PRESENTATION BY Ms. LAXMI.
R
MSc(N)
MENTAL HEALTH NURSING
DEPARTMENT
NURSING TUTOR TSRTC CON
UNIT – 11
SCHOOL HEALTH SERVICES
LEARNING OBJECTIVES
What is School Health Services
Objectives of School Health Services
Health Problems of School Children
Components of School Health Services
Maintenance of School Health Records
Initiation and Planning of School Health
Services
Role of a School Health Nurse
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
SCHOOL
School is one of the social institutions
where students learn many things that
help them grow into persons with
intellectual abilities, positive attitude
and matured behavior, and become
responsible citizens
-Shyamala D
SCHOOL HEALTH
School health refers to a state of
complete physical,mental,social
and spiritual well-being and not
merely the absence of disease
among pupils, teachers and other
school personnel.
-K.K Gulani
SCHOOL HEALTH NURSING
Specialized practice of professional nursing
that advances the wellbeing, academic
success and lifelong achievement of students
SCHOOL HEALTH SERVICES
School Health Services (SHS), as defined services provided by a health worker to
students enrolled in primary or secondary education, either within school premises or in
a health service situated outside the school.
-World Health Organization
The need based comprehensive services rendered to pupils, teachers and other personnel
in the school to promotes and protect their health, prevent and control diseases and
maintain their health.
-Dr.T.Vasundhara Tulasi
MILESTONES IN SCHOOL HEALTH SERVICES IN
INDIA
1909 – Medical Examination Conducted For The First Time
( Baroda City)
1946 – Bhore Committee Report Of School Health Services
1977 – Central Sponsored National School Health Scheme Was
Started
1955 – World Health Organization Appointed on School Health
Education And Health Promotion
1966 – Government Of India Launched The School Health Scheme
AIM
The ultimate aim of school health
services is to promote, protect and
maintain health of school children
and reduce the death rates in them.
OBJECTIVES
To Promote Positive Health
To Maintain And Protect Health
To Prevent Diseases
To Promote Early Diagnosis, Treatment And Follow-up
To Refer Cases When Needed
To Create Health Awareness Among Children
To Provide A Safe And Healthful Environment
NEED FOR SCHOOL HEALTH SERVICES
School children are exposed to various stressful
situations
Children coming to school belong to different
socio economic and cultural backgrounds
which affect their health and nutritional status
Children in school age are prone to get specific
health problems
PRINCIPLES OF SCHOOL HEALTH
SERVICES:
It should be based on the need of school children.
It should be planned in coordination with school health personnel,
parents& community people
It should be a part of community health services.
Emphasis should be on the preventive & promotive aspects of
health.
Emphasis on health education to promote ,protect , improve and
maintain health of the children.
Emphasis on learning through active participation.
Be on continuous programme.
SCHOOL HEALTH TEAM
SCHOOL PRINCIPAL
SCHOOL TEACHER
PARENTS
COMMUNITY
CHILDREN
MEDICAL OFFICER
SCHOOL HEALTH NURSE/COMMUNITY
HEALTH NURSE
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.
SCHOOL PRINCIPAL
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.
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
4. Referral of child having any problem to school health clinic
for further action
5. Informing the parents and maintaining follow up
SCHOOL TEACHER
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
9. Imparting of health education on healthful living habits
and behavior etc
10.Participate in investigation of epidemic or any
communicable
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 behavior.
3. Through "Parents- Teachers Association" the parents
can involved in planning, be organizing and
implementation of school health programme
COMMUNITY
1. Providing building; suitable land for school
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 programme activities. implementation
5. Motivating parents to send their children to school and
take care of their health .
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
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
MEDICAL OFFICER
6. Initiating promotive and preventive programme
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
SCHOOL HEALTH NURSE
1. Biological aspects of the child
2. School and family environment
3. Health knowledge and health attitude of the
child and families
4. Living activities
SCHOOL HEALTH NURSE
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.
MAINTAINANCE
OF
SCHOOL HEALTH RECORDS
PERSONAL HYGIENE ANECDOTAL
RECORDS
IMMUNIZATION INFORMATION
GROWTH MONITORING
VISION TESTING
HEARING SCREENING FINDINDS
DENTAL SCREEENING RECORDS
ATTENDENCE DATA
PERIODICAL HEALTH SCREENING
COMMUNICABLE DISEASE RECORD
FALL RECORD
FIRST AID RECORD
ANNUAL MEDICAL CHECKUP RECORDS
MEDICATION DOCUMENTATION
NURSING DOCUMENTATION
HEALTH ROOM VISIT DOCUMENTATION
COMPONENTS
Physical
First-aid &
Infrastructur
Emergency
e of The
Care
School
Prevention of
Health
Communicabl
Appraisal
e Diseases
Remedial
Measures Nutritional
and Follow- Services
up
COMPONENTS
Promotion
Eye Health
of Mental
Services
Health
School
Health
Health
Education
Records
Education
Dental of
Health Handicappe
d Children
Physical Infrastructure of the School
Location : Centrally located with road facilities and away
from cinema halls, railways, factories
Protection: To be free from hazards and it should be
properly fenced.
