important in school health services to the students

1. SCHOOL HEALTH
SERVICE
By. SUJATA UMBARKAR
Msc, community health nursing

2. INTRODUCTION
• School health service is an important aspect of
community health. It is possible to increase the health level
of community and achieve growth in the health of future
generation through school health service.

3. DEFINITION OF 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 other school personnel.
k. k. gilani
DEFINITION OF SCHOOL HEALTH SERVICES
School health service refers to need based comprehensive service rendered to
pupils, teachers and other personnel in the school to promote, protect their
health, prevent and control disease and maintain their health.
k. k.gulani

4. AIM
• The ultimate aim of school health services is to
promote, protect and maintain health of school children
and reduce morbidity and mortality in them.

5. OBJECTIVES OF SCHOOL HEALTH
SERVICE
• The promotion of positive health
• The prevention of diseases
• Early diagnosis, treatment and follow up of defects
• Awakening health consciousness in children
• The provision of healthful environment.

6. NEED FOR SCHOOL HEALTH
SERVICES
 School children constitute a vital and substantial segment of population.
 Schoolchildren are vulnerable section of population by virtue of their
physical, mental, emotional and social growth and development during this period.
 School children are expressed to various stressful situations.
 Children coming to school belong to different socio economic and cultural
background which affect their health and nutritional status and require help and
guidance in promoting, protecting and maintaining their helath and nutritional
status.
 Children in school age are prone to get specific health problems.

7. PRINCIPLES OF SCHOOL HEALTH
SERVICES
• It is based on health needs of school children
• It is planned in co-ordination with school health personnel,
parents and community people.
• It emphasize on health education to promote, protect, improve
and maintain health of children and staff.
• It emphasize on promotive and preventive, aspects.

8. • It emphasize on health education to promote, protect,
improve and maintain health of children and staff.
• It emphasize on learning through active and
desirable participation.
• It is an ongoing and continuous program.
• It has an effective system of record keeping and
reporting.

9. COMPONENTS OF SCHOOL HEALTH
PROGRAMME
• Health appraisal of school children and school personnel
• Remedial measures and follow up
• Prevention of communicable disease
• Healthful school environment
• Nutritional service
• First aid and emergency care
• Mental health

10. • Dental health
• Eye health
• Health education
• Education of the handicapped children
• Maintenance and use of school health records

11. 1. Health appraisal of school children and school personnel
 Periodical medical examination of school children, teacher, health personnel.
 Medical examination on entry- 4 years
 Routine physical examination needs to be done.
 Clinical examination for nutritional deficiency, examination of faeces.
 Tuberculin testing/ screening for Hansen's annual testing of vision, regular
and quarterly wt/ht checking.
 Daily morning inspection by the teachers unusually flushed face, rashes,
spots, signs of acute cold, coughing and sneezing, sore throat, rigid neck, nausea,
vomiting, watery eyes, headache, chills, fever, etc.

12. 2. Remedial measures and follow up
 Following the regular examination, respective referral
services.
 Special clinics should be conducted in the health
units.
 Specialist should be employed in schools for the
same.
 Referral hospital must provide for beds for children
who are admitted and provide relevant treatment.

13. 3. Preventive of communicable diseases
 Protection of all school going children against preventable
disease by immunization according to the National
Immunization Schedule.
•Immunization

14. 4. Healthful school environment
1. An optimal school environment, location, building and
equipment's are important pre-requisites for a school health.
2. Agood school environment promotes physical, social and emotional health of
the pupils.
3.School should serve as exemplary place to reflect sanitation.
LOCATION

15. • SITE :
- Suitable high land
- 10 acres for high elementary school & 5 acres for primary
school & additional one acres land per 100 students.
-Nursery & Secondary schools as far as possible, be single
storied.
-Exterior walls should have minimum thickness of 10 inches &
should be heat resistant.

16. FACILITIES FOR PLAY

17. HUMIDITY THERMOMETER

18. NOISE

19. Class-room
• Verandas should be attached to class-
room
• No class-room should accommodate
more than 40 students
• Per capita space for students in a class-
room should not be less than 10 sq. ft.

20. AIR MOVEMENT

21. Furniture
• Suitable to the age group of students
• Desirable to provide single desks & chairs
• Chairs should be with proper back rest, with facilities of desk
work

22. Doors , windows and ventilation
• Broad with bottom still at a height of 2’-6’ from the floor level
• Doors & windows should be at least 25% of the floor space
• Windows should be placed on different walls for cross
ventilation

23. Colours
• Inside colour of the classroom
should be periodically white-
washed.
Lighting
• Classroom should have sufficient
natural light, preferably from the
left & should not be from the front

24. Water supply
There should be an
independent source of
safe & portable water
supply which should
continuous &
distribute from the
taps.

