School Health is an important issue for public health.

1. SCHOOL HEALTH
SERVICE

2. SCHOOL HEALTH SERVICE
 School health is an important branch of community health.
 According to modern concepts, school health service is an
economical and powerful means of raising community
health, and more important, in future generations.
 The school health service is a personal health service.
 It has developed during the past 70 years from the narrower
concept of medical examination of children to the present
day broader concept of comprehensive care of the health and
well-being of children throughout the school years.

3. Historical development
 1909-for the first time medical examination of school
children was carried out in Baroda city.
 1946-The Bhore Committee reported that School
Health Services were practically non-existent in
India, and where they existed, they were in an
under-developed state.
 1953-the Secondary Education Committee
emphasized the need for medical examination of
pupils and school feeding programmes.
 1960-the Government of India constituted a School
Health Committee to assess the standards of health
and nutrition of school children and suggest ways
and means to improve them.

4. Contd.
FYP-many State Governments have provided for
school health, and school feeding programmes.

5. HEALTH PROBLEMS OF
THE SCHOOL CHILD

6. OBJECTIVES OF SCHOOL HEALTH
SERVICE
 The objectives of the programme of a school health
 service are as follows :
 1. the promotion of positive health
 2. the prevention of diseases
 3. early diagnosis, treatment and follow-up of defects
 4. awakening health consciousness in children
 5. the provision of healthful environment.

7. Aspects of School Health
Service
 1. Health appraisal of school children and school personnel
 2. Remedial measures and follow-up
 3. Prevention of communicable diseases
 4. Healthful school environment
 5. Nutritional services
 6. First-aid and emergency care
 7. Mental health
 8. Dental health
 9. Eye health
 10. Health education
 11. Education of handicapped children
 12. Proper maintenance and use of school health records.

8. 1. Health appraisal
 The health appraisal should cover not only the students but
also the teachers and other school personnel. Health
appraisal consists of periodic medical examinations and
observation of children by the class teacher.
 -(a) Periodic Medical Examination :careful history
and physical examination of the child, with tests for
vision, hearing and speech.
A routine examination of blood and urine should be
carried out. Clinical examination for nutritional deficiency,
and examination of faeces for intestinal parasitosis.

9. CONTD.
 (b) School Personnel :Medical examination should be given
to teachers and other school personnel.
 (c) Daily Morning Inspection :The teacher is in a
 unique position to carry out the "daily inspection. The
following clues will help the school teacher in suspecting
children who need medical attention: (1) unusually flushed
face (2) any rash or spots (3) symptoms of acute cold (4)
coughing and sneezing (5) sore throat (6) rigid neck (7)
nausea and vomiting (8) red or watery eyes (9) headache (10)
chills or fever (11) listlessness or sleepiness (12)
disinclination to play (13) diarrhoea (14) pains in the body
(15) skin conditions like scabies and ringworm (16)
pediculosis
 Children showing any such signs or symptoms should be
referred to the school medical officer.

10. 2. Remedial measures and
follow-up
 Medical examinations are not an end.
 Special clinics should be conducted exclusively for
school children at the primary health centres in the
rural areas.
 Considering the high prevalence of dental, eye,
ear,nose and throat defects in the school children
,special clinics should be secured or provided for the
exclusive use of school children for examination.
 There should be provision for beds in the existing
referral hospitals for the children to be admitted.

11. 3. Prevention of communicable
diseases
 A well planned immunization programme should be
drawn up against the common communicable
diseases.
 A record of all immunizations should be maintained as
part of the school health records.

12. 4. Healthful school
environment
 (1) Location :The school should normally be centrally
situated with proper approach roads and at a fair distance
from busy places and roads, cinema houses, factories,railway
tracks and market places.
 (2) Site:The site should be on suitable high land, and not
subject to inundation or dampness and can be properly
drained. The School Health Committee had recommended
that 10 acres of land be provided for higher elementary
schools and 5 acres for primary schools with an additional
one acre of land per 100 students

13. CONTD.
 (3) Structure :Nursery and secondary schools, as
far as possible, be single storied. Exterior walls
should have a minimum thickness of 10 inches and
should be heat resistant.
 (4) Classroom :Verandhas should be attached to
classrooms. No classroom should accommodate
more than 40 students. Per capita space for
students in a classroom should not be less than 10
sq. ft.
 (5) Furniture :Furniture should suit the age group
 of students.

