School health

Services
 INTRODUCTION
• Children between the age of 5-17 years are
school age children. About 30% of population
comprised of this age group.
• The health care services to this section of
population are rendered through school system.
• This is because the school system provides an
exclusive opportunity for influencing the
knowledge, benefits, attitude & practices of
children for present & future.
 CONCEPTUAL ASPECTS
• SCHOOL- school is defined
as an educational
institution where group
of pupil pursue defined
studies at defined levels,
receive instructions from
one or more teacher,
frequently interact with
other officers &
employees such as
principles , supervisors.
• SCHOOL HEALTH-
• School health refers to state of complete
physical, mental & social & spiritual well being
& not merely the absence of disease.
 SCHOOL HEALTH SERVICES
• SCHOOL HEALTH
SERVICES- it refers to need
based comprehensive
services rendered to pupil,
teachers & other
personnel in the school to
promote & protect there
health & control diseases.
 NEED FOR SCHOOL HEALTH SERVICES
• School children constitute the vital &
substantial segment of population. They are
the future citizen & asset for their family &
nation & their health status affect the health
status of community.
• This is the age when personality develop. Also
they are exposed to various environmental
factors so requires help guidance & care.
• School children are exposed to
various stressful situation e.g..
School timings , study hours ,
heavy study, competitive
environment, public
reprimand & corporal
punishment by some teachers.
• These situation cause mental
problems affect growth and
development.
• Children coming to school
belong to different socio-
economic & cultural
background which affect
their health & nutrition
status & require help &
guidance in promoting
health & nutritional
status.
• Children in school age prone
to get specific health
problems. Health surveys
conducted in various school
in India reveals the
prevalence of condition as
under.
• Dental problems
• Malnutrition
• Gastro – intestinal problems
• Eye diseases
• Skin problems
• Respiratory
diseases&
behavioral
problems
• Others- tiredness,
defective posture
& headache, HIV
infection.
 PHILOSPHY OF SCHOOL
HEALTH SERVICES
• Following beliefs are related to these-
• Healthy child is mentally alert will not miss
school due to minor sickness.
• Health is not a just sickness from freedom
from sickness but the realization of full
potential of child which has physical, mental,
social & spiritual components.
 Cont..
• Prevention is better than cure, so the major
emphasis is on primary level preventive
measures involving teachers, parents ,& students
themselves.
• School health services will help to identify any
deviation from normal growth & development.
• Early diagnosis & prompt & adequate
treatment is of great importance.
• Rehabilitation of physically & mentally
handicap children can be done & must receive
adequate attention.
 AIMS & OBJECTIVES OF SCHOOL
HEALTH SERVICES
• The ultimate aim is to promote & protect &
maintain health of school children & to reduce
morbidity & mortality in them.
• Create health consciousness among the
children , parents & teachers.
• To provide healthy & safe environment.
• Impart healthy information & conduct health
education on the various aspects of healthful
living.
• Prevent communicable & non communicable
diseases .
• Identify & treat any abnormalities as early as
possible.
• Involve teachers ,student & their parents in their
management of health aspects of children.
• Help teachers and children make constructive and
productive use of co- curricular & extra curricular
activities.
 PRINCIPLES OF SCHOOL HEALTH
SERVICES
School health services should
be –
• Based on health need of
school children
• Be planned in coordination
with school, health
personnel, parents &
community people.
.
• Emphasis on
promoting &
preventive aspects.
• Emphasis on health
education to promote ,
protect & improved
health of children.
• Emphasis on learning
through active &
desirable participation.
• Be ongoing & continuous
programme.
• Have an effective system
of records keeping &
reporting.
 COMPONENTS OF SCHOOL HEALTH
SERVICES
• The components of school health services
include all those aspects which help achieve
its aim & objective
• Nutritional services
• Physical & recreational
activities
• Promotion of mental health
• Health education
• Immunization
HEALTH PROMOTIVE AND
PROTECTIVE SERVICES
1. Wholesome School Environment
2. Nutrition Promotion
3. Control of communicable diseases
4. Safety Measures
5. Physical and recreational activities
6. Promotion of Mental Health
7. Health Education
8. Early Detection of Diseases
9. Immunization
10. Treatment and Referral
 Wholesome School Environment
It is essential for holistic development of children coming
