SeminAR

OF
Community
Health
NUrsing
Topic-
Component of Health services
1)School health services
2)Institutional services
3)Defense medical services.

Submitted to:-
Respected Unita Deshmane Ma’am
College of nursing
Sir JJ group of Hospital Mumbai-08

Submitted by:-
Ram Purushottam Dahikar
College of Nursing
Sir JJ group of Hospital.
SCHOOL HEALTH SERVICES
Definition

School Health Services: "School Health services refers to

need based compreherısive services rendered to pupils,

teachers and other personnel in the school to promote

and protect their health, prevent and control diseases and

maintain their health."

Purposes of school health service programme.

1)To promote the physical and emotional health of student and staff
thereby maximizing the educational process.

2)To play an integral part in support of the health care provided by

parent.

3)the school health nurse often serves as the student vital link to
medical.
 Common health Problems of school children
1.Malnutrition: Anemia, protein calories malnutrition, vitamin
deficiencies, etc.

2.Dental problems: Dental caries, bleeding gums, bad odor, irregular

teeth, etc.

3.Gastrointestmal: Intestinal parasites, diarrheal diseases, constipation,

etc.

4.Skin conditions: Scabies, lice, eczema, dermatitis, pigmentation,

depigmentation, etc.

5.Eye diseases: Refracting defects, squint, conjunctivitis, dryness, etc.

6.Respiratory: Tuberculosis, pneumonia, asthma, etc.

7.Others: Tiredness, defective postures, inattentiveness, headache,

congenital heart problems,urinary intection, etc.
BEHAVIOR PROBLEMS OF SCHOOL CHILDREN
• Antisocial problem: Stealing, lying, and gambling, cruelly, sexual
offences, destitiveness.

• Habit disorder: Thumb sucking, nail biting, bedwetting,

masturbation.

• Personality disorder: Jealousy, temper tantrums, timidity, shyness,

daydreaming fears and anxiety.

• Psychosomatic complaints: Tremors, headache, asthma,

depression, delusion,hallucination.

• Educational difficulties: Backwardness in studies, school phobia,

school failures, etc.

• Some of the behavioral disorders are due to mental deficiency;

some are due to organic disease and some due to failure in
adjustment to external environment.
 IMPORTANCE/NEED OF SCHOOL HEALTH SERVICES OR
REASONS FOR GIVING SCHOOL HEALTH SERVICES
• School involves a large number of groups of children between 5-14
years of age

• This period of 5-14 years is the period of growth and development

• There is a rapid growth in physical, mental,emotional changes

occur

• lt provides an opportunity for the nurse to supervise and provide

guidance, whenever they require.

• The children's are more susceptible to nutritional problems,

communicable diseases

• School health provides an opportunity to identify such diseases at

earlier stage

• This school population is in easy reach, so it is easy to implement

and assess health problem among them.

• School is the best place to provide heal th education and moulding

the attitude and practice of children.

AlMS OF SCHOOL HEALTH SERVICES

• To promote growth and development of school children through
health supervision,health care and nutritional programmes

• To prevent and control communicable diseases.

• To promote school health so that children may develop favorable

attitude toward health.
 PRINCIPLES OF SCHOOL HEALTH SERVICES
 School health services should,
 Be based on healthneeds of school children
 Be well-planned in coordination with school, health
personnel, parents and community people
 Be part of community health services
 Emphasize on promotive and preventive aspects
 Emphasize on health education to promote, protect, improve
and maintain health of children and staff.
 Emphasize on learning through active and desirable
participation
 Be an ongoing and continuous program.
 Have an effective system of record keeping and reporting.

School health team

The school health team consists of

1.The school principal

2.The school teacher

3.The parents

4.The community

5.The children

6.The medical officer

7.The school health nurse/ community health nurse.

Aspect of school health services
1)Health appraisal:-
Childrwen as well as the teacher and other school
workers should also undergo periodic health check-up. Health
teachers havean important role in it.Children should be medically
examined,first,at the time of admission in the school,then every
fourth year and then at the time of leaving the school.
Immunization
All school children should be immunized according to the
national immunization schedule.Children should also be prevented from
infection diseases,prevalent in the particular area.

Treatment
Appropriate treatment of the deficiencies and the diseases marked
during physical and daily check up,should be started immediately.In
rural area responsibility of treatment and follow up lies to alarge extent
on PHC.
Nutrition
The objective of this aspect is to protect children against
malnutrition. Many organization help in this.Some specific feature of
nutrition services are:

Mid-day meal: According to the recommendation of school health

committee, minimum one nutritious meal should be given to children in
the school.

Food and nutrition for malnutrition and vit D deficiency children.

First Aid
First aid box should always be available in school to handle
accidents and unexpected situation like sports, accidents, stomachache,
epileptic convulsions ,unconsciousness, diarrhea, vomiting, slipping,
fall,etc.Teacher should be skilled in providing first aid.

School Environment
1)School should be away from crowd.

2)There should be proper arrangement of ventilation and light.

3)Height of room should not be less than 12 feet

4)Every student should get minimum 10-15 sq.feet of area.

5)There should be veranda in front of every classroom.

