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Thursday, 15 December 2011
Tuesday, 29 November 2011
GOVERNMENT OF ANDHRA PRADESH
ABSTRACT
Jawahar Bala Arogya Raksha - School Health Referral Guidelines – Orders –
Issued
________________________________________________________________
HEALTH, MEDICAL AND FAMILY WELFARE (F1) DEPARTMENT
G.O.Ms.No 319 Dated:27.10.2011
Read the following:-
(1) G.O.Ms No. 316 HM&FW (F1) Department, dated 10.11.2010.
(2) G.O. Ms. No. 7, SW (TW Edn) Department, dated 07.03.2006.
(3) G.O. Ms. No. 20, SE (PE) Department, dated 03.03.2011.
<<>>
ORDER
1. Government launched the School Health Programme across the state on
14.11.2010, under the name of Jawahar Bala Arogya Raksha (JBAR). Under this
scheme, all school children will be screened by a school health team and referral
of children requiring secondary and tertiary care to the appropriate facility for
specialist review, appropriate investigations, treatment of the disease and followup
will be undertaken.
2. Government of India has enacted the Right to Education where the state
should ensure free education for all children between 5-14 years age. JBAR in a
way ensures this by reducing drops out from school due to health reasons. As
Jawahar Bala Arogya Raksha (JBAR) is ensuring screening of all the children,
there is a gap to take further action on the children requires further treatments.
Thus, there is a need to develop referral system under JBAR for the school
children requiring specialist care is imperative to the success of not just the
school health programme but also for every child to realize their right to
education.
3. In order to ensure minimal dropouts of the children with ill health reasons,
there is necessity of issue of specific guidelines to the field functionaries on the
implementation of the programme and for proper screening referring the children
for further treatment and to ensure healthy schooling.
4. Hence, the following guidelines are issued for referral of the children under
the JBAR Scheme.
(i) Referral Mechanism: The referral for school health will be under
the following three modes.
a) By the PHC Medical Officer during the bi-annual school health
screening.
b) By the MPHA(F) during the monthly visit to the schools
c) In case of emergency the student is immediately taken to the
nearest medical facility by 108 ambulance services by the
concerned head master/parent.
(ii) Referral Procedure:
A. School level:
a) Medical Officer and his/her team will screen all children and
identify those children requiring specialist referral services (As
per referral criteria).
http://utfatp.tk
In Your Service, A.P.United Teachers Federation, Anantapur District Unit
U T F
2
::2::
b) If the referred student requires immediate medical attention,
then the student must be sent to the CHC/FRU at the earliest
else the student must be referred on the referral day (i.e.
Tuesdays).
c) The MO will refer to the nearest CHC/ FRU (or even secondary/
tertiary specialist services) along with the necessary medical
history and referral form.
B. Mandal Level:
Student requires further treatment have to be referred directly to the
Aarogyasri Network Hospitals.
C. CHC/ FRU/ Aarogyasri Network Hospital Level:
a) Separate counter to be established to give priority to school
health referrals on Tuesdays.
b) A pediatrician and general physician must be available at the
school health referral counter who will examine all school health
referrals. In case the students require consultation with other
specialists like gynecologist etc., then the pediatrician available
at the school health referral cell will intimate the specialist and
the child will be examined in the referral cell.
c) Necessary investigations and diagnosis need to be conducted
by the referral hospital free of cost . In case the necessary
diagnostic facilities/ treatment facilities are not available with the
referred hospital, then the student should be referred to the
nearest medical facility where such services are available in
normal conditions and in emergency conditions the referral
hospital has to provide treatment on par with Aarogyasri
beneficiary.
d) For any student requiring super specialty medical attention/ any
surgical intervention (if not possible at the FRU) then the
student should be referred to tertiary care hospitals.
e) If the student's ailment/illness falls under the approved
procedures of Aarogyasri and subject to the student’s eligibility
under Aarogyasri necessary action has to be taken to treat the
student under the Aarogyasree scheme.
f) If referred students are not eligible under Aarogyasri then the
District JBAR Coordinators should coordinate with the State
School Health Cell/ Addl. Director, School Health to ensure the
child receives proper treatment.