from varying socio-economic & cultural backgrounds. The
following criteria have been recommended for wholesome
environment in schools
1. Location and Site
2. The Building Structure
3. Furnishing of Classrooms
 Cont..
[Link] and other facilities like
• Water supply
• Lavatory
• Disposal of waste water and refuse
• Lighting
• Eating facilities
• Furniture
• Doors & Windows
• Color
1)Location and Site: The school should be located
away from the nuisance of noise, traffic, dust etc.
The site should be dry, on a raised surface with
proper drainage system. Provision for playground
should be there.
2) The Building structure: There should be single
storied building. The construction should be heat
proof. It is better to have proper trees and
plantation etc. to keep the surrounding neat and
clean.
3) Furnishing of Class rooms: The class rooms should
be well ventilated and attached to [Link] is desirable
to have single desk with chair.
Each class room should have adequate
teaching learning facilities according to needs of students
and resources available.
4) Sanitary and other facilities:
a) Water supply – There should be portable, continuous and
safe water supply from the tap. The water should be
chlorinated periodically.
b) Lavatory: Each school must have sanitary urinals
and latrines with adequate water supply.
Children's must be educated about the importance and
use urinals and latrines for environmental sanitation.
 Cont..
• Disposal of waste water and refuse: Each
school should have a proper system of
drainage of waste water. The refuse
comprising of dust, dirt, papers, pealing of
fruits- vegetables, left out foodstuffs,
[Link] be collected in dustbins kept in
each class rooms.
5) Lighting: Class rooms should have sufficient
natural light, preferably from the front.
6) Eating facilities: A school should have its own
canteen facilities or vendors should be approved in
school premises.
A separate room should be there for
taking mid-day meals.
7) Doors and Windows: Windows should be placed
on different walls for cross ventilation.
8) Color: Color of the classroom should be
periodically white – washed.
Nutrition Promotion:
Good Nutrition is very essential for children
educational achievement. Fresh milk 200 ml or
milk powder 50G , mixed with 200ml of water or
midday meal prepared from the locally available
cheap food.
• stuffs is provided to the children to combat
malnutrition in schools. For this school
committee started mid day meal programme
in [Link] meal should one-third of the daily
energy and half the daily protein requirements
of the child
 r
 Control of Communicable Diseases
a. Tetanus toxoid is given to the school children child
aged 10-15 yrs.
b. If an epidemic is raging in the community the
school is closed.
c. If any child contacted a communicable disease
and is advised to staying at home.
d. The schools are closed till the longest incubation
period.
 Safety Measures
• All parts of school are well illuminated.
• The floor & steps are of non- skid kind. The stairs
are fitted with handrails .
• Only safe equipment is used in laboratory and in
playground and they are properly maintained.
• Fire fighting equipment & first aid kits are kept
ready at all times.
• Some teachers are sent for training in first aid
 Physical and recreational activities
The school children are made to participate in
games, sports, drills, swimming . These promote
growth & development improve posture, build up
physical fitness and stamina .
They help the pupils learn the value of
teamwork and fair play.
 Promotion of Mental Health
Whole some mental health & behavior of a child is
very essential for making sound adjustment with
the overall environment. Maladjustment leads to
untoward behavior such as juvenile delinquency,
drug addiction etc
 Cont..
For promotion of mental health school
authority & school teachers can play
significant role . They need to plan & organize
well balanced curricular, co- curricular, & extra
curricular activities. Teachers and health
personal can also take role in guidance &
counseling for specific academic and health
related problems of students
o The classes are not held in one long unbroken spell,
but punctuated with short gaps for relaqation &
mental recuperation
o Too much homework and lengthy impositions are
avoided.
 Health Education
It is very important for school
children. It creates awareness, makes them
knowledgeable regarding health, develops
motivation and promotes change in health
behavior and health attitudes in them.
Therefore health education is considered as one of
the crucial and key element of school health
services.
Health education is related to routine
school activities. It includes;
•Nutrition education
•Hygiene education
•Anti- Addiction education
•Safe education
1) Nutrition education : The school children are made aware
