Scaling up childhood epilepsy management: lessons from India's school health program

In 2021, the WHO assessed national school health programs in Southeast Asia and collaborated with UNESCO to evaluate 87 school health interventions and identify essential components of comprehensive school health programs. 1,2Childhood epilepsy, despite being a significant neurological condition globally, lacked interventions from this list, primarily due to the lack of empirically validated, school-based epilepsy intervention strategies. 2,3his omission highlights a broader gap in the global child health policy frameworks, where it remains underrepresented despite its considerable impact on children's education and well-being.Existing efforts, largely limited to occasional seizure first-aid training in schools, emphasise the urgent need for comprehensive and systematic approaches to epilepsy management in the school setting. [4][5]5][6] Here, we build a case for including epilepsy in national school health programs while sharing our preliminary experience in developing and implementing school-based epilepsy interventions.Epilepsy affects 0.8% (95% CI: 0.6%-1.0%) of India's 250 million school children, making early detection and intervention crucial. 7,8Many children face exclusion from school, learning challenges, and social integration issues due to stigma and misconceptions. 5,9Despite such a scenario, epilepsy has neither a standalone national control program to its name nor does it figure in Noncommunicable Disease programs.However, epilepsy case detection and referrals are integrated into the Rashtriya Bal Swasthya Karyakram (RBSK) and Ayushman Bharat programmes, aligning with the UN's Sustainable Development Goal 3 and the Intersectoral Global Action Plan for neurological disorders. [10][11]][12] RBSK is a national initiative by the Government of India that provides a continuum of care for a panel of diseases across India for children aged 0-18, focusing on underserved areas and government or government-