School health program

This includes content on school health services and program.

1. School Health Program Dr. Ramya S

2. Outline Introduction School Health program School Health Services RBSK Mid Day Meal Scheme Other programs

3. Introduction WHO Definition : School health program encompasses School health services School health education School health environment Health promotion for school personnel School-community projects and outreach Nutrition and food safety Physical education and recreation Mental health, counselling and social support WHO technical report series

4. School Health – Evolution in India

5. School health program- INDIA Program for school health service under NRHM Integration of health in schools through decentralized management Implemented in all Government and private aided schools (12,88,750) covering around 22 Crore students Main focus: – N utrition interventions, counselling, education – H ealth needs of children – both physical and mental http://nrhm.gov.in/nrhm-components/rmnch-a/adolescent-health/school-health-programme-shp/

6. Components of School Health Program Health service provision Screening , health care and referral Immunisation Micronutrient ( Vitamin A & IFA) management De-worming Health Promoting Schools Capacity building Monitoring & Evaluation Mid Day Meal

7. Health problems of school children

8. Objectives of school Health

9. ASPECTS

10. ASPECTS

11. HEALTH APPRAISAL 1.PERIODIC MEDICAL EXAMINATION - At the time of entry and thereafter every 4 years.(The school health committee recommendation, 1961) - History, physical and clinical examination 2.SCHOOL PERSONNEL

12. HEALTH APPRAISAL 3.DAILY MORNING INSPECTION: Unusually flushed face(any rash or spots) Symptoms of acute cold(coughing, sneezing, sore throat) Rigid neck Nausea , vomiting Red or watery eyes Headache, chills, fever Listlessness ,sleepiness, disinclination to play Pains in the body Skin conditions like scabies, ringworm, pediculosis

13. REMEDIAL MEASURES AND FOLLOW-UP Treatment and follow up Special clinics should be conducted exclusively for children in rural(PHC) and in urban areas(for 5000 children in a selected school) C linics days and time should be intimated to concerned school

14. PREVENTION OF COMMUNICABLE DISEASES Control through immunization Immunization record should be maintained

15. HEALTHFUL SCHOOL ENVIRONMENT Location Site Structure Classroom Furniture Doors and windows Color Lighting Water supply Eating facilities L avatory

16. SCHOOL ENVIRONMENT 1.LOCATION: - Properly fenced & kept free from all hazards. 2.SITE: -On suitable highland -For higher elementary schools -10 acres -For primary schools -5 acres -an additional one acre of land per 100 students 3.STRUCTURE: -Nursery and secondary schools – single storied -Exterior wall thickness –min 10 inches & heat resistant

17. SCHOOL ENVIRONMENT 4.CLASSROOM: - 40 students - percapita space – 10 sq.feet 5.FURNITURE: - Desks: minus type - Chairs: with proper back rests 6.DOORS AND WINDOWS: - 2 ’ -6 ” from floor level - atleast 25% of the floor area -Cross ventilation

18. SCHOOL ENVIRONMENT 7.COLOR: - white and periodically white-washed 8.LIGHTING: -Natural lighting adequate and from left. 9.WATER SUPPLY: - Independent ,safe, continuous 10.EATING FACILITIES: -Separate room for mid day meals. 11.LAVATORY: -one urinal for 60 students &one latrine for 100 students

19. NUTRITIONAL SERVICES Mid day school meal : -to combat malnutrition -to provide a good nourishing meal ( atleast 1) -no profit no loss basis -provides one third of the daily calorie requirement and about half of the daily protein requirement.

20. NUTRITIONAL SERVICES 2.APPLIED NUTRITION PROGRAMME: assisted by UNICEF implements, seeds, manure and water supply equipment. for developing school gardens utilized in school feeding programs

21. FIRST AID & EMERGENCY CARE In every school a fully equipped first aid post should be provided. 1. Accidents leading to minor and serious injuries 2. Medical emergencies - gastroenteritis, colic, epileptic fits , fainting etc.

22. MENTAL HEALTH Juvenile delinquency, maladjustment and drug addiction - common The school and the school teacher has a positive and preventive role. The school routine should be planned with enough relaxation No distinction should be made Guided by vocational counselors and psychologists.

23. DENTAL HEALTH Common Dental diseases in India : Dental caries Periodontal disease Examination should be done atleast once a year

24. EYE HEALTH SERVICES Early detection of refractive errors Treatment of squint Detection & treatment of eye infections(trachoma) Administration of vitamin A to children at risk

25. HEALTH EDUCATION 1.Personal hygiene: Hygiene of skin, hair, teeth & clothing Attention to postures(sitting & standing) 2.Environmental health 3.Family life

26. EDUCATION OF HANDICAPPED CHILDREN Goal To assist the handicapped child and his family for reaching his maximum potential To lead as normal a life as possible To become as independent as possible To become a productive and self supporting member of the society. Requires the cooperation of health, welfare , social and educational agencies.

