The Analysis of Teachers' Perceptions of the Role of School Health Efforts (UKS) in Promoting Clean and Healthy Living Behavior (PHBS) Among Students at SD Negeri 93 Kendari City

 Corresponding author: Ruslan Majid Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. The Analysis of Teachers’ Perceptions of the Role of School Health Efforts (UKS) in Promoting Clean and Healthy Living Behavior (PHBS) Among Students at SD Negeri 93 Kendari City Annisa Qoriyah Nur Ramadhany, Ruslan Majid * and Jumakil Faculty of Public Health, Master of Public Health Program, Halu Oleo University, Kendari, Southeast Sulawesi, Indonesia. World Journal of Advanced Research and Reviews, 2025, 28(02), 474-481 Publication history: Received on 27 September 2025; revised on 02 November 2025; accepted on 05 November 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.28.2.3755 Abstract Background: The School Health Efforts (UKS) program is a strategic initiative aimed at fostering a healthy and conducive learning environment for students. Through health promotion, disease prevention, and the habituation of clean and healthy living behaviors (PHBS). UKS plays a vital role in shaping students’ character and awareness of healthy living. However, the program’s success largely depends on teachers’ perceptions and active involvement in implementing health values within the school environment. Method: This research employs a qualitative approach with a case study design. Informants were selected using purposive sampling, involving the principal, the UKS coordinating teacher, two homeroom teachers, and two students. Data were collected through in-depth interviews with the selected informants. Result: The findings indicate that teachers have a basic understanding of the objectives, scope, and benefits of UKS as both a first-aid facility and a medium for health education. Teachers actively instill PHBS values through role modeling, learning activities, and participation in UKS programs such as “little doctor” training, health check-ups, and healthy living campaigns. Nevertheless, the implementation of UKS still faces challenges, including limited teacher understanding of UKS objectives and benefits, as well as inadequate facilities, medical supplies, and sanitation resources. Conclusion: The implementation of UKS at SD Negeri 93 Kendari has been fairly good and has had a positive impact on fostering clean and healthy living behaviors among students. However, a broader understanding among teachers, along with improved facilities and infrastructure support, is needed to optimize the effectiveness of the UKS program. Keywords: Teachers’ Perception; School Health Efforts; Clean And Healthy Living Behavior 1. Introduction The School Health Efforts (UKS) program serves as one of the strategic means to support the school’s role in creating a healthy and conducive learning environment for students. The implementation of UKS is not only aimed at increasing knowledge and awareness but also at fostering sustainable clean and healthy living behaviors, thereby supporting the optimal growth and development of students [1]. The School Health Efforts (UKS) program in Indonesia plays an important role in promoting clean and healthy living behavior (PHBS) within educational settings. The main objective of UKS is to improve the quality of education and students’ learning outcomes by encouraging healthy habits and creating a school environment that supports students’ World Journal of Advanced Research and Reviews, 2025, 28(02), 474-481 475 health [2]. Clean and Healthy Living Behavior (PHBS) refers to conscious actions developed through learning and daily practices to maintain and improve health independently at the individual, family, and community levels [3]. Based on the 2007, 2013, and 2018 Basic Health Research (Riskesdas) data, although some improvements have been observed, the achievement of PHBS has not yet reached an ideal level. The main challenge in implementing PHBS lies in the lack of public awareness [4]. According to data from the Kendari City Health Office, UKS activities at SD Negeri 93 Kendari City from June 2024 to June 2025 included preventive health interventions such as deworming in February and August and immunizations in September and November 2024 to prevent diseases and support students’ health [5]. A study by Nabila and Azinar (2025) highlights the importance of human resources, facilities, funding, strategies, and support from community health centers (puskesmas) in promoting PHBS in schools. However, it has not examined teachers’ perceptions of the role of UKS, making this study necessary to complement previous research and strengthen efforts to enhance the UKS program [6]. Research by Aminah et al. (2021) shows that limitations in schedules, facilities, and training in the implementation of UKS have led to low student interest and awareness regarding PHBS. Therefore, this study is important to analyze teachers’ perceptions of the role of UKS in shaping PHBS and its effectiveness from an educational perspective [7]. Based on the above background, the author is motivated to conduct a study entitled “Analysis of Teachers’ Perceptions of the Role of School Health