The School Health Program, initially known as the School Health Plan, has been in place since 1967 with the objective of improving the health and nutrition standards of students. Based on the Health Promoting School concept introduced by WHO in 1997, the School Health Program has also undergone improvements aimed at:

• Maintain students’ health at the optimum level through health promotion, disease prevention, treatment, and referral.
• Identify health problems that may hinder students’ academic achievement in schools and subsequently making early referrals to enable early intervention and placement of students in special education systems.
• Empower school communities to be directly involved in health care by formulating strategic health-related policies.
• Encourage community involvement to develop schools as healthy and safe institutions for effective learning.
• Foster a healthy and safe school environment, including its physical surroundings as well as to support students’ social development.
• Mould school management and leadership to adopt a holistic healthy school model.

School health service is one of the school health programmes provided by the Ministry of Health Malaysia (MOH) to students in schools to ensure continuous health care can be given. Priority is given to students attending government schools and government-funded schools throughout Malaysia. In 1975, school health teams were established to enable visits to primary and secondary schools in Malaysia.The implementation of this service is carried out in close cooperation between the Ministry of Education (MOE) of Malaysia and MOH in line with the Education Act 1996. More than 34,000 primary and secondary schools are visited each year for the implementation of this service. The objectives of this programme are as follows:

The activities conducted under the school health service include:

• Health screening for students, including Thalassemia screening
• Health immunization in schools
• Health education
• Treatment and referrals
• Home visits

In general, nearly 2 million primary and secondary school students in Malaysia benefit directly from school health service each year.

E- Rekod Kesihatan Murid

Before 2017, the Buku Rekod Kesihatan Murid (RKM1) was the document used to record all health information obtained during schooling period. In line with technological advancements, the E-Rekod Kesihatan Murid (E-RKM) system was created to replace the RKM1 book. This system was developed jointly by the MOE and MOH for the school health teams to document health information related to examinations, treatments, referrals, as well as growth and development of students recorded during the delivery of health services in schools. Parents are required to fill in the students’ information in the system and provide consent for health officers to conduct health examinations and administer immunizations to their children. This information is stored by the MOE and MOH to facilitate the monitoring of student health and will be used until the end of the students’ schooling years.

Student Health Screening

Student health screening includes physical health examinations and Thalassemia screening conducted by Medical Officers, Health Nurses, and/or Assistant Medical Officers. Student health examinations are conducted during preschool, year 1, year 6, and form 3. The examinations conducted are as listed in the table below:

Health problems detected among school students include:

• Obesity
• Visual acuity
• Color blindness
• Abnormal skeletal structure
• Worm infections
• Scabies
• Hearing impairment

Thalassaemia Screening 

Thalassaemia screening in schools began in 2016 and is one of the activities under the National Thalassaemia Control and Prevention Programme. This service is offered to Form 4 students in government schools located in areas with high Thalassaemia prevalence. The vision of this programme is to reduce the number of births with Transfusion-Dependent Thalassaemia (TDT) and to improve the health quality of Thalassaemia patients. 

Until December 2023, a total of 1,490,621 Form 4 students have undergone Thalassaemia screening. Data collected until 2021 shows that 57,607 students have been confirmed as Thalassaemia carriers, leading to a Thalassaemia carrier prevalence rate of 5.9% in Malaysia. As of 2023, a total of 109 students (1.18 per 10,000 screened students) have been confirmed as Thalassaemia patients. BPKK 2022

Based on the Malaysia Thalassaemia Registry 2019, Malaysia has shown some changes in the Thalassaemia disease landscape with a decrease in new Thalassaemia births from 158 babies in 2011 to 70 babies in 2017. This change is the result of increased literacy and public awareness of this disease, participation in systematic Thalassaemia carrier screening activities as well as patient compliance with Thalassaemia treatment.

School Health Immunization 

As a continuation of childhood immunization, school students are provided with immunizations as below:

If children are found not to have received the aforementioned immunizations due to lack of parental consent or absence during a health team’s visit to the school, parents are requested to bring their children to nearby health clinics to receive these immunizations.

Health Education 

Health education in schools is divided into group and individual health education. 

Group health education is conducted through campaigns or health camps in schools. Students gain knowledge through exhibitions, lectures, and demonstrations by health personnel. Group health education prioritizes public health issues related to school students, such as thalassaemia screening, anti-smoking campaigns, and healthy lifestyles. 

Individual health education is provided as advisory and counselling services during health examination sessions. Common issues include nutrition, skin diseases, personal hygiene, and others. 

Treatment and Referral 

Treatment is provided to all students identified with minor issues such as small wounds, scabies, worm infections, head lice, fever, and flu. Referred cases are those requiring further examination for confirmation. Health problems referred include visual acuity issues, colour blindness, heart rate issues, and suspected scoliosis cases. 

Home Visits 

School health teams also conduct home visits during school holidays. These visits are carried out either by contacting parents at home or by mobilizing nurses to visit homes to ensure that students who missed the opportunity to receive immunizations at school come to health clinics for catch-up immunizations or to receive feedback on the status of referrals made to hospitals. 

SCHOOL DENTAL SERVICES 

This service is provided by school dental teams that visit all primary and secondary schools in Malaysia. For more information, please refer to the Main Page/Dental Health/General Dental/School Dental Services. 

SCHOOL ENVIRONMENTAL HEALTH SERVICES 

School environmental health services are implemented jointly by the Ministry of Health of Malaysia and the Ministry of Education of Malaysia. School environmental inspections cover school infrastructure, cleanliness, vector-borne disease control, cleanliness monitoring, and school canteen management. 

School environmental area services are subjected to several acts and regulations such as the Tobacco Control Act and the Vector-Borne Disease Control Act, which carry fines if school management is found to be in violation of these acts. Under this service, among the activities involved are the establishment of school dengue teams to destroy mosquito breeding sites in schools and declaring schools as smoke-free areas. Assistant Environmental Health Officers will conduct inspections at schools every year to ensure that schools are clean and safe. 

References: 

Annual Report of the Family Health Development Division 2022 

Malaysian Thalassaemia Registry Report 2018