School Health

Programme
Dr.SOURAB KUMAR DAS
Define School health service
• The school health service is a personal health service delivering
comprehensive health care service to the school students and
school personnel through out the school years.
Importance of School health
service
1. To control communicable disease among the students.

2. It is important place of learning next to home where a child learns to be

healthy.

3. It is the formative period, where what you educate the children they will
practice in adulthood.

4. The schools represent gathering places for a population of age 5-17

years, which is particularly prone and susceptible to many
communicable disease and vulnerable physical, mental and moral
hazards with which the students may come in contact in conception with
their school experience.

5. Moreover, a considerable proportion of school children particularly in

the underdeveloped and developing countries, suffer from malnutrition
and deficiency disease and as such they naturally deserve special
attention for their physical and intellectual development.
Objectives of School health
service
• A. general objectives:
• To provide comprehensive health care - promotive, preventive,
curative and rehabilitative - and socially for entry into adulthood
as a step towards achieving the goal of “Health For All”
• B. Specific objectives:

1. The promotion of positive health

2. The prevention of disease.

3. Early diagnosis, treatment and follow-up of defects.

4. Awakening health consciousness in children.

5. The provision of healthful environment.

Aspects of School health service
1. Health appraisal of school children and school personnel.

2. Remedial measure and follow-up

3. Prevention of communicable disease

4. Healthful school environment.

5. Nutrition services

6. First aid and emergency care

7. Mental health

8. Dental health

9. Eye health

10. Health education

11. Education of handicapped children

12. Proper maintenance and use of school health records.

Essential components of School health service
• 1. Screening of school children: By medical officer, public health nurse.
school teachers and class monitors.
• 2. Healthful school environment:
i. Satisfactory toilet and lavatory facilities.
ii. Pure water supply.
iii. Good lighting and ventilation
iv. Glare proof black boards, ceiling and walls.
v. Suitable chairs and desks
vi. Rest room & play ground.
vii. Clean environment.
Essential components of School
health service
• 3.Location: Away from busy areas, properly fenced and
kept free from all hazards.
• 4.classroom:
• Height-12 feet
• Floor –smooth
• Room-sound proof and dust proof.
• Area-not less than 480 sq. feet
• Floor space for each child-15 sq feet
• The distance black board should not be greater than 25 feet
or less than 7 feet.
• Temperature-68 degree F to 72 degree F.
• Humidity-close to 50%.
Essential components of School
health service
• 5. Play ground:
• Primary school-1/2 to 1 acre
• Secondary school 5 to 14 acre
• For 500 pupils-at least 7 acre
• 6.Seats and desks:(Zero desk, plus desk and minus desk).
• 7.Boys and girls needs separately-
• One urinal for each 60
• One toilet for each 100.
Essential components of School
health service
• 8.Water supply: provision of safe and potable water
supply.
• 9.Communicable disease control: early detection,
treatment and immunization.
• 10.Nutrition/school lunch service
• 11. Special surveys: For growth and
development(physical and mental), anemia, tuberculosis,
worms
• 12.First aid: given by school teacher
• 13.Education and instruction for health.
Periodic medical examination
• Periodic medical examination or screening of students to determine
their health and nutritional status, for early detection of physical,
behavioral and mental health problems intelligent quotient(IQ) by
the medical officer, assisted by the public health nurse.
• Screening of the health professionals should be performed at least
three times-once during the first year of enrollment at the primary
level and thereafter once in 2 to 3 years during their school life.
• The initial examination include a careful history and physical
examination of the child, with test for vision, hearing and speech
• A routine examination of blood and urine should be carried out
• Clinical examination for nutritional deficiency and examination of
faeces for intestinal parasites are particularly important.
School desks
• Zero desk: Here the posterior edge of the desk
is vertically in line with anterior edge of the seat.
• Plus desk: In this type there is a space between
the anterior edge of the seat and the posterior
edge of the desk.
• Minus desk: here the vertical line from the
posterior edge of the desk falls on the seat.
Importance of different school
desk:
• The seat take 2/3rd of the child thighs and the height of the seat so adjusted
that the thighs remain horizontal, legs remain vertical and the feet rest flat
on the floor.
• The desk is not too high or too low, not too near or too far from each other.
• There is sufficient room below the desk for the knees.
• The desk is low enough for the elbow and forearm to rest comfortably
without bending the back.
• The back of the seat support the spine in the lumber region in all positions
and thus prevent vertebral column deformity.
• Single seats and desk are ideal and next in order of preference come the
dual seats and desks.
• The faulty seats give rise to certain orthopedic defects
• The zero and minus types are suitable for reading and writing.
School health problem
•A. Problems related the health of the students:
•malnutrition: Under-nutrition or over nutrition.
•Communicable diseases-whooping cough, measles,
diphtheria, chickenpox.
•Helminthes disease-ascariasis, enterobiasis,
trichiuriasis, ankylostomiasis.
•Skin disease-scabies, ring worm infection.
•Eye problems-defective vision, conjunctivitis
•Dental problem-dental caries
•Ear problem: otitis media
•Throat problem-tonsilitis, sore throat.
• B. Environmental health problem:
• Sanitary problem
• water pollution
• Overcrowding class room
• Absence of playground
• Drug abuse including smoking.
Duties of school health medical
officer
• To plan and conduct training programme on school health for
school teacher, school health monitors and other PHC worker.
• To organize and implement necessary health education
programme in school in collaboration with other members of
school health team.
• To visit school and school hostels and suggests measure for
improvement of water supply, sanitation and ventilation, lighting
and seating arrangements in class room and school feeding
programme.
• To undertake periodic physical examinations of students
according to a fixed schedule and introduce health cards .

