Aspects and Components of School Health Program

Subject: Community Health Nursing II

Overview

Activities/Aspects of School

The task of a school health service is manifold, and varies according to local priorities. Where resources are plentiful, special school health services may be developed. Some aspects of school health service are as follows: 1. Health appraisal of school children and school personnel. to local priorities.

  • Proper maintenance and use of school health records,
  • Education of handicapped children,
  • Health education,
  • Eye health,
  • Dental health,
  • First aid and emergency care,
  • Mental health,
  • Healthful school environment,
  • Nutritional services,
  • Remedial measures and follow-up,
  • Prevention of communicable diseases.

Periodic Medical Examination:

For the school health program, Nepal has no set policy. However, routine medical exams are performed based on need and resource availability. The kid should get a comprehensive physical examination, a thorough medical history, testing for vision, hearing, and speech, and an unsupervised first assessment. Urine and blood samples should be routinely analyzed. In underdeveloped nations, it is especially critical to perform clinical checks for nutritional deficiencies and feces tests for intestinal parasites.

The instructor should assist in the medical inspection by documenting the student's medical history, regularly (quarterly) recording their height and weight, yearly checking their eyesight, and assisting the students in understanding the "how" and "why" of health evaluation.

  • School Personnel: Medical examination should be given to teachers and other school personnel as they form part of the environment to which the child is exposed.
  • Daily Morning Inspection: The teacher is in a unique position to carry out the "daily inspection", as he is familiar with the children and can detect changes in the child's appearance or behavior that suggest illness or improper growth and development. The following clues will help the school teacher in suspecting children who need medical attention:
    • Unusual,
    • Any rash or spots,
    • Symptoms of acute cold,
    • Coughing and sneezing,
    • Sore throat,
    • Rigid neck,
    • Nausea and vomiting,
    • Red or watery eyes,
    • Headache,
    • Chills or fever,
    • Listlessness or sleepiness,
    • Disinclination to play,
    • Diarrhoea,
    • Pains in the body,
    • Skin conditions like scabies and ringworm,
    • Pediculosis.

Children exhibiting any of these behaviors or symptoms have to be taken to the school physician. Given the shortage of skilled staff for school health work in developing nations like Nepal and India, teacher monitoring of students is especially crucial. The teachers should have the necessary training for this task.

Remedial Measures and Follow-up .

  • After identifying the problem it should be taken the appropriate steps for solving the problems. The following activities are done under the remedial aspect of school health service.
  • Provide health care.
  • Health guidance and counseling.
  • Referral system.
  • Follow up programme.

Prevention of Communicable Diseases

The most prioritized aspect of school health services is the prevention of communicable illnesses through vaccination. The common communicable illnesses should be protected against by a well-planned vaccination regimen. The school health record should include a list of each vaccine received. The health record should go with the student when he or she leaves school.

Healthful School Environment

All factors in the school or school district that might have a positive or negative impact on the whole school community's physical, mental, or emotional health are referred to as the "school environment." Through consultations and/or supervision services, the health authority is supposed to exert appropriate control over the school environment. The community health nurse must be informed with the current conditions among the instructors in order to alert the sanitarian and/or health officer of any significant problems.

Nutritional Services

A youngster that is physically frail will also likely be cognitively frail, making it impossible for them to fully benefit from education. Therefore, a school-aged child's nutrition should be given priority. Girls and women who are physically weak will also be intellectually frail, thus it is unrealistic to expect them to consume a balanced diet that is sufficient for maintaining good health. In Nepal, stunting, wasting, and underweight are typically associated with inadequate mental and intellectual development in school-aged children. Common micronutrient deficits including those of iron, iodine, and vitamin A can also have a negative impact on academic performance.

Children under five are seen as a particularly vulnerable category and are given priority treatment.

Whereas above 5 to 17 years i.e. school age children are also in critical phase as they are in contact with the people having different types of diseases. High morbidity and malnourishments of children is still a challenge for rural areas in Nepal. 

Mid-day School Meal:

It is currently standard practice in all developed nations to serve a healthy, substantial supper to students in order to battle hunger and enhance their health. At least one wholesome meal each day should be guaranteed for school pupils. Those who can't afford it can bring their own lunches from home and eat in class during lunchtime. A plan should be in place for schools to provide midday meals through their own cafeteria(canteen) on a "no profit no loss basis" in the absence of this.

School Health and Nutrition Programme:

Since 2006, the Timal region of the Kavre district has benefited from the work of Nepal Center for Cooperation and Development (CCD) Nepal, which is jointly coordinated by the District Education Office (DEO) and the District Health Office (DHO). The School Health Program is being run by CCD Nepal with the technical and financial assistance of Italy and is based on the Focusing Resource on Effective School Health (FRESH) approach, which has the support of both the Ministry of Education and the Ministry of Health and Population of the Government of Nepal.

