School health services

School health services is a branch of preventive medicine which deals with medical inspection of school children and their health protection, primarily in the environment of the school.

1. SCHOOL HEALTH SERVICES AB RAJAR ASSOCIATE PROFESSOR COMMUNITY MEDICNE MUHAMMAD MEDICAL COLLEGE.MPK

2. LEARNING OBJECTIVES Introduction. Definition. Aims & objectives School health team Aspects of school health services Duties of school health team Types of desks. School health problems

3. INTRODUCTION An important branch of community health. According to modern concepts, school health service is an economical and powerful means of raising community health , and more important, in future generations. The school health service is a personal health service. It has developed during the past 70 years from the narrower concept of medical examination of children to the present-day broader concept of comprehensive care of the health and well-being of children throughout the school years.

4. INTRODUCTION . SCHOOL HEALTH SERVICES: School health services is a branch of preventive medicine which deals with medical inspection of school children and their health protection, primarily in the environment of the school.

5. DEFINITION . 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. [k . k. gilani ]. DEFINITION OF SCHOOL HEALTH SERVICES : School health service refers to need based comprehensive service rendered to pupils, teachers and other personnel in the school to promote, protect their health, prevent and control disease and maintain their health .[- k. k. gulani ]

6. NEED FOR SCHOOL HEALTH SERVICES  School children constitute a vital and substantial segment of population. Schoolchildren are vulnerable section of population by virtue of their physical, mental, emotional and social growth and development during this period. School children are expressed to various stressful situations. Children coming to school belong to different socio economic and cultural background which affect their health and nutritional status and require help and guidance in promoting, protecting and maintaining their health and nutritional status. Children in school age are prone to get specific health problems.

7. AIMS & OBJECTIVES. Promotion of positive health. Early detection of defects through a program of periodical medical check-up of children. Treatment & follow-up of defects. Minimization of chances of spread of communicable diseases. Awakening health consciousness in school children. Teaching of the staff of school to detect defects. Provision of healthy environment.

8. GOALS OF SCHOOL HEALTH SERVICES   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. To help the younger generation become healthy and useful citizen 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.

9. SCHOOL HEALTH TEAM The school health team in a whole-time medical service consists of: School Medical Officer. Public Health Officer. Attendant . This team is located in one of the largest school & is for 3000 – 5000 children.

10. COMPONENTS OF SCHOOL HEALTH PROGRAMME Health appraisal of school children and school personnel. Remedial measures and follow up. Prevention of communicable disease. Healthful school environment. Nutritional service. First aid and emergency care. Mental health

11. 1. HEALTH APPRAISAL OF SCHOOL CHILDREN AND SCHOOL PERSONNEL  PERIODICAL MEDICAL EXAMINATION: Medical examination on entry- 4 years. Routine physical examination needs to be done. Clinical examination for nutritional deficiency, examination of faeces . Tuberculin testing/ T esting of vision, regular and quarterly wt/ ht checking. DAILY MORNING INSPECTION BY THE TEACHERS : Inspection of rashes , spots, signs of acute cold, coughing and sneezing, sore throat, rigid neck, nausea, vomiting, watery eyes, headache, chills, fever, etc . MEDICAL EXAMINATION OF SCHOOL PERSONNEL: Staff form part of the school environment.

12. 2.Follw-up Diseased children are treated at primary health centers.

13. 3. PREVENTION OF COMMUNICABLE DISEASES Clean environment,saniatary conditions and good hygiene prevent spread of communicable diseases. Immunization of children.

14. 4.Healthful school environment. A. Location of School. Proper approach with wide road. Fair distance from busy places. Premises are fenced and kept free from all hazards. B. Site: High land with proper drainage. C Structure: Nursery and secondary schools must be single stored. D. Class rooms. Verandas attached to classrooms. Each classroom should accommodate not more than 40 students. Rooms with sufficient lighting and ventilation.

15. 4.Healthful school environment.(Cont…) E. Furniture: Negative desks are recommended. F. Door and Windows: Windows 2 feet 6” above floor level. Window and door area should be at least 25% of the floor area. Cross ventilation ensured. G. Water supply. Continous,distribution through taps. H. Eating facility: Separate room for mid-day meals.

16. 5. Nutritional services Good nutrition is very essential not only for optimal health growth and development of the school child but also for his/her educational achievement. A nutritious mid-day meal for children in the school is considered as a practical solution to combat malnutrition in children. 

17.  6. First aid and emergency care  Facility available within school. Dispensary in school. Facilities for managing accident and medical emergencies like gastroenteritis, fainting, epileptic fits etc.

18. 7. Mental health School teacher plays both a positive and preventive role. Help and counsel the students. There is increased need of psychologists and vocational counselors in school for guiding children about career planning.

