Unit – 5 : Community Services In Rural, Urban

& School Health

Assignment of

SOCIAL AND PREVENTIVE PHARMACY

PHS-CC-7105

Session 2023-24

Supervisor: Submitted by:

Prof. Vandana Soni Group – 5 ( 64 – 77 )
Dr. Priyanka Jain B. Pharm VII Sem.
Miss. Sakshi

Department of Pharmaceutical Sciences

Dr. Harisingh Gour Vishwavidyalaya, Sagar, (M.P.)
(A Central University)
 HEALTH PROMOTION AND EDUCATION IN SCHOOL

Improvement of health literacy, health behavioural change, creating a supportive physical and
social environment to be more conducive to health should be the focus of child and adolescent
public health

The concept of Health Promoting School initiated by World Health Organization aims to move
beyond individual behavioural change and to consider organisational structure change such as
improvement of the school’s physical and social environment.

Health Education is defined as:

“Any combination of learning experiences designed to facilitate voluntary action conducive
to health”

Elaboration of the definition: -

 Combination: it emphasizes on the importance of matching multiple determinants of

behaviors with multiple learning experiences or educational intervention
 Designed: distinguishes health education from incidental learning experiences as a
systematically planned and organized activity.
Facilitate: creating favorable condition such as predispose, enable, reinforce.
 Voluntary: with full understanding and acceptance of the purpose of the action.
Action: means behavioural steps taken by an individual, group or community to achieve
an intended health effect.
Health promotion can be defined as:
“A combination of educational and environmental supports for actions and condition of
living conducive to health.”

Elaboration of the definition:

 Combination: refers to the necessity of matching multiple determinants of health with

multiple intervention or sources of supports.
 Educational: refers to the communication part of health promotion. That is health
education.
- Environmental: refers to the social, political, and economic, organizational, policy
and regulatory circumstances influence behavior or more directly health
A health promoting school approach includes:

 a participatory and action-oriented approach to health education;

 understanding that students have their own concepts of health and well-being;
 developing healthy school policies which promote health and well-being;
 developing a healthy physical and social school environment;
 developing life competencies;
 making effective links with home and the community;
 making efficient use of health services in the school context;
 developing the health and well-being of students and school staff

A more traditional approach to school health education focused on individual topics such as
healthy eating, smoking, physical activity and mental health. These health topics are not separate
in the lives of young people or in their health-related behaviours. In a topic-based approach,
health may be viewed at the level of the individual and their relationship to the topic being
explored, when in fact the social environment may be more powerful in determining

Behaviour -

 Education and health are closely related. The evidence suggests that:
o Healthy young people are more likely to learn more effectively;
o Health promotion can help schools to meet their social aims and to improve
educational attainment;
o Young people that attend school have a better chance of good health;
o young people that feel good about their school and who are connected to school
and significant adults, are less likely to undertake high risk behaviours and are
likely to have better learning outcomes.

Most of the evidence on the effectiveness of health education and health promotion in schools is
from work on

specific health topics. The most positive evidence is found in the topics of mental health
promotion, healthy eating and physical activity and the weakest evidence is in the area of
substance use.
Mental health and emotional health

 The evidence shows successful mental health initiatives in schools:

 are well designed and grounded in tested theory and practice;
 link the school, home and community;
• address school ecology and environment;
• combine a consistency in behavioural change goals through connecting students, teachers,
family and community;
• foster respectful and supportive relationships among students, teachers and parents;
• use interactive learning and teaching approaches;
• help to increase the connections for each student;
• help to develop improvements in achievement tests, social and emotional skills and
decreases in classroom misbehaviour, anxiety and depression;
• produce significant benefits in relation to reductions in aggressive behaviour, school drop-
out rates and in building a sense of community in the school.

Substance use –

 Some successful gains in substance use school programmes may include a short term delay in
use and or short term reduction in usage; positive effects are more likely to occur influencing
tobacco, rather than alcohol or illicit drugs. Specific programmes are more likely to have no
effects or harmful effects on alcohol use. Teaching staff who understand mental health issues,
achieve higher health and educational outcomes for the students. The evidence shows that
school-based drug reduction initiatives are more likely to be effective if:
• the programmes are interactive rather than teacher centred;
• focus on life skills, e.g. refusal skills, assertiveness;
• take a whole school approach;
• link with the family and local community;
• address the improvement of connections for students.

Hygiene -

 The scientific evidence about the health benefits for children and adolescents of hand
washing, drinking clean water and using proper sewage systems is very strong. The evidence
indicates that in developing countries, well designed and implemented initiatives, which have
included:
• a whole school approach involving the physical environment;
• links with the health sector;
• have suitable policies and curriculum; have increased school attendance rates and reduced
worm infestations (mainly through the provision of wormeliminating drugs) .
 Sexual health and relationships education
Sexual health and relationships education programmes, when conducted by trained and
empathic educators:
• increase sexual knowledge;
• may increase safe sex practices;
• do not promote earlier or increased sexual activity in young people;
• can build school connectedness for students, and this is strongly associated
with reduced sexual activity in adolescence.

Healthy eating -

 Healthy eating programmes that follow evidence-based teaching practices and a whole
school approach have been shown to regularly increase student knowledge about food and
diet. However, changes in student eating behaviours have been less successful. Girls tend to
benefit more than boys and some quality initiatives have reported a modest increase in
vegetable consumption. Successful initiatives have some or all of the following features:
• a whole school approach;
• links with parents and food preparation at home;
o consistency between the taught curriculum and food availability in the school;
o programme longevity (over three years) and regular inputs by staff and students in
planning and implementingactivities;
o on-going capacity building opportunities for staff
 PRINCIPLES OF COMMUNITY HEALTH SERVICES

1. Programme should be planned on a scientific priority basis .

2. Prevention and treatment of disease should be administratively combined .
3. Before starting a program , the picture of complete plan must be made .
4. Administration must be based on a sound economic consideration .
5. Provision must be made for desirable working conditions for all members of the staff .
6. There should not be overlapping in rendering treatment and prevention of disease.
7. Centralized direction and decentralized activity .
8. Evaluation of results is major responsibility of the health administration .
9. When a special function is to be undertaken , it should be undertaken by or in cooperation
with the official body .
 COMMUNITY SERVICES

Introduction: Community service is social work that is carried out in Groups and has goals as
well as has particular purposes.Community service if implemented properly will certainly

produce some useful outputs and products.

