HEALTH PROMOTION AND
EDUCATION IN SCHOOL

Dr. Vijay B. Lambole
Asso. Professor,
SNLPCP, Umrakh.

1
• A health promoting school (HPS) is one that
constantly strengthens its capacity as a healthy
setting for living, learning and working.
• Health is viewed as dynamic, changing, and
unfolding; it is the realization of a state of
actualization or potential (Pender, Murdaugh, &
Parsons, 2006). This basic human right is
necessary for development of societies.
• In order to understand health promotion and
health maintenance, it is important to
understand the definition of health first. The
World Health Organization defines health as a
state of complete physical, mental, and social
well-being and not merely the absence of
disease and infirmity (World Health
Organization, 1996).
• Health promotion refers to activities that
increase well-being and enhance wellness or
health (Pender, Murdaugh, & Parsons, 2006). These
activities lead to actualization of positive health
potential for all individuals, even those with chronic
or acute conditions. Examples include providing
information and resources in order to:
• Enhance nutrition at each developmental stage
• Integrate physical activity into the child’s daily
events
• Provide adequate housing
• Promote oral health
• Foster positive personality development
• Health promotion is concerned with
developing sets of strategies that seek to
foster conditions that allow populations to be
healthy and to make healthy choices (World
Health Organization, 2001).
• In 2015, WHO convened an expert meeting to
review the school-based interventions and
the HPS initiative at global level. Experts have
identified eight major barriers for an effective
implementation of HPS initiative:
• Lack of policies, guidelines, scale up plans, policy
implementation.
• Insufficient lobbying and advocacy for HPS and school
health activities.
• Insufficient amount of and timeliness of budget allocation.
• Lack of coordination among related ministries and
stakeholders (e.g. UN bodies, NGOs and academic
institutions).
• Lack of technical capacity on human resources and training.
• Lack of quality and quantity of resources for
implementation.
• Lack of monitoring and evaluation, as well as insufficient
data and evidence for promoting HPS and school health
interventions.
• Cultural barriers to implementation.
A health promoting school:
• Fosters health and learning with all the measures at its disposal.
• Engages health and education officials, teachers, teachers’ unions,
students, parents, health providers and community leaders in
efforts to make the school a healthy place.
• Strives to provide a healthy environment, school health education,
and school health services along with school/community projects
and outreach, health promotion programmes for staff, nutrition and
food safety programmes, opportunities for physical education and
recreation, and programmes for counselling, social support and
mental health promotion.
• Implements policies and practices that respect an individual’s
wellbeing and dignity, provide multiple opportunities for success,
and acknowledge good efforts and intentions as well as personal
achievements.
• Strives to improve the health of school personnel, families and
community members as well as pupils; and works with community
leaders to help them understand how the community contributes
to, or undermines, health and education.
Goals:
• One of the two major goals of Healthy People is
to help individuals of all ages increase life
expectancy and improve their quality of life.
• The concepts of health promotion and health
maintenance provide interventions that
contribute to meeting this goal.
• Many students in health professions begin their
studies with a strong interest in care of ill
individuals. However, as time progresses, they
learn that “well” people need care also.
• They need teaching to improve diet, reduce
stress, and obtain immunizations.
• The family’s role in children’s health is
critical. A thorough understanding of the
healthcare conditions that affect children is
needed so that health promotion and health
maintenance can be integrated within the
framework of comprehensive health care.
Some children have special healthcare needs
and these are integrated into the provision of
health promotion and health maintenance.
• They may seek information about how to exercise
properly or ensure a safe environment for their
children. These examples of care and teaching
are components of health promotion and health
maintenance.
• Health care management is a holistic profession
that examines and works with all aspects of
individuals’ lives, and has a strong focus on family
and community as well. Therefore it should be
uniquely positioned to provide health promotion
and health maintenance activities. In fact, these
activities should be a part of each encounter
with families.
Growth and Developmental Surveillance in
Schools
• Growth and developmental surveillance
provide important clues about the child’s
condition and environment. Evaluation of
growth, child height, weight, and body mass
index are should be calculated at each health
supervision visit. Parents should be given the
information in written form and interpreted
for them.
Nutrition
• Nutrition is a vital part of each health
supervision visit. Itmakes important
contributions to general health and fosters
growth and development. Include observations
and screening relevant to nutritional intake at
each health supervision visit. Eating proper foods
for age and activity ensures that children have
the energy for proper growth, physical activity,
cognition, and immune function. Nutrition is
closely linked to both health promotion and
health maintenance.
Physical Activity
• Physical activity provides many physical and psychological health
benefits. However, there is growing disparity between
recommendations and reality among most of our children. Research
by the Centres for Disease Control and Prevention (CDC) using the
Youth Media Campaign Longitudinal Survey (YMCLS) of parents and
children found that 61.5% of 9- to 13- year old children report that
they do not participate in any organized physical activity during
hours outside of school. While organized activities are important
and consistent forms of exercise, not all children can participate or
desire to do so. However, 22.6% of these children reported that
they do not engage in ANY physical activity outside of school.
Parents noted that barriers to physical activities included
transportation problems, lack of opportunities in area, expenses,
lack of parental time, and lack of neighbourhood safety (CDC,
2003). As the child grows older, insert questions about sedentary
activities such as number of hours spent watching television or
