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
INTRODUCTION
Children between the age of 5-17
years are school age children.
About 30 % of the population is
comprised of this age group
HEALTH PROBLEMS IN
CHILDREN
Malnutrition
Infectious diseases
Intestinal parasites
Disease of skin, eye and ear
Dental caries

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.
School health service is a branch of
community health which provides promotive ,
preventive & curative health care services to
the school children.

SCHOOL HEALTH SERVICES
IN INDIA
1909 - first time medical examination of school
children was done in Baroda city
1946-Bhore committee report on non existence
of adequate school health facilities.
1957 - Child Education-Nutrition Education
Committee and WHO assisted School Health
Education project were set up
1960 the Ministry of Health, Government of
India, set up a School Health Committee to
assess the standard of Health and Nutrition
of school children and also to suggest ways
and means of improving these.
1960-The Children's Act care , maintenance,
welfare, training, education & rehabilitation
of delinquent children


1977 when a Centrally Sponsored National
School Health Scheme was started
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


National Programme of Nutritional Support to
Primary Education, popularly known as the
Mid-Day Meal Scheme (MDM) was started in
1995 in an attempt to enhance enrolment,
retention and attendance while
simultaneously improving nutritional levels
among children in school. It currently covers
nearly 12 crore children.
In October 2007 the scheme was revised to
cover children in the upper primary section
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
OBJECTIVES:
General objective :To provide comprehensive
health care to school students in order to
prepare them physically, mentally & socially.
Specific objective :
promote health of the school children
through health supervision, health care &
nutrition progs.
prevent communicable & non-communicable
diseases
Early Diagnosis, Treatment & Follow up of
defects
inculcate healthy habits by proper health
education
Awakening Health consciousness in
children, teacher , parents
Provision of Healthful environment
Involve teachers, students and their
parents in the management of health
aspects of children

ASPECTS OF SCHOOL
HEALTH
1.Health appraisal of school children &
school personnel
2.Remedial measures & follow-up
3.Prevention of communicable diseases.
4.Healthful school environment
5.Nutrition serves



6.First aid & emergency care.
7.Mental health
8.Dental health
9.Eye health.
10.Health education.
11.Education of the handicapped children
12.Maintenance & use of school health
records

1.HEALTH APPRAISAL
a) Periodical medical examination: at time of
admission and thereafter every 4 year
b) School personnel: medical examination
should be given to teachers and other
health personnel
c) Daily morning inspection: Teacher should
detect changes in appearance and behavior


-CLUES for teachers for inspection
i) Unusually flushed face
ii) Any rash or spots
iii) Symptoms of acute cold
iv) Coughing and sneezing
v) Sore throat
vi) Rigid neck
vii) Nausea and vomitting
viii) Red or watery eyes
ix) Listlessness or sleepiness
x) Disinclination to play
xi) Diarrohea
xii) Pains in the body
xiii) Skin conditions like scabies and ringworm
xiv) pediculosis

2.REMEDIAL MEASURES & FOLLOW-
UP

Special clinics for school children in PHC in rural
areas/selected schools or dispensaries for 5000
children in urban areas
Special clinics for eye, ear, nose, dental and throat
defects
Required number of specialists should be employed
in the school health service in big cities
provision for beds in the existing referal hospitals

immunization
Record of all immunizations should be
maintained

3.PREVENTION OF COMMUNICABLE
DISEASES
4.HEALTHFUL SCHOOL ENVIRONMENT

Location: centrally situated with proper
approach roads and at a fair distance from
busy places and roads, cinema, factories,
houses, railway tracks and market places

Site : site should be on suitable highland
-5 acres land for primary schools with an
additional one acre of land per 100 students
-10 acres land for higher elementary school
- Public park or playground should be made
available to the students

Structure
- Nursery and secondary schools should be single
storied
- Exterior walls should have a minimum thickness of
10 inches and should be heat resistant
Class room
- Verandhas should be attached to class rooms
- No class room should accommodate more than 40
students
- Per capita space for students should not be <10
square feet

Furniture
-Desirable to provide single desks and chairs
-Chairs should be provided with proper back rest
with facilities of desk work

Doors and windows
-Windows should be broad with the bottom sill at
a height of 2-6 from floor level
-Combined door and window area should be at
least 25% of the floor space
- windows should be placed on different walls for
cross ventilation
-Ventilators should not be less than 2% of the
floor area

Colour: Inside colour of the classroom should be white
and routinely white washed
Lighting: Class room should have natural light from
left and not from front
Water supply: Continuous safe and potable water
supply from taps
Eating facilities:
-Separate room for mid-day meals
-Vendors should not be allowed inside school premises
other than those approved by school authorities

Lavatories:
-Separate arrangements for boys and girls
-1 urinal for 60 students
-1 latrine for 100 students

5.NUTRITIONAL SERVICES
Nutritional deficiencies relating to proteins, vitamins
A, C, thiamine and riboflavine, calcium and iron
Mid day school meal: School children should be
assured of atleast one nourishing meal
-School meal should provide atleast 1/3 rd of daily
calorie requirement

Applied Nutrition Program
-UNICEF is assisting ANP in the form of
implements, seeds, manure and water supply
equipment
-Facilities provided by the UNICEF should be
utilized in developing school gardens
-Produce may be utilized in the school feeding
programs as well as for nutrition education