Goals of Community Service Projects:

1. Foster a sense of love and togetherness among individual towards the surrounding
community.
2. Cultivate and apply the knowledge, skills and practice of civics value in each individual.
3. Contribute in the form of energy and skills to the community and the nation.
4. Develop personality and understand the concept of cooperation and helping one another.
5. Nurture the spirit of living together in a community regardless of race, religion, beliefs or
ideology.
6. Be a citizen who is patriotic, caring and responsible towards the society and nation.
7. Practise a healthy lifestyle and always active in helping others in need.
Themes:

Educational
responsibility
Community
Social entrepreneurship, development,
Well-being of society Innovation, art and
culture.
Community service's
themes

Information technology Health

Disaster management

Focuses:

1. Project to clean the university/college/schools/

2. kindergarten areas.
3. Project to beautify the school area.
4. Project to clean the recreational area.
 5. Project to clean the cemetery.
6. Project to clean the village community halls.
7. Community service projects at orphanages
8. Community service projects at the Old Folks’ Home; and
9. Other community service projects either in school,
10. village, town and national levels.
Importance of Community Services:

1. Improve knowledge and skills in solving people’s problems.

2. Participants or volunteers can learn about related issues in-depth;
3. Nurture a sense of love and togetherness in individuals towards the surrounding
community;
4. Form personality and understand the concept of cooperation and helping in the
community.
5. Inculcate the spirit of living together in a community, regardless of race, religion, beliefs
and ideology.
6. Practise a healthy lifestyle and always active in helping others who are in need.
7. Become citizens who are patriotic, concerned and responsible towards society and nation;
and
8. Increase the belief in community organisation and governance. Workingtogether to
enhance communication and understanding.
9. Find out what the government, people, community leaders and organisations can and
cannot do to reduce conflict in the future.

Implications of Community Service Projects to individuals

- Project positive input the self-development of each individualBenefits
1. The community service activities which are carried out together will create a sense of
understanding and strengthen self-esteem.
2. Activities that have been well-planned will have an impact on personal health in
terms of physical and spiritual aspects.
3. Activities implemented jointly in a community that is made up ofvarious ethnic
groups will result in a stronger sense of toleranceand strengthen the unity among the
ethnic groups.
4. Create a sense of consideration and love for other people, especially for the disabled
and elderly people.
5. The community service activity which is in the form of communalwork will reduce
the cost of implementation.
6. Create a deeper sense of neighbourhood and understanding amongthe society in a
neighbourhood area.
7. Produce citizens of good heart and are patriotic and love the country.

Self-Readiness as a Volunteer
Definition of Volunteer
“Volunteers can be defined as the readiness to get involved involuntary work”.
Criteria to become a Volunteer
1. To have a positive mindset to serve the particular section of the society.
2. Should have an interest, concern and a tendency to contributephysical energy, share
interests and experience to a target group or a particular community group.

Types of Community Services:

1. Rural community
2. Urban community
3. Tribal community

Rural Community: Rural community means community that lives in village, and is dependent
on natural environment.
Rural community mostly dependent on agriculture, these communities have low density of
population, intimate relationships and have oral traditions. group These communities are rich in
culture and traditions. Characteristics of rural communities:
 Size of the Community: The village communities are smaller in area than the urban
communities. Low population. Density of Population: As the density of population is low,
the people have intimate relationships and face-to-face contacts with each other. In a
village, everyone knows everyone. Agriculture is the Main Occupation: Source of Income
and way of life
 Close contact with nature: Villagers considers land as their real mother, as they depend on
land for food, clothing and shelter. Count...
 Homogeneity of Population: The village communities are homogenous in nature. Most of
their inhabitants are connected with agriculture and its allied occupations, though there
are people belonging to different castes, religions and classes. Social Stratification: In
rural society, social stratification is a traditional characteristic, based on caste. The rural
society is divided into various strata on the basis of caste.
 Social Interaction: The interaction level possesses more stability and continuity. The
relationships and interactions in the primary groups are intimate. The family fulfills the
needs of the members and exercises control over them. Primary relations are stronger.
Urban Community:
Urban community includes the towns, cities and metros with a specific way of life. Higher
density, nonagricultural occupation, service sectors. City Community, Urbanism is a way of life,
city may be defined as large dense and permanent settlement of socially heterogeneous
individuals. Majority of services are found in urban area.
Characteristics of urban community:
 Higher density of Population Cultural heterogeneity (migrants from different places)
 Man made environment
 Occupation based on manufacturing, governance. trade, commerce,
 Social mobility is more, class structure.
  Formal social control, (police, administration, courts)
 Large scale division of labor and specialization Individualization, unstable family
Tribal Community:
A tribe can be defined as a community living in hilly forest or well demarcated areas having its
own culture, religion, language, and strong ethnic identity.
 Ruled by tribal chiefs
 United in language or dialect Recognizing social distance with other tribes or castes
 Follows tribal traditions, beliefs and customs
Characteristics of tribal community:
 Well Demarcated geographical territory
 Live in forests and hilly areas Territory is usually isolated or semi- isolated compared to
other social groups
 Unique culture, folklore, cosmology, belief system Economically self-sufficient (barter
exchange) Count... They are interested in earning today's need and do not bother about
future.
 Own language, own political system,
 Own religion, (worshiping of soul or ancestor, non- livings things like stone, nature, river,
sun, forest) They have sense of belongingness to their own community, (son of soil

OBJECTIVES OF COMMUNITY HEALTH SERVICES&HEALTH CARE

ORGANISATION AT THE BLOCK LEVEL
OBJECTIVES OF COMMUNITY HEALTH SERVICES -

 Provide total health care to improve quality of life.

 Enhance the pace of adjustment of individual to his environment.
 Develop health and manpower to provide proper services to the community.
 Decrease mortality and morbidity rates.
 Enhance the average length of human life.
 Improving the individual's physical, emotional and social well-being.
 Develop health policies and their periodic revision from time to time.

HEALTH CARE ORGANISATION AT THE BLOCK LEVEL:

1. CHC
2. primary health centers
3. sub-centers and village health posts

CHC: -
Covering a population of 80,000- 1,20000.Has 30 beds and has facility for specialized services-
in surgery, medicine, obstetrics, gynecology and pediatric, DENTAL and ENT.
is considered as the first referral unit

PHC: -

 Each PHC covers a population of 30,000 in plain area, 20,000 in hilly and tribal areas.
 The team comprised of MO, nurse-midwife, ANM, Block extension educator, HA Male
and Female, lab technician and ancillary staff.

