Objectives of School Health Services
                     A  C O M P R E H E N S I V E  O V E R V I E W
Objectives of
School Health Services
Building the systems, people and habits that keep every child in school, healthy and 
learning.
W H AT  W E  W I L L  C O V E R
Agenda
01 02 03
Foundations Policy Context The Components
Definition, scope and why school health is a From the Renuka Ray Committee to Ayushman The twelve classical components and five 
public health priority Bharat and NEP 2020 objective clusters
04 05 06
Objectives in Detail Delivery & Measurement A Delivery Partner
Seventeen objectives, each with practice-level The school health team, indicators, barriers and How Blue Circle operationalises school health 
actions solutions at scale
Objectives of School Health Services 2
F O U N D AT I O N S
What are school health services?
A captive, reachable population
School health services are the organised, continuing programme Roughly a quarter of India's population sits in a classroom on any 
working day — the single largest organised group reachable by 
of health care, health promotion and a healthful environment preventive health.
provided to school children, staff and, through them, to families 
and the wider community.
The habit-forming years
Diet, hygiene, activity, tobacco and help-seeking behaviour are all 
They are not a once-a-year medical camp. They are a system.
set between ages 5 and 18 and carry into adult life.
T H R E E  I N S E PA R A B L E  A R M S
A  W O R K I N G  D E F I N I T I O N  I N  O N E  L I N E
• Health services — appraisal, treatment, referral
Everything a school does, deliberately and routinely, to protect and improve the 
health of the children in its care — and to make sure ill health never becomes the • Health education — knowledge and life skills
reason a child stops learning. • Healthful environment — physical and psychosocial
Objectives of School Health Services 3
F O U N D AT I O N S
Why school health earns its place on the budget
5–18 4 Ds 1 hr 2
Health & Wellness 
The age band What we screen for Weekly health promotion
Ambassadors
Every objective in this deck is built The Ayushman Bharat School Health 
Defects at birth, Deficiencies, Two teachers per school are trained 
around this window — the period of & Wellness Programme model: one 
Diseases, and Developmental delays to run sessions and act as the first link 
fastest growth and firmest habit dedicated hour, every week, led by 
including disability. to formal care.
formation. trained teachers.
A sick child in a classroom is an absent child. Absence compounds into learning loss, repetition and drop-out — which is why school health is an 
education outcome long before it is a health outcome.
Objectives of School Health Services 4
P O L I C Y  C O N T E X T
How the mandate evolved in India
School Health Committee RBSK launched NEP 2020
The Renuka Ray Committee Rashtriya Bal Swasthya Karyakram 
National Education Policy embeds 
reviews child health in schools and brings systematic 4 Ds screening 
health check-ups, nutrition and 
recommends a formal school for 0–18 years with free follow-up 
counsellors into school design.
health service. care.
1961 1995 2013 2018 2020
WHO Health Promoting Ayushman Bharat SHWP
Schools
Health and Education ministries 
A global shift from treating illness 
jointly fund weekly health 
in schools to building health-
promotion sessions and teacher 
promoting institutions.
ambassadors.
The direction of travel is consistent: from occasional medical inspection, to universal screening, to the school itself as a health-promoting institution.
Objectives of School Health Services 5
T H E  C L A S S I C A L  F R A M E W O R K
The twelve components of a school health programme
01 02 03 04
Health appraisal Remedial measures & follow-up Prevention of communicable Healthful school environment
disease
05 06 07 08
Nutritional services First aid & emergency care Mental health Dental health
09 10 11 12
Eye health Health education Education of children with Maintenance of health records
disability
Objectives of School Health Services 6
T H E  O B J E C T I V E S
Seventeen objectives, five clusters
ASSESS PREVENT PROTECT PROMOTE PARTNER
Know the health status of Make the campus itself safe, Bind teachers, parents and 
Stop avoidable disease before Build knowledge, skills and 
every child, and know it clean and ready for the health system into one 
it reaches the classroom. habits that outlast school.
repeatedly. emergencies. loop.
Objectives 1–3, 16 Objectives 4–6, 14 Objectives 7, 12, 13, 15 Objectives 8–11 Objective 17
Read the clusters as a cycle, not a list — assessment feeds prevention, prevention needs protection, promotion sustains it, and partnership makes it repeat next year.