14. CONTD.
 (6) Doors and windows:The windows should be broad with the
bottom sill, at a height of 2'-6" from the floor level;combined
door and window area should be at least 25 percent of the floor
space; windows should be placed on different walls for cross-
ventilation; the ventilators should not be less than 2 percent of
the floor area.
 (7) Colour :Inside colour of the classroom should be white and
should be periodically white-washed.
 (8) Lighting : Classrooms should have sufficient natural light,
preferably from the left,and should not be from the front.
 (9) Water supply : There should be an independent source of
safe and potable water supply, which should be continuous,
and distributed from the taps.

15. CONTD.
 (10) Eating facilities :there should be a separate room
provided for mid-day meals.
 (11) Lavatory : Privies and urinals should be provided
one urinal for 60 students and one latrine for 100
students. Arrangements should be separately made for
boys and girls.

16. 5. Nutritional services
 The diet of the school child should, therefore receive
first attention.
 The diet should contain all the nutrients in proper
proportion, adequate for the maintenance of optimum
health.
 School children, particularly deficiencies relating to
proteins; vitamins A, C, thiamine and riboflavin, calcium
and iron.

17. Mid-day School Meal
 In order to combat malnutrition and improve the health of school children, it is
now an accepted procedure in all advanced countries to provide a good
nourishing meal to school children. schools should have some arrangement
for providing mid-day meals through their own cafeteria on a 'no profit no loss'
basis.
 Criteria of Mid-day School Meal :
 1.The meal should be a supplement and not a substitute to the home
diet .
 2. the school meal should provide at least one-third of the daily
calorie requirement and about half of daily protein requirement of
the child.
 3.The cost of the meal should be reasonably low.
 4.The meal should be such that it can be prepared easily in schools
,no complicated cooking process should be involved.
 5.Locally available meal should be used.
 6.The meal should be frequently changed to avoid monotony.

18. Mid-day School Meal

19. 6. First-aid and emergency
care
 All teachers should receive adequate training during
"Teacher Training Programmes" or "In-service Training
programmes“ regarding child health and treatment .
 (a) accidents leading to minor
or serious injuries, and
 {b) medical emergencies
 such as gastroenteritis, colic,
epileptic fits,
fainting, etc.

20. 7. Mental health
 The mental health of the child affects his physical health and
the learning process. Juvenile delinquency, maladjustment
and drug addiction are becoming problems among school
children.
 The school routine should be so planned that there is enough
relaxation between periods of intense work, and every effort
should be made to relieve the tedium of the class room. No
distinction should be made between race, religion, caste or
community; between the rich and poor; and between the
clever and the dull.
 It is now increasingly realized that there is a great need for
vocational counsellors and psychologists in schools for
guiding the children into careers for which they are suited.

21. 8. Dental health
 Dental caries and periodontal disease are the two
common dental diseases among the school childrens.
-A school health programme should have provision for
dental examination,at least once a year.
-The school teacher should teach the children about
dental hygiene.

22. 9. Eye health services
 Schools should be responsible for the early detection of
refractive errors, treatment of squint and amblyopia, and
detection and treatment of eye infections such as
trachoma.
 Administration of vitamin A to children at risk, has shown
gratifying results. In other words, basic eye health
services should be provided in schools.

23. 10. Health education
 Health education in schools should cover the following areas:
 (1) Personal hygiene
 (2) Environmental Health
 (3) Family life
 11. Education of –handicapped children-
 The ultimate goal is to assist the handicapped child and
his family so that the child will be able to reach his
maximum potential, to lead as normal a life as possible, to
become as independent as possible, and to become a
productive and self-supporting member of society.

24. CONTD.
 12. School health records-A cumulative health record of
each student should be maintained. Such records
should contain (a) Identifying data- name, date of birth,
parent's name and address, etc.
 (b) past health history
 (c) record of findings of physical examination and
screening tests and record of services provided.
 The purpose of maintaining school health records is to
have cumulative information on the health aspects of
school children in order to give continuing intelligent
healthsupervision.

26. DIFFERENT TYPES SCHOOL
DESKS
 Zero desk-
Here the posterior edge of the desk is
vertically in line with the anterior edge of the seat.
Plus desk-
In this type,there is a space between the
anterior of the edge of the seat and the posterior edge of
the desk
Minus desk-
Here the vertical line from the posterior edge
of the desk fall on the seat .

27. Contd.

30. Instruments required to
examine the school children
 1.Weighing machine
 2.Height measuring machine
 3.Tongue depressor
 4.Thermo-meter
 5.Measuring tape
 6.Torch
 7.Bandage
 8.Otoscope
 9.Antiseptic solution
 10.Blood pressure measuring machine
 11.Stethoscpe
 12. Ishihara chart