Purpose: This study investigated the level of implementation of skill-based health education in secondary schools in Calabar, Cross River State in relation to the School Health Programme implementation guidelines. Methodology: Two hypotheses were formulated to guide the study. The study employed the descriptive survey design. The multi-stage sampling technique was adopted to select a total of 314 SS2 students, 100 teachers and 20 principals from 20 schools (10 public and 10 private) and 2 policy makers to make up the sample size of 436. A well validated questionnaire, key informant interview guides and observation checklist developed by the researchers were used to collect both qualitative and quantitative data from respondents. Results: The results of data analysis were presented in tables and figures. The results of the study revealed that a significant difference exist between the School Health Programme implementation guidelines and the skill-based health education in schools and that school ownership significantly influenced the implementation of skill-based health education in schools (P <0.05, critical t = 1.960). The study revealed that physical and health education was being taught in 100% of schools but not skill-based health education; because it was observed that only 10% of private schools and none of the public actually engage the students in practical sessions to develop their skills. Again, subject specialists were found in just 30% private and 60% public schools. Recommendation: The state Ministry of Education should ensure that every school must have at least one health education specialist who will guide other teachers through the instructional strategies of skill-based health education curriculum. Further, the government and private school administrators should ensure the provision of adequate materials for teaching health education.
