SCHOOL HEALTH SERVICES AND ITS PRACTICE AMONG PUBLIC AND PRIVATE PRIMARY SCHOOLS IN WESTERN 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 [1, 2]. 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 [3, 4]. 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) [4, 5].
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 %) [4, 5] 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 [6, 7].
School health has been described as the neglected component of Primary Health Care in Africa [8, 9]. 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 [12–14].