What underpins success in a health promoting school in Northeastern Thailand? : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University
A Health Promoting School (HPS) approach is now widely accepted
internationally, with a focus on children’s health, the school curriculum, and
whole school environment. In Thailand, the health and well-being of children is a
fundamental value. HPS programmes have been implemented in schools as a
strategy to focus on young people’s health. A number of barriers to successful
HPS have been identified. While there is international evidence to show the steps
and the key factors in creating successful HPS, little is known about successful
HPS in the Thai context, in particular, in Northeastern Thailand which has been
classified the poorest region.
Ethnographic methods were used to examine what understanding of the meaning
of HPS is necessary for a successful school, and how all those involved acted
from the adoption of the HPS programmes by the local school until it achieved
HPS status. A rural school which was successful in a HPS programme was
selected, in Mahasarakham province, Northeastern Thailand. The data were
obtained through participant observation, ethnographic interviews, and
ethnographic records, and data analysis took place simultaneously with data
collection. In this study, Lofland’s strategy for the analysis of the structure of
human interaction was used. A variety of techniques for improving and
documenting the credibility of the study such as prolonged engagement, persistent
observation, and triangulation were used.
This research revealed that the informants’ views reflected diverse understandings
of the meaning of HPS. Those views were based on their experiences of HPS
which differed according to the degree of participation, different levels of
knowledge about HPS, and in the roles they played in the implementation of HPS
in the school. Thai culture and school ethos influenced the success of HPS.
Community participation was also crucial in supporting the school’s achievement.
Key factors that underpinned success are identified. Implications of the findings
for the HPS programme, health professionals, the school and community are