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INTRODUCTION- School health is an important branch of community health. According to modern concepts, school health service is an economical and powerful means of raising community health, and more important, in future generations.         HISTORICAL DEVELOPMENT- The beginning of school health service in India dates back to 1909, when for the first time medical examination of school children was carried out in Baroda city. The Bhore committee(1946)(113) reported that school health services were especially non-existent in India, and where they existed, they were in an under-developed state. In 1953, the secondary Education Committee emphasized the need for medical examinations of pupils and school feeding program mes. During the five year plans, many state governments have provided for school health, and school feeding programmes. HEALTH PROBLEMS OF THE SCHOOL CHILD:- Any discussion of a school health services must be based on the local health problems of the school child, the culture of the community and the available resources in terms of money, material and man power. OBJECTIVES OF SCHOOL HEALTH SERVICE:- The objectives of the program me of a school health service are as follows:- 1.)    The promotion of positive health. 2.)    The prevention of diseases. 3.)    Early diagnosis, treatment and follow-up of defects. 4.)    Awakening health consciousness in children. 5.)    The provision of healthful environment.   FUNCTIONS OF SCHOOL HEALTH SERVICES:- The specific function of the school health services are  described below:- 1.)Determine the health status of each child. 2.)continually appraise changes in the health status of a child. 3.) conduct special screening programme which will disclose particular health problems. 4.) counsel pupils and their parents regarding the findings of the health appraisal. 5.) Institute referral of the student who has a remedial defect to an appropriate resources in the community. 6.) provide a basis for adopting the school program me to the needs of the individual children. 7.) provide one source of information for planning health instructions. 8.)Establish a need for corrective classes to assist pupils with visual, aural, postural, speech or emotional problems. 9.) Assist in maintaining the health of school personnel. 10.) Give emergency care in cases of accidents or sudden illness. 11.) offer immunization program me to prevent communicable diseases. 12.) observe youngsters for symptoms of communicable diseases and other health defects. 13.) stimulate interest of students, parents and school personnel in the values inherent in effective levels of physical, emotional and social health.   ASPECTS OF SCHOOL HEALTH SERVICES:- The tasks of a school health service are manifold, and vary according to local priorities. Where resources are plentiful, special school health services may be developed, some aspects of a school health service are as follows:- 1.)Health appraisal of school children and school personnel. 2.)Remedial measures and follow-up. 3.)prevention of communicable diseases. 4.)Healthful school environment. 5.)Nutritional services. 6.)First aid and emergency care. 7.)Mental health. 8.) Dental health. 9.) Eye health. 10.) Health education. 11.)Education of handicapped children. 12.)Proper maintenance and use of school health records. 1.)HEALTH APPRAISAL- The health appraisal should cover not only the students but also the teachers and other school personnel. Health appraisal consists of periodic medical examinations and observations of children by the class teacher.   a.)PERIODIC MEDICAL EXAMINATION:- The school health committee(1961) in India recommended medical examination of children at the time of entry and thereafter every 4 years(114). A routine examination of blood and urine should be carried out. Clinical examination for nutritional deficiency, and examination of faeces for intestinal parasitoses are particularly important in India. Tuberculin testing or mass screening  should not be withheld     b.) SCHOOL PERSONNEL:- Medical examination should be given to teachers and other school personnel as they form part of the environment to which the child is exposed. c.) DAILY MORNING NSPECTION:- The teacher is in a unique position to carry out the daily inspection, as he is familiar with the children and can detect changes in the child’s appearance or behaviour that suggest illness or improper growth and development. The following clues will help the school teacher in suspecting children who need medical attention:- 1.)Unusually flushed face. 2.)Any rash or spots. 3.)Symptoms of acute cold. 4.)Coughing and sneezing. 5.)Sore throat. 6.)Rigid neck. 7.)Nausea and vomiting. 8.)Red or watery eyes. 9.)Headache. 10.)Chills and fever. 11.)Listlessness or sleepiness. 12.)Disinclination to play. 13.)Diarrhoea. 14.) pains in the body. 15.) Skin conditions like scabies and ringworm. 16.)pediculosis. 2.) REMEDIAL MEASURES AND FOLLOW-UP-Medical examinations are not an end in themselves; they should be followed by appropriate treatment and follow-up. Special clinics should be conducted exclusively for school children at the primary health centres in the rural areas. 