rbsk work file

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7. School going studentsSchool going students
Class-I to class XIIClass-I to class XII
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8. • High coverage through schools
• Highly cost-effective: School network is universal
– with skilled workforce
• Help link and converge resources for health,
nutrition and sanitation components to school
network
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9. State: ADHS School Health
State Nodal Officer (Adolescent Health)
SHP Consultant
District: Dy CMOH-III / DFWO (Overall in-charge)
DMCHO (Capacity building)
DPHNO (Nodal Officer)
DPC
Programme Supervisor
Programme Associate
Block: BMOH / BPHN
School Health team
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10. 1) Micro-plan
2) Plan for follow up visit
3) Health check up of all students at school
4) Screening for 4 D’s:
Defect at birth - Deficiency – Disease – Disability
4) Manage minor issues and health education
5) Referral and linkage: PHC/RH and higher facilities
6) Follow up through Nodal Teacher and General Health
System
7) Record keeping – School Health Cards, Registers
8) Reporting
9) Monitoring ARSH and WIFS in school
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12. • Structure of School Health Team:
– Two Medical Officers (AYUSH) – preferably one
male and one female; one pharmacist; one
optometrist (wherever available).
– The team will work under supervision of
BMOH/BPHN, Borough Health
Executive/Municipal Health Officer.
– ACMOH of subdivision: Nodal officer; maintain
active monitoring and supervision of the program.
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13. • Microplan
– Microplan should be prepared as per given format.
– Microplan period: 1-30/31 of the previous month
– Draft plan: on 3rd
Monday at block head-quarter in
consultation with other partners.
– Draft plan to be shared with CPC/SI of circle on 3rd
Monday.
– Monday: dedicated for WIFS in upper primary schools; so,
only primary schools on Monday.
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14. • Microplan (contd.)
– After receiving response within 7 days, microplan should
be finalized on last working day of the month and shared
with CLRC/ULRC.
– CLRC/ULRC will be responsible to intimate concerned
schools well in advance.
– School will ensure presence of all students, sitting and
waiting arrangements for school health teams and
beneficiaries, logistic arrangement (school health cards,
drinking water, privacy).
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15. • Client load assessment:
⁻ Generally a school health team should visit one
school per day.
⁻ If the client load per doctor per visit comes below
100 during micro-planning, another nearby
school with similar or lower client load should be
incorporated in the plan.
⁻ If the client load per doctor per visit is more than
200, visits are to be taken up on subsequent days
to cover all students of the school in one go.
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16. • Mobility:
– Car specifically for the purpose of movement of
school health teams should be hired. The district will
follow existing norms and necessary cost may be
borne from the fund provided for ‘mobility support’.
– Car will move from block/municipality head-quarter
to field to block/municipality head-quarter.
– Any other kind of movements other than to school
will have to be done in concurrence with the BMOH/
Borough Health Executive/Municipal Health Officer.
– Logsheet should be maintained by MO of the School
Health Team for the car utilized for this purpose.
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17. • The teams will visit schools on every working day
including Saturday, except third Monday (for
preparing micro-plan) and last working day (for
finalizing micro-plan and preparing monthly report).
• Visit hours should be flexible as per school timings.
• School health team should carry registers, approved
medicines as per microplan, BP instrument,
stethoscope, height/weight/BMI machine, snellen’s
chart, ishihara chart etc.
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18. • At school, medical officers will examine the students
and screen for 4Ds (Defect at Birth, Deficiency,
Disease and Disability), provide palliative / minor
management, give health education and refer to
appropriate facilities as required. The pharmacist will
dispense the drugs and will also be responsible for
record keeping in the school and reporting later on.
• Nodal teachers including other teachers will assist in
uninterrupted service delivery including queue
management, record keeping, maintaining school
health cards and referral cards in an organized way.
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19. • After completion of check up, the medical officers