Site: Should be on high land and not subject to inundation.
Land area required: Primary schools-5 acres with an
additional 1 acre of land for every increase in numbers of
100
Physical Infrastructure of the School
Structure: Nursery and secondary schools should be separated
Classrooms: Should be attached to verandas.
Furniture should suit the age group. Desirable is single desk
and chair. Chairs should have backrests and deskwork
facilities. Doors and windows should be 2-6 feet from floor
level
Color: inside wall, color should be white.
Physical Infrastructure of the School
Lighting: sufficient natural lighting from left to right. Water:
safe and continuous supply of potable water.
Eating facilities: separate place to eat, no vendors should be
allowed other than permitted.
Disposal of wastewater and refuse: school should have a
wastewater drainage system. Most often schools in rural
areas drain wastewater into a soak pit or school garden or
nearby agricultural field. The refuse consisting of dust, paper,
dirt, peelings of fruit and vegetable remains should be
disposed of in a dustbin.
Health Appraisal : For Students
PERIODIC MEDICAL EXAMINATION
Regular medical examination of school
children
Complete physical & medical examination
Examination at the time of entry and
annually
At the entry collecting prior history,
physical and medical examination
Health Appraisal : For Students
MEDICAL EXAMINATION
Head to toe examination
Testing vision, hearing and speech
assessing vital signs
Routine examination of blood, urine
and stool
Tuberculin testing
Health Appraisal : For School staff
DAILY INSPECTION BY THE
TEACHER
Class students observation: fever,
rashes, acute cold, cough, sneezing,
watery eyes and nose, sore throat,
headache, body ache, lack of intrest to
play, diarrhea, vomiting, frequent
urination
Remedial Measures And Follow-up
Proper treatment and follow up for the medical
examination
Special clinics to be run in rural areas
Urban areas should have special clinics for a group of
5000 children
School should be intimated about the clinic schedule
Special clinics should focus on problems that are highly
prevalent like dental, eye, ear, nose and throat defects.
First-Aid & Emergency Care
All teachers must have first aid
training especially where there is
no school health nurse
First aid posters at school
Common emergencies treatment to
be given knowledge to students
Prevention of Communicable Diseases
Immunization programs
Records for immunization to be registered in the
school health records
Health Records should accompany the child
whenever child leaves school or transfers
Nutritional Services
Child who are physically well may not be active in
performing daily activities
Specific attention need to be paid to the nutrition of
the children
School meal should be provided with calorie
requirements
Providing water supply and snacks
Promotion of Mental Health
Teacher should be careful in concerns of the students in
the class
Helps children attain mental health
Identify if any abnormal behaviors are seen
Teacher must never discriminate against students in
terms of being rich or poor, clever or dull, color and caste
Counsellors should be available in schools
Health Education
PERSONAL HYGIENE:
o Hygiene for skin, hair, teeth and clothing
should be taught
o Students should adopt correct postures while
sitting and standing
o Observe the students for any bad habits
HEALTH PROBLEMS OF
THE SCHOOL
CHILDREN
INTRODUCTION
Provision of school health services corresponds
to the prevailing health problems of the
schoolchildren.
Not necessarily all the schools should have the
same health problems because they vary from
school to school.
The surveys carried out in India indicate that the main
emphasis will be on the following categories:
Malnutrition
Infectious diseases
Intestinal parasites
Diseases of skin, eye and ear
Dental caries
Chronic health problems among school children
Diabetes
Asthma
autism spectrum disorders (ASDs)
juvenile rheumatoid arthritis
seizure disorders
attention deficit hyperactivity disorder (ADHD)
Nutritional problems- anaemia
obesity/ overweight
mental illnesses
Stomach aches
Headaches
colds, and flu
INITIATION
AND
PLANNING OF SCHOOL
HEALTH SERVICES
INTRODUCTION
School health promotion activities
under Ayushman Baharat is a joint
initiative of “ministry of health and
family welfare and department of
school education and literacy”
OBJECTIVES
To provide age appropriate information about
health
To give information about nutrition to the children
To provide healthy behavior among the children
To detect and treat diseases early in children
To promote safe driniking water in schools
To promote safe menstrual hygiene practices by
girls
To promote yoga and meditation
PLANNING
SCHOOL HEALTH
PROGRAM
PLANNING
Selection of “Health & Wellness
Ambassadors”
Capacity Building of
Ambassadors
Activities in School
School Health Promotion
Activities
Health Screening
PLANNING
Provision of Services
Electronic Health
Records
Upgrading Skills in
Emergency Care
Program Implementation
Selection of “Health & Wellness Ambassadors”
Two teachers, preferably one male and one female
designated as "Health and Wellness Ambassadors" are
trained to transact health promotion and disease prevention
information in the form of interesting activities for one hour
every week.
The students will pay a major role in improving the health
practices by acting as Health and Wellness Messengers in
the society.
Schools will observe Health and Wellness Day on every
Tuesday.
