School health services refers to need based comprehensive services rendered to pupils, teachers and other personnel in the school to promote and protect their health, prevent and control of diseases and maintain their health.

1. SCHOOL HEALTH
SERVICES
SAPNA THAKUR
MSC(N) COMMUNITY
HEALTH NURSING

2. 2
• Children between the age of 5-17 years are school age children.
They spent most of their time of the day in the school under the
direct supervision and guidance of their teachers. They are also
exposed to various epidemiological factors in the school which
influence their present and future state of health
• Hence school is the best place for giving health education and make
a strong foundation to the healthy nation.
• School health services are primarily meant for preserving and
promoting health of the students.
INTRODUCTION

3. Sapna Thakur 3
It refers to a state of complete physical,
Mental, Social and spiritual well being and
not merely the absence of disease or infirmity
among pupils, teachers and other school
personnel.
-K.K GULANI

4. 4
To prevent the risky behavior of children such as alcohol and
tobacco, etc.
To promote healthy behavior among the children.
To detect diseases early in children and treat diseases early.
To encourage healthy habits of children.
OBJECTIVES OF
SCHOOL HEALTH

5. DEFINITION
• It refers to need based comprehensive
services rendered to pupils, teachers
and other personnel in the school to
promote and protect their health,
prevent and control diseases and
maintain their health
Sapna thakur 5

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 To promote the health of the children.
 To promote growth and development of school children through
nutritional programs.
 To control the communicable diseases.
 To detect diseases early and provide treatment and follow-up.
 To promote healthy behavior in children through awareness.
 To prevent disease.
 To refer cases when needed.

7. Following are the needs for schools:
• School involves children between 5-14 years of
age.
• It provides opportunity to supervise and provide
guidance to the children.
• It provides opportunity to identify diseases in
earlier stage.
• It is based on health needs of school children.
• School is the best place to provide health
education and helps the younger generation
become healthy.
• They are prone to get exposed to various
stressful situations. 7

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Some common problem which are common in school children’s are-
• Malnutrition
• Infectious diseases
• Intestinal parasites
• Diseases of skin, eye and ear
• Dental carries

9. The components can vary from one region to
another based on local policies and initiatives,
but here are some common aspects often
found in Indian school health programs:
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• Health appraisal
• Prevention of communicable diseases.
• Nutritional services
• Immunization and First aid
• Treatment and follow-up
• Mental health and Dental health
• Eye health services
• Health education
• Healthful school environment
• School health records
• Education of school handicapped children.

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Health appraisal covers all the staff and students working in school. The
services used to be Comprehensive, i.e. preventive, promotive,
therapeutic and rehabilitative in nature.
It is responsibility of PHC to provide school health services in rural
area. They are also responsible for the follow-up of children.
Medical examination of all the students must done during admission
time and after every 4th year after admission.
Physical Examination also done.
Training provided to the school teacher to find out the students, who are
deviating from normal health and refer to the doctor.
HEALTH APPRAISAL

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Protection of all school-going children
against communicable diseases
through immunization and through the
self precautions such as wearing mask,
hand washing, etc.

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Many school children are suffering from various Nutritional
deficiencies, such as vitamins and mineral deficiency,
blindness, anaemia, PEM, etc.
These diseases can be corrected by giving proper and
adequate diet.
Mid-day meal program also prevents children from various
nutritional diseases.
Vitamin A prophylaxis given to children.

13. ADD A FOOTER 13
All school children
should be
immunized
according to the
national
immunization
schedule or
program. Record
should be
maintained and
handed over to the
parents when the
child leaves the
school.

14. ADD A FOOTER 14
It should be
available in all the
schools to provide
first aid during
accidents,
abdominal pain,
convulsions,
sports injury and
diarrhoea, etc. it is
important to
provide emergency
care to the
children.

15. ADD A FOOTER 15
• The children who are sick should be followed by
appropriate treatment and follow-up.
• The school should also be informed about any kind of
major illness or defect.
• Special clinics should be conducted exclusively for
school children at PHC and CHC.

16. ADD A FOOTER 16
• The stress or burden of study lead to mental
illness. Mental health also affect the physical
health and learning process of the children.
• Teachers need to plan and organize well
balanced curriculum and extra-curricular
activities so that students do not feel over
burdened.
• There should be vocational or psychological
counselling in the school for helping the children.

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It is a important aspect for school children and their parents too. It
creates awareness and provide knowledge and promote change in
the health behaviour and health attitude.
It is a key element of school health services.
Health education may include all the areas such as personal
hygiene, environmental health, nutrition, prevention of
communicable and non-communicable diseases, first-aid and
emergency care, home care, reproductive health and control of
psychological problems.