Sub-Centre: -
 Covers a population of 5000 in general and 3000 in hilly, tribal and backward areas.
 Is manned by a team of male and female health worker/ANM.
 Services includes MCH & family welfare, immunization, health education, training and
supervision of indigenous dais etc.
 The work of male and female health workers is supervised by male and female health
supervisors

Village Level: -
 Each village has a village health post for 1000 population which is manned by a VHG
who has had three months of training.
 She is expected to spare 2-3 hours daily
 They are given an honorarium of Rs 50/- each per month.
 The other personnel are trained birth attendant (TBA).
 They participate in MCH and Family welfare services
 Anganwadi workers work for a population of 1000 people. each after undergoing four
months of training in health, nutrition and child development.
 Anganwadi workers provides services to children enrolled in her Anganwadi which
include health checkups, immunization, health education, non-formal pre-school
education, supplementary nutrition and referral services.
 These workers are the first link between the community and health care services at
the block level.

FUNCTION OF BLOCK HEALTH ORGANISATIONS

Level of health care:

Introduction:

 Health care is a multitude of services rendered to individual, families or communities by

the agent of health services or professions for the purposes of promoting, maintaining
monitoring or restoring health.
 The health care goal of system is health development i.e. a process of continuous and
progress improvement of health status of a population.
 To achieve this goal health care service are usually organized at three levels, each level
supported by a higher level to which the
client is referred.

 Level of health care:

 Primary Health Care
 Secondary Health Care
 Tertiary Health Care

HEALTH ORGANIZATION AT BLOCK LEVEL -

 It consists of approximately 100 villages and a population of 80,000 to 1,20,000.

 It consists of primary health centers, health centers for the community, dispensaries and
sub- centres.
FUNCTIONS OF BLOCK HEALTH ORGANISATIONS:

 National ealth Programs

o Primary Health Care
o Family Welfare
o Community Participation
o School Health Education Programme
NATIONAL HEALTH

PROGRAMS

The National Health Programs, which have been launched by the Central Government of control/
eradication of communicablediseases, improvement of environmental sanitation, raising the
standard of nutrition, control of population and improving rural health.

National Health Programme are given below

Reproductive And Child Health Programme -

  Revised National Tuberculosis Control Programme (RNTCP)
 Dots Strategy National Aids Control Programme
 Vector Borne Diseases Control Programme
 National lodine Deficiency Disorder control Programme
 National Mental Health Programme
PRIMARY HEALTH CARE

Primary health care is "essential health care" that is based on scientifically sound and socially
acceptable methods and technology. This makes universal health care accessible to all
individuals and families in a community.

FAMILY WELFARE

Family welfare includes not only planning of birth, but they welfare of wholes family by means
o naf total family health care.The Union Ministry of Health & Family Welfare is instrumental
and responsible for implementation of various programmes on a national scale in the areas of
health and family welfare, prevention and control of major communicable diseases and
promotionof traditional and indigenous systems of medicine.

COMMUNITY

PARTICIPATION IN PRIMARY

HEALTH CARE

Community participation isthe process by which individuals and families assume responsibility
for their own health and of the community they live in.

SCHOOL HEALTH EDUCATION

PROGRAMME

“the school measures that contribute to the preservation and enhancement of the health of
children and school personnel, as well as health services healthful living andhealth.
 COMMUNITY HEALTH

INTRODUCTION

 Community health is a major field of study in the medical and clinical science that
focuses on the maintenance, protection and improvement of public health status and
community health groups.
 According to the world health organization community health can be defined as an
environmental, social and economic resources to sustain people′s emotional and physical
well-being in ways that advance their aspirations and satisfy their needs in their unique
environment
CLASSIFICATION OF COMMUNITY HEALTH

1. Primary health care

2. Secondary health care
3. Tertiary health care

1. Primary health care –

Primary health care programs aim to decreases risk factors and improve the promotion of
health.
2. Secondary health care –
Secondary health care is defined as‶ hospital care ″ where in a hospital department
setting, acute care is provided.
3. Tertiary health care –
Tertiary health care is a highly specialized care that typically involves the management of
disease and disability.
Objectives of Primary, Secondary and Tertiary Healthcare -

Medical services are divided into primary, secondary and tertiary healthcare. While primary care
focuses on general care for overall patient educational wellness, secondary and tertiary care
treats more severe conditions that require specialized knowledge and intensive health
monitoring.

PRINCIPLES OF COMMUNITY HEALTH SERVICES

 Programme should be planned on a scientific priority basis.
 Presentation and treatment of disease should be administratively combined.
 Before starting a program, the picture of complete plan must be made.
 Administration must be based on a sound economic consideration.
 Provision must be made for desirable working conditions for all members of the staff.
 There should not be overlapping in rendering treatment and prevention of disease.
 Centralized direction and decentralized activity.
  Evaluation of results is major responsibility of the health administration.
 When a special function is to be undertaken, it should be undertaken by or in
cooperation with the official body.
OBJECTIVES OF COMMUNITY HEALTH SERVICES –

 Provide total health care to improve quality of life.

 Enhance the pace of adjustment of individual to his environment.
 Develop health and manpower to provide proper services to the community.
 Decrease mortality and morbidity rates.
 Enhance the average length of human life.
 Improving the individual's physical, emotional and social well-being.
o Develop health policies and their periodic revision from time to time.
HEALTH ORGANIZATION AT BLOCK LEVEL
 It consists of approximately 100 villages and a population of 80,000 to
 It of primary health centres, health centres for the community, dispensaries and sub-
centres.
FUNCTIONS OF THE BLOCK HEALTH ORGANIZATIONS
 National Health Programs
 Primary Health Care
 Family Welfare
 Primary Health Care
 Community Participation
 School Health Education Programme

COMMUNITY HEALTH CENTRE

 One community health center in each block.

 In community health center there are four specialist doctors i.e. Surgeon, Gynecologist,
Physician and Pediatrician.
 In community health centre there are 3 to 4 PHC.
 Community health centre is managed by four specialist doctors
 Dental, Ear, Nose, Throat, Medicine, Gynaecology, Paediatric and Surgery
services are available there in community health centre.
FUNCTIONS OF COMMUNITY HEALTH CENTER
 Implementation of all National Health Programmes with active participation providing
specialty services.
 Caring and supervision of concerned (PHC's) Primary Health Centres.
 Referring patients to teaching hospitals and district hospitals.
 Providing child health programmes.
 Provides all preventive health services.
 FUNCTIONS OF COMMUNITY HEALTHCENTRE

Defination-
community is a social group determined by geographical boundaries and/or common
values and interest. Its members know and interact with each other. It functions within a
particular structure and exhibits and creates certain norms, values and social institutions.

functions:
 Immunization services
 Provisions for safe drinking water
 Basic sanitation
 Prevention and control of endemic diseases
 Implementation of all national health programmes with active participation.
 Providing specialty services.