will hand over the school health cards and referral
cards to the class/ nodal teachers for safe custody
and future use.
• Fixed day approach for referral (except acute
problems): The students, who are in need of
specialized care, will be referred together to the
nearest health facilities on each Saturday between
11 AM to 2 pm.
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20. • In upper primary school, the medical officers
– will share the information on Anwesha clinic and ARSH
(adolescent reproductive and sexual health) services,
– will collect the information regarding ARSH activities by
Anwesha Counsellor in the school,
– will monitor the ongoing WIFS activities (supply,
supervised intake of IFA and Albendazole, any bottleneck
in implementation etc.) and
– inform the BMOH/BPHN and ACMOH to address the
issues.
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21. • School health cards: will be kept with the school and used only during
check up and filled up by school health team.
• Referral cards: to be issued in duplicate by the medical officers, one copy
will be kept in the school for future reference and the other copy will be
handed over to the student/parents.
• Register: Two types of registers – (a) Students’ register and (b) Stock
register. Registers will be filled up regularly and kept by the school health
team.
• Monthly report: Monthly reports to be prepared for one calendar month
in the prescribed format on the last working day of the month, and to be
shared with BMOH/BPHN, Borough Health Executive/Municipal Health
Officer and to be sent to Dy. CMOH-III/DFWO at district level by 3rd
of
every month.
• The block/Municipal health officials will be sharing the report with the
CLRC/ULRC counterparts.
• District health authorities will compile the block/municipal level reports
and send it to the State Family Welfare Bureau by 7th
of every month. The
report should also be shared with district counterpart of education
department.
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22. School Health Team will screen pre-school and
out of school children at AWC level in cluster
mode during:
– Vacations
– Examination times
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24. • Malnutrition – under nutrition (or over-
nutrition)
• Anaemia
• Vitamin (A, D, B etc.)
• Iodine
• Other micronutrients (Zinc, Copper, Calcium,
Flouride etc.)
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25. • Under and over nutrition
• Measuring scale (BMI):
<16 =Severe undernutrition
16-18.5 =Undernutrition
18.5-23 =NORMAL
23-24.9 =Pre-overweight
25-29.9 =Overweight
>30 =Obese
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26. • Lack of oxygen carrying capacity of RBC
• Different causes (Iron deficiency, folic acid
deficiency, Vit-B12 def, worm infestation, bleeding,
congenital etc.)
• Prevalence of anaemia: 56.2% females, 24.3%
males (NFHS-III)
• Hb level: <12gm% for female
<13gm% for male
• Management: WIFS etc.
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27. • Vita-A: Bitot’s spot, Xerophthalmia, night-
blindness, hyperkeratosis, phrynoderma
• Niacin: Pellagra (diarrhoea, dementia, dermatitis)
• Riboflavin: Cheilosis, angular stomatitis, glossitis
• Ascorbic acid: Scurvy
• Vita-D: Ricket
• Iodine: Goitre
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28. • Diarrhoea
• Skin diseases
• Chronic diseases: Dental caries, eye and ear
problems, chronic respiratory problems, TB,
leprosy,
• Acute onset of fever: Viral fever, respiratory
tract infection, malaria, UTI, enteric fever,
Japanese Encephalitis, jaundice etc.
• Fever with rash: Chicken pox, measles, rubella,
mumps, dengue, chikunguniya etc.
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29. • Passage of 3 or more loose or liquid stools per
day
• Can cause death which is preventable
• Causes: unsafe drinking water, unhygienic
food habit, side effect of medicines etc.
• Management: Hygienic habits – hand washing,
improved sanitation, safe drinking water, ORS,
adequate nutrition, intravenous infusion (in
severe cases), antibiotic (in selected cases)
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Two of the following signs:
· Lethargic or unconscious
· Sunken eyes
· Not able to drink or
drinking
poorly
· Skin pinch goes back very
slowly.
SEVERE
DEHYDRATION
Refer URGENTLY to
hospital
with mother giving
frequent
sips of ORS on the way.
Two of the following signs:
· Restless, irritable
· Sunken eyes
· Drinks eagerly, thirsty
· Skin pinch goes back
slowly.
SOME
DEHYDRATION
•Give fluid and food for
some dehydration (Plan B).
•Follow-up in 2 days if not
improving.
Not enough signs to
classify as
some or severe
dehydration.
NO
DEHYDRATION
•Give fluid and food to
treat diarrhoea at home
(Plan A).
•Follow-up in 2 days if not
improving

