School Health Nurses Research Articles

Attained body mass index among children attending rural outdoor or urban conventional kindergartens.

This study aimed to examine whether children in rural outdoor kindergartens had attained a lower body mass index z-score (BMIz) and were at lower risk of overweight after school entrance compared to children in urban conventional kindergartens. This is a longitudinal observational study of 1,544 children from outdoor kindergartens and 1,640 from conventional kindergartens. The mean age at kindergarten enrolment was 3.5 years (SD: 0.9) in the outdoor kindergartens and 3.6 years (SD: 1.0) in the conventional kindergartens. Anthropometry was measured after school entry by school health nurses when the children were 6 to 8 years old. Attained BMIz was included as the primary outcome. The risk of attaining overweight (including obesity) was included as a secondary outcome. Register-based information was available on potential confounding factors. Linear and logistic regression models were used to assess group differences in outcome measures. Our basic models, with information on outcome, kindergarten type, and birth weight showed a borderline statistically significantly lower attained BMIz (-0.07 [95% CI: -0.14, 0.00], P = 0.060) and a lower risk of overweight (adjusted risk ratio: 0.83 [95% CI: 0.72, 0.97], P = 0.016) among children attending outdoor kindergartens. However, when adjusting for sociodemographic factors and parental BMI, there was no evidence of differences in attained BMIz (P = 0.153) or overweight (P = 0.967). When considering confounding factors, our findings indicate no differences in attained BMIz or risk of overweight after school entry among children attending rural outdoor kindergartens compared to those attending urban conventional kindergartens.

Exploring Wellness Through Concept Analysis.

Modern wellness is a concept that has been discussed in the literature since the 1960's. To better understand wellness complexities in a school setting, a concept analysis was conducted using a modified version of Walker and Avant's method incorporating the nursing paradigm in the implications. A literature review was conducted and except for background information, the publication dates were limited to 2017-2022. Key search terms included "wellness," "school wellness," "wellness concept." Additional literature reviews were conducted based on data related to the definitions, attributes, antecedents, and consequences of wellness that were collected from the reviewed studies. Defining attributes of wellness included healthy habits, conscientiousness, and optimum state of health. The antecedents, consequences, and empirical referents of wellness were identified with examples from the literature and case exemplars. Wellness is a dynamic process that has unique implications for school health and school nurses. This concept analysis lays the foundation for future research incorporating nursing domains.

Significance of an Online Evidence-Based Practice Education Module for Acute, Ambulatory, Public, and School Health Nurses

Recent surveys of Magnet facilities and nurses found low rates of implementation of evidence-based practice in U.S. health care settings. Nursing Experts: Translating the Evidence (NExT) is a collaboration of nurses and librarians providing free online evidence-based practice nursing education benefiting nurses in all settings. The NExT online modules empowered participants to efficiently access valuable resources to inform and improve their practice in a convenient, accessible, self-paced format. Quantitative and qualitative evaluation methods and the value of collaboration are discussed. [J Contin Educ Nurs. 2023;54(4):176-184.].

Auxiliary delivered school based oral health promotion among 12-14-year-old children from a low resource setting-A cluster randomized trial.

This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12-14-year-old children who received a school based oral health promotion delivered by auxiliaries in a rural setting in India. The interventions in this school based cluster randomized trial were delivered using schoolteachers and school health nurses. Oral health education (once in 3months), weekly classroom based sodium fluoride mouth rinsing and biannual oral health screening/ referral were provided for 1 year. The control arm did not receive these interventions. Oral health indicators and self-administered KAP questionnaire were evaluated at baseline and 1-year follow-up. Oral health indicators included oral hygiene index simplified, DMFT/DMFS net caries increments, prevented fraction, number of sites with gingival bleeding, changes in care index, restorative index, treatment index, and dental attendance. The improvement in total KAP score, oral hygiene, and gingival bleeding from baseline to follow up was higher in the intervention arm (p < 0.05). The prevented fraction for net caries increment were 23.33% and 20.51% for DMFT and DMFS, respectively. Students in the intervention group had a higher dental attendance (OR 2.92, p < 0.001). The change in treatment index, restorative index, and care index were significantly higher in the intervention arm (p < 0.001). Inclusion of available primary care auxiliaries like school health nurses and teachers in oral health promotion is a novel, effective, and sustainable strategy to improve oral health indicators and utilization in rural areas in low resource settings.

