school health services

2. INTRODUCTION
Children between the age of 5-17 years are school age
children.
About 30 percent of the population is comprised of
this age group.

3. SCHOOL
 School is defined as an educational institution where
groups of pupils pursue defined studies at defined
levels, receive instructions from one or more teachers,
frequently interact with other officers and employees
such as principal, various supervisors/ instructors, and
maintenance staff etc., usually housed in a single
building.

4. SCHOOL HEALTH
School health refers to a state of complete physical,
mental, social and spiritual well being and not merely
the absence of disease or Infirmity among pupils,
teachers and other school personnel.

5. SCHOOL HEALTH SERVICES
 Ideally School health services refer to need based
comprehensive services rendered to pupils, teachers
and other personnel in the school to promote and
protect their health, prevent and control diseases and
maintain their health. But practically, it refers to
providing need based comprehensive services to pupils
to promote and protect their health, control diseases
and maintain their health.

6. SCHOOL HEALTH SERVICES IN INDIA
• Before Independence Era
• Post Independence Era

7.  1909, when for the first time medical examination of
school children was done in Baroda city.
• 1957 when Child Education -Nutrition Education
Committee and WHO assisted School Health
Education project were set up.

8.  1960 the Ministry of Health, Government of India, set
up a School Health Committee under the
chairmanship of Smt. Renuka Ray, the then member of
parliament to assess the standard of Health and
Nutrition of school children and also to suggest ways
and means of improving these.
• 1977 when a Centrally Sponsored National School
Health Scheme was started.

9.  1979, the National School Health scheme was handed
over to State Governments.
• 1981, a Task Force was established by the Government
of India, Ministry of Health and Family Welfare to
study the progress of School Health programme
functioning in various states of the country.
• 1984-85.Delhi had its own comprehensive school
Health Scheme which is continuing.

10. • 1988, a proposal for the comprehensive school health
service.
• 1989, the Central Health Education Bureau, Directorate
General of Health Services, had launched an intensive
School Health Education Project.
• At present "child to child” and "Youth to child”
approaches.

11. AIM OF SCHOOL HEALTH SERVICES
The ultimate aim of School Health Services is to
promote, protect and maintain health of school
children and reduce morbidity and mortality in them

12.  OBJECTIVES OF SCHOOL HEALTH SERVICES
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

13.  GOALS OF SCHOOL HEALTH SERVICES
1) To prepare the younger generation to adopt measures
to remain healthy so as to help them to make the best
use of educational facilities, to utilize leisure in
productive and constructive manner, to enjoy
recreation and to develop concern for others

14. 2) To help the younger generation become healthy and
useful citizens who will be able to perform their role
effectively for the welfare of themselves, their families,
and the community at large and country as a whole

15. NEED FOR SCHOOL HEALTH SERVICES
1. School children constitute a vital and substantial
segment of population.
2. School children are vulnerable section of population
by virtue of their physical, mental, emotional and
social growth and development during this period.
3. School children are exposed to various stressful
situations.

16. 4. Children coming to school belong to different socio-
economic and cultural backgrounds which affect their
health and nutrition status and require help and
guidance in promoting, protecting and maintaining
their health and nutritional status.
5. Children in school age are prone to get specific health
problems

17. PHILOSOPHY OF SCHOOL HEALTH SERVICES
1. A healthy child is mentally alert, receptive, will not
miss school due to minor sickness and will have
better performance in his/her studies.
2. Health is not just freedom from sickness or infirmity
but the realization of the full potential of the child
which has physical, mental, social and spiritual
components

18. 3. Prevention is better than cure; interventions when
health breaks down are costly and time consuming.
4. School health services will help identify any
deviations from normal growth and development, any
health problem so that timely, therapeutic, corrective
and rehabilitative actions can be taken to improve and
maintain health and continue studies.

19. 5.While early diagnosis and prompt and adequate
treatment is of great importance, follow up care is
equally important for effective school health services.
6. Rehabilitation of physically and mentally
handicapped children can be done and must receive
ad-equate attention.
7. Health knowledge and skills learnt not only will
benefit the child but also it will benefit the school, the
parents, family and community.

20. PRINCIPLES OF SCHOOL HEALTH SERVICES
1. Be based on health needs of school children.
2. Be planned in coordination with school, health
personnel, parents and community people.
3. Be part of community health services.
4. Emphasize on promotive and preventive aspects

21. 5. Emphasize on health education to promote, protect,
improve and maintain health of children and Staff.
6. Emphasize on learning through active and desirable
participation.
7. Be ongoing and continuous programme.
8. Have an effective system of record keeping and
reporting.

22. COMPONENTS OF SCHOOL HEALTH SERVICES
I) Health Promotive and Protective Services
1. Wholesome school environment
2. Maintenance of personal hygiene.
3. Nutritional services
4. Physical & recreational activities
5. Promotion of Mental health
6. Health Education
7. Immunization

23.  II) Therapeutic Services
1. Health appraisal
2. Treatment and follow up
3. First aid and emergency care
4. Specialized health services
III) Rehabilitative Services
• Care of the handicapped
IV) School Health Records

24. SCHOOL HEALTH PROBLEMS
• Health problems:-
1. Malnutrition
2. Infectious diseases
3. Intestinal parasites
4. Diseases of skin, eye and ear
5. Dental caries.