Specific Nutrients:

Advances in the knowledge of nutrition have revealed that specific nutrients may be necessary for the prevention of some nutrient disorders. Dental caries, endemic goiter, night blindness, protein malnutrition, anemia and a host of other nutrient disorders are eminently preventable. Use of specific nutrients is indicated where such nutrient disorders are problems in a community.

First Aid and Emergency Care

The responsibility of giving First Aid and Emergency Care to pupils (students) who become sick or injured on school premises rests with the teacher and therefore all teachers should receive adequate training during Teacher Training Programmes or in service Training programmes to prepare them to carry out this obligation. The emergencies commonly met with in schools

  • Accidents leading to minor or serious injuries and
  • Medical emergencies such as gastroenteritis, colic, epileptic fits, fainting etc.

Mental Health

The child's learning process and physical health are both impacted by his mental health. Drug addiction, maladjustment, and juvenile criminality are issues that are increasingly affecting schoolchildren. The best environment for influencing a child's behavior and fostering mental health is at school. It is the responsibility of the school teacher to assist all students achieve excellent mental health so that they can grow up to be responsible, mature, and well-adjusted individuals.

Every effort should be taken to reduce the monotony of the classroom, and the school day should be structured such that there is ample downtime in between periods of heavy work. There should be no discrimination between rich and poor, intelligent and stupid, race, religion, caste, or community. It is becoming increasingly clear that there is a tremendous demand for psychologists and vocational counselors in schools to help youngsters find occupations that suit them.

Dental Health

Dental illnesses and abnormalities are typically seen in children. The two most prevalent dental illnesses in emerging nations are dental caries and periodontal disease. Dental exams should be included in a school health program at least once a year. Dental hygienists are employed in schools in industrialized nations to help the school dentist examine students' teeth. They do a prior examination of the teeth and prophylactic cleaning, which is very beneficial for preventing gum problems and enhancing look. As they work with the kids, they learn how to teach dental hygiene.

Health Education

The most important element of the school health programme is health education. The goal of health education should be to bring about desirable changes in health knowledge, in attitudes and in practice, and not merely to teach the children a set of rules of hygiene. Health Education in schools should cover the following areas:

Personal Hygiene

The health education curriculum in schools should be engaging, applicable, and focused on kids' interests and daily needs. They should be taught the need of maintaining good hygiene for their skin, hair, nails, teeth, and clothes. It's crucial to pay attention to your posture. Children frequently stand and sit with poor posture. Such inclinations need to be recognized and changed. It is becoming more widely accepted that bad health practices developed early in life are the root cause of the main degenerative illnesses that affect adults. One public health issue that should be addressed in schools is cigarette smoking.

Environmental Health:

An essential role of school health services is to motivate children to engage in healthy activities and maintain a clean environment. Excellent options for health education include visits to watch community health programs and, even better, involvement in community action initiatives (such as vaccination campaigns, fly-control efforts, and the installation of hygienic wells and latrines).

The role of the school teacher in health education is crucial. The teacher is the main individual in the presentation of the content to the children, even if the health officer and the public health nurse/worker/assistant may provide teaching materials and suggestions. The instructor should be knowledgeable about health education strategies and genuinely concerned for the wellbeing of the students.

Eye Health Services 

Early diagnosis of refractive problems, squint and amblyopic (disorder of vision) therapy, and detection and treatment of eye infections like trachoma should all be the responsibility of the school. Vitamin A administration to vulnerable youngsters has shown positive outcomes. In other words, fundamental eye care treatments must to be made available in educational settings.


Education of Handicapped Children

Children with certain impairments are given specialized instruction to help them live regular lives. A typical activity pattern will be possible for them with the aid of adequate comfort gadgets. The ultimate objective is to provide assistance to the family of the handicapped kid in order for the child to realize his full potential, live as normally, independently, and as a contributing part of society as possible. The tools available for managing disabled children differ from nation to nation. It necessitates the collaboration of social, welfare, health, and educational organizations.

School Health Records

It is crucial to have thorough, accurate, and ongoing records on students' health. These health records will be helpful for giving children the advice and healthcare they need. Additionally, it will aid in the evaluation of the school health services and the ongoing growth and improvement of health services provided to schoolchildren. Information on: should be included in health records.

  • Identification and personal data - name, date of birth, parent's name and address etc.
  • Personal and family health history,
  • Findings of physical and medical examination,
  • Findings of routine investigations and screening,
  • Services rendered and the prognosis.

The purpose of maintaining school health records is to have cumulative information on the health aspects of school children in order to give continuing intelligent health supervision. These records will also be useful in analyzing and evaluating school health programmes.

Things to remember

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