https www yenepoya edu in 1272020 12 35

https: //www. yenepoya. edu. in 12/7/2020 12: 35 AM Yenepoya College ANANDA YNCNursing ASST. PROFESSOR 1

LEARNING OBJECTIVES At the end of the class the student will be able toØ Define school health services Ø Learn the aim and objectives of school services Ø Discuss the principles of school health services Ø List down the health problems of school children Ø Explain the components of school health services Ø Mention the school health team Ø Describe the role of school health nurse 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 3

INTRODUCTION • School is a setting that plays an important role in the physical, emotional, social and mental development of children. • It is a personal health service and provides an… • …opportunity to help millions of young people to acquire health supportive knowledge, values, attitudes and behaviour. Also influences health behaviour of other children, their families and community. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 4

• School health service is an important aspect of community health. • It is possible to increase the health level of community and achieve growth in the health of future generation through school health service. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 5

History 1909 - Medical examination for school children in Baroda city. 1946 - Bhore committee report on non existence of adequate school health facilities. 1953 - The Secondary education committee stressed on the need for regular examination & school feeding programme. 1960 - Constitution of school health committee at village , state, national level to assess health and nutrition of school children 1963 - The “National School Health Council” has been established to plan and organize school children’s health care 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 6

DEFINITION OF SCHOOL HEALTH • 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 students, teachers and other school personnel 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 7

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. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 8

AIM • The ultimate aim of school health services is to promote, protect and maintain health of school children and reduce morbidity and mortality in them. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 9

OBJECTIVES OF SCHOOL HEALTH SERVICE • The promotion of positive health • The prevention of diseases • Early diagnosis, treatment and follow up of defects • Awakening health consciousness in children • The provision of healthful environment. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 10

PRINCIPLES OF SCHOOL HEALTH SERVICES • It is based on health needs of school children • It is planned in co-ordination with school health personnel, parents and community people. • It emphasize on health education to promote, protect, improve and maintain health of children and staff. • It emphasize on promotive and preventive, aspects. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 11

• It emphasize on health education to promote, protect, improve and maintain health of children and staff. • It emphasize on learning through active and desirable participation. • It is an ongoing and continuous program. • It has an effective system of record keeping and reporting. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 12

Health problem of school children 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 13

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COMPONENTS OF SCHOOL HEALTH PROGRAMME 1. Health appraisal of school children and school personnel 2. Remedial measures and follow up 3. Prevention of communicable disease 4. Healthful school environment 5. Nutritional service 6. First aid and emergency care 7. Mental health 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 16

8. Dental health 9. Eye health 10. Health education 11. Education of the handicapped children 12. Maintenance and use of school health records 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 17

1. Health appraisal of school children and school personnel Ø Periodical medical examination of school children, teacher, health personnel. • Medical examination on entry and after 4 years • Screening of children includes • Height and Weight , Routine examination of blood and urine, Acuity of vision, Hearing, Skin condition, Intestinal worms Ø Daily morning inspection by the teachers unusually flushed face, 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 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 18

2. Remedial measures and follow up Ø Special clinics should be conducted in the health units (PHCs) for school children. Ø Selected health unit or a school should be arranged for about 5000 children in urban areas Ø Results are recorded in the health record card and parents should be advised regarding remedial action 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 19

Ø Referral hospital must provide for beds for children who are admitted & provide relevant treatment. Ø Prevention of communicable diseases by Immunization is the most emphasized function of school health services 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 20

3. Preventive of communicable diseases • Protection of all school going children against preventable disease immunization according to the National Immunization Schedule 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 21

Healthful school environment • An optimal school environment, location, building and equipment's are important prerequisites for a school health. • A good school environment promotes physical, social and emotional health of the pupils. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 22

• Location Ø Away from busy places. Ø Keep free from all hazards. • Site Ø Suitable highland with proper drainage Ø Land area-10 acre for high schools and 5 acre for primary school…. …additional one acre per 100 students • Play ground: Ø For a primary school it should be 0. 5 to 1 acre. Ø For a secondary school it should be 5 to 14 acres. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 23

• Infrastructure Ø Nursery and secondary school building should be single storied Ø Exterior walls about 10 inch thick and heat resistant • Furniture Ø Preferably single desk and chair should be provided Ø Desk should be “minus” type with proper back rest 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 24

• Class room: Ø Verandas should be attached to classrooms Ø Maximum accommodation of 40 student per classroom Ø Height of the class room about 12 feet Ø Room sound proof & dustproof and Floor should be smooth Ø Area not less then 480 sq feet Ø Floor space> 10 sq feet / child 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 25

• Doors and windows Ø Combined area should be at least 25% of floor area Ø Windows broad and located at 2’ 6” from floor Ø Cross ventilation is a mandate • Colour Ø Colour of the wall preferably white • Lighting Ø Sufficient natural light, preferably from the left 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 26

• Water supply Ø Independent source of safe and potable water supply Ø Continuous and distributed from taps • Eating facilities Ø Vendors not approved should not be allowed inside school premises Ø Separate rooms for mid day meal • Toilet facility Ø For 100 pupils…. . 1 latrine Ø 1 urinal for 60 student Ø Arrangements should be separately made for boys and girls. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 27

