Intersectoral Collaboration for the Development of a National Framework for Health Promoting Schools in Australia

Article excerpt

The National Health Promoting School Initiative (NHPSI) was a policy development process that aimed to enhance and further expand health promoting schools in Australia. A grant of $247,000 (U.S.) was provided by the Commonwealth Department of Health and Family Services. The NHPSI was conducted by the Australian Health Promoting Schools Association (AHPSA)[1] over seven months in 1997. This article describes the rationale and process of the NHPSI. Subsequent articles summarize the commissioned research conducted to inform the development of a National Framework for health promoting schools in Australia[1] and describe the recent outcomes of the project. A final article applies the health promoting school framework to HIV/AIDS.

Founded as a British colony in 1788, Australia became a Federation in 1900. Australia includes six states and two territories, with education largely a state responsibility. Each state includes three school systems: public, catholic (religious), and independent schools (many with a religious affiliation). Each system shares a common state curriculum.

Health education/promotion in various forms has been an ad hoc feature of Australian schools for 90 years. "Health and Physical Education" is one of eight national key learning areas. While health often has a low priority compared to other learning areas, policies on a variety of health issues exist at the state education level. At a national level, the first health promoting schools network began in 1991.[2] Subsequent joint projects between state health and education departments and other organizations resulted in publication of state-based guidelines for health promoting schools in New South Wales, South Australia, and Western Australia. Although "vocal" advocates for health promoting schools exist in the education sector, the health sector largely has been the driving force. If the education sector can be conceptualized as the "car," both "car" and "driver" are needed to arrive at the common destination.

A health promoting school has been defined as "a school which has an organized set of policies, procedures, activities, and structures, designed to protect and promote the health and well-being of students, staff, and the wider school community members."[3] The concept of the health promoting school can provide an organizational context within which policy and program initiatives can be coordinated to enable the maximum impact of health education/promotion to occur. It is more than health promotion programs in schools.[4]

Before the NHPSI began, several parallel activities existed. First, there were local health sector funded activities. Second, formal agreements existed between health and education ministries in a number of states. Third, the major health research and advisory body (comparable to the US National Institute of Medicine), the National Health and Medical Research Council (NHMRC), endorsed a national policy document outlining evidence for developing schools as health promoting settings and recommended areas of action to strengthen activity.[4] Within this national policy document, health promoting schools are conceived as drawing together major aspects of school operations: the school health curriculum, and the nature of the teaching and learning processes occurring in classrooms; the climate, organization, and environment of the school, including its social and physical environments and its policy framework; and the links and interactions between the school and its families and community, including partnerships with health services and agencies.

The NHPSI described here sought to implement recommendations from the NHMRC report. The project aimed to model good health promotion practice in the development of the National Framework and so adopted a set of guiding principles based on strategies from the Ottawa Charter for Health Promotion:[5] enabling, mediating, and advocating. These principles establish health promoting schools as a social movement concerned with equity, consultation, collaboration, and the school as a social institution (Figure 1). …