CHAPTER III

Medical Health Program

Mark Ian E. Derapete Pauline J. Vital

OBJECTIVES

General Objective
Promote and maintain the health and nutritional status of the school population and community through the provision of effective medical services and health education.

Specific Objectives
a. Minimize the incident of common ailments among school children and personnel; b. Institute preventive measures in the control of communicable diseases;

c. Render remedial measures for the treatment of common ailments; d. Encourage propagation and utilization of scientifically tested medical plants for the treatment of common ailments;

e. Provide learning avenues to develop health values of pupils/ students, teachers and parents; f. Monitor the maintenance of safe and healthful environment through the utilization of standard health and nutrition facilities;

g. Establish/ strengthen linkages with government and nongovernment organizations for school/ community health and nutrition programs; h. Monitor and evaluate the implementation of the health and nutrition programs in the school/ community.

POLICIES AND GUIDELINES

1. The medical officer shall conduct physical examination. 1.1. Pupils/ Students
1.1.1 All Grade 1 pupils shall be examined on or before September 30 of every year.

1.1.2. First Year High School and referred cases shall be given priority. 1.1.3. Examination of a minimum of 10, 000 pupils yearly. 1.1.4. Visitation of at least 70 different schools per school year.

1.1.5. Physical examination of female student by a male physician or male student by a female physician requires the presence of a third party. 1.1.6 Athletes should undergo thorough physical examination before participating in divisional/ regional/ national athletic meets.

1.1.7. Collaboration with the Department of Health in the physical examination of the school children/ students as per Memorandum of Agreement between DECS and DOH partnership in Health and Health Education in the context of Primary Health Care and DILG Assistory support for health services shall be done.

1.1.8 Individual health card of Grade 1 pupils shall be kept by the teacher in-charge.

1.2. DECS personnel

1.2.1. All teachers and other school personnel shall undergo annual physical examination.

1.2.2. C.S. Form 86 shall be accomplished by the school medical officer or any government physician as a requirement for annual clearance and shall be field in the division office, Health and Nutrition Section.

1.2.3. Chest x-ray examination shall be required every year. Fat and moderately advanced TB cases shall be subjected to sputum examination and immediate short course chemotherapy. Cases found sputum positive shall go on leave until he becomes sputum negative. Follow-up chest x-ray examination shall be done periodically.

1.2.4. The school medical officer shall collaborate with the District Hospitals, TB pavilions and other Chest Clinics in the implementation of the TB Control Program.

1.3. All newly appointed school personnel are required to undergo a thorough health examination to include urinalysis chest x-ray, blood test, neuropsychiatric examination.
1.3.1 C.S. Form 211 shall be accomplished by the medical officer or any government physician.

1.4. Official chest x-ray examination results shall be attached to C.S. Form 211 and shall be filed in the Regional/ Division Health and Nutrition Unit/ Section.

2. Sick leaves exceeding five days, maternity leaves and reinstatement shall be duly certified by the school medical officer.

2.1. In case the attending physician is a private practitioner or another government physician, a medical certificate shall be attached to C.S. From 41 duly attested by the medical officer.

2.2. In cases where there is no medical officer in the division, the medical certificate issued by any government or private practitioner shall be noted and filed in the Health and Nutrition Section.

2.3. In cases of complete abortion not certified by a health personnel, a thorough verification of the case shall be pursued before a medical certificate is issued.

2.3.1. School administrators shall be notified immediately who shall refer the case to the school medical officer or other school health and nutrition personnel. 2.3.2. Product of conception shall be preserved for examination. 2.3.3. In case of habitual abortion, the medical officer shall certify/ attest to the reinstatement of the teacher/ personnel.

3. The medical officer shall not issue exemption for military training. 3.1. The medical officer may certify to an existing ailment or illness and make appropriate recommendation.

4. The medical officer shall institute measures for the prevention and control of communicable diseases. 4.1. Reportable diseases shall be immediately reported to local health and school authorities.

4.2. Exclusion of pupils/ students from class shall be done for those suffering from communicable diseases.

4.3. He shall coordinate the implementation of the joint circular Memorandum of Agreement of the Department of Local Government, Department of Health and Department of Education, Culture and Sports partnership.

