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SCHOOL NUTRITIONAL PROGRAMME
DR SHAHRANIZA BAHARI PUBLIC HEALTH PHYSICIAN
SENIOR PRINCIPAL ASSISTANT DIRECTOR (FAMILY HEALTH)
JOHOR STATE HEALTH DEPARTMENT
OUTLINE
• History of School Health Programmes in Malaysia
• School health programmes and activities
• School nutritional programmes
Nutritional education
Nutritional rehabilitation
• Information sharing: Japan School Health Programmes
HISTORY
YEAR ACTIVITIES
1920 Physical education taught in English Oriented School
1948 Establishment of School dental health services
1924 Coordinator for Physical Education for negeri-negeri Selat
1932 Training for Physical Education in Peninsular Malaysia
1948 Establishment of Maternal and Child Health Service
1952 Teachers sent for Health education training in England
1961 Tuberculosis Prevention and Control activities – BCG and treatment
1966 Establishment of Physical Activity and Health Education Curriculum in Malaysia
1968 Joint MOH and MOE School Health Committee established
1968 - 1970
State Joint MOH and MOE School Health Committee
1971 1st Review of Health Curriculum
1972 School Health Teams established
1976 School Food Supplement Program
1990 School Health Program Policy and Implementation Guideline ( 3 component model)
1991 Detection of Visual Defect among Standard 1 Schoolchildren as Quality Assurance Indicator
1996 Review of Education Act, Adolescent Health Program established
1998 Health Promoting School adopted from WHO (Program Bersepadu Sekolah Sihat, PBSS)
HISTORY(2)
HISTORY (3)
YEAR ACTIVITIES
2000 Young Doctor Club introduced as co curricular activity
2005 Introduction of Standard Operating Procedure for School Health
2008 Rebranding of HPS to National 3K Committee ( Cleanliness, Health, Safety)
2010 Introduction of National School Based HPV Immunisation
2012 MOE introduced BMI check in School
MOE introduced Guidelines on Healthy Nutrition in School
School Health Activities
Health education
Physical health
Communicable diseases
Tobacco/ Drugs
Food hygiene
Nutrition
etc
Health examination
Hygiene
Anthropometry
Visual screening
Hearing screening
Physical assessment
Immunization
Deworming
Treatment of minor ailment
Referral
School Health Inspection
Dengue Free School
School Canteen
School Environmental
School Dental Services
Peer to peer programs
Young Doctor
PROSTAR
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Health education and examination
Visual acuity test and Immunization
Oral Health Care
SCOPE OF SCHOOL HEALTH PROGRAM
Ministry of Health
Health Education
Primary prevention through vaccination
Health screening and Physical examination
Curative and referral
Dental health
Environmental Health
Ministry of Education
Nutritional rehabilitation School Milk Program
Food Supplementary Program
Health Education through Curriculum Physical and Health Education
Family Life Education
Health across curriculum
Co curricular Young Doctor Club
Nutritional Education in School
• Incorporate into primary and
secondary school
• Physical and Health Education
• Science subjects
Rancangan Makanan Tambahan (RMT)
1976
For primary schoolchildren from poor families
Aim to provide extra nourishment for schoolchildren
Served during recess (10.30am or 3.30pm)
Nutritional Rehabilitation in School
Nutritional Rehabilitation in School
Program Susu Sekolah (PSS)
1983
Cultivate milk drinking habit
Improve calcium intake
Free for the poor
Initiatives to prevent obesity among schoolchildren
• Introduction of guidelines for healthy nutrition in schools
Garis Panduan Pengurusan Berat Badan Murid Sekolah
Garis Panduan Penjualan Makanan dan Minuman di Kantin Sekolah
Garis Panduan Larangan Penjualan Makanan dan Minuman di Luar Pagar Sekolah
Japan Education System
• Under the Ministry of Education, Culture, Sports, Science and Technology
• Starting April to March
• Compulsory education:
Primary schools (Elementary school)
Age 6 to 11
Lower Secondary Schools (Junior High School)
Age 12 to 15
Month Term, Vacation School events, etc
April Spring vacation March 25 to April 7
First Trimester
