| dc.description.abstract | Introduction and background. Health related causes contribute significantly to school
dropout and absenteeism. Sixty percent of school dropouts are due to sickness (MOE,
2003). This has resulted into low primary school completion rate of 64% (UBOS, 2006)
despite the increased enrollment as a result of UPE. In HSSP 1 of 2001, the school health
programme was introduced to create an enabling environment for delivering quality
education (MOH, 2006). This was aimed at improving the health of learners there by
reducing absenteeism and dropout.
Goal of the study This study was aimed at assessing the availability and adequacy of
school health services and factors affecting their provision in primary schools of Mukono
County so as to make recommendations for effective interventions to improve school
health, academic performance and reduce dropouts and absenteeism due to health related
causes.
Methods. It was a cross-sectional study carried out in Mukono County. Seventy one
Schools were selected through multistage stratified sampling. A person in charge of
pupils’ health was the respondent. Questionnaires and observation checklists were used to
collect quantitative data. This was triangulated with focus group discussions for pupils.
Quantitative data was analyzed using SPSS version 17. Associations between dependent
and independent variables were tested using Pearson’s Chi-square test and Odds ratios.
Charts and graphs were generated by MS-Excel. FGD results were analyzed using a
master sheet and results presented as text along with quantitative results.
Results. All school health services were available in over 90% of schools. Nutritional
services were significantly more available in non-government schools than government
schools (P = 0.04). Availability of essential drugs and supplies in first aid kit (Odds ratio
(OR) 0.31, 95% CI 0.11-0.86), regular visits by medical personnel (OR 2.70, 95% CI
1.00-7.30) and immunization programme for adolescent girls (OR 4.54, 95%CI 1.65-
12.49) were significantly associated with school ownership. While more than two-thirds
of the schools had most of their health services assessed as adequate, only 30% and 41%
of schools had adequate nutrition and medical services respectively. Medical and
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nutrition services were significantly more adequate in boarding schools than other
schools (P = 0.01 and P<0.001 respectively) and nutrition services were more adequate
in non-government schools (P=0.03) and those with teachers trained in health (P=0.02).
Government owned schools were also significantly less likely to have a water source
nearby (OR=0.17, 95% CI 0.05-0.56) and clean classrooms (OR=0.34, 95% CI 0.11-
0.99) but more likely to have fire-fighting equipment (OR=4.24, 95% CI 1.56-11.52). A
majority of the teachers (79%) assessed were not knowledgeable about school health.
The level of knowledge was significantly higher in teachers who received training in
school health (χ
2 = 39.56, 1 df, P = 0.02). Lack of funds, trained health teachers, space
and commitment were some of the factors that affected availability and adequacy of
school health services, with lack of commitment and space being significantly lower
factors in non-government schools compared to government schools (OR=0.14, 95% CI
0.30-0.69 and OR=0.09, 95% CI 0.01-0.73).
Conclusion. School health is available in over 90% of the schools assessed, which is
above the target of 75% set by ministry of health in the health strategic plan 1. Medical
and nutrition services were adequate in only 41% and 30% of the schools. This is below
the national set target of 75%. Government schools lack nutrition services while physical
education services are lacking in non-government schools due to lack of space.
Government should consider providing meals to pupils at school and Mukono District
Health Team should provide training in school health to all teachers in the district. | en_US |
