school health service.docx

nursing

1. School health service
INTRODUCTION: Child spends more time at school than anywhere else except
home.School have a major effect on children’s health. Children between the age of 5-
14 years are school age children. About 15 percent of the population is comprised of
this age group. School Health Service is the most important aspect[branch] of
community health .
DEFINITION:
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.
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.
SCHOL 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.
SCHOOL HEALTH SERVICES IN INDIA
• Before Independence Era
• 1909, when for the first time medical examination of school children was done in
Baroda city.
 The school health services were taken after the Bhore committee report in
1946 .
Post independence Era
• 1957 when 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 under the chairmanship of Smt. Renuka Ray, the then member of

2. 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.
• 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.
• 1984-85Delhi had its own comprehensive school Health Scheme which is
continuing.
• 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.
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.
COMMON HEALTH PROBLEMS OF THE SCHOOL CHILDREN: The prevalence of
morbidity conditions in developing countries is very high.
 Health problems :-
1. Malnutrition- Anaemia, PEM, Vitamin deficiencies
2. Respiratory- Tuberculosis,pneumonia, asthma
3. Gastrointestinal - Intestinal parasites, diarrheal diseases
4. Skin Conditions- scabies,lice, eczema, dermatitis
5.Eye Diseases- Refractive defects,squint , conjunctivitis
6. Dental Problems- Dental caries , bleeding gums ,irregular teeth.
 Behaviour problem:-
1. Antisocial problem: - stealing, lying, gambling, destructiveness, sexual offence.
2. Habit disorders: - nail biting, thumb sucking, bed wetting.
3. Personality disorders: - temper tantrum, shyness, day dreaming, and jealousy.
4. Educational difficulties: - backwardness in study, school fear, school failure, etc.

3. OBJECTIVES OF SCHOOL HEALTH SERVICES:
1. The promotion of positive health.
2. The prevention and control of communicable diseases.
3. Early diagnosis, treatment and follow up of defects.
4. Awakening health consciousness in children.
5. The provision of healthful environment
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.
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.
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.
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.
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.
3. Prevention is better than cure; interventions when health breaks down are costly
and time consuming.

4. 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.
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 adequate 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.
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.
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.
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

5. SCHOOL HEALTH ADMINISTRATION 1. School Health Committees 2. Primary health
centres
SCHOOL HEALTH POLICY 1. Health centre staff is responsible for implementation of
school health programme.
2. The school health programme is carried out in schools by the health centre staff
working together with school’s 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.
ASPECTS / COMPONENTS / ACTIVITIES OF SCHOOL HEALTH PROGRAMME
1. HEALTH APPRAISAL : Children should be medically examined first – at the time
of admission in the school then every 4
th
year after admission and then at the
time of leaving.
 Height , weight , teeth , eyes , speech and hearing should be examined as a part
of physical examination .
 In school health services: daily health check-up of children is conducted by
teacher.
2. TREATMENT AND FOLLOW-UP : Treatment and follow-up of children should be
done by school health nurse and follow-up visits must be given to maintain the
health of the children.
3. IMMUNISATION : Communicable disease control through immunisation .
 Proper record of all immunisations should be maintained and this should be
given to child , when the child leaves the school.
4. NUTRITIONAL SERVICES : Midday School Meal - In order to prevent malnutrition
and improve the health of school children the midday meal is needed .
 Due to malnutrition children suffer from vitamin deficiency blindness ,
anaemia, beri-beri , low resistance.
 Malnutrition can be corrected by proper and adequate diet.
5. FIRST AID : First aid box should be always be available in school to handle
accidents and expected situations like sports accidents , pain in abdomen ,
epileptic convulsions , diarrhea etc.
 Teacher should be skilled in providing first aid kits and list of drug advised .
6. HEALTH EDUCATION : It is one of the crucial and key element of school health
services , it creates awareness , makes them knowledgeable regarding health
matter .

6.  Areas included personal hygiene, environmental health , nutrition, prevention
and control of communicable and non-communicable diseases , first aid and
emergency care .
 Teachers should demonstrate healthful environment and motivates students to
practice healthful habits .
7. MENTAL HEALTH : The burden or stress of study can lead to mental illness.
Juvenile delinquency , maladjustment , drug addiction, etc. are common
problems among schoolchildren .
8. DENTAL HEALTH : Children frequently suffer from dental disease and defects .
Make inspection of teeth and do cleaning which help in preventing gum
troubles .
9. EYE HEALTH SERVICES : Early detection of refraction errors , treatment of squint
and myopia , detection and treatment of eye infection , administration of
vitamin A .
10. HEALTHFUL SCHOOL ENVIRONMENT : School should be away from
railway stations , railway lines, bus stands , market places and cinema .
 One toilet for every 25 students up to strength of 300 students , separately
made for boys and girls.
 Window size should be 25% of floor area .
 Direct glare from electric bulbs and filaments should be avoided.
 Classrooms should have sufficient natural light.
 Safe and portable water supply
11. SCHOOL HEALTH RECORDS : Health record of each student must be
maintained properly .
 Health record should contain- name , DOB and address . Past health history .
Record of services provided .

ROLE OF NURSE IN SCHOOL HEALTH SERVICES: 1. General physical examination
2. Identify any abnormalities / defects / diseases
3. Health education
4. First aid services
5. Periodic visit
6. Immunisation records
7. School environment
8. Health records

7. BIBLIOGRAPHY

1. The Short Textbook Of Community Health Nursing , By Veerbhadrappa
Gm, Volume 2
nd
, Jaypee Publications , First Edition , Page No. 187-202.
2. Textbook Of Community Health Nursing 2
nd
, By Ravi Prakash Saxena, Lotus
Publication, Page No. 181-194.
3. Community Health Nursing , By Bt Basvanthappa , Page No. 824-8311