Excerpt from Health-promoting schools: a resource for developing indicators, (2006) Schools for Health Europe, Amsterdam
Kadi Lepp, Anita Villerusa & Aldona Jociute Self-assessment tool for dissemination of health-promoting schools on the school level: collaboration between Estonia, Latvia and Lithuania pp 94-101
In March 1993, with ten schools in each of its networks, Estonia, Latvia and Lithuania joined the ENHPS. Since 1997, the health-promoting schools concept has been disseminated in all three Baltic countries. Currently, 85 schools and 73 preschools are involved in the Estonian Network of Health Promoting Schools. The Latvian Network of Health Promoting Schools has 120 schools, and the Lithuanian Network of Health Promoting Schools has 159 schools of general
education and 195 preschools. Indicators are currently used in all three countries with respect to the dissemination of the concept of health-promoting schools, which refer to activities aiming to disseminate the health-promoting schools concept among members of schools and the community outside of school, as the development of the health-promoting schools has moved from an initial pilot stage into a stage of wider implementation in all three countries. Indicators are assigned to schools to help them to do selfevaluation. It was considered valuable to work collaboratively across the three Baltic countries on the elaboration of indicators in the area of dissemination of the concept of the health-promoting schools for the school self-evaluation that could be used in common by these schools.
National frameworks of indicators and evaluation. Estonia has two different tools for school self-evaluation. One will become compulsory for all educational institutions in 2007 and the second (determination of the capacity of school health teams – capacity index) is recommended for use in all health-promoting schools. Estonia revised its indicators on 20–21 March 2006
when regional coordinators of health-promoting schools and representatives from the educational sector discussed indicators during a meeting. The meeting decided to propose some indicators of capacity index for common evaluation in all three countries. Latvia has a framework of indicators, which are used early in evaluating the pilot health-promoting schools.
In Lithuania a pilot study of an internal audit method was started towards the end of 2004 in close collaboration with Moletai Educational Centre and schools of general education in the Municipality of Moletai. This Municipality has led the
process of developing the method for internal auditing of educational institutions. At the end of December 2005, the first draft of the internal audit method was produced, covering six areas related to health-promoting schools. One of the six
areas relates to the dissemination of the concept of the health-promoting schools. The structure of the health-promoting schools indicators has been developed to be consistent with the method for internal auditing in educational institutions so
that both could be undertaken together. The outcome of this collaborative project was the development of an instrument
for the school self-evaluation using indicators for the dissemination of the health-promoting schools concept at the school level.

Excerpt of a Case Study from Better schools through health: learning from practice Third European Conference on Health Promoting Schools, held in Vilnius, Lithuania, 15–17 June 2009
Siivi Hansen, Liana Varava, Karin Streimann THE NETWORK OF HEALTH PROMOTING KINDERGARTENS
AND SCHOOLS IN ESTONIA pp 25-27
Ten Estonian schools joined the European Network of Health Promoting Schools in 1993. The first kindergartens joined the network in 2001. By the beginning of 2009, 262 kindergartens and schools from all counties joined the network, which is 23% of the 1126 educational institutions. In 2005, a network of coordinators was established from all counties (15) and bigger cities (3) in Estonia to assist kindergartens and schools in linking health promotion activities with everyday school work. This has been financed by the Estonian Health Insurance Fund project “Development of School Health Board Activities” and the Strategy to Guarantee the Rights of the Child. In 2008, school coordinators conducted an assessment of school health board activities in health promoting schools, which is being used as a basis on which to plan future counselling and training.
The key findings of the assessment include:

• the local networks show different levels of activity in different areas
• both health promoters as well as coordinators are needed in order for a network to function well
• the personality of the coordinator has an important role in empowering the network. It is very difficult to keep the network working if the key person changes
• as networks operate differently, it is necessary to provide individual advice and supervision to coordinators as well as representatives of local networks by NIHD
• project based financing of the work of coordinators is not sustainable
• cooperation with the Ministry of Education and Research has been weak.