School Health

Programmes

Priscilla Ngunju
Introduction
•School health focuses on ensuring
health promotion, conservation,
protection and correction of
abnormalities of the school
population.
•A school health approach is
advocated in the provision of health
services as school children are easy
to reach, they also disseminate
health messages to the larger
population.
Objectives
• Describe how to organise a school
health programme
• State the objectives of a school health
programme
• Explain how to plan and implement
school health services
• State the activities undertaken
during a school
health service
• Evaluate school health programmes
 Organisation of School
Health Programmes
• To organise a practical school health
programme you need to involve the rest of
the health team members, the school
administration and the community.
Members of school health team:
• Teachers
• Pupils and students
• Parents
• Community formal and informal leaders
• Community health nurse
Organization involves
•Assess the problems of school
children
•Establish practical goals for
the school population
•Carry out the needed activities
•Evaluate the process and
results of the programs
Needs of the school child
• A Stable Home: The home should provide
basic needs especially shelter and security.
• Proper Nutrition: The child needs to grow
well physically and mentally. It is therefore
important for the child to take adequate
nutrition at least three times a day.
• Freedom from Fatigue: The child needs to
have enough rest at home from school
activities.
Needs of the school child
• Clothing: This is normally provided as
school uniform, which should be clean
and tidy.
• Good Sight, Hearing and Speech:
Defects of sight, hearing and speech
interfere with the learning process of a
child
• Freedom from Infection: All school
children should be immunised against
childhood diseases.
Needs of the school child
• Pure and Safe Water: This should be
provided in the school and at home to
prevent water related diseases.
• Clean Buildings: The home and school
environment should be kept clean.
Objectives of School Health
• Promoting and maintaining the
health of the school children.
• Promoting positive health
behaviour among staff and
students.
• Bringing up citizens who understand
basic good health habits.
• Ensuring general community health
by using the child as a channel for
health messages to the family.
Objectives of school health
• Improving the physical and social
environment of the school.
• Providing the following aspects of
prevention of disease; Primary
prevention, for example eating diets rich
in vitamins A and C, iron and protein;
Secondary prevention, that is, early
diagnosis and treatment; Tertiary
prevention which includes rehabilitation.
Activities undertaken to
achieve the objectives
• Carrying out observation, screening,
physical examination and
epidemiological investigations.
• Rendering emergency services and care
of a continuing illness.
• Counselling or arranging for counselling
of pupils, teachers and other persons in
the school population. Rwanda case
• Involving parents, pupils and teachers
in planning and conducting health care
activities.
Activities undertaken to
achieve the objectives
• Contributing to the development of a
curriculum in health related
matters, through clubs such as,
biology, mathematics.
• Consultation with teachers and
other personnel.
• Referral for specialised/continued
care.
Planning and Implementation
of School Health Services
1. Assessing Health Needs: by conducting a
survey. School health needs are sourced from;
•The Clinic Records :Clinic records from the
health care facility near the school.
•Reports: Previous reports on school health
services at the health centre and at the district
level.
•Health Team Workers: You can hold
discussions with the health care teams in your
catchment area, to find out health problems of
school children and their possible solutions.
Planning and Implementation
of School Health Services
• Teachers, Students & Parents:
Discussions with teachers, students and
parents will yield useful information about
their problems, and will also give you a
chance to explain the importance of
school health services.
• Personal Observations and
Experiences: You can gather a lot of
information merely by observing and
listening to people
Planning and Implementation
of School Health Services
• Formal and Informal Leaders: Village
leaders usually have a repotoire about the
most disturbing health care problems,
