This document outlines the objectives and components of school health services in India. It discusses the history of school health services in India since 1909 and describes the current objectives to provide comprehensive healthcare to students, promote positive health, prevent and diagnose diseases, and create a healthful school environment. It then explains the various aspects of school health services including health appraisal, remedial measures, healthful school facilities, nutritional services, first aid, and health education. The role of primary health centers and school health committees in coordinating and administering school health programs is also summarized.

1. School health services
Dr Utpal Sharma
Assistant Professor
Department of Community Medicine
SMIMS, Gangtok, Sikkim

2. Introduction
 School is a setting that plays an important role in the physical,
emotional, social and mental development of children.
 It is a personal health service and provides an…
…opportunity to help millions of young people to acquire
health supportive knowledge, values, attitudes and behaviour.
 Also influences health behaviour of other children, their families
and community.
 School health services is an economical and powerful means of
raising community health.
 In past 8 decades this service has developed from a narrower
concept of health examination to comprehensive health care and
well being of children throughout school years

3. History
 1909- Medical examination for school children in Baroda city.
 1946- Bhore committee report on non existence of adequate school
health facilities.
 1953- The Secondary education committee stressed on the need for
regular examination & school feeding programme.
 1960- Constitution of school health committee at vill, state, national
level to assess health and nutrition of schoolchildren.
 FYP –Initiatives for school health feeding programme by many states.
 1963 - The “National School Health Council” has been established to
plan and organize school children’s health care.

4. Health problem of the school
child

5. Objectives Of School Health
Services
General objective :
 To provide comprehensive health care to school students in
order to prepare them physically, mentally & socially
Specific objectives :
 Promotion of Positive Health
 Prevention of Diseases
 Early Diagnosis, Treatment & Follow up of defects.
 Awakening Health consciousness in children.
 Provision of Healthful environment.

6. Aspect of School
Health services

7. Health appraisal
 Periodic medical examination
 Recommended examination at school entry and
thereafter 4 yearly
 Screening of children includes
 Height and Weight
 Routine examination of blood and urine
 Acuity of vision
 Hearing
 Skin condition
 Intestinal worms
 Medical examination of school personnel
 Daily morning inspection

8. Remedial measures &
follow up
 Special clinics should be conducted in the health units (PHCs)
for schoolchildren.
 Selected health unit or a school should be arranged for about
5000 children in urban areas
 Results are recorded in the health record card and parents
should be advised regarding remedial action
 Referral hospital must provide for beds for children who are
admitted & provide relevant treatment.
 Prevention of communicable diseases by Immunization is the
most emphasized function of school health services

9. Healthful school
environment

10. Cont….
Location
 Away from busy places.
 Keep free from all hazards.
Site
 Suitable highland with proper drainage
 Land area-10 acre for high schools and 5 acre for primary school….
…additional one acre per 100 students
Play ground:
 For a primary school it should be 0.5 to 1 acre.
 For a secondary school it should be 5 to 14 acres.
Infrastructure
 Nursery and secondary school building should be single storied
 Exterior walls about 10 inch thick and heat resistant

11. Cont…
Class room:
Verandas should be attached to classrooms
Maximum accommodation of 40 student per classroom
Height of the class room about 12 feet
Room soundproof & dustproof and Floor should be smooth
Area not less then 480sq feet
Floor space> 10sq feet / child
Furniture
Preferably single desk and chair should be provided
The seat should take 2/3 rd of the child’s thigh
Desk should be “minus” type with proper back rest

12. Cont…
Doors and windows
 Combined area should be at least 25% of floor area
 Windows broad and located at 2’6” from floor
 Cross ventilation is a mandate
 Ventilator area at lest 2% of floor area
Colour
 Colour of the wall preferably white
Lighting
 Sufficient natural light, preferably from the left

13. Cont….
Water supply
 Independent source of safe and potable
water supply
 Continuous and distributed from taps
Eating facilities
 Vendors not approved should not be allowed inside school
premises
 Separate rooms for mid day meal
Toilet facility
 For 100 pupils…..1 pan
 1 urinal for 60 student
 Arrangements should be separately made for boys and girls.

14. Nutritional services
 School health committee (1961) recommended that school
children should be assured for at least on nutritional meal
 Mid day meal- supplementary but not substitute, operational
since 1961 under Ministry of education, GoI
 Children provided with 1/3rd
of calorie and ½ of protein
requirements in school
 Applied nutrition programme with the assistance of UNICEF
advocates developing school gardens
 Measures should be taken to combat nutritional deficiencies
by providing specific nutrients.

15. First aid & emergency care.
 Teachers should be trained during teacher’s
training programme or “in service” training programme.
 First aid box should be made available.
Mental health
 The teachers should help children in attaining
a positive mental health among the learners.
 Suitably modify learning strategies, incentives.- rest, relaxation
between periods of intense work
 Instituting vocational counsellors and psychologists in schools to
guide children into their careers.

16. Dental health
 Dental hygienist & dentist are to be employed.
 Provision for dental examination, at least once
a year should be made
 During the dental check up should focus on prophylactic
cleansing & dental hygiene.
Eye health services
 Teachers to be trained to detect…
 reflective errors
 squints and ambylopia
 eye infections….
…….and refer the child for treatment
 Vit A administration should be done in the schools.

17. Health education
 This should aim at imparting desirable changes among
students it includes…
 Personal hygiene
 Care of skin, hair, teeth nails…etc
 Attention regarding posture
 Environmental health
 Encourage to part in health activities
 Visits to community health programmes and participation
in community action programmes
 Family life
 Education regarding reproductive life should be provided
from the very beginning

18. Education of handicapped children
 Ultimate goal is to assist the special child
and his family to…
 Achive maximum potential
 To lead a normal life
 To become as independent as possible
 To become a productive and self- supporting member of society
 This is done in a coordinated manner
School health records.
 Cumulative health records providing pertinent information
health supervision tool
 Also serves as tools to evaluate the school health services.

19. School health administration
 School health in India is under the Department of Health and Education
 School health committee (1961) recommended school health services to
be integral part of general health services
 As general health services is represented by primary health centres,
SHS is essentially an important function of PHC
Primary health centres
 Requires a full-time medical officer to cover 5000-6000 children in a
year
School health committee(1961)
 Recommends formation of SHCs at village, state and national level to
mobilize community resources and make SHP sustainable
 National school health council will be an advisory and coordinating body

20. Thank you
for taking
care….