Level of Online Game Addiction on Adolescents

Online game is increasingly popular entertainment for all ages, especially on adolescents. Previous study had shown that the most internet users in Indonesia are adolescents and playing online game is the most activities frequently accessed by adolescents. Previous research also showed that online game addiction among Indonesian students was estimated at 10,15%. This study aimed to identify the level of online game addiction in adolescents. This research was in form of quantitative descriptive. The study population was all students of class X dan XI who obtained students from screening results and have met certain criteria with total of 241 people. The population and sample criteria in this study were adolescents who played online games for at least 6 months starting from the first time playing online game. The sampling technique used was total sampling, that all members of the population were used as sample. Data was collected within a month using The Indonesian Online Game Addiction Questionnaire and data obtained directly through google form. The result of the study was analyzed by univariate analysis then grouped into groups of respondents with a score of 7-13 no addiction, 14-21 on mild level of addiction, and 22-35 on high level of addiction. Base on the data analysis, the result of this study showed that almost all respondents were male (87,1%) with duration of ≤ 3 hours/day atau ≤ 21 hours/week to play online game (69,3%). Nearly half of respondents were addicted at a mild level (49,8%) and partially at a high level (10,8%). The conclusion of this study was that the level of addiction in adolescent was dominated at a mild level. The suggestion for school and school health nurses are to collaborate in prevention and treatment efforts by providing education about time management and the dangers of online game addiction to students.

The Impact of COVID-19 on the Mental-Emotional Wellbeing of Primary Healthcare Professionals: A Descriptive Correlational Study

The present study aimed to examine work environment related factors and frontline primary healthcare professionals’ mental-emotional wellbeing during the COVID-19 pandemic in school communities of Hong Kong. A total of 61 (20%) school health nurses (frontline primary healthcare professionals) participated in a cross-sectional online survey from March to June 2020. Outcomes of mental-emotional health were measured using the Mental Health Continuum-Short Form (14-item scale with three subscales related to emotional, social and psychological wellbeing); the Perceived Stress Scale (10-item scale with two subscales related to perceived helplessness and lack of self-efficacy; and the Coping Orientation to Problems Experienced Inventory (Brief COPE), a 28-item inventory with two subscales related to adaptive and maladaptive strategies. Almost half (42.6%) of participants experienced mental health problems. Those employed in government subsidized schools had signifi- cantly lower scores in mental health wellbeing than those who worked in private schools. Factors relating to increased mental health problems included lack of emotional support, inadequate training relating to infection prevention and control measures, disengagement and self-blame. A variety of factors influencing school health nurses’social, emotional and psychological wellbeing in their work environment during the COVID-19 pandemic were also reported. The mental-emotional wellbeing of school nurses may relate to their subjective feeling of loneliness as participants were the sole frontline primary healthcare professional working in the school community during the COVID-19 pandemic. Study findings provide relevant evidence for management teams to build a culture of psychological and social support into workplace policies and procedures. Continuous staff development and adequate social support are important to promote the mental-emotional wellbeing of primary healthcare professionals in school communities as they play a significant role in safeguarding resources during pandemics.

Effect of a School-Based Interventional Package on the Cardiovascular Risk of Adolescents