18. ADD A FOOTER 18
• School building and its environment also plays an
important role in school health.
• School building should be away from airport, railways,
bus stands, market place and cinema hall.
• Toilet facility according to the strength of students.
• There should be safe drinking water, separate school
kitchen and washbasins should also be available.
• Classroom should have sufficient natural light.
• Food hygiene and sanitation should be maintained in
the school.

19. ADD A FOOTER 19
It is very important to maintain complete, accurate and
continuous health records of school children.
Each student health record must be maintained.
It is useful to provide need based care and guidance to the
children.
Health record should contain present and previous
information of student.

20. ADD A FOOTER 20
DENTAL: School children suffer from dental
diseases like dental caries; dental examination of
the student once a year must be done.
EYE: Students may also suffer from eye
disorders such as myopia, trachoma. Vitamin A
prophylaxis should be provided to the children.
Basic eye check-up should be done in the
schools.

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 All the children with special needs must be enrolled
in primary school without any discrimination.
 Special education services should be available to
children who need them.

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SCHOOL HEAD
MASTER
TEACHERS
PARENTS
STUDENTS
REPRESENTATIV
ES
AUXILLARY
HEALTH WORKER
SCHOOL HEALTH
NURSE
THE
COMMUNIT
Y
MEDICAL OFFICER

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SCHOOL
ENVIRONMENT
School is a second home because children’s spend 6-8 hours a day in
school.
Following criteria are recommended:
• Physical environment
• Sanitary and other facilities
• Disposal of waste and refuse
• Canteen and eating facilities
• Safety
• Emotional climate

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It includes:
• The location and site
• The building structure
• Classroom furnishing
• Floor
• Door and windows
• Colour and lighting
• Furniture
• Play ground
• Beautification of the school
• School garden

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Location and site:-
• Centrally located
• Noise free, Dust free
• Away from traffic & away from busy places and roads,
cinema theatre, railway track, market, bar and restaurants.
• The school has to be properly fenced.
• 10’ acres of land in higher elementary school & 5’ acres
for primary school.
Building structure:-
• single storied building( nursery and secondary school).
• Heat, rain and noise insulated
• Facility for fire proof and fresh air
• Class-room height- 12 feet (allowing good light and air)

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o Well ventilated
o Attached verandas
o One class contain only
40 students
o 10 square feet per
capita space for
adequate ventilation.

27.  Clean
 Smooth
 Easy to wash
 Should not be slippery
 Staircase railing for protection
 Class-room size:-
Height, length and wideness:-
4*8*6 meter.
Sapna Thakur 27

28. COLOUR
• From inside classroom- white
coloured walls
• Periodically white wash at
least annually
• From outside schools- light
colour to reduce glares
Sapna Thakur 28
LIGHTING
• Sufficient natural light from left and
right side of the students
• Cross ventilation from both the sides
• Window- ‘150’ cm down from ceiling
and ‘120’ cm up from floor

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• Suited with the age group of
students
• Each student should have a single
desk with a chair
• Duster should be cleared outside
to prevent allergic reactions to
dust

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• Dry, smooth and safe
• Partly planted with trees
• Facility for attempting games
and sports
• Space for own school garden,
fish pond or poultry farm

31. DOORS
• Broad
• Height- ‘6’ feet from
floor level
• Total area covered
approximately 20% of
floor space
Sapna Thakur 31
WINDOWS
• Windows should be
‘150’ cm down from
ceiling and ‘120’ cm
up from the floor
According to student committee
recommendations.

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• School should have good appearance.
• White washing and colouring should be
done annually.
• Students should be encouraged to keep
the buildings and surroundings clean.
• There should be periodically ‘deadliness
campaigns.

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• Plantation of trees
• Use of waste water effectively

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• WATER SUPPLY: continuous potable safe.
• Taps should be clean and dry and should have proper
drainage.
• Periodically chlorination of water system.
• Water tap is recommended for 50 students and 1 pot
is recommended for 30 students.
• LAVATORY: each school must have sanitary urinals
and latrines with adequate water supply that should be
separate for boys and girls. 1 urinal for 60 students
and 1 latrine for 100 students are advocated.

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DISPOSAL OF REFUSE: dustbin must be placed in
each class-room and various strategic areas. It should be
emptied either in the composite pit/or burnt it in one
corner away from class room. The compost from the pit is
excellent manure for school garden.
DISPOSAL OF WASTE WATER: there should be
proper underground drainage system for the disposal of
waste water in the school. Soakage pit can be used in rural
areas even waste water can be used for school garden.