31. • Acne Vulgaris
• Scabies
• Pediculosis
• Ring worm
• Seborrheic dermatitis
• Pityriasis versicolor
• Eczema
• Arsenicosis
• Allergic diseases and contact dermatitis
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32. • Upper and lower
• Common symptoms: running nose, sneezing,
cough, fever, nasal blockade, aural discharge
• Management: cough hygiene, saline water
gargle, saline nasal drop, management of
fever, antibiotic (in selected cases)
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33. • Dental:
– Caries
– Bleeding gum
– Gingivitis
– Foul breathing
– Flourosis
• Ophthalmological:
– Refractive error
– Conjunctivitis
– Corneal ulcer
– Squint
– Chalazion and stye
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34. • Ear:
– Wax
– Discharge
– Pain
• Nose and para-nasal sinuses:
– DNS
– Sinusitis
– Epistaxis
– Infection
• Throat:
– Adenoids and tonsillitis
– Pharyngitis
– White patch
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35. • Diptheria
• Pertussis (whooping cough)
• Tetanus
• Polio
• Measles / Mumps-Measles-Rubella
• Tuberculosis
• Hepatitis-B
• Japanese Encephalitis
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36. • Malaria
• Dengue and Chikungunya
• Tuberculosis
• Leprosy
• Kala-azar
• Filariasis
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37. • Enteric fever
• Jaundice
• Cholera
• UTI
• Psychological problems
• Violence and Sexual abuse
• Behavioural problems and conduct disorders
• Substance abuse
• Non-communicable diseases: Congenital heart disease,
other congenital diseases
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38. • DPT at 5-6 years
• TT at 10 years
• TT at 15 years
• Vaccine preventable diseases - notification
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39. • Menstrual problems – amenorhoea,
dysmenorrhoea, menorrhagia,
polymenorrhoea, hypomenorrhoea
• Common symptoms: white/yellowish/blood
stained/foul smelling/profuse discharge from
genital organs; lower abdominal pain, inguinal
lymphadenopathy etc.
• Herpes, Candidiasis, Syphilis, Gonorrhoea,
Non-Gonococcal urethritis etc.
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40. Appropriate referrals to counselling services
(Anwesha) for :
– Size and shape of genital organs, different body
parts including breasts
– Voice change
– Body hair
– Skin colour
– Ejaculation, night falls
– Menarche
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41. • Visual
• Hearing
• Speech
• Movement
• Learning
• Other psychological
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42. International Classification
• Impairment: any loss or abnormality of psychological,
physiological or anatomical structure or function.
• Disability: any restriction or lack (resulting from an
impairment) of ability to perform an activity in the manner
or within the range considered normal for a human being.
• Handicap: a disadvantage for a given individual that limits
or prevents the fulfilment of a role that is normal.
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43. Traditionally used:
Impairment refers to a problem with a structure or
organ of the body;
Disability is a functional limitation with regard to a
particular activity;
Handicap refers to a disadvantage in filling a role in life
relative to a peer group.
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SHP – Microplan Format

46. Jun 19, 2015 46

47. Jun 19, 2015 47
2012-13: 1st visit
2012-13: 2nd visit
2013-14: 1st visit
2013-14: 2nd visit
2014-15: 1st visit
2014-15: 2nd visit
2015-16: 1st visit
2015-16: 2nd visit
2016-17: 1st visit
2016-17: 2nd visit
2- Other
micronutrient Def
4- High BMI 5-Anaemia
7-Refractive errors 9-Dental 10-Infection
12- Physical
disabilities
14- Behaviour
problems
15-Hearing problems
2012-13
2013-14
2014-15
2015-16
2016-17
2012-13
2013-14
2014-15
2015-16
2016-17
2012-13
2013-14
2014-15
2015-16
2016-17
2nd visit
2nd visit
Visiting doctor
Referral Remarks
1st visit
Treatment History
1st visit
13- Learning disorder
Overall Health Status
1st visit (DD/MM) 2nd visit (DD/MM)
Code of disease & illness
1- Vitamin Def 3-Low BMI
6- Disease 8-ENT
11- Worm Infestation
Disease and illness status

