An investment in our nation’s future

School Health Service has been a prime area of activity of IHS since 1997. Initially, due to lack of awareness, it was difficult to make the school administrators appreciate the need to adopt a school health system. We had to work hard to make  the educationists understand the importance of school health services in the overall mental & physical development of a child. Although in Pakistan school health has been a part of the government health infrastructure since 1952 but practically on ground it is still non-existent.

Now after almost 10 years in school health IHS is a market leader in provision of various types of health services to the educational institutions in Pakistan. Due to our commitment and non-commercial and professional approach IHS  is the largest operator of school health in the country with over 0.8 million students enrolled so far and 223,180 current registrations (till June 2007).

IHS has been involved in provision of school health services across Pakistan. We believe in developing self sustainable models that can continue for a long time. We are providing school health solutions to both the private and public schools. But it has been more successful In Islamabad & Karachi than other cities. IHS has developed a comprehensive eight component model of school health that encompasses all basic health and developmental requirements of a child. Some schools (due to various constraints) have selected just a few components while others like the following schools have full fledge School Health Clinics staffed with lady doctors and nurses:

• Islamabad Convent Schools (H-8 & F-8 Campuses)

• City School (Margalla Campus)

• Sheikh Zayed International School, H-8

• St. Mary's Academy

To take the school health services to places where it is most needed - the public sector schools with poor children - recently in collaboration with organizations like Save the Children (UK) and Global Fund IHS has started a school health initiative in 11 districts of Pakistan including the following:

1. Punjab: Gujrat, Sialkot, Mandi Bahauddin, Narowal & Khushab

2. Sindh: Tando Muhammad Khan & Tando Allahyar

3. Balochistan: Quetta

4. NWFP: Abbotabad, Mansehra & Balakot

5. Azad Jammu Kashmir: Muzafarabad & Bagh

IHS School Health Services are aimed at early detection, correction and prevention of deformities and disabilities during the growing years. Our goals are:

1.      Promotion of positive health

2.      Prevention of communicable diseases

3.      Early diagnosis, treatment and follow-up of disease

4.      Awakening health consciousness in children (The 'Child to Child' approach & capacity building of teachers and school staff), and

5.      Provision of a healthy environment

IHS School Health Services include a range of interventions that can be adopted collectively or individually depending on the requirements of a particular institution. Following are the main components of IHS School Health Services: 

1. Periodic Medical Examinations

• To evaluate growth and detect potential health problems at an early stage

• Frequency: Annual or bi annual

• Standardized history and examination formats

• Conducted in-house at the school by IHS doctors

• No invasive procedure involved

• All paper work done by IHS

• Individual health report to each student

• Individual medical file of every student

2. Health Education

• To educate children on common health issues / diseases and make them the "Ambassadors of Health"

• Lectures on many common and preventable medical problems

• Through slide and multi media presentations

• Group discussions

• Distribution of awareness leaflets

• Conducted by IHS Doctors, school teachers and students (IHS has developed training modules to train the teachers and students so that they themselves take up health education in their school and community)

• School Health Clubs are also formed that become a base for spreading positive health messages and practices (The 'Child to Child' approach)

3. Medical Emergency Response System (Download Emergency Protocols) 

• To deal with day to day emergencies

• Round the clock

• On call doctors, paramedics and fully equipped ambulances

• 24 hr. telephone medical help line (111 DOCTOR)

• Coordination with local health facilities on credit basis

• First aid & disaster management training

• Earthquake drills

4. Vaccination Services

• Covering all vaccine preventable diseases

• Arrangement of vaccination at school or at specified centers outside the school

• World Health Organization approved vaccines and regimens

• Conducted by well-trained vaccinators

• Issuance of Vaccination Cards and Vaccination Certificates

• Awareness lectures and information literature on vaccine preventable diseases 

• Regular follow-up for 2nd / 3rd dose through a tailor-made reminder software

5. First Aid Training

• Specially designed to meet the needs and understanding of school children

• One day 5 hour course

• Interactive through audio visual aids

• Certified course

• First Aid Kits for School & Home use

• Advanced level courses for teachers 

6. In-House School Clinic

• Staffed with a Lady Doctor / Nurse during school hours

• Basic medical equipment like Nebulizer, Glucometer, Oxygen, etc.

