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WEST AFRICAN JOURNAL OF MEDICINE
TABLE OF CONTENTS
West African Journal of Medicine Vol. 38, No. 4, April 2021 1A
ORIGINAL ARTICLES
HIV-Associated Nephropathy among Children with Renal Disease in Port Harcourt, Nigeria
T. A. Uchenwa, I. C. Anochie
Dental Trauma in Adult and Elderly Nigerians: A National Survey
E. C. Otoh, O. O. Taiwo, O. A. Adeleke, O. J. Majekodunmi, S. O. Ajike
Knowledge, Attitude and Practice on Covid-19 among Clinical Healthcare Workers in Bingham University Teaching
Hospital (BHUTH) Jos, Plateau State, Nigeria
M. Shehu, H. Shehu, O. Momodu, O. Abraham, E. E. Eseigbe
Comparison of the Diagnostic Relevance of Albumin Creatinine Ratio Versus Cystatin C in Assessment of
Cardiovascular Complication in Type 2 Diabetics
B. K. Myke-Mbata, S. C. Meludu, D. O. Ochalefu, B. C. Basil
Self-perceived Burden on Caregivers, Anxiety and Depression among Chronic Kidney Disease Patients in Southern Nigeria
O. A. Adejumo, E. I.Okaka, A. A. Akinbodewa, O. I. Iyawe, I. R. Edeki, O. S. Abolarin
Frequency of Osteoporosis in Black Nigerian Women Aged 50 and above with Degenerative Musculoskeletal
Diseases and Fractures
O. A. Adewole, S. O. Idowu, M. O. Shoga, M. O. Kayode, O. O. Adelowo
Knowledge, Attitudes, and Practices towards COVID-19 Transmission and Preventive Measures among Residents of
Nigeria: A Population-Based Survey through Social Media
A. T. Akafa, A. Amos , A. Okeke and A. C. Oreh
School Health Instructions in Primary Schools - A Study of Gwagwalada Area Council, Federal Capital Territory Nigeria
U. A. Sanni, U. M. Offiong, E. A. Anigilaje, K. I. Airede
Plasma L-Arginine in Sickle Cell Anaemia Patients in Crises and its Correlation with Markers of Severity of Disease
O. W. Aworanti, T. S. Akingbola, A. Adeomi, A. E. Alagbe, A. O. Salako
Meniscus Sign: A Test for the Confirmation of Correct Placement of Epidural Catheter
H. O. Idehen, G. Agbonkhese
Clinicopathological Pattern and Management of Primary Lung Cancer in Ilorin, Nigeria
P. O. Adeoye, O. O. Desalu, C. K. P. Ofoegbu, A. E. Fawibe, A. K. Salami, R. O. Akanbi,
C. M. Opeyemi, O. O. K. Ibrahim, O. B. Ojuawo, A. O. Aladesanmi, I. Olaoye
CASE REPORTS
Protein C Deficiency in a Patient with Anomalous Hemiazygous Vein and Portal Vein Thrombosis
F. A. Fasola, A. Akere, C. U. Akunwata, C. Onyejelam, M. A. Osundina
Aplasia Cutis Congenita: A Case Report
O. J. Ugowe, S. A. Balogun and E. A. Adejuyigbe
Favourable Outcome of Severe Lassa Fever Following Early Diagnosis and Treatment: A Case Report
J. A. Onuh, A. E. Uloko
CLINICAL ARTICLE
Comparison of Short Course Versus Long Course Antibiotic Prophylaxis for Caesarean Section:
A Randomised Controlled Trial
A. C. Ezeike, C. O. Agboghoroma, E. R. Efetie, K. W. Durojaiye
GENERAL INFORMATION
INFORMATION FOR AUTHORS
EDITORIAL NOTES
INDEX TO VOLUME 38, NO. 4, 2021
Author Index
Subject Index
IC
1F
299
307
313
321
328
335
342
347
359
366
374
380
391
395
398
405
387
406
School Health Instructions in Primary Schools - A Study of
Gwagwalada Area Council, Federal Capital Territory Nigeria
ABSTRACT
Background: School Health Instructions (SHI) entail the
instructional aspect of school health programme, which provides a
classroom opportunity for inculcating healthy habits into the
school- age child.