 Caring and supervision of f concerned (Ph.C.’s) primary health centres. Referring patients
to teaching hospitals and district t i hospitalsprovidesall preventive health services.
Collection of vital statistics of the area

health education:

Process of providing information and advice related to healthy lifestyle and

encouraging the development of knowledge, attitudes and skills aimed at behaviour
change of individuals or communities’ Enables and influences control over own's
health leading to optimalization of attitudes and habits related to lifestyle and
increasing quality of life. Educating people to have healthier lifestyles so they can
AVOID disease

Health Education aims to:

 Inform people through knowledge

 Change unhealthy attitudes
  Change unhealthy behaviours
It’s REALLY difficult to get people to change their attitudes and behave.

Object of community health service –

 Provide total health care to improve quality of life.

 Enhance the pace of adjustment of individual to his environment. Develop health
and manpower to provide proper services to the community. Decrease mortality and
morbidity rates. Enhance the average length of human life.
 Improving the individual's physical, emotional and social well-being. Develop
health policies and their periodic revision from time to time.
 PRIMARY HEALTH CENTRE

INTRODUCTION -

The primary health Centre occupies a key position in the nation’s health care system. It provides
an integrated curative and preventive health care to the rural population with emphasis on
preventive and promotive aspects of health care.

Population covered by one PHC Rural populations in the plains - 30,000

In hilly, tribal & backward areas-20,000.

Definition -

Primary health care - 1978

Alma-Ate defined the “primary health care is essential health care made universally accessible to
individuals and acceptable to them through their full participation and at a cost the community
and country can afford

Primary health Centre -

Primary Health Centre is an institution for providing comprehensives health care viz.,
preventive, promotive and curative services, to the people living in a defined geographical area.

BASIC REQUIREMENTS FOR SOUND PHC (THE 8 A’S AND THE 3 C’S) -

 Appropriateness
 Availability
 Adequacy
 Accessibility
 Acceptability
 Affordability
 Assess ability
 Accountability
 Completeness
 Comprehensiveness
 Continuity

STAFFING PATTERN -
  Medical officer -1
 Pharmacist -1
 Nurse midwife - 1
 Health worker F (ANM) -1
 Block extension Educator -1
 Health Assistant (F)/LHV -1
 Health Assistant (M) -1
 UDC and LDC -2 (1 each)
 Lab technician -1
 Driver (if vehicle is there) -1
 Class IV -4

FUNCTION OF PHC -

 Medical care
 Mhc including family plan
 Safe water supply and sanitation
 Prevention and control disease
 Collection and reporting of vital statistics
 Health education
 National health program
 Referral service’s

MEDICAL CARE -

Out Patient Department:

Ambulatory medical care provided to patients who are not confined to bed can be provided at a
general practitioner’s clinic, a specialist clinic, a health Centre or a hospital.

 To provide care for patients who are not registered as in patients while receiving health
services.
 Section of hospitals with allotted physical facilities.

Two types of OP services -

1. Centralized outpatient services.

2. Decentralized outpatient services.

Based on type of patients -

1. General outpatient.

2. Emergency outpatient.
 3. Referred outpatient.

Function -

 To provide the highest possible quality of medical and nursing for care of the patients.

 To provide necessary equipment, essential drugs and all other stores required for patient
in an organized manner.

 To furnish most desirable environment substituting as temporary home for the patients.

To provide facilities to meet the needs of the visitors and attendants.

 To provide highest degree of job satisfaction for the nursing & medical staff including
training & research.
 To promote health by Health Education Program.

24 Hours Emergency Services -

appropriate management of injuries and accident, MEDICAL CARE …cont. First-aid,

stabilization of the condition of patient before referral.  dog bite/ snake bite/scorpion bite cases,
and other emergency conditions;  Referral services;

MCH INCLUDING FAMILY PLANNING -

Antenatal Care -
 Early registration of pregnancy and minimum 3 antenatal check-up;
 Minimum laboratory investigations such as hemoglobin, urine albumin and sugar.
 Nutrition and health counseling.
 Supplementation of folic acid and iron tablets and tetanus toxoid immunization.
 Identification of high-risk pregnancies and appropriate management;
 Refer to other hospital in case of high pregnancy beyond the management capability of
medicalofficer in PHC.

Post Natal Care -

 Within 48 hours of delivery and 2nd within 7 days through sub centers staff;
 Initiation of breast-feeding of delivery within half-hour of delivery;
 Education on nutrition, hygiene and contraction and
 Provision of facilities under Janani Suraksha Yojana.

New Born Care -

 Essential new born care;  Facilities and care for neonatal resuscitation and
 Management of neonatal hypothermia and jaundice
Care Of the Child -

 Emergency care of sick child including Integrated Management of Neonatal and

childhood Illness (IMNCI);
 Care of routine childhood illness;
 Promotion of breast-feeding for 6 months;
 Full immunization of all infants and children against vaccine preventable diseases as per
guidelines.

TRAINING-

 Initial and periodic training of paramedics in treatment of minor ailments.

 Training of ASHAs.
 Training of ANM and LHV in antenatal care and skilled birth attendance.
 Training of AYUSH doctor in imparting health services related to National Health and
Family Welfare program.

NUTRITION SERVICES -

 Diagnosis and management of malnutrition, anemia and vitamin A deficiency and

coordination with ICDS.

MONITORING AND SUPERVISION -

 Monitoring and supervision of activities of sub-centers through regular meetings/

periodic visits, etc.

MONITORING OF ALL NATIONAL HEALTH PROGRAMS -

 Monitoring activities of ASHAs. Health assistant’s male and LHV should visit sub-
centers once a week.
 IMPROVEMENT IN RURAL SANITATION

INTRODUCTION

 Sanitation is the hygienic means of promoting health through prevention of human contact
with the hazards of wastes as well as the treatment and proper disposal of Sewage &
wastewater.
 Hazards can be either physical, microbiological, biological or chemical agents of disease.
 Individual Health and hygiene is largely dependent on adequate availability of drinking water
and proper sanitation. There is, therefore, a direct relationship between water, sanitation and
health.
 Improper disposal of human excreta, improper environmental sanitation and lack of personal
and food hygiene have been major causes of many diseases in developing countries Like
INDIA.
 It was in this context that the Central Rural Sanitation Programme (CRSP) was launched in
1986 primarily with the objective of improving the quality of life of the rural people and also
to provide privacy and dignity to women.
CONCEPT OF SANITATION AND HYGIENE

 The concept of sanitation was earlier limited to disposal of human excreta by open ditches,
pit latrines, bucket system etc.
 The concept of sanitation was expanded to include personal hygiene, home sanitation, safe
water, garbage disposal, excreta disposal and waste water disposal etc.
 Today it connotes a comprehensive concept, which includes liquid and solid waste disposal,
food hygiene, personal, domestic as well as environmental hygiene.
WHY SANITATION AND HYGIENE?