and can assist you to plan school health
services.
Planning and Implementation
of School Health Services
2. Discuss your findings, and plan your
programme with stakeholders from the
Ministry of Health.
•These include the:
•County medical officers of health
•County public health nurse
•Transport officers
•County health administrative officer
•County health education officer
•County public health officer
•County medical records officer
Resources Required for School
Health Programmes
• Money: Funding for school health
programmes mainly is the responsibility
of the government. Stakeholders also
give financial support to the government
through procurement of equipment, drugs
and supplies, vehicles, training of
personnel, supporting advocacy,
meetings and development of policies,
guidelines and standards.
Resources Required for School
Health Programmes
• Manpower : Personnel from the
ministry of health and education need
to be trained on relevant issues for the
implementation process. More human
resources can also be sourced from the
community by training the community
leaders, and the communities own
resource personnel to ensure support
and sustainability of the programme
Resources Required for School
Health Programmes
• Materials: Policies, guidelines and
training materials, drugs, vaccines,
supplies and transport.
• Time: Time is required for the planning,
implementing and evaluating.
The time for the programmes should not
interfere with school activities, and
should be convenient for both the
implementers and the beneficiaries. There
should be sufficient time for the
implementation process.
Pupil Awareness and
Participation
• Children should participate in health policy
development and implementation efforts, to
create a safer and more sanitary environment.
• Health promotion aimed at their parents, other
children, community members is taught during
school health services. Children in turn
disseminate. This is an effective way to help
young people and the community acquire the
knowledge, attitudes, values and skills needed
to adopt healthy lifestyles, and to support
health and education for all.
Implementing School Health
Services
• You should start by preparing a work
plan together with members of your
health facility team. Make sure you allow
enough time, depending on the number of
schools to be covered and their health
needs.
• You should also organise the resources
you will need to perform the tasks at
hand, so that you and your team can be
punctual on the day of the service.
Implementing School Health
Services
•Since some of the resources at
your disposal will be teachers,
pupils and community leaders,
remember to promote teamwork
during implementation.
•Their morale and enthusiasm
should be kept high as they
participate.
Activities Carried out During
School Health Services
• Physical Examination
Head
Tinea capitis(ring worms), hair colour,
texture, cleanliness and lice.
• Eyes
• Visual acuity.
• Colour of conjunctiva.
• Discharge.
1. Physical Examination
• Nose: nasal discharge, deviated septum and polyps.
• Ear: Ear discharge or pain, tinnitus and impacted wax.
• Mouth: Cleanliness or oral hygiene, smooth
appearance, swollen beefy red sores and atrophic
papillae.
• Teeth and Gums: Dental cavities, malpositioned,
molted appearance (fluorosis), bleeding and cleanliness
• Neck :Enlarged cervical glands, distended jugular
veins and enlarged thyroid gland.
• Arms: Absence or presence of B.C.G scar.
Weak and tender or swollen arms and presence of
oedema.
• Hands: Cleanliness.
Physical Examination
• Nails: If short and clean. Colour: Pallor indicates signs of
anaemia.
Shape: Spoon shape indicates iron deficiency anaemia.
• Skin
Rashes, cuts, scabies, lack of fat under the skin. Rough
and dry swollen.
• Body
Tinea corporis, cleanliness and signs of malnutrition.
• Legs
Orthopaedic problems, jiggers, injuries, deformities,
bowed and knock knees.
• Clothing
Cleanliness.
• Height and Weight
Screening the children for height and weight to assess
their development.
2. Referral Services
•This service is given to children
who have ailments needing care
outside the school. They are
referred to the nearest health
facility or hospital, depending on
the nature of illness and if it
requires to be seen by a specialist.
3. Inspection of the School
Environment
•Since the children spend a
lot of the time in school, it is
important to ensure that
their environment is safe and
clean.
4. Location of the School

