XIII: CROSSTAB OF PUBLIC AND PRIVATE SCHOOLS AGAINST THEIR PRACTICE SCORES PRACTICE SC0RE PUBLIC

SCHOOLS – N= 180 (%)

PRIVATE SCHOOLS - N= 180 (%)

TOTAL - N= 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Poor Good

117 (65.0) 63 (35.0)

70 (38.9) 110 (61.1)

187 (^51.9) 173 (48.1)

29.120 0.001

The practice score of the Public and Private Schools when compared in Table XIII above was dependent on the type of school. The difference was statistically significant (X²= 29.120, P=0.001).

TABLE XIV: CROSSTAB OF RESPONDENTS’ PRACTICE AGAINST KNOWLEDGE CHARACTERISTICS

Grade of Score: (Poor)

Grade of Score: (Fair)

Grade of Score: (Good)

TOTAL – N= 360 (%)

TEST STATISTIC VALUE (X²)

p-VALUE

Knowledge of School Health Programme Poor Knowledge Inadequate or Fair knowledge Adequate or Good knowledge

114 (61.0) 72 (38.5)

1 (0.5)

93 (54.4) 77 (45.0) 1 (0.6)

1 (50.0) 1(50.0) 0 (0.0)

208 (57.8) 150 (41.7) 2 (0.6)

1.652 0.799

The Practice of School Health Programme was not dependent on the knowledge of the Head Teachers as shown in Table XIV (X²=1.653, P=0.799).

74 LOGISTICS REGRESSION

MULTIVARIATE ANALYSIS.

TABLE XV: PREDICTORS OF PRACTICE OF SCHOOL HEALTH PROGRAMME.

S/N VARIABLES ADJUSTED OR (95% CI)

1. TYPE OF SCHOOL PRIVATE

PUBLIC

4.551 (1.918 – 10.799) 1.00

2. AGE 31 – 40 41 – 50 >50

0.377 (1.121 – 1.172) 0.596 (0.232 – 1.530) 0.905 (0.434 – 1.887) 3. ETHNICITY

IBO OTHERS YORUBA

0.214 (0.043 – 1.055) 0.264 (0.049 – 1.423) 1.00

In the multiple logistic regression model, only one variable (Type of School) was found to be a predictor of School Health Programme. (OR = 4.551, CI = 1.918 – 10.799).

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CHAPTER FIVE DISCUSSION

This study set out to compare the School Heath Programme in Public and Private Primary Schools in Ogun State, Nigeria. The importance of a good and functional School Health Programme as a component of Primary Health Care in the overall development of children and the citizenry of a nation cannot be over emphasized.

Various studies in the last 20 years or more in Nigeria have indicated poor status of the School Health Programme13,16,21,46,60.

The overall mean age for the Public and Private School Head Teachers in this study was 45.7±9.9 years with a range of 21-68 years. The mean age for Public Head Teachers was 53.0±3.6 years while that for the Private Head Teachers was 37±8.0years. The overall mean age was similar to that in a study in a Nigerian community where the mean age for all the Head Teachers was 44 years with a range of 27-58 years⁵⁷. Private Schools have a tendency to take in younger school leavers as Teachers who can eventually rise up to become the Head Teacher. This may explain the overall lower ages found within the Private Schools.

The study population has a relatively higher educational qualification when compared to that of similar studies that have been conducted. About 50% of the Head Teachers were holders of a University Degree whereas the findings in other studies showed majority of the Head Teachers were holders of Certificate from Colleges of Education^{13, 61}.

The Private Schools had more single Head Teachers than the Public Schools and the female Head Teachers were about three (3) times the number of their male

counterpart in both groups similar to the findings from another study in South-western Nigeria⁶². Over 80% of the respondents were Christians. This is in line with the predominant religion in the study area located in the south western part of the country.

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Generally in this study the demographic variables of the respondents were not significant outside their age and marital status. Sex, religion, ethnicity and years of experience on the job showed essentially the same distribution.

All the Head Teachers were examined and scored on the various domains of the School Health Programme. Significant difference in knowledge was found in only three (3) main domains.

Knowledge was generally poor among all the respondents. Almost all (99.4%) of the Head Teachers had inadequate knowledge about the School Health Programme especially as it relates to its basic definition and components. This is consistent with previous studies in Egor⁵⁷, Jos⁶³, Lagos⁶⁴ and Turkey⁶⁵.

Though generally poor, knowledge of the School Feeding Services was better among the Public School Head Teachers than the Private School Head Teachers. This may be explained by the fact a lesser number of Private Schools make use of the services food vendors. This was however in contrast to a study in Egypt where Private Head Teachers had better knowledge regarding nutritional services when compared to their Public counterparts⁶⁶. However, another study in Taiwan concluded that

Teacher’s knowledge on nutrition was generally poor and only increased significantly after a health education intervention⁶⁷.

Knowledge of the School Health Services domain was again generally poor but the scores from the Public School Head Teachers though just slightly better was enough to cause a significant difference. This may be due to the fact that the training

curriculum for Public School Teachers has some modules on School Health

incorporated into it. The Private School Teachers do not have such a training manual for their staff. The general poor knowledge on School Health Services has been demonstrated in other previous studies^13,63.

Eighteen percent of the Private School Head Teachers as against 5% of the Public School Head Teachers knew the most important personnel necessary for the implementation of the School Health Programme. The mean knowledge scores between the two groups, though poor, revealed that the Private School Head

In document “Evaluación de la calidad del desempeño docente y directivo en educación básica en el Colegio Fiscomisional Río Upano en cantón Sucúa, provincia de Morona Santiago, durante el año académico 2011 – 2012” (página 32-35)