of the following
 The nutritive value of the common food stuffs.
 The method of construction of balanced diets by including
one serving from each of the seven basic food groups (
cereals, pulses, nuts & oilseeds, sugar & jaggery, green
leafy, milk and milk products )
 The need to avoid those cooking practises that lead to
loss of nutrients such as cooking rice in excess water, over-
milling rice, over refining wheat flour
 The value of protection of foods from flies, rats,
etc. by keeping them in fly – proof cupboards or
covering them with polythene sheets.
2) Hygiene Education :
The school children are made aware of the
following principles :
 Daily bathing and changing of clothing
 Washing hands with soap after visit to the toilet or
touching the soil and before taking food
 Washing the community cup or glass after drinking water
from it
 The correct methods of sitting, standing and walking
3) Anti - Addiction Education :
Following truths are brought home to the students ;
 Psychoactive substances like tobacco & alcohol should be
avoided as they give rise to physical, psychological and
social problems.
 It is no longer fashionable to get hooked on drugs.
 One should not even experiment with drugs.
 Students are advised to talk to their
addict- friends
and prevail on them to quit the habit.
 It is the current “ in “ thing to say,
 “ No, thanks,” to drugs.
4) Sex Education :
School health services used to educate children
about development of sex organs, anatomy and their
function and about menstruation, ejaculation, pregnancy
& STD’s.
• By 30 months of age children should be taught about
parts of the body of both boys & girls at home by parents.
• By sixth grade, children may be taught about
menstruation & puberty. They should taught about social
& religious norms & about sexual behavior
• In adolescent, children should be taught about
reproduction & AIDS
 Early detection of diseases:
Role of teachers :
Alert teachers can detect diseases in their children's
by watching for telltale symptoms, signs and mood
alterations. Such as, redness & swelling of eyes, pallor of
face, cough, hoarsness, straining at the blackboard etc.
Examples of mood change are excessive
moodiness, lack of concentration, withdrawal and
incoherent speech etc.
The teachers can measure the weight of each pupil half-
yearly and record it on his progress chart.
• Health Appraisal:
Every school child is subjected to detailed
clinical examination at school entry, then 4 yrs later
& finally at school leaving. If necessary laboratory
tests are carried out.
• Early detection through Surveys:
Early detection is also possible through special
surveys, such as surveys for the detection of leprosy, under
nutrition, scabies, goiter, rheumatic fever and heart disease
 Immunization :
Immunization of children against specific
communicable disease is necessary to prevent the
occurrence of such diseases. These diseases include
tuberculosis, diphtheria, tetanus, measles, polio.
The immunization is complete by the time the
child is 5 – 6 yrs old. It is necessary to find out at the time
of admission whether the child has completed the
immunization schedule or not.
If there is no clear history of previous immunization with DPT
then 2 doses of DT need to be given at an interval of 4 wks
at the age of 5-6 yrs, 2 doses of TT at one month interval at
the age of 10 yrs and again at 16 yrs need to be repeated.
If immunization is done completely then one
dose of DT need to be given at 5-6 yrs, one dose of TT at
the age of 10 yrs and again at 16 yrs of age.
A proper record of immunization should be
maintained as part of comprehensive health record which
should be handed over to the child at the time of leaving
school.
 Treatment and Referral:
Minor ailments are treated at the school itself
or at the primary health centre. Pupils found to be
suffering from major diseases are referred to the
district hospital.
 THERAPEUTIC
SERVICES ,
REHABLITATIVE
SERVICES
AND
SCHOOL HEALTH
RECORDS
 Therapeutic Services
• Health problems of school child
Health problems of school children may vary from one place to
another but emphasis will fall in following categories:-
1. Malnutrition
2. Infectious diseases
3. Intestinal parasites
4. Diseases of skin, eye and ear.
5. Dental caries
6. Poor performance of school children
 Health appraisal
Regular periodic appraisal of health of school children
is very necessary to identify the deviation from
normal conditions of body parts and systems .
 It requires complete health check- ups.
 Remedial measures and follow up.
 Prevention of communicable diseases.
 First aid and emergency care.
 Specialized health services.
The School Health Committee in
1961 had recommended initial
health appraisal at the time of
entry in the school and
thereafter at four year interval.

