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Primary Health Care
COMPREHENSIVE SCHOOL HEALTH
There is an urgent need for the rapid and universal introduction of Comprehensive School Health Programs. Nurses have an important role to play in providing a primary health care approach for children and youth who are experiencing health problems or require help with special needs in order to participate in school programs.
A comprehensive school health approach includes a broad spectrum of activities and services that take place in schools and surrounding communities and enable children and youth to enhance their health, develop to their fullest potential, and establish productive and satisfying relationships in their present and future lives. The goals of such comprehensive approaches are to: promote health and wellness; prevent specific diseases, disorders and injuries; intervene to assist children and youth who are in need or at risk; and, help support those who are already experiencing poor health.1
Background
In the past, health education has received little of the formal recognition granted to other disciplines in a child's education. While historically the practice has been to respond with special programs as health issues emerge, there is now a movement in Canada to a broader view and more comprehensive approach to educating clients through health promotion activities.
Health promotion is a process that enables people to increase control over, and improve, their health. Comprehensive school health programs are one significant method of promoting health because health practices and realizing responsibility for ones' own health are best learned at an early stage. This is crucial because health can affect school performance and the "resulting feelings of success or failure can influence the child's self-concept as well as the level of motivation and achievement."2
The Canadian Nurses Association endorses the concept of Comprehensive School Health Programs, the statement of the International Council of Nurses (ICN) on the Rights of Children3 and the international Declaration on the Rights of the Child.4 These statements identify the need to deliver primary health care services with an emphasis on the prevention of disease and disability, and on the enhancement of the means of protecting those with special needs. This includes the right to health services and special treatment, and education and care for the physically, mentally or socially handicapped child.
Principles for success
When considering comprehensive school health programs, it is essential to have a clear sense of direction and a firm idea of what such a program entails. Therefore, the responsibility for these programs lies with a team of school and community health educators, and other interested individuals.
Comprehensive school health programs should be adapted to the special needs of children in the schools, with attention to multicultural, linguistic, physical and emotional factors. There must be appropriately supervised structures and protocols to cover the provision of physical care services in the school context.
Nurses must provide leadership for health promotion and, as client advocates, must "act in the best interests of the client"5 to help them gain access to the health care system. As members of a team, nurses have an important role to play in encouraging the move to comprehensive health programs in schools, and in developing, implementing and evaluating these services. This includes providing expert input into curriculum content, and developing strategies to ensure a primary health care approach with emphasis on health promotion and disease prevention. Counselling services and help for those who are at risk, and appropriate services for children and youth who are experiencing particular health problems or require help with special needs in order to participate in school programs, are included.
Involvement of individuals, families and communities as active partners in their health care significantly increases the potential for positive results. The success of comprehensive school health programs depends on meaningful participation of individual students, educators, parents and other members of the school milieu and the surrounding environment in the planning and implementation of programs. Regular and ongoing evaluation of curriculum objectives and community participation as well as planned and ongoing in-service programs for teachers and others involved, are imperative.
Approved by the CNA Board of Directors, June 1994
- Canadian Association for School Health. Statement on
Comprehensive School Health. Endorsed by CNA in March 1992.
- Health and Welfare Canada, "Comprehensive School Health,"
Health Promotion, Vol. 29, No. 4, Spring 1991.
- International Council of Nurses. Statement on Rights of
Children. Geneva: 1986.
- Human Rights Directorate, Department of Multiculturalism and
Citizenship. Convention on the Rights of the Child. Ottawa:
1991.
- Canadian Nurses Association. The Code of Ethics for Nursing. Ottawa: 1991.