5. All regions/ divisions/ schools must have functional regional/ division/ school clinics. 5.1. The medical officer shall supervise and coordinate with other school health and nutrition personnel the maintenance of a functional clinic.

6. Maximum utilization of tested medicinal plants shall be encouraged in all schools.

SCOPE OF WORK

I. Health and Nutrition Education

1. Utilize the school health services for health and nutrition values development of pupils/ students.

2. Coordinate with the public health nurse in the training of first aid teachers in simple remedial work. 3. Disseminate health and nutrition information in coordination with other health and nutrition personnel.

4. Serve as a resource person/ consultant during in-servicetraining/ orientation and seminar/ workshop and preparation of instructional materials and visual aids in health education.

5. Provide teachers with updated health and nutrition information. 6. Provide an opportunity to build positive health attitudes and practices.

II. Healthful School Living

1. Collaborate with the local school administrator in setting up policies and procedures for maintaining and promoting the health and nutrition of the school population.

2. Coordinate with the administrator in the supervision and maintenance of the sanitation and safety of the school plant. 3. Take leadership in the campaign for the provision of standard health and nutrition facilities in the school.

III. Health and Nutrition Services

1. Render routine physical examination to the school population.

2. Provide medical consultation/ treatment of minor ailments and emergency cases with the use of generic drugs and scientifically tested medicinal plants. 3. Make appropriate referrals and follow-up of cases when necessary.

4. Determine the physical and mental fitness of the school population who will participate in physical education programs, athletic meets and other related activities.

5. Provide health examination of school personnel to certify maternity and/ or sick leaves as well as re-admission to or exclusion from classes of pupils/ students.

6. Take leadership in organizing, providing technical supervision of a functional school clinic.

7. Inform immediately, reportable diseases to local health and school authorities.

IV. School Community Coordination for Health and Nutrition

1. Create public awareness on the importance of the schoolcommunity health and nutrition program. 2. Collaborate with other health and nutrition personnel in the control/ prevention of communicable disease.

3. Advise the school administrators regarding the health and nutrition programs of the community and their relationship to the school health program. 4. Act as resource person in schoolcommunity health council meetings and assemblies.

5. Establish harmonious relationship between the school and community.

6. Monitor and evaluate the implementation of the health and nutrition programs in the school and the community.

V. Special Project/ Research Studies

1. Engage in special project/ research studies in coordination with other health and nutrition personnel.

VI. Plan of Work

1. Schedule of Work 1.1. Annual Schedule 1.2. Monthly Schedule

1.1. Annual Schedule

Before the end of the calendar year, the school physician shall prepare a tentative annual schedule for the approval of the School Division Superintendent. This schedule shall be posted in the division clinic on or before the 5th day of January and a copy of which shall be submitted to the Regional Office.

1.2. Monthly Schedule A monthly schedule shall be prepared and submitted to the school division superintendent for approval and posted at the division clinic to serve as a guide. School administrators shall be furnished a copy prior to actual visit.

The Medical Officer, Dentist Incharge and Nurse In-charge shall report every Monday for his duties and activities, and during the last 2 working days of the months for the preparation and admission of reports and planning of activities in the succeeding months.

If, for unavoidable reasons, the Medical Officer cannot meet his schedule, he should duly notify the school administrators concerned. Suggested monthly activities are as follows:

1. examine a minimum of 1,000 pupils/ month 2. visit a minimum of 7 different priority schools/ month 3. attend staff conferences, seminars, community assemblies, athletic meets

4. initiate and participate in special health and nutrition programs 5. treat/ refer of cases found 6. perform activities health education

2. School Visit 2.1. The school medical officer shall visit a minimum of seven (7) different priority schools per month.

2.2. A master list of schools with the corresponding enrollment shall be accomplished as basis in the presentation of his schedule and shall be posted in the division clinic. 2.3. The medical officer shall wear the prescribed white uniform.

3. Activities During School Visit 3.1. Courtesy call to the Administrator The school medical officer shall confer with the school administrator regarding the purposes/ objectives of the visit.