Objective: To assess the status of implementation of school health
instruction in primary schools in Gwagwalada Area Council of the
Federal Capital Territory, Nigeria
Methods: A cross-sectional descriptive study of 146 primary
schools in the Gwagwalada Area Council of the Nigerian Federal
capital was carried out to assess the implementation of SHI with
respect to the contents, methods of delivery and teachers
preparation for health teaching using an evaluation checklist for
SHI.
Results: Of 146 schools, 115(78.8%) schools attained the
minimum acceptable score of 27. Of the 40 public and 106 private
schools, 27(67.5%) public and 88(83.0%) private schools attained
the acceptable minimum score of 27. There was a statistically
significant difference between the mean scores attained
cumulatively in the various components of the school health
instruction by the public and private schools (t=2.721, p= 0.008).
Public schools had significantly more teachers with education-
related qualifications than private schools (p<0.001). Teachings on
HIV/ AIDS, safety education and community health were
undertaken by 95.9%, 93.2% and 95.2% schools respectively.
Only 5(3.4%) schools followed the recommendation of giving
health instruction at least thrice a week.
Conclusion: Implementation of SHI was adequate in the study
area, with a better performance among the private schools.
WAJM 2021; 38 (4): 359-365
Keywords: School Health Instruction, primary school, private,
public, Gwagwalada Area Council, Federal Capital Territory,
Nigeria
ABSTRAIT
Contexte: L'enseignement de la santé à l'école (SHI) comprend
l'aspect pédagogique du programme de santé scolaire, qui offre en
classe la possibilité d'inculquer des habitudes saines à l'enfant
d'âge scolaire.
Objectif: Évaluer l'état de la mise en œuvre de l'enseignement de
la santé scolaire dans les écoles primaires du Conseil régional de
Gwagwalada du territoire de la capitale fédérale, Nigéria
Méthodes: Une étude descriptive transversale de 146 écoles
primaires du Conseil régional de Gwagwalada de la capitale
fédérale nigériane a été menée pour évaluer la mise en œuvre de
l'AMS en ce qui concerne le contenu, les méthodes de prestation et
la préparation des enseignants à l'enseignement de la santé en
utilisant une liste de contrôle SHI.
Résultats: Cent quinze (78,8%) écoles composées de 27 (67,5%)
écoles publiques et 88 (83,0%) écoles privées ont atteint le score
minimum acceptable de 27, avec une différence statistiquement
significative entre les scores moyens des deux catégories d'écoles
(t = 2,721, p = 0,008). Les écoles publiques avaient beaucoup plus
d'enseignants avec des qualifications liées à l'éducation que les
écoles privées (p <0,001). Des enseignements sur le VIH / SIDA,
l'éducation à la sécurité et la santé communautaire ont été
dispensés respectivement par 95,9%, 93,2% et 95,2% des écoles.
Seulement 5 écoles (3,4%) ont suivi la recommandation de donner
des cours de santé au moins trois fois par semaine.
Conclusion: La mise en œuvre de SHI a été adéquate dans la zone
d'étude, avec une meilleure performance parmi les écoles privées.