Efforts (UKS) in Promoting Clean and Healthy Living Behavior (PHBS) Among Students at SD Negeri 93 Kendari City.” 2. Material and methods This study is a qualitative research employing a case study design focused on SD Negeri 93 Kendari City, aiming to explore in depth the teachers’ perceptions of the role of the School Health Efforts (UKS) program in shaping clean and healthy living behavior (PHBS) among students. The selection of informants was carried out using a purposive sampling technique, involving key informants namely the UKS coordinator teacher and classroom teachers as well as general informants, including the school principal and sixth-grade students. Primary data were obtained directly from teachers involved in the implementation of the UKS program and the promotion of PHBS at the school. Data collection techniques included in-depth interviews with teachers as key informants to explore their perceptions of the role of UKS in fostering students’ clean and healthy living behaviors. Data validity was ensured through triangulation techniques by comparing the accuracy of data from various sources, methods, and times. Source triangulation was also conducted by comparing information obtained from classroom teachers, UKS teachers, and school administrators involved in implementing the UKS program. 3. Result The informants in this study consisted of the UKS Coordinator Teacher, Classroom Teachers, the School Principal, and sixth-grade students. The UKS Coordinator Teacher and two Classroom Teachers served as key informants because they possess an in-depth understanding of the policies, implementation, and development direction of the UKS program at the school. Meanwhile, the School Principal and two sixth-grade students acted as general informants, as although they were not the main focus of the study, their experiences and perspectives contributed to enriching and strengthening the research findings. No. Name Characteristics of Informants Age Gender Education Occupation 1. Key Informant (S) 57 Female Bachelor’s Degree (S1) Teacher 2. Key Informant (D) 42 Female Bachelor’s Degree (S1) Teacher 3. Key Informant (AL) 45 Female Diploma 1 (D1) Teacher 4. General Informant (H) 58 Male Bachelor’s Degree (S1) Teacher 5. General Informant (F) 12 Female Currently in Elementary School Student 6. General Informant (A) 12 Female Currently in Elementary School Student World Journal of Advanced Research and Reviews, 2025, 28(02), 474-481 476 3.1. Teachers’ Understanding of the Objectives, Scope, and Benefits of UKS Based on the results of interviews and observations at SD Negeri 93 Kendari City, it was found that the informants had a good understanding of the concept of the School Health Efforts (UKS) program. Key informant S (57 years old) stated, “Yes, the school health effort,” while informant D (42 years old) explained, “It has been used by students when someone gets injured or when during the flag ceremony some students feel unwell, they are allowed to rest in the UKS room.” In addition, informant AL (45 years old) added, “UKS is about health education and raising awareness of the importance of maintaining health through the teaching and learning process at school.” This understanding is consistent with the views of the general informants. Informant H (58 years old) mentioned, “UKS is the first aid service for students before being taken to the community health center,” while student F (12 years old) said, “UKS stands for school health effort,” and student A (12 years old) added, “UKS is for treatment when someone gets injured and for resting when they are sick.” The interview results indicate that UKS at SD Negeri 93 Kendari City primarily functions as a first-aid facility and a medium for promoting health awareness. Informant S (57 years old) stated, “During Monday ceremonies, if a student feels dizzy or gets hurt, they are usually taken to the UKS room,” while informant D (42 years old) added, “The purpose is to provide a resting place and treatment for students who are sick or faint.” Informant AL (45 years old) emphasized, “The purpose is to raise awareness about the importance of cleanliness and health, as well as to create a clean, safe, and pleasant school environment.” Similar views were also expressed by the general informants. Student F (12 years old) said, “If someone gets injured or faints, they can be taken directly to the UKS,” student A (12 years old) explained, “For treatment if I have a headache, I can rest in the UKS room,” and informant H (58 years old) added, “UKS is an extension of the health office within the school; if the case can be handled there, only then do we refer to the community health center.” Based on the interview results, the UKS program at SD Negeri 93 Kendari City is considered to provide tangible benefits for the school community, particularly for students. Key informant S (57 years old) stated, “In general, it’s mainly for the students if someone falls, they are taken to the UKS, while teachers usually only come to check their weight.” Informant D (42 years old) explained, “It has been utilized well; every semester it is used to measure students’ weight and height,” while informant AL (45 years old) emphasized, “It improves students’ health, hygiene awareness, and clean living habits, as well as creates a healthy and comfortable school environment.” These statements were supported by the general informants. Informant H (58 years old) said, “It is very beneficial for the school if an unwanted incident occurs, it can be handled by the UKS,” student F (12 years old) added, “The benefit is to measure weight and height,” and student A (12 years old) mentioned, “For treatment when someone is sick after getting treatment, they recover.” 