 25 lakhs diarrhoea deaths globally & 6 lakhs in India alone.

 60,000 roundworm, 65,000 hookworm deaths
 70% of Indian population resides in rural areas. 67% of rural households defecate in the
open.
 More than 1600 children under the age of 5 die daily due to diarrhea and other sanitation
related preventable diseases
 Contamination by human excrement puts at risk both toilet users as well as non toilet users.
 Rural India being the main producers of food, about 100,000 tons of excrement heads to
markets everyday on fruits and vegetables.
 Women and adolescent girls exposed to risks of assault.
 Each gram of feces in an open field contains 10 million viruses, 1 million bacteria and 1,000
parasite cysts.
WHY RURAL SANITATION ?
 The concept of sanitation broadly includes liquid and solid waste disposal, personal and food
related hygiene and domestic as well as environmental hygiene.
 Most of the people still defecate in the open space, most of the villages lack waste disposal
and drainage systems and many in the villages are ignorant about the consequences of poor
sanitation and unhygienic conditions. As a result, many people suffer and even die of
diseases caused by unhealthy practices of personal and environmental hygiene.
IMPACTS OF POOR SANITATION

Sanitation and Health:

 Open defecation plays a primary role in polluting water sources (both under and over ground)
exposing communities dependent on these sources to several health hazards. It is also
responsible for spread of air and vectors borne disease.
Sanitation and Women:

 Practice of open defecation exposes women to risks of sexual assault. Women often wait for
darkness to descend before venturing out to relieve themselves. Holding in for long periods
causes diseases and adversely impacts health.
Sanitation and Education:

 Girls are reluctant to attend school, and parents are disinclined to send them, if there are no
safe, private toilets for them. Many girls are forced to miss class during their menstrual cycle.
Sanitation and Productivity:

 The economic deprivation of the urban poor increases manifold when healthcare expenses
and the cost of lost potential due to sickness arising from inadequate sanitation is added.
VISION OF GOVT. OF INDIA

 All Indian cities become totally sanitised, healthy &liveableensure good public health &
environmental outcomes for all their citizens with a special focus on hygiene and affordable
Sanitation facilities for poor.
MEASURES TO IMPROVE SANITATION IN RURAL AREAS

 Environmental Hygiene Committee, 1948

 Recommended that 90 percent of the country's population should be covered with water
supply and sanitation facilities within a period of forty years for which the national
programme was to be initiated.
 The Introduction of sanitation programme in the health sector, 1954
National Water Supply and Sanitation Programme

 The Government launched the programme as part of the First Five Year Plan (1951-56).
 The first five-year plan had a provision of Rs. 6 crores for rural water supply and
sanitation programmes.
 It was envisaged that 25 percent of rural population would be provided with sanitation
facilities by the end of the seventh five year plan period.
 Transfer of Rural Sanitation Programme to the Department of Rural Development from
the ministry of urban development, 1985.
Programme to construct one million sanitary latrines in houses of SC/ST, 1986

 Programme was launched under Indira AwaasYojana and to provide 2,50,000 additional
latrines to health centres, schools, Panchayat Ghars and Anganwadis under NREP (Nat.
Rural Employment Prog.) and RLEGP (Rural Landless Employment Guarantee Prog).
 Rural sanitation was included under the Minimum Needs Programme (MNP) in 1987.
CENTRAL RURAL SANITATION PROGRAMME (CRSP)

 A centrally sponsored Rural Sanitation Programme, launched in 1986. The CRSP is

implemented in different states and union territories for improving sanitation facilities
through construction of sanitary latrines for individual households.
 The programme provided 100% percent subsidy for construction of latrines for SCS/STs
and landless labourers and subsidy as per the rates prevailing in the states for the general
public.
OBJECTIVES(CRSP)

 To improve the quality of life of the rural people and provide privacy and dignity to
women.
 To provide sanitary latrines to the SCS/STS, landless labourers and people living below
poverty line.
 To provide clean, healthy and environmentally acceptable disposal of excreta with a view
to create good sanitation and consequent improved health standards.
ACTIVITIES

 The important components of this programme are Information, Educationand

Communication (IEC), which raise the demand for sanitary facilities inrural areas for
households, schools, Anganwadis, Balwadies, and womencomplexes.
 Activities carried out under these components should be areaspecific and should also
involve all sections of rural population in a mannerto generate willingness among the
people to construct latrines.
TOTAL SANITATION CAMPAIGN (TSC)

 Total Sanitation Campaign (TSC) was launched after restructuring Central Rural
Sanitation Programme and initiated on 1st April 1999 under sector reform process and is
operational in 451 districts.
COMPONENT(TSC)

 Construction of household latrines.

 Construction of sanitary complex for women.
 Toilets for schools.
 Toilets for Balwadi/Anganwadi etc.
 Funds are being provided for Start-Up Activities, Information, Education and
Communication and Administrative Charges.
OBJECTIVES (TSC)

 1)To improve the general quality of life in rural areas,

 2) To accelerate maximum sanitation coverage in rural areas,
 3) To generate felt need for sanitation facilities by creating awareness and
 imparting health education,
 4) To provide sanitation facilities in schools/anganwadis of rural areas and
 promote hygiene education and sanitary habits among students,
 5) To encourage cost-effective and appropriate technologies in sanitation,
 6) To eliminate open defecation to lower the risk of contaminating drinking
 water sources and food, and
 7) To convert dry latrines to pour-flush latrines, and eliminate manual
 scavenging practice in rural areas.
FEATURES (TSC)

 Greater household involvement and participation.

 Technology options as per choice of beneficiary households.
 Stress on Information, Education and Communication (IEC) as part of the campaign.
 Emphasis on school sanitation, women sanitary complexes.
 Integrating with various rural development programmes.
 Involvement of NGOs and local groups.
 Promoting access to institutional finance and social marketing concept.
NIRMAL GRAM PURUSKAR

 2003-Nirmal Gram Puruskar, reward for 100% sanitation.

