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School Health Service in Delhi

ORGANIZATIONAL SETUP
Ministry of Health and Family Welfare, Govt. of Delhi ---> Department of Health &Family Welfare, Delhi Secretariat I.P.Estate, New Delhi ------> Directorate of Health Services, F-17 Karkardooma, Delhi --------> Additional Director, School Health Scheme Delhi Govt. Dispensary Building Complex, Karkardooma, Delhi-92

CHACHA NEHRU SEHAT YOJNA (CNSY)

Chacha Nehru Sehat Yojna was announced by Hon’ble Chief Minister of Delhi, in her budget speech on 22nd March 2011. This landmark scheme was launched on 19th November 2011, to provide free and comprehensive health services to all school aged children in the National Capital Territory of Delhi.
Chacha Nehru Sehat Yojna programme (Department of Health and Family Welfare) is functional in co-ordination with department of education and private hospitals.

Under CNSY , School Health Clinics are providing comprehensive health care to 18 lakhs students enrolled in
• Government and
• Government Aided Schools in Delhi Government

OBJECTIVES OF CHACHA NEHRU SEHAT YOJNA (CNSY)

1. Ascertaining health status of children studying in Govt. schools till XII class
2. Screening for deficiencies, diseases and disabilities.
3. Counselling & treating wherever deficiencies and diseases are detected.
4. Referral wherever required to CNSY district FRU/tertiary hospitals.
5. Facilitating continuum of health care by creating data base.
6. Synergizing with relevant programmes of Education Deptt. (Yuva) & Health Deptt. (blindness control, deafness control & AIDS programme)

ASPECTS OF SCHOOL HEALTH SERVICES BEING COVERED UNDER CNSY (SHS)

In CNSY there are 11 Districts and each district is headed by a District In-charge.
In each district there are clusters of Delhi Govt./ Aided schools comprising of 10,000 to 12,000 school students.
Each cluster is catered by one CNSY team and the services provided to the students include:

Screening for diseases, deficiencies & disabilities, free treatment and Referral

• Screening of General Health, Anaemia/Nutritional status, Visual acuity, Hearing problems, Dental check-up, common skin conditions, Heart defects, Physical disabilities, Learning disorders, behaviour problems etc.
• Basic medicines are provided to the CNSY teams to take care of common ailments prevalent among school going children.
• Referral to CNSY Special Referral Clinics and District hospitals/ Tertiary Hospitals

Immunization

• As per national Immunization schedule Inj. Tetanus Toxoid at age 10 yrs & 16 yrs.
• Fixed day activity coupled with education about the issues like pulse polio

Nutrition

• Micronutrient(IFA & vit.-A) supplementation
• Weekly supervised distribution of Iron-Folate tablets coupled with education about the issue.
• Administration of Vitamin-A (need based).

Hygiene

• Provision of sanitary napkins to adolescent female students(need based)
• Installation of sanitary napkin dispensers in female toilets
• Promotion of Personal hygiene, oral & dental hygiene, hand-washing etc.

De-worming

• Annually supervised schedule through school based & community approach.

Health Education/Promotion

• The most important element of school health programme is health education. The goal of health education should be to bring about desirable changes in health, knowledge, attitudes and in practices and not merely to teach the children a set rule of hygiene.
• Formation of CNSY clubs of students & CNSY monitors-Peer leaders as health educators/ facilitators.
• First Aid room/corners or clinics in schools with CPR training of teachers/health monitors.
• Healthful school environment-the school building, site and equipments are part of the environment in which the child grows and develops. A healthful school environment is necessary for the best emotional, social and personal health of the students.

Mental Health

• Awareness creation – regarding important mental health issues like exam stress, substance/drug abuse, academic performance anxiety, peer influence etc.
• Early detection, treatment and referral of learning disabilities, drug abuse, mental health illnesses etc.
• First Aid room/corners or clinics in schools with CPR training of teachers/health monitors.
• Positive mental health promotion-enhancing coping skills, resilience, empathy etc. to prevent bullying, aggression.