25.  Behavior problem:-
1. Antisocial problem: - stealing, lying, gambling,
destructiveness, sexual offence.
2. Habit disorders: - nail biting, thumb sucking, bed
wetting.

26. 3.Personality disorders: - temper tantrum, shyness, day
dreaming, and jealousy.
4. Educational difficulties: - backwardness in study,
school fear, school failure, etc

27. SCHOOL HEALTH TEAM
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/community health nurse

28. THE SCHOOL PRINCIPAL
1. Ensure that school health programme has the
approval and support of school administrative
authority.
2. Setup a school health committee/school health
council to work out the school health plan and plan
for its implementation.
3. Ensure that teachers are adequately trained for health
care of school-children.

29. 4. Provide facilities for implementation of school health
activities.
5. Make sure that proper health records are maintained.
6. Ensure that parents are involved and follow up of
children is done.

30. THE SCHOOL TEACHER
1. Daily inspection of children for personal hygiene and
cleanliness;
2. Daily observation of children for detecting any
evidence of any deviation from normal health,
behavior, any communicable disease, malnutrition
etc;
3. Help in control of communicable diseases;

31. 4.Referral of child having any problem to school health
clinic for further action;
5. Informing the parents and maintaining follow up;
6. Maintaining record of anthropometric measurements
and other health record of children;
7. Help in providing safe environmental sanitation;
8. Giving First Aid and Emergency care to children

32. 9. Imparting of health education on healthful living
habits and behavior etc;
10.Participate in investigation of epidemic or any
communicable disease etc.

33. THE PARENTS
1. They can help in correction of defects if any and
follow up of children found sick.
2. They can help in formation of good healthful living
habits and behaviour.
3. Through "Parents- Teachers Association" the parents
can be involved in planning, organizing and
implementation of school health programm

34. THE COMMUNITY
1. Providing suitable land for school building;
2. Providing funds and labour in building proper school;
3. Participation in school health committees or councils
and contribute in formulation of school health
policies and plan;
4. Participation in implementation of programme
activities.
5. Motivating parents to send their children to school
and take care of their health etc

35. THE CHILDREN
1. Learn values of medical and health examinations,
personal hygiene, good nutrition, environmental
sanitation etc.;
2. Co-operate in various aspects of school health
programme;
3. Develop positive habits and healthful living activities
as educated upon;
4. Extend this knowledge to other members of the
family, neighborhood etc.

36. THE MEDICAL OFFICER
1. Medical examination of the students.
2. Making diagnosis.
3. Prescribing treatment.
4. Making referral to specialists.
5. Ensuring follow up of children.
6. Initiating promotive and preventive programme.

37. 7.Inspection of school environment and sanitation
8. Holding meetings with parents and teachers.
9. Ensuring maintenance of records and reports.
10.Evaluation of the programme and redefining
programme objectives and activities.

38. THE SCHOOL HEALTH NURSE
Is responsible for comprehensive health of the child. She
takes care of all the factors which influence the health
of the child such as:-
1. Biological aspects of the child,
2. School and family environment,
3. Health knowledge and health attitude of the child and
families

39. 4. Living activities,
5. Personal habits,
6. Health behavior followed by the child and his/ her
family members;
7. Family and individual health history;
8. Family and community resources and their utilization
etc.

40.  SCHOOL HEALTH ADMINISTRATION
1. School Health Committees
2. Primary health centers

41.  SCHOOL HEALTH POLICY
1. Health center staff is responsible for implementation
of school health programme.
2. The school health programme is carried out in schools
by the health center staff working together with
schools administrators/ teachers, local government,
parents and community including both agencies and
students.
3. Priority should be given to school health programme
at primary school levels.

42. 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

43. 8. Dental health
9. Eye health
10.Health education
11.Education of handicapped children
12.Proper maintenance and use of school health records

44. ROLE OF NURSE IN
SCHOOL HEALTH
SERVICES

46. 2) Remedial measures and follow-up
3) Prevention of communicable diseases

48. Nutritional services

49. FIRST-AID AND EMERGENCY CARE

50. MENTAL HEALTH

51. DENTAL HEALTH

52. EYE HEALTH SERVICES

53. HEALTH EDUCATION

54. Education of handicapped children

55. SCHOOL HEALTH RECORDS

56. BIBLIOGRAPHY
 Text book of “preventive and social medicine” k. park
,21st edition, m/s banarsidas bhanot publisher. page
no-812 to 814.
 “Community health nursing”, ‘principal &
practices'. k.k gulani, published by, neelam
kumari,page no-34-36
 “Community health nursing”, BT basavanthappa,
jayapee brothers medical publisher- page no-19-20.

57. Cont…..
 Community health nursing, “concept and
practice”, barbara walton spradly, lippincott 4th
edition, page no-70 to 76.
 “Nursing care in the community”,joan m.
cookfair,second edition,page no-671 to 678
 “Community health nursing”,stenhope, Lancaster
trends, page no-172-171.