School health services

Dr Utpal Sharma Assistant Professor

Department of Community MedicineSMIMS, Gangtok, Sikkim

Introduction School is a setting that plays an important role in the physical,

emotional, social and mental development of children.

It is a personal health service and provides an…

…opportunity to help millions of young people to acquire health supportive knowledge, values, attitudes and behaviour.

Also influences health behaviour of other children, their families and community.

School health services is an economical and powerful means of raising community health.

In past 8 decades this service has developed from a narrower concept of health examination to comprehensive health care and well being of children throughout school years

History 1909- Medical examination for school children in Baroda city.

1946- Bhore committee report on non existence of adequate school health facilities.

1953- The Secondary education committee stressed on the need for regular examination & school feeding programme.

1960- Constitution of school health committee at vill, state, national level to assess health and nutrition of schoolchildren.

FYP –Initiatives for school health feeding programme by many states.

1963 - The “National School Health Council” has been established to plan and organize school children’s health care.

Health problem of the school child

Objectives Of School Health Services

General objective :

To provide comprehensive health care to school students in order to prepare them physically, mentally & socially

Specific objectives :

Promotion of Positive Health

Prevention of Diseases

Early Diagnosis, Treatment & Follow up of defects.

Awakening Health consciousness in children.

Provision of Healthful environment.

Aspect of School Health services

Health appraisal Periodic medical examination Recommended examination at school entry and

thereafter 4 yearly

Screening of children includes Height and Weight Routine examination of blood and urine Acuity of vision Hearing Skin condition Intestinal worms

Medical examination of school personnel

Daily morning inspection

Remedial measures & follow up

Special clinics should be conducted in the health units (PHCs) for schoolchildren.

Selected health unit or a school should be arranged for about 5000 children in urban areas

Results are recorded in the health record card and parents should be advised regarding remedial action

Referral hospital must provide for beds for children who are admitted & provide relevant treatment.

Prevention of communicable diseases by Immunization is the most emphasized function of school health services

Healthful school environment

Cont….Location Away from busy places. Keep free from all hazards.

Site Suitable highland with proper drainage Land area-10 acre for high schools and 5 acre for primary school….

…additional one acre per 100 students

Play ground: For a primary school it should be 0.5 to 1 acre. For a secondary school it should be 5 to 14 acres.

Infrastructure Nursery and secondary school building should be single storied Exterior walls about 10 inch thick and heat resistant

Cont…

Class room:Verandas should be attached to classrooms

Maximum accommodation of 40 student per classroom

Height of the class room about 12 feet

Room soundproof & dustproof and Floor should be smooth

Area not less then 480sq feet

Floor space> 10sq feet / child

FurniturePreferably single desk and chair should be provided

The seat should take 2/3 rd of the child’s thigh

Desk should be “minus” type with proper back rest

Cont…

Doors and windows

Combined area should be at least 25% of floor area

Windows broad and located at 2’6” from floor

Cross ventilation is a mandate

Ventilator area at lest 2% of floor area

Colour

Colour of the wall preferably white

Lighting

Sufficient natural light, preferably from the left

Cont….

Water supply

Independent source of safe and potable water supply

Continuous and distributed from taps

Eating facilities

Vendors not approved should not be allowed inside school premises

Separate rooms for mid day meal

Toilet facility

For 100 pupils…..1 pan

1 urinal for 60 student

Arrangements should be separately made for boys and girls.

Nutritional services School health committee (1961) recommended that school

children should be assured for at least on nutritional meal

Mid day meal- supplementary but not substitute, operational since 1961 under Ministry of education, GoI

Children provided with 1/3rd of calorie and ½ of protein requirements in school

Applied nutrition programme with the assistance of UNICEF advocates developing school gardens

Measures should be taken to combat nutritional deficiencies by providing specific nutrients.

First aid & emergency care.

Teachers should be trained during teacher’s training programme or “in service” training programme.

First aid box should be made available.

Mental health

The teachers should help children in attaining a positive mental health among the learners.

Suitably modify learning strategies, incentives.- rest, relaxation between periods of intense work

Instituting vocational counsellors and psychologists in schools to guide children into their careers.

Dental health

Dental hygienist & dentist are to be employed. Provision for dental examination, at least once

a year should be made During the dental check up should focus on prophylactic

cleansing & dental hygiene.

Eye health services

Teachers to be trained to detect… reflective errors

squints and ambylopia

eye infections….

…….and refer the child for treatment

Vit A administration should be done in the schools.

Health education

This should aim at imparting desirable changes among students it includes…

Personal hygiene Care of skin, hair, teeth nails…etc Attention regarding posture

Environmental health Encourage to part in health activities Visits to community health programmes and participation

in community action programmes

Family life Education regarding reproductive life should be provided

from the very beginning

Education of handicapped children

Ultimate goal is to assist the special child and his family to… Achive maximum potential To lead a normal life To become as independent as possible To become a productive and self- supporting member of society

This is done in a coordinated manner

School health records.

Cumulative health records providing pertinent information health supervision tool

Also serves as tools to evaluate the school health services.

School health administration

School health in India is under the Department of Health and Education School health committee (1961) recommended school health services to

be integral part of general health services As general health services is represented by primary health centres,

SHS is essentially an important function of PHC

Primary health centres

Requires a full-time medical officer to cover 5000-6000 children in a year

School health committee(1961)

Recommends formation of SHCs at village, state and national level to mobilize community resources and make SHP sustainable

National school health council will be an advisory and coordinating body

Thank you for taking

care….