The health-promoting school: what role for nursing?

To review the existing literature on health-promoting schools and put forward recommendations for continuing progress.

The World Health Organisation's Ottawa Charter for Health Promotion in 1986 sought to create a framework for health promotion action that conveyed the notion of capacity building as it related to specific settings. It provided the catalyst from which the health-promoting school movement emerged, against the backdrop of health professionals adapting to the changing needs and demands of clients and the evolving social context of the communities in which they live. Since then, the international health-promoting school movement has been one of the most successful of the settings-based projects and has expanded considerably over recent years.

An extensive review of available health-promoting school-related literature provides the basis for critical discussion and recommendations.

Traditionally, the school nursing movement has provided the backbone of nursing-related health promotion activity in the school setting. The literature, however, is generally critical of its contribution over the years - especially as its role is mainly confined to a 'conventional' health education function and has little to do with health-promoting school projects. There are more and more calls now for the school nursing service to either re-evaluate its function and processes or be devolved back into a broader primary health care practitioner role.

Nurses should view the health-promoting school movement as another opportunity to embrace evolving broad-based health promotion concepts truly, as a means to forge and own their own health agenda and also as a means to move beyond a traditional reliance on a limited health education role. Schools also need to adapt and expand their efforts to focus on health promotion activities, in collaboration with the ever-widening community networks of health and social agencies. This requires the commitment of all healthcare professional groups. Nurses who practice in all settings, and not just school nurses, should be aiming to initiate and promote radical health promotion reform as set out in the health-promoting school movement.

If health professionals wish to be at the forefront of current health-promoting school strategies they must embrace the radical health promotion reforms that are emerging from the current literature and put forward in this article. Building such group capacity, through developing social interaction, cohesion, participation and political action can only benefit the community at large and further emphasize the health promotion role of nursing. The health-promoting school movement is truly an international concept and, as such, deserves a concerted nursing representation and resourcing well beyond its current commitment.