SCHOOL NUTRITIONAL PROGRAMME

DR SHAHRANIZA BAHARI PUBLIC HEALTH PHYSICIAN

SENIOR PRINCIPAL ASSISTANT DIRECTOR (FAMILY HEALTH)

JOHOR STATE HEALTH DEPARTMENT

OUTLINE

• History of School Health Programmes in Malaysia

• School health programmes and activities

• School nutritional programmes

Nutritional education

Nutritional rehabilitation

• Information sharing: Japan School Health Programmes

HISTORY

YEAR ACTIVITIES

1920 Physical education taught in English Oriented School

1948 Establishment of School dental health services

1924 Coordinator for Physical Education for negeri-negeri Selat

1932 Training for Physical Education in Peninsular Malaysia

1948 Establishment of Maternal and Child Health Service

1952 Teachers sent for Health education training in England

1961 Tuberculosis Prevention and Control activities – BCG and treatment

1966 Establishment of Physical Activity and Health Education Curriculum in Malaysia

1968 Joint MOH and MOE School Health Committee established

1968 - 1970

State Joint MOH and MOE School Health Committee

1971 1st Review of Health Curriculum

1972 School Health Teams established

1976 School Food Supplement Program

1990 School Health Program Policy and Implementation Guideline ( 3 component model)

1991 Detection of Visual Defect among Standard 1 Schoolchildren as Quality Assurance Indicator

1996 Review of Education Act, Adolescent Health Program established

1998 Health Promoting School adopted from WHO (Program Bersepadu Sekolah Sihat, PBSS)

HISTORY(2)

HISTORY (3)

YEAR ACTIVITIES

2000 Young Doctor Club introduced as co curricular activity

2005 Introduction of Standard Operating Procedure for School Health

2008 Rebranding of HPS to National 3K Committee ( Cleanliness, Health, Safety)

2010 Introduction of National School Based HPV Immunisation

2012 MOE introduced BMI check in School

MOE introduced Guidelines on Healthy Nutrition in School

INTRODUCED IN 1997

KESELAMATAN

Safety

KESIHATAN

Health

KEBERSIHAN

Cleanliness

School Health Activities

Health education

Physical health

Communicable diseases

Tobacco/ Drugs

Food hygiene

Nutrition

etc

Health examination

Hygiene

Anthropometry

Visual screening

Hearing screening

Physical assessment

Immunization

Deworming

Treatment of minor ailment

Referral

School Health Inspection

Dengue Free School

School Canteen

School Environmental

School Dental Services

Peer to peer programs

Young Doctor

PROSTAR

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Buku Rekod Kesihatan Murid

RKM1 (Pindaan 2011)

BMI for Age

Health education and examination

Visual acuity test and Immunization

Oral Health Care

SCOPE OF SCHOOL HEALTH PROGRAM

Ministry of Health

Health Education

Primary prevention through vaccination

Health screening and Physical examination

Curative and referral

Dental health

Environmental Health

Ministry of Education

Nutritional rehabilitation School Milk Program

Food Supplementary Program

Health Education through Curriculum Physical and Health Education

Family Life Education

Health across curriculum

Co curricular Young Doctor Club

Nutritional Education in School

• Incorporate into primary and

secondary school

• Physical and Health Education

• Science subjects

Rancangan Makanan Tambahan (RMT)

1976

For primary schoolchildren from poor families

Aim to provide extra nourishment for schoolchildren

Served during recess (10.30am or 3.30pm)

Nutritional Rehabilitation in School

RMT

Nutritional Rehabilitation in School

Program Susu Sekolah (PSS)

1983

Cultivate milk drinking habit

Improve calcium intake

Free for the poor

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Initiatives to prevent obesity among schoolchildren

• Introduction of guidelines for healthy nutrition in schools

Garis Panduan Pengurusan Berat Badan Murid Sekolah

Garis Panduan Penjualan Makanan dan Minuman di Kantin Sekolah

Garis Panduan Larangan Penjualan Makanan dan Minuman di Luar Pagar Sekolah

Healthy Nutrition in Schools

EPP JAPAN – MALAYSIA SCHOOL HEALTH PROGRAM

11 – 26 FEBRUARY 2013

Japan Education System

• Under the Ministry of Education, Culture, Sports, Science and Technology

• Starting April to March

• Compulsory education:

Primary schools (Elementary school)

