Advances in health promotion in Africa: promoting health through hospitals.

A district hospital in a rural area of the Limpopo Province in South Africa has recently been launched as a 'Health Promoting Hospital', based on the principles of the Ottawa Charter and according to standards developed by WHO-Europe. The initiative was conceived as a project in partnership with stakeholders from the local community and is considered a pilot by Provincial health authorities, representing an advance in health promotion practice in the region. The project was designed as a research intervention, guided by the principles of critical action research integrated with the Precede-Proceed model for the systematic evaluation of health promotion and education. This commentary reports on the process undertaken in successfully transforming this community-based hospital into a Health Promoting Hospital by integrating the concept, values and standards of health promotion into its structure and culture, thereby creating a healthy setting and promoting the health and wellbeing of the hospital's staff, its patients, and their relatives.