[School health in France: evolution and perspectives]

The school health service in France was attached to the Ministry of national education from 1945-1964, then to the Ministry of health until 1984, and has since returned to the Ministry of national education. From a global service in its beginnings, including physicians, nurses and social workers, it progressively grew into a social service on one hand, as well as a medical service and nursing service on the other, that act in close collaboration. Health and social personnel insure the technical advising of administrative heads of the Ministry of national education, at each level (ministerial, academic, and departmental). The strong coherence of the fundamental texts of the Ministry of national education allows the health and social service personnel to take health into account in the daily lives of establishments. They act as technical advisors in public health among school directors and heads of establishments. School medical centres are organised in districts of more than 5,000 inhabitants. The medical files of students are regrouped in these centres. The provision of personnel remains insufficient. The funds for functioning are sparse. The initial training of nurses and social workers depends on academic initiatives, while doctors benefit from a statuary initial training, either for eight weeks or a year. The school health teams implement new work procedures based on the methods of public health, the systematic health exams having been put into question. The March, 1998 "plan for relaunching school health" focuses on health education and prevention in schools.