Background: Cardiovascular diseases (CVDs) are the number one cause of death globally. Several risk factors are associated with CVDs evident in childhood through adolescence. The major metabolic risk factors include high blood pressure (BP), increased body mass index (BMI), raised blood glucose, raised blood lipids and increased waist circumference (WC). Physical activity, diet, BP, WC, obesity and cardiovascular fitness are the risk factors that can be measured non invasively among adolescents. The identification of these risk factors in adolescents can enable healthcare providers to initiate interventions to reduce the risk and help adolescents to move forward to healthier adulthood in the future. Objectives: The objectives of the present study were to assess the cardiovascular risk of adolescents and to evaluate the effect of a school based interventional package on the cardiovascular risk for adolescents with high cardiovascular risk. Methods: The study was conducted in two phases. Phase I adopted a descriptive design and Phase II adopted a quasi experimental non equivalent control group before and after design. It was conducted in four schools among 401 adolescents aged 10–14 years and their mothers who have given signed consent. The sociodemographic data sheet and the 24 h recall of the adolescents were completed by the mothers. The adolescents completed a physical activity questionnaire child The Physical activity questionnaire for older children and the tobacco, alcohol and drug questionnaire in their classroom. The height, weight, BP and WC were measured as per standard procedures. The 20 m shuttle run was conducted to assess their cardiovascular fitness and levels and shuttles obtained by the adolescents were recorded and graded. The BMI was calculated. The adolescents (n = 31) with the highest risk scores in the experimental schools underwent a school based interventional package. The control group (n = 30) did not have any intervention. The post tests were conducted on the last day of the 8th and 16th weeks using the cardiovascular risk scale. Results: The mean score for cardiovascular risk was 14.35 with a standard deviation of 3.23. There was a statistically significant difference in the cardiovascular risk scores of the adolescents between the control and experimental group in post test 1 (t = 5.69; P = 0.001) at the 8th week and post test 2 (t = 11.61; P = 0.001) at the 16th week. Hence, it can be concluded that a school lbased interventional package elicited a reduction in cardiovascular risk among adolescents. Conclusion: Nurses, particularly school health nurses, can play a pivotal role in encouraging cardiovascular risk surveillance programmes among adolescents in school and to conduct multi component interventional programmes including education, physical activity and diet.

Comparison of Motor Difficulties Measured in the First Year of School among Children Who Attended Rural Outdoor or Urban Conventional Kindergartens.

Kindergartens can potentially contribute substantially to the daily level of physical activity and development of motor skills and might be an ideal setting for improving these as a public health initiative. We aimed to examine whether children from rural outdoor kindergartens had a lower risk of motor difficulties than children from urban conventional kindergartens. Motor test results were measured during the first school year by school health nurses using a six-item test of gross- and fine motor skills (jumping, handle a writing tool, cutting with a scissor following a line, one-leg stand on each leg, throwing and grabbing). Register-based information was available on potential confounding factors. We included 901 children from outdoor kindergartens and 993 from conventional kindergartens with a mean (SD) age of 6.5 years (0.4). The children from the two types of kindergarten differed according to demographic information, with outdoor kindergarten children more often being from more affluent families (long maternal education level: 47.5% vs. 31.0%, p < 0.0001) and fewer girls attending the outdoor kindergartens (42.7% vs. 49.5%, p = 0.003). In the adjusted models, we found no evidence of differences in the risk of motor difficulties between children attending either type of kindergarten (OR: 0.95, 95%CI: 0.71; 1.27, p = 0.72). Our results do not support outdoor kindergartens as a potential intervention to improve motor abilities among children. Randomized controlled trials are needed to confirm these findings.

Overcoming barriers and improving public health nursing practice.

Public health nurses (PHN) are critical to ensuring the health of communities. Absent the most basic information on the PHN workforce in our state, we conducted interviews with 21 PHN and school health nurse (SHN) leaders and an online survey of PHNs and SHNs practicing in Maryland (N=491). Our study identified an older, very experienced, and well-educated workforce. Both the interviews and survey identified similar barriers: low salaries, recruitment and hiring challenges, limited funding for public health programs, and no opportunities for education or career advancement. Survey participants also identified barriers of inadequate leadership, recognition, and communication including PHNs not being represented at decision-making tables or at the state leadership level. Strategies to promote public health nursing from leaders and survey participants were similar: increasing awareness about what public health and PHNs do and their value; improving advocacy and stakeholder engagement; improving access and availability of services; improving PHN leadership representation at the state level; a improving PHN salaries and benefits including tuition reimbursement. Although results were similar to national studies, comprehensive, granular workforce data is critical to ensure the public health workforce can meet current and emerging public health needs and that public health infrastructure and services are appropriately funded.

‘You are Constantly Trying to Make the Best Out of All Situations’: Adolescents with Overweight and School Health Nurses in Norway on Weight Stigma and Physical Activity