WAJM 2021; 38 (4): 359-365
Mots clés: Enseignement de la santé à l'école, école primaire,
privé, public, Conseil régional de Gwagwalada, Territoire fédéral
de Capital, Nigéria
WEST AFRICAN JOURNAL OF MEDICINE
1 2 3 4
U. A. Sanni, U. M. Offiong, E.A. Anigilaje, K. I. Airede
1 2 3
Federal Medical Centre, Birnin-Kebbi, Kebbi State. University of Abuja Teaching Hospital, Gwagwalada, Federal Capital Territory. University of
4
Abuja Teaching Hospital/University of Abuja, Gwagwalada, Federal Capital Territory. University of Abuja Teaching Hospital/ University of Abuja
*Correspondence: U.A. Sanni. E-mail: talktosani81@gmail.com
ORIGINAL ARTICLE
Enseignement De La Santé Scolaire Dans Les Écoles Primaires - Une Étude Du Conseil
Régional De Gwagwalada, Territoire De La Capitale Fédérale Du Nigeria
Abbreviations: AIDS: Acquired Immunodeficiency Syndrome; FCT: Federal Capital Territory; GAC: Gwagwalada Area Council; HIV: Human Immunodeficiency Virus
LGA: Local Government Area; NERDC: Nigerian Education Research and Development Council; SHI: School Health Instruction; SPSS: Statistical Programme for
Social Science UBE: Universal Basic Education; ZEO: Zonal Education Office
INTRODUCTION
According to the World Health
Organization (WHO), health education
is defined as any combination of
learning experiences designed to help
individuals and communities improve
their health by increasing their
knowledge and influencing their
1
attitudes. School health instruction is a
means of providing health education to
the school-aged children. It is an
instructional aspect of school health
programme, which provides an avenue
to inculcate into the school age child,
healthy habits, attitudes, practices and
knowledge which he/she maintains
2
throughout life. It entails a well-planned
and organized learning experience for
the school children under the direction
and supervision of a school teacher or
3, 4
accredited health care provider.
Important aspects include organization
and periodic allotment for health
instruction, curriculum development,
knowledge /training of teacher's
skills/attitudes.
Children often pass on health-
related knowledge and skills acquired
from schools to their parents and other
members of the household. Hence,
school based health education benefits
not only the students but family
5
members and community at large. It is,
therefore, an effective way of reducing
many high-risk behaviours, teenage
pregnancy, smoking rates among young
6
people and the community at large. Its
effectiveness was also demonstrated in
the control of infectious diseases in
some African countries, such as teaching
school children personal hygiene to
achieve behavioural change in Lushoto
(Tanzania) for schistosomiasis and
7
helminth infestation control.
School health instruction had been a
curriculum subject in Nigerian schools
for decades. The instruction was given at
various times as hygiene education,
health science, health education or
physical and health education. In spite of
these long years, its role in positively
impacting on knowledge, attitude and
behaviour on health has remained a
source of concern. This may be due to
poor implementation as indicated
bymost studies in Nigeria, mainly from
2,8, 9
the Southern part of the country. To
improve its implementation, there must
be data from every region of the country.
Currently, there is paucity of data on
assessme n t of the l e v e l of its
implementation in Northern Nigeria
within which the current study was
10
ca rr ie d o ut . Al so , s i n ce th e
development of national school health
policy and implementation guidelines in
Abuja in 2006, 4'11 there had been no
study to assess implementation of school
health instruction (a component of
school health programme) at the nation's
capital.
This study, therefore, sought to
assess the implementation of school
health instruction in primary schools in
Gwagwalada Area council of the FCT.
This would add to the statistics of
Northern Nigeria and also help to assess
thec urrent situation in Nigeria federal
capital.
SUBJECTS, MATERIALS AND
METHOD
STUDY AREA
The study was carried out from April to
October 2017 in the Gwagwalada Area
Council(GAC) of the Federal Capital
Territory (FCT), Nigeria. It is one of the
six area councils in the FCT located in
North central, Nigeria. Its projected
population as of 2016 was 402 000
people,12 consisting of the indigenous
Gbagyis and Bassa along with settlers
such as the Hausas, Koros , Yorubas and
Ibos from different parts of the country.
Gwagwalada Area Council hosts a
university, teaching hospital as well as
several research institutions including
Na tional Research Dev e lopment
13
Council.
There are 291 registered primary
schools, consisting of 80 public and 211
private schools in the Area Council. The
authority of the schools lies with the
Universal Basic Education (UBE) Board
and Zonal Education Office (ZEO),
Gwagwalada.
STUDY DESIGN
This study was a descriptive cross-
sectional study.