27. SCHOOL HEALTH RECORDS It Contains 1.Identifying data 2.Past health history 3.Record of findings of physical examination, screening tests & services provided

28. School health Record Findings Outlook: Lean/ Moderate/ Obese Skin & Hair: Boils/ Ulcers/ Scars/ Lice Hands & Nails: Ulcer in web of fingers/ Deformity/ Cleanliness of nails Eye: Pallor/ Icterus/ Squint/ Redness/ Watery eyes/ Eye Sight defects/ Bitot ’ s spots Ear: Discharge/ Pain/ Deformity/ Wax/ Hearing Defects Nose: Bleeding/ Running nose/ Irritation Mouth: Ulcers/ Dental Caries/ Gum bleeding/ Cleft Lip palate/ Tonsillitis Abdomen: Pain/ Worms/ Not eating well Neck: Lymph node Swelling/ Thyroid swelling

29. School health record contd.. Speech: Stammering Chest: Wheezing/ Cough/ Pain/ Deformity Skeletal System/ Bones: Deformities in shoulder / Limb/ Pigeon chest Pedal Edema Visual Acuity: Lt Eye - Rt Eye - Behaviour : Tiredness/ Lack of attention/ Furious/ Frequent absence Any Complaint: Diagnosis: Advice: Medical Officer Sign

30. SCHOOL HEALTH ADMINISTRATION School health service is administered by the Departments of Health and Education. Integral part of general health services. Important function of the PHCs. Medical officer to cover 5000 to 6000 children/yr.

31. SCHOOL HEALTH COMMITTEES Should mobilize resources and make the program continuous and self supporting. The National school health council will be an advisory and coordinating body.

32. RBSK… Health screening is expanded to cover all children: – Birth to 18 years of age Early detection and management of 4D’s prevalent in children Defects at birth Diseases in children Deficiency conditions Developmental Delays including Disabilities

33. School Health Program: Puducherry I mplemented in all 4 regions under RBSK Under this programme: Puducherry – 4 teams Karaikal – 3 teams Mahe – 1 team Yanam – 1 team Each dedicated team : – 2 Doctors – 1 Nurse – 1 C ounsellor Of the 66946 students to be covered during 2013-14 – 60077 students were screened for 30 diseases 32208 students – provided IFA National Programme of Mid Day Meal in School(MDMS)-Annual Work Plan and Budget, pondicherry,2014–15

34. School Health Program: Puducherry… % of Anaemia and Obesity – more among urban girls in government schools than in rural areas Low BMI – more among the rural boys Vitamin deficiency – 3% among urban and 2% among rural school children Skin infections, dental problems and worm infestations are more among rural school children http://health.puducherry.gov.in/PSHM

35. MID-DAY MEAL SCHEME National Program of Nutritional Support to Primary Education Launched on 15 August 1995 To improve: – School attendance – Reduce drop out – Beneficial impact on child nutrition I t is the largest school feeding program in the world – covering 10.44 crore children in 12.12 lakh schools Survey – Scheme operational in 87% schools Around 92% children were beneficiaries Annual report 2012-13, Ministry of HRD, Govt. of India

36. OTHER PROGRAMS IN SCHOOL AGE GROUP

37. School Eye Screening Program Integral part of NPCB since 1994 Planning of SES - respective District Health Societies ( DHS) Usually carried out during April-September From each school, one teacher is selected for a one-day training course During the training, teachers are provided with a kit for screening the children in their schools The teacher’s kit contains – Measuring tape – Standard vision screening “E” – Referral card for children with suspected poor vision – Educational material

38. School Mental Health Program Included in 11 th five year plan: under NMHP District mental health team will facilitate the program Life Skills Approach is used – empowerment of adolescents Critical thinking & creative thinking Decision making & problem solving Communication skills & Interpersonal relations Coping with emotions & stress Self awareness & empathy

39. School Dental Health Program Part of School Health Scheme under National Oral Health Program – At least 1 dental surgeon/district to be in charge of School dental health program Oral health awareness through Dental health education – private sector involvement – Colgate-Palmolive India: Over 4 million school children (6-12yr) covered

40. School AIDS Education Program Under Adolescence Education Program - NACO To raise the awareness level among school students Includes training of teachers, peer educators Life Skills – debates, discussions, role play

41. 12 – by – 12 Initiative launched by MOHFW, FOGSI, UNICEF, WHO – 2007 Aim: Every child – Hb of 12g by age of 12 Children (10-14yr) are screened: – If Hb < 12 : Iron supplements started

42. Thank You