• N Mbatha, J Shirinde, and C McCrindle.
• Department of Health Promotion, School of Health Sciences and Public Health, University of Pretoria, South Africa. mbathanothando@yahoo.com.
• S. Afr. Med. J. 2024 Jun 24; 114 (6b): e1363e1363.

BackgroundThe health-promoting school programme has been associated with numerous benefits for school communities where it is well implemented. In Tshwane, the implementation processes have not been evaluated.ObjectiveA qualitative research approach based on grounded theory was used to investigate the experiences of 27 health-promoting school programme implementers across Tshwane.MethodsData were collected through a combination of methods, including semi-structured interviews with principals (n=6), educators (n=10) and school governing body members (n=4), one focus group discussion with health promoters (n=7), field notes from school observations and memos.ResultsImplementation fidelity was weak in the City of Tshwane, as a result of poor training of implementers, poor leadership and collaboration, weak accountability structures, and lack of resources and communication. A grounded theory was developed which showed that schools needed guidance and accountability to properly implement the programme. The theory offers a framework that could be used to improve implementation and evaluation outcomes.ConclusionImplementers were keen on improving the lives of learners - health-wise and academically. With proper guidance, support and accountability measures by government at district and provincial level, implementation of the programme is feasible in the City of Tshwane.

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