Youth Participatory Action Research as a Catalyst for Health Promotion in a Rural South African School

Rural schools in South Africa face many social and environmental challenges which impact negatively on learner wellbeing and performance. Given the severity and history of these problems, the situation is unlikely to change in the near future. Yet, schools are supposed to be enabling environments, providing holistic support to learners from communities plagued by severe economic, health and social challenges. A different strategy is clearly needed to promote the health and wellbeing of learners. Youth participatory action research (YPAR) appears to offer a plausible approach to kick start improved, health-promoting responses from within the school. We facilitated a YPAR process with volunteer learners from Grade10 to find out how they could begin to transform their rural school. Using arts-based methods, the learners were successful in raising awareness of the negative effects they were suffering as a result of the poor social-emotional climate in the school, the unsanitary facilities and the lack of opportunities to engage in physical exercise. The actions they took to address these issues were a catalyst for ongoing positive change in the school.  The findings add to literature about how YPAR can make schools more enabling spaces.

he study that gave rise to this article emerged from the concern of the first author, a teacher at a rural high school in Limpopo province, South Africa. Like many teachers working in under-resourced schools, she was worried that the school was not providing an environment conducive to promoting the optimal health and wellbeing of its learners. Rural schools often become sites of discrimination where learners from disadvantaged backgrounds are subjected to ridicule, insults, and harsh punishments by peers and teachers (Mphahlele, 2017;Steyn and Singh, 2018). Schools can also be dangerous places where children are subjected to abuse in the form of rape and sexual harassment by teachers (Head, 2017). In addition, many rural and township schools face a dearth of infrastructure, overcrowded classrooms, inadequate resources for teaching, learning and extra-mural activities, a lack of basic services, such as clean water and sanitation, and insufficient access to social welfare services (Du Plessis, 2014). The school then becomes a source of stress and a disabling environment wherein learners who need additional psychosocial support become disillusioned and feel disconnected from the school (Acosta- Gómez et al., 2018;Khuzwayo et al., 2016). These factors render it almost impossible to create an environment that promotes the holistic well-being of learners.
For vulnerable children in particular, teachers may represent the only stable adult contact they have (Chitiyo et al., 2010), thus the onus is on the school to create an enabling environment that provides care and support for learners (Mampane & Bouwer, 2011). Some rural schools can do this by strengthening their capacity for internal support (Ebersöhn & Ferreira, 2011). Similarly, Themane and Thobejane (2019) found that teachers in rural schools were able to discover creative ways to overcome barriers to learning when they collaborated with colleagues. Such teachers are to be commended for their resilience, but unfortunately not all teachers are sensitive to the needs and feelings of learners (Motsa & Morojele, 2016;Shann et al., 2013). The professional relationship between teachers also suffers in resourcescarce environments, making collaborative action for learner support difficult and unlikely (Mathikithela, & Wood, 2019).
In the absence of positive intervention by school management and other adults in the social ecologies of the learners, we investigated how vulnerable youth in a specific rural school could take action to create a health promoting and enabling environment. We did this through engaging learners in youth T participatory action research (YPAR). Being involved in such a process raises children's awareness that they have the potential to make life better for themselves (Kohfeldt & Langhout, 2011). This approach foregrounds the voices and agency of the learners (Kohfeldt et al., 2012), since they themselves are best placed to sensitize people to their needs and wants (Torres-Harding, 2018).
An earlier publication (Mathikithela, & Wood, 2019) reported on the first cycle of this study where participating learners generated data to explain how the poor social, physical and emotional environment was impacting on their learning and development. In this article we report on the process going forward and the actions learners initiated to create a more enabling and healthy school experience for themselves and their peers. We also evaluate the influence their actions had on the teachers and school in general. Finally, we discuss the complexities of using YPAR to bring about change in a school context. The findings inform both policy and practice in rural schools by providing guidelines for enabling the voices of learners to be a catalyst for (re)constituting schools as health-promoting spaces.

