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Regional Strategies for the Development of Health-Promoting Schools

Dr Rosmarie Erben
International Union for Health Promotion and Education
Director, Regional Office for the South West Pacific

Ladies and gentlemen, dear colleagues and friends,

it is a pleasure for me to be with you today, and to share with you strategies for the development of health-promoting schools as they have developed in the different Regions of WHO.

I wish to thank the organizers for inviting me to this conference. And I also wish to thank the traditional owners of this land for allowing us to share our experiences and ideas on their land.

This morning Jack Jones introduced to you the Global School Health Initiative of WHO.

My contribution is complementary to the global perspectives he outlined this morning. It is based on contributions to three fora he organized on:

Strengthening Strategic Approaches for Improving Health through Schools:

  • Global,
  • Regional, and
  • National Considerations

during the XVI World Conference of the International Union for Health Promotion and Education (IUHPE) in June of this year in Puerto Rico.

I shared the Forum on Regional Considerations and I have to thank Jack Jones' colleague, Isolde Birdthistle, who acted as rapporteur to the three fora and prepared a report, which will soon be published in the IUHPE Journal. She provided me with the manuscript.

In Puerto Rico, I was appointed Regional Director for the IUHPE South West Pacific Region, and it is in this role that I would like to contribute to the further development of health-promoting schools in the Region.

You will notice when I describe the strategies in the Western Pacific Region of WHO that I will be more detailed and perhaps more emotional than when talking about other Regions. I hope you will forgive me this bias.

But the development of health-promoting schools in the Western Pacific Region, which includes Australia, China, New Zealand and Papua New Guinea, was at the heart of my seven years of work as Regional Adviser in Health Promotion and Mental Health in the Western Pacific Region.

Many colleagues here in Australia have been supportive of this regional development and are still involved in it, and I would like to thank especially Louise Rowling, Lawry St Leger and Don Stewart for their important contributions. I hope they will complement my presentation with their specific views and experiences.

It would also be great if the participants from China, Papua New Guinea and New Zealand at this Conference would be willing to share with us if and how the regional strategies supported their work in developing health-promoting schools.

The development of health-promoting schools has its roots in the WHO Regions. It was initiated in Europe, then the Western Pacific Region followed and currently it gains momentum in the Americas.

In the other WHO Regions, there has been for many years a focus on comprehensive school health education and health promotion, which has provided a foundation for schools realizing their potential as a healthy setting for living, learning and working.

Today, there are efforts in all WHO Regions to help schools become health-promoting schools. They are supported by WHO's Global School Health Initiative (GSHI), which was launched in 1994.

The following provides the text of the transparancies used during my keynote address to the National Conference on Health-Promoting Schools in Brisbane (Australia) from 15-17 November 1998.

WHO Regional Office for the Americas (AMRO)

Some facts

110 million school-aged children, 90% at school at age 10

1993 - Proposal by 14 countries participating in a Consultation on Health Education and Promotion in the School Setting, Costa Rica, for a health-promoting schools initiative

1994 - Conceptual Framework Guide for the health-promoting schools initiative

1996 - Launch of Latin-American Network of Health-Promoting Schools with 12 countries

1998 - HPS Network Conference in Mexico City with additional 7 countries All 19 participating countries have initiated national networks for the development of HPS

WHO Regional Office for the Americas (AMRO)


  • Creating political will: 1997 Summit of First Ladies used to advocate for comprehensive school health promotion

  • Building partnerships:

    • Strategic partnership between AMRO and World Bank in regional study on school health

    • Working with 2 WHO Collaborating Centres for School Health

  • Disseminating conceptual framework and action guidelines

  • Enabling education and health sectors to formulate and put into practice joint policies

  • Support to countries for the development of health-promoting schools

  • Strengthening the Latin-American Network of Health-Promoting Schools

WHO Regional Office for Europe (EURO)

Some facts

1990 - Recommendation of WHO/EURO, the Council of Europe (CE), and the Commission of European Communities (EC) to create a health-promoting schools network during Conference on Health Education, Strasbourg, France, building on 1980's pilot project "Education for Health"

1991 - Pilot health-promoting schools projects in Hungary, Czech Republic, Slovak Republic, and Poland

1992 - European Network of Health-Promoting Schools (ENHPS) established by WHO/EURO, the CE, and the EC

1992 - Formation of an International Planning Committee representing the 3 major partners, providing the financial and political base for the ENHPS

Technical Secretariat at WHO/EURO
for coordination and technical assistance for the ENHPS

1992-1998 HPS conferences, workshops, exchange visits etc.