 In October 2003, elected local representatives of Gram Panchayats were involved to
promote collective community action through sanitation. Nirmal Gram Puraskar (NGP)
was instituted for this purpose.
  NGP awards were given to districts, blocks, and Gram Panchayats that have achieved
100 per cent sanitation coverage of individual households, 100 per cent school sanitation
coverage and free from open defecation and clean environment.
 In this, an amount ranging from 50,000 to 5,00,000 is given.
 On 24 February, 2005, former President of India, Dr. APJ Abdul Kalam gave away NGP
awards 40 Gram Panchayats from six States for open defecation free status.
NIRMAL BHARAT ABHIYAN

 Total Sanitation Campaign closed in 2012 after striving for 13 years in achieving
universal rural sanitation coverage.
 2012 - Nirmal Bharat Abhiyan, community led and people centred approach: IEC; solid
and liquid waste management.
 NBA programme has been initiated with a clear cut strategy to make grassroots
institutions as focal points and integrate planning and implementation of sanitation.
 To create awareness, Brand Ambassadors are identified to undertake nation wide
campaigns on water, sanitation and hygiene issues.
VISION OF NBA

 Bring about an improvement in the general quality of life in the rural areas.
 Motivate communities and Panchayati Raj Institutions promoting sustainable sanitation
facilities through awareness creation and health education.
 Develop community managed environmental sanitation systems focusing on solid &
liquid waste management for overall cleanliness in the rural areas.
SWACHH BHARAT MISSION

 Bharat Abhiyan abbreviated as SBA or SBM, is a national campaign by the Government

of India, covering 4,041 statutory cities and towns, to clean the streets, roads and
infrastructure of the country.
 The campaign was officially launched on 2 October 2014 at Rajghat, New Delhi, by
Prime Minister Narendra Modi.
 It is India's biggest ever cleanliness drive and 3 million government employees and
school and college students of India participated in this event.
 SBM aims to eradicate open defecation by 2019, thus restructuring the Nirmal Bharat
Abhiyan,, by constructing 12 crores toilets in rural India, at a projected cost of 1.96 lakh
crore.
 The programme has also received funding and technical support from the World Bank,
corporations as part of corporate social responsibility initiatives, and by state
governments under the SarvaShikshaAbhiyan and RashtriyaMadhyamikShikshaAbhiyan
schemes.
 An amount of 90 billion was allocated for the mission in 2016 Union budget of India.
 Government and the World Bank signed a US$1.5 billion loan agreement on 30 March
2016 for the Swachh Bharat Mission to support India's universal sanitation initiative.
 "Swachch Bharat SwachchVidhalaya" campaign was launched by SmritiIrani, Minister
of Human Resource Development.
 NATIONAL URBAN HEALTH SERVICES

The National Urban Health Mission (NUHM) is a flagship program launched by the Government
of India to address the health challenges faced by the urban poor in the country. It was
introduced as a sub-mission under the overarching National Health Mission (NHM) in 2013. The
primary objective of NUHM is to improve the health status of the urban population, particularly
the marginalized and vulnerable groups residing in urban areas.

Objective:

The primary goal of NUHM is to provide accessible, affordable, and quality healthcare services
to the urban poor, with a focus on preventive and promotive healthcare. It aims to reduce
morbidity and mortality among the urban disadvantaged populations, especially women and
children.

1. Key Components:

 Health Infrastructure Strengthening: NUHM focuses on strengthening the healthcare

infrastructure in urban areas, including the establishment and upgradation of health
facilities.
 Human Resource Development: The mission aims to enhance the skills and capacity of
healthcare providers in urban areas to ensure the delivery of quality healthcare services.
 Community Engagement: NUHM emphasizes community participation and partnerships
to promote health awareness and encourage preventive healthcare practices among the
urban poor.
 Disease Prevention and Control: The mission includes measures to prevent and control
communicable and non-communicable diseases prevalent in urban areas through
awareness campaigns, screenings, and vaccination programs.
 Maternal and Child Health Services: NUHM places a special focus on improving
maternal and child health outcomes by providing essential healthcare services, antenatal
and postnatal care, and immunization.

2. Implementation:

 The implementation of NUHM involves collaboration between the central government,

state governments, and urban local bodies. It follows a decentralized approach, with
active involvement from community-based organizations and other stakeholders.

3. Funding:

 NUHM is funded through a combination of central and state government funds, with
contributions from urban local bodies. The financial support is directed towards building
and upgrading infrastructure, training healthcare personnel, and conducting health
awareness campaigns.
PROGRAMMES UNDER NUHM

1. Health and Wellness Centers (HWCs):

NUHM aims to establish Health and Wellness Centers to provide comprehensive primary
healthcare services, including maternal and child health services, family planning,
communicable and non-communicable disease prevention, and essential drugs.

2. Urban Primary Health Centers (UPHCs):

UPHCs are intended to serve as primary healthcare facilities in urban areas. They play a
crucial role in delivering a range of health services to the urban population.

3. Maternal and Child Health Services:

NUHM focuses on improving maternal and child health outcomes. Programs under this
component include antenatal and postnatal care, immunization, and nutritional support
for pregnant women and children.

4. School Health Programs:

NUHM includes initiatives to address the health needs of school-going children. This
may involve health check-ups, vaccination programs, and health education in schools.

5. Communicable and Non-Communicable Disease Control:

NUHM works towards the prevention and control of both communicable and non-
communicable diseases. This includes awareness programs, screenings, and vaccination
campaigns.

6. Family Planning Services:

Family planning services are an integral part of NUHM, aiming to provide counseling
and access to contraceptive methods to eligible couples.

7. Urban Social Health Activist (USHA) or Community Health Workers:

NUHM involves the deployment of community health workers or Urban Social Health
Activists (USHAs) who play a crucial role in community mobilization, health education,
and improving health-seeking behavior.

8. Capacity Building and Training:

NUHM includes programs for the training and capacity building of healthcare providers
to enhance their skills in delivering quality healthcare services.

9. Information, Education, and Communication (IEC):

 IEC activities under NUHM focus on creating awareness about health issues, promoting
preventive healthcare practices, and educating the urban population about available
health services.

10. Public-Private Partnerships:

NUHM may involve partnerships with the private sector to enhance the reach and quality
of healthcare services in urban areas.

Goal:

The goal of the National Urban Health Mission (NUHM) in India is to improve the health status
of the urban population, particularly the urban poor and other vulnerable groups. NUHM was
launched as a sub-mission under the National Health Mission (NHM) to address the unique
healthcare challenges faced by people living in urban areas

SWOT:

SWOT analysis is a strategic planning tool used to identify and evaluate the Strengths,
Weaknesses, Opportunities, and Threats of a business, project, or initiative. This SWOT analysis
provides a picture of potential internal and external factors that can impact the success of
NUHM.

