Knowledge, attitudes, and practices of school health programs among teachers in Jigawa: implications for teacher training and institutional policy

School Health Programmes (SHPs) promote students’ health, well-being, and academic performance through health education, disease prevention, and safe school environments. Teachers play a central role in SHP implementation, but gaps in their knowledge, attitudes, and practices may limit programme effectiveness. This study assessed SHP-related knowledge, attitudes, and practices among primary and secondary school teachers in Jigawa State, Nigeria, to inform teacher training and institutional policy. A descriptive cross-sectional study was conducted among 344 primary and secondary school teachers selected using a multistage sampling technique. Data were collected using an interviewer-administered questionnaire and analysed with SPSS version 22 at a significance level of p ≤ 0.05. Participants’ ages ranged from 23 to 53 years (mean ± SD: 34.4 ± 6.8 years). Only 30.2% always participated in school health education activities, 27.9% in school health campaigns, and 10.8% consistently collaborated with parents on students’ health issues. Overall, 77.0% had above-average SHP knowledge, 92.4% demonstrated above-average attitudes, while only 47.7% had satisfactory SHP practices. Higher knowledge was associated with teaching in private schools (aOR = 2.7; 95% CI: 1.1–7.1), as well as combined junior/secondary schools (aOR = 8.7; 95% CI: 2.1–36.5). Teachers in rural schools had significantly lower odds of demonstrating above-average knowledge of the SHP compared with those in urban schools (aOR = 0.3; 95% CI: 0.1–0.7). Likewise, teachers working in schools where SHP guidelines were unavailable had substantially lower odds of having above-average SHP knowledge than those in schools where the guidelines were available (aOR = 0.1; 95% CI: 0.05–0.3) Female teachers (aOR = 7.1; 95% CI: 1.4–35.2), those with a Nigeria Certificate in Education (aOR = 28.4; 95% CI: 3.2–40.1), and teachers in schools with SHP guidelines (aOR = 0.1; 95% CI: 0.01–0.5) had more favourable attitudes. Satisfactory practices were associated with ≥ 5 years of teaching experience (aOR = 4.0; 95% CI: 1.9–8.5), urban schools, prior SHP training, serving as school health coordinators, and the availability of SHP guidelines. Knowledge correlated positively with attitudes ( r = 0.20, p < 0.001) and practices ( r = 0.50, p < 0.001). Good SHP knowledge and positive attitudes did not consistently translate into effective implementation practices. Strengthening pre-service and in-service teacher training, together with supportive institutional policies, SHP guidelines, supportive supervision, and school health coordination, is essential to improve programme implementation and sustainability.