SAMPLING TECHNIQUE FOR
THE SCHOOLS
The primary schools were stratified into
public and pri vate schools. An
anticipated population proportion of
50% was used for sampling in each
school category to attain a confidence
interval of 95% with an absolute
14,15
precision of 5%. Thus, with a
sampling ratio of 50%, 146 schools
were selected including 40 schools from
public and 106 from private schools.The
146 schools were randomly selected
from the list of schools by the lottery
16
method as suggested by Bennett et al.
INCLUSION CRITERIA
1. Registered primary schools (both
public and private) located within
GAC
2. Registered primary schools founded
2 years or more prior to this study.
The minimum school age of 2 years
was because the FCT's education
secretariat expects that at the end of
the second year of a school
esta b l i s h m e n t , the school is
expected to have had facilities for
SHP implementation along with a
minimum single stream of 6
classrooms, after which, a final
approval can be given for any
established school.
EXCLUSION CRITERIA
1. Registered primary schools (both
public and private) whose head
teachers did not consent to the study.
2. Schools with mixed primary and
secondary education (13 private
schools excluded).
THE RESPONDENTS OF THE
S T U D Y / S O U R C E O F
INFORMATION
Information about the school health
i n st ru c ti on a nd i t s l e v e l o f
implementation was gotten from the
West African Journal of Medicine Vol. 38, No. 4, April 2021
360
School Health Instructions in Primary SchoolsSanni and Associates
head teacher and 3 teachers from each
school surveyed. In each school, a
teacher was selected from an alternate
list of classes from primary one through
six. Where there was more than one arm
of a class in a school, the teacher was
randomly selected from the arms using
balloting. Two pupils from each selected
school also corroborated or dispelled the
information gotten from the head
teacher and the three teachers. These two
pupils (a male and female) were selected
by simple random sampling of the
primary six pupils of each school. Again,
when there was more than one arm of
primary six, the choice of the arm was by
balloting system, where an arm was
blindly chosen from a list of the
available arms.
The respondents were separately
interacted with.
ETHICAL CONSIDERATION
Ethical approval for the study was
obtained from the University of Abuja
Teaching Hospital's Research and Ethics
Committee, FCT Universal Basic
Education Board, and Zonal Education
Office, GAC. Verbal consent was
ob tained from eac h participa nt.
Confidentiality was assured by use of
codes on the assessment forms.
DATA COLLECTION
The study instrument was an adapted
school health instruction evaluation
checklist from "School Health Practice"
by Anderson and Creswell in the United
17
Kingdom. The checklist was modified
and validated for use in resource poor
settings of developing countries by
3
Akani. It had been pretested and used
for school health programme assessment
2,18,19
studies in Nigeria. The checklist was
completed for each school by direct
interview and inspection by the
researchers. A pilot study was carried out
in two (one public and one private)
schools in Kwali Area Council (a
neighbouring Area Council) prior to the
study, to identify problems that may be
encountered in the administration of the
questionnaire for which the questions
were modified to make them clearer. The
findings from the pilot study were not
included in the data collected.
The h e ad t e a chers provid e d
in fo rm at io n on sc ho ol h ea lt h
administration and other information
that could not be check-listed by
observation at each school. Direct
observation of all aspects of school
health instruction that could be directly
in spected wa s carried out wi th
clarification sought where applicable.
Three health teachers as well as two
pupils were also separately interviewed
to ensure accuracy.
To ens ure object ivity in the
assessment of scope /conduct of the
school health instruction, the lesson
notes of the health teachers (or class
teachers) along with supplementary
teaching aids (like illustration charts,
posters etc) were inspected. Class notes
of the pupils as well as the school
timetable were also inspected. The
classroom teaching of health instruction
in some schools was also attended.
Based on these, the scope of health
instruction, frequency of its teaching
and teaching methods were deduced.
For example, the lessons' timetable was
not solely used to arrive at the frequency
of health instruction; this was further
ascertained by asking the pupils how it
was frequently done and corroborating
their responses with findings in their
health education notebook.