Use of specific nutrients
6.FIRST AID AND
EMERGENCY CARE
Adequate training to teachers should be imparted
for giving first aid and emergency care
Common emergencies:
-Accidents leading to minor or serious injuries
-Medical emergencies such as gastroenteritis, colic,
epileptic fits, fainting etc
First aid post should be provided as per regulations
of St, John Ambulance association
7.MENTAL HEALTH
Juvenile delinquency, maladjustment and drug
addiction are becoming problems among school
children
Teacher should help children attain mental health
There should be enough relaxation between the
periods of work
No distinction should be made on the basis of caste,
creed, colour, religion, between rich and poor, between
the clever and dull
8.DENTAL HEALTH


Dental caries and periodontal diseases are
common dental diseases in India
Dental examination should be done at least
once in a year

9.EYE HEALTH SERVICES
Administration of vitamin A
Early detection of refractive errors, treatment
of squint, and amblyopia and detection and
treatment of eye infections such as trachoma

10.HEALTH EDUCATION
Goal: To bring about desirable changes in health
knowledge , attitudes, practice and not merely teach
the children set of rules of hygiene
Areas to be covered:
-Personal hygiene
-Environmental health
-Family life

Health officer and public health nurse, health
worker/ health assistant may furnish teaching
material but teacher is the key person in the
presentation of material to pupils

11. EDUCATION OF
HANDICAPPED CHILDREN
Assist the handicapped and his family so that
the child will be able to reach his maximum
potential
12. SCHOOL HEALTH
RECORDS
Health record of each student should contain:
-Identifying data : name, date of birth, parents
name and address etc
-Past health history
-Records of findings of physical examination
-And screening tests and record of services
provided
Records are helpful in analyzing and
evaluating the programes

SCHOOL HEALTH ADMINISTRATION
Health of a school child is a responsibility of
parents, teachers, health administrators and
community
School health service is an important
function of PHC
PHC requires 1 medical officer for 5000-6000
population a year
School health committees should mobilize
community resources and make the school
health programe continuous and self
supporting
SCHOOL HEALTH
CHANDIGARH
The implementation of School Health Programme in
Punjab State with the following objectives.
1 To conduct the medical check-up of all school going
children from Primary to 12 th standard.
2 To prepare permanent record of complete health
profile of school going children up to 12 th standard in
the form of Registers or Cards.
3 To inform the parents regarding health status of the
students and any follow up treatment required (if any)
4 To give information to the teachers and students on
general health topics

5 Micro Nutrients :-
Anaemia: - i) Deficiency of Iron-100 Tablets of Iron Folic
Acid gave to children to prevent anaemia.
ii) Worm infestation is another cause of anaemia more
common in rural areas for this advised about personal
Hygiene, Environment sanitations and Tablet Albendazole
shall also be given. Students found anaemic advice to
green leafy vegetables, Black Gram, Jajgary etc.
iii) For vitamin A deficiency advise about green leafy
vegetables, yellow fruits, Butter. Concentrated vitamin A
solution is given up to 5years of age at an internal of 6
months, (starting from 9 months of age).
iv) Iodine is necessary for physical and mental growth of
the child. Iodized salt should be advised in the diet.
6 To advise children and school health authorities
regarding importance of safe drinking water and good
environmental sanitation etc.
7 School Teachers will serve as a health counsellor for
children regarding their personal hygienic habits,
Posture and encourage them to develop good health
practices. Teacher should also supervise how food is
prepared, procured, stored or served in the school and
encourage children to develop health full food habits.
8 Teachers should also help in measuring height,
weight as well as preparing the list of the students to
be examined.


9 District school health medical officer should stress up of the following points
during their visits to schools to parents and children :-
a. Regarding harmful effects of Drug-Addiction, Smoking, Chewing of Tobacco
and alcohol etc.
b. Tuberculosis-Cough more than 3 weeks sputum exam at PHC level.
c. Fever-More than fifteen days, blood examination for Typhoid and Hepatitis etc.
d. Sore throat-more than 3 weeks for Rheumatic heart disease, swab from throat
should be taken.
e. Any kind of lump for cancer detection.
f. White spot on the skin with loss of sensation for Leprosy.
g. Importance of blood donation, prevention of female foeticides etc.
h. To detect children suffering from heart ailment and cancer and refer them to
State Headquarter for their free treatment in PGI.
i. For adolescent girls and during teacher Parent meeting stress upon early
registration of pregnancy, hospital delivery, spacing methods etc, should be
given.
j. In addition to medical check-up, the teacher and the students are given health
education on various general health topics, as stated above, so as to create
awareness for accepting the principle of positive health

SPECIAL PROGRAMME
RHEUMATIC HEART DISEASE AND CONGENITAL
HEART DISEASE
The treatment of the students of Govt. and Govt.-aided
schools of Punjab suffering from Rheumatic Heart Disease
and Congenital Heart Disease under School Health
Programme was started in November, 2008 funded by Govt. of
Punjab under NRHM . Up to October,09 about 400 students
referred to PGI, Chandigarh , DMC, Ludhiana , IVY, SAS
Nagar and Silver Oaks, SAS Nagar and about 100 cases have
been treated under this Programme.
CANCER PROGRAMME
A Programme for the treatment of the students studying in
the Govt. and Govt.-aided school of the State Punjab
suffering from Cancer has been started in May, 2009
funded by Govt. of Punjab under NRHM under School
Health Programme. Up to October, 09 about 28 students
referred to PGI, Chandigarh.
EPIDEMIOLOGY SCHEME
Epidemiology Scheme is a Non-Plan Scheme. The
services of the staff are being utilized for imparting, School
Health Programme, Health Education Camps, Organising
Exhibitions on various health programme, Film shows and
Radio T.V. Talk. They also distribute printed material to the
people so that awareness is generated in the community or
positive health.