Mbatha, NothandoMcCrindle, CherylShirinde, Joyce2025-06-252025-06-252024-06Mbatha, N., McCrindle, C. & Shirinde, J. 2024, 'Perceptions and views of key implementers on the implementation of the health-promoting school programme in the City of Tshwane, South Africa', South African Medical Journal, vol. 114, no. 6b, pp. 30-36. https://doi.org/10.7196/SAMJ.2024.v114i6b.1363.0256-9574 (print)2078-5135 (online)10.7196/SAMJ.2024.v114i6b.1363http://hdl.handle.net/2263/102982BACKGROUND : The 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. OBJECTIVE : A qualitative research approach based on grounded theory was used to investigate the experiences of 27 health-promoting school programme implementers across Tshwane. METHODS : Data 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. RESULTS : Implementation 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. CONCLUSION : Implementers 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.en© 2024 N Mbatha, J Shirinde, C McCrindle. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.Health promoting schoolsImplementationEvaluationHealth promotionGrounded theorySouth Africa (SA)Article