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SCHOOL NUTRITIONAL PROGRAMME DR SHAHRANIZA BAHARI PUBLIC HEALTH PHYSICIAN SENIOR PRINCIPAL ASSISTANT DIRECTOR (FAMILY HEALTH) JOHOR STATE HEALTH DEPARTMENT
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SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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Page 1: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

SCHOOL NUTRITIONAL PROGRAMME

DR SHAHRANIZA BAHARI PUBLIC HEALTH PHYSICIAN

SENIOR PRINCIPAL ASSISTANT DIRECTOR (FAMILY HEALTH)

JOHOR STATE HEALTH DEPARTMENT

Page 2: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 3: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 4: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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)

Page 5: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 6: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

INTRODUCED IN 1997

Page 7: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

KESELAMATAN

Safety

KESIHATAN

Health

KEBERSIHAN

Cleanliness

Page 8: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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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Page 9: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

Buku Rekod Kesihatan Murid

RKM1 (Pindaan 2011)

Page 10: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess
Page 11: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess
Page 12: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess
Page 13: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess
Page 14: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess
Page 15: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

BMI for Age

Page 19: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 21: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 22: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

RMT

Page 23: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

Nutritional Rehabilitation in School

Program Susu Sekolah (PSS)

1983

Cultivate milk drinking habit

Improve calcium intake

Free for the poor

Page 24: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess
Page 25: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess
Page 27: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 28: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

Healthy Nutrition in Schools

Page 29: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

EPP JAPAN – MALAYSIA SCHOOL HEALTH PROGRAM

11 – 26 FEBRUARY 2013

Page 30: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 31: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 32: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 33: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 34: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

Fitness Training

Page 35: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

Gargling with tea

Page 36: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

Gargling with tea

Page 37: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 38: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

Roles of the Yogo Teacher

Page 39: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

School Health Office - Hokenshitsu

Page 40: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

School Health Office - Hokenshitsu

Page 41: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

Height and Weight Measurement

Page 42: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 43: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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

Page 44: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

School Lunch Experiences

Page 45: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

School Lunch Experiences

Page 46: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

School Lunch Experiences

Page 47: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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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Page 48: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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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Page 49: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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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Page 50: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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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Page 51: SCHOOL NUTRITIONAL PROGRAM...Rancangan Makanan Tambahan (RMT) 1976 For primary schoolchildren from poor families Aim to provide extra nourishment for schoolchildren Served during recess

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