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School Health Service

Introduction

School health service is a service provided by the Ministry of Health Malaysia to school children to ensure optimum health care. Priority is given to school children in government-aided schools throughout Malaysia. Health services were first provided in this country in 1967 and in 1975 the school health services was introduced. The services provided by school health teams were to make scheduled visitations to primary and secondary schools in Malaysia.

Target groups

Nearly about 1.8 million primary and secondary school children in Malaysia will benefit from the school health service every year. The school children who will receive the services provided by the school health teams are those in the following category:

  • Pre-school.
  • Standard 1.
  • Standard 6, and
  • Form 3.

School Health Service Components

School Health Service can be divided into three main components namely:

  • School Health Service.
  • School Dental Service.
  • School Environmental Health Service.

School Health Service Activities

Under School Health Service activities, school children will receive preventative health services, health screening, treatment of mild cases and referral to health centre or hospital. The aim of this service is to:

  • Maintain the health of school children at the most optimum level through health promotion, disease prevention, treatment and referral.
  • Detect of any health problems that can hinder academic achievement of school children and early referral to enable early intervention and placement of students in special education system.
  • Encourage community involvement in making school a safe and healthy institution that will then enable effective learning.

Student Health Record Book

Student Health Record (RKM1) for school children is a document containing all the health information obtained during the schooling years. This book is a reference book that records the growth and development during schooling years. The book is provided free by the Ministry of Education for every Standard 1 student. Parents are required to complete the information of their child in the book and grant consent for health workers to provide health screenings and immunizations to their children.

It is important for PARENTS and GUARDIANS to understand the content of RKM1 that serve as a guide for managing the health of their children during their school years. This book will be kept by the school to facilitate health monitoring of their pupils but will be handed over to students if they were to switch school or proceed to the secondary school. This book will then be given to the new school for safekeeping. Parents may request this book from the school if they wish to see their child’s health record.

Health Education

Health education is part of the school health services activities. This activity is divided into health education in groups and individual health education.

Health education in group is carried out through health education campaign or health camp in the school. Students can acquire knowledge through exhibitions, lectures and demonstrations by health personnel. More often, health education in group will prioritise public health problems associated with school children such as thalassemia screening, Anti-Smoking Campaign and Healthy Lifestyle.

Individual health education, on the other hand is given as advice and counselling during medical examination session. Common issues are those related to diet, skin diseases, and personal hygiene.

School Health Immunisation

As an extension to childhood immunization, school children will be given immunizations as follows:

The Immunisation Schedule for School Children Recommended by Ministry of Health
Standard 1
BCG (if no scar)
Diphtheria & Pertussis
Polio
Mumps, measles dan rubella
Form 3
Tetanus Toxoid

Parents can bring their children to the nearest health centre to receive their vaccination, should their children did not obtain the necessary immunisation, either because of no consent or absence from school at the time of visit by school health team.

Medical Examination

Medical Examination is also part of the activity during the school health visitation. Medical Examination is a physical examination conducted by a doctor, public health nurse and/or Assistant Medical Office. The type of examination conducted is shown in the following tables:

Types of Medical Examination for Standard 1 School Children
Medical Examination
Purpose
Height & Weight To determine the nutritional status of school children
Eye examination Detecting refractive errors and lazy eye that can interfere with academic achievement.
Hearing Screening Detecting both mild and moderate hearing problems that can hinder academic achievement.
Examination of Heart & Lungs Detecting congenital heart disease that was not identified during infancy. Cases that were identified will be referred for confirmation.
Skeletal Examination Detecting skeletal defects that were not identified during infancy .
Personal Hygiene Examination Detecting head lice infection, scabies, and other skin problems so that it will be treated.
Testicular examination Detecting problems such as ‘hydrocele’ and ‘undescended testicle’ among boys.
Detection For Learning Disabilities Receive referral from teacher who has identified those school children that have problems with reading, writing, mathematics and reasoning. These school children will be referred to a specialist for confirmation and determining the appropriate learning placement for these school children.

 

Types of Medical Examination for Standard 6 School Children
Medical Examination
Purpose
Height & Weight To determine the nutritional status of school children whether having ideal body weight, overweight or obese.
Eye examination To detect unidentified refractive errors and increasing refractive errors among those school children with spectacles.
Colour Blindness Screening
  • Screening conducted on boys since it affects boys only.
  • Detection of colour blindness that will affect career choices of these school children.
Skeletal Examination Detecting scoliosis at earlier stage. Suspected cases will be referred to hospital for confirmation and early intervention.
Personal Hygiene Detecting head lice infection, scabies, and other skin problems so that it will be treated.

 

Types of Medical Examination for Form 3 Students
Medical Examination Purpose
Height & Weight To determine the nutritional status of school children whether having ideal body weight, overweight or obese.
Eye examination To detect unidentified refractive errors and increasing refractive errors among those school children with spectacles.
Colour Blindness Screening
  • Only if it was not done in Standard 6.
  • Detection of colour blindness or colour vision deficiency that will affect career choices of these school children.
Hearing Screening Detecting risk of deafness.
Skeletal Examination Detecting scoliosis at earlier stage. Suspected cases will be referred to hospital for verification and early intervention.
Adolescent Health Screening Optional. Only carried out in some schools. Interested parents can bring their children to be screened at the nearest health centre.

Health problems detected among school children

Among the health problems commonly detected among school children are:

  • Obesity
  • Visual acuity
  • Colour blindness
  • Skeletal Abnormalities
  • Worm infection
  • Scabies
  • Hearing loss

Treatment and health referral

Treatment will be given to all school children detected having minor health problems such as minor wounds, scabies, worm infections, head lice infection, treatment of fever and flu. The cases that need to be referred are those which require further medical examination for case confirmation. Among the health problems that need to be referred are visual acuity problem, colour blindness, heartbeat problem and suspected cases of scoliosis.

Home visits

The school health team will also conduct home visit during school holidays. Home visits are carried out either by making a call to the parents at home or visit by a nurse to the home. The objective was to follow-up on those students who have missed immunization at school to go to the nearest health centre for immunization, or to obtain feedback on the status of referral to the hospital.

School Dental Health Examination Component

A school dental team will visit all the primary and secondary schools in Malaysia.

School Environmental Health Service Component

School environment health service is implemented by the Ministry of Health and Ministry of Education in an integrated manner. Inspection of the school environment includes an examination of school infrastructure, vector-borne disease control, hygiene monitoring and operation of the school canteen.

School environment health service is regulated under various laws such as the Tobacco Control Act and the Control of Vector-Borne Diseases Act that can lead to penalty if the school management failed to comply with these acts. Under this service, the schools need to set up teams to destroy mosquito breeding places in schools to combat dengue fever. Besides that, activities need to be carried out to ensure the school complies with the Tobacco Act as schools are gazetted as ‘No Smoking Areas’. The Assistant Environmental Health Officer will inspect each school every year to ensure that the school is clean and safe.

Other health-related services at the school

Apart from the Ministry of Health, Ministry of Education is also responsible for the welfare of school children at the school. Supplementary Food Programme and School Milk Programme provided to eligible primary school children are example of health-related services that are included in this category.

Last Reviewed : 27 September 2013
Writer : Dr. Saidatul Norbaya bt. Buang

 

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