SCHOOL HEALTH

By Dr: Ehab Omrani

M.B.B.Ch
M.P.H (Occupational Health)
D.T.M&H(Tropical Medicine
 Content
• Health Problems of School Child.
• Objectives of School Health Service.
• Aspect of School Health Services.
• Healthy School Environment.
School health is an important branch of
community health.
 It has developed during the past 70 years
from the :
i. Narrower concept of medical examination
of children to
ii. The present-day broader concept of
comprehensive care of health and well-
being of children through out school years.
 Health Problems of School Child
School health service must based on:
1. The local health problems of the school child.
2. The culture of the community.
3. The availability of the resources in term of
money, material and manpower.
 Objectives of School Health Service

In general the objectives of the (school

health service) are as follow:
1. The promotion of positive health.
2. The prevention of diseases .
3. Awakening health consciousness in children .
4. The provision of healthful environment .
5. Early diagnosis of diseases.
 Aspect of School Health Services
The tasks (aspects) of school health
service:
1. Health appraisal of school children and
school personnel.
2. Preventive services.
3. Remedial measures and follow up .
4. Healthful school environment.
5. Nutritional services.
 Aspect of School Health Services
6. First aid and emergency care.
7. Mental health.
8. Dental health.
9. Eye health.
10.Health education.
11.Education of handicapped childre
12.Prober maintenance and use of school
health records.
 1.Health Appraisal
 Objectives :

1. Early detection of disease and treatment with

reference to specialist when needed.

2. It gives good chance for health education by:

provides information and health advice for
children , their teachers and families .
 1.Health Appraisal
3. It helps in planning and organization of school
health services according to data information which
collected during health appraisal activities.
 1.Health Appraisal
• Health appraisal covers the students , teachers
and other school personnel.
• It consists of :-
1. Periodic medical examination:
 At the time of entry thereafter every 4 years, includes;
full history , physical examination with tests for vision,
hearing, speech and nutritional deficiency, vaccination, as
well as a routine examination of blood, urine and
tuberculin testing.
Notes: in Libya (‫) سنه أولى إبتدائ سنه ثالثه إبتدائ سنه أولى إعدادي سنه أولى ثانوي‬
 1.Health Appraisal
2. School personnel health :
 Medical examination should include teachers and
other school personnel because?
 They form part of the environment to which the child
is exposed.
3. Daily morning inspection:
 The daily inspection carried out by teachers to detect
any changes in the child's appearance or behavior that
suggest illness or improper growth or development.
 2.Remedial measures and follow up

In many developing countries medical services

are provided to each school child in medical
clinic , school health unit or even when
referred to special hospital and center.
 3.Prevention of communicable diseases:

 Communicable diseases are common among the school

children , these diseases include:
1) Disease due to contamination of foods and water as
gastroenteritis(Rota virus), and hepatitis(HAV).
2) Intestinal parasite infestation:
Worm infestation is a major problem in children from
developing countries due to bad hygienic conditions.
It produces nutritional deficiencies and anaemia in
children, especially when hookworm infestation is
present.
 3.Prevention of communicable
diseases:
3) Diseases transmitted by droplet as measles ,
mumps and rubella.
4)Diseases due to closes contact such as skin
disease as scabies , eye diseases as
conjunctivitis.

Many communicable diseases can be

controlled through immunization.
 5.Nutritional Services

 The diet should be contain all the nutrient in proper

proportion and adequate for the maintenance of optimum
health.

 Mid-day School Meal in order to combat malnutrition and

improve the health of school children, it is know an
accepted procedure in all advanced countries.

 Schools should have some arrangement for providing

mid-day meals through their own cafeteria on a no profit
basis.
 6. First Aid and Emergency Care

Should be available in each school ,it includes:

1) Provide first aid by trained personal (teacher

and school nurse).

2) Special room contains instrument , material

and drugs needed to provide health care for
injured or diseased individual.

3) Family should be informed about the accident.

 6. First Aid and Emergency Care

4) Refer the injured or diseased person to special

care if needed.

