Recently, "school health" is drawing attention as an efficient approach in order to improve child health in the developing countries. Since 1980's, the assistance for the school health has been advancing in the world. However, there is very little information and research reports on the details of health related knowledge and behavior in primary school in developing countries. Therefore, this article aims to clarify problems of school health from a standpoint of educational cooperation. In particular, this report focused on the present conditions of health education and sanitation in primary schools of Republic of Niger of West Africa, i.e., about sanitary facilities, especially toilets and water supply system. As a result, it became clear that most of the diseases affecting Niger children on a daily basis are caused by the environment and lifestyle of the children. Meanwhile, sanitary facilities in schools, i.e. lavatories and water service were not fully utilized on a day-to-day basis. The reason was that the children haven't acquired knowledge and habit of disease prevention. At the same time, most of the teachers did not have enough time for teaching, teaching contents, nor teaching skill and experiences. As a conclusion, this article suggests that we should take health education more seriously with preventive action oriented approach aiming at the change of behaviors. Furthermore, the assistance should also be focused on improving the capacity with teaching methods at primary schools in order to address the child health problem from the educational point of view in Niger.