INITIAL
EXAMINATION
It should be thorough and should
include careful history and
physical and medical
examination.
Physical examination
include:-
observation of child from head to
toe of general normal
characteristics.
Measurements of height, weight
Measurement of arm and chest
circumferences.
Testing of vision , hearing and
speech.
Observation of vital signs such as
pulse respiratory rate and
temperature.
Routine examination of blood , urine and stool should
be carried out.
Screening for tuberculosis should also be done.
This should be co-ordinated with tuberculosis clinic.
The details of physical examination
can be taken care by nursing
personnel with the help of school
teachers.

A proper record of health

information obtained should be
kept properly.

Parents should be involved in health

appraisal of children.
Medical examination includes:-
Complete and thorough check-up of all the systems of
body which is done by a medical officer.
The record of findings is done in a health record.
A minimum of three health
appraisals are carried out
i. On school entry at the age of
5-6 years.
ii. On passing out from primary
school at the age of 10-11
years.
iii. On passing out from middle
school at the age of 13-14
years.
In addition to health appraisal , regular recording of
weight and height at an interval of three months
should be done at the school by the class teachers.
Daily morning inspection
The class teachers should also do daily
morning inspections of personal
hygiene and make observation of
children to detect any deviation in
normal behaviour or any change in
appearance which may suggest any
abnormality.

Children should be kept under

observation , any child found having
any signs and symptoms of any illness
should be referred to school medical
officer.
 Treatment and follow up
Treatment and follow-up of children who are found
having any illness or defect is essential for their cure.
It is therefore very important to have such
arrangements exclusively for school children.
In Rural areas it should be at the Primary Health
Centres.
In Urban areas School Health Clinics can be at the
selected school or at local dispensaries.
There should be fixed days and timings which should be
known to teachers and parents.
The parents should be informed and explained about
any kind of major illness or defect.
Follow up of such children should be done by
SCHOOL HEALTH NURSE to make sure that regular
treatment is taken and proper care is given to the
children.
 Prevention of
communicable disease
Communicable diseases control through immunization
is the most important school health service function.
A record of all immunization should be maintained as a
part of school health records.
 First aid and emergency care
The school must have an arrangement for providing
First aid and emergency care to children who get
injured or sick at the school.
Teachers who are available at the spot can provide such
care. For this they need to be prepared for.
The basic facilities for
providing First aid and
Emergency care should be
as per standard laid down
by St. John Ambulance
Association of India.
Senior students can also be
involved , they also should
be trained for the same.
 Specialised Health Services
• Specialised health services given to various
children include-
 Dental check –ups
 Eye check ups
Mental health check ups
 Dental check-ups
Dental caries and periodontal diseases are two
dental diseases commonly seen among the
school going children.
A school health program should have provision
for dental examination at least once a year.
 Eye check-ups
Eye check-up in school should be done for early
detection of refractive disorders , defective vision,
squint and treatment of eye infections such as
trachoma.
Provision of Vitamin A 2,00,000 units IM should be
given to children at risk for prevention of blindness .
 Mental health
Mental health of child affects his physical health and
learning process, juvenile deliquency ,
maladjustment, drug addiction and smoking are
burning problems among school children.
School routine should be so planned
that there is enough relaxation
between periods of intense work.
There is need of vocational
counsellor and psychologists in
schools for guiding children into
careers for which they are suited.
 Rehabilitative services
Rehabilitative services are required for those children
who are born with or acquired any disability or
handicap due to road accident / infection/ some
serious disease / burn injury etc.
These children require special care.
The disability or handicap may be physical or mental or
both.
Children with marked physical abnormalities such as
blindness, deafness, mutism, marked mental retardation
etc. Should be trained in special institutions and
rehabilitated.
Those with minor physical and mental defects may be kept
in normal schools .
However , teachers and health workers need to give
increasing attention and care to them.
The child and his family should be educated and helped to
attain his/her maximum potential to become as
independent as possible to lead a normal, useful and
productive life.
 School health records
It is essential to maintain complete , accurate
and continuous health records of school
children. Such health records will be useful for
providing need based health care nd guidance
to children.
It will also help to evaluate the school health
services and assist in further development and
improvement of health services rendered to
school children.
Health record should include information on
1. Identification and personal aspect.
2. Personal and family history.
3. Findings of physical and medical examination
4. Findings of routine investigations an screenings.
5. Services rendered and the prognosis.
The health record should be kept in a safe and
secure place.
These are not only important documents for
providing of need based services but also for
legal and administrative purposes.
 SCHOOL HEALTH
SERVICES IN INDIA
 School health services in india

