COMMUNITY HEALTH NURSING

TOPIC: SCHOOL HEALTH PROGRAM

INTRODUCTION
A healthy and educated child’s population means a healthy and prosperous future .There are
about 1000 million children and young people of school age in the world today and out of this
number ,hundreds of million are actually attending school.
The World Health Organization Expert Committee on School Health Services noted as long as
1950 that ‘to learn effectively children need good health “WHO 1950 .Research also indicated
that nutritional deficiencies and poor health in primary school age children are among the cause
of low school enrollment, high absenteeism, early drop out and poor classroom
performance .The connection between a child health and education is a powerful one ..
Consequently the overall aim of School Health Program is to develop the abilities of pupils to act
at the personal and societal levels i.e. increase their action competence. (Jensen 1997)
DEFINITION : School health program is defined as the school procedure that contribute to the
understanding ,maintenance and improvement of the health of pupils and school personnel .Thus
by this we mean any procedure that are carried out by teachers ,doctors nurses ,health
educator ,nutritionist ,dentist etc. to appraise ,protect and promote the health of school children
and school personnel .It is to ensure that pupils are well enough to learn and school personnel are
fit to carry out their duties to the best of their abilities
Procedures are;
1. Routine and continuous appraisal of the health status of the school children
2. The treatment of common ailment among the school children and school personnel
including provision of emergency care for injuries and sudden illnesses
3. The control of common communicable disease in the school
4. The promotion of optimum sanitary conditions of the school
 5. The counseling of children, their parents and the teachers.

HISTORY OF SCHOOL HEALTH PROGRAMS IN NIGERIA

History of School Health Programme in Nigeria

The colonial period was not the best for School Health in Nigeria. Before the 19th century, there
were no school facilities. The British Empire started to implement the western education in
Nigeria only in the 19th century.
The starting point was in 1842 with the primary education in Nigeria. The secondary education
in Nigeria started in 1859, with the first Grammar School in Lagos. However, the sanitary
standards for pupils were pretty low.
Only in the beginning of the 2000s did the Federal Government of Nigeria start to reform the
National Health Policies and implement a new National Health Programme. This programme is
still active and has the main goal to follow the international standards of health and the WHO
recommendations.
According to official documents, the National School Health Programme must promote and
follow the international rules and recommendations of the WHO, UNESCO, and UNICEF.
Despite this, the actual reality of school health education in Nigeria is pretty depressing. For
now, it's up to the schools to follow and implement these health programmes in Nigeria.
OBJECTIVES OF SCHOOL HEALTH PROGRAM
1. Promotion and maintenance of the healthy growth and development in all school
children.
2. Controlling the spread of communicable disease among school children
3. Promotion of a optimum sanitary condition of the school
4. Provision of emergency care for school children
5. Inculcating the principles of good health in the school children
6. Counselling pupils, teacher and parent.
7. Offering good guidelines to children in the choice of professions
8. Provision of social educational therapy for handicapped children
9. Protection and promotion of the health of the school personnel
10. Appraisal of the health status of school children in order to detect early any physical or
mental defect that may deter them from benefitting from educational opportunities.
11. Promotion of school and community collaboration.
COMPONENTS OF THE SCHOOL HEALTH PROGRAM
Broadly the components can be divided into 3
1. SCHOOL HEALTH SERVICES
2. HEALTHY SCHOOL ENVIRONMENT
3. HEALTH EDUCATION /INSTRUCTIONS
1. SCHOOL HEALTH SERVICES: Services provided for students to appraise, protect,
and promote health. These services are designed to ensure access or referral to primary
health care services to foster appropriate use of primary health care services, prevent and
control communicable diseases and other health problems, provide emergency care for
illness or injury, promote and provide educational and counseling opportunities so as to
promote and maintain individual, family, and community health. Qualified professionals
such as physicians, nurses, dentists, health educators, and other allied health personnel
provide these services.
A. Physical Examination : Periodic medical inspection of school children should be carried
out at least twice a year in primary schools and twice a year also in post primary schools
by medical officers or nurses .These examination include :
a. Hygiene inspection – hair, nails, clothe, teeth etc.
b. Height and weight measurement
c. General examination of the skin for rashes, ulcer, ring worms, angular stomatitis etc.
d. Examination of the eyes, ears, nose and throat for infection.
e. Auditory testing to measure hearing ability of children
f. Simple laboratory investigations of urine ,stools ,blood
g. Radiographical examination of the chest of all new entrants and finalist
h. Dental examination for carries and calculus
i. Psychological examination.
B. Provision of treatment facilities /First aid and Emergency services
a. Adequate facilities within the school for management of medical emergencies e.g.
injuries, minor ailment, illness.
b. Treatment facilities that should be available in special school clinics
There are three tiers of care;
1. School Medical treatment by teachers
2. Special school clinics by nurses’ etc.
3. Treatment in the hospital
 Equipment required by schools for medical care are materials for dressing;
bandages, gauze, plasters, G.V, splint, drugs, thermometer etc.
C. Lay down policies
In any emergencies the school should be responsible for the following;
1. Notification of parent when pupils are ill
2. Transportation of pupil to the nearest and most appropriate medical institution
D. Screening test for discovery of handicapped children
E. Control of communicable disease
F. Early diagnosis of common disease in the community e.g. mumps ,T,B,
schistosomiasis
G. Immunization of school children.
ASSIGNMENT: REVIEW THE IMMUNIZATION SCHEDULE
2 HEALTHY SCHOOL ENVIRONMENT