25. Eating
• Eating facilities ventures others than those
approved by the school authorities should not be
allowed inside school premises, there should be
separate room provided for mid-day meals.
SEPARATE ROOM FOR EATING

26. Lavatory
• Privies & urinals should be provided one urinal for
60 students & one latrine for 100 students
arrangements should be separately made for boys
& girls

27. 5. NUTRITIONAL SERVICES
• Good nutrition is very essential not only for optimal health growth
and development of the school child but also for his/her educational
achievement.
•  Anutritious mid-day meal for children in the school is considered
as a practical solution to combat malnutrition in children.
Mid-day meal
In order to combat malnutrition & improve health of school children.
- Providing mid ay meal trough their own cafeteria on a ‘no profit no
loss’.
- It should provide at least one-third of the daily calorie requirement &
about half of daily requirement of the child.
- It assure at least one nourishing meal

28. Applied nutrition
programme
UNICEF is assisting in
the implementation of
the applied nutrition
program in the form of
implements seeds,
manure & water supply
equipment.
SPECIFIC NUTRIENTS
Advances in the knowledge of
nutrition have revealed that specific
nutrients may be necessary for the
prevention of some nutrients
disorder. Dental caries, endemic
goiter, night blindness, protein
malnutrition, anemia & a host of
other nutrient disorders are
eminently preventable.

29. FIRST AID & EMERGENCY CARE
• The emergencies commonly met within schools are-
• The school must have an arrangement for providing first
aid and emergency care
• To children who get injured or sick at the school. The
teachers should receive adequate training during teacher
training program or in service training programs to prepare
themselves to carry out this obligation.
- Accidents leading to minor or serious injuries &
- Medical emergencies such as gastroenteritis colic,
epileptic fits, fainting etc

30. MENTAL HEALTH
• The mental health of the child affects his
physical health and the learning process.
Juvenile delinquency, mal-adjustment & drug
addiction are becoming problems among
school children.
• The school teacher has both a positive &
preventive role, so that they may develop into
mature responsible & well adjusted adults.

31. DENTAL HEALTH
• School children usually suffer from dental diseases
and defects.
• School health should incorporate dental health
components too.
• Dental hygienist and dentist are to be employed.
• During the dental check up should focus on
prophylactic cleansing and dental hygiene classes.
• Dental diseases & periodontal disease are the two
common dental diseases in India. A school health
program should have provision for dental exam. at
least once in a year

32. EYE HEALTH
• School should be responsible for early
detection of refractive errors. Treatment of
squint & amblyopic & detection & treatment
of eye infections trachoma,
• Teachers are in key position to detect
reflective errors, refer for treatment for
squints, amblyopia and to detect eye
infections.
• Vitamin A administration could be done.

33. EAR HEALTH

34. HEALTH EDUCATION
• Health education in
school children
- Personal health
- Environment health
- Family life

35. 10. Health education
 Health education is very important for school children as it creates
awareness, gives knowledge regarding health matter, gives knowledge
regarding health matter, develops motivation and promotes change in
health behavior and health attitudes.
 Health education content areas include personal hygiene,
environmental health, nutrition, prevention and control of
communicable and non-communicable diseases.

36. EDUCATION OF
HABDICAPPED CHILDREN
• The ultimate goal is to assist the
handicapped child & his family,
so that the child will be able to
reach his maximum potential, to
become as dependent as possible
to become a productive & self-
supporting member of society.
• Every child irrespective of the
disability, should be encouraged to
become productive and self
supporting.

37. SICK ROOM

38. SCHOOL HEALTH RECORDS
•A cumulative records contain
- Identification data
- Past history of illness
- Recording of findings of physical exam & screening test & records of
service provided

39. BEHAVIOURAL PROBLEMS
The behavioral problems are as follows
a. Antisocial- Stealing, Lying, Gambling, Destructiveness
b. Habit Disorders- Nail Biting, Thumb Sucking, Bed
Wetting
c. Educational Difficulties- Backwardness In Studies,
School Fear, School Failures Etc.
D. Personality Disorders: - Temper Tantrum, Shyness, Day
Dreaming, And Jealousy.

40. THE SCHOOL PRINCIPAL
1. Ensure that school health programme has the
approval and support of school administrative
authority.
2. Setupa school health committee/school health
council towork out the school health plan and plan
for its implementation.
3. Ensure that teachers are adequately trained for health
care of school-children.

41. 11. Education of handicapped children
Every child irrespective of the disability, should be
encouraged to become productive and self supporting.
12. School health records
The schools have cumulative health records providing
pertinent information and serves as tool to evaluate the
school health services.