D. Tertiary Care Hospitals:
a. Conduct necessary investigations and diagnosis. Treatment has
to be provided and may even be hospitalized if necessary.
b. In case the necessary diagnostic facilities/ treatment facilities
not available then the student should be referred to the nearest
super speciality facility where such services are available.
c. If the student's ailment/illness falls under the approved
procedures of Aarogyasri and subject to the student eligibility
under Aarogyasri necessary action has to be taken to treat the
student under the Aarogyasri scheme.
(P.T.O)
http://utfatp.tk
In Your Service, A.P.United Teachers Federation, Anantapur District Unit
U T F
3
:: 3::
(iii) Other logistics: Transport and other financial support for the
referral will be provided under the scheme.
a) For tribal areas: A lump sum amount of Rs.5,000/- to be made
available at all tribal PHCs which will be earmarked for school
health referrals. The PHC Medical Officer in consultation with
the Project officer, ITDA will arrange transport for all students
and their parents/guardians who have been identified as
requiring referral services.
b) For plain areas: The parents of the students requiring referral
services will be intimated to take the child to the specified
referral centers.
(iv) Roles and responsibilities for school health referral are as
follows:
Level Officer(s) Responsible Activities to be Undertaken
School School Headmaster/ Principal and Sub-
Centre MPHA(F)/ Paramedical Staff as
health coordinator under the overall
supervision of the Medical
Officer/MEO/DyEO
1. Maintain details of students referred
in (a) School Health Register (b)
Student Health and Education
Register (c) PHC Referral register
2. Ensure all the referred students
consult appropriate specialist
3. Enter follow-up action in the Student
Health and Education Record
(SHER)
4. Ensure the student completion and
compliance of the treatment
prescribed by the specialist
5. Send consolidated referral report to
the Primary Health Center (PHC) on
a monthly basis
PHC
Medical Officer and
Mandal Education Officer as school
health coordinators under the overall
supervision of DMHO/ DEO/ PO RVM
1. If student is referred during the
monthly screening by MPHA(F)
then, MO will conduct available
investigations, provide diagnosis/
treatment.
2. If MO suggests further specialist
treatment for the student, then the
MO must provide medical history
and referral form along with
investigations done to the next
health facility.
3. The MO will consolidate and update
the details of the students referred
and submit the same to the SPHO/
District JBAR Coordinator/ DMHO.
4. The MEO, in consultation with the
MO, will track every referral and
ensure completion of the course of
treatment and follow-up.
5. They will consolidate the details of
the students referred and submit the
same to the PO RVM.
http://utfatp.tk
In Your Service, A.P.United Teachers Federation, Anantapur District Unit
U T F
4
:: 4 ::
Community
Health and
Nutrition
Cluster
Senior Public Health Officer
under the overall supervision of
DMHO
1. The SPHO will track every referral
and ensure completion of the
course of treatment and follow-up.
2. Will provide support services to
every student referred to the CHC.
3. The cases which are referred by the
CHC/ FRU to higher institutes, the
SPHO must immediately inform the
District JBAR Coordinator/ DMHO.
4. Consolidate and update the details
of the referred students in all the
PHC areas under their purview and
submit the same to DMHO/ District
JBAR Coordinator.
Community
Health
Center/ FRU
Superintendent under the overall
supervision of SPHO/DMHO/
DCHS
1. Ensure priority services for students
referred
2. Appropriate investigations must be
conducted for confirmation of
diagnosis.
3. Treatment/ hospitalisation may be
provided where necessary.
4. In case student requires further
specialist services then, student
should be sent to the higher
institution along with the medical
history, referral form and diagnostic
reports. The details of such students
will be intimated to the SPHO
immediately.
5. If the student has been advised
follow-up services which are
available in the CHC/FRU, then they
must be provided for the entire
duration till the student’s treatment
is completed.
