School health care | Health Portal

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Health checks and vaccinations carried out by school nurses are often a child's first independent contact with healthcare. School nurses are important support persons for children: they help them understand why it is important to develop healthy habits and provide practical advice in addition to what is taught in school.

A child's sensitive health issues must remain between the child and the school nurse – every student has the right to privacy. For example, if lice are discovered at school, all students' heads must be checked, but this must be done privately, not in front of the class.

The school nurse also checks whether the school environment is safe, whether school meals meet nutritional recommendations, whether health lectures are held, whether information materials are distributed, and whether first aid skills are taught.

The school nurse performs health checks on students in grades 1, 3, 7, and 10.

The purpose of health checks at school is to identify health risks early and, if necessary, agree on steps to reduce them. This may mean referral to a specialist, assessment of the need for glasses, exercise recommendations for posture, visits to a youth counseling center, repeated counseling with the school nurse, etc.

In addition, school health care involves cooperation with various parties in the prevention of dental diseases, referring students to their family doctor for preventive health checks if necessary, and organizing the necessary health services for children living in dormitories.

School health care services are provided during school hours.

See the list of Health Insurance Fund contract partners(Opens in new tab) providing services in schools.

The objectives of school health care are:

to monitor the health status of students;
to promote a healthy lifestyle among students;
prevent students from falling ill and developing chronic diseases;
ensure that the workload is manageable for each student and that the learning environment is healthy;
provide emergency assistance.

The objectives of school health care are:

to monitor the health status of students;
to promote a healthy lifestyle among students;
prevent students from falling ill and developing chronic diseases;
ensure that the workload is manageable for each student and that the learning environment is healthy;
provide emergency assistance.

Necessary information for parents

At the beginning of the school year, parents are asked to give their consent for a health check. The family is notified of the check in advance. After the health check, the child is usually given a report with the results and recommendations.

If the form provided by the school for consent to vaccination has not reached your home, you can find it on the Health Board website(Opens in new tab).

The school nurse always asks for the parent's written consent for vaccination. This is important in order to rule out any possible contraindications. If the family does not wish to have their child vaccinated, they must also notify the school in writing – the decision will be noted on the student's health card.
If the check-up reveals that the child's health needs to be further assessed, the school nurse will recommend that the family doctor or a specialist be consulted. The appointment must be booked by the parent or the student themselves.
The school nurse will help if the student needs (temporary) special arrangements at school due to health reasons. For example, the school nurse will ensure that post-illness restrictions or recommended measures are implemented.
If the family doctor has treated the child, they can give the parent an extract from the child's health record, which can be submitted to the school. This helps the school to take the child's health into account and provides guidelines for limiting physical activity.

A sick child should not be sent to school. The school nurse does not prescribe treatment, perform tests, or write sick notes. If a child is ill, you should contact your family doctor. Outside of your family doctor's office hours, you can get initial advice 24 hours a day by calling the family doctor's advice line at 1220.
If a child has an allergy or illness that could cause a sudden health problem (e.g., diabetes, asthma, epilepsy), the school nurse must be informed. This will enable first aid to be administered quickly if something happens to the child at school.
In small schools, the school nurse is not present every day. However, all schools must have information availableabout when and where the school nurse is available, and it is advisable to include their phone number.
If a child lives in a dormitory far from home, it is advisable to register them with a family doctor working in the same area. This will allow the school nurse to refer a sick child to a family doctor in a timely manner. If parents wish to leave their child on the list of their family doctor in their home town, they must ensure that the child receives medical care from the family doctor in case of illness.

Frequently asked questions

Why is school health care necessary?

The school nurse contributes to the prevention of diseases during childhood and adolescence.

Health problems that flare up and worsen in adulthood often originate in school age. The focus of a school nurse's work is disease prevention (including vaccination with parental consent), monitoring children's health, developing healthy habits, and providing first aid.

If a child falls ill or is injured at school, the school nurse will provide first aid. The nurse will assess the severity of the situation and perform the necessary first aid procedures. If necessary, she will call an ambulance or arrange for the child to be taken to hospital. In most cases, the child's parents are notified and the best way to take the child home for treatment is found, unless urgent intervention is required.

All health-related incidents are recorded in the child's health card.

What are the most common health problems among Estonian children?

In addition to prevention, the goal of school health care is to identify problems early and draw attention to them.

The most common health risks among Estonian schoolchildren are

unhealthy diet,
lack of physical activity,
smoking and alcohol consumption,
risky sexual behavior.

The most common health problems are:

poor dental health,
frequent viral infections,
vision, posture, and mental health problems.

The most common health risks among Estonian schoolchildren are

unhealthy diet,
lack of physical activity,
smoking and alcohol consumption,
risky sexual behavior.

The most common health problems are:

poor dental health,
frequent viral infections,
vision, posture, and mental health problems.

When should a school nurse be present at school?

Not all schools have a school nurse on site at all times.

There should be one full-time school nurse for every 600 students. This means that the workload of a school nurse depends on the number of students at the school.

A school must have a nurse's office if it has more than 200 students. In small schools in rural areas, the school nurse and family nurse are usually the same person.

You can find the Health Insurance Fund's contract partners(Opens in new tab) providing services in schools on the Health Insurance Fund's website.

There should be one full-time school nurse for every 600 students. This means that the workload of a school nurse depends on the number of students at the school.

A school must have a nurse's office if it has more than 200 students. In small schools in rural areas, the school nurse and family nurse are usually the same person.

You can find the Health Insurance Fund's contract partners(Opens in new tab) providing services in schools on the Health Insurance Fund's website.

What are the responsibilities and competences of a school nurse?

A school nurse is a healthcare professional, not a teacher.

School nurses are not legally part of the school staff, as healthcare services can only be provided by healthcare institutions with the appropriate operating license. At the same time, the work of a school nurse is closely related to supporting the school environment and students, so it is important that they are a natural part of the school team and a good partner for cooperation.

The school nurse's responsibility is limited to her own activities. In other respects, she can assess the situation, make recommendations, and propose improvements to the school environment, but the school is responsible for implementing them.

The school nurse plays an important role in promoting cooperation between the parties so that the student and their family, teachers, school management, and, if necessary, a psychologist and social worker can work together for the health and well-being of the child.