3.2. Implementation of Clean and Healthy Living Behavior (PHBS) Values by Teachers in Learning Activities Based on the results of interviews and observations, the implementation of Clean and Healthy Living Behavior (PHBS) values at SD Negeri 93 Kendari City has been consistently applied by teachers through both classroom learning and daily school activities. Key informant S (57 years old) stated, “For example, during class duty schedules, we remind students to keep the school environment clean. In physical education (PE) lessons, I remind them to maintain personal hygiene, especially to dress neatly and cleanly.” Similarly, informant D (42 years old) mentioned, “We always provide education to students about healthy living, such as washing hands before eating during breaks; if someone gets injured, they can go to the UKS.” Meanwhile, informant AL (45 years old) added, “For instance, before starting lessons in class, everything must be clean, orderly, and neat. I also remind them to dress properly.” This information aligns with the results from general informants. Informant H (58 years old) stated, “During assemblies, students are reminded about healthy food choices and buying snacks from the school canteen. There is also a handwashing station in front of each classroom, so they must wash their hands before eating.” Student F (12 years old) said, “Usually, the teacher reminds us to wash our hands regularly, do our class duty, and throw trash in the bin,” while student A (12 years old) added, “We are taught not to litter, to bathe twice a day, brush our teeth before bed, trim our nails, and dress neatly.” The research findings indicate that teacher role modeling plays an important role in shaping students’ clean and healthy living behavior. Key informant S (57 years old) stated, “We only give reminders to maintain cleanliness. The activities are usually carried out by the community health center (puskesmas).” However, other informants demonstrated more active forms of exemplary behavior. Informant D (42 years old) explained, “When there is trash scattered around, we pick it up, then I wash my hands as an example. Before starting lessons, we clean the classroom together.” Meanwhile, informant AL (45 years old) shared, “What I do is ensure my clothes are neat and clean, and I bring my own tumbler and food from home so that students can follow my example.” The views of the general informants also supported these findings. Informant H (58 years old) stated, “Whenever there are cleaning activities, I immediately participate in cleaning myself. Likewise, other teachers also take the lead before the World Journal of Advanced Research and Reviews, 2025, 28(02), 474-481 477 students, setting an example by joining directly.” Student F (12 years old) added, “Eat nutritious food, bring a tumbler from home, and don’t buy snacks outside,” while student A (12 years old) said, “For example, teachers tell us to throw trash in the bin, eat healthy food, and wear clean clothes.” Based on the results of interviews and observations, it can be concluded that PHBS value education by teachers at SD Negeri 93 Kendari City is implemented in an integrated manner through teaching and daily school routines. Key informant S (57 years old) stated, “During class duty, we always remind students to maintain the cleanliness of the school environment, and I always remind them to keep themselves clean in every lesson.” Informant D (42 years old) added, “We always remind students to throw trash in the bin, wash their hands before eating during recess, and if someone is injured, they can go to the UKS.” Meanwhile, informant AL (45 years old) mentioned, “I remind them to live clean and healthy lives, eat nutritious food, and bring their own tumbler from home.” General informants reinforced these findings. Informant H (58 years old) said, “Each teacher on duty always emphasizes clean and healthy living habits, which are conveyed every morning during assembly.” Meanwhile, student F (12 years old) added, “Exercise regularly, wake up early, and avoid staying up late,” and student A (12 years old) shared, “Behave well and don’t bully friends.” 