The term HSE denote all the consciously organized planned and executed efforts to ensure safety
and healthy living conditions for all members of the school community
The physical and aesthetic surroundings and the psychosocial climate and culture of the school.
Factors that influence the physical environment include the school building and the area
surrounding it, and biological or chemical agents that are detrimental to health, and physical
conditions such as temperature, noise and lighting. The psychological environment includes the
physical, emotional, and social conditions that affect the well-being of students and staff.
OBJECTIVES
1. To create a healthy and safe learning environment in the school
2. Provide adequate safe water supply and sanitation facilities
3. Also for the biological being to provide an adequate meal at least I daily to all children
CHARACTERISTICS OF HSE
1. Location of school away from potential environmental hazards
2. Protection of the school community from excessive noise ,heat ,cold and dampness
3. Provision of adequate building, constructed in line with approved standard with
particular emphasis on facilities for physical challenged learners.
4. Provision of an appropriate and adequate amount of furniture for learner and staff
5. Provision of an adequate number of gender - sensitive toilet facilities
6. Provision of adequate safe water supply and sanitation facilities for the school
community.
7. Provision proper drainage and waste disposal facilities
8. Provision of safe recreational and sport facilities
9. Perimeter fencing of the school’
10. Observation of annual school health days.
11. Promotion of healthy human relationship in the school community
12. Promotion of health related school policies
13. Promotion of a maintenance culture.

3 .HEALTH EDUCATION /HEALTH INSTRUCTIONS

This is to promote the development of sound health knowledge, attitude, skills and
practice among the learner .The subject is also aimed at meeting the growth and
development needs and interest of learner.
OBJECTIVES
1. To provide information on key health issues affecting the school community
2. Develop skill – based educative curriculum for the training of teachers and learners
3. To provide participatory learning experience for the development of
knowledge ,attitude ,skill and desirable habit in relation to personal and community
health
4. Evaluate learner’s progress towards healthy development.
CHARACTERISTICS
The following broad arrears will be covered by the skill – based H.E curriculum
a. Personal Health
b. Disease HIV/AIDS
c. Mental and social health
d. First Aid and safety education
e. Community health
f. Family life education
g. Environment health
h. Maternal and child health
i. Nutrition
j. Drug Education
k. Ageing and Death (Bereavement ) education
l. Parts of human body
m. Health agencies
OTHER IMPORTANT COMPONENTS ARE;
SCHOOL FEEDING SERVICES