Objectives of School Health Services 7
O B J E C T I V E  0 1   ·   A S S E S S
Health appraisal: a current baseline for every child
Periodic medical examination Growth monitoring Daily teacher observation
A structured examination at entry and at least Height, weight and BMI-for-age plotted on The class teacher is the true first filter: pallor, 
annually thereafter — general physical, growth charts so that faltering, stunting, fatigue, itching, squinting, frequent absence 
systemic, skin, ENT and posture — recorded on thinness or rising obesity are caught as a trend, and mood change surface here long before a 
a standard proforma. not a one-off reading. formal check-up.
W H Y  T H I S  O B J E C T I V E  M AT T E R S
Appraisal exists to convert vague concern into documented, comparable data. Without a baseline, no later objective can be measured — and no parent 
can be given a clear reason to act.
Objectives of School Health Services 8
O B J E C T I V E  0 2   ·   A S S E S S
Early detection: screening for the four Ds
Defects at birth Deficiencies
Neural tube defects, cleft lip and palate, club foot, congenital cataract, Anaemia, vitamin A and D deficiency, severe acute malnutrition, goitre — the 
congenital heart disease, developmental dysplasia of the hip and congenital quiet conditions that dull attention and attendance long before they look like 
deafness. illness.
Diseases of childhood Development delays & disability
Skin conditions, otitis media, rheumatic heart disease, reactive airway disease Vision and hearing impairment, speech and language delay, motor delay, 
and asthma, dental caries, convulsive disorders. learning disorders, ADHD, autism spectrum and behavioural conditions.
Objectives of School Health Services 9
O B J E C T I V E  0 3   ·   A S S E S S
Remedial action and follow-up: closing the loop
01 02 03 04
Detect Inform Refer Verify
A named referral to PHC, CHC, The school confirms the child 
Screening or teacher referral Parents receive a written, plain-
District Hospital or a District Early was seen, treatment started and, 
flags a condition and it is entered language note with the finding, 
Intervention Centre — with the where needed, arranges 
on the child's health record the what it means and where to go 
appointment, not just the transport, cost support or a 
same day. next.
address. second reminder.
A screening programme that does not verify closure is data collection, not health care. Referral closure rate is the single most honest indicator of a school health 
service.
Objectives of School Health Services 10
O B J E C T I V E  0 4   ·   P R E V E N T
Prevention and control of communicable disease
Surveillance and early warning
Watch absenteeism patterns and cluster symptoms — measles, chickenpox, mumps, 
conjunctivitis, influenza, dengue, scabies, pediculosis, tuberculosis.
Exclusion and return-to-school rules
Contain the outbreak before A written, published policy on when a child stays home and the criteria for coming back — 
it becomes an epidemic applied without stigma to staff as well.
Everyday control measures
Schools amplify transmission: dense seating, Hand hygiene stations, respiratory etiquette, safe drinking water, disinfection of surfaces, vector 
control and elimination of stagnant water on campus.
shared surfaces, shared water and close contact for 
six hours a day. Rapid, unembarrassed action is the 
whole objective.
Notification and contact tracing
Timely reporting to the local health authority, line listing of contacts and coordinated action 
with the PHC or municipal health officer.
Objectives of School Health Services 11
O B J E C T I V E  0 5   ·   P R E V E N T
Immunisation: verify, complete and catch up
Verify at admission
Immunisation status against the Universal Immunisation Programme schedule is checked and recorded when a child joins — not assumed from the 
parent's memory.
School-based doses
The school is the delivery point for age-specific boosters such as Td at 10 and 16 years, and for measles-rubella and other campaign rounds run with the 
local health team.
Catch-up for the missed child
Every partially immunised or zero-dose child is identified and linked to the nearest session site, with a follow-up date on the record.
Consent, cold chain and AEFI
Informed parental consent in advance, verified cold chain on the day, an observation period after the dose, and a written protocol for adverse events 
following immunisation.
Objectives of School Health Services 12
O B J E C T I V E  0 6   ·   P R E V E N T
Nutritional services and the double burden
Mid-day meal quality and safety Anaemia and deworming
Menu adequacy, kitchen hygiene, food handler health checks, tasting Weekly Iron and Folic Acid Supplementation for children and adolescents, and 
protocol, safe storage and clean water — under PM POSHAN. biannual albendazole under the National Deworming Day rounds.
