The school health nurse plays a key role in promoting health and well-being among students. They work with teachers, parents, and the community to implement school health programs. The nurse's responsibilities include conducting health screenings, providing first aid and medical treatment, delivering health education, maintaining student health records, and coordinating referral services. The overall goals are to ensure students remain healthy, identify issues early, and prevent illness through promotion of healthy behaviors and environments.

2. INTRODUCTION :
School health programme is an integral
part of community health. It is the main place of
community health and family health services that
promotes the well being of the child and his education
for healthful living.

3. DEFINITIONS
SCHOOL :
School is defined as an educational institution
where groups of pupils pursue defined studies at
defined levels, receive instructions from one or more
teachers, frequently interact with other officers and
employees such as principal, various
supervisors/instructors, maintenance staff etc., usually
housed in a single building.

4. SCHOOL HEALTH :
Scholl health refers to a state of complete
physical, mental social and spiritual well being and not merely the
absence of disease or infirmity among pupils, teachers and other
school personnel.
SCHOOL HEALTH SERVICES :
Ideally it refers to need based
comprehensive services rendered tom pupils, teachers and other
personnel in the school to promote their he3alth, prevent and
control diseases and maintain their health.

5. NEED FOR SCHOOL HEALTH SERVICES
School children constitute a vital and substantial segment of
population. They are the future citizens and asset for
their families and nation.
School children are vulnerable section of population by
virtue of their physical, mental, emotional and social growth
and development during this period. IT is in this age their
personality develops.
School children are exposed to various stressful
situations e.g. school timings, studies , study hours, heavy
studies, competitive environment, indifferent behaviours of
students, favouritism, public reprimand and corporal
punishment by some teachers.

6. Children coming to school belongs to different socio-economic
and cultural backgrounds which affects their healthy and nutrition
status and require help and guidance in promoting, protecting and
maintaining their health and nutritional status.
Children in school age are prone to get specific health
problems. The various acute and chronic conditions which can
be encountered during school period.

7. HEALTH PROBLEMS OF THE SCHOOL CHILD :
The problems of the school children vary from one place to
another. Surveys carried out in India indicates the main
health problems of the school child have,
Malnutrition
Infectious diseases
Intestinal parasites
Diseases of skin, eyes and ear
Dental caries

8. PHYLOSOPHY OF SCHOOL HEALTH SERVICES :
A healthy child is mentally alert, receptive, will not miiss school due to
minor sickness and will have better performance in his/ her studies.
Health is not just freedom from sickness or infirmity but the
realization of the full potential of the child which has physical, mental ,
social and spiritual components.
Prevention is better than cure, interventions when health breaks
down are costly and time consuming.
School health services will help identify any deviation from normal
growth and development, any health problems so that timely,
therapeutic, corrective and rehabilitative actions can be taken to
improve and maintain health and continue studies.

9. While early diagnosis and prompt and adequate treatment is of
great importance, follow up care is equally important for effective
school health services.
Rehabilitation of physically and mentally handicapped
children can be done and must receive adequate attention.
Health knowledge and skills learnt not only will benefit the
child but also it will benefit the school, the parents, family and
community.

10. PRINCIPLES :
 Be based on health needs of the school children.
 Be planned in coordination with school, health personnel,
parents and community people.
 Be part o0f community health services.
 Emphasis on promotive and preventive aspects.
 Emphasis on health education to promote, protect,
improve and maintain health of children and staff.
Rather, health education should be integrated in regular
school curriculum.

11.  Emphasis on learning through active and desirable participation.
 Be ongoing and continuous programme.
 Have an effective system of record keeping and reporting.

12. NATURE OF SCHOOL HEALTH PROGRAMME :
School health programme should be based on the local problems.
It should be according to problems arises i.e. if malnutrition is detected
MID-DAY MEAL programme can be started.
It should be according to community’s cultures and customs.
Availability of the resources must be taken care

13. It should be based on the needs of the child i.e proper
assesment, diagnosis, planning, implementation and evaluation.
It should promote the health status of the child and the school
personnel.
GOALS OF SCHOOL HEALTH PROGRAMME
To prepare the younger generation to be healthy and to lead
healthy life style.
To help the younger generation to become healthy and useful
citizens who will be able to perform their role effectively for the
welfare of themselves, their families, the community at large and
country as a whole.

14. AIMS OF THE SCHLOOL HEALTH PROGRAMME :
The main aim of the school health programme is to promote
healthy children so that they can reach optimum growth and
development which will enable to them to learn and study.
This will be achieved by,
protecting them from diseases.
Appropriate medical and dental care including emergency
services of injury and sudden sickness.

