This chapter outlines the development of two health promoting schools (HPS) programs in resource-limited settings in South Africa, informed by work from two PhD tracks and a round table discussion on core health promotion competencies. The chapter focuses on the development, implementation, and evaluation of a training program for HPS among high school educators in the Limpopo Province guided by an assessment of priority needs; and factors influencing HPS implementation in three secondary schools in Cape Town. The first case study focuses on training program objectives, learning outcomes, and critical cross-field outcomes related to introducing the concept of HPS, empowerment of educators to initiate and evaluate HPS program design, and implementation. The second case study focuses on the role of external actors and stakeholders in designing and implementing HPS in resource-limited settings and the barriers and enablers related to HPS capacity building. The findings are discussed with reference to the national context and international literature and the competencies needed to guarantee successful HPS program implementation.

Global health education is expanding rapidly in terms of both demand and opportunities. While traditional models of international field work educational experiences have their merit, innovative models in both undergraduate and graduate health education are critical to meet student demands and support international partnerships. This chapter describes examples of undergraduate and graduate global health international educational program that employ bilateral approaches to facilitate increased engagement and communication between partners in the global north and the global south. The following chapter illustrates methods and models in global health education to foster dialogues and mutually beneficial partnerships. Due to the fast pace of globalization and development, countries situated in the global south need to build their public health workforce now more than ever. Bilateral dialogue offers opportunities in ownership and education for both partners, which strengthens partnerships and ultimately builds a more robust global public health workforce.

Background: This study evaluated the effects of a school-based intervention on cognitions and self-reported behaviours related to increased HIV risk amongst South African adolescents. Methods: The (“PREPARE”) intervention was based on the Information, Motivation, Behavioural skills model and incorporated 12 key messages into pre-existing health promotion in schools. The intervention was delivered by teachers in five 3-hour units over 5 weeks. A cluster-randomised trial involving 24 schools and 2588 adolescents aged 13-14 years in Limpopo, South Africa was employed to evaluate the intervention. Targeted beliefs, attitudes, norms, culture-specific beliefs and self-reported behaviours (e.g. condom use) were assessed via researcher-administered questionnaires at baseline and two months follow up. Findings: A series of targeted cognitions (e.g. condom use attitudes and self-efficacy) and self-reported condom use showed significant differences (p<.05) in favour of intervention participants. However, effect sizes were generally small (Cohen’s ds<.25). Discussion: A theory- and evidence- based intervention improved HIV-preventive education among South African adolescents.

Non-communicable diseases (NCDs) are increasingly prevalent in sub-Saharan Africa and require cost-effective and evidence-based measures to reduce the projected burden of disease. Health promotion as a key strategy may meaningfully be implemented in health care settings such as hospitals. In this study, a comprehensive needs assessment was conducted related to health education and promotion needs and behaviours among hospital staff, patients and their relatives. Results indicate a need for health education related to healthy lifestyles, in particular healthy diets, and preferred methods of communication were identified. Based on these results a number of recommendations were formulated and translated in health promoting activities.

This project aimed at transforming a rural District Hospital in the Limpopo Province of South Africa into a Health Promoting Hospital according to standards developed by WHO-Europe. The intervention used a diagnostic approach and baseline needs assessment of hospital staff, patients, and their relatives to identify health education and promotion needs. Activities included empowerment training and skills development, implementation of health education and promotion activities, and the integration of health-promoting standards and values in the hospital structure and culture. The project indicated applicability of the model in a resource-limited setting, based on staff empowerment, local leadership, and stakeholder engagement.

A district hospital in a rural area of the Limpopo Province in South Africa has recently been launched as a ‘Health Promoting Hospital’, based on the principles of the Ottawa Charter and according to standards developed by WHO-Europe. The initiative was conceived as a project in partnership with stakeholders from the local community and is considered a pilot by Provincial health authorities, representing an advance in health promotion practice in the region. The project was designed as a research intervention, guided by the principles of critical action research integrated with the Precede-Proceed model for the systematic evaluation of health promotion and education. This commentary reports on the process undertaken in successfully transforming this community-based hospital into a Health Promoting Hospital by integrating the concept, values and standards of health promotion into its structure and culture, thereby creating a healthy setting and promoting the health and wellbeing of the hospital’s staff, its patients, and their relatives