By Dr Ali Faisal Saleem
Ensuring that children learn in a safe, healthy, and protective school environment is a fundamental responsibility of any society. Schools are not merely places of academic instruction; they are environments where children spend some of the most formative years of their lives. Protecting their physical safety, health, emotional well-being, and dignity must therefore be a national priority.
In Pakistan, particularly in metropolitan cities such as Karachi, the educational landscape is complex and diverse. There are >12,000 registered private schools alongside public schools and Madaris, collectively educating millions of children from varied socioeconomic backgrounds. Despite this vast educational network, health and safety standards remain inconsistent across institutions. In many schools, basic safety provisions, such as clearly marked emergency exits, functional firefighting equipment, trained health personnel, and hygienic sanitation facilities, are either inadequate or absent. These gaps expose children to preventable risks, including injuries, medical emergencies, infectious diseases, and environmental hazards.
Globally, several frameworks guide the development of safe and resilient schools. The Comprehensive School Safety Framework is supported by UNESCO, UNICEF, and international disaster risk reduction organizations. This framework emphasizes three core pillars: safe learning facilities, school disaster management, and risk reduction education. Pakistan has also developed guidance through the Pakistan School Safety Framework (PSSF), encouraging educational institutions to conduct systematic risk assessments, develop emergency response plans, and establish protective policies for students. However, the implementation of these standards across provinces and school systems remains uneven, requiring stricter adherence to standards and policy commitment.
A critical but often overlooked aspect is the linkage between schools and the health sector. Schools should maintain active partnerships with nearby health facilities and public health departments. Such collaboration can facilitate routine health screening, emergency medical referral, and health education programs for students and staff. Strengthening these connections ensures that schools function as integral components of the broader public health system. Currently, schools also serve as a platform for health interventions, including typhoid, polio, and HPV vaccination campaigns, and most recently, deworming programs.
Equally important is the availability of trained personnel capable of responding to medical emergencies. Teachers and administrative staff should receive periodic and regular training in Basic Life Support (BLS), including cardiopulmonary resuscitation (CPR), choking management, and emergency responses to injuries. These skills can save lives when immediate professional assistance is unavailable. Schools should also establish dedicated health rooms or sick bays, equipped with essential first-aid supplies and supervised by trained personnel. Ideally, large schools should employ or have access to a school nurse who can manage minor illnesses, provide health counseling, maintain student health records, and coordinate with parents and healthcare providers when necessary.
Preventive healthcare should begin even before a child enters the school system. Schools should require verification of routine childhood vaccinations at admission, in accordance with the Expanded Programme on Immunization of Pakistan. This helps in identifying zero-dose or partially immunized children, enabling catch-up immunization and preventing outbreaks of vaccine-preventable diseases within schools and communities. Sanitation and hygiene are equally critical. Clean restrooms, safe and clean drinking water, and proper handwashing facilities are essential for maintaining children’s health. Poor sanitation contributes to infectious diseases and can reduce school attendance, particularly among younger children. Ensuring hygienic and gender-sensitive sanitation facilities, therefore, supports both health and educational participation.
Child protection education is another essential component of school safety. Children should receive age-appropriate lessons on personal boundaries, safe and unsafe touch, and how to seek help when feeling uncomfortable. Teachers and staff must be trained to recognize signs of abuse or neglect and follow clear reporting protocols, while confidential reporting systems allow children to raise concerns safely. Schools should promote gender-sensitive environments, provide separate sanitation facilities, and ensure supervision. Infrastructure and evacuation plans must accommodate children with disabilities. Effective security measures, including surveillance systems, controlled entry points, and trained personnel, can enhance safety while respecting privacy. Fostering a culture of safety requires transparent reporting systems, robust anti-bullying policies, and supportive leadership to create an inclusive learning environment.
Strengthening school safety is key to addressing the issue of out-of-school children. When parents perceive schools as unsafe, they may hesitate to enroll their children, especially girls or those with disabilities. Improving safety standards and communicating these enhancements can build trust and encourage enrollment. Effective implementation requires coordination among education departments, health authorities, and local institutions. Regular safety inspections and capacity-building programs for school staff can ensure consistent standards across all schools. Ensuring children’s safety and health in schools demands ongoing policy commitment, accountability, and community involvement. Safe schools foster parental confidence and provide environments where students can learn and thrive. Investing in school safety is a long-term investment in human capital, enabling children to grow and contribute meaningfully to society.
The author is Associate Professor and Vice Chair, Department of Paediatrics and Child Health, The Aga Khan University Hospital.