STRENGTHS:

Government Support:

 NUHM is backed by government support, providing it with a stable and sustained

funding source.
Infrastructure Development:

 The mission focuses on establishing and upgrading health infrastructure in urban areas,
contributing to improved healthcare delivery.
Community Health Workers (USHAs):

 Deployment of Urban Social Health Activists (USHAs) facilitates community

engagement and enhances the reach of healthcare services.
Maternal and Child Health Focus:

 NUHM places a strong emphasis on maternal and child health services, addressing
critical healthcare needs.
Public-Private Partnerships:
  Collaboration with the private sector allows for leveraging additional resources and
expertise.

WEAKNESSES:

Urban Health Challenges:

 Urban areas often present unique health challenges, including higher population density
and issues related to migration, posing potential difficulties in service delivery.
Infrastructure Gaps:

 Despite efforts, there may still be gaps in the health infrastructure in some urban areas,
affecting the quality and accessibility of healthcare.
Resource Allocation:

 Resource allocation across different urban areas may vary, leading to disparities in
healthcare services.
Community Awareness:

 The effectiveness of community engagement and health education initiatives may vary,
and there could be challenges in raising awareness in certain communities.

OPPORTUNITIES:

Technological Integration:

 Leveraging technology for healthcare delivery can enhance efficiency, accessibility, and
data management.
Innovative Partnerships:

 Exploring new partnerships with NGOs, academic institutions, and innovative healthcare
providers can bring in fresh perspectives and resources.
Data Analytics:

 Utilizing data analytics for evidence-based decision-making can improve program

effectiveness and resource allocation.
Preventive Healthcare Emphasis:

 An increased focus on preventive healthcare can lead to long-term health benefits and
reduced healthcare costs.
THREATS:

Political and Policy Changes:

 Changes in political leadership or policies can impact the continuity and focus of the
NUHM.
Economic Constraints:

 Economic challenges may affect the availability of funds for healthcare programs.
Pandemics and Health Emergencies:

 Unforeseen health emergencies, such as pandemics, can strain healthcare systems and
resources.
Population Growth and Urbanization:

 Rapid population growth and urbanization can exacerbate existing healthcare challenges.
.

INSTITUTIONAL FRAMEWORK UNDER NATIONAL URBAN HEALTH MISSION:

The institutional framework under the National Urban Health Mission (NUHM) in India involves
a multi-tiered structure that includes both governmental and non-governmental entities. The
framework is designed to facilitate the planning, implementation, and monitoring of health
programs in urban areas.

The institutional framework is designed to ensure effective coordination, resource allocation, and
implementation of NUHM programs at various levels. It involves collaboration between different
government bodies, urban local bodies, and community health workers to addressthe diverse
healthcare needs of the urban population. It's important to note that specific structures may vary
between states and union territories in India

1. National Level:

 Ministry of Health and Family Welfare (MHFW):

The MHFW at the national level provides overall guidance, policy formulation, and
coordination for NUHM. It sets the strategic direction and allocates resources for urban
health programs.

 National Health Mission (NHM):

NUHM operates as a sub-mission under NHM. The NHM oversees the implementation
of health programs at the national level and provides overall guidance for both rural and
urban health initiatives.
2. State Level:

 State Health Society (SHS):

At the state level, the SHS is responsible for the implementation of NUHM. It serves as
the executive body and executes the mission's strategies and programs within the state.

 State Urban Health Mission (SUHM):

Many states have a separate State Urban Health Mission to focus specifically on the
urban health challenges. The SUHM is responsible for the planning, implementation, and
monitoring of NUHM activities in urban areas.

3. District Level:

 District Health Society (DHS):

At the district level, the DHS is responsible for coordinating and implementing NUHM
programs within the district. It acts as the nodal agency for planning and execution.

 District Urban Health Unit (DUHU):

Some districts may have a specific unit focusing on urban health. The DUHU oversees
the implementation of NUHM activities in urban areas within the district.

4. Urban Local Bodies (ULBs):

 Municipal Corporations/Municipalities:
Local urban bodies play a crucial role in implementing NUHM programs. They are
responsible for the delivery of healthcare services, maintaining health facilities, and
coordinating with other stakeholders.

5. Community Health Workers:

 Urban Social Health Activists (USHAs):

These are community health workers deployed at the community level to facilitate
community engagement, health education, and awareness. They play a vital role in
connecting the community with healthcare services.

6. Public-Private Partnerships (PPPs):

Collaboration with the private sector involves engagement with private healthcare
providers and organizations to complement public health services and leverage additional
resources.
7. Training and Capacity Building Institutions:
Institutions responsible for the training and capacity building of healthcare professionals,
ensuring that the workforce is equipped to deliver quality healthcare services.
 HEALTH PROMOTION AND EDUCATION IN SCHOOL

The promotion of health is a common function in public health. Public health is the science of
health promotion, disease prevention and the premature death of a population, usually in the
presence of limited financial resources, through the systematic efforts of society, communities or
individuals. It covers three key areas:
1. Health improvement or Promotion: Promote health through education.
2. Health care services: Providing, analyzing, and improving health care services.
3. Health Protection: Protection against infectious diseases and contaminated environmental
conditions.

PRINCIPLES OF HEALTH PROMOTION

1. Promote Social Responsibility for Health: Involve the population in the content of their
everyday life. Shift focus from people at risk for specific disease.

2. Increase in community capacity and empower the individuals: Individual

communication and education, legislation, organizational and community development.

3. Increase in investment and infrastructure for health development: Action on the

determinants of ill health or its causes. Sector-to-government co-operation.

4. Expand partnership for health: Involvement of a variety of health professionals,

particularly in primary care.

5. Quality: A quality health system is one that delivers the right treatment to the right
individual at the right time in the right way.

6. Sustainability: To provide high-quality service and encourage innovation and continuous

improvement, the system must be long-lasting.

HEALTH EDUCATION

Health education is the mechanism by which individuals and community of people learn to:
 Promote health
 Maintain health
 Restore health

HEALTH EDUCATION METHOD

1. Provide more detailed information and guidelines.

2. Provide basic information.
 3. Draw attention to a particular problem.
4. Guidelines focused on the behavior change.
(1) Providing more detailed information and guidelines:
Education focused on the attitude change by.
 Books
 Lectures
 Discussions
 Internet
 Brochures
(2) Provide basic information:
Basic information warning, recommendation, advices are provided by.
1. Leaflets
2. Calendars
3. Articles in newspapers
4. TV and radio broadcasts
(3) Drawing attention to a particular problem:
1. TV spots
2. Posters
3. Campaigns
(4) Guidelines focused on the behavior change:
1. Set of guidelines
2. Interactive
3. PC Programmes
4. Manuals
5. Exhibitions
6. Courses and systematic educational plans
 PRINCIPLE OF HEALTH EDUCATION

HEALTH EDUCATION IN SCHOOL :

It is process of transferring health knowledge during a student’s school . the definition of school
health education has evolved much throughout the 21stcentury .school health education today is
seen as a comprehensive curriculum for health. It is a mixture of society , school and practices of
patient care. Health education covers continuum from disease , prevention and promotion of
optimal health to treatment, rehablitaion and longer- term care for detection of illness ,

OBJECTIVES

 To encourage behavior which promotes and maintains health.

