Barriers to Effective School Health Program Among Secondary School Teachers
Chapter One
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
CHAPTER TWO
LITERATURE REVIEW
SCHOOL HEALTH POLICY
The school environment is one of the key settings for promoting children’s environmental health and safety as explained in the National Health sector strategic plan as well as the Nigeria education sector support programme. A national school health policy (2009) and national school health guidelines (2009) have been developed and disseminated.
This national school health strategic implementation plan aims to identify and mainstream key health interventions for improved school health and education. The strategy comprises eight thematic areas; these are: Gender issues, Values and life skills, Child rights, child protection and responsibilities, disability and rehabilitation, Special needs, sanitation and hygiene, Water, Nutrition, Disease prevention and control and School infrastructure and environmental safety. The strategy outlines critical issues on health and education linkages that are important towards the improvement of child health while in school.
CAPACITY BUILDING
CSHP contemplates a situation where a school has adequate and able human resource to deliver key objectives of the program among these is addressing life skills education and gender issues. World Education Forum in Senegal-Dakar in April 2000 resulted in a Dakar framework for action 2000 which refers to life skills in goal 3. Life Skills Education are abilities which allows an individual develop adaptive and positive behavior so as to effectively deal with demands of everyday and life challenges. The main goals of the Life Skills approach is to enhance young people’s ability to take responsibility for making choices, resisting negative pressure and avoiding risky behavior. Where life skills education is well developed and practiced, it enhances the wellbeing of a society and healthy behavior promote and positive outlook. Life skills are classified into three broad categories namely; skills of effective decision making, skills of knowing and living with oneself, skills of knowing and living with others,
Values are beliefs, principles and ideas that are of worth to individuals and their communities. They help to define who people are and the things that guide their behavior and lives. People obtain values from families, friends, traditional culture, political influences, school environment, life experiences, religious teaching and economic experiences. Our values shape our behavior and a world view. For this program, health and education is intended to ensure that children are taught and assisted to acquire positive values (National school health policy 2009).
Ages 0-19 years are critical formative years for the development of behavior and skills in an individual. Learners in pre-school, secondary and secondary school, face varied challenges, which are compounded by various factors. These include intra & interpersonal conflicts, lack of positive role models, negative mass media influence and unreliable and inadequate sources of information especially on human sexuality. Traditional education addressed the holistic view of human personality through the informal education system. However, due to historical reasons, educational and traditional family ties have largely broken down thereby leaving young people vulnerable. Therefore, there is need for the youth to be enabled to develop positive attitudes, values, skills and healthy behavior in order to help them effectively deal with the challenges of everyday life (WHO, 2003 – Skills for Health; UNICEF, 2005- The voices & identities of Botswana’s school children). Skill based health education supports the basic human rights included in the Convention on the Rights of the Child (CRC ) especially those related to the highest attainable standards of health Life Skills Education enables learners to develop and acquire skills such as critical thinking, problem solving, decision-making, interpersonal relationships, stress and anxiety management, effective communication, self-esteem and assertiveness. KIE has developed Life skills Education Curriculum for Secondary and Secondary schools and disseminated for implemented on January 2009.
CHAPTER THREE
RESEARCH METHODOLOGY
RESEARCH DESIGN
Research design is the outline plan or structure that is used to generate answers to the research problem. It is the glue that holds the research elements and enables the researcher to gather accurate and reliable data (Kombo and Tromp, 2011). The researcher used descriptive survey research design for this study. This is a scientific method of investigation in which data is collected and analyzed in order to describe the current conditions, terms or relationship concerning a certain field problem (Mugenda and Mugenda, 2003). Descriptive survey research design seeks to establish factors associated with certain occurrences, outcomes, conditions or type of behavior. This design was appropriate for the study since the study involved assessment of human behavior which is highly diverse. In addition, the researcher aimed at getting the perceptions of the respondents regarding the issues under study hence this methodology was effective in meeting the objectives of the study.
TARGET POPULATION
Target population is defined as universal set of the study that includes all members of real or hypothetical set of people, events or subjects to which the researcher wishes to generate results (Mugenda and Mugenda, 2003). According to online reports, there are 179 teachers and 127 members of BOM/PTA in the 10 secondary schools within Orumba north local government area.
