The opinions of secondary school administrators on the reflections of school health services practices on the education process: The case of Tokat province

This study aims to analyse the views of administrators working in secondary education institutions on the effects of health services provided in schools on the educational process (academic success, absenteeism, dropout, etc.). In the research, mixed method combining quantitative and qualitative data sources was used in order to ensure the consistency of the data and to analyse the research problem in depth. In the research process, it was aimed to obtain different but complementary data on the same subject and in this direction, parallel design, which is a sub-design of mixed method, was preferred. The population of the quantitative dimension of the research consists of school administrators working in secondary education institutions in Tokat city centre. In the research, descriptive survey model was used to describe the current situation. In the analysis process of quantitative data, SPSS 26 package programme was used based on descriptive statistics and evaluations were made on frequency and percentage distributions. The qualitative dimension of the research was structured within the framework of the case study method. In the research process, criterion sampling method was adopted in order to examine the situations that are suitable for the determined and established criteria. The participants in the study consisted of 17 school administrators. In the qualitative data collection process, semi-structured interview questions were developed in line with expert opinions, and content validity was ensured by evaluating the suitability of the interview form for the purpose of the research. The data obtained were analysed systematically using the content analysis technique. The research results show that school administrators have insufficient knowledge about health and psychosocial education, and school health services pose serious security risks due to limited budgets and inadequate medical equipment. While visual impairments, asthma and diabetes are the most common health problems, smoking, unbalanced nutrition, inadequate physical activity and stress are defined as the main risk factors for students. In educational institutions, deficiencies in cleaning, waste management and drinking water safety negatively affect the learning environment. In addition, health screenings cannot be carried out regularly and it is observed that health services are generally inadequate. The prominent problems in the field of health services include financial difficulties, lack of cleaning budget and personnel, inadequate physical space and lack of legal regulations. While it is emphasized that administrators need to receive more comprehensive training on school health services, the lack of health personnel, lack of infirmary rooms and inadequate physical space hinder the effective provision of health services. In addition, the limited flow of information between family physicians and schools makes it difficult to coordinate health services. It has been determined that students and families with low socioeconomic backgrounds have low health awareness, and school administrators show deficiencies in emergency interventions. It is observed that female students and obese individuals are at risk of stigmatization, which negatively affects psychosocial development and educational processes. It has been determined that there is a significant relationship between students' health status and academic success and absenteeism rates. While psychological problems and obesity negatively affect academic success and social adaptation, health problems increase absenteeism rates. It is recommended that health clinics be established, regional school medicine units be established, and regular health screenings be carried out to improve school health services. It is recommended that family physicians and health formators be assigned to monitor student health more effectively, that the e-School system be integrated with health institutions, and that cooperation be made with relevant institutions to increase physical activity. In addition, it is recommended that measurement systems be used to ensure hygiene in the school environment and that air quality be monitored with sensors, and that attention is drawn to the potential risks as well as the opportunities offered by health technologies.