SCHOOL HEALTH SERVICES

Define School Health

School health refers to a state of complete physical, mental, social and spiritual
wellbeing and not merely the absence of disease or infirmity among pupils,
teachers and others school personnel.

Define School Health services

It refers to need based comprehensive services rendered to pupils ,teachers and

other personnel in the school to promote, protect their health, prevent and control
diseases and maintain their health.

Aims and Objectives of School Health service

Aim: To promote, to protect and maintain health of school children and reduce

Morbidity and mortality in them

Specific Objectives:

1) To create health consciousness among school children, parents and teachers.

2) To provide healthy and safe environment which is conducive to comprehensive

development of children

3) Impart health information and conduct health education on various aspects of

healthful living in school, home and community.

4) Prevent communicable and non-communicable diseases

. 5) Identify and treat any abnormalities/defects/diseases as early as possible and do

the referral and follow up

6)Involve teachers, students and their parents in the management of health aspects
Principles:

1) School health services should be based on health needs of children

2) School health services should be planned in coordination with school,

health personnel ,parents and community people

3) School health services should be pa part of community health services

4) School health services should emphasize on promotive and preventive

aspects

5) School health services should emphasise on health education to

promote,protect,improve and maintain health of children and staff.

6) School health services should emphasise on learning through active and

desirable participation.

7) School health services should be continuos and ongoing process.

8) School health services should be ongoing and continuous programme.

9) School health services should have an effective system of record keeping

and reporting.

Components of school health Services:

1) Health promotive and Protective services

2) Wholesome school environment

3) Maintainence of personal hygiene

4) Nutritional services

5) Physical and recreational activities

6) Promotion of mental health Health education Immunization

7) Therapeutic Services Health appraisal Treatment and follow-up

First aid and emergency care Specialized health care services
 8) Rehabilitative services Care of the handicapped

9) School health Records Components of school health Services

10) Health promotive and Protective services

Wholesome school environment

It is essential for holistic development of children coming from varying

socioeconomic and cultural backgrounds. It comprises of the site,location,the
building structure and its surroundings, the sanitary and other facilities.

i)Location; School should be located away from the nuisance of noise, traffic, dust
and easily approachable. Site should be dry on a raised surface with proper
drainage system and with a proper play ground.

ii) Building structure It should be single storeyed building Construction should

be heat proof. Well ventilated and attached to verandas and there should be
cross ventilation. Classroom should be spacious enough with a space of 10.sq
feet for each student. It is better to to have trees, plantations etc to keep the
environments cleanand fresh. iii) Furnishing of classrooms It is desirable to have a
single desk with chair for each student.

iv) Sanitary and other Facilities Water supply- It should be continuous, potable
and safe water supply from the tap. Water should be chlorinated periodically for
safety. Drinking water should be handled properly with long handle and a tumbler
kept along with it.

Lavatory- Each School must have school urinals and latrines with adequate
water supply. The habit of micturition should not be allowed anywhere. Disposal
of waste water and refuse-Each school should have a proper system of drainage
of waste water.

In rural areas drainage comprised of dust,paper,dirt,peelings of fruit,vegetables

and left out of vegetables should be disposed off in a dustbin. v) Canteen and
Eating-School should have its own sanitary canteen facility on subsidy basis. water
can be drained in soak pit or garden or nearby agricultural field. Food items should
be prepared and maintained in a hygienic manner by the food handlers
2)Maintainence of personal hygiene

It is important on the part of the teachers to explain the

importance of personal hygiene among children and promote it.
They can be a role model of personal hygiene. Daily inspection
of personal hygiene(eg: checking nails, daily baths, Proper care
of the body should be explained to te students(eg:care of
hair,nails,eyes,ears)

3)Nutritional services

A good nutritional intake is very important in the growth and development

of a child and also for his educational achievement. A nutritious mid-day meal is
considered a very practical solution to combat malnutrition.In view to curb
malnutrition,in the year 1961 the mid-day meal committee had started the mid-day
meal programme which caters atleast the 1/3rd of the caloric requirements of the
child

4)Physical and recreational activities

Physical activities and recreational activities in the school promote

musculoskeletal development inculcate team-spirit and help release physical and
mental stress. This helps to achieve optimal health and promote growth and
development.