playing computer games. See if the child plays sports at school or in
the community. Ask about activities in a typical day to measure
amount of activity.
Oral Health
• While oral health may seem to require the knowledge
of a specialist, many implications relate to general
health care. Oral health is important because teeth
assist in language development, impacted or infected
teeth lead to systemic illness, and teeth are related to
positive self-image formation. Children are affected by
tooth decay and pain that interfere with activities of
daily living such as eating, sleeping, attending school,
and speaking. Health promotion to dental health by
teaching about oral care and access to dental visits
should be done. Health maintenance activities relate
to prevention of caries and illness related to dental
disease.
Eye and Vision
• Eye exams for children are extremely important,
because 5 to 10 percent of pre-schoolers and 25
percent of school-aged children have vision problems.
Early identification of a child’s vision problem can be
crucial because children often are more responsive to
treatment when problems are diagnosed early.
• Infants should have their first comprehensive eye exam
at 6 months of age. Children then should have
additional eye exams at age 3, and just before they
enter the first grade — at about age 5 or 6. For school-
aged children, an eye exam every two years is
recommended if no vision correction is required.
Children who need eyeglasses or contact lenses should
be examined annually or as recommended by the
optometrist.
Mental and Spiritual Health
• Mental and spiritual health is important concepts to address
in health promotion and health maintenance visits. Parents
can be encouraged to keep a record of mental health issues to
bring to health supervision visits. This helps them understand
that the healthcare professional is willing to partner with
them to assist in dealing with mental health.
• Suggest topics such as child and parental mood, child
temperament, stresses and ways that family members
manage stress, or sleep patterns. Be alert for signs of
depression, stress, anxiety, and child abuse/neglect. Both
health promotion and health maintenance goals related to
child and family mental health should be established.
• Health promotion goals relate to adequate
resources to meet family challenges, protective
factors such as involvement in extended family
and the community. Teaching stress reduction
techniques such as meditation, relaxation, and
imagery, as well as providing resources for yoga
or other techniques, is helpful. Health
maintenance goals relate to prevention of mental
health problems.
• The spiritual dimension is a connection with a
greater power than that in the self, and guides a
person to strive for inspiration, respect, meaning,
and purpose in life Spiritual health is seen in the
large context as those entities that provide
meaning in life.
Disease prevention strategies
• Disease prevention strategies focus mainly on health
maintenance, or prevention of disease. Some health
disruptions can be detected early and treatment for
the condition can begin. Screening is a procedure used
to detect the possible presence of a health condition
before symptoms are apparent. It is usually conducted
on large groups of individuals at risk for a condition
and represents the secondary level of prevention.
Examples include developmental screening, blood
pressure screening, and vision/hearing screening.
Most screening tests are not diagnostic by them but
are followed by further diagnostic tests if the screening
result is positive. Once a screening test identifies the
existence of a health condition, early intervention can
begin, with the goal of reducing the severity or
complications of the condition.
Vaccination
• Like eating well and exercising, immunization is a
foundation for a healthy life. Getting vaccinated
is a safe and necessary part of keeping you and
your family healthy. Vaccinations are incredibly
important, because immunization doesn’t just
protect you; it also protects everyone around
you. When you get vaccinated against a disease,
you build up your immune system, making you
stronger and more resistant to that disease. No
matter how healthy you are, if you haven’t had
the vaccine, you don’t have the antibodies to
protect you if you are ever exposed to the
disease.
Encourage health promotion activities
• Families often need health education and counselling to promote healthy
behaviours in their own child. Examples of focused health education and
counselling may be information about environmental control to limit
sedentary behaviours, dietary changes to increase fruit and vegetable
intake, and switching to low-fat dairy products. Patient education and
counselling are most effective when the family understands the
relationship between a behaviour change and the resulting health
outcome. When identifying that a family would benefit from a change in
health behaviour, consider the family members’ perceptions about the
health change, barriers and benefits to change, and plan interventions to
enhance the possibility for change.
Steps in promoting patient education and
counselling include:
• Clarifying learning needs of child and family
• Setting a limited agenda
• Prioritizing needs with family
• Selecting-teaching strategy (explaining,
showing, providing resources, questioning,
practicing, giving feedback)
• Evaluating effectiveness
Periodic Health Check-up
• Periodic health check-ups and screenings with
health care provider are key to maximizing the
chance of living a longer and healthier life. Not
only can they help prevent health problems
before they start, but regular check-ups may also
help discover health problems early enough to
increase chances of successful treatment and
recovery. Regular health check- ups can help to
identify the risk factors for common as well as
rare diseases, both acute and chronic. Getting
examined periodically can help in the detection
of diseases that could be asymptomatic in the
initial stages.
The criteria for inclusion were school-based
interventions involving health promoting
activity in each of three areas, in which there
was evidence of active participation by the
school:
✓ The school ethos and/or environment.
✓ The curriculum.
✓ The family and/or community.
Conclusion:

Education
• Curriculum
• Learning
•Teaching
Environment
• Physical
• Cultural
• Policies
• procedure
Partnerships
• Students
• Families
• Staff
• Community health services
• Agencies
Public Sector
• Sarv Shiksha Abhiyan
• Rashtriya bal Swasthya kalian (RBSK)
• Madhyhyaan bhojhna Yojana
• National service scheme (NSS)
• Health Maintenance visits
• Mental health services
• Counselling