 Before independence era

 Post independence era

 Before independence era
• Before independence the school health
services were almost negligible.
• In 1909, for the first time medical examination
of school children was done in Baroda city.
• In 1944, The Central Advisory Board of
Education recommended that there should be
separate programme of school health services
under the administrative control of education
department.
• In 1946, the Health Survey & Development
Committee headed by Sir Joseph Bhore
recommended that school health services should
not be isolated from general health services. It
strongly recommended that school health services
should be one of the important elements of primary
health centres for school children in rural areas.
 Post independence era
• After independence of the country, Shri Jawahar Lal
Nehru the first prime minister of our country
accorded high importance to health of children
because he visualized them as the future builders of
the nation. He emphasized on fulfilling the basic
needs of children which include physiological
needs, love, security, recognition of self & others,
his/ her duties & responsibilities, creativeness etc.

• In 1957, Child Education- Nutrition Education

Committee & WHO assisted School Health project
was set up.
• In 1958, School Health Education Division was set up in
Central Health Education Bureau (CHEB) to provide
technical help to Ministries of Health & Education both.
• In 1960, School Health committee under the chairmanship
of Smt. Renuka Ray was set up to assess the standard of
health & nutrition of school children & also to suggest ways
& means of improving these.
The committee recommended - 1. to
have school health services as a part & parcel of general
health services of the community.
2. to establish school health councils at national, state,
district, block & village level.
• In 1977, a centrally sponsored National School
Health Scheme was started & its services
reached to children studying in primary
schools in remote, rural, backward, hilly &
tribal areas. The scheme was fully financed by
the Central Government.
• In 1979, the National School Health Scheme was handed
over to the State Governments leaving only UT’s with the
Central Government. Gujarat was the first state to appoint
district level health Inspectors for implementation of the
scheme.
The mid- day meal was also introduced in
many of the states.
• In 1981, a Task Force was established by the Government of
India to-
study the progress of School Health programme
functioning in various states of the country &,
to propose comprehensive school health model
which can be tried out.
The performance was not up to the standards due to lack
of :
# transport facilities # adequate budget
# adequate trained teachers # health workers
# coordination between various departments
# proper documentation etc.
• The Task Force suggested to launch an intensive Pilot
Project on school health services in selected 25 blocks
of 17 states & 3 UT’s. In 1984-85 the project was
extended to 75 more blocks covering 4 more states .The
major component of school health scheme included:
*observation & screening of students for defects &
deviations from normal health, height, weight, vision,
screening & treatment of minor ailments by teachers.
*regular annual medical examination of students & their
immunization.
*identification of sick children & their referral to
specialists.
*maintenance of cumulative health
record for each student in the school.
*health education of students to
inculcate desirable health knowledge,
attitude & practices.
*training of teachers.
To facilitate intensive
involvement of teachers, schools were
provided with :
1. Weighing machine & measuring scale,
[Link] medicines for treatment of
minor ailments,
[Link] for teachers & health
education material.
In this project about 10 lakh primary school children
were covered studying in 10000 schools & 29000
teachers were involved.
• In 1988,a proposal for comprehensive school health
services was on its way to be implanted but it could
not be implemented because of draught conditons
in the country.
• In 1989, the Central Health Education Bureau had
launched an intensive School Health Education
Project to benefit about 10,00,000 primary school
children in 100 blocks of 10 states
The main aim of the project was to
improve health & nutrition status of primary school
children.
Innovative measures such as :
# “child to child” & # “youth to child” approaches were
used to reach messages from children to other members of
the family
Inspite of such projects the school health services have not
reached adequate national &states’ attention & priority.
However efforts for augmenting comprehensive school
health services are continuing by the Central & State
Governments.
SCHOOL HEALTH TEAM
 INTRODUCTION
• The concept of school has
evolved with generalized
family and community health
services.