Age 6 to 11

Lower Secondary Schools (Junior High School)

Age 12 to 15

Month Term, Vacation School events, etc

April Spring vacation March 25 to April 7

First Trimester

Entrance ceremony, Health Examination

May Home visit by teachers, School trip, Fire Drill

Jun School Visit by Parents

July General cleaning, End of term ceremony

August Summer Vacation Outdoor activities

July 20 to August 31

September

Second Trimester

Opening ceremony, Fire Drill

October Athletic Meeting

November Presentations of Students Works at Open Day

December School Visit by Parents, Fire Drill, End of Term

Winter vacation December 25 to January 7

January

Third Trimester

Opening ceremony

February Marathon-race, school visit

March Graduation Ceremony

Spring vacation

School Calendar

Subjects and Standard Class Sessions • Japanese • Social studies • Arithmetic • Science • Life Environment Studies • Music • Drawing, Handicraft • Home Economics • Physical Education • Moral education • Special activities • Comprehensive learning

Time table in Elementary School

Time Monday - Friday

8.20 – 8.35 Morning Activities

8.40 – 8.50 Opening

8.50 – 9.35 1

9.45 – 10.30 2

10.30 – 10.50 Recess

10.50 – 11.35 3

11.45 – 12.30 4

12.30 – 13.20 SCHOOL LUNCH

13.25 – 13.40 Cleaning

13.40 – 13.50 Recess

13.50 – 14.35 5

14.35 – 15.45 Closing/ Recess

15.45 – 16.30 -/ 6

1 class = 45 min

Fitness Training

Gargling with tea

Gargling with tea

Health education and examination

• Role of Yogo (school health) teacher

• Yogo teacher: special licensed educator who supports children’s growth and development through health education and health services in all areas educational activities in school

• School Health Office – Hokenshitsu

Roles of the Yogo Teacher

School Health Office - Hokenshitsu

School Health Office - Hokenshitsu

Height and Weight Measurement

SCHOOL LUNCH

• First school lunch began in 1889 by a priest in Tsuruoka City, Yamagata Prefecture – rice ball, grilled fish and pickles

• Extended gradually until 1923

• Bread, milk and side dishes were gradually introduced – 1951

• School Lunch Law - 1954

Toyohashi School Lunch Programme

• School Lunch Preparation Center

• Lunch preparation process

Staple food by bread or rice provider

Side dishes – lunch preparation center

Milk - Milk provider

• Transported to schools by their respective providers

• Lunch fees - ¥ 220

School Lunch Experiences

School Lunch Experiences

School Lunch Experiences

School Nutritional Program

MALAYSIA

• Education Act 1996

• School Health Team

• Parent Teacher Association

• Rancangan Makanan Tambahan (RMT)

• Program Susu Sekolah

• Program Susu 1Malaysia

• School based school meal program

• Nurse in school

JAPAN

• School Health and Safety Law 1958

• YOGO teacher

• School Health Committee

• School Lunch Program

• Centralized school meal program

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NURSE IN SCHOOL PILOT PROJECT

Current system

• Yearly visit by school health team

• Screening for health problems for targeted students

• Refer cases to nearest health clinic

• No continuity of care in clinic

Nurse in school

• Nurse available in school / regularly visits school

• Nurse to screen health problem periodically to all students

• Long term intervention and follow up in school

• Communicate with parents and teachers as part of monitoring students

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NURSE IN SCHOOL PILOT PROJECT

• Adopt and adapted from YOGO teacher concept • Nurse with Public Health experience to be placed in

school for 1 year – Continuous Integrated management of behavior related

health problems in school – Feasibility of up scaling project for national roll out

• Proposal discussed at MOH, with MOE • MOH Secretary General proposed for pilot project in

50 schools throughout Malaysia – Urban vs rural, static vs regular visit, primary and

secondary school, integration of various health programs.

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IMPEMENTATIONS OF SMP PILOT PROJECT

• Voluntary basis

• Open to : Standard 1 students (morning session) and

Standard 2 students (afternoon session)

• Types of food and time served :

morning tea (recess time for morning session) and

afternoon tea (recess time for afternoon session)

• Menus served are based on the existing Healthy School Canteen Guidelines, 300-400 kcal for each menu.

• Canteen operators can operate as usual to cater those not involved in the programme. The foods sold must abide to the guidelines.

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