3.2. Inspection of the school plant The school medical officer shall look into the environmental sanitation and provision of health facilities like clinic, toilets, school canteen, feeding centers, drop-in centers, garbage disposal, compost pit, water facilities and classroom lighting and ventilation.

3.3. Physical examination of school children and personnel Minimum Target Pupils 1,000/ month/ physician 10,000/ year/ physician

Teachers 50/ month/ physician 500/ year/ physician

All Grade 1 pupils and 1st year high school students are the priority groups including the student population of identified poor and nutritionally deprived municipalities. Annual physical examination of teachers and personnel can be done in the school preferably during summer in the division clinic. Ate the end of the school year, health clearance should be included.

3.4. Post-conference
After examination and treatment, the school medical officer shall call a conference. Findings, if any are explained to the teachers and their respective role regarding the case follow-up is suggested. Recommendations are given to the administrators, regarding the various findings including those related to the school plant.

3.5. Health talk At least five (5) health talks per school are given by health and nutrition personnel after the physical examination. Appropriate topics relevant to the findings are taken up.

4. Remedial and curative measures 4.1. Provides consultation, treatment and management of cases discovered during physical examination and cases referred by teachers, nurses and parents.

4.2. Renders first aid for emergency cases 4.3. Refers cases as necessary.

5. Other related work of school medical officer 5.1. Guides and helps teachers and nurses in the observation for signs and symptoms of communicable diseases or acute illness and evidences of abnormal growth and development.

5.2. Attends inter-agency conferences, athletic meets, seminars, conventions and inservice trainings. 5.3. Acts as resource speaker/ consultant during health seminars or community assemblies. Suggested topics to be taken up:

5.3.1. Results of physical examination like leading common ailments, communicable and endemic diseases, malnutrition, vitamin and mineral deficiency and others. 5.3.2. Prevention and control of drug abuse.

5.3.3. Use of tested medicinal plants in the treatment of common ailments. 5.3.4. Other current issues and concerns. health

5.4. Monitors and evaluates health and nutrition programs and other special projects.

6. Accomplishment of reports The Regional/ Division Medical Officer shall prepare a quarterly/ monthly report of the activities during the quarterly and monthly visits and shall be submitted to the School Health and Nutrition Center/ Regional Health and Nutrition Unit.

The medical officer will also recommend/ note the itinerary of travel and daily time record of all school health and nutrition personnel in the Regional Health and Nutrition Unit/ Division Health and Nutrition Section.

6.1. Regional Level 6.1.1. The Regional Medical Officer V/chief-RNHU shall prepare quarterly accomplishment reports to be submitted to the School Health and Nutrition Center, Pasig City.

6.1.2. Likewise, all other reports prepared by the Regional Health and Nutrition Unit staff shall be duly initialed by the Regional Medical Officer V before submission to the Health and Nutrition Center and other concerned offices/ agencies.

6.1.3. The Regional Medical Officer V shall recommend/ note travel authority, itinerary of travel, daily time record of all RNHU staff. 6.1.4. All out-going communication and other documents shall be duly noted/ initialed by the Medical Officer V.

6.2. Division Level 6.2.1. The Division Medical Officer IV/ Chief of Health and Nutrition Section shall prepare annual/ monthly accomplishment reports to be submitted to the Regional Health and Nutrition Unit and Health and Nutrition Center, DECS Complex, Pasig City.

6.2.2. All other required reports (monthly/ Annual) prepared by the Division Health and Nutrition Section (Dentist In-Charge and Nurse In-Charge) shall be duly noted by the Division Medical Officer before submission to the Regional Health and Nutrition Unit and other agencies/ offices.

6.2.3. The Division Medical Officer IV shall recommend/ note travel authority, itinerary of travel and daily time record of Division Health and Nutrition Section staff.

6.2.4. All outgoing communication/ documents shall be duly noted/ initialed by the Medical Officer IV.

7. Certificate of Appearance The school medical officer shall have his/ her certificate of appearance signed by the school administrator before leaving the school.

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