•Surroundings should be
clean, free from noise
pollution, away from
industrial and other waste or
swampy area.
5. Sanitation
•The school should have a good
water supply, clean and enough
latrines, and solid waste
disposal systems. There should
be separate toilets for female
and male students. The
environment should be clean
and well maintained.
6. Playground

•It should be dry with no

potholes or stones to prevent
accidents.
7. Classroom
• This should be clean, well ventilated with
adequate lighting. It should not be
overcrowded and the students should be
able to hear the teacher and see the black
board from where they sit.
8. Furniture
•The seats should be simple
and not attached to each
other so that the pupils can
move them.
9. Promotion of Proper
Nutrition
• This consists of the importance of eating a
balanced diet and good feeding habits, if
there is a feeding programme observe the
following:
• Methods of cooking and storage of food
• Personal hygiene of food handlers and
children
• Cleanliness of the utensils
• Cleanliness of the kitchen
• Screening of the food handlers
10. Sharing Health Messages
• You should identify and plan to share the
appropriate health messages with the
school population. The health messages
shared should include, prevention of
common health problems, such as,
sexually transmitted infections, HIV/AIDS,
skin conditions amongst others.
11. Promotion of Personal
Hygiene
• This is done by advising the children to do
the following:
• Taking a daily bath
• Brushing teeth after meals
• Washing of hands before eating and
after visiting the toilet
• Keeping the hair and nails short and
clean
• Wearing clean clothes
12. Record Keeping
• It is important to record every health activity
that you undertake.
This applies to school health service activities.
These records are used for evaluation.
The records should reflect:
• The no. of schools covered.
• The no. of pupils treated and types of
ailments
• The number of pupils referred
• Activities carried out
• Health messages shared
• Information on the environmental health
• Effectiveness of the school health services
Evaluating School Health
Services
• You should also ask yourselves the
following questions:
• Did you follow the work plan?
• Were the services geared towards meeting
the priority health needs?
• Did you carry out all the necessary
activities during the school health
services?
• How effective were the services you
provided?
steps to evaluate school
health services.
• Gathering Information: This is done using
the same sources that you used earlier during
planning.
• Analysing Information
Compare the work actually done with what
you had indicated in your work plan. E.g.
▫ How many schools were included in your plan
and how many actually received the services?
▫ What is causing the difference between
planned activities and the actual work done?
steps to evaluate school
health services.
• Identify Areas Needing
Improvements: You can gather this
information from your analysis once you
identify the type or nature of
improvement needed, you will then need
to decide your course of action. It might
be that you will need to change the roles
and activities of the team.
• Take Corrective Action: Make a list of
things that should be done and then go
ahead and do them.
OCCUPATIONAL HEALTH
SERVICES
Occupational Health Services
• Objectives
• Describe occupational health
• Describe the aims and objectives of
occupational health services
• Describe occupational health hazards and