Entrance ceremony, Health Examination
May Home visit by teachers, School trip, Fire Drill
Jun School Visit by Parents
July General cleaning, End of term ceremony
August Summer Vacation Outdoor activities
July 20 to August 31
September
Second Trimester
Opening ceremony, Fire Drill
October Athletic Meeting
November Presentations of Students Works at Open Day
December School Visit by Parents, Fire Drill, End of Term
Winter vacation December 25 to January 7
January
Third Trimester
Opening ceremony
February Marathon-race, school visit
March Graduation Ceremony
Spring vacation
School Calendar
Subjects and Standard Class Sessions • Japanese • Social studies • Arithmetic • Science • Life Environment Studies • Music • Drawing, Handicraft • Home Economics • Physical Education • Moral education • Special activities • Comprehensive learning
Time table in Elementary School
Time Monday - Friday
8.20 – 8.35 Morning Activities
8.40 – 8.50 Opening
8.50 – 9.35 1
9.45 – 10.30 2
10.30 – 10.50 Recess
10.50 – 11.35 3
11.45 – 12.30 4
12.30 – 13.20 SCHOOL LUNCH
13.25 – 13.40 Cleaning
13.40 – 13.50 Recess
13.50 – 14.35 5
14.35 – 15.45 Closing/ Recess
15.45 – 16.30 -/ 6
1 class = 45 min
Health education and examination
• Role of Yogo (school health) teacher
• Yogo teacher: special licensed educator who supports children’s growth and development through health education and health services in all areas educational activities in school
• School Health Office – Hokenshitsu
SCHOOL LUNCH
• First school lunch began in 1889 by a priest in Tsuruoka City, Yamagata Prefecture – rice ball, grilled fish and pickles
• Extended gradually until 1923
• Bread, milk and side dishes were gradually introduced – 1951
• School Lunch Law - 1954
Toyohashi School Lunch Programme
• School Lunch Preparation Center
• Lunch preparation process
Staple food by bread or rice provider
Side dishes – lunch preparation center
Milk - Milk provider
• Transported to schools by their respective providers
• Lunch fees - ¥ 220
School Nutritional Program
MALAYSIA
• Education Act 1996
• School Health Team
• Parent Teacher Association
• Rancangan Makanan Tambahan (RMT)
• Program Susu Sekolah
• Program Susu 1Malaysia
• School based school meal program
• Nurse in school
JAPAN
• School Health and Safety Law 1958
• YOGO teacher
• School Health Committee
• School Lunch Program
• Centralized school meal program
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NURSE IN SCHOOL PILOT PROJECT
Current system
• Yearly visit by school health team
• Screening for health problems for targeted students
• Refer cases to nearest health clinic
• No continuity of care in clinic
Nurse in school
• Nurse available in school / regularly visits school
• Nurse to screen health problem periodically to all students
• Long term intervention and follow up in school
• Communicate with parents and teachers as part of monitoring students
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NURSE IN SCHOOL PILOT PROJECT
• Adopt and adapted from YOGO teacher concept • Nurse with Public Health experience to be placed in
school for 1 year – Continuous Integrated management of behavior related
health problems in school – Feasibility of up scaling project for national roll out
• Proposal discussed at MOH, with MOE • MOH Secretary General proposed for pilot project in
50 schools throughout Malaysia – Urban vs rural, static vs regular visit, primary and
secondary school, integration of various health programs.
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IMPEMENTATIONS OF SMP PILOT PROJECT
• Voluntary basis
• Open to : Standard 1 students (morning session) and
Standard 2 students (afternoon session)
• Types of food and time served :
morning tea (recess time for morning session) and
afternoon tea (recess time for afternoon session)
• Menus served are based on the existing Healthy School Canteen Guidelines, 300-400 kcal for each menu.
• Canteen operators can operate as usual to cater those not involved in the programme. The foods sold must abide to the guidelines.
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