42. SCHOOL HEALTH TEAM
• The school principal
• The school teacher
• The parents
• The community
• The children
• The medical officer
• The school health nurse/ community health nurse

43. THE SCHOOL PRINCIPAL
1. Ensure that school health programme has the approval and support
of school administrative authority.
2. Setupa school health committee/school health council towork out
the school health plan and plan for its implementation.
3. Ensure that teachers are adequately trained for health care of school-
children.
4. Provide facilities for implementationof school health activities.
5. Make sure that proper health records are maintained.
6. Ensure that parents are involved and follow upof
children is done.

44. THE SCHOOL TEACHER
1. Daily inspection of children for personal hygiene and
cleanliness;
2. Dailyobservationof children fordetecting any
evidence of any deviation from normal health,
behavior, any communicabledisease, malnutrition
etc;
3. Help in control of communicablediseases;

45. 4.Referral of child having any problem to school health
clinic for furtheraction;
5. Informing the parents and maintaining follow up;
6. Maintaining record of anthropometric measurements
and other health record of children;
7. Help in providing safe environmental sanitation;
8. Giving First Aid and Emergency care tochildren
9. Imparting of health education on healthful living habits and
behavioretc;
10.Participate in investigation of epidemic orany communicable
disease etc.

46. THE PARENTS
1. They can help in correction of defects if any and follow up of
children found sick.
2. They can help in formation of good healthful living habits and
behaviour.
3. Through "Parents- Teachers Association" the parents can be
involved in planning, organizing and implementation of school
health programm

47. THE COMMUNITY
1. Providing suitable land forschool building;
2. Providing fundsand labour in building properschool;
3. Participation in school health committeesorcouncils
and contribute in formulationof school health policies and
plan;
4. Participation in implementationof programme activities.
5. Motivating parents tosend theirchildren to school
and takecare of their health etc

48. THE CHILDREN
1. Learn valuesof medical and health examinations,
personal hygiene, good nutrition, environmental
sanitation etc.;
2. Co-operate in variousaspectsof school health programme;
3. Developpositive habits and healthful living activities
as educated upon;
4. Extend this knowledge toother members of the
family, neighborhood etc.

49. THE MEDICAL OFFICER
1. Medical examination of the students.
2. Making diagnosis.
3. Prescribing treatment.
4. Making referral tospecialists.
5. Ensuring follow upof children.
6. Initiating promotiveand preventive programme.

50. 7.Inspection of school environmentand sanitation
8. Holding meetings with parents and teachers.
9. Ensuring maintenanceof records and reports.
10.Evaluationof the programme and redefining
programme objectivesand activities.

51. THE SCHOOL HEALTH NURSE
Is responsible forcomprehensive health of thechild. She
takescare of all the factors which influence the health
of thechild such as:-
1. Biological aspectsof the child,
2. School and familyenvironment,
3. Health knowledgeand health attitudeof the child and
families

52. 4. Living activities,
5. Personal habits,
6. Health behavior followed by thechild and his/ her
family members;
7. Familyand individual health history;
8. Familyand communityresourcesand their utilization
etc.

53. School Health Programme
BY
CBSE
www.schoolofeducators.com 53

54. Introduction to a comprehensive School
Health Program
• The idea of a comprehensive School Health programme,
conceived in the 1940’s,included the following major
components viz. medical care, hygienic school environment
and nutritious school lunch and health and physical
Education. These components are important for the overall
development of the child and hence need to be included as
a part of the curriculum. The more recent addition to the
curriculum is Yoga. 54

55. Themes
The activities revolve around six different themes-
Knowing your body
Food and Nutrition
Personal and Environmental Hygiene
Physical Fitness
 Being Responsible and Safe
Behavior and Life skills section.
55

56. Comprehensive School Health Policy
• The WHO defines a health promoting school as one that is
constantly strengthening its capacity as a healthy setting for
living, learning and working . It focuses on creating health and
presenting important causes of death, disease and disability by
helping school children, staff, family and community to care for
themselves, take informed decisions over circumstances that
affect their health and create conditions that are conductive to
health. 56

57. What Does This School Health Policy Aim To
Do?
• The policy aims to:
• Provide an effective guide for school administrators /educators to
assist them in developing Health Promoting Schools.
• Ensure that school health programmes are based on formally
assessed and evidence based practice.
• Advocate the value of a comprehensive and planned approach to
school health through education sector.
57

58. Components of the policy
 The eight components of the comprehensive school Health Policy are:
 1.A School environment that is safe.
 2.A sequential Health Education curriculum taught daily in every
grade.
 3.A sequential Physical Education curriculum taught daily in every
grade.
 4.A nutrition services program that includes a food service program
and employs well- prepared staff who efficiently serve appealing
choices of nutritious foods.
58