3.3. The Role of Teachers in Supporting the Implementation of the UKS Program Based on the results of interviews and observations at SD Negeri 93 Kendari City, teachers play an important role in supporting the implementation of Clean and Healthy Living Behavior (PHBS) in schools. A key informant stated, “The most important thing is that we must conduct socialization and provide knowledge about healthy living, then practice it directly so that students can imitate what the teachers do at school” (AL, 45 years old). In line with this, another informant said, “We never get tired of reminding the students; we always emphasize it. The teacher’s role, thank God, is already optimal maybe not 100%, but around 90%” (S, 57 years old). However, limited facilities remain an obstacle, as expressed by another informant: “It’s already good, although not yet optimal. In terms of health facilities, they are still lacking sometimes if a student is quite seriously injured, we take them to the community health center” (D, 42 years old). Similarly, the general informants noted that teachers serve as the main role models in implementing PHBS. “Before teaching cleanliness to students, teachers must first set an example and have a better understanding of UKS and hygiene” (H, 58 years old), and “Teachers actively guide students about healthy living during the morning assembly” (F, 12 years old). Teachers also demonstrate active participation in UKS activities. A key informant explained, “For example, in the ‘little doctor’ program and in demonstrating the six steps of handwashing, which is usually done every new school year” (S, 57 years old), and “All teachers are involved in the training program (PKG) from the community health center, so all teachers and students participate” (D, 42 years old). In addition, “I once took part in the Healthy School program and other activities from the community health center, such as healthy food campaigns, anti-drug education, and anti-bullying socialization” (AL, 45 years old). This shows that teachers actively participate in various health-related activities at school. Consistently, the general informants stated, “During the ‘little doctor’ activity yesterday, I participated directly. The PE teacher and I personally accompanied the students to join the event” (H, 58 years old), and “We are reminded every day, sometimes in class or during the morning assembly” (A, 12 years old). Teachers play an active role in shaping students’ clean and healthy living behaviors. A key informant explained, “Teachers play a very supportive role in PHBS activities because they are highly beneficial for the school environment, making it cleaner and providing a more comfortable and healthy learning atmosphere” (D, 42 years old). Another informant added, “Every time I enter the classroom, I remind the students to wear sports uniforms during practice, dress neatly, and always maintain cleanliness” (S, 57 years old). Teachers also constantly remind students about the importance of maintaining school cleanliness, as expressed by another informant: “Teachers must always remind students to keep the school environment clean, such as throwing trash in the proper place and maintaining their health” (AL, 45 years old). This statement was supported by a general informant who said, “Teachers play a very important role, especially the physical education teacher. But during every morning assembly, the teacher on duty always delivers messages about clean living, and it has become a daily routine” (H, 58 years old). Another student informant added, “They set a good example for instance, teachers also throw trash in the proper place” (A, 12 years old). World Journal of Advanced Research and Reviews, 2025, 28(02), 474-481 478 3.4. Forms and Roles of the School Health Program (UKS) Contributing to PHBS Based on interviews with key informants at SD Negeri 93 Kendari City, the implementation of the UKS activities is carried out through collaboration between the school and the community health center (puskesmas). Informant S (57 years old) stated, “From the health center, there used to be the little doctor (dokter kecil) program, but it hasn’t been conducted recently. The point is, we always cooperate with the health center.” Informant D (42 years old) added that the UKS activities also include maintaining the cleanliness of the school environment and restrooms, while informant AL (45 years old) mentioned the existence of “PHBS socialization, monitoring of healthy food, and cervical cancer vaccination activities for fifth and sixth graders.” This was supported by a general informant, H (58 years old), who explained that “The school participates in health center programs such as immunization, deworming medication, and little doctor training.” However, some students, such as A (12 years old), admitted, “I rarely join, usually only when they measure height and weight.” The activities perceived as most influential on clean and healthy living behavior (PHBS) vary among informants. Informant S (57 years old) mentioned that “there are no activities that are most influential,” while informant D (42 years old) stated that “cleaning the school environment is very influential,” and informant AL (45 years old) emphasized that “the handwashing program has the most noticeable benefits.” This perspective aligns with the views of general informants H (58 years old) and A (12 years old), who regarded “throwing trash in its place and keeping the classroom clean” as the most impactful activities. Meanwhile, F (12 years old) added that “measuring height and weight” is also beneficial for understanding one’s health condition. Key informants also believed that the UKS program needs to be strengthened in several aspects. Informant S (57 years old) emphasized that “handwashing activities before meals should be reinforced,” D (42 years old) suggested “adding more medicines and cleaning equipment,” while AL (45 years old) highlighted “the need to provide separate trash bins for organic and non-organic waste.” General informants also agreed on the need for improvement; H (58 years old) expressed hope that “cooperation with the health center and little doctor training should be conducted regularly each semester,” and A (12 years old) stated that “there should be little doctors to assist teachers during flag ceremonies.” 