3.) PREVENTION OF COMMUNICABLE DISEASES- Communicable diseases control through immunization is the most emphasized school health service function. A well planned immunization program me should be drawn up against the common communicable diseases. 4.) HEALTHFUL SCHOOL ENVIRONMENT- The school building, site and equipment are part of  the environment in which the child grows and develops. A healthful school environment therefore is necessary for the best emotional, social and personal health of pupils. The following minimum standards of or sanitation of the school and its environs have been suggested in India. 1)LOCATION- The school should normally be contrary  situated with proper approach roads and  at a fair distance from busy places and roads, cinemas houses factories, railway tracks and market places. 2) SITE- The site should be on suitable high land, and not subject to inundation or dampness and can be properly drained. The school Health Committee(1961) recommends that 10 acres of land be provided for higher elementary schools and 5 acres for primary schools with an additional one acre of land per 100 students. 3) STRUCTURE- Nursery and secondary schools, as far as possible be single storied. Exterior walls should have a minimum thickness of 10 inches and should be heat resistant. 4) CLASSROOM- Verandahs should be attached to classrooms. No classroom should accommodate more than 40 students per capita space for students in a classroom should not be less than 10 sq.ft. 5) FURNITURE- Furniture should suit the age group of students. It is desirable to provide single desks and chairs. Desks should be of minus type. Chairs should be provided with proper back rests, with facilities for desk work. 6) DOORS AND WINDOWS- The windows should be broad with the bottom still, at a height of 2-6 from the floor level; combined door and window area should be at least 25 percent of the floor space; windows should be placed on different walls for cross ventilation; the ventilators should not be less than 2 percent of the floor area. 7) COLOUR- Inside colour of the class room should be white and should be periodically white- washed. 8) LIGHTING- Class rooms should have sufficient natural light, preferably from the left, and should not be from the front. 9) WATER SUPPLY- There should be an independent source of safe and potable water supply which should be continuous, and distributed from the taps. 10) EATING FACILITIES- Vendors other than those approved by the school authorities should not be allowed inside school premises, there should be a separate room provided for mid-day meals. 11) LAVATORY- Privies and urinals should be provided. One urinal for 60 students and one latrine for 100 students. Arrangements should be separately made boys and girls. 5.) NUTRITIONAL SERVICES- A child who is physically weak will be mentally weak, and cannot be expected to take full advantage of schooling. The diet of the school child should, therefore receive first attention. The diet should contain all the nutrients in proper proportion, adequate for the maintenance of the optimum health. a) MIDDAY SCHOOL MEAL- In order to combat malnutrition and improve the health of school children, it is now an accepted procedure in all advanced countries to provide a good nourishing meal to school children. Those who can afford it may bring their lunch pockets from home and during lunch hours take their meals in school. b) APPLIED NUTRITION PROGRAMME- UNICEF  is assisting in the implementation of the applied nutrition program me in the form of implements, seeds, manure and water supply equipment. c) SPECIFIC NUTRIENTS- Advances in the knowledge of nutrition have revealed that specific nutrients may be necessary for the prevention of some nutrient disorder. Dental carries, endemic goiter, night blindness, protein malnutrition, anemia and a host of other nutrient disorders are eminently preventable. 6) FIRST AID AND EMERGENCY CARE- The responsibility of giving first aid and emergency care pupils who became sick or injured on school premises rests with the teacher and therefore all teachers should receive adequate training during teacher training program mes or inservice training program mes to prepare them to carry out this obligation. 7) MENTAL HEALTH- The mental health of the child affects his physical health and the learning process. Juvenile delinquency, maladjustment, drug addiction are becoming problems among school children. The school is the most strategic place for shaping the child’s behaviour and promoting mental health. The school teacher has both a positive and preventive role he should be concerned with helping all children attain mental health, so that they may develop into mature, responsible and well adjusted adults. It is now increasingly realized that there is a great need for vocational counselors and psychologists in schools for guiding the children into careers for which they are suited. 8) DENTAL HEALTH- Children  frequently suffer from dental diseases and defects. Dental caries and periodontal disease are the two common dental diseases in India. A school health program me should have provision for dental examination, at least once a year. In developed countries, Dental hygienists are employed in schools to assist the school dentist with the examination of the teeth. 