The information gathered was
recorded and scores awarded using the
evaluation scale. The scores on the SHI
were awarded from the average of the
four respondents for each school to the
nearest whole number by the researchers
after seeking appropriate clarifications
from respondents.
The evaluation scale comprises
sections on school administrative
information, scope and time allotted to
health teaching, method of health
instruction as well as in service training
for teachers.
A school was adjudged to have an
adequate SHI if its cumulative score was
3
at least 27, though the maximum
.
attainable score was 41.
DATA ANALYSIS
The data collected were sorted on the
basis of school ownership (private/
public). The data were analysed with
Statistical Programme for Social
Science (SPSS) version 20. Categorical
data were reported as proportions and
continuous data as means and standard
deviations.
Student t- test was used to compare
group means while Pearson chi-square
test or Fischer's exact test (where
appropriate) was used for comparison of
frequencies in the contingent tables and
differences between proportions.
In all statistical tests of significance,
only P-value of less than 0.05 was
regarded as significant.
RESULTS
This study was undertaken in one
hundred and forty-six (146) primary
schools in Gwagwalada Area Council
(GAC). Of these, 40(27%) were public
while 106(73%) were private schools.
Population of the schools a n d
qualifications of the teachers are
represented on Table 1. There was a total
of 52 756 pupils and 2 154 teachers in the
schools surveyed. The population of
female pupils was 26,774 while those of
males was 25,982, giving a male to
female ratio of 1:1.03. Public schools
ha d mor e pu p ils, 38685 (73%)
compared to 14071 (27%) in private
schools. The teacher to pupil ratio was 1:
36 and 1: 13 in public and private
schools, respectively
At the time of the study, the mean
school age was 18.98 ±9.67 SD years.
Public primary schools in the Area
Council had mean age of 27.60 ±
12.26years while that of private schools
was 8.74 ± 5.04 years.
Nigerian Certificate in Education
(NCE) was the qualification of
1135(52.69%) teachers in the study. Of
the 885 Bachelor's degree holders
among the teachers, 527(59.54%) were
degree in education. Public schools had
significantly more teachers with
education-related qualifications (Grade
II teacher certificate, NCE, Bachelor's in
West African Journal of Medicine Vol. 38, No. 4, April 2021 361
School Health Instructions in Primary SchoolsSanni and Associates
Education) than private schools (964
a n d 7 0 1 r e s p e c t i v e l y }
(p<0.00 1 ) . Teache r s wit h senior
secondary certificate were present in
80(3.7%) schools (exclusively private
schools).
A total of 137(93.8%) schools had
Parent-Teacher-Association. There was
significant difference between public
and private schools (37.5% versus
14.2% respectively) for the presence of
school health committee (p=0.002).
Table 2 shows time allotted to health
te a ching and content of health
instruction in schools. School health
instruction was taught in all schools.
However, 5 (3.4%) schools {1 (2.5%)
public and 4(3.8%) private schools}
gave the instruction three times a week.
The majority (72.6%) of the schools
allotted two periods per week for its
teaching
All schools taught personal health.
In all public schools and 94.3% of
private schools, HIV/AIDS was taught.
However, all public schools and 95
(89.6%) of private schools social and
emotional health was taught (p=0.034).
Method of health instruction and
training exposure of teachers in schools
surveyed are depicted in Table 3. Health
instruction was given by direct/
conventional teaching method, in
addition to its correlation with other
subjects (such as social studies, family
living) in all the schools surveyed.
Classroom activities (such as play, and
sanitary activities etc.) were integrated
into health teaching in 32 (80%) public
an d 95( 8 9.6%) private schools .
Occasional health talks to pupils by
visiting medical specialist and voluntary
groups (such as red cross, red crescent)
were reported by 13(32.5%) public
co m p ared t o 27(1 8 .5%) p r ivate
schools(p=0.007). Supplementary
teaching aids were used in 97.9% of the
schools surveyed.