6. Maintain record of the students,
diagnosis and treatment details at
the Center.
District JBAR Coordinator(NRHM)/
JBAR Coordinator(RVM) under
the overall supervision of
DMHO/ DEO/ PO RVM
1. Monitor and follow-up all school
health referrals in their district.
2. District JBAR Coordinators must be
provide supportive services and
guidance for cases referred to
tertiary care.
3. Coordinate with all CHCs, Area
Hospitals and District Hospitals to
ensure that children referred
through the school health screening
receive priority treatment and followup.
4. Cases of students referred to super
speciality to the State Captial, then
the details must be immediately
intimated to the Addl. Director,
School Health.
5. Coordinate with District Rajiv
Aarogyasri Health Insurance
Scheme Coordinator to link referred
http://utfatp.tk
In Your Service, A.P.United Teachers Federation, Anantapur District Unit
U T F
5
(v) Other Guidelines:
a) Any dropout due to health reasons/ after diagnosis, must entail
analysis and adequate follow up/ corrective measures for re-enrolment
by class teacher/MPHA(F) in consultation will Principals/ Headmasters
and Medical Officers including house visits, motivation of family etc.
b) The District JBAR Coordinators (NRHM)and JBAR Coordinators(RVM)
must ensure that the District School Health Committee consisting of
the DMHO, DEO, PO RVM meet regularly to review the JBAR
screening and referral.
c) The Addl. Director, School Health will ensure that the State School
Health Committee will meet regularly to review the JBAR screening
and referrals.
d) Heads of Departments and District Officials of concerned departments
ie. Health & Family Welfare, School Education, Tribal Welfare, Social
Welfare, BC Welfare, Minority Welfare, Women & Children, Disabled
Welfare, DRDA etc. are requested to monitor the JBAR programme
and take up random field visits.
5. The Commissioner Family Welfare, Mission Director (NRHM)/ the Director
of Public Health, State Project Director of Rajiv Vidya Mission and Director &
Commissioner School Education shall take necessary action in this regard.
6. This order is issued with the concurrence of School Education
Department.
(BY ORDER AND IN THE NAME OF THE GOVERNOR OF ANDHRA PRADESH)
K.R.KISHORE
PRINCIPAL SECRETARY TO GOVERNMENT
To
The Commissioner of Health and Family Welfare
The Mission Director, NRHM
The Commissioner and Director of School Education
The Director of Public Health and Family Welfare
students, where applicable, for
support.
6. Consolidate the list of all students
referred, the cause for referral, status
of the student and required follow-up
action and send it to the Addl. Director,
School Health (O/o CHFW).
State Addl. Director, School Health
and ASPD (RVM) under the
overall supervision of the
CHFW, MD NRHM, DPH&FW,
SPD RVM and Commissioner
School Education
1. Monitor and follow-up all school
health referrals in the state
2. The Addl. Director School health
will provide supportive services and
guidance to cases of students
referred to super speciality to the
State Capital.
3. Consolidate and update the details
of the referred students
4. Report the details to the Mission
Director (NRHM)/ SPD (RVM)
ABSTRACT
Jawahar Bala Arogya Raksha - School Health Referral Guidelines – Orders –
Issued
________________________________________________________________
HEALTH, MEDICAL AND FAMILY WELFARE (F1) DEPARTMENT
G.O.Ms.No 319 Dated:27.10.2011
Read the following:-
(1) G.O.Ms No. 316 HM&FW (F1) Department, dated 10.11.2010.
(2) G.O. Ms. No. 7, SW (TW Edn) Department, dated 07.03.2006.
(3) G.O. Ms. No. 20, SE (PE) Department, dated 03.03.2011.
<<>>
ORDER
1. Government launched the School Health Programme across the state on
14.11.2010, under the name of Jawahar Bala Arogya Raksha (JBAR). Under this
scheme, all school children will be screened by a school health team and referral
of children requiring secondary and tertiary care to the appropriate facility for
specialist review, appropriate investigations, treatment of the disease and followup
will be undertaken.