• The services to children in

school is in continuation of
the services which are
rendered to age under five
year children.

• But in some places it is a

specialized service
• Whether school health
is a part of generalized
health service or
specialized service it is
a team function and is
very important for
effective
comprehensive school
health programme.
 MEMBERS OF SCHOOL
HEALTH TEAM
The school health team should be
comprised of;
[Link] medical officer
[Link] health nurse
[Link]
[Link]
[Link]
[Link] representatives from the
community
[Link] auxiliary health worker
• Each member in the team has an
important role in promoting health of
school children.
• The team needs to function in a
group and follow group dynamics in
assessing;
 School health needs.
 Planning
 Organizing and
 Implementing school health activities
by delegating specific responsibilities
to team members according to their
defined roles and abilities.
• The team should also do the
evaluation of the
programme and its
activities implemented
,continue further planning
and implementation on the
basis of feedback.

• The major possible

functions of team members
are as under;
 THE SCHOOL PRINCIPAL

• The school principal has the

responsibility to;

 Ensure that the school health

programme has the approval and
support of school administrative
authority.
 Set up a school health
committee/school health council
to work out the school health plan
and plan for its implementation;
 Ensure that teachers are
adequately trained for health
care of school children;

 Provide facilities for

implementation of school
health activities;

 Make sure that proper health

records are maintained

 Ensure that parents are

involved and follow up of
children is done.
 THE SCHOOL TEACHER
 Is an important member of team.

 She is the key person because she is

in continuous contact with students
and in position to make observation
of their health.

 Some of the specific functions which

are expected of teachers are as
follows;

 Daily inspection of children of

personal hygiene an cleanliness;
 Daily observation of children for
detecting any evidence of any
deviation from normal health
behaviour,any communicable
disease, malnutrition etc;

 Help in control of communicable

diseases

 Referral of child having any

problem to school health clinic
for further action;

 Informing the parents and

maintaining follow up;
 Maintaining records of
anthropometric measurements
and other health records of
children;

 Help in providing safe

environmental sanitation;

 Giving first aid and emergency

care to children;

 Imparting health education on

healthful living habits an
behaviour etc;

 Participate in investigation of
epidemic or any disease etc;
• The school health nurse plays an
important role in helping teacher
to carry on these responsibilities .

• She can hold conference with

teacher an discuss some of these
aspects.

• Together they can work out plan

for daily inspection observation of
anthropometric measurements
,health education ,follow up of
children.
 THE PARENTS
 The parents have lot of responsibility
towards health of their school children
while they are in school. These are;

 Providing information regarding past an

present history of their child as well as
the members of the family;

 Can participate and co-operate in

physical an medical examination of
children an also in immunization of
children.
 They can help in
correction of defects if
any and follow up of
children found sick.

 They can help in

formation of good
healthful living habits and
behaviour.
 Through “parents-teachers
association ” the parents can
be involved in planning
,organizing and
implementation of school
health programme

 Above all, the parents must

the relieve child of work
pressure at home so that
child can take advantages of
school.
 The parents need to be
prepared. They can be
educated during parents –
teachers meetings.

 The parents of those children

who are found to have health
problems can be invited in
the school to discuss the
problems individually.
• Both teacher and the nurse
can discuss the nature,
medical care , progress of
the problems.

• They can work out plan of

care of the child which is
workable in the family.
 THE COMMUNITY

 School going children are the

important segment of community
in which they live. community has
a responsibility towards promotion
of health of children. the
community can contribute by
supporting school health
programme by ;

 Providing suitable land for school

building;
 Providing funds and
labour in building
proper school’

Participation in school
health committees an
contribute in formulation of
school health policies an plan;
• Participation in
implementation of
programme activities;

• Motivating parents to
send their children to
school an take care of
health.
 THE CHILDREN

• Are the clients for school health

services an nee to know about the
importance of school health services
an the activities which are to be
carried under the school health
[Link] child has the
responsibility to;
• Learn values of medical and health
examinations ,personal hygiene,
good nutrition,envionironmental
sanitation etc.
Cooperate in various aspects of school health
program

develop positive habits and

healthful living activities as
educated upon;

Extend this knowledge to other

members of the
family,neighbourhood etc
 THE MEDICAL OFFICER
 Usually is a team leader

 Has overall responsibility of managing

the school health programme.