5) The emergencies commonly met within

schools are :
• Accident leading to minor or serious injury
• Medical emergency such as gastroenteritis , asthma
attack, epileptic fit and fainting.
 7.Mental Health Services

 Mental health of child affects his physical health and

learning process.

 The school teacher has both a positive and a

preventive role?

 Provide vocational counsellors and psychologists in

schools for guiding the children into careers for
which they are suited.
 8. Dental Health

 Children frequently suffer from dental diseases and

defects.

 A school health programme should have provision

for dental examination at least once a year

 In developed countries dental hygienist are employed

in schools to assist the school dentist with the
examination of the teeth
 9. Eye Health Services

 Schools should responsible for the early detection

of refractive errors, treatment of squint and
treatment of eye infection as trachoma .
10. School health education
 The most important element of the
school program is health education.

 The objective of health education:

1) Change the health knowledge.

1) Increase the level of healthy habit

and behavior among school
children , their family and
community.
 10. School Health Education
The health education cover the following
areas:
1. Personal hygiene:
 It is increasingly recognized that the major
degenerative disease of adults have their origin in
poor health habits formed early in life .
 Health education programme should be practical
based on every day needs and interests of children,
for example the need for hygiene of skin, hair,
teeth and clothing should be impressed among
them.
 10. School Health Education

2. Environmental health :
 By encourage young people to take part on health activities
and keep their environment clean is an important function
of school health services
 For instance , visits to observe community health
programme.

Note: Health education in schools is a function of school

teacher, he is the key person in the presentation of materials
and advice which provided by the health officer and the public
health (nurse/health worker/health assistant).
 11. Education of Handicapped Children

 The ultimate goal is to assist the child and his family

to make him able to reach his maximum potential.

 The assistance requires the cooperation of health ,

welfare, social and educational agencies.
 12. School Health Records

A cumulative health record of each student

should be maintained.

The record should contain : identifying data ,

past health history, record of (finding of
physical examination , screening testes ) and
service provided.
 12. School Health Records

Why these records are important?

1. Provide the children a continuous intelligent
health supervision.
2. Useful in analyzing and evaluating school
health programme.
3. Providing a helpful link between the home,
school and community.
4.Healthy School Environment

By Dr: Ehab Omrani

M.B.B.Ch
M.P.H (Occupational Health)
D.T.M&H(Tropical Medicine
 Introduction
• A healthy and safe school environment
implies a positive and welcoming school
climate for all students.
 WHY?
• It supports learning and contributes to students’
health by:
1. Minimizing distractions that either threatens
their mental or physical wellbeing
2. Promotes expectations that all students can
succeed.

• Healthy school also serve as demonstration

centres of good sanitations to the community.
Physical School Environment
 1.Location

School should be centrally situated with

proper approach roads and at a fair distance
from busy places , railway , factories and
market places.

The school premises should be properly fenced

and kept free from all hazards.
 2. Site
 Should be on suitable high land
 The recommendation that:
1. For higher elementary school 10 acres (4 Hectare) are
required.
2. For primary school 5 acres (2 Hectare) are required.

notes: With an additional 1 acre of land per 100 students

 3.Structure

Nursery and secondary school should be

single storied.

Exterior walls should have a minimum

thickness of 10 inches (25.4 cm) and heat
resistance.
 4. Class Room

No class room should accommodate more than

40 students.

Per capita space for students in the class room

should not be less than 10 sq. ft. (0.93 sq.m)
 5. Furniture

Suit the age group of students.

It is desirable to provide single desks and
chairs.
Chairs should be provided with a proper back
rests with facilities for desk work.
 5. Furniture
Table height adjusted to set at elbow height.
If non-adjustable, then seat height should be
adjusted .
Sufficient leg clearance under the study
surface .
 Why?

• To decrease stress and strain

• To decrease musculo-skeletal disorder (MSD) for
example:
– Low back pain
• To reduce accident
• To decrease absenteeism
• To improve student performance
 6. Doors and Windows

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.
 Clean Air
1. Use low volatile organic compound (VOC) paint
because after traditional paint is applied to walls or
other surfaces, it can "off-gas" VOCs for years.