2. Government of India has enacted the Right to Education where the state
should ensure free education for all children between 5-14 years age. JBAR in a
way ensures this by reducing drops out from school due to health reasons. As
Jawahar Bala Arogya Raksha (JBAR) is ensuring screening of all the children,
there is a gap to take further action on the children requires further treatments.
Thus, there is a need to develop referral system under JBAR for the school
children requiring specialist care is imperative to the success of not just the
school health programme but also for every child to realize their right to
education.
3. In order to ensure minimal dropouts of the children with ill health reasons,
there is necessity of issue of specific guidelines to the field functionaries on the
implementation of the programme and for proper screening referring the children
for further treatment and to ensure healthy schooling.
4. Hence, the following guidelines are issued for referral of the children under
the JBAR Scheme.
(i) Referral Mechanism: The referral for school health will be under
the following three modes.
a) By the PHC Medical Officer during the bi-annual school health
screening.
b) By the MPHA(F) during the monthly visit to the schools
c) In case of emergency the student is immediately taken to the
nearest medical facility by 108 ambulance services by the
concerned head master/parent.
(ii) Referral Procedure:
A. School level:
a) Medical Officer and his/her team will screen all children and
identify those children requiring specialist referral services (As
per referral criteria).
http://utfatp.tk
In Your Service, A.P.United Teachers Federation, Anantapur District Unit
U T F
2
::2::
b) If the referred student requires immediate medical attention,
then the student must be sent to the CHC/FRU at the earliest
else the student must be referred on the referral day (i.e.
Tuesdays).
c) The MO will refer to the nearest CHC/ FRU (or even secondary/
tertiary specialist services) along with the necessary medical
history and referral form.
B. Mandal Level:
Student requires further treatment have to be referred directly to the
Aarogyasri Network Hospitals.
C. CHC/ FRU/ Aarogyasri Network Hospital Level:
a) Separate counter to be established to give priority to school
health referrals on Tuesdays.
b) A pediatrician and general physician must be available at the
school health referral counter who will examine all school health
referrals. In case the students require consultation with other
specialists like gynecologist etc., then the pediatrician available
at the school health referral cell will intimate the specialist and
the child will be examined in the referral cell.
c) Necessary investigations and diagnosis need to be conducted
by the referral hospital free of cost . In case the necessary
diagnostic facilities/ treatment facilities are not available with the
referred hospital, then the student should be referred to the
nearest medical facility where such services are available in
normal conditions and in emergency conditions the referral
hospital has to provide treatment on par with Aarogyasri
beneficiary.
d) For any student requiring super specialty medical attention/ any
surgical intervention (if not possible at the FRU) then the
student should be referred to tertiary care hospitals.
e) If the student's ailment/illness falls under the approved
procedures of Aarogyasri and subject to the student’s eligibility
under Aarogyasri necessary action has to be taken to treat the
student under the Aarogyasree scheme.
f) If referred students are not eligible under Aarogyasri then the
District JBAR Coordinators should coordinate with the State
School Health Cell/ Addl. Director, School Health to ensure the
child receives proper treatment.
D. Tertiary Care Hospitals:
a. Conduct necessary investigations and diagnosis. Treatment has
to be provided and may even be hospitalized if necessary.
b. In case the necessary diagnostic facilities/ treatment facilities
not available then the student should be referred to the nearest
super speciality facility where such services are available.
c. If the student's ailment/illness falls under the approved
procedures of Aarogyasri and subject to the student eligibility
under Aarogyasri necessary action has to be taken to treat the
student under the Aarogyasri scheme.