<strong>Background:</strong> Weight stigma is highly present in physical activities in the lives of adolescents with overweight. Nevertheless, increased physical activity is one of the target lifestyle determinants in health workers’ follow-up with adolescents at risk of negative weight development. The present study examines how adolescents with overweight and school health nurses who monitor and guide these young people perceive weight stigma in physical activity. <strong>Methods:</strong> We interviewed a community sample of 10 adolescents (13–18 years) with overweight or obesity and six school health nurses about weight stigma in physical activity. Data were analysed using reflexive thematic analysis. <strong>Results:</strong> We generated three main themes describing experiences with weight stigma in physical activity. 1) ‘being (in)visible’ identified contradictory motives of both wanting to hide their body to avoid being on display and at the same time working hard to be physically active to disprove the stereotypical view of people with overweight, 2) ‘being perceived as unacceptable’ identified adolescents’ understandings of themselves as individuals who ought to transform into a slimmer version through exercise and 3) ‘dealing with social interaction’ identified different strategies used to handle the stigma. <strong>Conclusion:</strong> Insight into adolescents’ complex experiences with weight stigma related to physical activity and follow-up with school health nurses is essential to inform approaches to increase physical activity participation without reinforcing weight stigma.

Okul Temelli Ergen Sağlığı Tarama Programı Sonuçları

Amaç: Bu çalışmada, halk sağlığı hemşireliği uygulamaları kapsamında yürütülen okul temelli ergen sağlığı tarama programı sonuçlarının paylaşılması amaçlanmıştır. Yöntem: Kesitsel tipteki araştırma, 2019-20 eğitim-öğretim yılında Tekirdağ İl Milli Eğitim Müdürlüğü’ne bağlı üç ayrı okulda yürütülmüştür. Araştırma verileri 1913 öğrenciden toplanmıştır. Okullarda hipertansiyon, boy, kilo, görme keskinliği, işitme, diş çürüğü, skolyoz, baş biti ve dijital oyun bağımlılığı taraması yapılmıştır. Veriler SPSS 21 paket programı kullanılarak sayı, yüzde, ortalama ve standart sapma kullanılarak analiz edilmiştir. Bulgular: Öğrencilerin yaş ortalaması 14,60±2,21’dir, %52,7’si erkektir. Tarama sonucunda sırasıyla öğrencilerin %51,75’inde diş çürüğü, %23,9’nda fazla kilo/obezite, %20,49’de dijital oyun bağımlılığı, %18,98’de skolyoz, %14,85’inde sağ göz, %13,23’inde sol göz, %7,42’inde her iki göz görme keskinliğinde azalma, %10,82’de hipertansiyon, % 9,5’de düşük kilolu olma riski tespit edilmiştir. Sonuç: Okul sağlığı hizmetleri kapsamında çocukların sağlık risklerini belirlemek, bu riskleri önlemeye çabalamak ya da erken dönemde tanı ve tedavisi için yönlendirme yapmak aşamalarında, okul sağlığı hemşirelerinin önemli sorumluluklar ve roller üstlenebileceği gösterilmiştir. Okul sağlığı hemşireliği uygulamalarının yaygınlık kazanması çocuk sağlığının geliştirilmesi, sağlık hizmetlerinin yükünün azaltılması, sağlıklı ve üretken nüfusun artması ve ülke ekonomisinin gelişmesine fayda sağlayacaktır.

Experiences of Norwegian child and school health nurses with the “Starting Right™” child health assessment innovation: a qualitative interview study

BackgroundAlthough child health services are well established in Norway, the use of information technology for the systematic collection of evidence-based child- and proxy-reported health measures may be beneficial in the early identification of child development problems. The Norwegian “Starting Right™” health service innovation consists of parent- and child-reported online structured health assessments tools, including practical routines for child and school health assessments. The aim of this study was to explore the experiences of child and school health nurses with the Starting Right innovation.MethodsWe used a qualitative design and conducted three focus group interviews with 18 child and school health nurses from three child health centres one year after the implementation of the innovation.ResultsThe experiences of professionals with the Starting Right innovation were captured by three themes: (1) the digital innovation could be used to obtain a good overview of a child’s health and development; (2) interpreting the questionnaires was a challenge; and (3) implementing the new digital innovation was time-consuming.ConclusionsOverall, the child and school health nurses experienced that the Starting Right innovation was useful for providing a comprehensive overview of child development and health. The challenges related to interpreting the parents’ scores and follow-up of children, as well as providing the questionnaires in relevant foreign languages, should be addressed to allow all children and families to be reached.

Exemplar: Social Media as a Format for Nursing Advocacy

Social media refers to internet-based applications that facilitate communication and collaboration between individuals and communities around the globe. Social media use is not without controversy. Use has been associated with violence, isolation, and spread of misinformation (Bumpus, 2022; Mammoser, 2018). Nurses have a unique opportunity to engage with the larger community on a broad array of healthcare topics. Nurses advocate in many ways from professional leadership opportunities to grassroots efforts to impact health and health policy. This article describes the trajectory Robin Cogan, nurse, author, and advocate, took to becoming a nationally known leader for school health nursing.

