Why back-to-school medical examinations?

Experts reveal how Back-to-School medical exams are degenerating into money-making racket  

Kampala, Uganda | THE INDEPENDENT |  As suppliers of school materials are busy raking in money from shoppers in last-minute shopping for children who return to school on Monday, health workers have also found themselves ‘drafted’ into the cash bonanza as parents flock to their clinics with medical forms from schools for stamping before the learners are allowed back in class and dormitories.

At one clinic in Najjera, a doctor who had only expected to put in a couple of hours on Saturday morning found himself still busy late evening examining and filling forms for students whose anxious parents wanted their children cleared to be allowed back into school.A similar situation obtained at clinics visited in and around Kampala in Najjera, Kira Buukoto and Kamwokya.

But pediatricians have expressed concern over the kind of health tests learners are asked to do by schools as part of their wellness programs.

Speaking to URN on Saturday, Dr. Richard Idro, a senior pediatrician at Mulago National Referral Hospital said while child health problems are age-related and it is important that necessary screening is done at various levels of child growth, but schools are now asking for unrealistic and uninformed health checks.

The tendency of requiring a child to present a fully filled medical form while reporting to school has been on for some time with secondary schools especially requiring girls to do pregnancy tests but the trend is increasingly being adopted by many schools. As a result, some private laboratories and clinics have developed back-to-school test packages that are being advertised via different media platforms.

For instance, a flyer seen by URN shows that the lab based at the International Hospital Kampala (IHK) is charging forty-five thousand shillings for their School Pre-Medical which entails a physical examination, Full Blood Count (FBC), malaria, a urinalysis and typhoid screening.

But according to Idro who is also a professor of Pediatrics at Makerere University, some of these tests are useless. He gives an example of a widal test that is used in screening for typhoid which he says misleads people into starting typhoid treatment unnecessarily and should be scrapped.

He advises that some tests should be done strictly under request by a qualified health worker and not school administrators.

As a solution to this issue which is seen by sections as a money-making venture, pediatricians under their umbrella, the Uganda Pediatrics Association have started a review process and will eventually develop a draft school health card with standardized tests that would be necessary for a school-going child.

Idro says this document will be made available after consensus building with the relevant ministries but its standardization should be approved by health authorities.

When contacted, Dr Charles Olaro, the Director Clinical Services in the Ministry of Health said while this is a health issue, the development of such guidelines are a responsibility of the ministry of Education.

However, it’s not clear whether such guidelines exist within the Ministry of Education and Sports as officials contacted by URN on Saturday said they would provide a response on Monday.

But, experts say such issues would be contained in the Uganda School Health Policy first drafted in 2008 by the Ministries of Health and Education. This policy has not yet been passed 14 years later.

Now, the important health checks and screenings that Idro lists for schools include ensuring all children joining nursery and primary schools from baby class up to P1 have Child Health Cards showing up to date and completed vaccination.

He also notes that beyond concerns of good nutrition and transmission of infections, parents and teachers should pay attention to other critical issues like adequate physical activity, rest and sleep with the growing problem of obesity in urban and peri-urban schools where children pack a lot of sugar-rich snacks, and mental health problems especially from the strain of very high expectations and inadequate sleep in urban schools.

The doctor says parents should give nursery school children a dose of vitamin A once every six months.

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URN