9) EYE HEALTH SERVICES- Schools should be responsible for the early detection of refractive errors, treatment of squint and amblyopia, and detection and treatment of eye infections such as trachoma, administration of vitamin A to children at risk, has shown gratifying results. In other words, basic eye health services should be provided in schools. 10)HEALTH EDUCATION- The most important element of the sschool heath program me is health education. The goal of  health education should be to bring about desirable changes in health knowledge, in attitudes and in practice, and not merely to teach the children a set of rules. Health education in schools should cover the following areas:- a) PERSONAL HYGIENE- Health education program me in schools should be lively, practical and based on everyday needs and interests of children. The need for hygiene of skin, air, teeth and clothing should be impressed upon them. Children often adopt bad postures while sitting and standing cigarette smoking is an example of a public health problem that should be tackled in schools. b) ENVIRONMENTAL HEALTH- Encouraging young people to take part in health activities and keep their environment clean is an important function of school health services. Visits to observe community health program mes, and even better, participation in community action program mes (eg:-vaccination, fly control campaigns, construction of sanitary wells and latrines) are excellent opportunities for health education. c) FAMILY LIFE- Family life education is being increasingly recognized as a priority in both developed and developing countries. The school health service is concerned not only with the development of healthy lives  but also with healthy attitudes towards human reproduction. In developing countries, where ill health is a major problem, “every school child is a health worker.” a public health problem that should be tackled in schools. b) ENVIRONMENTAL HEALTH- Encouraging young people to take part in health activities and keep their environment clean is an important function of school health services. Visits to observe community health program mes, and even better, participation in community action program mes (eg:-vaccination, fly control campaigns, construction of sanitary wells and latrines) are excellent opportunities for health education. c) FAMILY LIFE- Family life education is being increasingly recognized as a priority in both developed and developing countries. The school health service is concerned not only with the development of healthy lives  but also with healthy attitudes towards human reproduction. In developing countries, where ill health is a major problem, “every school child is a health worker.” 11) EDUCATION OF HANDICAPPED CHILDREN- The ultimate goal is to assist the handicapped child and his family so that the child will be able to reach his maximum potential, lead as normal a life as possible, to become a productive and self supporting member of society. 12) SCHOOL HEALTH RECORDS- A cumulative health record of each student should be maintained such records should contain (a) Identifying data, name, date of birth, parents name and address etc. (b) Past health history. (c) Record of findings of physical examination and screening tests and records of services provided. SCHOOL HEALTH ADMINISTRATION- The health of the school child is the responsibility of the parents, teachers, health administrators and the community. The success or efficiency of school health service depends largely on effective coordination between the participating agencies. School health service is therefore an important function of the primary health centres. a)PRIMARY HEALTH CENTRES- The primary health centres are charged with the responsibility of administering school health service within their jurisdiction. It requires a whole time, medical officer to cover 5,000 to 6,000 children a year. ) SCHOOL HEALTH COMMITTEES- The school health committee (1961) in India recommended the formation of school health committees at the village level, block level, state level and national level. These committees should mobilize community resources and make the school health program me continuous and self supporting. The national school health council will be an advisory and coordinating body. ROLE OF NURSE IN SCHOOL HEALTH PROGRAM ME. A school health nurse assumes a major part of the health program me responsibilities and works in collaboration with others in the school and community. 1)Supervisor. 2) Counselor. 3) Educator. 4)Caregiver. 5)coordinator. GENERAL OBJECTIVE- At the end of my class teaching I came to know that students gain knowledge about school health services. Introduction, historical development, objectives, functions and aspects of school health services. SPECIFIC OBJECTIVES:- 1)To tell them about the introduction of school health services. 2)Explain them about the historical development of school health services. 3)To tell them about the health problems of the school child. 4)To tell them about the objectives of school health services. 5)To tell them about the functions of school health services. 6)To tell them about the aspects of school health services.


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