4. Discussion 4.1. Teachers’ Understanding of the Objectives, Scope, and Benefits of the School Health Program (UKS) The results of the study show that, in terms of understanding, all informants possess good knowledge of the basic implementation of the School Health Program (UKS). Teachers understand UKS as a school health facility that provides first aid for students who are sick or suffer from minor injuries, while also serving as a learning medium to instill awareness of personal hygiene and health. This understanding serves as an important foundation for the continuous implementation of Clean and Healthy Living Behavior (PHBS) values. These findings are consistent with the study by Fitria et al. (2024), which found a significant relationship between teachers’ understanding of UKS and students’ healthy living behaviors. Teachers with a strong understanding of the UKS program are able to foster healthy habits through routines, exemplary actions, and educational activities in schools [8]. In terms of objectives, most informants stated that UKS functions as a first aid center for students experiencing health problems during learning activities. Additionally, UKS plays a role in fostering awareness of personal hygiene and creating a clean, safe, and comfortable school environment. One informant also added that UKS serves as an extension of the health office within the school. These results support the findings of Bili et al. (2022), who stated that the main goal of UKS in elementary schools is to shape clean and healthy living behaviors through the synergistic involvement of teachers, students, and parents [9]. Furthermore, in terms of benefits, teachers understand that UKS serves as a place for initial treatment of students who are sick or slightly injured, as well as for health check-up activities such as measuring weight and height every semester. Teachers also participate in monitoring students’ health and personal hygiene. Based on the perception factors, from the individual (perceiver) aspect, teachers demonstrate positive attitudes, strong motivation, and hope for the optimal implementation of UKS. From the object (target) aspect, teachers have a clear understanding of the function of UKS as a health facility and an educational medium for PHBS. Meanwhile, from the situational (situation) aspect, a supportive school environment, regular health check activities, and the active participation of teachers and students all contribute to the sustainability of the UKS program in the school. World Journal of Advanced Research and Reviews, 2025, 28(02), 474-481 479 4.2. Implementation of Clean and Healthy Living Behavior (PHBS) Values by Teachers in Learning Activities The results of the study indicate that, in terms of implementation, teachers consistently instill clean and healthy living behavior (PHBS) values in students through daily school activities. These efforts are reflected in various habituation practices, such as dressing neatly, washing hands before meals, and maintaining the cleanliness of classrooms and the school environment. In addition to habituation, teachers also provide direct education to students about the importance of personal hygiene and health. This implementation demonstrates the school’s commitment to shaping students’ positive behaviors, thereby creating a healthy, safe, and comfortable learning environment. These findings align with Aminah et al. (2021), who found that PHBS implementation in elementary schools heavily depends on teachers’ exemplary behavior in their daily school routines. Therefore, continuous guidance is needed to ensure that PHBS implementation becomes more effective and supports the UKS goal of fostering healthy behaviors among students [7]. From the aspect of teacher role modeling, most informants explained that teachers serve as role models for students in practicing clean and healthy living behaviors. Teachers’ exemplary behavior is reflected in concrete actions such as dressing neatly, disposing of waste properly, and keeping the classroom clean. Only one informant mentioned that examples of PHBS activities were mostly provided by the local public health center (puskesmas). However, in general, teachers actively provide direct examples that motivate students to imitate and apply them both at school and at home. From the aspect of PHBS value learning, informants stated that teachers consistently give directions and reminders to students to maintain personal and environmental cleanliness for instance, by disposing of trash properly, washing hands before eating, and bringing