• First dose of oral medicines for children reporting sick

• Annual medical checkups of all students

• Regular Health Education and Training program

• Maintenance of Health Files of all students

• No invasive procedure or injections are allowed except with the expressed consent of parents under special circumstances

• On call ambulance evacuation services

• Issuance of 'Health Cards' to all students

5. Health Provider Networking

• Through the 'School Health Card'

• Government & private health providers are put on the school health panel

• Providers get more patients - an increased volume

• Children & their families get discounts and priority services

• System for health record maintenance & follow up

5. Teachers Capacity Building

• Through specially developed 'Teachers Health Capacity Building Manuals' in line with Pakistan's socioeconomic and cultural realities

• To train them to educate children on health issues and hygiene besides developing skills to identify illnesses and negative health practices among children at an early stage

• Interactive training modules from 10 to 20 hrs duration

• Conducted either at the school or at our training rooms

• Special emphasis on prevention and early detection

• Modules also for members of the school 'Health Clubs'

COST:

Charges for various services mentioned above vary depending on the following: 

1. The services selected
2. Strength of students, and
3. Location of the school

An exact estimate for services can be made after interaction of our representative with the school authorities. However all services are designed to be extremely affordable and are based on no profit no loss in order to promote school health in Pakistan.

IHS SCHOOL HEALTH CONCEPT

A comprehensive school health program is an integrated set of planned, sequential, school-affiliated strategies, activities, and services designed to promote the optimal physical, emotional, social, and educational development of students. The program involves and is supportive of families and is determined by the local community based on community needs, resources, standards, and requirements. It is coordinated by a multidisciplinary team and accountable to the community for program quality and effectiveness.

A successful school health program not only strives to prevent illness but also provides the opportunity for students to enhance their ability to learn by promoting physical and mental health and social well-being. While there is no universally accepted model for school health programs, the eight-component model is usually used by IHS and is enhanced by integration and overlap between the components to meet requirements of specific areas. Modifications are also made to cater to the special socio-economic and cultural factors.

In recent years, in US & Europe additional models, definitions, and descriptions of school health programs have emerged that build on previous models, including expanded school health services that provide a wide range of health access modalities for students to receive increased and improved access to care that they are not receiving elsewhere. A program with expanded health services may provide, for example, on-site immunizations, full medical histories and physical examinations, or on-site counseling for children with special mental or physical health needs.

School Health Models

Throughout the evolution of school health, many different models have been used to delineate the components of school health programs.

The Three-Component Model: This model originated in the early 1980s and evolved through out the decade. Considered the traditional model of school health, it consists of the following components:

(1)   Health Education,

(2)   Health Services, and

(3)   A Healthful Environment. 

The Eight-Component Model: In the late 1990s the three-component model was replaced by the eight-component model. Also known as the model for a “Comprehensive School Health Program,” it consists of eight elements:

(1)   Health education,

(2)   Physical education,

(3)   School health services,

(4)   School nutrition services,

(5)   Counseling, psychological, and social services,

(6)   Healthy school environment,

(7)   Health promotion for staff, and

(8)   Family/community involvement.

EXTENDED SCHOOL HEALTH SERVICES

Extended health services include:

School-Based Health Centers: A school-based health center (SBHC), also known as a school-based clinic, consists of one or more rooms within a school building designed as a place where students can go to receive primary health services. An SBHC is more than a school nursing station; students can receive on-site diagnosis and first dose of treatment from one or more members of an interdisciplinary team of clinicians that may include physicians, nurses, social workers and health aides.

Mental Health Centers: Arrangement either permanent or on need basis to provide counseling during various stages of child's development. It is one of the most neglected aspect in a child's life.

Health Clubs - Little / Young Doctors: School-based Health Clubs provide a wide range of activities – including health services, counseling, recreation and health education / promotion. These centers attempt to inculcate a healthy attitude and also an interest in the medical profession.

Family Resource Centers: This includes parent education, child care, counseling, health services, home visit and career training – to students of all ages and their families. These centers may be based either on the school campus or at some other community setting.