5. Nutritional services • School health committee (1961) recommended that school children should be assured for at least one nutritional meal • Mid day meal- to combat malnutrition and improve the health of school children • Children provided with 1/3 rd of calorie and ½ of protein requirements in school • Applied nutrition programme with the assistance of UNICEF advocates developing school gardens • Measures should be taken to combat nutritional deficiencies by providing 12/7/2020 12: 35 AM ANANDA YNCspecific ASST. PROFESSORnutrients. 28

6. First aid and emergency care • The school must have an arrangement for providing first aid and emergency care to children who get injured or sick at the school. • The teachers should receive adequate training during teacher training program or in service training programs on First aid • First aid box should be made available. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 29

7. Mental health • The mental health of the child affects his physical health and the learning process. • Juvenile delinquency, maladjustment and drug addiction are becoming problems among school children. So, teachers need to plan and organize well-balanced curricular activities • Vocational counsellors and psychologists in schools to guide children 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 30

8. Dental health • School children usually suffer from dental diseases and defects. • Dental caries and periodontal disease are the two common dental diseases in India • Dental hygienist and dentist are to be employed. • Provision for dental examination, at least once a year should be made • During the dental check up should focus on prophylactic cleansing and dental hygiene classes. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 31

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. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 32

10. Health education • Health education is very important for school children as it creates awareness. • Health education content areas include personal hygiene, environmental health, nutrition, prevention and control of communicable and non-communicable diseases. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 33

11. Education of handicapped children • Ultimate goal is to assist the special child and his family to… �Achive maximum potential �To lead a normal life �To become as independent as possible �To become a productive and self supporting member of society 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 34

12. School health records Ø Cumulative health records providing pertinent information health supervision tool Ø Also serves as tools to evaluate the school health services 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 35

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 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 36

Functions of the team • Important role in promoting the health of the school children • Assess school health needs, planning, organizing and implementation of school activities • Evaluates the school health programme and its activities implemented • Future planning 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 37

School principal role • Ensure that school health programme has approval and support of the school administrative authority • Ensures school teachers are adequately trained for health care of school children. • Ensures Parents are involved in follow up of the school children 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 38

• Provide facilities for implementation of school health activities • Set up a school health committee • Maintenance of health records 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 39

The School Teacher role • Daily inspection of children for personal hygiene and cleanliness • Daily inspection for evidence of any deviation from normal health, behaviour, malnutrition /communicable diseases. • Referral of child having any problem to school health clinic • Informing the parents and maintaining follow up conti……. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 40

• Giving first aid and emergency care to children • Imparting health education • Maintaining the record of anthropometric measurements • Help in control of communicable diseases 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 41

Parents -role • Help in providing information about past, present history of medical problems • Help in correction of defects and follow up of children • Help in formation of good healthful living habits and behavior Conti……. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 42

• Participate and co-operate in physical and medical examination of children & Immunization • Through parent –teachers association parents are involved in planning, organizing and implementation of school health programme 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 43

The community-role • Provide suitable land for school building • Providing funds and labor in building proper school • Participation in school health committees or councils and contribute in formulation of school health policies and plan. • Participation in implementation of programme activities. • Motivating parents to send their children to school and take care of their health. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 44

School children-role • Learn values of medical and health examinations, personal hygiene, good nutrition, environmental sanitation • Co-operate in various aspects of school health programme • Develop positive habits and healthful living activities • Extend this knowledge to other members of the family. 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 45

Medical officer-role • • • Medical examination of the students Making diagnosis Making referrals to specialist Ensuring maintenance of records and reports Ensuring follow up of children 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 46

• • • Initiating preventive and promotive programmes Inspection of school environment Holding meetings with parents and teachers Prescribing treatment Evaluation and redefining school health services objectives and activities 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 47

School health nurse-role 1. Health promotion & specific protection: • Immunization of children • Helping school authorities and teachers to plan mid-day meal which is cheap, nutritious, hygienical and supplemental. • Health education to children, their parents and teachers 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 48

• Helping students, their parents and teachers to develop positive attitude and health behaviour • Providing counseling • Designing of health education curriculum • Examination of school environment • Ensuring community participation 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 49

2. Early diagnosis & treatment: • • Regular and periodical appraisal of children Notifying parents about health appraisal results Making referrals Follow up Home visits of selected children Counseling of the students and the parents Teaching family, ANM’s/MPHW Provide first aid and emergency care for injury and illness 12/7/2020 12: 35 AM ANANDA YNC ASST. PROFESSOR 50

3. prevention of complications & Rehabilitation: • Helping in prevention of recurrence of acute conditions: by Elimination of the risk factors • Prevention of complications by meeting special needs • Prevention of adverse effects by counseling children 12/7/2020 12: 36 AM ANANDA YNC ASST. PROFESSOR 51

4. Other functions: • • • Maintenance of health records Assisting , guiding other health workers Management of school health clinic Holding conferences with the teachers Participate in health council /committee Participate in education of teachers. 12/7/2020 12: 36 AM ANANDA YNC ASST. PROFESSOR 52

Other roles • School health consultant • Practitioner • Planner • Organizer • Co-coordinator 12/7/2020 12: 36 AM • • • Guide Supervisor Educator Trainer Counselor ANANDA YNC ASST. PROFESSOR 53

Reference • K. Park Community Health Nursing • Neelam Kumari Community Health Nursing • Thressiamma Community Health Nursing. 12/7/2020 12: 36 AM ANANDA YNC ASST. PROFESSOR 54

THANK YOU 12/7/2020 12: 36 AM ANANDA YNC ASST. PROFESSOR 55