Table 3.1: Target Population
Table 3.1 presents the target population of this study. The population is categorized into two groups, these are teacher and members of Board of Management (BoM) of all secondary schools within Orumba north local government area , Anambra state, Nigeria.
CHAPTER FOUR
DATA ANALYSIS, PRESENTATION AND INTERPRETATION
RESPONSE RATE
In this study, out of 60 respondents sampled, 50 returned fully filled questionnaires. This represents a response rate of 83%. According to Mugenda and Mugenda (2003) a response rate of more than 80% is more likely to give the researcher accurate findings.
CHAPTER FIVE
SUMMARY OF THE FINDINGS, DISCUSSIONS, CONCLUSIONS AND RECOMMENDATIONS
SUMMARY OF THE FINDINGS
The study established factors of implementation of Comprehensive School Health Program in secondary schools: a case of Orumba north local government area, Anambra state, Nigeria by studying the following factors; Capacity building, support supervision and school infrastructure.
The findings show that capacity building is very important in implementation of Comprehensive School Health Program. Ranking the perceptions of the respondents on the extent to which capacity building influences implementation of CSHP based on the basis of the mean; shows that training CSHP is the most influential with a mean of 4.68 points and standard deviation of 0.68, followed by training on gender issue with a mean of 4.2 points with a standard deviation of 1.03 and life skills training had a mean score of 4.04 points with a standard deviation of 0.75. However, the fact that all the three capacity building strategies had a rating of 4 and more points at minimal standard deviation, indicate that the respondents considered capacity building to play a crucial role in the implementation of Comprehensive School Health Program. The findings also reveal that majority of the respondents had not been trained on CSHP and this could explain the poor state of implementation of the CSHP in Orumba north local government area.
The findings indicate that respondents consider support supervision to be crucial in the implementation of Comprehensive School Health Program. Majority of the respondents agreed that support supervision to schools on disease control and prevention, nutrition, special needs and rehabilitation, child rights and protection influenced implementation of CSHP. In order of priority, disease prevention and control had the highest rating with a mean rate 4.08 points with standard deviation of 1.07, nutrition 4.04 points with a standard deviation of 0.64, special needs 3.94 points with a standard deviation of 1.0 and child rights 3.82 points with a standard deviation 1.08. Therefore majority of the respondents agreed that the four support supervision areas are key in the implementation of Comprehensive School Health Program.
Majority of the respondents agreed that school infrastructure influenced implementation of Comprehensive school health Program. In order of priority water and sanitation was ranked as the most influential with a mean score of 4.76 points and standard deviation of 0.43. This is despite the majority of the respondents 70% stating that the schools they represented did not have access to clean water always and only got clean water sometimes. Environmental safety had a mean rate of 3.82 points with a standard deviation of 0.66 while conducive classrooms had a mean rate of 3.22 points with a standard deviation of 0.93. This indicates that the respondents considered water and sanitation to be the most important infrastructure in the implementation of Comprehensive School Health Program.
Over all, the respondents rated capacity building as the most important factor influencing implementation of comprehensive school health Program with a mean rate of 4.66 with a standard deviation of 0.48. Support supervision had a mean score of 4.24 with a standard deviation of 0.96 while school infrastructure had a mean score of 4.22 with a standard deviation of 0.91. Other factors identified by the respondents were coordination and parental involvement. This indicated that the respondents considered all the three factors to be critical in the implementation of Comprehensive School Health Program. On inferential statistics, all the independent variables namely capacity building, support supervision and school infrastructure were found to have a significant relationship with the dependent variable which is implementation Comprehensive School Health Program. All the independent variables had a t statistic p value of less than 0.05 which indicated that there was a relationship with the independent variable at 5% level of significance
DISCUSSIONS OF THE FINDINGS
The researcher discusses the findings of this study and compares them with the findings of similar studies or literature conducted by other researchers. In doing this, the researcher is guided by the three independent variables of the study which are capacity building, support supervision and school infrastructure.