(P.T.O)
http://utfatp.tk
In Your Service, A.P.United Teachers Federation, Anantapur District Unit
U T F
3
:: 3::
(iii) Other logistics: Transport and other financial support for the
referral will be provided under the scheme.
a) For tribal areas: A lump sum amount of Rs.5,000/- to be made
available at all tribal PHCs which will be earmarked for school
health referrals. The PHC Medical Officer in consultation with
the Project officer, ITDA will arrange transport for all students
and their parents/guardians who have been identified as
requiring referral services.
b) For plain areas: The parents of the students requiring referral
services will be intimated to take the child to the specified
referral centers.
(iv) Roles and responsibilities for school health referral are as
follows:
Level Officer(s) Responsible Activities to be Undertaken
School School Headmaster/ Principal and Sub-
Centre MPHA(F)/ Paramedical Staff as
health coordinator under the overall
supervision of the Medical
Officer/MEO/DyEO
1. Maintain details of students referred
in (a) School Health Register (b)
Student Health and Education
Register (c) PHC Referral register
2. Ensure all the referred students
consult appropriate specialist
3. Enter follow-up action in the Student
Health and Education Record
(SHER)
4. Ensure the student completion and
compliance of the treatment
prescribed by the specialist
5. Send consolidated referral report to
the Primary Health Center (PHC) on
a monthly basis
PHC
Medical Officer and
Mandal Education Officer as school
health coordinators under the overall
supervision of DMHO/ DEO/ PO RVM
1. If student is referred during the
monthly screening by MPHA(F)
then, MO will conduct available
investigations, provide diagnosis/
treatment.
2. If MO suggests further specialist
treatment for the student, then the
MO must provide medical history
and referral form along with
investigations done to the next
health facility.
3. The MO will consolidate and update
the details of the students referred
and submit the same to the SPHO/
District JBAR Coordinator/ DMHO.
4. The MEO, in consultation with the
MO, will track every referral and
ensure completion of the course of
treatment and follow-up.
5. They will consolidate the details of
the students referred and submit the
same to the PO RVM.
http://utfatp.tk
In Your Service, A.P.United Teachers Federation, Anantapur District Unit
U T F
4
:: 4 ::
Community
Health and
Nutrition
Cluster
Senior Public Health Officer
under the overall supervision of
DMHO
1. The SPHO will track every referral
and ensure completion of the
course of treatment and follow-up.
2. Will provide support services to
every student referred to the CHC.
3. The cases which are referred by the
CHC/ FRU to higher institutes, the
SPHO must immediately inform the
District JBAR Coordinator/ DMHO.
4. Consolidate and update the details
of the referred students in all the
PHC areas under their purview and
submit the same to DMHO/ District
JBAR Coordinator.
Community
Health
Center/ FRU
Superintendent under the overall
supervision of SPHO/DMHO/
DCHS
1. Ensure priority services for students
referred
2. Appropriate investigations must be
conducted for confirmation of
diagnosis.
3. Treatment/ hospitalisation may be
provided where necessary.
4. In case student requires further
specialist services then, student
should be sent to the higher
institution along with the medical
history, referral form and diagnostic
reports. The details of such students
will be intimated to the SPHO
immediately.
5. If the student has been advised
follow-up services which are
available in the CHC/FRU, then they
must be provided for the entire
duration till the student’s treatment
is completed.
6. Maintain record of the students,
diagnosis and treatment details at
the Center.
District JBAR Coordinator(NRHM)/
JBAR Coordinator(RVM) under
the overall supervision of
DMHO/ DEO/ PO RVM
1. Monitor and follow-up all school
health referrals in their district.
2. District JBAR Coordinators must be
provide supportive services and
guidance for cases referred to
tertiary care.
3. Coordinate with all CHCs, Area
Hospitals and District Hospitals to
ensure that children referred
through the school health screening
receive priority treatment and followup.
4. Cases of students referred to super
speciality to the State Captial, then
the details must be immediately
intimated to the Addl. Director,
School Health.