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Referral Card
School Health Programme
______________________________________________________________________________________
Referred to: Date:
Name of the student:
Name of the school:
Block: Panchayat: Village:
Police station:
______________________________________________________________________________________
Nature of disease or illness:
______________________________________________________________________________________
Referred by:
Name Designation Signature Date
.....................................................................................................................................................................................................
(DUPLICATE)
Referral Card
School Health Programme
______________________________________________________________________________________
Referred to: Date:
Name of the student:
Name of the school:
Block: Panchayat: Village:
Police station:
______________________________________________________________________________________
Nature of disease or illness:
______________________________________________________________________________________
Referred by:
Name Designation Signature Date

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SchoolHealthProgramme
HealthCheckUpRegister
Sl.No
Date
(dd/mm/y
yyy)
Natureof
Visit
(1st/2nd) NameofSchool
NatureofSchool
(usecode)
NameofAnganwadi
Centre Nameofthechild
Classand
section
Sex
(M/F)
Age
(complete
dyears)
Height
(cm)
Weight
(kg) BMI
Deficiency
(usecode)
Disease
(use
code)
Disability
(use
code)
Treatment
(usecode)
Referred
(use
code)
Referredand
availed
services(use
code)
Referred
and
followedup
SignatureofMO
performing
screening
Codes:
NatureofSchool
Deficiency
Disease
1=Govt.;2=Govt-aided;3=Other(specify)
1=Vitamin;2=Othermicronutrient;3=Underweight;4=Overweight;5=Nutritionalanaemia;6=Other(specify)
1=Disease;2=Refractiveerrors;3=ENT;4=Dental;5=Infection;6=Worminfestation;7=Other(specify)
1=Physical;2=Learning;3=Behaviour;4=Hearing;5=Other(specify)
1=On-spotmedicalattention;2=Spectaclesdistributed;3=Otheraids(hearing/prosthetic/other)distributed;4=IFA;5=Deworming;6=Others(specify)
1=Primaryhealthfacility;2=Secondaryhealthfacility;3=Tertiaryhealthfacility;4=Superspeciality
1=Primaryhealthfacility;2=Secondaryhealthfacility;3=Tertiaryhealthfacility;4=Superspeciality
Disability
Treatment
Referred
Referred&availedservices

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School Health Programme
Stock Register
Date Name of the item
Opening
stock
Stock
received Batch No.
Expiry
date Consumed Wastage
Closing
stock Remarks Signature
* Index of items should be prepared on the first page of the register.
** Fixed assets should be mentioned in given format in the last page of the register.

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52. Timeline Functions Responsible
3rd
Monday Draft microplan
Sharing with Education
School health team &
Nodal officer
Last working day 1) Finalization of
Microplan & sharing
with Education and
health
2) Monthly report
School health team &
Nodal officer
3rd
of every month Monthly report to district Nodal officer
7th
of every month Compilation and sharing of
Monthly reports to State
Dy. CMOH-III
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53. • District:
– Team: Dy. CMOH-III, Dy. CMOH-II, DMCHO, DPHNO,
DPC, Programme Supervisor, Programme Associate,
Dist. Homoeopathy Coordinator
– Roles:
Quarterly convergence meeting (planning and review)
Supervisory visits
Monitoring
Report compilation and sending to state
Report sharing with allied departments regularly
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54. • Sub-division:
– ACMOH: Overall in-charge of the Sub-division
– Roles:
Supervisory visits
Monitoring
Coordination
Convergence with allied departments
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55. • Block:
– BMOH: Overall in-charge
– BPHN: Coordinator
– Roles:
Convergence meeting monthly
Microplan
Supervisory visits
Monitoring
Reporting – to district, allied departments
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