• To organize and operationalize a referral system for the students

who need specialized medical care for illness or defects.
• To help control epidemic outbreaks of disease in the
schools.
• To implement deworming program in school with
help of PHN.
• To keep the parents informed through the teachers
about physical and mental health problems of the
students.
Duties of school teacher in school
health service
• To impart health education according to curriculum of
school system.
• To organize and conduct physical exercise and games.
• To take measure to improve school environment.
• To manage mid day meal.
• To communicate with parents of sick children and advise
them.
• To give first aid
• To identify sick children and refer them to MO, or to
nearest health institution.
Handicapped children
• A handicap Is define as disadvantage for a given
individual, resulting from an impairment or a
disability, that limits or prevents the fulfillment
of a role that is normal(depending on age, sex
and social and cultural practice) for that
individual.
• Handicap may be intrinsic or extrinsic
• Intrinsic-eg. Blindness
• Extrinsic-eg. Loss of parents
Classification of Handicapped
children
• 1.Physically handicapped:
• E.g. Blind, deaf, mute.
• Cause:
• Birth defect
• Infections
• Accidents
Classification of Handicapped
children
• 2. Mentally handicapped: eg. Mental retardation.
• cause;
• Genetic condition. Down`s syndrome, klinefelter syndrome etc.
• Antenatal factors: eg. Neural tube defect, Rh incompatibility etc.
• Perinatal factors: e.g. birth injuries
• Postnatal factors: e.g. head injuries, accidents, encephalitis,
physical and chemical agents such as lead and mercury
poisoning may result in mental retardation.
• Miscellaneous: e.g maternal malnutrition, Iodine deficiency.etc
• 3. Socially handicapped: e.g. Parental inadequacy,
environmental deprivation etc.
Classification of Handicapped
children
• Prevention:
• 1. Primary prevention:
• Genetic counseling
• Identification of the people at risk
• Immunization against poliomyelitis, rubella etc.
• Nutrition.
• Others: health care of mothers and children through pre-natal, natal and post
natal periods.
• 2. Secondary prevention(management):
• Early diagnosis of handicap
• Treatment
• Training and education.
Juvenile delinquency
• Causes of juvenile delinquency:
• Biological cause: Hereditary defects, feeble-
mindedness, physical defects and glandular
imbalance.
• Social causes: Death of parents, separation of
parents, step mothers and disturb home
conditions e.g. poverty, alcoholism, parental
neglect, ignorance about child care, too many
children etc.
Juvenile delinquency
• Types:
• Incorrigible
• Ungovernable
• Habitually disobedient
• Those who desert their home and mix with immoral
people.
THANK U