School health service

1. School health service Dr . Rekha Dutt

2. It is powerful and economical means to raise community health in future generations. • History – 1909 in Vadodra , medical examination of school children were conducted . • In 1953, the secondary education committee emphasized the need for medical examination of students and school feeding programme. • In 1960,GOI started school health committee to assess the standard of health and nutrition of school children.

3. Significance • School children constitute 25% of total population. • They are most impressionable group. • They can be used as resource for communication of ideas and values to family and neighbors. • Growth and development is at rapid pace which needs to be supervised. • The diseases and defects which are common are:

4. Malnutrition – underweight in urban slums and rural areas, and overweight in urban. • Caries teeth • Refractive errors and visual problems • Skin diseases – pyoderma and scabies • Worm infestation • ENT problems • Local endemic diseases • Iodine deficiency disorders • Injuries, postural defects

5. objectives • To inculcate healthy habits and lifestyles to promote healthy behavior and to learn values of hygiene. • To protect against specific diseases with immunization. • To promote health seeking behavior. • Training of teachers for health activities. • To establish parent teacher association and regular contact for counseling. • To improve healthy environment in the school which includes safe water, safe disposal of excreta, waste water and garbage disposal.

6. Components of school health services 1. Health appraisal – Periodical examination and observation of children by class teacher. • The school health committee recommends medical examination of children at the time of admission and there after every 4 years. • Health checkup of school personnel is equally important. • Daily morning inspection :if child has following problems, he should be referred to medical officer.

7. Unusually flushed face • Any rash • Coughing, sneezing, sore throat • Nausea, vomiting • Red watery eyes • Fever, chills and headache • Sleepy and does not want to play • Diarrhea • Pediculosis, scabies, ringworm • The teachers should be adequately trained during teacher training course subsequently by short in service training course.

8. 2. Remedial measures and follow up Special clinics should be conducted exclusively for school children at PHC or RHC or dispensaries. 3. Prevention of communicable diseases Immunization – DT – AT SCHOOL ENTRY TT- AT 10 YEARS TT AT 16 YEARS record should be maintained at school and parents should be informed in advance. 4. Healthful school environment The following minimum standards for sanitation of school have been suggested in India.

9. Location – should be with proper approach road. Cinema houses, factories, railway tracks and market places should be far. School premises should be fenced. Site – 10 acres of land for higher secondary and 5 acres for primary school. In congested areas, the nearest public park should be made available to students. Structure – as far as possible the building should be single storied. The minimum Thickness of walls should be 10 inches and walls should be heat resistant.

10. Class room – Verandahs should be attached to classrooms. No class should accommodate > 40 students. • Per capita space for students should not be less than 10 square foot. • Furniture – should suit age groups. Chairs should be with back rest. • Doors and windows – at least 25% of floor area. • Colors – white • Light – sufficient light

11. Water supply– potable and continuous water supply • Eating facility- vendors should not be allowed. Separate rooms for midday meal. • Lavatory – 1 urinal for 60 students and 1 latrine for 100. separate toilets for boys and girls. • Nutritional services – diet should have all nutrients in proper proportion, adequate for maintenance of optimum health. Nutrition disorders are common in school children

12. Mid day meal – should be given to improve nutritional status. At least one nourishing meal per day which should have 1/3 of daily calorie and ½ of protein requirements. • It should be a supplement meal. • Cost should be reasonably low • Easy recipes • Use of locally available food • Menu should be frequently changed

13. Mid day meal scheme – also called as Nutritional support to primary education Objectives- • Improve enrolment, retention and attendance in school • Improve nutritional status • The central assistance provided to states under the programme is by supplying food grain from nearest food corporation of India godown at the rate of 100 gm/ student/day. • 300 calories and 8-12 gm protein to all children from class 1- 5 std.

14. First aid and emergency care – all teachers should receive adequate training during teacher training programme. Common emergencies in school are – • Accidents, falls • Gastroenteritis • Fits and fainting • Mental health – juvenile delinquency, drug addiction common in adolescents. There should be a counselor in the school

15. Dental health- examination once a year Teaching of dental hygiene • Eye health - early detection of refractive error, vitamin A deficiency. • Health education – Personal hygiene , posture, environmental health, sex education. • Education of handicap children – it is helping the child to reach his maximum potential to lead an independent life.

16. School health records –for each child should be maintained. Identification data Past history Physical examination Immunization history These are useful in analyzing and evaluating school health services and provides a useful link between home, school and community. In rural area services can be provided with help of PHC.