5)Promotion of mental health

Wholesome mental health and behavior of the child is making sound

adjustmen with overall environment around him/her in the school and with the
studies expected. Maladjustment may lead to untoward behavior such as
truancy,juvenile delinquency, drug addiction etc.

6)Health education

Health education creates awareness, makes them regarding health matter;

develops motivation and promotes change in health behavior and health attitudes in
them. It consists of areas including personal hygiene, environmental health,
nutrition, prevention and control of communicable and non-communicable
diseases.

7)Immunization
 Immunization of children against specific communicable diseases is
necessary to prevent the occurrence of diseases like tuberculosis, diphtheria,
tetanus, measles and polio. Immunization schedule is complete by the time the
child is 5-6 years old. A proper record of immunization should be maintained as
part of comprehensive health record which should be handed over to the child at
the time of leaving school

2) Therapeutic Services

1) Health appraisal Regular periodical appraisal of health of

school children is very necessary to identify the deviation from
normal body parts and systems. It requires complete physical
and medical check-ups. Initial appraisal should be done at the
time of entry of the child which includes history taking,
physical and medical examination. Physical examination
includes observation of child from head to toe, measurement of
height, weight, arm and chest circumference. Testing of
vision,hearing and speech,observations such as vital signs as
pulse, respiratory rate and temperature. A routine examination
of blood, urine and stool should be carried out. Screening for
tuberculosis should be done at the tuberculosis clinic A
minimum of three health check-ups need to be carried out at
i)on school entry at the age of 5-6yrs ii)on passing out from
primary school at the age of 10-11 years. iii)on passing out
from middle school at the age of 13-14 years

2 Treatment and follow-up

*Treatment and follow-up of children who are found to have

any illness or defect is essential for their cure. *It is therefore
very important to have such arrangements exclusively for
children in the rural area specifically at the primary health
centers. First aid and emergency care *The school should make
arrangements for providing first-aid and emergency care to
children who get injured and sick at school. *Teachers who are
available at the spot can provide such care. Specialized health
care services *School children often suffer from problems like
dental carries,periodontal diseases;eye problems like defective
vision,squint, eye infection.
 3) Rehabilitative services

Rehabilitative services are required for those candidates who

are born with or and acquire any disability or handicap due to
road accident/infection some serious diseases, burns, injury etc.
Children with special disabilities like autism, blindness,
deafness should be trained in special institutions for
rehabilitation.

4) School health Records

It is essential to maintain complete, accurate and continuous

records of school children. Such health records are very useful
in monitoring the health status of the children They are used for
i) identification and personal aspect ii) findings of physical and
medical examination iii) findings of physical and medical
examination iv) findings of routine examination and screening
v) services rendered and the progress School health Team

The concept of school health team has evolved with generalized

family and community services. The services to the children in
school is in continuation of the services which are rendered to
age of under five children. It consists of the several members
like:

1.The School Principal

2) The School Teacher

3) The Parents

4) The Community

5) The Children
 6) The Medical Officer

7) The School Health Nurse

Role of community health nurse in school health programme.

1. Health counseling services for children regarding their personal hygienic

habits, Posture and posture and encourage them to develop good health
practices

2. Supervise how food is prepared, procured, stored or served in school and

encourage children to develop healthful food habits.

3. Help in measuring height, weight as well as preparing list of students to be

examined.

4. Education regarding harmful effects of drug addiction,smoking,chewing

tobacco and alcohol,etc.

5. Health education on various general health topics

6. Depending on the age and immunization status of the children,they are given
services as per schedule under immunization programme.

7. Early detection of defects in children and their proper treatment through

referral sevices

8. Provide emergency medical kits in all schools

9. To advise the school authorities about safe drinking water supply and good
environmental sanitation.

10.Provide quality healthcare and intervene with actual and potential health
problems

11. Collaborate with others to build student and family capacity for
adaptation,self management,self advocacy and learning.

12.The nurse may take an additional roles as needed to meet the needs of the
school community.