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School health

School health. Definition School health program has been defined as the school health procedures that contribute to improvement an maintenance of health status of the pupils and school personnel. . Public health significance: 1- School children are the future productive group

courtney-macdonald
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School health

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  1. School health

  2. Definition School health program has been defined as the school health procedures that contribute to improvement an maintenance of health status of the pupils and school personnel. 

  3. Public health significance: 1- School children are the future productive group of population. 2- They represent from one third to one half of the total population. 3- They represent a vulnerable group where they undergo physical, mental, and social growth and development. 4- They spend more than half of their day time at the school where they may exposed to many health hazards. 

  4. Program applicability The target population can be easily reached and the risk factors to which they may be exposed can be detected, so preventive measures can be applied. Basic component of the program 1- School health services. 2- Health education. 3- Healthful school environment

  5. School health services School Health Services are provided as part of the School Health Program to appraise, protect, and promote the health status of students. Importance of services The program is designed to • encourage parental awareness of students‘ health status. • discover and prevent health problems. • School Health Services supplement, rather than replace, parental responsibility to student health. • encourage utilization of physicians, dentists, and community health services

  6. Comprehensive medical examination School children should be at least examined four times during their school years: 1- At the first primary school entry. 2- at the mid-primary period. 3- at the preparatory school entry. 4- at the secondary school entry

  7. Screening tests • Screening tests has been defined as the presumptive identification of unrecognized disease or health condition (not yet under medical care) by application of simple tests or other procedures to sort out apparently well person who probably have the disease from those who probably do not. • Screening can be concerned with many diseases and called multiphase screening

  8. Items of screening 1- Growth and development. 2- Visual acuity. 3- Hearing acuity. 4- Dental examination. 5- Intelligence quotient. 6- Simple laboratory tests; urine, stool and blood analysis.  Screening tests most commonly done by teachers, nurses or any qualified person.

  9. Health record School • Every child should have his or her own health record for registration of all events and activities concerning health. • The record has to start at birth or later in preschool age and goes with the pupils throughout his education and future life  Content of the record 1- Personal data 2- Results of medical examination. 3- Immunization given. 4- Any disease, injuries, hospitalization.  Value of the record 1- Health reference for diagnosis and follow up of chronic diseases. 2- Source for statistical data and indices. 

  10. Preventive aspectincludes two phases: 1- Prevention and control of communicable diseases. 2- Prevention of accidents. 

  11. Prevention and control of communicable diseases 1- Sanitation of school environment. 2- Health education for healthy behavior of the pupils, school personnel, and parents. 3- Immunization of school children. 4- Periodic physical examination and daily supervision of the pupils. 5- Measures for school personnel including pre-employment, periodic examination, health education and laboratory tests. 6- Improvement of the nutritional status of the pupils through school feeding program. 

  12. Prevention of accidents An injury is the physical damage to a person that occurs as a result of exposure to physical or chemical agents at rates greater than the body can tolerate. First aid • At the school, the first aid is the first assistance given to the injured child and aimed at reducing suffering from pain and prevention of further harm before the child is in charge of a physician. • The requirements for first aid include; rest room, adequate blankets, wash basin, soap, towels, table, splints, gauze and cotton. Also the important phone department and a method of transportation should be available 

  13. School Health Support Services The goals: • To facilitate the integration of students with special needs into the regular school system and the community. • To provide health-related education, teaching and consultation services to school staff and parents in the school setting. Items: • NURSING • Physiotherapy  • Speech Therapy • Nutritional Counseling • Information and Referral Services • Coordination of Services  

  14. Health education Health education is defined as the process of teaching the public the basic knowledge of health. Any combination of learning opportunities designed to facilitate voluntary change in behavior that are conductive to health is defined as health education.

  15. Objectives of health education 1- To create a state of health consciousness among the children and their parents. 2- To change bad health habits. 3- To motivate the children, their parents and school personnel to acquire healthy behavior.   Content of health educationis determined by: 1- Physical, emotional and intellectual needs of the children. 2- Teacher observation and results of medical examination. 3- Public health needs 

  16. Healthful school day 1- Educational aspect. 2- Schedule of the day. 3- Emotional climate. 4- Mental health. 5- Food services Hazards of unsanitary school environment 1-Favour spread of respiratory infection. 2-Children suffer manifestation of ill ventilation. 3-Eye troubles due to inadequate light. 4- Skeletal deformities due to faulty postural habits and inconvenient desks and seats.

