ASSESSMENT AND DETERMINANTS OF SCHOOL-BASED HEALTH CAREPRACTICES IN SECONDARY SCHOOLS LOCATED WITHIN AHMADUBELLO UNIVERSITY, ZARIA, KADUNA STATE, NIGERIA

Abstract

School health services (SHS) are essential for promoting students’ well-being, yet their implementation in
Nigerian schools remains uneven. This study assessed SHS practices in secondary schools within Ahmadu Bello
University, Zaria, with emphasis on school type, student attitudes, and organizational structures, in order to
determine whether being in a university community translates to improved practice. A cross-sectional research
design was employed, using a multistage sampling method to select 346 consenting students across three
secondary schools located within Ahmadu Bello University, Zaria. A semi-structured questionnaire was
administered to collect information on respondents’ socio-demographic characteristics. Attitudes toward SHS
were assessed using a 5-point scale, with scores ≤ 34 classified as negative and scores > 34 classified as positive.
The mean attitude score was 34.82 ± 7.91. The practice of school-based health care was categorized as poor (≤18),
moderate (>18–36), and good (>27), with a mean practice score of 18.37 ± 3.51. Quantitative data were analyzed
using descriptive statistics for socio-demographic characteristics and inferential statistics, including Chi-square
and logistic regression tests, at a significance level of p = 0.005, while qualitative data were analyzed thematically.
The mean age of the respondents was 13.25 ± 1.652 years, ranging from 10 to 19 years. Findings revealed that
only 49.1% of respondents demonstrated good SHS practice, while 57.8% exhibited negative attitudes. Hypothesis
testing showed significant associations between school type and SHS practice (χ² =93.360, p<0.001), and between
students’ attitudes and SHS practice (χ²=35.27, p<0.001). Private schools were more likely to engage health
educators (94.4%) and conduct periodic screenings (73.3%), whereas missionary schools employed more
professional staff, including nurses (79.8%) and doctors (5.3%). Logistic regression further confirmed that school
type strongly predicted practice, with students in private schools over eight times more likely to report good SHS
practice (OR = 8.324, 95% CI: 4.423–15.666). However, attitude, gender, and age were not significant predictors
in the model (p > 0.05). Key informant interviews also revealed consensus among discussants that students
generally displayed negative attitudes and poor practices toward SHS. The study concludes that SHS in these
schools remain suboptimal, with clear disparities between preventive services and professional medical care. It
recommends strengthening personnel training, enhancing government support, and fostering school community
partnerships to improve SHS delivery.