Capacity Building
The study sought to find out whether capacity building influences implementation of comprehensive school health program in secondary school. The findings reveal that capacity building through training in CSHP, gender issues and life skills has high influence on implementation of Comprehensive School Health Program. This finding is in line with the finding of McLean at al. (2004) who studied health capacity building in schools and found that school systems are open and adaptive to small scale innovations such as introducing programs on individual health or social issues but resistant to large scale reforms that shift basic priorities away from their academic, vocational and accreditation functions towards their socialization or custodial functions through their loosely-coupled and bureaucratic structures. He recommended that key stakeholders be properly trained on new programs before rolling them out in schools to avoid resistance or perceived interruption from the learning path.
On gender issues, the findings reveal that gender norms training is crucial in the implementation of Comprehensive School Health Program. This findings are in line with the literature of Fiona Lean (2006) who argues that gender violence in and around school has been recognized in recent years as a serious global phenomenon. We have ignored for too long what goes on in the school environment. The sad fact is that schools are not always the child-friendly places we expect them to be. Violence can be perpetrated by pupils or teachers in or around the school, or by out of school youth and/or older men who demand sex in exchange for money or gifts. Acts of gender violence are disproportionately directed at girls, but boys and teachers can also be targets hence the need to reach all stakeholders on gender norms training. In addition, United Nations (2006) study on violence against children recommended implementation life skills education to enable students to build personal skills. Governments should ensure that rights-based life skills programs for non-violence should be promoted in the curriculum through subjects such as peace education, citizenship education, anti-bullying, human rights education, and conflict resolution and mediation; with emphasis placed on child rights and positive values such as diversity and tolerance, and on skills such as problem-solving, social and effective communication, in order to enable girls and boys to overcome entrenched gender biases and to prevent and deal with violence and harassment, including sexual harassment. This is in line with the findings of the study.
SUPPORT SUPERVISION
The study sought to find out ways in which support supervision influences implementation of Comprehensive School Health Program by studying support supervision on disease prevention and control, nutrition, special needs and child rights and protection. Majority of the respondents agreed that support supervision on these areas is key in the implementation of the program. This is in line with the findings of R. Govinda and Shahjahan Tapan (1999) study on support supervision in Bangladesh schools that found support of school programs by external personnel enhanced the performance of students and improved the conditions of the school.
SCHOOL INFRASTRUCTURE
The study also sought to find out the influence of school infrastructure on the implementation of Comprehensive School Health Program. The finding revealed that infrastructure is tied to the health of the pupils hence is key in implementing the program. This is in line with the finding of Sheets, M.E (2009) who studied the impact of school facilities on students and teachers and found that Poor facilities affected the health and productivity teachers and make retention of teachers difficult. On the academic side, a shift from the best facilities to the worst decreases student test performance by 3%. The study also found that the condition of school facilities has a measurable effect over and above socioeconomic conditions on student achievement and teacher experience/turnover. In addition, according to Schneider, M (2003) Schools play a critical role in promoting the health and safety of young people and helping them establish lifelong healthy behaviors. School health facilities can reduce the prevalence of health risk behaviors among young people. This argument is in line with the findings of this study.
CONCLUSION
The study established that implementation of Comprehensive School Health Program is influenced by capacity building, support supervision and school infrastructure. Capacity building as a factor influences implementation of the program by equipping the stakeholders with knowledge and skills on CSHP, gender norms and life skills training. The study established that majority of the respondents were not trained on these yet they identified these areas as key in the implementation of Program.
Support supervision was also found to be key in disease prevention and control, special needs, child rights and rehabilitation and Nutrition. This mainly requires additional expertise that may not be readily available within the school or on issues that keep changing over time and require technical assessment and control. Support supervision not only enhances the health of the students but also promotes academic performance and general school welfare.
Infrastructure also was found to influence implementation of the program since health of the students could be affected by the state of the infrastructure. The researcher established that the infrastructure play a crucial role in prevention of infections and diseases and cannot be ignored while implementing Comprehensive School Health Program.
RECOMMENDATIONS
Based on the findings of this study, the researcher makes the following recommendations;
- All teachers and BOM should be trained on Comprehensive School Health Program, gender norms and life skills to equip them with the skills and knowledge required to implement the
- Schools should work closely with other health related institutions such as hospitals, ministry of health among others for support in technical health issues that the schools may not have the capacity to
- All schools should be equipped with reliable source of clean water and child friendly facilities that cater for the need of children living with
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