  17. School health problems 1- Deficiency diseases. 2- Infectious diseases. 3- Parasitic diseases. 4- Accidents. 5- Handicapping Deficiency diseases 1- Iron deficiency anemia. 2- Protein deficiency. 3- Dental caries. 4- Vitamin A deficiency. 5- Healed rickets.  Predisposing factors: 1- Inadequate nutrition. 2- Nutritional ignorance. 3- Low income. 4- Parasitic infections 

  18. Prevention of deficiency diseases 1-School feeding program which is expected to provide about 50% of recommended dietary requirements. 2- Nutrition education of the children and their parents. 3- Dietary supplementation. 4- Prevention and control of parasitic diseases. 5- Health appraisal for early detection and management of deficiency diseases. 

  19. Infectious diseases Predisposing factors: 1- Unsanitary school environment, Over-crowded classrooms, unsanitary drinking taps, deficient food and milk sanitation. 2- Faulty health habits of young children. 3- More susceptibility to infection by young age, malnutrition and poor housing. 4- Presence of unapparent source of infection which may be a child or school personnel. Parasitic diseases Predisposing factors: 1- Unsanitary environment. 2- Bad health behavior. 3- Deficient health services.  Prevention: 1- Environmental sanitation. 2- Health education. 3- Case finding through stool and urine analysis. 

  20. Evaluation of school health program An evaluation is a systematic way of learning from experience so as improve current activities and promote further learning. Simply an evaluation is a comparison of an object of interest with standard of acceptability. Objectives: 1- To collect information needed for planning. 2- To guide uses of resources. 3- To improve health services Methods of evaluation 1- Coverage / utilization 2- Administrative scheme of the work 3- Efficiency 4- Effectiveness 5- Impact 

  21. School health at the level of the whole Palestine: • The project  began  by promotion  of school  health bilaterally from ministry of health (MOH) and ministry of education with the help of UNICEF. • The project tried to promote and develop the childhood in the West Bank and Gaza with comprehensive project to cover the school health through help of M.O.H in planning, control and evaluation of preventive examination for the First class of governmental school.  From the achievements that have been done to apply this program in the year 2005 for school health is to Unify: • The examination for the first year class children in all schools • Introduce the examination of eyes for 7th and 10th classes • Introducing the health of mouth and tooth in the activity of school Health. • Increase the level of cooperation between M.O.H, UNRWA and non governmental organizations. 

  22. At the level of M.O.H (ministry of health): • Complete the medical examination (preventive and ophthalmic) in 230 School and preschool in Gaza and in West bank.  • The preventive examination was done for the first class and preschools, • eye examinations was done for 7th and 10th class added to the 1st class, • The number of those who benefit from these examinations was (22123) male & female (Males 11030, Female 11093)  Another project done by Palestine Medical Relief. • This project is a unique type which share in Administration of Preventive Medical School Health in Palestine. • The total number of schools in which the work done with them during in the year 2007 were 427 schools and 134 preschools. • The total number who benefit from this program were 104136 M & F students

  23. The program achievements: 1- Complete training of more than 100 teachers M & F 2- Arrangement of exhibition of school health in all schools. 3- Complete supply of centers of school health by equipment and materials needed.

  24. There is also social association called Health Work Committees; This union introduces the program of school health in Jerusalem. It covers 47 schools by: • Total medical examination • Cultural education about health in the year 2008. • It also offers the national common vaccination in 60 schools in Jerusalem, and it includes (25910) Students 14.725 are females and 11.195 are males. • And they have role in 2007 to offer school health in Jerusalem. The number of schools benefit from total medical examination were (34) schools, with 1819 students male and female. 

  25. The cases were discovered: 1- 152 cases weakness in looking. 2- 21 cases have heart problems. 3- 6 cases of undescended tests 4- 5 cases of Hernia All were referred to medical centers.  Also they examined teeth and mouth for 1st, 4th, 7th and 10th classes with total of 5589 students 2247 M, 2342 F.  The level of teeth defects for students reached to 7,5% .

  26. UNRWA School health New entrants' medical examination • During the 2006-2007 school year, a total of 49,682 new entrants were registered in UNRWA schools of whom 24,157 were girls and 23,691 were boys. Each new student was immunized, and received a thorough medical examination and follow-up from UNRWA Health staff.

  27. The main morbidity conditions detected among new students were: • Oral health problems, mainly dental caries in 47.1%, gingivitis in 3.8%, and 96 students with flourosis reported from Gaza. • Vision defects in 5.8%, Bronchial asthma in 1.8%, • Hernia in 1.2%, Squint in 1.1%, • Hearing impairment in 1%, Chronic otitis media in 0.8%, • Un-descended testicles in 0.9%, Heart disease in 0.7%, • Thyroid enlargement in 0.6%, • Congenital mals in 0.4%, Hemolytic anaemia in 0.7%, • Arthritis in 0.3%, Physical disabilities in 0.2%, • Type I Diabetes in 17 children.   Epilepsy in 0.2%, • Health problems related to personal hygiene were prevalent among school children with pediculosis reported among 2.5% and scabies in 0.5% of new entrants. 

