School communities’ expectations of a school-based health promotion intervention in South Africa

Background: School-based health promotion interventions in resource-constrained settings must align with curriculum requirements and the local context to be sustainable and effective. In South Africa, there is a need to integrate support for nutrition, psychosocial well-being, and environmental sustainability within everyday teaching and learning. Aim: This study explored the expectations of school communities regarding Wellness in Lifestyle, Intake, Fitness, and Environment (Win-LIFE), a school-based health promotion intervention designed for use in resource-constrained South African contexts. Methods: A qualitative, multiple-case design was employed using Participatory Reflection and Action (PRA) methodology to co-develop and adapt the intervention with teachers, parents, learners, and institutional stakeholders. Data were generated through document reviews, semi-structured interviews, focus groups, workshops, and observations conducted in three primary schools. Reflexive thematic analysis was used to identify patterns in stakeholder expectations. Results: Five key expectations were evident across stakeholders: namely, that the intervention should be educational and practical; that it should be aligned with the South African Curriculum and Assessment Policy Statement for Grades 4–6; that it should be grounded in cooperative learning; that it should be engaging and enjoyable for learners; and that it should be inclusive of parental involvement. Conclusion: The findings from this study highlight the importance of contextual alignment, meaningful stakeholder participation, and curriculum integration in the design of sustainable school-based health promotion interventions. The study demonstrates how schools can function as inclusive hubs for promoting health and well-being in marginalised communities.