This document outlines the key aspects of school health services. It defines school health services as a branch of preventive medicine dealing with medical inspection of school children. The objectives of school health services are to promote positive health, prevent and control communicable diseases, enable early diagnosis and treatment of defects, and provide a healthful school environment. It describes the roles and duties of the school medical officer and school health nurse in providing these services.

1. SCHOOL HEALTH
SERVICES
BY
Dr. Riaz Ahmed

2. SCHOOL HEALTH SERVICES
 DEF:
• BRANCH OF PREVENTIVE MEDICINE DEALING WITH
MEDICAL INSPECTION OF SCHOOL CHILDREN & THEIR
HEALTH-PROTECTION PRIMARILY IN ENV.OF SCHOOL.
• CONTINUATION OF MCH-SERVICE
• PERSONAL TYPE
• PERIOD OF MAX.GROWTH (PHYSICALLY, MENTALLY etc)
 OBJECTIVES:
• PROMOTION OF POSITIVE – HEALTH.
• PREVENTION & CONTROL OF COMMUNICABLE DISEASES.
• EARLY DIAGNOSIS, TREATMENT & FOLLOW UP OF
DEFECTS.
• AWAKENING HEALTH CONSCIOUSNESS IN CHILDREN.
• EDUCATION OF TEACHERS
• PROVISION OF HEALTHFUL ENVIRONMENT

3. • PATTERN OF SCHOOL HEALTH
• SERVICE IN U.K / PAKISTAN
• An Attendant
• SCHOOL HEALTH TEAM
• SCHOOL MEDICAL OFFICER.
• SCHOOL HEALTH NURSE.
• AN ATTENDANT.
• S.M.O
• S.H.N
• SCHOOL HEALTH PROBLEMS
• ANY DISCUSSION OF S.H.S SHOULD BE BASED ON
THE 1) LOCAL – HEALTH PROBLEMS OF THE
COMMUNITY 2) CULTURE OF THE COMMUNITY 3)
AVAILABLE- RESOURCES IN TERMS OF MONEY,
MATERIAL AND MAN POWER (TRIPPLE ‘M’)

4. SCHOOL HEALTH PROBLEMS
• ABSENCE OF WELL-ORGANIZED S.H.S IN THE COUNTRY FOR
THE PROTECTION AND PROMOTION OF HEALTH OF SCHOOL
CHILDREN.
• POOR CULTURAL HERITAGE IN MATTER OF HEALTH.
• POOR HEALTH ATTITUDE OF SCHOOL TEACHERS.
• MALNUTRITION.
• PREVALENCE OF DENTAL CARIES.
• PREVALENCE OF PARASITIC- INFESTATION.
• PREVALENCE OF EYE DEFECTS
• ------
• -------
• 8) EAR, NOSE AND THROAT DISORDERS
• E
• N
• T
At School
• 9) ACCIDENTS Home
• R.SA

5. • 10) SKIN – DISORDERS e.g. PEDICULOSIS / SCABIES
• 11) UN-HEALTHY ENVIRONMENT
• 12) COMMUNICABLE DISEASES
• 13)
• a. IN ADEQUATE SEATING ARRANGMENTS.
• b. IMPROPER VENTILATION.
• c. POOR SANITARY CONVENIENICES WITH
• REGARD TO
• WATER- SUPPLY.
• COLLECTION & REMOVAL OF REFUSE.
• INSPECTION OF FOOD.

6. DUTIES OF SCHOOL MEDICAL
OFFICER
FOLLOWING ARE THE DUTIES OF SMO:
IN ROUTINE
•
• 1) PERIODICAL MEDICAL INSPECTION OF SCHOOL
CHILDREN
• 2) ANNUAL MEDICAL CHECK-UP
• 3) ARRANGEMENT FOR IMMUNIZATION OF CHILDREN / IN
GIRLS ESPECIALLY IMMUNIZATION AGAINST TETANUS AND
LADIES OF C.B.A Esp:
• 4) ADVISE TO PARENTS ON THE MENTAL & PHYSICAL
CONDITIONS OF CHILDREN.
• 5) INSPECTION OF PHYSICAL TRAINING PROGRAM
• 6) CASES REFERRED BY CLASS TEACHER / OR SCHOOL
AUTHORITY.

7. • 7) HEALTH EDUCATION OF TEACHERS
ESPECIALLY IN
– RECOGNIZING COMMON AILMENTS
– DEFECTS OF SCHOOL CHILDREN.
– IN PRACTICE OF 1ST AID
– IN GENERAL HYGIENE OF SCHOOL ENVIRONMENT.
– VENTILATION & SEATING ARRANGEMENTS / AS THE
CASE MAY BE.
• 8)PERIODICAL INSPECTION OF WATER- SUPPLY,
SANITARY CONVENIENCES
• 9)PERIODICAL VISITS TO HOSTELS
• 10) SCHOOL BUILDING INSPECTION
• 11) ADVISE TO SCHOOL AUTHORITIES BY S.M.O
ON CONSTRUCTION OF SCHOOL BUILDING.
• 12) TO ATTEND STAFF CONFERENCES.

