1. SCHOOL HEALTH
Dr. Abd Alla El hamadi

2. OBJECTIVES Students should know how to: 1-Define school health.
2- Understand Health promotion through school health services.
Know disease prevention & control of health hazards through school health services.
Understand the importance of early diagnosis & treatment of diseases.
Understand the special care for the disabled
Know the rehabilitation of the handicapped

3. DEFINITION
An organized activity to promote, protect and improve the health of school pupils, staff & the community.
Objectives of school health program:
Health promotion of school children
Prevention & control of health hazards
Early diagnosis & treatment of diseases.
Special care of the disabled
Rehabilitation of the handicapped

4. Why SCHOOL HEALTH ? School pupils = 15% of population
Vulnerable group(for infectious diseases)
Liable to accidents( very active)
Growing age
School years the best time for health education
Family health promotion through schools

5. COMPONENTS OF SCHOOL HEALTH PROGRAM
School health environment
School health services(medical care, health promotion& prevention of health hazards)
School health education

6. SCHOOL HEALTH ENVIRONMENT
Site of school:
Easily reached
Away from noise
Away from dangerous areas
Away from bad odor sources
Away from pollution
Well drained area

7. SCHOOL BUILDING Solid material Not more than three floors
Shape allow good natural ventilation & light
Adequate space between buildings
2/3 of total area for playgrounds

8. THE CLASSROOM Shape: 1- rectangular(6x8 m)
2- students not more than 30(1-1.5 m2/student)
Ventilation:
Windows= 1/5 of surface area
At two sides for better air flow
Designed according to weather

9. LIGHT Adequate quantity, quality & distribution Natural or artificial
From sides of building never from front

10. DESKS AND SEATS Comfortable Different sizes Space between each 60 cm
Front space> 1.5 m
Desk better to be slope
Feet rested on ground

11. Water Supply
Better from piped system or underground
No common cup

12. Sewage Disposal In urban Water carriage system
In rural pit latrines or any
7-10/100 (7-10 lat.for 100 students)
Refuse disposal:
Municipal system
Burning or any

13. Food Safety Sanitary kitchen, lunch room, canteen & food stores
Food handlers screening
Prevent street food sailors around schools
Health education
Insect & rodents control

14. SCHOOL HEALTH SERVICES
Health promotion
Prevention of health hazards
Medical care
Health education

15. Health promotion Adequate nutrition(school feeding program)
Sanitary school environment
Physical exercise
Fulfill needs for mental development
Prevent mental fatigue(good arrangement of day activities and home work)
Social welfare & recreation

16. SCHOOL FEEDING PROGRAM
Must provide 50% of recommended dietary needs of proteins, vitamins & minerals.
Food safe, popular & palatable
Canteen contain snacks & milk

17. Value of school feeding
Support growth & health promotion
Contributes to educational progress
Provide a chance for nutrition health
education
Supplement home feeding in poor countries

18. PREVENTION OF HEALTH HAZARDS
Infectious diseases
Parasitic diseases
Nutritional deficiency diseases
Injuries
Disability

19. Infectious Diseases
Respiratory diseases: common cold, bronchitis measles, mumps…..
Food borne diseases: enteric fever, hepatitis A, dysenteries & food poisoning
Contact diseases: scabies, trachoma

20. Predisposing factors of infection
Insanitary school environment(crowded, ill-ventilated class rooms, bad food sanitation)
Unhealthy habits
Lowered body resistance
Existing reservoir of infection(carrier)

21. Prevention Environmental sanitation Health education Vaccination
Chemoprophylaxis(rheumatic fever, Meningitis, TB…..

22. Prevention cont….
Measures for school personnel(pre-employment health examination, screening for common diseases, training on food safety, periodic examination)
Case finding & management
Control of contacts & environment

23. PARASITIC DISEASES As entrobius vemicularis, Ascaris, Schistosoma……
Predisposing factors:
1- Insanitary school & community environment
2- Poor personal hygiene
Prevention:
1- Environmental sanitation
2- Health education

