The term “school health programme” refers to a series of activities that are planned, coordinated, and carried out within the context of the school environment with the goal of enhancing the physical and mental well-being of the student body (FGN, 2006). To strengthen a school’s capacity to promote a healthy background for living, learning, and working, a series of activities are required to be carried out. The combination of these activities would create an environment that is conducive to learning, work toward improving the health of everyone within the system, reduce life-threatening circumstances such as malaria, waterborne diseases, drug and alcohol abuse, and malnutrition, and most importantly, instill in the learners the knowledge, skills, and attitudes that are necessary for healthy living. This allows for an examination of both the breadth and the current state of the programs that are covered by the policy.
Healthful school environment
The policy provides that for schools to be healthy, all services, facilities and tools needed for physio-social and emotional well-being must be assured, provided and preserved in a sustainable manner. Accordingly, such schools are located in siren environment free from noise, cold, heat, have adequate and appropriate building, furniture, toilet facilities that are gender sensitive, waste disposal facilities and safe water supply, recreational and sport equipment, perimeter fencing, observance of annual school health Days among others. Keen observations of these indices indicate that this policy provision is not adequately implemented. For instance, in 2017, the report of epidemic outbreak in a popular government secondary school in Lagos state went viral (Uwandu, 2017 & Folarin, 2017). According to the report, the epidemic outbreak left more than 200 students sick and two dead in the hospitals at different times within a short period. The students were alleged to have been treated for abdominal pains, fever, vomiting and diarrhea which were attributed to unhealthy and unhygienic environment of the school. In an earlier occurrence, Maradun (2016) reported that two students were killed of food poisoning in Zamfara State. These instances depict the poor enforcement of the salient provision on healthy school environment as prescribed in the School Health Policy. The report of Ademokun, Osungbade, and Obembe (2012) that, the implementation of SHP was poor especially in the sphere of healthful school environment, school managers lack good knowledge of the NSHP and that the health programmes in their schools did not comply with the requirements of the policy confirmed thesescenarios.
School feeding services
The cardinal target of this policy provision is to provide all children enrolled in schools nationwide with a meal per day in order to improve their nutritional status, reduce hunger and enhance their learning ability (FME, 2006). Although this provision has been in place over a decade, the indices of the services such as meal provision, food fortification and supplementation, regular de-worming and sanitation and hygiene practices especially among food vendors are not consistently and comprehensively available in the schools. The report of Tijani, Opara and Jime (2018) that the school feeding programme in Maduguri metropolis does not reduce or satisfy hunger due to inconsistency or irregular availability of the mealconfirmed this submission. Where the programmes were found to have improved the nutrition status of the children as reported in Falade, Otemuyiwa, Oluwasola, Oladipo and Adeusi (2012), the programmes did not cover all the children in basic and post basic
Skill based health education
Removing ignorance of healthy habits and creating awareness on harmful substance/practices is essential to having a healthy school environment. Thus, the skill-based health education was designed to facilitate the inculcation of sound health knowledge, attitudes, skills and practices among learners. This is to be achieved by providing teachers and learners with curriculum covering personal hygiene, diseases, mental and social health among others. Implementation of this curriculum appears poor despite its availability especially at the basic level of education. For instance, Alafin, Adesegun, Izang and Alausa (2019) reported that all the rural community primary schools investigated had poor skill-based health education. They found that none of the schools had SHP implementation guideline and that majority did not have health-based information, education and communication (IEC) materials in form of posters and textbooks. In the same vein, Adebayo, Makinde and Omode (2018) reported that the training and involvement of public primary school teachers in the school health programmes was suboptimal in their study area. This implies that the delivery of skill-based health education could not have been effective since the facilities needed for its delivery are not available. It is thus, not surprising that Alex-Wart and Akani (2014) and Adebayo and Onadeko (2016) found that health instructions are given as integral part of other subjects without instructional materials and that teachers had inadequate knowledge of school health programmes in both rural and urban schools
School health services
The SHP recommends the provision of curative and preventive health services in order to promote the health of learners and others in the school community. These services include pre-entry screening, routine examination, health records, sickbay, first aid box and referral services, and advisory and counseling services for the school community and parents. These services are to be rendered by specialists such as Medical doctors, Nurses, Health Educators, School Guidance Counselors, Dieticians among others. The report of Alafin, Adesegun, Izang and Alausa (2019) revealed that these services and the specialists are not available in many schools. The report showed that none of the school investigated conduct pre-entry and routine medical screening for their teachers and students. The reports of the Ondo state ministry of economic planning and budget (2010) and that of Akpabio (2010) confirmed that this worrisome status of school health service has persists over the years.
School, Home and Community Relationship
The policy aptly noted that life at home should complement a healthy life-style provided in the school in order to achieve a balanced development of the child. This necessitated the need for interaction between the school and the homes in form of home visit by teachers, nurses, social workers and regular visit of the school by the parents. More important is the communication of health status of learners to their parents/guardians by the school health personnel as well as active participation of parents in health planning, implementation, monitoring and evaluation of health services.Adedokun, Osungbade and Obembe cited in Diana and Adebayo (2019) reported that the relationship between the school and the home was good while it was poor between the school and the community. These scholars however lamented that the implementation of the SHP across the country was sub-optimal and remains at the minimum