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• Each school should have its own
sanitary canteen or approved
vendors in school premises. There
should be facility for eating and
washing in the canteen.

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• Early detection of students who deviate from
normal.
• Making adjustment in school programmes to
meet the needs of child.
• Reduce the stress or frustrations among school
children.
• Providing opportunities to make decisions,
develop responsibilities and leadership qualities.
• Encourage each child and emphasizing his
achievements rather then their failures.

39. ADD A FOOTER 39
Maintenance of school records is a crucial component of school
health services. These records help in tracking and monitoring the
health status of students, identifying health trends, and providing
necessary interventions.
Every institution that is permanently organized should maintain
their all records and it also includes the health records.
It is essential to maintain complete accurate and contains health
records of school children
It is useful in providing need based health care services.

40. ADD A FOOTER 40
It is also helpful to improve the health services rendered for the
school children.
It is important to maintain health record of both students and
staff.
It is important to keep track of health related incidents, students
medical records and action to access their record every-time.
Students health record should not be shared with everyone.
All information R/T health of the students must share with the
parents of the children so that they provide proper treatment of
the children.

41. ADD A FOOTER 41
Student health profile-
• each students should have
health profile that include
personal information,
medical histories, allergies,
chronic conditions & any
special health needs.
• This allows school staff to
be aware of individual
health concerns
Immunization record-
• school should maintain up-to-date
records of students.
• Immunization ensure that they are
protected against preventable
diseases.
Health screening-
Records of health screening such as
vision, hearing , dental and other
periodic health assessment help to
identify potential health issues.

42. ADD A FOOTER 42
Health appointments
Keeping track of
appointments with healthcare
providers, specialist or
follow-up visits related to
school- identified health
concerns
First aid and medical
intervention-
Any instances of first aid
provided to students, along
with any medical treatment
administered at the school,
should be documented
Medication
administration
If any students require
medication during school
hours, record of medication
administration, dosage and
timings need to be
maintained accurately.

43. Growth and development
Recording measurement of height,
weight and other growth parameters
help in monitoring students physical
development over time.
Allergies and dietary needs
Documenting any allergies or specific
dietary requirements is essential for
ensuring students safety during meal
times and other activities.
Chronic conditions
For students with chronic conditions(
DM, asthma) maintain detailed
records of their conditions, treatment
plan and emergency protocols
Mental health records
If school offer mental health services,
keeping records of counselling
sessions or interventions R/t students
mental well-being is important
Emergency contact
Ensuring accurate and up-to date
emergency contact information for
each student is essential in case of
urgent health situations
Confidentiality
It is important to handle health records
with utmost confidentiality, ensuring
that only authorized personnel have
access to sensitive health information.

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SCHOOL HEALTH PROGRAM
INTRODUCTIO
N • NRHM has taken cognizance of the potential impact of the
school health program on the health of the students and their
families and brought this initiative within context of RCH
(reproductive and child health) program.
• It is the cost-effective tool to provide nutritional service,
health education & hygiene services to the children in the
school and it help to prevent control communicable and non
communicable diseases.
• All states introduced school health Program from the year

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Early detection of health problem
Development of healthy behaviour and attitude.
Promote health of students as well as non-teaching staff working in school
It help the younger generation become healthy and useful citizen.
To provide supportive information about health and nutrition of the school
children.
To promote use of safe drinking water in school.
To promote safe menstrual hygiene practices by girls
To promote yoga and meditation.
OBJECTIVES

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COMPONENTS
• Health screening and medical examination
• General health and personal hygiene
• Eye, ear & dental examination
• Early detection of skin diseases & heart diseases
• Training provided to teacher's to find out learning disorder, behaviour problem
and stress or anxiety.
• Documentation and maintain health records
• Transport for screening and referrals
• Immunization check-up`
• Routine periodic examination
• Clinical laboratory for assessment of anaemia and to find out nutritional
deficiencies in children

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ROLE OF SCHOOL
HEALTH NURSE
School health team comprised of medical officer, school nurse and auxiliary
health workers, teacher, parents, students and representative from the
community. the school health nurse provide comprehensive care i.e.
preventive, Promotive, Curative and rehabilitative care to the children’s,
parents, school teachers and community.
She act as a supervisor and manager.
The main role of community health nurse is to provide school health services.

