Health Check-Ups in School: Challenge Accepted

Swasthya Swaraj, the organization where I work, runs a project with schools in tribal community of Kalahandi, Odisha under which we aim to improve the attendance in schools and better the living conditions of local people. It broadly covers the major issues of healthcare, nutrition and education. A major part of the program is to conduct village meetings for improving their awareness about the functioning of schools, mid-day meal program and associated benefits provided by the government. This is followed by a health checkup of all the students enrolled in the school.

In the first half of 2018, the project was initiated and headed by me, with help from field staff, community nurses and dedicated lab staff. We were able to complete school health check-ups in 14 schools within a month, with nearly 451 students examined and all their problems suitably handled. Each school program had the following steps:

1. Visit the school on the previous evening
2. Meeting with the parents of school-going students on the morning of check-up
3. Quick introduction of parents
4. A brief educational program on malaria – its causes and effects on children along with preventive measures for the same
5. Discussion on attendance of school-going children, teachers, reasons for dropout
6. Running the Mid –day Meal program (MDMP)
7. Importance of sports, formation of children’s sports clubs run by students.
8. Health check-up

In the middle of the project, we found that three of our villages namely Taramundi, Maltipadar and Rupen had no school buildings while the Serkapai had an unfinished shell of a structure. The roofs at Dandpadar and Sylet schools were leaky. Although, it’s very difficult to go into specific detail of each school, there were only a few where MDMP was run properly. These were also the schools where teacher and student attendance was higher.

Wherever we could interact with the school teacher, we found a number of logistical problems that teachers face in conducting regular classes. For example, the treacherous terrain through which the vehicles pass with MDMP supplies, unresponsive government authorities to improve infrastructure, maintenance of toilets and contract status of teachers. A common theme in all schools was the presence of toilets built under Swachch Bharat scheme without running water in any of the 14 schools.

Out of 451 students examined, 236 (more than 50%) were anaemic while 185 were diagnosed with Malaria, of which 91 (1/3rd) had a positively palpable spleen. Out of these 185 students with Malaria, 108 showed no symptoms of the disease. A total of 104 students (23%) had dental caries.

Prevalence of diseases like Scabies and Bitot’s spots has come down drastically if we compare it to last years’ school health check-ups. A number of students with disabilities and those requiring further consultation were identified and referred accordingly.

There were a number of operational difficulties while conducting school health check-ups, one of which was transportation of Anthropometry instruments and medication to respective schools. Another challenge was to get all the children enrolled in the school for the check-up as a lot of them, especially girls always had some or the other work at home or on the hills where tribal Kondh community cultivates. In a particular week, when check-ups were scheduled in three different schools, they clashed with the tribal wedding season and we had to change our schedule completely.

Despite these difficulties, we were able to examine 40% of the enrolled students. We hope to move into the next phase with our Children’s sports clubs, kitchen gardens and training of local field-staff.