 Manages the team dynamics

 Makes sure that all activities are carried

out smoothly;
• As one of the member of the team
he is responsible for ;
Medical examination of the
students;
Making diagnosis;
Prescribing treatment;
Making referral to specialists;
Ensuring follow up of children;
• Initiating promotive and
preventive programme;

• Inspection of school environment

and sanitation

• Holding meetings with parents an

teachers

• Ensuring maintenance of records

an reports;

• Evaluation of the programme and

redefining programme objectives
an activities.
THE SCHOOL HEALTH NURSE/
COMMUNITY HEALTH NURSE
“In general the functions of school
health nurse are related to
establishment and
implementation of school health
policies and programmes for the;
a. protection and promotion of
health of students,
[Link] maintenance of school
environment which is conducive
to healthful living;
(c).the building of the components of
the curriculum which have
significance for health ;”.

(d).the management of health service

including screening programmes and
emergency care services,

(e).the handling of special health

problems and relating the school
health programmes to those of the
community”.
• Considering the nurse’s responsibility
for comprehensive health care of
school children, her responsibilities
are are classified into three areas.
these are state as below.
 HEALTH PROMOTION AND SPECIFIC
PROTECTION
 Refer to primary prevention.
• These includes;
 Immunization of children.
 Helping school authority to plan mid-
day meal for students .
 Health education of children, their
parents and teachers.
 Helping students, their parents
and teachers develop positive
attitude and health behaviour by
demonstrating healthful
behaviour and by providing
health experiences.
 Providing knowledge regarding
problem solving skills to students
,their parents an teachers.
 Helping school authorities to
design health education
curriculum an provide
consultation to teachers on
health education topics.
 Involving community
participation to eliminate safety
hazards in the community.
EARLY DIAGNOSIS AND TREATMENT
• Refers to secondary level of
prevention.
• Includes;
• Regular and periodical health
appraisal of school children;
[Link] conduct general physical
examination and recording
these observations before
medical examination.
[Link] arrange for and assist in
medical examination of children.
 Notifying parents about
health appraisal results.
interpret an discuss the
finings an the corrective
measure plan.
 Making referrals
 Follow up of referral cases.
 Home visits of certain
selected children
 Counseling
Dispensing medicines as
prescribed, perform
special treatments or
procedures as require for
identified health problems
Providing first aid and
emergency care for injury
or illness
Help set up facilities for an
demonstrate first aid
procedures.
PREVENTION OF COMPLICATIONS AND
REHABILITATION;

THIS IS TERTIARY LEVEL OF PREVENTION

 Helping in prevention of recurrence of
acute conditions by;
[Link] risk factors.
[Link] education
 Prevention of complications an
promotion of adjustments to chronic an
handicapping conditions by;
[Link] parents/family meet special
nutritional of any other needs,
[Link] parents/family in
finding sources of financial help
to deal with chronic and
handicapping conditions,

[Link] in meeting special

needs for transportation,
equipment or any other facility.
 Help in prevention of
adverse effects of learning
disabilities by;

[Link] of children and

their parents

[Link] with school

authority to design
individualized learning
programme.
• OTHER FUNCTIONS
• Maintenance of health records and
preparing reports of health appraisal
and medical reports of health
appraisal and medical examination
,episode of illness, any defect,
treatment and follow up care given.
• Assisting supervision an guidance of
ANM’s
• MPHW in carrying school health
activities.
• Management of school health clinic.
• Participate in service education of
teachers on health matters.
 The community health nurse thus perform variety of
roles in the school health setting. these include role
of;
• School health consultant
• Practitioner
• Planner
• Organizer
• Co-ordinater
• Guide
• Supervisor
• Educator
• Trainer
• Counselor.