CHAPTER ONE

1.0 INTRODUCTION

1.1 BACKGROUND OF STUDY

In Nigeria, the provision of health services for the citizenry is accorded a priority status by the national government. Every year, huge sums of money are allocated to the health sector. In particular, considerable effort is directed at combating childhood diseases. Thus, the National Programme on Immunization (NPI), a programme of immunization against deadly communicable diseases is substantially funded by the national government. The national government’s focus on children is understandable against the background that the children of today are the adults of tomorrow and that a healthy citizenry is an asset to the nation. Today, most of these children are of primary school age, and many of them indeed, have unhindered access to school (UNICEF Nigeria, 2004). It is the contention of health professionals, educators and social workers that the provision of school health services is a cost effective way of meeting the health needs of children (Nakajima, 1992). Therefore, it is a welcome development for the Nigeria government to have made specific provisions for the rendering of health services in all schools in the federation, as enunciated in its policy document (Federal Republic of Nigeria, 1998).

School health services refer to the health-care delivery system that is operational within a school or college. The services aim at promoting and maintaining the health of school children so as to give them a good start in life. In addition, the services seek to enable children benefit optimally from their school learning experiences (Okafor, 1991; Ezedum, 2003). Health appraisal is a major component of health services. Health appraisal according to Ogbuji (2003), is that aspect of health services which concerns itself with evaluating the health of an individual objectively. Health appraisal dovetails into three specific activities, each of which is related to the others. The activities are health observation (which involves physical inspection of the physiology and behaviours of children), health examination (which involves screening tests or medical diagnoses), and health records (which involves the keeping of records of the health histories of the children).

Health appraisal is of benefit to school health programme in a number of ways. First, it affords 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 school children. Besides, health appraisal helps in providing information to parents and school personnel on the health status of school children (Cornacchia, Olsen & Nickerson, 1991).

1.2 STATEMENT OF RESEARCH PROBLEM

There have been attempts at investigating the provision of school health services in Nigeria schools, with a view of ascertaining whether the lofty ideals that informed the setting up of the services are being realized. The status of school health services is usually determined through an examination of the health appraisal services that are provided. This is understandably so, because appraisal or diagnosis precedes prescription or treatment. In their studies, (Nwana, 1982, 1988, Imoge 1987, Okafor, 1991) reported large scale deficiencies in the provision of school health services in both primary and secondary schools. This is not the case with Guyuk L.G.A; some of the problem identified that may be affecting the flexibility in the distribution of health appraisal services in this area may be as result of:

1. lack of good roads
2. poor infrastructural facilities and
3. high level of illiteracy

1.3 AIM AND OBJECTIVES OF STUDY

The main aim of the research work is to determine the challenges of health appraisal services in some selected primary school in Guyuk L.G.A. Other specific objectives of the study are:

1. to determine the status of health observation services provided for primary school children in Guyuk L.G.A in Adamawa state
2. to determine the status of health examination services provided for primary school children in Guyuk L.G.A of Adamawa state
3. to determine the status of record keeping of health histories of primary school children in Guyuk L.G.A of Adamawa state
4. to proffer solution to the above stated problems

1.4 RESEARCH QUESTIONS

The study came up with research questions so as to ascertain the above stated objectives of the study. The research questions for the study are:

1. What is the status of health observation services provided for primary school children in Guyuk L.G.A in Adamawa state?
2. What is the status of health examination services provided for primary school children in Guyuk L.G.A of Adamawa state?
3. What is the status of record keeping of health histories of primary school children in Guyuk L.G.A of Adamawa state?

1.5 STATEMENT OF RESEARCH HYPOTHESIS

Hypothesis 1

H0: health appraisal services in some selected primary school in Guyuk L.G.A is ineffective

H1: health appraisal services in some selected primary school in Guyuk L.G.A is effective

1.6 SIGNIFICANCE OF STUDY

The study on the challenges of health appraisal services in some selected primary school will be of immense benefit to the entire Guyuk L.G.A., the State, the federal government and other researchers that desire to carry out similar research on the above topic as the findings of the study will educate the above population on health appraisal services, the challenges faced by the health center in Nigeria and the way forward. Finally the study will contribute to the body of existing literature and knowledge in this field of study and provide a basis for further research

1.7 SCOPE OF STUDY

 The study on the challenges of health appraisal services in some selected primary school is limited to three (3) primary schools in Guyuk L.G.A of Adamawa State.

1.8 LIMITATION OF STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work

1.9 DEFINITION OF TERMS

Health appraisal: This refers to a series of procedures to assess or determine the health status of the students through the use of teacher's observations, screening tests, health histories or medical records, medical and dental inspections and psychological tests