A canteen policy with teeth Both ends of the curve
Undernutrition and childhood obesity now sit in the same classroom. 
Restricting foods high in fat, salt and sugar around the campus, promoting 
Screening must look for thinness and for rising BMI, and the response differs 
safe local produce, and following the FSSAI Eat Right School approach.
for each.
Objectives of School Health Services 13
O B J E C T I V E  0 7   ·   P R O T E C T
A healthful school environment — physical and psychosocial
Water, sanitation and hygiene Building and classroom The psychosocial climate
Safe tested drinking water, adequate gender- Ventilation, natural light, noise, seating A published anti-bullying and anti-ragging 
separate and disability-accessible toilets, ergonomics, safe electrical fittings, clean stance, freedom from corporal punishment, 
running water and soap at handwash points, kitchen and store, waste segregation, pest non-discrimination, and a visible, safe way for a 
and menstrual waste disposal. control and a maintained playground. child to raise a concern.
W H Y  T H I S  O B J E C T I V E  M AT T E R S
Children absorb the environment whether or not anyone teaches them about it. A campus that models hygiene, safety and respect teaches more 
effectively than any lesson on the timetable.
Objectives of School Health Services 14
O B J E C T I V E  0 8   ·   P R O M O T E
Health education: skills, not just information
Timetabled, not occasional
A fixed weekly slot integrated into the curriculum and taught by trained teachers, rather than an 
annual guest lecture.
The life-skills approach
Change behaviour, not only Self-awareness, empathy, critical and creative thinking, decision-making, problem-solving, 
awareness communication, coping with stress and emotion.
Peer educators and health clubs
Trained student leaders carry messages further than adults can, especially on hygiene, 
Knowing that handwashing prevents disease menstruation, bullying and substance use.
changes nothing on its own. The objective is 
practised skill, repeated until it is habit.
Contemporary content
Screen time and sleep, road safety, digital safety, body image, and how to seek help — alongside 
classical hygiene and nutrition topics.
Objectives of School Health Services 15
O B J E C T I V E  0 9   ·   P R O M O T E
Mental health and psychosocial wellbeing
Early identification Access to a counsellor
Watch for withdrawal, falling grades, sleep and appetite change, irritability, 
A trained counsellor available on a predictable schedule, in a private space, 
unexplained physical complaints and rising absence — and act on the pattern, 
with confidentiality explained to students and parents in advance.
not the incident.
Teachers as gatekeepers A written escalation pathway
Teachers trained to notice, to have a first supportive conversation, and to A named protocol for a student in acute distress or at risk of self-harm: who is 
hand over — not to diagnose or to counsel beyond their training. called, in what order, and which service the child is taken to.
Objectives of School Health Services 16
O B J E C T I V E  1 0   ·   P R O M O T E
Adolescent, reproductive and menstrual health
Age-appropriate puberty education
Accurate information about physical and emotional change, delivered before the change happens, to boys and girls alike and without embarrassment or 
euphemism.
Menstrual hygiene management
Product access, a private space to change, water and disposal, permission to use the toilet without negotiation, and no attendance penalty during 
periods.
Protection, consent and safety
Age-appropriate personal safety education, awareness of the POCSO framework, a named and trained child protection officer, and a working complaints 
route.
Linkage to adolescent-friendly 
services
Referral to Adolescent Friendly Health Clinics and peer-educator programmes under RKSK for counselling, anaemia care and confidential consultation.
Objectives of School Health Services 17
O B J E C T I V E  1 1   ·   P R O M O T E
Vision, hearing and oral health
Vision Hearing Oral health
Annual visual acuity testing, referral for 
refractive error, and free spectacles through the Screening for hearing loss and chronic ear Screening for dental caries, gingivitis and 
national blindness control programme. discharge, treatment of otitis media, and malocclusion; supervised brushing habit, 
Uncorrected vision is a leading, entirely preferential seating plus assistive devices where fluoride advice, and restriction of sugary items 
reversible cause of poor classroom impairment is confirmed. sold on campus.
performance.
W H Y  T H I S  O B J E C T I V E  M AT T E R S
These three are the highest-yield screenings in school health: cheap to perform, common in findings, and correctable with a device or a single treatment 
that immediately changes a child's ability to learn.
