SCHOOL HEALTH SERVICES

BASIC CONSIDERATIONS

The School Health Service is expected to provide a health promoting services by acting in a co-ordinating role, making use of the skills and capacity in different sectors of society, including the community, the learners themselves, educators and NGOs.

Standards set for the School Health Service need to take into account the diverse situation of schools and school health services at present and the changing philosophy introduced by the education sector, including outcomes based education and inclusive education. The introduction of the philosophy of inclusive education means that children with barriers to learning will be included in ordinary schools and that these schools and communities will have to be develop to provide acceptable services for these children. Teachers generally do not have the capacity to deal with these children and the school health services can play a role in enabling teachers to identify and integrate these children into the classroom. School Health personnel may not have the capacity to implement their new role so a transformation-training programme is required. New resources for school health promotion need to be developed and funded. The School Health Teams are becoming an integral part of the primary health team and intrasectoral (i.e. they work with other sections of the Health Department).

These recommended standards are based on the assumption that the Primary Health Service is built on the Sub-district approach to service delivery.

SERVICE DESCRIPTION

The school health service is a health promotive service dealing with the individual in the context of the family and community and with the school environment. The service encourages the school to seek to develop and implement school policies that promote and sustain health, improve the physical and social environment within which children learn and develop and improve children’s capacity to become and stay healthy.

NORMS:
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  1. Each sub-district has a minimum of one School Health Promoting Team.

  2. Every clinic will be able to access a specially trained nurse on school health within the district

  3. District School Health Promoting Teams are supported from provincial level with an appropriate, effective transformation training programme, and the development of standardised resource packs and the training occurs during those times of the year when schools are closed. The transformation is completed by the year 2003.

  4. Screening Programmes are provided to give adequate coverage to identify all children at risk of barriers to learning and are not limited to certain age groups.

  5. The School Health Promoting Service creates a positive learning environment, by identifying barriers to learning, and developing ways to remove these barriers in a community inclusive way.

  6. School Health Promotion Programmes promote acceptance and celebration of diversity among individuals through a learner centred approach.

  7. An accessible, healthy physical and social environment in which children can learn is promoted.
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STANDARDS
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  1. References prints and Educational Material

1.1 A standardised questionnaire for use by teachers to screen for the presence of factors causing barriers to learning in the individual (e.g. "School Readiness Screening Pilot: April – July 1997, School and Youth Health Directorate" and a questionnaire developed by an Intersectoral team in the Ladysmith Region of Kwazulu-Natal).
1.2 A standardised questionnaire for use by school health promoting teams to assist them detecting barriers to learning in the environment of the learner (e.g. the draft of "The Index - an instrument to assess Health Promoting Schools in South Africa").
1.3 A resource register for the district for use by School Health Promotive Teams and Educators, by which available health services can be identified, and how they can be accessed, to be compiled by each district and regularly updated.
1.4 Health promoting educational materials in the local language and accessible to people with disabilities, including films, videos, posters, booklets, visual aids and audiotapes.

  1. Equipment

2.1 As for mobile teams
2.2 Projector, video recorder, slide projector, white boards and audiotapes.
2.3 Access to administrative support, including typing services, telephone and fax, photocopying services, stationary and appropriate transport for the environment.

  1. Medicines, supplies and assistive devices

3.1 Access to medication for control of specific disease conditions identified at district level, e.g. prevention of blindness from trachoma, treatment of scabies outbreak.
3.2 Assistive devices for daily living for people with disabilities. (Assistive devices required to access education is supplied by the Education Department).

  1. Competencies

4.1 The School Health Promoting Team is able to:

4.1.1 Function as an effective and efficient team.
4.1.2 Promote the whole person and life-style skills development of pupils and educators.
4.1.3 Identify resource people and involve them to promote the transformation.
4.1.4 Promote community participation and the participation of all stakeholders in programmes e.g. Participatory Learning and Action (PLA) skills.
4.1.5 Plan and implement health promoting programmes.
4.1.6 Apply and interpret the screening questionnaires for individuals and schools and transfer these skills to the teachers.
4.1.7 Identify gaps in the service and barriers to learning.
4.1.8 Promote healthy nutrition, mental health and reproductive health.
4.1.9 Counsel for substance abuse and victims of violence including rape.
4.1.10 Identify and seek to reduce stress.
4.1.11 Promote healthy sexuality and deal with the results of unhealthy sexual behaviour.

  1. Patient Education

5.1 Address health risk behaviours with the provision of behaviour specific knowledge and opportunities to practice knowledge and skills.

  1. Referrals

6.1 Refer to nearest clinical service, the students that require more intense clinical assessment and management.

  1. Records

7.1 An information system at all levels of the service, which informs the different sectors to make effective use of existing services, identifies gaps in the service and monitors the progress toward the development of Health Promoting Schools.

  1. Community based activities

8.1 Promote the development of child–to–child programmes as an important resource.
8.2 Work with school boards to promote activities in the community such as libraries and sport activities.

  1. Collaboration

9.1 Clinic staff collaborate with and involve officials from health, welfare, education, agriculture sectors, educators, learners, parents, community leaders CBOs and NGOs,
9.2 School Health Promoting Teams are intra- and intersectoral.

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