  28. As part of the UNRWA school health service, children with disabilities were assisted with the provision of eyeglasses, hearing aids and other prosthetic devices according to their conditions and available resources. • In the absence of a well established Agency-wide mechanism for hearing screening, it was not possible to assess the prevalence of hearing impairment; however after the purchase of audiometers and the implementation of a multiphase hearing screening programme, there was a substantial increase in detected cases of hearing impairment during 2007, with a total of 482 casesdetected compared to 206 cases in 2006. 

  29. Screening • UNRWA screening activities in 2007 targeted pupils in the fourth and seventh grades in all Fields, and involved testing of vision, hearing and thyroid enlargement as well as checking for oral health problems. Of the 54,111 students enrolled in the seventh grade, 47,924 were screened with a coverage rate of 88.4% compared to 97.4% in 2006. • The main reason for this decline was the screening activities in the Jordan Field, where screening was not completed in the South Amman Area. The main morbidity conditions detected were vision defects in 14.1% and hearing impairment in 0.87%.

  30. Of the 53,891 students enrolled in the fourth grade, 50,250 were screened with a coverage rate of 93.3%. The main morbidity conditions detected were vision defects in 11.2% and hearing impairments in 0.85%. • These screening activities including the purchase of the audiometers and provision of hearing aids were generously funded by the European Union. • During 2007, Health Tutors also received training on first phase screening and life support skills, and vision charts were provided to all UNRWA schools. 

  31. Immunization During the 2006-2007 school year, school children were immunized according to the immunization schedules as follows: • New entrants received a booster dose of DT/Td immunization, and coverage Agency-wide was 98.5% (100.0% in Lebanon and Syria, 99% in the West Bank, 98.8% in Jordan and 97% in Gaza). The coverage rates of OPV for new entrants were 99.8% in Gaza, 99.1% in Jordan and 96% in the West Bank.

  32. Sixth grade females in the West Bank and Gaza received the Rubella vaccine, and the coverage rates were 99.1% and 97% respectively. • Of note is the overall coverage rate of Td vaccination among ninth grade school children in the five Fields which was 98.7%. 

  33. De-worming programme In order to improve the health status of school children, UNRWA, in accordance with WHO recommendations, made arrangements for the implementation of a de-worming programme for school children enrolled in UNRWA schools in all Fields. • This programme of de-worming used a single dose of an effective wide-spectrum anti-helminthic for three successive years. During the 2004-2005 school year, all Fields completed the three year campaign with a high response rate (approximately 96% of students took the tablets).

  34. Since 2006, only new entrants have received the medications for three successive years, and during the 2006-2007 school year the de-worming programme targeted school children in first, second and third elementary classes with much success. The coverage reached in these grades in 2007 was 98%. • In addition to the distribution of de-worming medicine, a health awareness campaign was implemented to educate students on the importance of personal hygiene. 

  35. Vitamin A supplementation • During the 2006-2007 school year, two doses of 200,000 International Units (IU) of Vitamin A supplementation six months apart were given to school children from grade one to grade six in all UNRWA schools, and high coverage was achieved.

  36. Health educational materials • The self-learning material on prevention of HIV/AIDS and tobacco use, were revised, reproduced and distributed to preparatory school children and adolescents in the vocational and teacher training centres. • Approximately 75,000 copies of the booklet “Facts about tobacco” and 51,500 copies of the booklet “Facts about AIDS” where reproduced during 2006 and distributed to students during the 2006-2007 school year. 

  37. School health activities by Field Gaza • Training on first phase screening for vision and hearing was completed by teaching staff in 180 schools. • In coordination with Medecins Sans Frontieres (France) five training workshops on first aid and life support were conducted with 100 preparatory students so they could become trainers of trainers in their schools. • Vision charts for first phase screening of vision impairments were distributed to all schools in coordination with the UNRWA Education Department. • Emergency packages (portable first aids kits) which contained about 40 items were distributed to all schools in coordination with the UNRWA Education Department and Medecins Sans Frontieres. • In coordination with Medecins Sans Frontieres, UNRWA teaching staffs were trained on emergency and crisis management. 

  38. West Bank • A new national strategy on Child Growth Monitoring and Nutritional Status among school children has been developed, and 60 weighing scales and 60 stadiometers in addition to printed forms for schools were received in 2007 from the Palestinian Authority in preparation for the implementation of the strategy. • In coordination with Saint Jones Hospital, 10 training workshops on vision screening were conducted for school Health Tutors at all UNRWA schools together with school health teams. • Schools participated in a number of World Health Days including World Smoking Day, World Diabetes Day, World Aids Day, and Infants and Children Days. • Posters and Flip Charts on Adolescence, Personal Hygiene, Menstruation and Early Marriage were distributed to health centres and education departments to be used by the Health Tutors at schools.

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