Notes: prolonged exposure to these compounds can trigger

asthma attacks and other respiratory problems, irritate eyes, cause
nausea and dizziness , what's more , extended exposure has also
been linked to kidney & liver disease and even cancer.
 Clean Air
2.Use odorless and non-toxic cleaning,
maintenance and school supplies.
3.Ventilate rooms well and Control dust
4. Prevent roaches and other pests.
5. Eliminate exposure to tobacco smoke.
 Health Effects of Poor Indoor Air
Quality
• Asthma.
• Respiratory infections.
• Learning disabilities.
• Difficulty concentrating.
• Stomach illnesses, nausea and dizziness.
• Kidney or liver damage.
Glare
 7. Lighting
Class rooms should have sufficient natural
light the best from the left side of students
and shouldn’t be from the front.

The design of windows position and room

layouts should maximize natural light.

Make daylighting a priority, especially in

classrooms.
 7. Lighting
At the same time glare and hot spots should
be avoided because it can undermine the
learning process.

Integrate daylighting with high-efficient

electric lighting to optimize visual comfort.
 GLARE
• Glare is excessive light stimuli (excessive
luminance), in the field of vision which disturb the
adaptation process of the retina
– Direct
– Reflective

• Glare impairs the visual function of the eye

Notes: Luminance is a measure of brightness (it is a measure

of the quality of a surface that we perceive as brightness.
 GOOD ILLUMINATION
Table of recommended (ranges of) illuminance
Class of visual task Recommended Typical examples
illuminance
Very difficult 1200-2400 Inspection of small parts
Difficult 800-1200 Fine bench & m/c work
Normal range of 600-800 Computer room
task Typing/writing/reading
Moderately difficult 400-600 Schoolroom/kitchens
Ordinary 300-400 Rough bench & m/c work
Simple 200-300 Loading bays/locker
Rough intermittent 100-200 room
 8. Colour

Inside colour of the class room should be

white and periodically white-washed.

The closer to white the better the light yield.

 EFFECTS OF BAD LIGHTING

• Affects safety
• Low productivity
• Eye strain
• Fatigue
• Headaches
 9. Water Supply

It should be independent source of safe and

potable water supply , as well as continuous
and distributed from taps.
The water should be ideally supplied by
fountains.
 10. Eating Facilities

Only vendors that approved by school

authorities are allowed inside school premises
and there should be a separate room provided
for mid-day meals.
• School food service should serve healthful
foods following guidelines, such as the food
guide pyramid
• Provide low-cost funding for students.
 11. Acoustic Comfort
Reduce sound reverberations, including those
from electric lighting , “outside” noise from
roads, playgrounds and cafeterias.
 11. Acoustic Comfort
Excessive background noise interferes with the
learning process and leads to:
1. Noise-induced hearing loss
2. Stress
3. Behaviour problems
4. Decreased school performance and cognitive
delays.
 12. Restrooms

Privies and urinal should be provided.

 In day school, there should be a wash basin WC for

every 30 girls, 1 toilet for 60 boys and 1 urinal for 30
boys.

Arrangement should be separately made for

boys and girls.
 13. Safety & Security

Provide careful exterior lighting to minimize

the areas of the school that are hidden,
attractively fenced playgrounds and a limited
building entries will increase safety and
security.
Maximize visual access to corridors and
school grounds
Availability of first-aid room and first aid boxes.
Positive Emotional Environment
 Positive Emotional Environment
• Warm and nonthreatening learning environments
promote health and learning.

• Teacher’s personality and behavior determine

emotional climate.

• Schools can promote attitudes of respect,

understanding and sensitivity by recognizing and
accepting differences.
 Responsibility for Health is Shared by
All
• School personnel
– Teachers
– Administrators
– Staff
• Students
• Parents
• Community
• Government
 How can we deal with school
environmental issues?
4 STEPS:
Step one:
• Form a team to investigate the school environment and
select an issue area.
Step two:
• Look closely at the issue area, make presentations to teach
others and hold group meetings.
Step three:
• Learn about the issue, develop and pass a program or policy
change.
Step four:
• Support the new program or policy by publicizing it.
THANK YOU