This study sought to find out the barriers affecting implementation of school health program in Orumba north local government area, Anambra State, Nigeria. The study focused on secondary schools within the target location. The government of Nigeria has already developed and disseminated the National school health policy and the school health implementation strategy 2009. However, little is known about the implementation of the policy hence the need to conduct this study. The study was guided by three objectives which are capacity building, support supervision and school infrastructure in relation to how they influence implementation of Comprehensive School Health Program. The researcher used descriptive survey research design where factors influencing the implementation of Comprehensive School Health Program were described as they were. A sample size of 60 respondents was selected using stratified random sampling method from all the 10 secondary schools within the location under study but only 50 respondents returned completely filled questionnaires. Qualitative and quantitative methods of data collection were used to generate the desired data through the use of a questionnaire comprising open and closed ended questions and an interview guide was used for triangulation. The findings were be analyzed using descriptive and inferential statistics and presented descriptively and through the use of tables and figures. The study established that majority of the respondents had not been trained on Comprehensive School health Program and majority of the schools represented in the sample did not have access to clean water hence predisposing students to disease outbreaks. Most schools did not have school health committees and some had inactive school health committee which indicated that the schools did not have structures in place to implement Comprehensive School Health Program. The study also established that capacity building, support supervision and school infrastructure are some of the factors that influence implementation of CSHP and also established that there was a relationship between independent variables which are capacity building, support supervision and school infrastructure; and the dependent variable which is implementation of Comprehensive School Health Program. The findings of the study are expected to contribute to effective and efficient implementation of CSHP and strengthen the capacity of school health committee in dealing with school health. The study recommends training of teachers and BOM on CSHP, gender norms and life skills, collaboration of schools and health facilities and developments of child friendly facilities in schools to assure the safety and health not only of students but also those working within the school. The researcher suggests that more studies be done on engagement of parents in school health programs.
1.1 BACKGROUND TO THE STUDY
Integrated, comprehensive and strategic school health programs have greater potential to achieve good results. In 1980, World Health Organization (WHO) orientation toward developing healthy structures instead of focusing only on individual behaviors founded a comprehensive approach for the health promotion activities. The Health Promoting Schools’ (HPS) initiative was implemented in 1995 by collaboration of the health promotion, education and communication sectors, the intra-sectorial school health working group, and the regional office of WHO. This initiative highlights capacity development and encouragement of participation, for health which all have been accepted as powerful prerequisites to promote health and empowerment in schools. HPS addresses the relationship between health and education which is clearly reflected in the Health for All and Education for All goals of the United Nations and also in the social model of health which was corner stone of the Ottawa Charter. Attention and application of the principles of the Ottawa Charter in schools and the focus has been put on the development of health promotion structures led to the establishment of HPS.
In Iran, with a population of about 75 million and a total of 13 million students, the initiative was first practiced in 2007. A joint agreement between the Ministry of Health and Medical Education (MOHME) and Ministry of Education (MOE) was signed and led to establishment of School Health Management System and also Schools’ Ranking Plan to support and monitor local HPS programs that are exploited within the network of the country’s schools. The HPS initiative was first exercised as a pilot program in East Azerbaijan Province at 36 schools in 2009-2010 and later it was expanded to 700 schools in 2011-2012.
HPS has been developed by WHO over the last decade and is being implemented globally. Studies on the experiences of participating countries in the HPS have resulted to varying results and challenges. The most important identified challenges were the mobilization of human resources and facilities to implement the initiative, inclusion of societies as whole identities, policy makers, public, private and non-governmental sectors and, also students, their parents and teachers. In the first meeting of the Caribbean HPS Network, the main obstacles to attain HPS aims were defined as the lack of continuous funding, insufficient and unstable governmental support, inappropriate development of HPS national networks, limited involvement, and restricted access to education and continuing education.8 The need to strengthen collaboration between the education and health sectors, technical support, and insufficient funding were among the major challenges listed by the European HPS Network. Leiger et al. (2001) referred to the insufficient preparedness of teachers and educational institutions in terms of health issues, shortage of time and resources, and weakness of facilities as the greatest barriers to achieve HPS goals. In the Eastern Mediterranean Regional Office (EMRO), HPS member countries addressed the insufficient funding and technical expertise, lack of awareness among the political leaders about the program, and also lack of infrastructures as key issues. HPS has now been adopted in all EMRO countries, except for Afghanistan and Libya and through using different methods many local networks have been established during the past decade. In Bahrain, HPS is organized by a committee comprising representatives from WHO and the Ministry of Health. In Jordan, the committee comprises representatives from the Ministry of Health and Education and is directed by the School Health Director-General of the Ministry of Health. Authorities in Lebanon sought help from private and governmental sectors and international organizations to implement the program.
1.2 PROBLEM STATEMENT
Despite the importance of student health and school hygiene as an aspect of the infrastructure of community health, few feasibility studies have been conducted on school health programs in developing countries such as Nigeria. This study examined possible barriers to and challenges of such programs among secondary school teachers in Orumba North Local Government.
1.3 OBJECTIVES OF THE STUDY
The following are the objectives guiding the study;
- What are the barriers to effective implementation of school health program
- To establish the effect of Capacity building on the implementation of comprehensive school health program
- To find out the effect of support supervision on the implementation of comprehensive school health
- To find out the effect of school infrastructure on the implementation of comprehensive school health program
1.4 RESEARCH QUESTIONS
1. In what ways does capacity building affect implementation of comprehensive school health program?
2. How does support supervision affect implementation of comprehensive school health program?
3. In what ways does school infrastructure affect implementation of comprehensive school health program?
- SIGNIFICANCE OF THE STUDY
The study will give a clear insight into the barriers to effective school health programme among secondary school teachers. There is however, insufficient evidence about the achievements of the plan and to the best of our knowledge this study will be the first systematic attempt to investigate pros and cons of the executed program to identify potential barriers and challenges school health programme have encountered in Orumba North local Government.
1.6 LIMITATION OF THE STUDY
The researcher encountered unwillingness from some respondents to reveal information especially sensitive information that portrays them negatively. To counter this, the researcher assured the respondents of confidentiality and informed them that the study is purely academic endeavor therefore the information given will not be used against them whatsoever
1.6 SCOPE OF THE STUDY
The research focuses on the barriers to effective school health programme among secondary school teachers in Orumba North Local Government.
1.7 ORGANIZATION OF THE STUDY
This study is organized into five. Chapter covers background of the study, statement of the problem, purpose of the study, objectives of the study, delimitations of the study, definition of significant terms and organization of the study. Chapter two consists of literature review which is subdivided into subheadings concerning factors influencing implementation of comprehensive school health program in Orumba north local government area, Anambra state, Nigeria. Chapter three covers research methodology divided into; research design, target population, sample and sampling procedures, research instruments, validity of instruments, reliability of the instruments, data collection and data analysis.
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