 To make health an asset valued by the community .
 To keep the child physically and mentally healthy .
 To improve the immune system of the children .
 To make the children free from disease and hence, good performance in studies .
 To imbibe in children good manners which they can carry throughout their life .
 To describe the importance of a healthy diet .
 To increase knowledge of the factors that affect health.

AIM OF HEALTH EDUCATION

 Health promotion and disease prevention .

 Early diagnosis and management.
 To provide the public with accurate data on medical discoveries .
 To facilitate the general public about the principles of physical and mental hygiene and
methods of avoiding preventable diseases .
 To create an informed body (social workers and teachers ) of opinion and knowledge.

PROMOTE HEALTHY LIFESTYLE IN SCHOOL

 Provide healthy environments in school .

 Work for safer, healthier communityenvironments .
 Teach children to be critical of media advertising .
 Involve parents in supporting health education .
 Increase health-related knowledge .
 Increase physical activities and promote physical education for healthy life .
 SCHOOL HEALTH SERVICES

Introduction :-

School age is a formative period of physical as well as mental health, during which
the school child is transformed into a promising adult.
 Health habits formed during this period are carried to the adult age, old age, and even to
the next generation.
 Thus, school health service is an opportunity for improving the nation health.

Aim :-

The ultimate aim of school health services is to promote , protect and maintain health of school
children and reduce morbidity in them.

Objectives :-

 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.
Goals :-

 To prepare the younger generation to adopt measures to remain healthy so as to help them
to make the best use of educational facilities, to utilize leisure in productive and
constructive manner, to enjoy recreation and to develop concern for others.
 To help the younger generation become healthy and useful citizen who will be able to
perform their role effectively for the welfare of themselves, their families and the
community at large and country as a whole.

Components –

 Health appraisal of school children and school

personnel.
 Remedial measures and follow up.
 Prevention of communicable disease.
 Healthful school environment.
 Nutritional service.
 First aid and emergency care.
 Mental health.
 Dental health
 Eye health
 Health education
 Education of handicapped children
 Maintenance and use of school health recoard

School Health Team :-

 The school principal

 The school teacher
 The parent
 The community
 The children
 The medical officer
 The school health nurse/ community health nurse
Health Teaching And Health Education –

Health teaching and health education involves inclusion of health lessons in the textbooks, and
also includes the following:-
1. Insisting on maintaining high standards of cleanliness in the school,
2. Improving water supplies and toilets and teaching their proper use,
3. Introducing healthy practical diets in the school lunch program, and
4. Demonstrating personal hygiene, such as cutting of nails, dressing of hair,
5. bathing with soap and water, etc.

Maintenance Of Health Giving Environment -

 This includes maintaining sanitation of school premises and the surroundings, having
moral, physical and mental impact on the children.
 Maintenance of the school building is more important than selecting a site for school and
its construction.
 The school site should be –
1. Dry
2. Situated on a raised ground
3. Away from the road to reduce dust
4. Noise
5. Heavy traffic
Advise The School Authorities –

The medical officer or sanitary inspector should advise the school authorities on the following
measures of sanitation:

1. Water Supply:
 If no tap water available and the source of water is a well, it should be properly
chlorinated.
 Drinking water should be available in aproper container with a tap and a glass.
 If water is present in earthenware containers, it should have a ladle.
 All the children should learn to drink water either directly from the tap or by
pouring water from a glass into the mouth.
2. Drainage:
 The waste water should be drained into a soak pit or a garden.
3. Urinals:
 Cheap soak pit or trench type urinals should be provided in rural schools.
 The children should be prohibited from urinating at any other places.
4. Toilets:
 All the schools should have toilets.
 Provision of a toilet in rural schools is also a source of educating the children to
make them understand the need for proper disposal of excreta.

5. Refuse:
 All the classrooms and other rooms in the schools should have a refuse basket that
should be emptied into a compost pit.
 All the rooms should be swept and cleaned.
 Dust, paper and other refuse material should be collected in the refuse basket that
should be later disposed of by burning.
6. Ventilation:
 The rooms should have sufficient doors, windows, and ventilators to allow the
entry of fresh air and light.
 This is because good light and ventilation and other items of environmental
sanitation promote physical and mental health.
7. Playground:
 All the schools should have a playground for recreation and physical education.
Health Services -
Health services for school-going children include regular medical check-ups and preparation of
health cards; prompt treatment of defects; follow-ups; and referral for special problem.

1. Medical check-up:
 Every school-going child should undergo a detailed examination by the medical
officer, who should also fill the school health card.
 The medical officer may be assisted by a school health assistant or a teacher for
recording general and family history, weight, height, etc.
2. Treatment:
 Schools should have provisions for the treatment of minor illnesses.
 All defects should be treated at the central school health clinic, PHC, or
dispensary.
 Expert help for diagnosis and treatment should also be made available.
3. Follow-up should be taken for the cases with defects and the parents should be informed
about it.
4. Special problems:
 A full or part-time dentist should be available to provide teeth health services.
Dental health education and knowledge about caries and gingivitis should be
provided.
 Children with eyes defective vision and squint need the services of a specialist
and should be prescribed with glasses.
 Children having ear wax, discharge and hearing defects should also be attended.
 Communicable diseases (e.g., leprosy, tuberculosis, diphtheria, scabies, ring
worm, etc.) should be quickly treated and also notified for required mass
measures.
5. Preparation of health cards :-
 A health card is an identification of the policyholder provided by the health
insurer at the time of availing of the medical insurance plan. In order to enjoy the
services of a healthcare insurance plan, you must hold the health card as proof.
6. Referral for special problem :-
 Referral system Referral System, involves sending a patient to another physician
for ongoing management of specific problem , with the exception that the patient
will continue to see the original physician for coordination of total care.
 Definition - Also defined as… a process in which the P.H.C physician who has
lesser facilities to manage clinical condition seeks the assistance of specialist
partner with resources to guide in managing clinical episode.

Thankyou……..