their management
• Describe the function, duties and role of
an occupational health nurse
Definition of occupational
health
•Occupational health is the
physical, mental and social
well being of a person in
relation to their work and
working environment, as well
as their adjustment to work and
the adjustment of work to them.
why workers require special
health services.
• At work, people often come together in
large numbers that can be conveniently
cared for at a single service point.
• At work, healthy people can be exposed
to health risks.
• Illness among workers creates a loss
to both individual and national
productivity. Thus every effort should be
made to decrease the chances of workers
becoming sick.
Occupational health is also
concerned with:
• The effect that work may have on
health that is in causing injury or disease
• The effect that injury or disease may
have on ability to work
• The effect of hazardous industrial
fumes or toxic wastes to the
environment (which pollute the air,
sewers and rivers).
Effect of Work on People’s
Health
• Physical Injuries: The use of new tools and
machines, for example, a wood maker may lose a
finger in a circular saw if not well trained. There is
a risk of health problems from fumes, dust, noise
and extreme temperatures.
• Chemical Injuries: Risk of poisoning from
chemicals, for example pesticides. Naivasha
flower farms
• Diseases: Infections, for example, anthrax due to
poor handling of animals or animal products.
Other diseases like cancer may result from
exposure to toxic substances.
• Emotional Injuries: Stress related effects from
work environment or people. tight deadlines,
tough bosses
• Work can have both negative and positive effects
on people’s health.
Actors involved in occupational
health
•The health team
•Employers
•The employees
•The community’s formal and
informal leaders
Aims of Occupational Health
Services
• The promotion and maintenance of the
highest degree of physical, mental and
social health in all occupations.
• The protection of workers in their
employment, from any risk factors
adverse to health.
• The placing and maintenance of the
worker in an occupational environment
adapted to their
physiological equipment.
Preventative measures in
Occupational Health Services
•Primary Prevention
•Secondary Prevention
•Tertiary Prevention
Primary Prevention
• Promotion of good occupational health
involves the following:
▫ Good construction of machines and
buildings.
▫ Training of the workforce on how to work
with machines.
▫ Proper utilisation of protective, safety
equipment and clothing.
▫ Good personal hygiene and health.
▫ Adequate rest when working with
machines.
Primary Prevention
• preventing and dealing with the following:
• Wounds and cuts caused by machines and
tools.
• People falling over equipment or equipment
falling on people.
• The effect of a toxic substance entering the
body through inhalation, skin or eye
contact.
• Increased risk of any of the above because
of the employee’s own poor personal habits,
attitudes or physical condition.
Examinations
• Types:
• Pre-placement examinations : This is the
medical examination that is done before a
person is employed.
• Routine medical examinations are one of
the essential cornerstones of occupational
health services.
Objectives of Pre-placement
Examination
• Determine suitability for a
particular job.
• Detect untreated pathological
conditions and 'asymptomatic'
disease.
• Provide a baseline record against
which any future findings or routine
examinations can be compared
Benefits of pre-placement
examination
• The results enable the occupational
health worker to advise the personnel
department on the suitability of the
applicant for the particular job.
• The applicant also benefits in the sense
that the examination could discover a
medical condition they were not aware
about and be able to seek early treatment
for it. In addition, a well run pre-
placement examination programme may
help to reduce a high labour turnover,
absenteeism, injury and illness thus
increasing productivity.
Secondary Prevention
This objective concentrates on three types
of screening:
•Screening of employees at risk of a
particular hazard.
•Regular screening for non occupational
illness during employment.
•Screening of the working environment
to check that recommended preventive
measures are put in place by employers, to
be used by employees.
Secondary Prevention

• Once an employee has been recruited, it

is the responsibility of the enterprise or
organisation to maintain a persons health
through two separate but complementary
methods. These are:
• Maintaining a safe and healthy
environment. if necessary, through
sampling and measuring exposure to
physical or chemical agents.
• Periodic medical examinations
Periodic Medical Examination

• This is an effective method which enables

the occupational health worker to stay
informed about the health of
individuals and groups, and at the same
time detect adverse trends which may be
caused by work. Periodic physical
examinations are essential in the early
detection of intoxications and other
effects of occupational hazards, for early
management.
Tertiary Prevention

•Tertiary prevention includes

the whole spectrum of
healthcare from first-aid to
treatment and rehabilitation.
Occupational Hazards
.
• An occupational hazard is any condition of
a job that can result in illness or
injury, a source of danger, a possibility of
incurring a loss or misfortune.
• Physical Hazards give examples
• Chemical Hazards
• Mechanical Hazards
• Biological Hazards
• Psychosocial Hazards
 Common Methods of
Dealing with Hazards
1. Remove the Hazard or Toxic
Substance from the Work Place
2. Reducing Exposure to the Hazard
3. General Ventilation
4. General Cleanliness
5. Personal Hygiene
6. Protective and Safety Equipment
 Functions of an
Occupational Health
Nurse and psychological
• Physical
assessment of workers to facilitate
proper selection and placement
• Prevention of occupational and non
occupational illness
• Provisions of treatment
• Fostering a high level of well being of the
workers
 Responsibilities of an
Occupational Health
Nurse
• Participating in the health assessment
program that is, both pre-placement and
routine medical examination of workers.
• Keeping a continuous watch on working
conditions, equipment and materials for
safety precautions and possible dangers.
Counselling workers regarding personal and
family health problem.
• Cooperating with management in the
application, enforcement and training on
the use of protective measures.
• Giving advice on environmental sanitation
and safety education activities.
 Responsibilities of an
Occupational Health
Nurse
• Carrying out nursing administrative
duties, which assure the efficient
management of the occupation health
services.
• Maintaining records on which to base
surveillance, prevention and control of
occupational illness or accidents.
• Evaluating health programme and
activities.