Assessment of Injury-Related Chief Complaints Among School Children Managed by School Nurses in Nepal
Bimal Singh Bist （ Tribhuvan University, Nepal ）
Puspa Raj Pant （ University of the West of England, UK ）
Sanu Krishna Shrestha （ Dhulikhel Hospital, Kathmandu University, Nepal ）
Pavan Sah （ Health Coordination Division, Ministry of Health and Population, Government of Nepal ）
Lokendra Sherchan （ Tribhuvan University, Nepal ）
Subash Neupane （ Institute of Crisis Management Studies, Nepal ）
Dipendra Gautam （ Universal College of Medical Sciences, Lumbini, Nepal ）
SujanAdhikari （ Weifang Medical University, Shandong Province, China ）
Ashis Thapa （ Nepal Armed Police Force Hospital, Nepal ）
Ram Prasad Neupane （ Tribhuvan University, Teaching Hospital, Nepal ）
https://doi.org/10.37155/3060-8708-0302-1Abstract
Background: In Low- and Middle-Income Countries (LMICs) like Nepal, school nurses serve as the first point of contact for managing childhood injuries and acute illnesses. However, the actual pattern of complaints they manage remains poorly documented. This study aimed to assess the prevalence and types of chief complaints, particularly injuries, among school children presenting to school nurses in rural Nepal and to identify demographic and temporal associations.Methods: A cross-sectional study was conducted using secondary data from five schools with qualified school nurses in Dhading district. Records of 1,167 students (aged 5–18 years) who presented with a chief complaint during school hours across three fiscal years (2022–2024) were analyzed. Complaints were categorized into ten clinical groups. Descriptive statistics, chi-square tests for associations, and trend analyses were performed. Results: The majority of students were female (58.4%) and aged 11–15 years (57.8%). The most common chief complaints were neurological (28.0%, primarily headache), musculoskeletal/injury (23.9%), and gastrointestinal (21.0%). Within injuries, cut injuries (34.8%) and fall injuries (15.1%) predominated. Significant associations were found between complaint type and age (p < 0.001) and gender (p < 0.001), but not ethnicity (p = 0.204). Male students had higher injury rates (30.5% vs. 19.2%), while females reported more neurological and reproductive complaints. Injury related consultations peaked during the monsoon months. Conclusions: Musculoskeletal injuries account for nearly one in four school nurse consultations, with distinct demographic and seasonal patterns. These findings provide an evidence base for strengthening school nurse training in acute injury management, developing gender-sensitive services, and implementing seasonally-targeted prevention programs in rural Nepal.
Keywords
School nursing; child injuries; Nepal; chief complaints; musculoskeletal injuries; school healthFull Text
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