Healthy Settings

Types of Healthy Settings

Health Promoting Schools

Children at school
The World Bank/John Isaac

The Health Promoting Schools programme may well be the second most widespread settings-based approach. The tenets of the programme are to generate awareness of the linkages between health and the environment, to improve upon the school environment given these concepts, and to facilitate the inclusion of best practices the wider community.

Health Promoting School programmes states that schools have various roles and responsibilities in communities which go beyond simply imparting knowledge. Thus, capitalizing on these roles to ensure the creation of a sustainable social health model provides a benefit to the entire community. To meet Health Promoting School criteria, the community must be committed to working for a healthy living, learning, and working environment.

Similar to other Healthy Settings approaches, the Health Promoting Schools movement relies heavily upon committed community members to maintain momentum and accomplish lasting change. Health Promoting School programmes are flexible to allow individual schools to address their most pressing needs. Trends have been identified along the socio-economic platforms of communities, however, which enable the WHO and associated regional networks to publish strategies for implementation and specific interventions.

Examples of implementation

With roots in a 1980 seminar, the European Network of Health Promoting Schools began in 1992. Subsequently, the Global School Health Initiative began in 1995, followed in 1996 by the Mega Country Health Promotion Network. The Mega Network encompasses the 11 most populous countries in the work, and encourages adoption of true Health Promoting School principles by facilitating communication and dispersing consolidated research throughout the countries.

Programmes have been established in all six regions; however networks and resources are limited aside from in the WHO European Region.

Today, Health Promoting Schools exist in 40 WHO European Region Member States, the 11 member countries of the Mega Country Network (Bangladesh, Brazil, China, India, Indonesia, Japan, Mexico, Nigeria, Pakistan, Russian Federation, and the USA), at least 32 countries in Africa, and several other countries throughout the world, particularly in the WHO Western Pacific Region and the WHO Region of the Americas.


Programmes have been established in all six regions; however networks and resources are limited aside from in the WHO European Region.

Evaluations of the Health Promoting Schools initiatives point out several strengths and weaknesses of the programmes. Overall, the most successful and sustainable programmes include:

  • Total school support;
  • Outside support, like that from local officials, NGOs, and community members, and multisectoral partnerships;
  • Long term planning.

Some of the biggest challenges facing Health Promoting School programmes revolve around unreliable funding and resources, the long duration needed to create lasting change, and the relevance of the approach, as each school needs to address specific issues to make the programme "fit".

Selected publications
  • Deschenes et al. (2003) Comprehensive approaches to school health promotion: how to achieve broader implementation. Health Promotion International. 18(4): 387-396.
  • Rowling, L. (1996) The adaptability of the health promoting schools concept: A case study from Australia. Health Education Research. 11(4): 519-526.