59. Cont..
 5.A school Health Services Program that is designed to ensure access or
referral to primary health care services, prevent and control communicable
disease and other health problems.
 6.A counseling ,Psychological, and Social Services Program that is designed
to ensure access or referral to assessments, interventions, and other services
for student’s mental,emotional,and social health and whose services are
provided for by well-qualified and well-supported professionals.
 7.Integrated Family and Community Involvement activities that are designed
to engage families as active participants in their children’s education
 8.A Staff Health Promotion Policy that provides opportunities for school staff
to improve their health status through activities such as health assessments,
health, education and health-related fitness activities.
59

60. AIM & OBJECTIVES
Comprehensive Care’ for the Health & Well being of
all children.
1. Promotion of Positive Health
2. Prevention of Diseases
3. Early Diagnosis, Treatment & Follow up of defects.
4. Awakening Health consciousness in children.
5. Provision of Healthful environment.

61. School Health Programme
Services provided:
• Health check up
• Prevention of communicable disease
• Spot treatment
• Referral services
• Free spectacles
• Free super specialty treatment for Heart ,
Kidney and Cancer disease including renal
transplant
• IEC activities
• Nutritional Services(mdm, Applied Nutritional
Program,specfic Nutrition)

62. Strategies
• A State level Steering Committee, under the
chairmanship of the Health Minister.
• The Steering Committee takes important policy
decisions regarding the School Health Programme
• Meeting of all stake holders.
• Micro planning at PHC level .
• State level master plan.
• Primary, secondary and tertiary care.

63. Four Levels Of Health Care
SCHOOLS & ANGANWADIS
By Teachers/ASHA/ MPHW
BASIC
SCHOOLS & ANGANWADIS
By Medical Officers
PRIMARY
CHC / DISTRICT HOSPITALS
By Specialist Doctors
SECONDARY
TERTIARY
INSTITUTE / APEX HOSPITALS

64. School Health Programme 2010-11
•
•
•
•
New “School Health week” Concept
State:- 45 Working Days Programme
Village level:- Five days Programme
Involvement of Village Health & Sanitation Committee
/AWW & ICDS staff/ Teachers & Education
Inspectors/ MDM workers/ Panchayat
Department/Waters supply
•
•
Appointment of Nodal officer Village wise
“Health Exhibition”

65. • The basic strength of School health Programme is
* Widely accessible Communication network
* Easily retrievable health data
* Through micro planning for the entire project
* Appreciation & reward system for the peripheral
health provider
* Dedicated team for the programme
* Designated referral centers for the screened out
children
* The beneficial results obtained so far

66. Comprehensive School Health programme
• In which the Board has requested Schools to set up ‘Health Clubs’ in
order to implement the Comprehensive School Health Programme.The
Objectives of the School Health Club are
• To create Health Cards for each student.
• To create a health newspaper at least twice a year/poster competition
related to health issues.
• To conduct surveys on health related concerns.
• To organize ‘health walks’ as part of social campaigns 66

67. Cont…
 To organize health fairs and immunization projects.
 To tap the local resources in the community to arrange health talks.
 To render service in any area affected by a disaster or a calamity.
 To create health help line within the school to distress, cope with
emotional and social behavior and to clarify misconceptions
regarding adolescent health.
 To teach the students techniques of yoga and meditation from an
early age.
67

68. Cont….
• To inculcate in the students healthy and positive ways of living.
• To teach health songs on various health topics.
• Celebrating of important days(World Health Day-April 7)
• Creating awareness regarding –World No Tobacco Day(May
31),World AIDS Day (Dec 1) etc.
68

69. CURRENT STATUS OF SCHOOL
HEALTH IN INDIA
• The present status of school health is not so rosy. Very low
priority is given to the health promotion within the school
& community The health of the children & teachers is seen
only for the curative point of view.

71. ROLE OF NURSE

72. BIBLIOGRAPHY
Text book of “preventiveand social medicine” k. park
,21st edition, m/s banarsidas bhanot publisher. page
no-812 to 814.
“Community health nursing”, ‘principal &
practices'. k.k gulani, published by, neelam
kumari,page no-34-36
“Community health nursing”, BT basavanthappa,
jayapee brothers medical publisher- page no-19-20.

73. Cont…..
Community health nursing, “conceptand
practice”, barbara walton spradly, lippincott 4th
edition, page no-70 to 76.
“Nursing care in thecommunity”,joan m.
cookfair,second edition,page no-671 to 678
“Community health nursing”,stenhope, Lancaster
trends, page no-172-171.

74. THANKYOU