Introduction: school health instruction (SHI) is the instructional aspects of school health programme. It provides information on key health issues to school children who are in their formative years.

Methods: a cross sectional descriptive study of all the primary schools in a focal Local Government Area in Nigeria was carried out to ascertain the implementation of SHI with regards to the contents, methods of delivery and teachers preparation for health teaching using an evaluation checklist for SHI.

Results: there were more female pupils enrolled in the study area compared to their male counterparts with a male to female ratio of 0.9:1.0 and only 3.0% of the teachers had In- service training on health related issues in the previous five years preceding the study. 79.4% of the teachers had the recommended qualification to work in the schools. Teachings on emotional health, communicable diseases and safety education were sparingly given by 1.6%, 4.7% and 56% schools respectively. Only three (4.7%) schools (all private) had health instruction given by designated health education staff. No school gave health instruction at least thrice a week as recommended.

Conclusion: compliance with the implementation of SHI was very poor in the study area.