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School Health Services
Definition:
a coordinated health system that ensures a continuum of care from school to
home to community health care provider and back.
The need for school health services:
- Since schools bring large numbers of students & staff together, system
must be introduced to deal with such issues as first aid, medical
emergencies & detection of contagious conditions that could spread in a
group situation.
- This system should also be established to provide routine administration
of medications, since students may not be able to assume this
responsibility themselves.
- Schools should also be able to provide services for students who need
special care, such as monitoring of vital signs, changing dressing,
catheterization or tube feeding.
- The school must also provide services to students with chronic health
problems such as asthma, diabetes or seizures.
- Since schools are places where children spend a significant portion of
their time, they are considered as a logical site for services that are
based on public health principles of population- based prevention.
- Schools are strategically positioned to serve against the resurgence of
infectious diseases such as TB & hepatitis.
- Schools are also places to expand the knowledge base (relationship
between nutritional status & learning capacity), for assessing unmet
needs & for monitoring the health status of children & adolescents.
- The team providing school health services consists of physicians,
nurses, dentists, psychologists, counselors, social workers for all
schools.
- as well as (physical, occupational, speech, language & hearing
therapists, audiologists) for children with special needs.
The goals of a school health program:
1)Ensure access to PHC:
the school health service should be considered an integral part of a
community's preventive health system.
Utilizing the school health service for screening & detection of problems,
follow-up, & the coordination or provision of services can make the
community's primary care system more efficient, effective & accessible.
Although the extent of the services provided at the school site will differ from
one community to another, mechanisms must be developed so that school
health services are coordinated with the community's mainstream health
services to ensure efficiency, continuity & quality of care
The followings are initial steps that a community might take to ensure
student access to primary care:
- Identify sources of health care in the community.
- Identify needs of population & barriers to health care; are they
geographic, financial, cultural or other?
- Determine where & for what reason students have utilized a
health care facility in the past year.
- Consider the range of school-affiliated services needed on or near
a school site & how they might be provided or supported.
- Set up communication systems between providers of care & the
school health service (phone for referrals, feed-back, follow-up).
2) Provide a system for dealing with crisis medical situations:
Medical crises may occur every day at schools (falls from heights, burns,
lacerations, seizures, asthmatic attacks, acute complications of DM).
Procedures must be present to deal with such crises such as access to
community emergency medical care, requesting first aid & contacting parents.
School personnel & older students should be trained in CPR & necessary first
aid procedures as well as accident prevention.
3) Provide mandated screening & immunization monitoring:
Screening is the process of using a relatively simple test to identify those who
may have a particular problem.
Screening programs are ineffective unless procedures are in place for ensuring
follow-up of identified problems.
In a climate where resources are scarce, a balance may have to be struck
between population-based screening & targeted interventions for high-risk
groups.
4. Provide systems for identification & solution of students' health &
educational problems:
The school alone cannot identify & solve all problems that affect all students.
However, a team approach utilizing the many resources within the school &
community can lead to greater progress than will be achieved by separate,
isolated efforts.
An example of whether a community is meeting a student's health &
educational needs would be the correction of visual defects identified through
routine school screening. While screening may be properly done, correction &
follow-up may not.
Other problems, such mental health conditions & family problems may be
more difficult to diagnose, follow-up & treat.
The solutions to such problems usually requires a more comprehensive type of
care & involving many more health & social professional.
5) Provide comprehensive & appropriate health education:
Health services personnel can be involved in classroom health education, both
in developing the instructional program & perhaps in delivering classroom
lessons.
6. Provide a healthy & safe school environment that facilitates learning:
The school environment is comprised of the broad areas of the physical,
psychosocial & policy environment.
A range of issues is involved; policies regarding the possession of drugs &
alcohol, the existence of a supportive nurturing atmosphere, & the presence of
environmental hazards & pollutants.
Staff wellness is also an important aspect of the environment, as is safety.
7. Provide a system of evaluation of the effectiveness of the school health
program:
Evaluation of school health programs is critical, both for strengthening
programs & for maintaining accountability, & communities must be prepared
to allocate sufficient resources to evaluation.