The Settings-Based Approach

The Ottawa Charter (WHO, 1986) defined health promotion (HP) as “the process of enabling people to increase control over and improve their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.”

By adopting this definition, health is seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities (WHO, 1986). Good health is perceived as a major resource for social, economic and personal development that goes beyond healthy lifestyle1s to well-being which is not solely the responsibility of the health sector.

To implement this definition, the settings-based approach has been promoted by the World Health Organization, where a settings is “a place or social context where people engage in daily activities in which environmental, organisational and personal factors interact to affect health and well-being” (Nutbeam, 1998).

The settings-based approach has been successfully implemented among schools (Lee, Tsang, Lee, & To, 2003) and cities (De Leeuw, 2009), where a health-promoting school has been described as “a school that is constantly strengthening its capacity as a healthy setting for living, learning and working”[[1]]. This definition is applied in schools by reviewing 8 standards.

Eight standards for a health-promoting school

  • The whole of government is committed to and invests in making every school a health-promoting school.
  • The school is committed to and invests in a whole-school approach to being a health-promoting school.
  • A whole-school model of school governance and leadership supports a health-promoting school.
  • The school is engaged and collaborates within the local community for health-promoting schools.
  • The school’s curriculum supports physical, social–emotional and psychological aspects of students’ health and well-being.
  • The school has a safe, supportive social–emotional environment.
  • The school has a healthy, safe, secure, inclusive physical environment.
  • All students have access to comprehensive school-based or school-linked health services that meet their physical, emotional, psychosocial and educational health-care needs.

Reference [1] Health promotion. Manila: WHO Regional Office for the Western Pacific; 2020 (