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RESPONSIBILITY OF SCHOOL
HEALTH NURSE
Health promotion
Early diagnose and treatment
Prevention of complication and
rehabilitation
Health services and health education
Promotion of healthy safe school
environment
Specific protection

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CONTROL OF
COMMUNICABLE
DISEASE
IMMUNIZATION
MEDICINE
ADMINISTRATION
SPECIAL NEEDS
PROMOTION OF
HEALTHY SCHOOL
ENVIRONMENT
INITIATION AND
IMPLEMENTATION
HEALTH RECORD &
PERIODIC VISIT
HEALTH EDUCATION
ACTIVE PARTICIPATION
LIAISON ACTIVITIES
EVALUATION & CO-
ORDINATION
GUIDANCE AND
TRAINING
REFERRAL SERVICES &
FOLLOW-UP
PROMOTION OF ORAL
HYGIENE
DISEASE SCREENING
ANTHROPOMETRIC
MEASUREMENT
GENERAL PHYSICAL
EXAMINATION
IDENTIFY
DISEASE/ABNORMALITY
ROLE OF CHN

50. PROMOTION OF ORAL HYGIENE
The responsibility of SHN to assess the oral,
mucosa and tell the students to maintain good
oral and dental hygiene to prevent bad breath,
tooth decay and gum diseases.
ANTHROPOMETRIC MEASUREMENT
The elements of anthropometric are height,
weight, head circumference.
It is used as an indicator for growth and
development in children
IMMUNIZATION
The responsibility of SHN to maintain the
record of student’s immunization and
motivate the parents to follow the national
universal immunization schedule(NUIS).
CONTROL OF CD’s
CHN helps to reduce outbreak of disease and
promote the health of people in community as well
as in school. She also provide HE about precaution
that help to prevent disease from spreading.
SCREENING OF DISEASES
CHN plays an important role to identify disease in
early stage through screening. SHN must use
screening to get an idea that student is showing a
sign of special attention.
MEDICINE ADMINISTRATION
The responsibility of SHN is to provide
medication to the school regarding minor injuries,
first-aid and emergency services.
PERIODIC VISIT
CHN should conduct periodic visits with her team
members for medical check-up, follow up and
NUIS in various schools And community
EVALUATION & CO-ORDINATION
CHN should evaluate School Health services & take
feedback of these services. She should co-ordinate with
doctors, teachers and NGO’s to provide effective
school health services.

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SPECIAL NEEDS
SHN should know about the behaviour of
the student so that she can find out the
various psychological health problems and
also give special attention to vulnerable
group and physically handicapped students.
REFERRAL SERVICES AND
FOLLOW-UP
It is important to refer students for any
special attention from schools to
specialized hospitals. SHN assess students,
their needs and make referral based on
actual problem and also help the students
and family to know about follow-up
treatment.
GUIDANCE AND TRAINING
CHN plays an important role in providing
guidance to teachers about daily check-ups and
maintain health records.
INITIATION AND IMPLEMENTATION
SHN provide school health services, collect
information about student’s health record and provide
health care services.
ACTIVE PARTICIPATION
Without participation of students and
teachers, it is not possible to provide health
care services so there must be active
participation of both the groups.
LIAISON ACTIVITIES
She should establish IPR between school, home
and community for the better health of the
students.
HEALTH EDUCATION
SHN provide HE about oral hygiene, physical,
mental, social, intellectual, sexual and
reproductive health of the students.

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PROMOTION OF HEALTHY SCHOOL
ENVIRONMENT
SHN promote the health of the school
children as well as school personnel by being
a resource to teachers and staff regarding their
own health. She should provide healthy
environment in school premises.
GENERAL PHYSICAL EXAMINATION
She should conduct physical examination i.e.
head to toe assessment of children for their
better health and early detection of harmful
diseases.
HEALTH RECORDS
SHN should maintain health record of
each student which includes name, age,
DOB, address, post medical history,
screening and physical examination etc.
IDENTIFY
DISEASES/ABNORMALITIES
SHN should identify and treat
abnormalities as early as possible and
provide referral services and follow-up
services to them. She should provide the
training to the teachers so that they can
identify abnormal behaviour and solve
the problems of children at school level.

53. School health program
under AYUSHMAN
BHARAT was launched by
PM Narendra Modi.
In 2013, Govt. of India
launched RBSK (Rashtriya
Bal swasthya Karyakaram)
and RKSK (Rashtriya
Kishore Swasthya
Karyakaram) by preventing
and promoting health of
school children.
SAPNA THAKUR & NAVDEEP KAUR
53