Objectives of School Health Services 18
O B J E C T I V E  1 2   ·   P R O T E C T
Physical activity, fitness and safe sport
Protected activity time Fitness assessment
A physical education period that is actually taught rather than surrendered to Periodic fitness testing under the Fit India and Khelo India frameworks, 
examination revision, plus free play and active breaks through the day. tracked per child so improvement is visible and not just aggregate.
Pre-participation screening Posture and load
Cardiac and respiratory clearance before competitive sport, known asthma School bag weight limits, desk and chair sizing to the child, and correction of 
and allergy flagged to the coach, and hydration and heat protocols in place. postural problems before they become chronic back and neck pain.
Objectives of School Health Services 19
O B J E C T I V E  1 3   ·   P R O T E C T
First aid and emergency care on campus
01 02 03 04
Ready Trained Respond Transfer
A functional infirmary or sick 
Certified first aiders on every A single emergency number, a A standing ambulance tie-up, a 
room, a stocked and in-date 
shift, staff trained in basic life defined incident commander, a mapped nearest hospital, an 
emergency tray, oxygen where 
support and CPR, and refresher protocol for anaphylaxis, asthma, accompanying adult, and every 
appropriate, and clearly 
training scheduled rather than seizure, fracture, burns, drowning child's emergency contact and 
signposted exits and assembly 
assumed. and head injury. consent held ready.
points.
Emergency capability is proved by drills, not by inventories. A stocked cupboard that nobody has opened under time pressure is not preparedness.
Objectives of School Health Services 20
O B J E C T I V E  1 4   ·   P R E V E N T
Safety, injury prevention and disaster readiness
Campus hazard audit
A scheduled walkthrough of playground equipment, staircases and railings, laboratory chemicals, kitchen gas lines, electrical points, water tanks and 
building maintenance.
Fire and disaster drills
Serviced extinguishers, marked and unobstructed evacuation routes, rehearsed drills including for earthquake and flood, and a headcount procedure 
that works.
Transport safety
Vehicle fitness, verified and trained drivers, attendants on board, speed governors, seat belts, boarding supervision and a no-child-left-behind check.
Incident recording and learning
Every injury logged with cause and location, reviewed monthly, and the recurring hazard fixed — the log exists to change the campus, not to defend it.
Objectives of School Health Services 21
O B J E C T I V E  1 5   ·   P R E V E N T
Substance use prevention
A tobacco-free institution
Signage, no use on campus by anyone including staff, and enforcement of the ban on sale of 
tobacco products near educational institutions under COTPA.
Cover what students actually meet
Prevent initiation, and Tobacco and gutka, alcohol, cannabis, inhalants and solvents, prescription misuse, and e-
respond without cigarettes and vaping — which are prohibited in India.
punishment
Refusal and resistance skills
Rehearsed responses to peer pressure and to advertising, taught as a skill in the life-skills slot 
Almost all lifetime tobacco use begins before the rather than as a warning lecture.
age of eighteen. Delaying initiation is the highest-
value intervention a school can make.
A non-punitive response route
A student found using is referred for counselling and, where needed, de-addiction support — 
expulsion removes the school's ability to help.
Objectives of School Health Services 22
O B J E C T I V E  1 6   ·   A S S E S S
Inclusion: disability and chronic conditions at school
Identify and certify Accessible by design
Screening for disability, support to obtain a disability certificate and UDID, and Ramps, accessible toilets, classroom placement, assistive technology and 
linkage for aids, appliances and early intervention services. reasonable accommodation as an entitlement under the RPwD Act, 2016.
Individual care plans Medication and exam policy
Written plans for asthma, epilepsy, type 1 diabetes, food allergy and sickle cell A clear policy on storing and administering medicine during school hours, plus 
disease — held by the school nurse, the class teacher and the office. documented exam accommodations such as extra time or a scribe.
Objectives of School Health Services 23
O B J E C T I V E  1 7   ·   PA R T N E R
Teachers, parents and the community as one system
Health and Wellness Ambassadors Parents as partners The community health link
Two teachers per school trained to lead the Findings shared in plain language, orientation A standing relationship with the PHC medical 
weekly health promotion session, spot early sessions each term, and consent and follow-up officer, ANM and ASHA, an active School Health 
signs and act as the bridge between classroom treated as a conversation rather than a form Committee, and coordination with local 
and clinic. sent home. sanitation and nutrition programmes.