5. Coordinate with District Rajiv
Aarogyasri Health Insurance
Scheme Coordinator to link referred
http://utfatp.tk
In Your Service, A.P.United Teachers Federation, Anantapur District Unit
U T F
5
(v) Other Guidelines:
a) Any dropout due to health reasons/ after diagnosis, must entail
analysis and adequate follow up/ corrective measures for re-enrolment
by class teacher/MPHA(F) in consultation will Principals/ Headmasters
and Medical Officers including house visits, motivation of family etc.
b) The District JBAR Coordinators (NRHM)and JBAR Coordinators(RVM)
must ensure that the District School Health Committee consisting of
the DMHO, DEO, PO RVM meet regularly to review the JBAR
screening and referral.
c) The Addl. Director, School Health will ensure that the State School
Health Committee will meet regularly to review the JBAR screening
and referrals.
d) Heads of Departments and District Officials of concerned departments
ie. Health & Family Welfare, School Education, Tribal Welfare, Social
Welfare, BC Welfare, Minority Welfare, Women & Children, Disabled
Welfare, DRDA etc. are requested to monitor the JBAR programme
and take up random field visits.
5. The Commissioner Family Welfare, Mission Director (NRHM)/ the Director
of Public Health, State Project Director of Rajiv Vidya Mission and Director &
Commissioner School Education shall take necessary action in this regard.
6. This order is issued with the concurrence of School Education
Department.
(BY ORDER AND IN THE NAME OF THE GOVERNOR OF ANDHRA PRADESH)
K.R.KISHORE
PRINCIPAL SECRETARY TO GOVERNMENT
To
The Commissioner of Health and Family Welfare
The Mission Director, NRHM
The Commissioner and Director of School Education
The Director of Public Health and Family Welfare
students, where applicable, for
support.
6. Consolidate the list of all students
referred, the cause for referral, status
of the student and required follow-up
action and send it to the Addl. Director,
School Health (O/o CHFW).
State Addl. Director, School Health
and ASPD (RVM) under the
overall supervision of the
CHFW, MD NRHM, DPH&FW,
SPD RVM and Commissioner
School Education
1. Monitor and follow-up all school
health referrals in the state
2. The Addl. Director School health
will provide supportive services and
guidance to cases of students
referred to super speciality to the
State Capital.
3. Consolidate and update the details
of the referred students
4. Report the details to the Mission
Director (NRHM)/ SPD (RVM)
G.O.319,dt.27.10.2011 :: JAWAHAR BALA AROGYA RAKSHA
minimal Dropouts of children with illhealth reasons,
Government vide G.O.Ms.No.319,Health,
Medical & Family welfare Dept., dt.27.10.2011
has issued necessary Guidelines for referral of
School children under Jawahar Bala Arogya
Raksha [ JBAR ] Scheme.
G.O.319,dt.27.10.2011
Jawahar Bala Arogya Raksha
Wednesday, Jan 26, 2011Andhra Pradesh - Anantapur
‘Jawahar Bala Arogyaraksha, a revolutionary step'
Staff Reporter Anantapur: Jawahar Bala Arogya Raksha scheme aimed at holistic
development of schoolchildren launched by the State government
and being implemented through the Rajiv Vidya Mission is being
viewed as a revolutionary step on the child health programme.
The Rajiv Vidya Mission and the District Education Department
have just completed training of teachers, paramedical staff,
doctors and NGOs concerned at the mandal level and also
launched the health check-up programme beginning from high
schools keeping in view the high schoolchildren taking public
examination.
In a phased manner about five lakh schoolchildren attending
government schools will be covered. The programme has been
a great boon to the children who in rural areas were frequently
falling sick resulting in absenteeism. District Collector
B. Janardhan Reddy had been visiting schools almost
on a daily basis and monitoring the programme implementation.
Presently officials are busy in the distribution of Arogya
Raksha cards.
Project Director of Rajiv Vidhya Mission
Ramachandra Reddy told The Hindu that the programme
of distribution of cards had started from January 20 onwards.
Free treatment for all minor and major ailments will be
arranged for under different schemes including Arogyasri.
Saturday, 26 November 2011
Wednesday, 23 November 2011
Thursday, 17 November 2011
Wednesday, 16 November 2011
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