15. OBJECTIVES OF SCHOOL HEALTH PROGRAMME
 Promotion of positive health including awakening of
health consciousness in school children.
 Early detection and prompt treatment of school health
problems and follow up/ referral.
 Prevention and control of communicable and non-
communicable diseases.
 To make provision and provide a healthy and safe
environment for the all around development of the child.

16. POLICIES RELATED TO SCHOOL HEALTH
PROGRAMME :
Health centre staff is responsible for implementation of school
health programme.
The school health programme is carried out in the school by the
health centre staff working together wit5h school administration,
teachers, local GOVT, parents and community, Including both
agencies and students.
Priority should be given to school health programme at primary
school level.

17. COMPONENTS OF SCHOOL HEALTH PROGRAMME :
Regular medical check up
Immunization
Training of teachers
Health education
Ensuring healthful environment
Provision of nutritional supplements

18. SCHOOL HEALTH SERVICES UNDER SCHOOL HEALTH PROGRAMME :
(ASPECTS OF SCHOOL HEALTH PROGRAMME)
Health appraisal
A) Periodic medical examination
B) School personnel
C) Daily morning inspection
The following clues will help the teacher in suspecting
children who needs medical attention.
1. usually flushed face.
2. Any rash or spot.
3. Symptoms of common cold.
4. Coughing and sneezing.
5. Sore throat.
6. Rigid neck.
7. Nausea and vomiting.

19. 8. Red or watery eyes.
9. Headache
10. Chills or fever
11. Disinclination to play.
12. Diarrhea.
13. Pains in body
14. skin conditions like scabies or ringworm.
15. Pediculosis
Remedial measures and follow up
Prevention of communicable diseases
Healthful school environment
1. The physical setting
a) Location

20. b) Site
c) Structure
d) Classroom
e) Furniture
f) Doors and windows
g) Colour of the classroom
h) Lighting
i) Water supply
j) Eating facilities
k) Lavatory
2. The emotional climate
- Minimizing purposeless tension and
frustration and providing appropriate for releasing pent-up energies
and emotions.

21. - Making adjustments in the school
programmes to meet the needs of the individual mental capacity,
cultural differences.
Nutritional services
A) Mid-day meal programme
B) Applied nutrition programme
C) Specific nutrients
First aid and Emergency care
Mental health
Dental health
Eye health services
Health education

22. HEALTH EDUCATION
Personal hygiene
Environmental health
Family life
Education of handicapped children
School health records
A) Identification data – Name, date of birth, parents
name and address etc
B) Past health history.
C) Records of findings of physical examination and
screening tests and records of services provided.

23. SCHOOL HEALTH TEAM
The school health team should be comprised of school
medical officer, school health nurse, an auxiliary health worker,
teacher, parents, students representatives from community.
The team needs to function in group and follow group
dynamics in assessing school health needs, planning, organizing and
implementing school health activities by delegating specific
responsibilities to team members according to their defined role
and abilities.
The team should also do evaluation of the programme
and its activities implemented, continue further planning and
implementation on the basis of feed back.

24. MAJOR FUNCTIONS OF HEALTH TEAM MEMBERS ARE :
THE SCHOOL PRINCIPAL
 Ensure that school health programme has the approval
and support of school administrative authority.
 Set up a school health committee/school health
council to work out the school health plan and plan for
its implementation.
 Ensure that teachers are adequately trained for health
care of school-children.
 Provide facilities for implementation of school health
activities.
 Make sure that proper health records are maintained.
 Ensure that parents are involved and follow up of
children is done.

25. THE SCHOOL TEACHER
 Daily inspection of children for personal hygiene and
cleanliness.
 Daily observation of children for detecting any evidence of
any deviation from normal health, behaviour, any
communicable disease, malnutrition.
 Help in control of communicable diseases.
 Referral of child having any problem to school health clinic
for further action.
 Informing the parents and maintaining follow up.
 Maintaining record of anthropometric measurements and
other health record of children.

26. Help in providing safe environmental sanitation.
 Giving first aid and emergency care to children.
 Imparting of health education on healthful living habits
and behaviour etc.
 Participate in investigation of epidemic nor any
communicable diseases etc.
The school health nurse can play a very important
role in helping the teacher to carry on these responsibilities. She
can hold conferences with the teachers and discuss some of these
aspects.

27. THE PARENTS :
 They can help in making assessment of health of children by
providing information regarding past and present history of
medical problems not only of the child but also o0f the other
members of the family.
 They can participate and co-operate in physical and medical
examination of children and also in immunization of the children.
 They can help in correction of defects if any and follow up of
children found sick.

28. They can help in formation of good healthful living habits and
behaviour.
Through “Parent-Teachers Association” the parents can be
involved in planning, organizing and implementation of school
health programme.
 Above all, the parents must relieve the child of work pressure
at home so that the child can take advantages of school.