W H Y  T H I S  O B J E C T I V E  M AT T E R S
Children carry health messages home. A well-run school health programme quietly raises the health literacy of an entire neighbourhood — which is why 
partnership is an objective in its own right, not an administrative afterthought.
Objectives of School Health Services 24
D E L I V E R Y
Who delivers it: the school health team
Medical Officer School Nurse Counsellor
Examination, diagnosis, referral decisions, Daily first contact, infirmary operations, Psychosocial screening, individual and group 
protocol design and clinical governance. screening, records, medication and follow-up. support, escalation and family liaison.
PE Teacher Teacher Ambassadors Parents & Management
Activity, fitness assessment, safe sport, injury Weekly health sessions, daily observation and the Consent, follow-through at home, budget, policy 
prevention and postural screening. link to parents. and the School Health Committee.
Objectives of School Health Services 25
D E L I V E R Y
Measuring whether it works
Illustrative annual target dashboard (%) Coverage
What share of enrolled children were actually screened this year — the 
denominator is enrolment, not attendance on screening day.
Screening coverage 100
Immunisation verified 100 Referral closure
Of children referred, how many were confirmed to have been seen and 
treated. The hardest number to collect and the most revealing.
Referral closure 90
Attendance and absence
Functional WASH 100
Illness-related absence days per child per term, and the trend after each 
intervention.
Staff first-aid trained 80
Condition prevalence trend
Health records digitised 100
Anaemia, dental caries, refractive error and BMI distribution tracked year 
on year in the same cohort.
Objectives of School Health Services 26
D E L I V E R Y
Common barriers and what actually fixes them
T H E  B A R R I E R T H E  F I X
Appoint a coordinator with time protected in the timetable, and a 
No named owner for the programme
School Health Committee that meets on a fixed date.
Track referral closure as the headline indicator and give one person 
Screening happens; follow-up does not
responsibility for chasing every open referral.
A digital health record per child, with dashboards for the school and 
Paper records that nobody can retrieve
plain reports for the parent.
Report health outcomes alongside attendance and learning data so 
Budget seen as a cost, not an investment
the return is visible to management.
Objectives of School Health Services 27
A  D E L I V E R Y  PA R T N E R
Blue Circle: school health, run as a managed service
Blue Circle Medi Services
14+ 90K+
A New Delhi based healthcare company that designs, staffs and operates health services Years of operations Patients served
for schools, campuses and corporates across India — combining clinical teams, on-site 
infrastructure and digital health systems in a single managed model.
550+ 95%
Managed Healthcare Clinic Setup & Operations
Medical professionals Service satisfaction
Medical Staffing Health Information Systems
Digital-first by default
Led by a founding team drawn from IIM Ahmedabad, IIM Calcutta and clinical practice, with Every child's record, the school's dashboard and the 
three decades of operating experience. parent's report run on one system.
Objectives of School Health Services 28
A  D E L I V E R Y  PA R T N E R
Blue Circle services mapped to the objectives
Clinical & Emergency Wellness & Training
Infirmary management · Doctor and nurse staffing · Primary care · Occupational Health screenings · Mental wellness programme · Substance use awareness · 
health · Ambulance support Stress support · First aid training
Objectives 1, 3, 13 Objectives 2, 8, 9, 15
Digital Health Infrastructure & Institutional
Digital health records · Student health tracking · Health dashboards · Parent and Clinic setup · Lab and pharmacy tie-ups · Hygiene and safety audits · Multi-site 
admin reports health models
Objectives 3, 17 Objectives 7, 14
One accountable partner across all four blocks — instead of four vendors and no owner.
Objectives of School Health Services 29
A  D E L I V E R Y  PA R T N E R
Proven on the ground — and how to start
Campus healthcare overhaul Shuttle accident response Bridge collapse support
Twelve ambulances arranged in twenty minutes, 
From no systems at all to fully digitised healthcare Rapid emergency mobilisation meant fifteen injured 
with on-ground care that kept escalation to a 
across an institute of more than 4,500 students. staff were treated within the hour.
minimum.
Start a conversation about better healthcare delivery
Thank you
Blue Circle Medi Services Pvt Ltd — corporate, school and institution healthcare across India.
www.bluecircle.in/n/ Sarita Vihar, New Delhi 110076 Questions, and a walk-through of your campus 
health gaps, are welcome.
Objectives of School Health Services 30