SCHOOL HEALTH
INTRODUCTION:
Children - 5-17 years.
About 30% of the population
DEFINITION
School:
School is defined as an educational institution where
groups of pupils pursue defined studies at defined
levels, receive instructions from one or more
teachers, and frequently interact with other
officers and employees such as principal, various
supervisors/instructors, and maintenance staff
etc., usually housed in a single building.
School Health:
School health refers to a state of complete
physical, mental, social and spiritual well being
and not merely the absence of disease or infirmity
among pupils, teachers and either school
personnel.
School Health Services:
Ideally school health services refer to need based
comprehensive services rendered to pupils,
teachers and other personnel in the school to
promote and protect their health, prevent and
control diseases and maintain their health.
NEED FOR SCHOOL HEALTH
SERVICES
School Health Services are necessary and important
because of the following reasons: School Health constitutes a vital and substantial
segment of population.
School
children are vulnerable section of population
by virtue of the physical, mental, emotional and
social growth and development during this period.
NEED FOR SCHOOL HEALTH
SERVICES
School
children are exposed to various stressful
situations ex: school timings.
School
age children are prone to get specific
health problems.
Common health problems in School
children are
Dental
problems.
Malnutrition
Gastro-intestinal
Skin condition
Eye diseases
Respiratory
Behaviour problems
Others.
AIMS AND OBJECTIVES OF
The specific objectives are:SCHOOL
HEALTH
SERVICES:
Create health consciousness among school children, their
parents and teachers.
Provide healthy and safe environment which is
conductive to comprehensive development of School
children.
Impart health information and conduct health education
on various aspects of healthful living in school, home
and community.
AIMS AND OBJECTIVES OF
Prevent communicable and non communicable
SCHOOL HEALTH SERVICES:diseases.
Identify
and treat any abnormalities/ defects/
diseases as early as possible and do the necessary
referral and follow up.
Involve teacher, students and their parents in the
management of health aspects of children.
Help teachers and children make constructive and
productive use of the co-curricular and extra curricular
activities.
Help children to make the best use of educational
facilities, to utilize leisure and recreation opportunities in
a productive and constructive manner.
To promote appropriate social and emotional behaviour.
PRINCIPLES OF SCHOOL HEALTH
SERVICES
Be based on health needs of the school children.
Be planned in coordination with school, health personnel, parents
and community people.
Be part of community health services.
Emphasise on promotive and preventive aspects
Emphasise on health education to promote, protect, improve and
maintain health of children and staff.
Emphasise on learning through active and desirable participation
Be ongoing and continuous programme.
Have an effective system of record keeping and reporting.
Eight Component Model
ASPECTS OF SCHOOL HEALTH
1.
2.
3.
4.
5.
6.
Health appraisal of school children and school
personnel.
Remedial measures and follow-up.
Prevention of communicable diseases.
Healthful school environment.
Nutritional services.
First aid and emergency care.
ASPECTS OF SCHOOL HEALTH
7. Mental Health.
8. Dental Health.
9. Eye Health.
10. Health education.
11. Education of handicapped children.
12. Proper maintenance and use of school health
records.
1. Health appraisal
Periodic
Medical Examination
Daily morning Inspection
School Personnel
Periodic Medical Examination:
The school health committee in India
at the time of entry and there after every 4 years.
The initial examination should be thorough and
careful history and physical examination of the child, with tests
for vision, hearing and speech.
A routine examination of blood and urine should be carried out.
Clinical examination of nutritional deficiency and
examination of feaces for intestinal parasites
Daily morning Inspection
Teacher
detect changes in the childs appearance or
behavior
School Personnel:
Medical examination to teachers and other school
personnel
2. Remedial measures and follow-up.
Medical
examinations -followed by appropriate
treatment and follow-up.
Special clinics should be conducted at the primary
health centres in the rural areas and
In selected schools or dispensaries for a group of
about 5000 children in the urban areas.
3. Prevention of communicable diseases
through
immunization.
A record should be maintained as part of the
school health records.
When the child leaves school, the health records
accompany him.
4. Healthful school environment
minimum standards for sanitation of the school
Location
Site
Structure
Classroom
Furniture
Doors and windows
Color
Lighting
Water supply
Eating facilities
Lavatory
Location:
proper approach roads and at a fair distance from
busy places and roads, cinema houses, factories,
railway tracts and market places.
Site:
on suitable highland and properly drained.
Structure:
Exterior walls should have a minimum thickness of 10
inches and should be heat resistant.
Classroom:
Verandas should be attached to classroom.
No classroom should accommodate more than 40 students.
Per capita space for students in a classroom should not be
less than 10 sq ft.
Furniture:
age group of students.
single desks and chairs.
Doors and windows:
combined door and the window area should be
atleast 25% of the floor space;
windows should be placed on different walls for
cross ventilation;
Color:
white washed
Lighting:
sufficient natural light.
