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Health appraisal should be done for the students by periodic medical examination and daily
morning inspection by the class teacher. Health appraisal of teachers and other personnel is
also necessary.
Medical examination to be done for each and every child at the time of school entry and
thereafter every 4 years or less. Basic investigations like urine, stool and blood tests should
also be done. Recording of weight and height should be done quarterly and vision testing
annually. Daily morning inspection helps to detect any deviation from normal health status or
change in childs appearance or behavior that suggests illness or improper growth and
development. A teacher should be trained about the common health problems of children
during basic training and later in-service training courses.
Appropriate treatment and follow-up should be arranged after medical check-up. Special
clinics should be conducted for school children at primary health centers in the rural areas
and in dispensaries or in one of the selected school in the urban areas. Special attention
should be paid to dental, eye and ENT problems. There should be provision for referral along
with further investigations and treatment of the specific problem.
Immunization program should be planned for the prevention of common communicable
diseases like tetanus, typhoid, hepatitisB, etc. Record of all immunization should be
maintained and this record should accompany the school leaving certificate.
A healthful school environment with good sanitation is essential requirement for the best
emotional, social, and personal health of the students.
The school should be located centrally with approaching roads but at a far distance from busy
markets, cinema house, factories, etc. The school campus should be fenced and free from
dampness or any other hazards. The land must be high and properly drained. Playground
should be made available for the students.
The school structure should be single storied for nursery and secondary schools and
multistoried for higher schools. Walls should be heat resistant. Verandas should be attached
to classrooms. No classroom should accommodate more than 40 students. Doors and
windows should be broad and should be placed for cross ventilation.

Furniture of the classroom should be appropriate for the age of the students. Classroom inside
wall should be painted white and periodically white washed should be arranged. Class rooms
must be well lighted. There should be provision of safe and potable water supply, preferably
continuous and distributed from taps. Provision for separate room for mid day meal or tiffins
should be made. Separate toilet facilities must be made for boys and girls.
Diet for the school children should receive first attention for the maintenance of optimum
health. Nutritional disorders are widely prevalent among school children. To prevent
malnutrition and improve the health of school children, it is now accepted procedure to
provide a good nourishing meal to school children. Mid-day school meal can be brought from
home or provided by the school on a no profit no loss basis. UNICEF assisted applied
nutrition program or specific nutrients supplementation may also be available to the school
First aid and emergency care should be provided by the teachers in situations like accidents,
fainting, vomiting, diarrhea, convulsions, injuries, etc. Teacher should have adequate training
regarding first aid and emergency measures.
The school is an important place for development of childs behavior and promotion of
mental health. The school teacher has positive and preventive role to help the children to
attain mental health and to develop into mature responsible and well-adjusted individual. In
the school hour, there should be provision for relaxation between periods of intense work.
There should be no unhealthy comparison or discrimination in religion, caste, social status,
etc. provision of vocational and psychological counseling are a great need for the school
children. Juvenile delinquency, maladjustment , drug addiction are becoming problems
among school students and need early preventive interventions.
Dental caries and periodontal disease are two common dental problems among school
children. There should be provision for dental examination once in a year to detect problems.
Guidance for maintenance of dental hygiene and improvement of dental appearance should
be emphasized during dental checkup. Improvement of dental health is a part of school health

Early detection of problems in school children is essential to prevent further complications.
Refractive errors, squint, vit.A deficiency conditions and eye infections should be detected
early and referred for necessary treatment.
Health education is the most important aspect of school health program to bring about
desirable changes in knowledge, attitude and practices related to health.
The essential areas of health education to the school children are related to different aspects
of personal hygiene, environmental health and family health including human reproduction
and sexual hygiene.
Community health nurse has great responsibility in health education programs at schools.
Teachers are the key persons in the presentation of the materials to the children but they
should get help from school health nurse and other health team members.
The school health service must have facilities for assisting handicapped children and their
families to achieve maximum potential to become as independent as possible and to become
productive and self-supporting member of society. This requires the cooperation of health
workers with social welfare and educational agencies.
Maintenance of school health records is an useful function to have cumulative information on
the health aspects of school children to provide continuing health supervision. It helps to
evaluate school health programs and provide useful links between home, school and
The maintenance of health of school children is the responsibility of parents, teachers, health
care providers and the community. In India, school health service is administered jointly by
the Dept. of health and the Dept. of Education. According to School Health Committee
(1961), school health program should be continuous and self-supporting by the formation of
school health committees at the village level, block level, district level, state level and
national level.

As an integral part of general health service, the primary health center is responsible to
deliver school health service. PHN (primary health nurse ), health supervisor and health
workers are key persons to conduct school health program. Periodic visit, health check up,
immunization, health education, nutritional education, referral and health recording are
important functions of them.