School feeding services aimed at providing an adequate meal a day to all

children enrolled in schools Nationwide.
The services builds upon the Government current national Home – Grown School
Feeding and Health Programs (HGSF & HP) which aims to contribute to the
realization.
OBJECTIVES
1. Reduce hunger among school children
2. Increase school enrolment, attendance, retention, and completion rates
particularly among children in poor rural communities and urban
neighborhood.
3. Improve the nutritional status of school children
4. Enhance the comprehension and learning abilities of pupils /students
CHARACTERISTICS
1. Provision of at least one adequate meal a day to school children
2. Adequate sanitation and hygiene practices among food handlers including
routine medical examination and vaccination.
3. Food fortification and supplementation
4. Regular deworming
5. Promotion of health related school policies
 SCHOOL COUNSELING, PSYCHOLOGICAL AND SOCIAL SERVICES

Services provided to improve student's mental, emotional, and social health

These services include individual and group assessment, interventions, and referrals.
Organizational assessment and consultation skills of counselors and psychologists contribute not
only to the health of students but also to the health of the school environment. Professionals
such as certified school counselors, psychologists, and social workers provide these services.
HEALTH PROMOTION FOR SCHOOL STAFF
Opportunities for school staff to improve their health status through activities such as health
assessment, health education health-related fitness activities. These opportunities encourage
school staff to pursue a healthy lifestyle that contributes to their improved health status,
improved moral, and a greater personal commitment to the schools's overall coordinated health
program. This personal commitment often transfers into greater commitment to the health of
students and creates positive role modeling. Health Promotion activities have improved
productivity, decreased absenteeism, and reduced health insurance costs.
SCHOOL, HOME AND COMMUNITY RELATIONSHIP
The first health educator of the child are the parent ,who shaped the child’s habits from
infancy .long before the child is ready for school ,the parents should secure needed immunization
and medical care and inculcate good habits into the child.
OBJECTIVES
1. To build and strengthens capacity for effective community involvement and participation
in school management
2. To improve advocacy and community mobilization to bring about necessary support from
stakeholders.
 CHARACTERISTICS
The characteristics of school, home and community relationship shall include:
a. Home visit by teachers ,school nurses and social workers
b. Regular visit of parent to school
c. Regular communication of the health status of the learner to the home by the school
health personnel and the teacher
d. Active participation of the school in community outreach activities and campaign
e. Active participation of the school in community health planning, implementation,
monitoring and evaluation.
f. Advocacy and community mobilization for the SHS through traditional and modern
media.
g. The community shall be involved in the promotion of health related school policies
STEPS TO USE
a. Know the community
b. Be familiar
c. Identify the entry point
d. Make contact with the community head
e. Tell them
f. Arrange meetings
g. Answer questions
h. Follow up
ADVANTAGES OF SCHOOL HEALTH PROGRAM
1. It helps to identify abnormalities promptly among pupils and to give immediate
treatment
2. It enable health workers to monitor growth and development of pupils
3. It promote normal growth and development of the children
4. It helps to checkmate the spread of infection among the school children
5. It enhances learning
6. It relieves congestion in the hospital as minor ailments such cough, acute respiratory
infections, fever malaria etc. are treated .
NEEDS OF THE SCHOOL CHILD
1. Happy home ,freedom ,
2. Adequate nutrition
3. freedom from infection ,stress and fatigue
4. Good sight
5. Portable water for drinking
6. Safe and playing ground
7. Recreational facilities
8. Clean environment
9. Adequate facilities for sewage disposal
10. Adequate clothing and well fitted shoes
11. Freedom for handicap
12. Safe classroom building
 13. Accident free environment
14. Immunization schedule

PHYSICAL EXAMINATION
1. EYES : - Test the equity of vision
- Examine the defect
- Examine for disease e.g. Vit deficiencies
- Examine for anaemia
2. TEETH - Look for carries ,bleeding gum
3. THROAT ; Look for enlarged tonsils ,thyroid gland
4. EARS: Test for hearing ,look for discharges
5. CHEST : Auscultate the heart and lung
6. ABDOMEN : Palpate for enlargement of spleen or liver ,look for enlarged lymph nodes
and tenderness ,undescended testes
7. LIMBS : Look for signs of rickets and defect e.g. Kyphosis ,club foot, observe gaits
8. SKIN AND HAIR ; Look for any hypo pigmented patches with loss of
sensation ,ulcer ,boils ringworms ,scabies lice ,texture of hair and its distribution