19. 8. Dental health  School children usually suffer from dental diseases and defects. School health should incorporate dental health components too . Dental hygienist and dentist are to be employed. During the dental check up should focus on prophylactic cleansing and dental hygiene classes.

20. 9. Eye health services  Teachers are in key position to detect reflective errors, refer for treatment for squints, amblyopia and to detect eye infections . Vitamin A administration could be done. 

21. 10. Health education  School teacher is key person for health education. Personal hygiene of skin,teeth,hair and refraction of errors.

22. 11. Education of handicapped children Every child irrespective of the disability, should be encouraged to become productive and self supporting. 

23. 12. School health records  Such record must contain identity, past health history and record of findings of physical examination and screening tests. Help in evaluating school health program.

24. SCHOOL HEALTH PROBLEMS  Any discussion of a school health service must be based on: T he local health problems of the school child, T he culture of the community and T he available resources in terms of money, material and manpower. While the health problems of school children vary from one place to another, surveys indicate that the main emphasis will fall in the following categories.

25. Health Problems of the School Children Dental problems Malnutrition Infectious diseases/Communicable diseases Parasitic infestations Lice infestation Diseases of skin Diseases of eye Diseases of ear Congenital abnormalities Psychological problems

26. Health Problems of the School Children Dental problems : Dental caries, fluorosis, gingivitis Malnutrition : Stunting, anemia, Vit.A deficiency, obesity Infectious diseases/Communicable diseases: Measles, mumps, rubella, chicken pox, whooping cough, acute tonsillitis, pneumonia, etc. Parasitic infestations : Hook worm, round worm, pin worm Lice infestation Diseases of skin: Scabies, fungal infections Diseases of eye : Poor eyesight, color blindness Diseases of ear : Acute or chronic OM, ear wax, earache Congenital abnormalities : Cleft of lip/palate Psychological problems Injuries/falls: Major/minor

27. PSYCHOSOCIAL SCHOOL HEALTH PROBLEMS  BEHAVIOR PROBLEM: 1. ANTISOCIAL PROBLEM : - S tealing, Lying , G ambling , D estructiveness , sexual offence. 2. HABIT DISORDERS: - Nail biting, T humb sucking, B ed wetting.

28. PSYCHOSOCIAL SCHOOL HEALTH PROBLEMS   BEHAVIOR PROBLEM : 3.PERSONALITY DISORDERS : - Temper tantrum, S hyness , S ay dreaming, and jealousy. 4. EDUCATIONAL DIFFICULTIES : - Backwardness in study, S chool fear, S chool failure, etc.

29. SCHOOL HEALTH TEAM The school principal. The school teacher. The parents. The community. The children. The medical officer. The school health nurse/ community health nurse

30. DUTIES OF MEMBERS OF SCHOOL TEAM

31. Duties Of A School Medical Officer[MO] Preparation and maintenance of health record of all the children/teachers and other staff. Routine medical inspection of children/teachers. Treatment of common aliments/injuries. Referral (if required) and follow up of cases. Health education and training in first aid . Coordination for physical education Inspection of class rooms, canteen, wash rooms, playground, hostels, offices, etc. The aim is to inspect: Seating arrangements Lighting, ventilation, heating, cooling facilities Waste disposal system Drinking water facility Meeting with the administration and parents (if required).

32. Comprehensive Medical Examination

33. 2. SCHOOL HEALTH NURSE: She should be qualified in public health nursing. Assisting MO in his/her duties and examination. Record keeping. Supervising the health habits of all the school children. Update MO about progress of children health. If required, she pay home visits. Treat minor ailments. Attend conferences of doctors and nurses.

34. TYPES OF DESKS

35. Types of desks. There are three types of desks: 1. POSITIVE OR PLUS DESK: A vertical line drawn from the edge of desk falls outside the edge of chair. 2. ZERO OR MINUS DESK: A vertical line drawn from the edge of desk touches the edge of the chair . 3.NEGATIVE OR MINUS DESK: A vertical line drawn from the edge of desk falls on the seat. Note: Minus desks are the best and preferred.

36. Types of desks.

37. Types of desks (Cont….) What is a minus desk? A vertical line drawn from the edge of the desk falls on the seat . What is a zero desk? A vertical line drawn from the edge of the desk touches the edge of the seat. What is a plus desk? A vertical line drawn from the edge of the desk falls outside the edge of the seat .

38. Desks recommended for school children. Minus or Zero desks are recommended for school. Minus or zero desk will enable the student To keep the proper distance from the desk to his eyes and also avoid postural deformities .(Kyphosis and Scoliosis).

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