29. THE COMMUNITY :
 Providing suitable land for school building.
 Providing funds and labour in building proper school.
 Participation in school health committees or councils and
contribute in formulation of school health policies and plan.
 Participation in implementation of programme activities e.g.
conduct of medical examination, immunization of children,
maintenance of environment5al sanitation, health education
activities, control of communicable diseases, provision for mid-
day meal for children.
 Motivating parents to send their children to school and take
care of their health etc.

30. THE CHILDREN :
1) Learn values of medical and health examination, personal
hygiene, good nutrition, environmental sanitation, etc.
2) Co-operate in various aspects of school health
programme.
3) Develop positive habits and healthful living activities as
educated upon.
4) Extend this knowledge to other members of the family,
neighbourhood, etc.

31. THE MEDICAL OFFICER :
 Medical examination of students
 Making diagnosis
 Prescribing treatment
 Making referral to specialists
 Ensuring follow up children.
 Initiating promotive and preventive programme.
 Inspection of school environment and sanitation.
 Holding meetings with parents and teachers.
 Ensuring maintenance of records and reports
 Evaluation of the programme and redefining programme objectives
and activities.

32. THE SCHOOL HEALTH NURSE
(COMMUNITY HEALTH NURSE)
“In general, the functions of the school
health nurse are related to establishment and
implementation of scho0ol health policies and programmes
for the protection and promotion of health of the
students, the maintenance of a school environment which is
conductive to healthful living, the building of components
of the curriculum which have significance for health, the
environment of the health services including screening
programmes and emergency care services, the handling of
special health problems and relating the school health
programmes to those of the community”

33. 1. HEALTH PROMOTION AND SPECIFIC PROTECTION
 Immunization of children
Helping school authority and teachers to plan midday meals for
students which is cheap but nutritious, hygienical and
supplementary
 The health education of children ,their parents and teachers
regarding maintenance of personal hygiene, growth and
development prevention of communicable diseases , balanced diet
and good nutrition, mental health and hygiene etc.
 Helping students, their parents and teachers develop positive
attitudes and health behaviour by demonstrating healthful
behaviour and by providing health experiences
 Providing counseling regarding problem solving skills to
students, their parents and teachers.

34.  Examination of school environment, identify safety
hazards and report to the authority.
Involving community participation to eliminate
safety hazards in the community
Helping school authority and teachers to
design health education curriculum and
provide consultation to teachers on health
education topics.

35. 2. EARLY DIAGNOSIS AND TREATMENT.
 Regular and periodical health appraisal of school
children.
 Notifying parents about health appraisal results.
Interpret and discuss the findings and the corrective
measure plan.
Making referrals for further investigations or to
specialists as needed.
Follow up of referred cases.

36.  Home visits of certain selected children to ensure implementation
of corrective measures and to prevent further damage
 Counseling of students, their parents and teachers regarding
personal problems, to make informed decisions to solve the
problems.
 Dispensing medicines as prescribed, perform special treatments
or procedures as required for identified health problems.
Teaching family members, auxiliary nurse midwife/multi purpose
health workers (F) to perform special treatment or procedures.
 Providing first aid and emergency care for injury or illness.
 Help set up facilities for and demonstrate first aid procedures.

37. 3. PREVENTION OF COMPLICATIONS AND
REHABILITATION
Helping in prevention of recurrence of acute conditions
by
a) Eliminating risk factors responsible for
particular conditions.
b) Health education of students, their
parents and teachers.
Preventions of complications and promotion of adjustments to
chronic and handicapping conditions by,
a) Helping parents/family meet special
nutritional of any other needs.
b) Helping parents/family in finding sources of
financial help to deal with chronic and
handicapping conditions.

38. c) Helping parents/family in meeting
special needs for transportation,
equipments or any other facility.
Help in prevention of adverse effects of learning
disabilities by,
a) Counseling of children and their
parents,
b) Discussing with school authority to
design individualized learning
programme.

39. 4. OTHER FUNCTIONS
Maintenance of health record and preparing reports of
health appraisal and medical reports of health appraisal and
medical examination, episode of illness. Any defect,
treatment, corrective measure and follow up care given etc.
Assisting, supervision and guidance of Auxiliary Nurse
Midwife/Multi purpose Health Worker (F) in carrying school
health services.
Management of school health clinic.
Holding conferences with teachers, students and parents
to discuss and plan on health matters related to students,
health education content and health education sessions
et5c.

40. Participating in health committee or health council.
Participate in service education of teachers on
health matters.
“ The community health nurse thus performs
variety of roles in the school health setting. These include
role of school healthy consultant, practitioner, planner,
organizer, co- ordinator, guide, supervisor, educator,
trainer and counselor. ”