Capacity building

• Training of doctors /PHN/Health Monitor in early detection of deficiencies & diseases /learning disabilities, for referral to CNSY FRUs/ district mental health programme units
• Training of teachers/ peer educators in life skills

Synergizing with programmes of Education dept. e.g. Adolescent Education Programme

• Yuva-Implementation of Adolescent Education Programme
• Creation of Adolescent Friendly Clinics
• Life skill education for responsible and healthy behaviour.
• Health education & counselling on drug abuse/sexual abuse/domestic violence
• Strengthening of the YUVA helpline with education dept.

Student e-health Record

A cumulative health record of each student is being maintained which contains identified data i.e. past health history; record of findings of physical examination and blood investigation like Hb Estimation, Random Blood Sugar and Blood Grouping and record of services provided is being uploaded online on the health server.

M-Health Messages Intervention

M-Health message are on various health and nutrition related topics likes WIFS, health screening ,Stress/anxiety during exams and leading a healthy dietary, lifestyle, prevention and cure of dengue/ malaria ,drug/ substance abuse etc.
The users are required to register their mobile numbers for the m-health initiative by giving a call to the toll free number(022-33598516) to receive a free of cost health messages.

Emergency Response System (ERS)

An emergency response system has put in place for Delhi Govt./ Aided Govt. Schools all the Schools & AWCs are linked with nearby health facilities. Cluster of 4 schools have either one Doctor / Paramedical staff is deputed to manage any adverse effect. CATS ambulances are roped in for ERS. A central control room has been established.

Weekly Iron and Folic acid Supplementation (WIFS):

WIFS Programme was launched on 15th July 2013 with the aim of improving the nutritional status of adolescents, decreasing prevalence of anaemia & to improve scholastic performance of adolescents.
The IFA tablets are at present being distributed to the students of class 6th to 8th in Delhi Govt. / Govt. Aided schools.
Scaling up the of WIFS programme from class 9th -12th in all Education Districts of Directorate of Education is being undertaken
The various outreach activities which are being taken up for the sustainability of WIFS programme:-
• Newspaper advertisements
• Individual Compliance card for students,
• Brochure for parents/Principal and Teachers,
• WIFS Health Monitor Badges
• In convergence with MTNL, SMS related to WIFS and other health messages are being delivered to the beneficiaries on every Wednesdays and a day before.
• Addressing of morning assemblies in schools.
• Addressing PTM in schools to create awareness among parents.

First aid Box Provision:

Provision of first Aid kits in schools as per DCPCR Guidelines
A training manual on Prathmik Chikitsa have been developed for the distribution to the Nodal Teacher during First Aid training.
Capacity building of 3000 Nodal Teachers of 1206 Delhi Govt. /Delhi Govt. Aided Schools in Basic Life Support and First Aid
The first aid trainings district wise are commencing from 15th April 2014.

Nidarshan:

A programme of CNSY to provide free spectacles to students with refractive errors studying in Delhi Govt. / aided Delhi School
The Spectacles will be distribution to the needy students in the school itself.
The Nidarshan programme will be implemented District wise from 1st April 2014.

In addition to CNSY, School Health Program is being run by the Municipal Corporation of Delhi (MCD)
Beneficiaries are the Primary school students of the government schools within Delhi
Also some other agencies provide school health services in Delhi like:
• NGO’s
• Some hospitals etc.

for lecture on School Health Program: http://www.ihatepsm.com/resource/school-health-program
School Health program:http://www.ihatepsm.com/blog/school-health-program
for lecture on school health services: http://www.ihatepsm.com/resource/school-health-service
Reference:
School Health Scheme; Government of NCT of Delhi, available at: http://delhi.gov.in/wps/portal/!ut/p/c0/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hv... accessed on 3rd August, 2016