Since the publication of the Ottawa Charter (WHO, 1986) schools have been regarded as a central location for health promotion. In particular, a holistic approach involving all members of a school and the school community is considered desirable (WHO Expert Committee, 1997). School leaders are seen as key players in the implementation of health promotion measures (Dadaczynski et al., 2021; Gieske & Harazd, 2009; Zumbrunn et al., 2016), although little is known about how exactly they manage health promotion and what characteristics are important for their related leadership practices (Dadaczynski et al., 2022). At the school leadership level, various contextual and personnel factors, such as gender, attitudes toward health promotion, or health literacy of school leaders may be relevant to the implementation of health promotion (Clarke et al., 2015; Dadaczynski et al., 2020; Dadaczynski & Paulus, 2015).

This comparative project focuses on the extent to which school leaders from Malaysia and Switzerland were able to implement school health promotion during the Covid 19 pandemic. The comparison between Switzerland and Malaysia is of interest because the two countries differ in terms of educational governance. In Switzerland, school principals can set local priorities, but at the same time must adhere to governmental guidelines. In contrast, Malaysia has a much more centralized system: in education, formal goals are clearly set for schools. Notwithstanding these differences, both countries faced similar challenges in the context of the Covid 19 pandemic. Nevertheless, the national and local context influences the extent to which school leaders are empowered and enabled (see Sears & Marshall, 1990) to respond to challenges such as the Covid 19 crisis and are able to make adjustments according to the local context.

The following research questions were of interest:

What is the level of implementation of emotional and social health promotion in Swiss and Malaysian Schools?

What are the relationships between health promotion implementation and contextual factors and School leader’s attitudes and wellbeing in Switzerland and Malaysia?

Can we explain the different levels of implementation with regulations and educational policy in the two countries?

To answer the research questions an online survey was conducted in June 2021, with N = 1058 school leaders from both countries participating. Implementation of health promotion is measured using the Survey of School Promotion of Emotional and Social Health (SSPESH) scale (Dix et al., 2019), which is based on the World Health Organization (WHO) Health Promoting Schools (HPS) framework (Langford et al., 2015) and measures the extent to which a school has implemented measures and practices to promote students' emotional and social health. We conducted regression analyses and simple slope analyses using SPSS 28 and PROCESS for SPSS. Following the quantitative survey, a qualitative follow-up study was conducted in May 2022, including interviews with school principals in Switzerland and Malaysia. Eight Interviews were conducted in Malaysia and ten interviews in Switzerland. The interviews were transcribed and analyzed based on a deductively developed coding system. The coding systems was developed using the WHO global standards and indicators for Health Promoting Schools (World Health Organization & UNESCO, 2021) as a guidance, ensuring comparability between the two countries.

Results indicate that Malaysia has higher levels in the implementation of a positive school climate, student social and emotional learning and engaging families (primary prevention) whereas Switzerland has a higher implementation level on supporting students facing difficulties (secondary and tertiary prevention). Preliminary results from regression analyses and simple slope analyses indicate that attitudes toward health promotion, student body composition, and school level are relevant factors for health promotion implementation in both countries. Attitudes toward health promotion also show a different effect in the two countries. It In Switzerland the level of health promotion depends highly on the attitude of the school leader. In Malaysia the wellbeing of the school leader has a small effect on the level of health promotion. Initial findings from the Interviews provide further evidence on potential factors at the national and local levels that influence health promotion practices (e.g., scope of action of school principals, guidelines and requirements of the government, etc.). In addition, relevant actors and processes could be identified. For example, in Malaysia, each school has special school leaders who are responsible for health promotion and counselors for students are also permanently installed In Switzerland, such strongly institutionalized structures do not exist. Health promotion is therefore highly dependent on individuals and there is an enormous variety of health-promoting activities.

Clarke, J. L., Pallan, M. J., Lancashire, E. R., & Adab, P. (2015). Obesity prevention in English primary schools: Headteacher perspectives. Health Promotion International, 32(3), 490–499. https://doi.org/10.1093/heapro/dav113 Dadaczynski, K., Carlsson, M., & Gu, Q. (2022). Guest editorial: Leadership in school health promotion. The multiple perspectives of a neglected research area. Health Education, 122(3), 261–266. https://doi.org/10.1108/HE-04-2022-138 Dadaczynski, K., & Hering, T. (2021). Health Promoting Schools in Germany. Mapping the Implementation of Holistic Strategies to Tackle NCDs and Promote Health. International Journal of Environmental Research and Public Health, 18(5), 2623. https://doi.org/10.3390/ijerph18052623 Dadaczynski, K., & Paulus, P. (2015). Healthy Principals – Healthy Schools? A Neglected Perspective to School Health Promotion. In V. Simovska & P. Mannix- McNamara (Hrsg.), Schools for Health and Sustainabilty (S. 253–273). Springer. 10.1007/978-94-017-9171-7 Dadaczynski, K., Rathmann, K., Hering, T., & Okan, O. (2020). The Role of School Leaders’ Health Literacy for the Implementation of Health Promoting Schools. International Journal of Environmental Research and Public Health, 17(6), 1855. https://doi.org/10.3390/ijerph17061855 Dix, K. L., Green, M. J., Tzoumakis, S., Dean, K., Harris, F., Carr, V. J., & Laurens, K. R. (2019). The Survey of School Promotion of Emotional and Social Health (SSPESH): A Brief Measure of the Implementation of Whole-School Mental Health Promotion. School Mental Health, 11(2), 294–308. https://doi.org/10.1007/s12310-018-9280-5 Gieske, M., & Harazd, B. (2009). Schulisches Gesundheitsmanagement an Grundschulen. In C. Röhner, C. Henrichwark, & M. Hopf (Hrsg.), Europäisierung der Bildung (S. 246–252). Verlag für Sozialwissenschaften. Langford, R., Bonell, C., Jones, H., Pouliou, T., Murphy, S., Waters, E., Komro, K., Gibbs, L., Magnus, D., & Campbell, R. (2015). The World Health Organization’s Health Promoting Schools framework: A Cochrane systematic review and meta-analysis. BMC Public Health, 15(1), 1–15. https://doi.org/10.1186/s12889-015-1360-y Marshall, J. D., Otis‐Wilborn, A., & Sears, J. T. (1989). Leadership and pedagogy: Rethinking leadership in professional schools of education. Peabody Journal of Education, 66(3), 78–103. https://doi.org/10.1080/01619568909538650 WHO. (1986). Ottawa-Charta zur Gesundheitsförderung, 1986. WHO Expert Committee. (1997). Promoting Health Through Schools Rport of a WHO Expert Committee on Comprehensive School Health Education and Promotion. World Health Organization & UNESCO. (2021). Making every school a health-promoting school: Global standards and indicators. World Health Organization. https://apps.who.int/iris/handle/10665/341907 Zumbrunn, A., Solèr, M., & Kunz, D. (2016). Umsetzung Gesundheitsförderung und Prävention in Schulen. Fachhochschule Nordwestschweiz.