1998 - ENHPS involves 38 countries with over 500 project schools and more than 2000 schools linked through national arrangements




  • Impact on policy
  • Network development
  • Security of funding
  • Developing new tools
  • Evaluation
  • Resource development to help identify "best practice"

Innovation and Collaboration:

  • New thinking
  • New methodologies to push old boundaries
  • Creating new partnerships
  • Introducing change
  • Action

Mobilising Resources and Expertise:

  • Utilising resources and expertise of the EC, CE, and WHO
  • Utilising expertise in the Region

WHO Regional Office for South East Asia (SEARO)

Some facts

  • 5 of SEARO's 10 countries among the world's least developed

  • 3 of the most populated countries (India, Indonesia, Bangladesh)

  • 25% of the world's school-aged population

  • 1992: Guidelines for Implementing and Strengthening Comprehensive School Health Education

  • 1993-1998: Intercountry seminars and consultations on comprehensive School Health Promotion and Health-Promoting Schools

  • 1997: Workshop on the Development of Health-Promoting Schools


Strategies (identified but not yet implemented)


  • Development of national policies in support of health-promoting schools

  • Establishment of pilot health-promoting school projects

Identifying Priority Entry Points: Malnutrition and micro-nutrient deficiency, tobacco-use prevention

Networking and Collaboration:

  • Ministries of Health and Education to act jointly

  • Involvement of non-governmental organisations

  • Partnership with families at school level

  • Linkages to Healthy Cities Movements

WHO Regional Office for the Western Pacific (WPRO)

Some facts


  • Regional Health Promotion Programme with a focus on settings, especially schools endorsed by Member States


  • Policy document New Horizons in Health with health promotion and protection as central concepts endorsed by Member States

  • Workshop on School Health Promotion in Sydney results in mandate for the development of HPS in the Southern Part of the Region


  • Workshop on School Health Promotion in Singapore results in mandate for the development of HPS in the Northern Part of the Region

  • Minister of Health of Pacific Island Countries express commitment to Healthy Islands in the Yanuca Island Declaration

  • In response to WHO Proposal for the Development of HPS and Theme 1 of New horizons in health, Preparation for Life, 27 countries express interest in collaboration

  • Pilot HPS developed in 8 countries

  • Draft Regional Guidelines for the Development of HPS reviewed in national and international meetings; Workshop for National Coordinators of Health-Promoting Schools in the Pacific, Suva, Fiji, results in establishment of the Pacific Network of Health-Promoting Schools;

  • WHO Working Group on the Development of Health-Promoting Schools, Shanghai, China, finalizes Regional Guidelines

  • AusAID-funded Healthy Island Project for 5 islands includes HPS


  • Regional Guidelines for the Development of HPS printed and distributed as No 5 in WHO Series on Health-Promoting Schools

  • Countries establish National Committees for the Development of HPS;

  • HPS projects established in 11 more countries, existing projects extended, specific health issues use as entry-points; training in HPS supported;


  • WHO Workshop on Networking among HPS, Beijing, China, confirms Singapore's role for coordinating network activities in the Northern Part of the Region;

  • Publication of a manual by the Pacific Network of HPS


  • 15 countries include funds for HPS in their 1998-2000 Programme Budget with WHO



Building Supportive Policies

Collaborating with countries

  • Building consensus on the development of HPS

  • Issuing Regional Guidelines as framework for action and support their adaptation and adoption

  • Supporting the development of pilot HPS and their extension

  • Supporting the establishment of National HPS Committees with representatives from education and health departments

  • Facilitating training

  • Using specific health issues as entry points

  • Supporting evaluation

  • Monitoring of country activities with regular feedback to influence political decisions

Networking and Partnerships

  • Supporting regional network development: Pacific Network of Health-Promoting Schools / HPS Network of Countries in the Northern Part of the Region

  • Working with: UN Organizations on regional level (UNICEF, UNESCO, UNFPA, UNEP), South Pacific Commission, NGO's such as Education International, IUHPE, Foundation of the People of the South Pacific, Red Cross

  • Working with WHO Collaborating Centres for Health Promotion and Education

Joint Regional Strategies for Improving Health Through Schools

  • Operationalise the Ottawa Charter for Health Promotion: Advocating, Enabling, Mediating

  • Give meaning to the Jakarta Declaration:

    • Promote social responsibility,
    • Increase investments for health development,
    • Consolidate and expand "Partnerships for Health",
    • Increase community capacity and empower the individual,
    • Secure infrastructure for health promotion

  • Support the development of HPS Networks as part of the Global School Health Initiative

How can regional strategies support schools to become healthy places for living, learning and working?

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