8. • EQUIPMENT FOR SCHOOL CLINIC
• DRUGS FOR SCHOOL CLINIC
• DUTIES OF SCHOOL HEALTH NURSE:
• QUALIFIED IN PUBLIC HEALTH
NURSING
• FAMILIAR WITH PROBLEMS OF
ENVIRONMENTAL – HYGIENE
• PREVENTION OF DISEASES
• FOLLOW UP / HOME VISITING

9. DUTIES
• THE FOLLOWING ROUTINE DUTIES ARE
RECOMMENDED FOR HER.
• ASSITANCE OF M.O IN PLANNING OF MEDICAL
INSPECTION OF SCHOOL CHILDREN IN
CONSULTATION WITH SCHOOL TEACHER.
• RECORDING HEIGHT, WEIGHT AND PRELIMINARY
VISION TESTING.
• PARTICIPATION IN PHYSICAL TRAINING
• SUPERVISION OF HEALTH HABITS OF SCHOOL
CHILDREN
• PARTICULARLY
• CLEANLINESS OF CLOTHES; HAIRS, NAILS & ANY
OTHER UN-HYGENIC HABIT.LIKE: THUMB
SUCKING, BED-WETTING, NAIL-BITING.

10. • 5) SHE CAN TAKE ACTIVE PART IN
MAINTAINING RECORD OF
ABNORMALITIES DETECTED BY SMO.
• 6) FOLLOW UP OF SERVICE.
• 7) HOME VISITING.
• 8) TREATMENT OF MINOR AILMENTS
IN ABSENCE OF DOCTOR.
• 9) MAINTAINING OF RECORD
PROPERLY BOTH AT SCHOOL & OF
HOME VISITS.
• 10) TO ATTEND MONTHLY
CONFERENCES

11. TYPES OF RECORDS:
• PLANNING OF MEDICAL INSPECTION
• INTIMATION CARDS TO PARENTS
• MEDICAL INSPECTION CARD
• HEALTH HABIT CARD

12. • ROLE OF RESEARCH:
• TEACHING IS STERILE WITH OUT RESEARCH.
SCHOOL OFFERS THE BEST OPPORTUNITIES FOR
AN OBSERVATIONAL STUDY.
• A FEW PROBLEMS STUDIED IN SCHOOL HEALTH
SET UP IN KARACHI / SHOWS INTERESTING
FINDINGS.
• DIPHTHERIA:
• D.M.R – FOR LAST 12 YEARS ON
• PARASITES:
• STOOL EXAMINED FOR 5,800 SAMPLES.
• MIXED PATHOLOGY 43.9 % PARASITES OF
ANY KIND.
• 21 SAMPLES SHOWED ASCARIASIS.
• 3) ABSENTEEISM STUDY: 72 % due to SICKNESS

13.  CAUSES OF SICKNESS IN
 BOYS:
• TONSILITIS
• BOWEL DISORDERS
• RES.DISEASES LIKE
• BRONCHITIS, PNEUMONIA, PHARYNGITIS.
 GIRLS:
• P.U.O
• ENT DISORDERS
• BOWEL DISORDERS
• DYS.MENORRHOEA.
• 4) INVESTIGATION OF HEIGHT / WEIGHT FOR
PRIVATE + GOVT / AMERICAN.
• SCHOOL OBSERVATION WAS NOTED IN
CHILDRENS OF HIGHER SOCIO-ECONOMIC
GROUP. 5) DENTAL CARIES:
• D.M.F MORE THAN 50 %

14. FUNCTIONS OF S.H.S
• FOLLOWING ARE THE FUNCTIONS OF S.H.S:
• MEDICAL INSPECTION.
• DETECTION & CORRECTION OF DEFECTS
• NUTRITIONAL DEFECTS / CORRECTION.
SCHOOL MEAL PROGRAM
• DEFECTS OF VISION, DENTAL & AUDITARY
THROUGH HOSPITAL BY PRIOR
APPOINTMENT
• FOLLOW UP SERVICE
• TREATMENT OF MINOR AILMENTS
• C.D.C (Communicable Disease control)
• DETECTION OF CASE OF C.D

15. 9)ENVIRONMENTAL SANITATION
10) HEALTH EDUCATION
11) ACCIDENT PREVENTION
12) CO-ORDINATION IN PHYSICAL
TRAINING
13) P.T. MEETING
14) REFERAL OF ABNORMAL CASES
15) TRAINING OF TEACHERS
• ACTION OF DETECTION OF A CASE
OF INFECTIOUS DISEASE:

16. ROLE OF SCHOOL TEACHER
• KEY ROLE
• CENTRAL IN POSITION
• FIRST OBSERVER
• GRADING OF STUDENTS
• IN ATTENTIVENESS
• IST AID
• DELIVERING OF LECTURE IN HYGIENE
CLASS

17. • EITHER HIMSELF VACCINATION / IN
ABSENCE OF M.O
• OR REQUESTS THE AUTHORITIES FOR
VACCINATOR.
• REPORTS ON HEALTH / EDUCATION TO
PARENTS
• SUPERVISION OF ENV. HYGIENE
• DEMONSTRATION ON NUTRITION
• TO ATTEND P.T.M
• ACTIVE PARTCIPATION IN SCHOOL MEAL
SERVICE
• ACTIVE PATICIPATION ALSO IN
PHY.TRAINING