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Effect of Health Education on Deworming Uptake among Primary School Children in Nigeria

Abstract

Soil-transmitted helminth infections remain an important public health concern among school-aged children, particularly in communities where inadequate sanitation, unsafe water, poor hygiene, and limited access to preventive healthcare may increase the risk of infection. Regular deworming is an important component of preventive child health programmes because it can reduce the burden of intestinal worm infections and support children's health, school attendance, and general wellbeing. Health education provides children, parents, teachers, and caregivers with information about intestinal worm infections, modes of transmission, symptoms, prevention, hygiene, sanitation, safe water practices, and the importance of participating in recommended deworming programmes. Deworming uptake refers to the participation of eligible children in recommended deworming programmes and receipt of the appropriate deworming medication through approved school-based or healthcare delivery channels. In Nigeria, inadequate deworming uptake may be associated with limited knowledge, misconceptions about deworming medicines, fear of adverse effects, parental concerns, poor awareness of deworming schedules, inadequate school health education, and limited access to preventive health services. Effective health education may improve children's and caregivers' knowledge and acceptance of deworming and encourage participation in recommended deworming programmes. Against this background, this study investigates the effect of health education on deworming uptake among primary school children in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding deworming decisions through perceived susceptibility to intestinal worm infections, perceived severity, perceived benefits of deworming, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, peer influence, family support, school environment, and behaviour in shaping children's preventive health practices. The Knowledge-Attitude-Practice framework provides a basis for examining how health education may improve knowledge and attitudes and influence participation in deworming programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how health education may influence deworming uptake among primary school children in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from pupils in selected public and private primary schools in Nigeria using age-appropriate structured questionnaires, deworming knowledge and awareness assessments, and deworming uptake records. Because the participants are children, parental or guardian consent and appropriate child assent procedures will be obtained in accordance with applicable ethical requirements. A multistage sampling technique will be employed to select states, local government areas, schools, classes, and eligible pupils. Where feasible, selected schools or pupil groups will be assigned to intervention and comparison groups. Pupils in the intervention group will receive structured, age-appropriate health education covering intestinal worm infections, transmission, symptoms, personal hygiene, sanitation, safe water practices, prevention, the purpose and safety of recommended deworming, and the importance of participating in scheduled deworming programmes. Deworming uptake will be assessed using indicators such as receipt of the recommended deworming medicine during the relevant programme period, participation in school-based deworming activities, completion of scheduled doses where applicable, and documented participation in approved deworming programmes. Where feasible, uptake will be verified using school health records, programme registers, or other available documentation rather than relying solely on self-report. Descriptive statistics will be used to summarize pupils' sociodemographic characteristics, previous exposure to health education, deworming knowledge, and participation in deworming programmes. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic regression analysis, will be used to determine the effect of health education on deworming uptake. Where appropriate, deworming uptake before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that health education has a significant positive effect on deworming uptake among primary school children in Nigeria. Pupils exposed to structured health education are expected to demonstrate improved knowledge of intestinal worm infections, transmission, prevention, hygiene, and the purpose of recommended deworming. Education may increase acceptance of deworming programmes and reduce misconceptions and fears surrounding deworming medicines. Involving teachers and parents or caregivers in the educational process is also expected to strengthen support for children's participation in scheduled deworming activities. However, health education alone may not guarantee high deworming uptake because children and families may continue to experience barriers such as limited programme coverage, inadequate availability of deworming medicines, poor school health infrastructure, parental concerns, inadequate sanitation, and inconsistent implementation of school-based deworming programmes. Consequently, health education is expected to be most effective when supported by reliable deworming medicine availability, effective school-based delivery systems, parental engagement, teacher participation, adequate sanitation, safe water, and continuous monitoring of deworming programmes. The study is expected to contribute to the literature on deworming programmes, school health, child health education, intestinal worm prevention, preventive healthcare, community health, maternal and child health, and public health in Nigeria by providing empirical evidence on the effect of health education on deworming uptake among primary school children. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, state ministries of health and education, primary schools, school health programmes, teachers, community health workers, development partners, and policymakers regarding strategies for improving participation in childhood deworming programmes. The study will also provide evidence-based recommendations for integrating age-appropriate health education into school-based deworming programmes, strengthening parent and teacher engagement, improving deworming programme awareness, ensuring reliable medicine availability, strengthening school health records and monitoring systems, promoting hygiene and sanitation education, and improving the coverage and sustainability of deworming programmes among primary school children in Nigeria.

Keywords: Health education, deworming uptake, primary school children, Nigeria, deworming programme, intestinal worm infections, school health, child health education, preventive healthcare, hygiene education, sanitation, community health, maternal and child health, public health.