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.
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.
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
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