Factors Affecting Infection Control Performance of School Health Nurses During the COVID-19 Pandemic in South Korea.

PurposeMany patients with coronavirus disease 2019 (COVID-19) are asymptomatic or infected by unclear infection routes. Significant group infections may result from transmission in schools, and thus, it is necessary to improve infection control efficiency in schools by identifying the factors associated with the performance of COVID-19 infection control by school health nurses.MethodsThe participants were 130 school health nurses in Korea. The survey variables included knowledge of COVID-19, infection control attitude, job stress, and school organizational culture.ResultsThe results demonstrated that among the variables, infection control attitude, job stress, and the level of infection control in schools perceived by school health nurses were significant. The explanatory power of the model including these variables was 25.8% (F=14.39, p<0.001, R2=0.255, Adj-R2=0.258).ConclusionThe results showed that the infection control attitude and job stress of school health nurses had a significant effect on their infection control performance during the COVID-19 pandemic. The results will be used as basic data for developing programs to enhance the competence of school health nurses to manage new infectious diseases.

The effect of social phobia and peer pressure on substance use among adolescents

ABSTRACT Objective The aim of this study was to determine the effect of social phobia and peer pressure on substance use among adolescent. Methods The study was conducted in three high schools in the city of Van/Turkey between November 2015-July 2017. The descriptive study was conducted with 1996 adolescents using face-to-face data collection method. Data were collected using a sociodemographic questionnaire, Social Phobia Scale for Children and Adolescents (SPSCA), and Peer Pressure Scale (PPS). The data were collected face to face in the classroom environment. All ethical principles were observed in the study. Results It was determined that the SPSCA and PPS mean scores of adolescents were at a low level. The mean PPS and SPSCA scores of adolescent were found to be positively and weakly correlated (p < .05). It was concluded that there was a statistically significant difference between the mean SPSCA and PPS scores of adolescent who smoke tobacco and drink alcohol (p < .001). Conclusion As the result of the research, it is identified that substance use among adolescents is at a considerable level. It is observed that several sociodemographic variables are effective in substance use on peer pressure and social phobia perceived by adolescents. It is recommended that school health nurses include the topic “the effect of social phobia and peer pressure on substance use” in training programs.

Comparison of Discretionary Food and Drink Intake Based on a Short Web-Based Sugar-Rich Food Screener and a Validated Web-Based 7-Day Dietary Record.

A high consumption of discretionary foods and drinks has been associated with increased risk of multiple adverse health outcomes, including risk of overweight and dental caries. The family-based cluster randomized intervention study “Are you too sweet?” aimed at reducing the intake of discretionary foods and drinks in a population of children starting pre-school. As part of the intervention a new short web-based sugar-rich food screener (SRFS), was developed to make the parents and the school health nurses aware of the children’s intake of discretionary foods and drinks. In addition to the short assessment tool the parents also completed a validated web-based 7-day dietary record for the children. In the present study, estimates for intake of discretionary foods and drinks from the two assessment tools were compared (n = 80). There was significant correlation between estimates from the two assessment tools, but the SRFS provided lower estimates for intake of discretionary foods and drinks compared to the 7-day dietary record. The correlation coefficient between the two assessment tools was 0.49 (p < 0.001) and Kappa coefficient was 0.33. It is concluded that the SRFS can provide a fairly ranking of participants according to their intake of discretionary foods and drinks when compared to a validated 7-day dietary record. The screener may be a useful tool in practical settings, such as school health nurse consultations, in order to gain insight into the child’s sweet intake habits.

Elementary School Nurses' Perceptions Regarding Menstruation Education: An Exploratory Study.

Menarche can be a difficult transition for young people. With appropriate education, youth can feel more positively about the menstrual experience. Since many elementary teachers are not equipped with menstrual health knowledge, the education falls to the school nurse. However, it is unknown if school nurses feel comfortable communicating about menstruation with young people. The purpose of this study was to explore school nurses' perceptions regarding menstrual health education in elementary schools (grades K-5).An online mixed-methods survey was established using Qualtrics. Through snowball sampling, 30 elementary school nurses responded. Using the Integrated Behavioral Model (IBM) as a framework, a deductive semantic thematic analysis was used to identify themes for each question.Data suggested that elementary school nurses would participate in professional development regarding menstrual health and hygiene. School health nurses are receiving limited knowledge/skills surrounding pedagogy and are not familiar with cultural differences when it comes to menstrual health.

