AVAILABILITY & UTILIZATION OF GOVERNMENT HEALTH CENTRES & ITS IMPLICATIONS IN PRIMARY SCHOOLS

CHAPTER ONE

INTRODUCTION

• Background of the study

The School health services refer to the health care delivery system that is operational within a school or college. These services aim at promoting and maintaining the health of school children so as to give them a good start in life. In addition, these services seek to enable children benefit optimally from their school learning experience. Globally the number of children reaching school age is estimated to be 1.2 billion children (18 % of the world’s population) and rising. In many homes across the world, children start to attend school from as early as 5–6 months because mothers have to wean early to return to their work place. The purpose of the school health services is to help children at school to achieve the maximum health possible for them to obtain full benefit from their education. School health services deal with health appraisals, control of communicable diseases, record keeping and supervision of the health of school children and personnel. It is the aspect that concerns itself with the evaluating the health of an individual objectively. Health appraisals afford the school authorities the opportunity to detect signs and symptoms of common diseases as well as signs of emotional disturbances that could impede the learning activities of children. School health services are both preventive and curative services and it helps in providing information to parents and school personnel on the health status of school children. It also provides advisory and counselling services for the school community and parents. It include pre-entry medical screening, routine health screening/examination, school health records, sick bay, first aid and referral services. Other services rendered include health observation (which involves physical inspection of the physiology and behaviours of children), health examinations (screening tests and medical diagnosis) and health records (keeping of records of the health histories of children).

A National study of the school health system in Nigeria by the Federal Ministries of Health and Education revealed that only 14 % of head teachers indicated that pre-enrolment medical examination was mandatory in their schools and 30 % of the students had low body mass index (BMI). It further indicated that 30 % of students have low BMI and the common health conditions that contribute to absenteeism include fever (56 %), headache (43 %), stomach ache (29 %), cough/catarrh (38 %) and malaria (40 %). There is a dearth of school health clinics in Nigeria and where they exist, the services are not comprehensive enough or not organized to meet the needs of the pupils. Studies have shown that primary school children in Nigeria were not provided with basic health examination services and pre-entrance medical examinations thus baseline health information about them was absent. There is also a lack of routine medical examination which would have picked up deviations from normal which make early referrals impossible and children vulnerable to preventable diseases. School health has been described as the neglected component of Primary Health Care in Africa. Since almost every small community has a primary school, in those communities without health centres, it should be possible to use the primary school as a centre for primary health care delivery not just for the pupils but also for the community. A well organized and properly executed school health programme can be used to create safe environment for school children. School health programme can become one of the strategies for promoting primary health care services. All efforts at addressing the school health programme in Nigeria have remained largely at policy level, with minimal implementation. Where implementation has been attempted the emphasis has been on outside rather than within the schools. This study was therefore designed to determine the school health services available and its practices in primary schools in Ogun state Nigeria. This has implications in the primary health care of the school children and reduction in incidence of preventable diseases early in life. The goal of primary health care (PHC) was to provide accessible health for all by the year 2000 and beyond. Unfortunately, this is yet to be achieved in Nigeria and seems to be unrealistic in the next decade. The PHC aims at providing people of the world with the basic health services. Though PHC centers were established in both rural and urban areas in Nigeria with the intention of equity and easy access, regrettably, the rural populations in Nigeria are seriously underserved when compared with their urban counterparts. About two-thirds of Nigerians reside in rural (http.//www.fao.org/countryprofiles/ index.asp) areas therefore they deserve to be served with all the components of PHC. Primary health care, which is supposed to be the bedrock of the country’s health care policy, is currently catering for less than 20% of the potential patients (Gupta et al., 2004).

• STATEMENT OF THE PROBLEM

There are three health care delivery systems in Nigeria (primary, secondary and tertiary).There are innumerable problems within primary health care delivery system which affect the whole population. An assessment of these problems and needs is important to assure easy accessibility to health care services by primary school pupils in the rural community. Apparently, people living in remote areas show an adaptability that allows them to adjust to the adverse conditions especially among the elderly and youth; it is against this backdrop that the researcher intends to investigate the availability and utilization of government health centres and it implications in primary schools

• OBJECTIVE OF THE STUDY

The main objective of this study is to investigate the availability and utilization of government health centres and its implications in primary schools; but for the successful completion of the study, the researcher intends to achieve the following sub-objectives;

1. To investigate the role of government in the establishment of primary health care service in rural community
2. To ascertain if the primary health care service is at the beckon call of the primary school pupils

• To investigate if there is any relationship between government health center availability and health care utilization by primary school student

1. To evaluate the impact of health care availability and pupil academic performance
   • RESEARCH HYPOTHESES

To aid the completion of this study, the following research hypotheses were formulated by the researcher;

H₀: government does not play any significant role in the establishment of primary health care centers

H₁: government does play a significant role in the establishment of primary health care centers

H₀²: there is no significant relationship between government health center availability and health care center utilization by primary school pupils

H2: there is a significant relationship between government health center availability and health care center utilization by primary school pupils

• SIGNIFICANCE OF THE STUDY

It is believed that at the completion of the study, the findings will be of great importance to the primary health centers workers as the study seek to enumerate their role in the health and well-being of primary school pupils in rural community. The study will also be of great importance to the primary school teachers as the study seeks to explore their role in health education. The study will also be of importance to the federal ministry of health, as the study seek to highlight the importance of functional health center availability and utilization by primary school pupils and teachers. Finally, the study will also be of importance to researchers who intend to embark on a study in similar topic as the work may serve as a reference point to further research.

• SCOPE AND LIMITATION OF THE STUDY

The scope of the study covers availability and utilization of government health centers and its implication in primary schools, but during the cause of the study, the researcher encounters some constrain which limited the scope of the study;

1. a) AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study.
2. b) TIME: The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities        and examinations with the study.
3. c) FINANCE: The finance available for the research work does not allow for wider coverage as resources are very limited as the        researcher has other academic bills to cover.

1.7 DEFINITION OF TERMS

Health care centers

A healthcare center, health center, or community health center is one of a network of clinics staffed by a group of general practitioners and nurses providing healthcare services to people in a certain area. Typical services covered are family practice and dental care, but some clinics have expanded greatly and can include internal medicine, pediatric, women’s care, family planning, pharmacy, optometry, laboratory testing, and more. In countries with universal healthcare, most people use the healthcare centers

Government health facilities

government health facility is, in general, any location where healthcare is provided which is own by government. Health facilities range from small clinics and doctor’s offices to urgent care centers and large hospitals with elaborate emergency rooms and trauma centers. The number and quality of health facilities in a country or region is one common measure of that area’s prosperity and quality of life. In many countries, health facilities are regulated to some extent by law; licensing by a regulatory agency is often required before a facility may open for business

• ORGANIZATION OF THE STUDY

This research work is organized in five chapters, for easy understanding, as follows Chapter one is concern with the introduction, which consist of the (overview, of the study), statement of problem, objectives of the study, research question, significance or the study, research methodology, definition of terms and historical background of the study. Chapter two highlight the theoretical framework on which the study its based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding.  Chapter five gives summary, conclusion, and recommendations made of the study.

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