Description
L. Müller, MD MPH, M. Patseadou, MD PhD, N. Mezger, MD MPH DTMH, D. Baratti-Mayer, MD, DMD, MPH
*both authors contributed equally
The World Health Organization has long emphasized the link between health and education. School health services implement preventive activities, detect health issues at an early stage, and contribute to the promotion of students' global health and well-being. They have easy access to children and young people and their families without time, cost and transportation issues and also without language limitations, thanks to the availability of translation services. They serve as a coordinator between multiple actors: community and hospital-based healthcare providers, social services and educational and training institutions. Addressing social determinants of health through interventions in the school environment improves academic achievement, social integration and inclusion, as well as economic development. School health services are offered to all school-age children, but their specific functioning best responds to vulnerable populations, such as children and adolescents with migrant backgrounds who are considered at risk of multiple health conditions due to their life experiences before, throughout and after displacement in their new environments.
In the county of Geneva, every newly arrived migrant child and adolescent benefit from an initial comprehensive health assessment from the school health provider, as a complement to the hospital-based medical visits. This initial assessment is performed at no cost, usually in the first 3 months post-arrival, with the presence of a certified interpreter. It takes place in a secure and confidential setting with respect of the different cultural backgrounds. During this appointment, healthcare needs are determined and time is preserved to discuss about life conditions (home, social security, health insurance, residence permit, presence of family and friends) and health-related behaviors (substance use, eating habits, sexual issues, physical and leisure activities, emotional difficulties). This appointment can sometimes serve as an entry point into the local healthcare system. If needed, follow-up appointments and/or referrals to primary care or specialized healthcare services may be organized at that time. Importantly, school health providers can help migrant students to understand how to navigate through the complex Swiss healthcare system. In addition, the school health provider participates in regular meetings with school staff (educators, social workers and psychologists), as well as exterior actors such as legal representatives, social security services and families in order to share (always with consent) appropriate information and coordinate necessary decisions and actions. This ensures a continuum of care.
Geneva School Health Service play a central role in the promotion of students' health, particularly those with migrant backgrounds. This model of community health services best illustrates the principle of a biopsychosocial approach in healthcare as well as an effective interdisciplinary and interprofessional collaboration between different services.
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