Capacity Building of Ambassadors
o Trainers from Ministries of Health and Education will conduct the National
Level training .
o The National Level Master Trainers will train, four State level trainers (State
Council of Educational Research and Training -SCERT, Department of
Health/State Institute of Health and Family Welfare) at National level.
o These State trainers will train three trainers per district at the State level. The
three district level trainers.
o They will train three trainers per block, at the district level, who can be Block
Medical Officer, RBSK doctor and Block Resource Center (BRC)
Coordinators.
o The block level trainers will train two teachers per school (Health and Wellness
Activities in School
Weekly :
classroom transaction by health and
wellness ambassadors
Administration of IFA tablets
Monthly:
Thematic school assembly
Question box responses
Quarterly:
Parent teacher meetings
School Health Promotion Activities
With a special focus on health promotion activities "age
appropriate health education" for the students applied to
influence behavior and enhance skills.
The framework shows great attention on physical,
psychosocial and mental aspects according to the
developmental stages of the child.
PRIMARY SCHOOL MIDDLE SCHOOL HIGH SCHOOL
Health, growth & Eye care oral Prevention of
development hygiene substance abuse
Personal safety Nutrition Violence prevention
Nutrition & physical Meditation & yoga Unintentional
activity Internet safety injuries
Hygiene practices Prevention of Road safety
Prevention of substance abuse Nutrition
communicable Mental health Meditation & yoga
diseases Menstrual hygiene
Health Screening
Rashtriya Bal Swasthya Karyakram (RBSK) identifies
and provides early intervention for 4 'D's (Defects at
birth, Deficiencies, Diseases, Development delays
including disability) in children from birth to 18 years.
After screening and referral from school, it is
necessary to ensure whether treatment/ intervention
delivered at zero cost to the family.
Provision of Services
o Weekly Iron Folic Acid Supplementation through 6-19
years of age will follow the existing guidelines in the
schools.
o These services will continue to be delivered through
schoolteachers
Deworming
To combat parasitic worm infections,Government of
India has declared 10th August and 10th February as
fixed days to provide Albendazole tablets for
deworming school-age children.
During National deworming day ,Albendazole 400
mg chewable tablets will be administered to children
at government, government aided, and private
schools.
Menstrual Hygiene Management
Sanitary napkins maybe provided in the
schools for adolescent girls as per MHS
guidelines.
Health Screening
identification of 30 diseases including
malnutrition and anemia with appropriate
referrals.
Identification of children with refractive errors
may be done and spectacles provided.
Physical and Mental Fitness
Classes on yoga and meditation through Health and
Wellness Ambassadors may be promoted on the lines
of "International Yoga Day" to inculcate the habits of
yoga and meditation among children since their
childhood.
Classes to be taken for all the school children
Research
Provisions may be made for research and studies on
health, wellness and nutrition for children to assess the
impact of the program.
Other preventive services in the form of regular age
appropriate vaccination of children through local
health staff are being considered.
Electronic Health Records
There is also a plan to develop an electronic health record for each
student.
Student Health Card will include health screening and service
access data for each student.
Under the Rashtriya bal swasthya karyakram, the screening and
referral records of all the school children will be digitalized.
The relevant information related to school health activities/ will be
added to existing electronic records maintained under RBSK.
Upgrading Skills in Emergency Care
Students and teachers should know the basics of first aid to
respond to emergencies.
First aid box should be available in each school.
The teachers and students should be trained about the various
services available to attend to emergencies like the ambulance,
fire brigade, closest health facility etc.
Training sessions on basic first aid should be conducted and
linkages with local disaster response teams will be made, to build
the capacity of school teachers and children to respond to
emergencies
Program Implementation
National Level, State Level, District level and
Block level Coordination Committees are
responsible for implementing School Health
Program under Ayushman Bharat.
Primary health centers are responsible to render
school health services in the areas under their
coverage.
ROLE OF A
SCHOOL HEALTH
NURSE
Nurse practitioner: identifying children at risk for
specific health problems for the management of certain
chronic diseases and acute health concerns.
Nurse teacher: Teaches the health concepts and identifies
ways to transmit knowledge that supports change in
behavior.
Consultant: she can be consultant to children, parents
and teachers to identify health problems and guide for
good health practices.
Advocate: represents the interest of the individual
student, special need group .
Functional role: fulfills the functions of screening, follow
ups, immunization
Primary role: it includes direct health services like: caring
of sick children, control of communicable diseases and
health education.
Team member: she is a member of multidisciplinary team.
She may act as a coordinator in the team, who will convey
the health information about problem areas.
RESPONSIBILITIES OF SCHOOL HEALTH NURSE
Health promotion and specific protection: includes immunization,
nutritional supplementation, health education.
Early diagnosis and treatment: includes regular and periodical health
appraisals, making referrals, follow- up of referred cases, counseling.
Prevention of complications and rehabilitation: includes eliminating
risk factors responsible for a particular condition, health education of
students etc.
Other functions: Maintenance of health records, collaboration with the
physician, participate in health committee, in-service education
THANK YOU
