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EDITORIAL ANALYSIS :Revamp India’s school health services

 Source: The Hindu

  • Prelims: Current events of national importance, Healthcare, evolution of school healthcare in India, Different social service Schemes,NEP, UNESCO, UNICEF etc
  • Mains GS Paper I & II: Social empowerment, development and management of social sectors/services related to Health and education, NEP etc


  • A few weeks ago, following a review of the implementation of the National Education Policy, the Prime Minister’s Office (PMO) is said to have advised regular health check-ups and screening schoolchildren.
  • Some letters were said to have been sent to the Health Department and requests made to depute medical interns and students in post-graduate courses to conduct a health check-up in schools
  • Children across India are back to school for in-person classes after an unnecessarily prolonged and arguably unwarranted closure (especially for the last one year) in the wake of the COVID-19 pandemic.
  • There should be concrete policy measures and actions that target schoolchildren.




National Education Policy, 2020



  • School Education: Universalization of education from preschool to secondary level with 100% Gross Enrolment Ratio (GER) in school education by 2030.
    • To bring 2 crore out of school children back into the mainstream through an open schooling system.
    • The current 10+2 system to be replaced by a new 5+3+3+4 curricular structure corresponding to ages 3-8, 8-11, 11-14, and 14-18 years respectively.
    • It will bring the uncovered age group of 3-6 years under school curriculum, which has been recognized globally as the crucial stage for development of mental faculties of a child.
  • Higher Education: Gross Enrolment Ratio in higher education to be raised to 50% by 2035.
    • Also, 3.5 crore seats to be added in higher education.
    • The current Gross Enrolment Ratio (GER) in higher education is 26.3%.
  • National Educational Technology is Forum (NETF): An autonomous body, the National Educational Technology Forum (NETF), will be created to provide a platform for the free exchange of ideas on the use of technology to enhance learning, assessment, planning, administration.
    • National Assessment Center- ‘PARAKH’ has been created to assess the students.

Need for healthcare services to schoolchildren:

  • Health-care needs equated with medical care needs: One of the reasons school health services receive inadequate policy attention is because health-care needs are often equated with medical care needs.
  • Age specific health needs: Though school age children have a relatively low sickness, they do have a wide range and age-specific health needs that are linked to:
    • Unhealthy dietary habits
    • Irregular sleep
    • Lack of physical activity
    • Mental health
    • Dental and eye problems
    • Sexual behaviour
    • Use of tobacco and other substances, addiction, etc.
  • Foundation of healthy behaviour: The health knowledge acquired, and lifestyle adopted in the school-going age are known to stay in adulthood and lay the foundations of healthy behaviour for the rest of their life.
    • For example, scientific evidence shows that tobacco cessation efforts are far more successful if started in school.


Evolution of School Healthcare:



Recent initiative by Delhi government:

In two and half years of the COVID-19 pandemic, there has barely been any serious initiative about school health

  • The government of Delhi began 20 school health clinics with the promise of more.
    • It recognises the importance of school health services in the post-pandemic period.
    • The importance of multi-stakeholder partnership for school health services as these are being set up through corporate social responsibility(CSR) funding from a donor on the one hand and internal collaboration between health and education departments within government on the other.


FRESH approach:

  • The World Health Organization (WHO) and the World Bank(WB) have published an inter-agency framework called FRESH — an acronym for Focusing Resources on Effective School Health.
  • The core areas suggest that school health services need to focus on school health policies.
    • Water, sanitation and the environment
    • Skills-based health education
    • School-based health
    • Nutrition services.
  • The supporting strategies include effective partnerships between the education and health sectors, community partnership and student participation.


Guidelines by the Centers for Disease Control and Prevention, Atlanta, U.S.:

  • It advised that school health services should focus on four main areas:
    • Acute and emergency care:
    • Family engagement
    • Chronic disease management
    • Care coordination.


WHO guidelines:

  • School health services should be designed based on local need assessment.
  • Should have components of health promotion, health education, screening leading to care.
  • Referral and support as appropriate.


Objectives of school health services:




  • Revamp and strengthen school health services: Every Indian State needs to review the status and then draw up a road map to revamp and strengthen school health services, along with a detailed timeline and dedicated budgetary allocation.
    • The Fifteenth Finance Commission grant for the health sector should and could be leveraged.
  • Comprehensive, preventive, promotive and curative services: Built upon the existing school health infrastructure; the renewed focus has to have comprehensive, preventive, promotive and curative services with a functioning referral linkage.
  • Health talks and lifestyle sessions: By school teachers and invited medical and health experts should be a part of teaching just as physical activity sessions are.
    • Some of the teaching must look at adolescent sexual health; also, subjects such as menstrual hygiene, etc. should be integrated into regular classroom teaching.
  • Online consultation for physical and mental health needs: School health clinics should be supplemented with online consultation for physical and mental health needs.
    • This could be an important starting point to destigmatize mental health services.
  • Participation of parents: The role and the participation of parents, especially through parent-teacher meetings should be increased.
    • Parents need to be sensitized about how school health services are delivered in other countries.
    • This may work as an important accountability mechanism to strengthen school health.
    • Innovative approaches that offer limited health services to parents, families and even school teachers could increase use, acceptance and demand.
  • Inclusion of private schools in government services: The Government’s school health services initiatives do not include private schools most of the time.
    • Private schools do have some health services, which are nearly always restricted to curative care and taking care of emergencies.
    • Clearly, school health services should be designed to take care of schoolchildren be they in private or government-run schools.
  • Review initiative under Ayushmann Bharat Programme: Under the Ayushman Bharat programme, a school health initiative was launched in early 2020, but its implementation is sub-optimal.
    • There is a need to review this initiative, increase dedicated financial allocation to bring sufficient human resources and monitor performance based on concrete outcome indicators. Otherwise, it will end up being a ‘missed opportunity’.
  • Responsibility by civil servants: Children are the future of society, but only if they are healthy and educated.
    • Elected representatives, professional associations of public health and pediatricians have the responsibility.
    • Every citizen should raise the issue and work towards improved school health services being present in every State of India.


Way Forward

  • Health needs of schoolchildren: On the education front, while there has been some discourse on ‘learning recovery’, there is an urgent need to factor in the health needs of schoolchildren
  • Learning from best practices: In the last three decades, many countries, especially in Europe have successfully implemented School healthcare approaches as part of the health-promoting schools (HPS) initiative. A lot can be learnt from them in terms of designing school health services.
  • Onus on health policy makers and programme managers: The onus is on health policy makers and programme managers in every Indian State to do everything in the best interests of children.
  • Collaboration among Departments of Education and Health: The Departments of Education and Health in every Indian State must work together to strengthen school health services.
  • Common platform and goals: It is an opportunity to bring children, parents, teachers, health and education sector specialists and the Departments of Health and Education on a common platform to ensure better health and quality education for every child in India.
  • Convergence of the National Health Policy, 2017 and National Education Policy, 2020: A convergence of the National Health Policy, 2017 and National Education Policy, 2020 should result in the provision of comprehensive school health services in every Indian State.



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