Public–private comparative study of the quality of implementation of the school health programme in a metropolitan city in Nigeria

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The Nigerian National School Health Policy (NSHPo) was adopted more than a decade ago, yet its quality of implementation (QoI) remains poor. Diverse variations exist between public and private schools yet most studies in Nigeria did not consider this in their evaluation. This study was conducted to assess the QoI of the School Health Programme (SHP) in public and private primary schools in Ibadan metropolis, using the NSHPo framework as a guide.

Subjects and methods

The study utilized a comparative-descriptive cross-sectional design. A two-stage sampling technique was used to select one of five local government areas in a Metropolitan city and 68 primary schools. An observational checklist was used to assess the five domains of the SHP, namely: Healthful School Environment [HSE]; School Health Services [SHS]; Skills Based Health Education [SBHE]; School Feeding Services [SFS], and School, Home, and Community Relationship [SHCR]), as listed in the Nigerian SHPo framework. QoI was assessed by exploring availability, suitability, adequacy, and functionality of the domains measured.


About half of the primary schools (38.5% public; 75.9% private) had first-aid boxes, but they were empty in 66.7% of public and 20.7% of private schools. A few (19.1%) had hand-washing facilities. Almost all the schools (97.1%) did not perform medical examination for school vendors. Only 35.3% of the schools had waste-disposal facilities, of which a significantly higher proportion were in private schools (72.4%) (P < 0.001). None of the schools had counselling schedule or record of counselling sessions. Overall, QoI of the SHP was significantly poor in 36.8% of the schools, with a higher proportion (46.2%) in public schools compared with private schools (24.1%) (p < 0.001).


The School Health Programme in selected urban private and public primary schools had poor quality of implementation but private schools had a better quality of implementation.

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The authors would like to express their appreciation the Head Teachers for the permission given and for their time.


The study was sponsored by the authors.

Author information

Correspondence to Ayodeji Matthew Adebayo.

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Ethical approval

The procedures of this study, as they involve human participants, were in line with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the principal of each school.


Ayodeji Adebayo has no conflict of interest to declare, Oluyinka Dania has no conflict of interest to declare, Akinwumi Akindele has no conflict of interest to declare, and Temidayo Fawole has no conflict of interest to declare.

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Adebayo, A.M., Dania, O., Akindele, A. et al. Public–private comparative study of the quality of implementation of the school health programme in a metropolitan city in Nigeria. J Public Health (Berl.) (2020).

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  • School health policy framework
  • School health programme implementation
  • Public–private
  • Urban area
  • Nigeria