PSM Made Easy

School Health Program

School Health Program

  • MoHFW, GOI launched ‘School Health Scheme’ in 1996-97 but that remained mostly a token service until recently
  • Under National Rural Health Mission, fresh impetus was given to strengthen school health service in 2008
  • School Health program is a program for school health service under National Rural Health Mission as a part of RCH program
  • With the vision of:
  1. ‘Decentralizing’ the school health through
  • Program management at the level of State
    • States have been given the power to implement the program utilizing their:
  • Experience
  • Indigenous innovations
  • Public private partnerships
  • NGO’s
  1. Convergence of health related sectors like education, drinking water, sanitation and nutrition at the grass root level
  2. All the schools in each state, rural or urban will be covered in a phased manner
  • The programme at the national level has been developed
    • to provide uniformity and guidance to States who are already implementing or plan to implement their own versions of programme and
    • to give guidance in developing a strategy for starting the school health programme to States who have not yet started their programme
  • So that important components are not missed
  • Optimum efficiency can be achieved
  • The decentralized framework of implementation under NRHM has enabled various states to devise and implement their own version of School Health Programme.
  • A detailed study of the programs being implemented in various States was undertaken.
  • After analyzing the strengths and weaknesses of the programs in various States, broad guidelines for the school health programme were developed.
  • These guidelines are used to suggest various states with planning and implementation of the program
  • The States are to report the status, performance and experience of the program
  • MoHFW analyzes these reports and adapt the guidelines and suggest strategies to the States for further strengthening the program
  • Components of School Health Program:
  1. Health service provision
  • Screening, health care and referral:
    • Screening of
  • general health,
  • assessment of Anemia/Nutritional status,
  • visual acuity,
  • hearing problems,
  • dental checkup,
  • common skin conditions,
  • Heart defects,
  • physical disabilities,
  • learning disorders,
  • Behavior problems, etc.
    • Basic medicine kit will be provided to take care of common ailments
    • Referral Cards for priority services at District / Sub-District hospitals.
  1. Immunisation:
  • As per national schedule
  • Tetanus Toxoid at 10 and 16 yrs. of age
    • Fixed day activity
    • Coupled with education about the issue
    • Micronutrient (Vitamin A & IFA) management:
    • Weekly supervised distribution of Iron-Folate tablets coupled with education about the issue
    • Administration of Vitamin-A in needy cases.
    • De-worming
    • As per national guidelines
    • Biannually supervised schedule
    • Prior IEC
    • Siblings of students also to be covered
    • Mid-day meal
  1. Health Promoting Schools
    (Physically and Psychologically Safe and Supportive Environment)
  • Safe drinking water
    • Adequate sanitation:
  • Separate toilets for girls and boys
  • privacy and safety to girls
  • Provision of sanitary pads to girls
    • Keeping schools free of violence and any discretions
  • No corporal punishment
    • Counselling services
    • Regular practice of Yoga, Physical education, health education
    • First Aid room/corners or clinics
  1. School Based Nutrition Services
  • Mid-day meals
  1. Health, Hygiene and Nutrition Education
  • Adolescent health education-existing in few places
    • Linkages with the out of school children
    • Health clubs, Health cabinets
    • Peer leaders as health educators

Capacity building

  • Nodal teachers to identified by the principal
  • One nodal teacher per 250 students
  • at least one nodal teacher per school
    • Training is to be organized for them
    • Refresher trainings at regular intervals

Monitoring & Evaluation

  • Formation of Core Management Groups at levels of
  • State
  • District
  • Block and
  • Village level
    • Members include representatives from
  • Dept. of Health
  • Dept. of Education
  • Dept. of Women and Child Development
  • Principals and teachers
  • Parents’ representative
  • Students’ representative
    • NRHM mission director to oversee at District and State level
    • VHSC at the village level to oversee
  • Strategy Suggested for the Programme

Various options of implementation have been suggested under the programme (based on the on-going school health programmes in various States)

  1. OPTION-1: main suggested strategy
  • it is proposed that ANM may be spared once a week for school health only if she has either MPW(male) or second ANM to support her at the health sub Centre.
  • The Multi-Purpose Worker(male) will be more appropriate for exclusive boys’ senior basic schools
  1. OPTION-2: Existing ANM/MPW visits on a fixed day for screening, treatment of minor ailments and referral and a Doctor visits 1 school per week
  • A Doctor from Block CHC/any PHC will visit one school per week to cover 32 schools per annum.
    • The selection of school will be based on the screening reports submitted by ANMs.
  1. OPTION-3: Two ANMs/MPWs/GNMs/PHNs/JPHNs are engaged per Block on contractual basis (@Rs.5000/month)
  • State Program Implementation – Delhi (2008)
  • Target group: Students from primary classes from all government schools
  • Number of target students will be calculated from the information given by the Directorate of Education
  • Nodal teachers are being identified and their training being planned and organized
    • One teacher per 250 students
    • Training booklets has been prepared and circulated
  • Students are screened by medical and paramedical personnel assisted by the trained teachers
    • A school wise schedule of visits is drawn up
    • The dates are intimated to panchayats, school health authorities, students and parents in advance
  • Mass deworming with single dose Albendazole undertaken
  • The ‘Core Management Group’ comprises of
    • Panchayat
    • Officers of health and education departments
    • School authorities
  • Referral:
    • A list of referral centers drawn up and linkages established
    • Children carrying referral slips are given top priority at the referred health facility
  • Format for record keeping has been developed for use by the teacher
  • The Municipal Corporation of Delhi (MCD) implements and monitors the program in Delhi
  • In addition, CNSY is being implemented in Delhi since 2011, by the GNCTD, for all govt. schools up to class XII
  • Other agencies also provide school health services in Delhi like
    • NGO’s
    • Some hospitals etc.

for lecture on School Health Program: School Health Program
School Health Services in Delhi: School Health Service in Delhi
for lecture on school health services: School Health Service

references