No public, compared to 48(45.3%)
private schools went on health-related
excursions.
There was a significant difference
between the number of private {82
(77 . 4 % )} an d public { 8 ( 1 0.0%)}
primary schools that organized training
f o r t h e ir t e ac h e rs o n he a l th
teaching(p=0.001). Training in personal
health and community health was
included in the training courses/ seminar
of teachers in 88(60.3%) and 86(58.9%)
schools respectively. Only 4 schools (all
privately owned) had training for
teachers in the area of school health
programme and its various components
like school health instruction.
Of the 40 public and 106 private
schools, 27(67.5% ) public and
88(83.0%) private schools attained the
acceptable minimum score of 27. There
was a statistically significant difference
in the number of public and private
schools attaining the acceptable
minimum score for school health
2
instruction (χ=4.182, p= 0.041).
The mean and standard deviation
scores on school health instruction were
Characteristics
School Type
χ2P value
Private Public
Total
School population
Pupils
Male
Female
Total
n(%)
6,932(49.3)
7,139(50.7)
14,071(100.0)
n(%)
19,050(49.2)
19,635(50.8)
38,685(100.0)
n(%)
25 982(49.2)
26 774(50.8)
52756(100.0)
Staff
Teaching
1,072(49.8)
1,082(50.2)
2154(100.0)
Non-teaching
207(47.5)
229(52.5)
436(100.0)
Qualification of teachers
n(%)
n(%)
n(%)
NCE
497(46.4)
638(59.0)
1135(52.7)
172.153 <0.001*
Bachelor of Education degree
203(18.9)
324(29.9)
527 24.5)(
152.34 <0.001*
Other Bachelor degree
245(22.8)
113(10.5)
358(16.6)
304.484 <0.001*
Senior School Certificate
80(7.5)
0(0.0)
80(3.7)
84.165# <0.001*
National Diploma
43(4.0)
1(0.0)
44(2.0)
44.447# <0.001*
Master degree
4 (0.4)
6(0.6)
10(0.5)
2.783# 0.095
Total 1072(100.0) 1082(100.0) 2154(100.0)
Table 1: Schools populations and teachers' qualifications
School Type
Total
N=146
n(%)
χ2p value
Public
N=40
n(%)
Private
N=106
n(%)
Time allotted to health
Teaching
One period / week 12(30.0)
23(21.7)
35(23.9) 1.098 0.295
Two periods
/ week 27(67.5)
79(74.5)
106(72.6) 0.721 0.396
Three periods
/ week 1(2.5)
4(3.8)
5(3.4) 0.142#
0.706
Scope of health teaching
ψ
Growth and development
40(100.0)
102(96.2)
142(97.2) 1.552 0.213
Personal health
40(100.0)
106(100.0)
146(100.0) - -
Community health
37(92.5)
102(96.2)
139(95.2) 0.765 0.382
Social and emotional health
40(100.0)
95(89.6)
135(92.5) 4.489 0.034*
HIV / AIDS
40(100.0)
100(94.3)
140(95.9) 2.361 0.124
Safety education
39(97.5)
97(91.5)
136(93.2) 1.633 0.201
Health instruction beyond
classroom
Health and safety excursions 0(0.0) 48(45.3) 48(38.9) 25.674# <0.001
Table 2: Time allotted to health teaching, scope of health instruction, health
instruction beyond classroom and methods ofhealth instruction
West African Journal of Medicine Vol. 38, No. 4, April 2021
362
School Health Instructions in Primary SchoolsSanni and Associates
29.50 ± 3.91 and 28.02 ± 2.50 for private
and public schools respectively out of
the maximum score of 41. The
difference in t h e ir m e a n s wa s
statistically significant (t=2.721, p=
0.008)
DISCUSSION
School health instruction was taught in
all the schools surveyed. While majority
(72.6%) of the schools allocated two
periods per week to giving the
instruction, only 5(3.4%) schools
adhered to the recommended three
periods per week of the Nigeria
Education Research and Development
Council (NERDC).20 This was close to
9
the finding of Olatunya et al in Osun
6
state and Idehen et al in Edo state.