Water supply:
independent source of safe and potable water supply.
Eating facilities:
separate room - for mid-day meals.
Lavatory:
one urinals for 60 students and one latrine for 100
students.
5. Nutritional services
The
diet should contain all the nutrients in proper
proportions
various nutritional programmes
Mid-day meal programme,
applied nutritional programme etc.
6. First aid and emergency care
teachers
-teacher training programme.
fully equipped first aid kit & post should be
provided as per regulation of St .John Ambulance
Association of India.
7. Mental Health
enough
relaxation between periods of intense
work
No distinction should be made between any
students.
8. Dental Health
provision
for dental examination, at least once a
year.
inspection of the teeth and prophylactic cleansing
in preventing gum troubles and
in improving personal appearance should be
made.
Teaching regarding dental hygiene
9. Eye Health
early
detection of refractive errors,
treatment of squint and
treatment of eye infections such as trachoma.
Administration of Vit .A to children at risk
10. Health Education
personal
hygiene,
environmental health and
family life.
11. Education of the handicapped children
to
assist the handicap child and his family to lead
as normal life as possible, to become as
independent as possible, and to become a
productive and self-supporting member of society.
12. School Health Records
A cumulative
health record of each student
SCHOOL HEALTH TEAM
school
physician,
School health nurse,
counsellor,
psychologist,
social worker,
Teachers,
Students,
parents.
Community.
School Health Programme
a
program for school health service
is the only public sector programme specifically
focused on school age children.
Its main focus is to address the health needs of
children, both physical and mental, and
in addition, it provides for nutrition interventions,
yoga facilities and counseling.
Components of School Health Program:
Health
service provision:
Capacity building
Monitoring & Evaluation
Mid Day Meal
Health service provision:
Screening, health care and referral:
Immunisation:
Micronutrient (Vitamin A & IFA) management:
De-worming
Health Promoting Schools
Screening, health care and referral:
general health, assessment of Anaemia/Nutritional status,
visual acuity, hearng problems, dental check up, common
skin conditions,
Heart defects, physical disabilities, learning disorders,
behavior problems, etc.
Basic medicine kit will be provided to take care of common
ailments
Referral Cards for priority services at District / Sub-District
hospitals.
Immunisation:
As per national schedule
Fixed day activity
Coupled with education about the issue
Micronutrient (Vitamin A & IFA) management:
De-worming
Biannually supervised schedule
Prior IEC
Siblings of students also to be covered
Health Promoting Schools
Counseling services
Regular practice of Yoga, Physical education, health
education
Peer leaders as health educators.
Adolescent health education-existing in few places
Linkages with the out of school children
Health clubs, Health cabinets
First Aid room/corners or clinics.
ROLES
Direct care giver-Nurse Practitioner
Health Educator
Manager
Consultant
Counselor
Community outreach
Researcher
Advocate
Functional Role
Team Member
Direct care giver:
immediate nursing care to the ill or injured child
or school staff members.
public or private schools -during school hours,
boarding school 24/7
referral to other health care providers,
physicians and psychologists, counselors
Health Educator:
one-on-one and in the classroom.
proper nutrition
safety
changes in their bodies as puberty arrives.
Case Manager:
coordinate the health care for children with
complex health problems.
Consultant:
provide
professional information about proposed
changes in the school environment and their
impact on the health of the children.
Counselor:
Community
outreach:
nurses can be involved in community health fairs
or festivals in the schools,
The school nurse serves as a liaison between
school personnel, family, community, and health
care providers.
Researcher:
evidence based practice.
To advance school nursing practice.
Advocate:
The nurse advocate represents the interest of
individual student, special need group, or all
children within the school in the community etc.
Functional Role:
responsible for a group of schools to fulfil the functions
screening,
follow-up,
control of communicable diseases (outbreak of head
lice),
immunization,
responding to call from different schools.
Team Member:
active member of multidisciplinary team,
act as a co-ordinator or advocate,
conveying information about problem areas to
parents.
RESPONSIBILITIES
Organising
and conducting school health clinic.
Assisting in periodical examination of school
children and teachers.
Inspection of school health environment
Inspection of mid-day meal programmes.
Instruction to teachers for regular inspection of
school children.
Assisting in dental and eye check-up.
RESPONSIBILITIES
Counselling
the parents and children with physical
and mental problems.
Referral services
Health education on good nutrition, healthy habits,
reading habits, hygiene, and
Performs comprehensive physical, cognitive and
psychosocial evaluations
Manages a variety of minor illness or injuries
RESPONSIBILITIES
Place
special emphasis on teaching students to be
responsible for their own health promotion and
maintenance
Collaborates
with physicians/other health care
personnel and educators help in providing health care
Uses advanced physical and health assessment skills to
identify factors that may place the student at risk of
acquiring learning disorders or other physical or
emotional problems.