School Health Record

Health record of every child is kept in the school.Health card should
have clear information about the bio-data , physical examination and
other test reports of the child.
Health Education
Other than personal and environmental health education,school
health education should also include gender awareness and family life
education.It is of utmost important to make vocational educational a
part of curriculum of handicapped children.It is the felt need thet sex
education should be included in the school curriculum.

The community health nurse must perform following work for

school in rural areas:
General physical examination: School health nurse to conduct general
physical examination of children, which includes head to foot
examination (inspection),checking of ht, wt, teeth, testing of vision,
hearing and other tests, etc. and recording of these observation before
medical examination.

Identify any abnormalities/defects/diseases: School health nurse

identify and treat any abnormalițies/detects/diseases as early as
possible and do the necessary referral and follow-up

Health education: Health education of children, their parents and

teachers regarding. Maintenance of personal hygiene, Growth and
development, Prevention of communicable disease.Balanced diet and
good nutrition, etc.

First aid services: Provide first aid services and emergency care for injury
or illness.

Periodic visit: Periodic visit with her team for medical check-up, follow-
up and immunisation programe.
Immunisation records: Proper record of all immunisations should be
maintained andthis should be given to child, when the child leaves the
school.

School environment: Examination of school environment, identity safety

hazards and report to the authority.

Health records: Health record of each student must be maintained

properly.

Health record should contain:

Name, date of birth and address, past health history Record of

findings of physical examination and screening. Record of services
provided.

Institutional Service:-
The care which get in institutional hospital to maintain and
improve health via prevention,diagnosis,and treatment of the
disease,illness,injury and other physical and mental oimpairement in
people.

Institutional services are as follows:-

1)Hospital

2)Nursing Home

3)outpatient clinic

4)Clinic

5)Ambulatory care

6)Hospice care
Defense health service
Nursing services is the largest specialist group within the defence
medical services and ensure service medical personnel are ready and
medically fit for deployment.

This involves managing PHC,dental care,hospital

care,rehabilitation,occupational health,community mental health and
specialist medical care for all military personnel.

Research
The history of HSR is generally considered to have begun in the 1950s
and 1960s with the first funding of grants for health services research
focused on the impact of hospital organizations.19, 20 On the contrary,
HSR began with Florence Nightingale when she collected and analyzed
data as the basis for improving the quality of patient care and
outcomes.21 Also significant in the history of HSR was the concern
raised about the distribution, quality, and cost of care in the late 1920s
that led to one of the first U.S. efforts to examine the need for medical
services and their costs, undertaken in 1927 by the Committee on the
Costs of Medical Care. The committee published a series of 28 reports
and recommendations that have had a significant impact on how
medical care is organized and delivered in the United States. Other key
reports of historical importance to HSR were, for example, the national
health survey in 1935–1936 by the Public Health Service, the inventory
of the nation’s hospitals by the American Hospital Association’s
Commission on Hospital Care in 1944, and studies by the American
Hospital Association’s Commission on Chronic Illness on the
prevalence and prevention of chronic illness in the community.
In 1968, the National Center for Health Services Research and
Development was established as part of the U.S. Public Health Services
to address concerns with access to health services, quality of care, and
costs. The Center funded demonstration projects to measure quality and
investigator-initiated research grants. In 1989, Congress created the
Agency for Health Care Policy and Research and broadened its mission
to focus attention on variations in medical practice, patient outcomes of
care, and the dissemination of evidence-based guidelines for the
treatment of common disorders. Later Congress reauthorized and
renamed the agency, Agency for Healthcare Research and Quality
(AHRQ). AHRQ provides Federal leadership for the field, investing in
methods for quality measurement, development of patient safety
methods, and health information technology (e.g., electronic health
records and decision support systems).

The Federal role in HSR has expanded over time, and investments in
HSR are made by multiple Federal agencies. In addition to AHRQ, the
U.S. Department of Veterans Affairs, Centers for Disease Control and
Prevention, the National Institutes of Health, CMS, and other Federal
agencies fund HSR. The diversification of funding comes, in part, from
the recognition that HSR is important in managing health care systems,
such as the Veterans Health Administration, and provides essential
information on the translation of scientific discoveries into clinical
practice in American communities, such as those funded by National
Institutes of Health. It is estimated that total Federal funding of HSR
was $1.5 billion in 2003, of which AHRQ was responsible for
approximately 20 percent.

Private funding of HSR has also grown over time. Funding by private
foundations has a significant role and complements Federal funding.
Among the many foundations funding HSR are the Robert Wood
Johnson Foundation, Commonwealth Fund, Kaiser Family Foundation,
Kellogg Foundation, and Hartford Foundation. Other private funding
sources include the health care industry, for example, pharmaceutical
companies, health insurers, and health care systems.
Summary:-
Student learned about the definition of component of health
services in that school health services, defence health services, and
institutional services.

Conclusion:-
Hope you might understood about the component of health
services that is school health services,institutional services and defence
medical services.

Bibliography
Sr Name of the Book Name of Author
no.
1) Textbook of preventive and social K.Park
medicine
2) CHN Vol 2 Veerbhadrappa

3) CHN book Swarnakar

4) Internet source