Failure to adhere to the NERDC
recommendation of three periods per
week for teaching health education may
be because there is some overlap of
health-related topics in subjects such as
social studies and physical education. It
may also be due to failure of the
oversight function of the supervising
authorities/ agents for the schools.
An important and commendable finding
from this study was that virtually all the
schools wholly adopted the revised 2012
9-year basic education curriculum
which allows for the coverage of all the
topics of health instruction as contained
in the evaluation scale. The coverage of
the different topics was better than other
2,8,9,21
Nigerian studies. For instance, in the
8
study by Alex-Hart et al none of the
schools taught HIV/AIDSin consonance
2
with 12% observed by Toma et al in Jos.
These contrasted to its teaching in
majority of schools in the current study.
The observed difference could be due to
use of 1987 curriculum (which did not
include HIV/ AIDS as a topic) by
teachers in those studies. It could also be
due to more commitment by the teachers
or more enforcement by the school
supervising authority in the current
study area. The finding in the present
study, however, was similar to those
22
reported in Moronvia (Liberia), as well
as Arusha and Kilimanjaro regions of
23
Tanzania, where primary six pupils
wer e pr ovi d ed info r mat i on on
HIV/AIDS information resulting in their
increased tendency to use condom and
decreased likelihood to engage in sexual
activity respectively. However, this
impact seen in the fore mentioned
studies was not part of this study.
As regards process of disseminating
school health instruction to pupils,
topics were taught mainly by direct
teaching method in this study similar to
2,9,21
other Nigerian studies. This could be
because it was affordable by all schools,
and had also been the traditional
teaching method since timeimmemorial.
In all the schools, health-related topics
were also correlated and taught under
other subjects like social studies, family
living etc. This would facilitate adequate
coverage of the scheme of work on the
subject.
Furthermore, the teaching of health
in s t ruction was i ntegrated with
classroom activities such as play concert
and practical classroom activities in
majority (86.9%) of the schools in the
current study, compared to 44.6%
21
reported in Nnewi LGA. This teaching
m e t h o d c ou ld en ab le b et te r
understanding of health instruction. The
additional use of teaching aids as seen in
most schools in this study would further
enhance retention of knowledge by the
pupils and teachers' effective delivery of
the subject. This was at variance with
finding at Ikenne local government area,
24'
Ogun State.
An additional mode of health
instruction employed by 18% of schools
to enhance the learning experience of the
pupils was the use of voluntary
organizations and medical specialists to
give health talks and screen for diseases.
27
Ofovwe et al also reported this type of
enhanced learning activity in 12.9% of
their study, similar to the current study.
However, a study in Nnewi LGA
reported a 53.6% use of similar activities
Table 3: Method of health instruction and training of teachers for teaching health education
Variable
School Type
Total
N=146
n(%) χ2 p value
Public
N=40
N
Private
N=106
N
Methods of health instruction
ψ
Direct/ conventional
method
40(100.0)
106(100.0)
146(100.0) -
-
Correlation with other subjects
40(100.0)
106(100.0)
146(100.0) -
-
Integration with other classroom
Activities
32(80.0)
95(89.6)
127(86.9)
2.375 0.123
Educational visits by medical and voluntary
group
13(32.5)
14(13.2)
27(18.5)
7.171
0.007*
Use of
supplementary (audiovisual) teaching aids
39(97.5)
104(98.1)
143(97.9)
0.054 0.816
Training
exposure
8(10.0)
82(77.4)
90(61.6)
11.203 0.001*
Training
courses ψ
Personal health
8(10.0)
80(75.5)
88(60.3)
10.611 0.001*
Community health
8(10.0)
78(73.6)
86(58.9)
10.033 0.002*
SHP components
0 (0.0) 4(3.8) 4(2.7) 1.552# 0.213
West African Journal of Medicine Vol. 38, No. 4, April 2021 363
School Health Instructions in Primary SchoolsSanni and Associates
21
among their schools. This higher
proportion noted in Nnewi study may be,
pe rh ap s, b ec au se of a bet te r
collaboration between the health and
educational sectors than that seen in
other studies. In this study, more public
than private schools had a higher
number of visits by the voluntary
organization. This may be because more
teachers in the public schools were
members of these voluntary groups. It
could also be that government targets
public schools for such exercises
whenever the need arises.