Covid-19 Fear and Compliance with Protective Measures of Students Who Continue Face-to-face Education During the Covid-19 Pandemic

Objective: This research was conducted to determine the conditions of Covid-19 fear and compliance with protective measures of students who continue face-to-face education. Methods: The research was descriptively conducted between November 12-20, 2020. The universe of the study consisted of secondary and high school students in a province in The eastern black sea region of Turkey, and the sample consisted of 188 students who were reached by the snowball sampling method. Results: In the study, the average score of the Covid-19 fear scale of the students was 18.88±6.66. 89.4% of the students said they regularly used masks, 86.7% said they regularly washed their hands and 67.6% said they regularly followed social distance rules. The educational status of the students' fathers (β= -0.314; p = 0.000), their families catching Covid-19 (β = -0.178; p = 0.012), and their anxiety about their families being sick (β= 0.195; p = 0.007) were found to be a significant predictor on the Covid-19 Fear Scale.Conclusion: In the study, it was determined that most of the students have knowledge about the methods of protection against Covid-19. Students' fears of Covid-19 were found to be moderate. It is recommended that school health nurses increase their awareness by educating students about Covid-19 disease and preventive measures.

A cross-sectional study examining self-reported anthropometric measurements with adolescents' nutrition attitudes, obesity awareness and diet quality indices during the pandemic

PurposeThe purpose of this study is to evaluate the relationship between adolescents' nutritional attitudes, obesity awareness, and diet quality with their self-reported anthropometric measurements taken during the COVID-19 pandemic. Design and methodsThis cross-sectional type of study was conducted in a district in the south of Turkey. The research was carried out online with 907 adolescents who agreed to participate voluntarily. ResultsAmong the adolescents, 28.5% considered themselves overweight, and 32.1% were currently trying to lose weight. According to BMI, 16.1% were affected by overweight/obesity. Adolescents' nutritional attitudes and obesity awareness levels were moderate, while their KIDMED nutritional habits were also moderate. In this study, a negative relationship was found between the adolescents' ASHN mean scores and their body weight, waist circumference, hip circumference, neck circumference, waist/hip ratio and waist/height ratio measurements; and between their OAS mean scores and their body weight, waist circumference, waist/hip ratio and waist/height ratio measurements; and between their KIDMED index scores and their waist/height ratio measurements (p < 0.001). ConclusionsThe rate of adolescents who perceive themselves as overweight is higher than the results obtained from the measurement values. BMI levels and other anthropometric measurement values of adolescents with positive nutrition attitudes and physical activity behaviours are also positively affected. Practice implicationsThis study may have a significant impact on the formulation and implementation of interventions to prevent obesity and increase physical activity for school health nurses. Since the pandemic is still continuing, healthcare providers must stress the risk of obesity in adolescence.

Vision screening as part of the school health policy in South Africa from the perspective of school health nurses

BackgroundVision screenings of school-going children are essential in the early detection of visual anomalies common in different age categories, which may negatively affect their academic ability and social development. Hence, their inclusion in school health policies is imperative. The aim of this study was to assess the implementation of vision screening protocols in the current Integrated School Health Screening policy of South Africa from the perspective of school health personnel.AimThe study sought to explore the perceptions, experiences and attitudes of the school health nurses on vision screenings included as part of the school health screenings in Gauteng province (South Africa).SettingThis study was located across three public healthcare facilities across Gauteng at primary healthcare levels.MethodsThree teams of 13 school health personnel from three primary healthcare facilities in the district of Ekurhuleni were invited to participate in the study. Focus group interviews were conducted for generating information on collective opinions and the rationale behind their views.ResultsResults of the collected qualitative data revealed challenges related to training, vision screening tests, referral criteria and follow-ups or referral pathways. In addition, further challenges reported were related to communication, time, space and consent forms not signed by the parents.ConclusionImproved cohesion and communication between all role players will enable reasonable and professional provision of validated vision screening services that have the best chance of early detection of children with vision anomalies to negate possible adverse effects on their scholarly performance.