24. Control Case finding(urine & stool analysis)
Management of cases & prevention of autoinfection
Measures for contacts

25. Nutritional deficiency diseases
Protein, Iron, Vit A
Predisposing factors:
1- Inadequate home & school feeding
2- Unhealthy food habits(no breakfast, no fruits nor vegetables….)
3- Parasitic infections

26. Injuries Wounds, fractures, bleeding, falls, traffic & home accidents
Prevention:
1- Safety measures on buildings
2- Health education about dangerous behaviors
Control:
1- Trained personnel for emergency & first aid
2- Transport for referral

27. Disability
As congenital or acquired as rheumatic heart disease, polio, vision & hearing defects
Minor & mild cases of disability can attend school regularly with special care
Severe cases of disability (e.g. the deaf, blind, or mentally retarded) need special institutes

28. Medical care
Health appraisal: ( organized activities to assess the physical, mental, social & emotional status of the pupil)
Purpose:
1- Screening for health problems (weight.,height,vision,hering,dental exam.)
2- Pick pupils who need special care
3- Baseline data for follow up
4- Opportunity for health education

29. Components of health appraisal
Comprehensive medical exam
Curative clinical services
Screening tests
Survey studies
Daily observation

30. Comprehensive medical examination
Primary exam at school entry(6 years)
Periodic exam every 3 years( 9, 12, & 15 years)
Components of exam:
History
Physical exam
Personal interview
Investigations

31. Clinical services School health units Specialized clinics
Hospitals(referral)

32. Screening tests Anthropometric measures Visual disorders
Hearing defects
Dental exam
Nutritional deficiency
Parasitic diseases
Handicapping conditions
IQ testing

33. Survey Studies
Required for a definite health problem e.g. nutritional problem, parasitic diseases, smoking, dietary habits…..
To know the magnitude of the problem, plan for intervention & control

34. Daily observation Weight changes Loss of interest Easy fatigability
Visual problems
Skin conditions
Emotion & behavior problems
Personal hygiene
Absence

35. First aid services Materials Trained personnel
Transport for emergency referral

36. Comprehensive Mental Health Screening
Carried at three levels:
Level 1(school level):
1- At school entry (life style changes ?depression)
2- At 2ry school (anxiety)
Level 2 (school health unit)
Detection of developmental problems
Referral to specialized centers

37. Mental health screening…….
Level 3 (hospital level):
Concerned with:
1- Management of mental health problems
2- Communication with levels 1 & 2
3- Referral to special education systems

38. School health record
A record for every child for registration of all health data of the pupil it contains:
1- Personal & social data
2- Results of health appraisal
3- Vaccines
4- Detailed past medical & surgical history including injuries

39. Value of the record Provides valuable past medical history
Allows follow up of chronic diseases
Collection of data important for school health planning
Used for evaluation of services

40. School Health Education
Carried by school personnel, school nurse, health unit staff, NGOs
Directed to pupils, families & community
About health promotion, disease prevention & utilization of health services

41. Methods of HE
Individual
Small groups
Large communities

42. The Role of school health unit personnel
The physician:
1- Curative services
2- Preventive services
School nurse:
1- Daily observation of school environment, pupils
2- First aid & emergency measures
3- Health education

43. School teacher
Case finding through daily observation(visual & hearing problems)
Health education
Do simple screening tests after training
Provide special care for the handicapped
Supervision of school environment

44. Children with disability
Impairment(minor disturbance)
Disability(restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human at his age)
Handicap(Disadvantage that limits or prevent the fulfillment of a role which is normal for his age

45. Categories of Childhood Disabilities
Sensory( visual, hearing….)
Mental & psychological(IQ,….)
Traumatic Brain injury
Orthopedic(polio, amputation….)
Physical(RHD)
Delicate child(DM, Asthma)

46. Prevention & control of Disability
Etiology
Congenital( genetic or in utero exposure to risk) preventable at antenatal level
Acquired(preventable at school health level)
Both need rehabilitation

47. Thank you