SCHOOL HEALTH SERVICES

(SHS)

Dr.R.Parthasarathi M.D.CM
 Sub-Topics
• Importance
• Health Problems
• Objectives of SHS
• Aspects/Components of SHS
 IMPORTANCE
• Large group, Future Generation
• Effects- Prolonged & Powerful
• Economical
• Close relationship between health & education
• Health supportive knowledge, values, attitudes
and behaviour.
• Influence health behaviour of others
 HISTORY
• 1909- first medical examination of school
children - Baroda city.
• 1946- Bhore Committee - non-existent in India
• 1960- School Health Committee-report in 61’
• Even Now - Token service because of shortage of
resources and insufficient facilities
 HEALTH PROBLEMS
• Malnutrition
• Infectious diseases
• Intestinal parasites
• Diseases of skin, eye and ear
• Dental problems (caries)
• physical disabilities, learning disorders,
behaviour problems.
 Objectives of SHS

1. the promotion of positive health

2. the prevention of diseases
3. early diagnosis, treatment, follow-up of defects
4. awakening health consciousness in children
5. the provision of healthful environment.
 Aspects of SHS
1.Health appraisal 8. First aid & emergency care
2. Healthful school 9. Remedial measures and
environment follow-up
3. Nutritional services 10.Health education
4. Prevention of 11. Education of handicapped
communicable diseases 12. School health records
5. Mental health
6. Eye health
7. Dental health
 1.Health appraisal
• Students, teachers, other school personnel.
(a) Periodic Medical Examination :
• The school health committee (1961) recommended
medical examination at the time of entry and every 4
years thereafter
• History, physical examination, tests for vision, hearing,
speech, Clinical examination for nutritional deficiency,
anthropometry, examination of blood and urine, and
faeces for intestinal parasitoses
(b) School personnel
 1.Health appraisal
(c) Daily Morning Inspection by teacher :
• Familiar with children and can detect changes in
appearance or behaviour
• Trained during course or service
• flushed face, 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, sleepiness, disinclination to
play, diarrhoea, pains in the body, skin conditions like scabies and
ringworm, pediculosis
 2. Remedial measures and follow-up
• Special clinics exclusively for school children at PHCs in
rural areas, 1 selected school or dispensaries for 5,000
children in urban areas.
• The clinic days and time should be intimated to all
• High prevalence of dental, eye, ear, nose and throat
defects in the school children in India,
• Provision for beds in the existing referral hospitals for
the children to be admitted for investigation and
treatment
 3.Healthful school environment
(1)Location :
approach roads, at a fair distance from busy places,
roads, cinema houses, factories, railway tracks and
market places, properly fenced ,kept free from all
hazards.
(2) Site :
suitable high land with proper drainage
SHC (1961) recommends 10 acres for higher
elementary schools and 5 acres for primary schools
with a playground
 3.Healthful school environment
(3) Structure :
Nursery schools-single storied.
Exterior walls -10 inch thickness and heat resistant
(4) Class Room :
Verandas attached to class rooms.
Not > 40 students/class.
Not < 10 sq. Ft/student
(5) Furniture :
single desks and chairs.
Desks should be of "minus" type.
Chairs with proper back rests.
 3.Healthful school environment
(6) Doors and windows:
windows at height of 2'-6’ from floor with cross ventilation
combined door & window area >25% of floor space
the ventilators >2% of floor area.
(7) Colour :
Inside colour -white and should be periodically washed.
(8) Lighting :
sufficient natural light, preferably from left, not from front.
 3.Healthful school environment
(9) Water Supply :
source of safe, continuous, potable water supply
distributed from the taps.
(10) Eating Facilities :
Vendors not approved by school authorities-not
allowed inside premises, separate room provided
for mid-day meals
(11) Lavatory :
1 urinal for 60 students
one latrine for 100 students
 4.Nutritional services
• Weak child cannot take full advantage of
schooling.
• Adequate diet: all nutrients in proper proportion
• India: diet def. in protiens, vit.A, C, B1, B2, Ca, Fe.
• Mid-day Meal Programme-1/3 of calories + ½ of
protein provided
• Applied Nutrition Programme- UNICEF gardens
• Specific Nutrients
5.Prevention of communicable diseases

• Immunisation-most emphasised SHS function.

• A record of all immunisations maintained in
school health records.
• When the child leaves school, the health record
should accompany him.
 6. Mental health
• Problems: Juvenile delinquency, maladjustment, addiction
• School: strategic place for shaping behaviour
• Teacher: both a positive and preventive role
• Relaxation between periods of intense work to relieve the
tedium of the class room.
• No distinction between race, religion, caste ,community,
rich and poor, clever and the dull.
• Vocational counsellors and psychologists for guiding into
suitable careers.
 7. Eye health services
Schools responsible for
• early detection of refractive errors
• treatment of squint and ambylopia
• Detection, treatment of eye infections eg. trachoma.
• Administration of vitamin A
• Other basic eye health services
 8.Dental health
• Dental caries and periodontal disease
• A school health programme- dental
examination at least once a year.
• Developed countries: dental hygienists, school
dentist, preliminary inspection, prophylactic
cleansing, teaching of dental hygiene
 9. First-aid and emergency care
• First-aid, emergency care to sick or injured- teacher
• Adequate training during Teacher Training Programmes
or In-service Training programmes
• Accidents leading to minor or serious injuries,
gastroenteritis, colic, epileptic fits, fainting, etc.
• Fully equipped First Aid Post in every school
 10. Health education
The health officer, PHN/HW furnish teaching materials,advice
Teacher is the key person, function of the school teacher.
(1) Personal hygiene :
Health education programme
lively, practical and based on everyday needs and interests
Hygiene of skin, hair, teeth and clothing
Attention to posture while sitting and standing
 10. Health education
(2) Environmental Health :
Encouraging young people to keep their environment clean
Visits & participation in community health Programmes
(e.g., vaccination, fly control campaigns, construction of
sanitary wells and latrines)
(3) Family life :
Family life education with healthy attitudes towards human
reproduction.
11. Education of handicapped children
• Ultimate goal:
Assist the handicapped child and his family to reach
his maximum potential, to lead as normal a life as
possible, to become as independent as possible, and to
become a productive and self-supporting member of
society.
It requires the cooperation of health, welfare, social and
educational agencies.
 12. School health records
• A cumulative health record of each student
• a) Identifying data - name, date of birth, parent's name and
address, etc.
• b) past health history
• c) record of findings of physical examination
• d) screening tests and record of services provided.
• The purpose:
cumulative information on health of all children
analysing, evaluating school health programmes
link between the home, school and the community.
 School Health Administration
• No uniform pattern
• India: SHS administered by different departments in
different States
• School Health Committee (1960): SHS is integral
part of general health services i.e. PHCs mainly.
THANK YOU