This case study describes the Health Promoting Schools (HPS) programme in South Africa post 1994 to date. The school provides a setting for across sectoral work between education, health and other sectors to prevent factors that place learners at risk, such as poverty, violence, substance abuse and HIV/AIDS. The case study is of a national level policy and programme, with further exploration of evidence from a rural primary school site in Western Cape initiated in 1996. The HPS programme was initiated in response to shared policy concerns across health and education sectors, and with support from WHO bringing options to address these concerns from international experience. The policy was developed through an alliance between government departments (particularly health and education) and between various disciplines, professionals, and sectors, based on shared goals. The case study shows the role of provincial departments, local authorities, technical support teams and community actors in taking the national concept to local level. The programme offered space for flexibility in application to facilitate local ownership and initiative, with support from provincial technical teams and management levels of schools. While there is limited evidence on evaluation of health impact, practitioners report greater cross sectoral collaboration and integration of health and achievement of process objectives. After several years there was a growing demand for processes to support institutionalization, including guidelines on roles and responsibilities, consistent training, budget support and formal tools for monitoring and evaluation. The role of parents and learners is not well reported in available documents and was noted by practitioners to need greater visibility in future work.
WHO Regional Office for Africa
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