lunch boxes and tumblers from home. Teachers also guide students to use the UKS facility when they experience minor injuries or health problems. Through this role, teachers not only instill discipline and awareness of the importance of PHBS but also contribute to creating a healthy and conducive learning environment. This finding is consistent with Miranda (2023), who emphasized that teachers play a crucial role in instilling clean and healthy living behaviors in young children through exemplary conduct, habitual practice, and direct motivation. Teachers act as role models, advisors, and motivators for students in implementing PHBS practices at school [10]. Based on the research results, from the individual factor (perceiver), teachers demonstrate positive attitudes, strong motivation to instill PHBS values, and interest and experience in guiding students toward a healthy environment. From the object factor (target), PHBS implementation is reflected in tangible, easy-to-understand activities such as handwashing, maintaining classroom cleanliness, and dressing neatly. Meanwhile, from the situational factor (situation), support from the school environment, collaboration with the public health center, and positive teacherstudent interactions reinforce the success of PHBS implementation at SD Negeri 93 Kota Kendari. 4.3. The Role of Teachers in Supporting the Implementation of the UKS Program The results of the study show that, in terms of the teachers’ role, informants generally stated that teacher involvement in supporting the School Health Program (UKS) has been running well, although it has not yet reached its full potential. Teachers play a role in implementing various activities such as providing health education, developing habits of cleanliness, and guiding students to utilize the UKS facilities when experiencing minor health problems. However, the implementation of the teachers’ role still faces obstacles, particularly the limited health facilities and infrastructure available in the school. These findings are consistent with Muhammad and Ali (2020), who emphasized the importance of the role of UKS teachers in shaping clean and healthy living behavior (PHBS) among elementary school students. Their study showed that the active involvement of UKS teachers has a significant impact on increasing students’ awareness and practice of healthy living in the elementary school environment [11]. From the aspect of teacher participation, informants explained that UKS activities at the school are carried out collaboratively by involving teachers, students, and health workers from the local health center (puskesmas). Several activities have been implemented, including young doctor training, six-step handwashing practice for new students, free health checkups (PKG), immunizations, and deworming programs. In addition, socialization and counseling activities such as education on healthy eating, the dangers of drugs, and bullying prevention are routinely conducted to enhance students’ knowledge and awareness of health. From the aspect of teachers’ role in supporting PHBS among students, teachers act as role models and mentors. They set examples of personal hygiene by dressing neatly, wearing sports uniforms during physical education classes, and maintaining the cleanliness of the school environment by properly disposing of trash. Teachers also guide students to maintain healthy eating patterns and practice daily clean living habits. These findings align with Khairunnisa et al. (2020), who found that the implementation of the UKS program involves cross-sector collaboration among teachers, students, and health professionals. Teachers play a crucial role in providing health education through habituation and socialization, while the puskesmas contributes through health checkups and monitoring of students’ conditions. World Journal of Advanced Research and Reviews, 2025, 28(02), 474-481 480 Although implementation remains limited to certain times, the study highlights the importance of teacher collaboration and participation in fostering healthy living habits among elementary school students [12]. Based on these findings, from the individual factor (perceiver), teachers demonstrate high interest and strong commitment in UKS activities that promote PHBS values among students. From the object factor (target), UKS activities such as young doctor training, handwashing practice, and health education effectively encourage active participation of both teachers and students in adopting healthy behaviors. Meanwhile, from the situational factor (situation), support from the school environment and collaboration with the puskesmas strengthen the implementation of the UKS program, although limited facilities remain a challenge in optimizing the teachers’ role in shaping PHBS among students at SD Negeri 93 Kota Kendari. 