The training of teachers is a key
factor in any effective school health
programme. Teachers well versed in the
aspects of school health are needed to
ensure that the programme objectives
are attained. Unfortunately, this study
revealed poor retraining programme of
teachers as there were no formal in-
service training. The finding in the
present study was similar to those
reported by Alex-Hart et al 8 and
9
Olatunya et al in Bonny LGA and Ilesa
East LGA respectively. Toma et al2 in
Jos North LGA, in contrast, reported that
teachers in a few (8%) schools surveyed
enjoyed some form of formal in-service
28
training. The finding from Kenya, with
teachers' training at an average of 35%
and 65% is a far cry from what is
obtained in this study and from other
parts of Nigeria. It may be that Kenya
placed higher priority on teachers
training than Nigeria. In the present
study, training and retraining of teachers
only took place in schools and at the
discretion of the head teachers. Private
schools were more involved in such
training possibly because more teachers
in the private schools had non-education
related qualifications; hence the need to
optimize their knowledge and skill.
Also, perhaps, most public schools' head
teachers felt in-service training should
be the responsibility of the government.
This calls for strong advocacy by
educationists and healthcare workers to
reverse this worrisome trend. The tender
minds of children should be met with
well knowle d g e a b l e , up-to-da t e
instructors to mould and shape them for
a brighter future.
Well trained teachers, high teacher to
pupil ratio and allowing enough time to
attend to the individual academic needs
of each child make qualitative delivery
of school health instruction to each child
a success. Though the training of
teachers in this study was not adequate,
the teacher- pupil ratio was within the
r an ge r ec om m e n d ed b y t h e
implementation committee of the
29
National Policy on Education. This was
better than finding from a similar
8
Nigerian study. The location of the
current study in the national capital may
be responsible for this observation.
Another encouraging observation in this
study was the high enrolment of female
children (female to male ratio of 1.03:1).
This was similar to report from Osun
9
state and better than the National
30,31
average of 0.9:1. This is a significant
finding in a locality where girl child
education is not considered a priority.
This demonstrated non-marginalization
of the girl child in terms of educational
opportunities in the study area. This
may, however, not be a true reflection of
situation in Northern Nigeria where girl
32
child education is still a challenge, as
most inhabitants of the study area were
from different parts of the country that
only came in search of greener pasture in
the Federal Capital Territory.
Despite some inadequacies seen in
the study, majority (79%) of schools in
the study area attained up to the
minimum acceptable score. Attainment
of the acceptable minimum scores by
most schools in the present study was
21
similar to those of Osuorah et al and
27
Ofovwe et al . This could signal
improvement in implementation of
school health instruction in the recent
times.
CONCLUSIONS
The implementation of School Health
Instructions in primary schools in
Gwagwalada Area Council is high
though with better situation in private
schools. There is, however, need for
improvement in the retraining of
teachers. Relevant authorities should
also compel schools to adopt the
recommended three periods per week
for SHI teaching.
ACKNOWLEDGEMENT
The authors wish to sincerely thank Mr
Dugule Daniel Hacks, the Zonal
Ed u c at ion O ff i c er , Ed u c at io n
Secretariat, Federal Capital Territory
Authority, and Mr Garba Auna, the Head
of School Services, FCT Universal
Basic Education Board. We cannot but
appreciate all the head teachers, teachers
and the pupils who participated in this
study for their patience, understanding
and cooperation
DECLARATION
This research is part of Dissertation
work with five parts; two of which has
the same methodology.
DUALITY OF INTEREST
There was no conflict of interest.
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