Integrating Hidden Health Needs into School Improvement Plans for Learner Inclusion: A Case for Addressing Nocturnal Enuresis

Universally, there have been immeasurable budgetary allocations towards curriculum reforms, procurement of educational materials, teachers’ continuous professional development, and infrastructural amenities. Nevertheless, many school improvement policies do not prioritize the hidden health needs of learners. One frequently cited issue is nocturnal enuresis (NE), also referred to as bedwetting. Available data indicates that nocturnal enuresis negatively impacts 6.7% to 10.9% of children of school-going age globally, with an average prevalence rate of 7.2%. In response to this concern, this study intends to (1) explore the psychosocial influences and prevalence of NE on learner inclusivity, (2) provide evidence-driven solutions for nocturnal enuresis-related issues, and (3) recommend strategies for school leaders and policymakers to incorporate NE programs into school improvement policies. Thus, the research relied on empirical studies from both the Indian context and global meta-analysis data for 2025 in order to integrate information on the prevalence of NE on educational outcomes, with a focus on inclusiveness and learners’ emotional well-being. The study uncovered that, NE is not a serious health issue, it significantly affects learners emotionally, impacts their sleep quality, disrupts school attendance, affects academic performance, as well as learners’ social engagement. In summary, it is recommended that school leaders and policymakers must integrate NE initiatives into school health policies so as to create awareness through seminars and continuous profession development of teachers, provide hygienic facilities to promote privacy, and partner with health care providers and parents to enhance sensitization efforts. Ultimately, these practical actions are vital and can foster inclusion, equity, and trauma-free school environments. In conclusion, though NE is a hidden barrier to school improvement and learner inclusion, it has received insignificant focus from stakeholders over the period. As a result, this has increased its adverse impact on learner academic progress such that those who experience it suffer marginalization, leading to interference with the goals of ensuring inclusive school improvement.