Comprehensive Multi-Component Program - Full Service Schools: Although the definition of “full-service” varies from place to place, a full-service school most commonly calls for restructured academic programs integrated with parent involvement and a wide range of services for students and families – health centers, family resource rooms, after-school activities, cultural and community activities, and extended operating hours. The full-service school model attempts to create an easily navigated network of school and community resources for parents and students, including but not limited to health services.

THE SCHOOL HEALTH CLUB CONCEPT

(Click here to download ppt on the Health Club: Block/Unit Model)

Need For Creating Health Clubs in Schools

After 10 years of experience of establishing and implementing school health in Pakistan we have come to the conclusion that viable, sustainable, long term and effective intervention to promote school health can only be guaranteed by making "Health Clubs" at school level. Initially a lot of effort is required to set up these clubs as per a format that we have developed but in 1-2 years these clubs become more independent and self dependant. In this world of fast communication coordination between the club members and a Central Coordination Center (CCC) is quite easy and efficient.

Healthy living incase of school children is the prime concern of all stakeholders including principals, parents, teachers and the community. To achieve this objective collective responsibility needs to be assumed.  An important dimension is that of experience and development of health skills and physique through practical engagements with play, exercises, sports and practices of personal and community hygiene.

Health and Wellness Clubs in Schools focus on the overall well being comprising emotional, social and mental health of the child. They act as the enabling and organizational point for conducting activities related to various dimensions of health and wellness. A Health Sheet is made for students, which forms a continuous part of their growth and development. This could form an effective monitoring and feedback system for the overall health of a child during his schooling.

Constitution of School Health Club

• Principal or Biology Teacher as Convener
• Psychologist / P.E. Teacher / Biology Teacher as Secretary
• Student representative (at least 2 students from each class)
• Identified Teachers
• Parents (preferably doctors/medical background)

Responsibilities of the Health Club

• As an organizer of all health relevant activities (at least 8-10 activities in the year at each level).
• As a Resource Centre for the overall well being of students
• Giving health education
• Creating "Health, Hygiene & Fitness" awareness in the society / community
• Supporting national and international health related issues / days.

Objectives of the Health Club

• To organize "Health Week" annually
• Provide First Aid & manage a First Aid Corner in the school
• Keep liaison with a doctor in the school vicinity who can be available either free or on nominal payment in case such help is required
• To create a health newsletter at least twice a year/poster competition related to health issues
• To conduct surveys on health related concerns
• To organize `health walks’ as part of social campaigns
• To organize health fairs and immunization campaigns (Vaccination Week)
• To tap the local resources in the community to arrange health talks
• To render service in any area affected by a disaster or a calamity
• To create health help line within the school to cope with emotional and social behavior and to clarify misconceptions regarding sexual and reproductive health
• To teach the students techniques of exercise & yoga from an early age
• To inculcate in the students healthy and positive ways of living
• To make their mates understand the importance of "Balanced Diet"/Health Eating Habits
• To teach health songs on various health topics and organize essay / speech competitions with health promoting themes
• Celebration of important days (e.g., World Health Day – April 7)
• Creating awareness regarding `World No Tobacco Day’ (May 31), `World AIDS Day’ (December 1) etc.

Health Ambassadors:

Student members of the "Health Clubs" act as the Ambassadors of Health in their class and community. They are kept in constant contact with a central IHS Health Club helpline based in Islamabad where the member can call and coordinate his/her activities. The members are given school bags with health promoting punch lines, for instance: "TB is curable", "Prevention is better then cure", etc. The Health Ambassadors under take the following activities that are laid down in the 'yearly plan' of the club:

• Create health awareness in their community

• Organize health promoting activities

• Promoting vaccination as a measure of prevention

• Teach first aid

• Help the sick class fellows

• Promote hygiene & cleanliness

Little Doctors Club:

Children who aspire to become doctors in future can be grouped under this category. These children are trained to detect illnesses, epidemics, contagious diseases and advise and monitor hygiene and cleanliness issues in their school and community as Class 'Health Proctor'.

IHS suggests a large number of activities in the table below for various levels of classes, which can be conducted as part of co-curricular inputs during a calendar year.  The activities mentioned here are recommended as pointers and many more can be added as per local needs and requirement.  We are also in the process of preparing a manual on a Comprehensive School Health Program, which will be available shortly.

Suggested Activities for Promoting Health in Schools