In 2015-2016, a renewed educational innovation programme based on healthy lifestyle and Health Promoting School values was established in the Andalusian region in Spain. It resulted from the collaboration of various regional ministries in Andalusia, who recommend that schools implement the policy. There was widespread awareness among the Schools4Health survey and roundtable participants that the government was promoting this policy; almost 75% of those who responded to the survey in Andalusia believed that national/regional policies recommend that the pillars and values of a Health Promoting School should be part of the school’s approach (with 16.2% thinking this was required). 

59.5% said they believed national/regional policies and programmes suggested that schools have a defined action plan, with 24.5% believing this was required. 59.5% believed national and regional policies recommended that health education be part of the curriculum (24.3% believing this should be necessary). Currently 2,351 primary schools and 919 secondary schools implement the programme. This constitutes 93% of primary and secondary schools in the region supported by public funds. 

Even though the Regional Ministries of Education and Health support and recommend implementing the renewed educational innovation programme, and respondents and round table participants in Spain expressed that health promotion is increasingly being addressed in schools, there is still room for improvement. This is because the activities are not being implemented comprehensively, and the work done is often fragmented, and not systematised. 

The Spanish survey broke down the question of whether health promotion was adequately addressed in schools and asked about the adequacy of attention for specific topics. While a slight majority of the respondents felt that there was sufficient attention for health promotion overall, many stakeholders felt that specific topics within health promotion did not get enough attention. Just over half agreed there was adequate attention in schools for good eating habits and physical activity, but over half disagreed that there was sufficient attention in the field of mental health and over a third both agreed/disagreed there was adequate attention to health education and health literacy. 

The Spanish report speculates that the different profiles of the professionals may have led to these differences in responses. Despite the feeling that there was still a lack of attention to topics like mental health and emotional wellbeing, with most activities being carried out in primary schools and virtually disappearing in secondary schools, it was noted that the Andalusian Healthy Schools Programme has improved awareness of these topics, and ‘has opened the eyes of many professionals to actions beyond physical health’. 

The report conveyed the added value of the education model put forward in the Andalusian programme, noting that while it is not widespread, it ‘opens the doors of schools to the community allowing public spaces to be democratised and creating synergies to work on a broader concept of comprehensive health for both the person and the community.’ Notwithstanding this, some uncertainty was reported among health and education professionals around the organisation of educational programs in Andalusia, which has been modified this school year, impacting, among others the Andalusian Health Promoting School programme. It was also noted that health professionals often lack training in this approach and are therefore unable to promote it adequately. 

About the Schools4Health mapping of health promoting school policies in the EU
This article is an extract of the Schools4Health ‘Report on policy and practice to strengthen the Health Promoting School approach across the EU’. A key objective of the Schools4Health project is to encourage and enable public authorities and other relevant actors to move from health promotion in schools, towards applying more holistic Health Promoting School approaches. This is supported through the initiative’s policy component, which seeks to raise awareness, mainstream and scale up Health Promoting School approaches among policymakers and practitioners, and to engage them in efforts to integrate this approach in their national/sub-national contexts. It means bringing together different stakeholders in policy and practice, across levels of governance and sectors, to optimise the contribution that schools can make to the health and wellbeing of students, staff, and the wider communities.

As a first step, the Schools4Health consortium focused on scoping the current policy landscape across different participating municipalities, regions and countries influencing or impacting school wellbeing. This was done by identifying and bringing together key actors in the respective partner countries to discuss the broader policy context around health promotion in schools, and identify what is required, from a policy perspective, to introduce or strengthen the implementation of the Health Promoting School model in school settings.

Visit the Schools4Health website to access all resources from the project https://schools4health.eu/