4.4. Forms and Roles of the School Health Program (UKS) Contributing to PHBS The results of the study indicate that, in terms of UKS program implementation, most informants stated that the UKS activities at SD Negeri 93 Kota Kendari have been running quite well and involved almost all members of the school community. Although one informant mentioned rarely participating in UKS activities, in general, the activities carried out included the Young Doctor Program, socialization of Clean and Healthy Living Behavior (PHBS), monitoring of healthy food in the school canteen, health examinations and immunizations, including cervical cancer vaccinations for fifthand sixth-grade students. In addition to collaborative activities with the local puskesmas (community health center), the school also routinely organizes environmental cleanliness programs, such as gotong royong (mutual cooperation) to clean school areas and bathrooms. These findings are consistent with Lumbanraja et al. (2022), who found that UKS implementation has generally been effective, although its overall efficiency still needs improvement. The success of the UKS program greatly depends on the synergy between schools, teachers, and students in fostering awareness and responsibility for maintaining clean and healthy living behaviors within the school environment [13]. From the aspect of the most influential activities, most informants considered environmental cleanliness activities and the handwashing program as the UKS components that have the greatest impact on shaping clean and healthy living behavior (PHBS). These activities are seen as having tangible effects in creating a clean, healthy, and comfortable school environment while fostering students’ awareness of personal hygiene and developing sustainable positive habits. This finding aligns with Putri et al. (2025), who emphasized that maintaining environmental cleanliness and practicing handwashing are essential components of UKS in promoting healthy behavior among elementary school students. Such activities not only help keep the school environment clean but also instill awareness and build students’ discipline and character in practicing PHBS [14]. Regarding program strengthening, informants noted that while the UKS implementation at the school has been good, it still requires improvement in several aspects to be more optimal. The habit of handwashing before meals should continue to be promoted and supervised to ensure it becomes part of students’ daily routines. Furthermore, enhancing UKS facilities is necessary, particularly in terms of the availability of medicines, cleaning supplies, and supporting equipment such as separate trash bins for organic and non-organic waste. Improving these facilities and infrastructure is expected to enhance the effectiveness of the UKS program while reinforcing the sustainable implementation of PHBS in the school environment. Based on the study findings, from the individual factor (perceiver), teachers demonstrate a positive attitude and active involvement in supporting various UKS activities and instilling PHBS values among students. From the object factor (target), UKS activities such as the Young Doctor Program, handwashing practice, and environmental cleanliness campaigns have proven effective in influencing students’ positive behavioral changes. Meanwhile, from the situational factor (situation), the success of UKS is supported by the school environment and collaboration with the puskesmas, although limited facilities remain a challenge that must be addressed to improve the overall effectiveness of the UKS program at SD Negeri 93 Kota Kendari. 5. Conclusion Teachers at SD Negeri 93 Kendari City have a basic understanding of the objectives, scope, and benefits of the School Health Efforts (UKS) program as a means of providing first aid for sick students and as a health education medium to foster awareness of clean and healthy living. However, this understanding remains limited to practical aspects and has not yet encompassed the broader strategic role of UKS. In its implementation, teachers consistently instill the values of Clean and Healthy Living Behavior (PHBS) through habits such as maintaining personal and environmental hygiene, setting good examples, and reminding students to practice healthy behaviors. Teachers also play an active role in UKS activities such as young doctor training, health check-ups, immunizations, and PHBS socialization; however, their World Journal of Advanced Research and Reviews, 2025, 28(02), 474-481 481 effectiveness is still hindered by limited facilities and infrastructure. Collaboration between the school and the puskesmas (community health center) has been running well through routine health activities that have positively impacted students’ awareness and behavior, particularly in handwashing habits and maintaining environmental cleanliness. Therefore, it is necessary to improve health facilities, provide adequate medicines, and strengthen hygiene infrastructure to support the optimization and sustainability of the UKS program at the school. Compliance with ethical standards Acknowledgements The author sincerely expresses gratitude to the Faculty of Public Health, the Postgraduate Program, Halu Oleo University, as well as to all individuals and institutions who have contributed to the completion of this research. Disclosure of Conflict of interest There is no conflict of interest in this study. References [1] Nurnainah, N., & Ismail, I. (2023). 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