Health Promotion in South African Schools
Globally, the concept of health-promoting schools has been gaining traction since the World Health Organization (WHO) produced the Ottawa Charter for Health Promotion in 1986. Health promotion has been recognized as an effective way of developing the health and wellness in schools through providing a healthy setting for living, learning and working (WHO, 2020), while accommodating for the many socio-systemic factors in communities that impact negatively on teaching and learning (Langford et al., 2014). Health promotion strives towards optimal physical, mental and social wellbeing through the development of personal and professional skills of role players in the school; the implementation of policies to protect and promote the various components of health; the improvement of the physical and social environment; the strengthening of external support in the surrounding community; and improving access to and use of social services (Evans et al., 2013).
Currently, a plethora of policies exist in South African education legislation to promote "the optimal health and development of school-going children and the communities in which they live and learn" (DOH/DBE, 2012, p. 5), in the form of the Integrated School Health Policy (ISHP). This is a systemic approach comprising a comprehensive package of policies, based on the following premises (Langford et al., 2014): • Provision of school policies to prevent and support learners affected by HIV/AIDS, pregnancy, lack of nutrition, violence and abuse (e.g. White • Creation of a supportive environment for the health and well-being of children through the work of school-based support teams (SBST) composed of teachers and other stakeholders whose main function is to identify and address barriers to learning (DBE, 2001). • School based health and nutrition services, such as feeding schemes and learner assessment and screening for various health issues. • Community participation to support the school in promoting the health of learners. The aim is to improve school access, retention and achievement. The ISHP, as part of the Care and Support for Teaching and Learning framework (DBE/MIET,2010) in schools has been hampered by a lack of collaboration between the government departments tasked with ensuring its implementation (Rasesemola et al., 2019). Many rural schools in South Africa still lack basic human and material resources to enact policies at school level (Lenkokile et al., 2019). The competence and attitude of school management usually determines the extent to which resources are deployed and sustained (Usman, 2016), and while some rural schools do have a supportive school environment (Hallal et al., 2012), in others, buildings and sanitation facilities have deteriorated, and vandalism and neglect have given rise to unwelcoming school environments. The physical environment in turn negatively influences the attitudes and behavior of both learners and teachers (Oyenuga & Lopez, 2012), and the emotional and relational wellness within the school suffers (Roffey, 2012).
Emotional and relational wellness foster the ability to recover from stress, trauma and adversity (Durlak et al., 2011) and enable individuals to set priorities, build relationship with others and have a positive view of life despite their daily challenges (Peterson, 2016). Such safe environments foster learners' sense of self-worth (Campbell et al., 2016), which in turn supports positive academic and behavioural outcomes (Kutsyuruba et al., 2015). A lack of emotional and relational wellness affects teachers, parents, and school management as much as it does learners, leaving all feeling disempowered, hopeless and unable to take action (Mudzielwana et al., 2017). It is evident that low levels of physical, emotional and relational wellness in many rural schools is a systemic issue that needs to be addressed by various sectors. However, since it is unlikely that the education system as a whole will improve in the near future, what can schools do in the meantime? A YPAR process has proven to be a useful way for youth to disrupt dysfunctional systems to bring about change.

YPAR as a Paradigm for Social Change
YPAR is grounded in an emancipatory paradigm, enabling youth to effect social change in matters that affect their lives (Marcus & Cunningham, 2016). As Fine (2008, p. 215) argues, "PAR is not a method"-it is a "radical epistemological challenge to the traditions of social science, most critically on the topic of where knowledge resides". This paradigm recognizes the value and validity of knowledge generated by the youth, and their right to mobilize such knowledge to inform policy and practice. Caraballo et al. (2017) explain its importance in transforming educational institutions by drawing on "epistemologies of resistance" to enable youth living in inequitable conditions "to critique, redefine, and overcome the very asymmetries they face in their schools and communities" (p.313).
Adult facilitators work with youth through cycles of action and reflection to identify issues, generate and analyse data, and disseminate findings as advocates for change in their environments (Shamrova & Cummings, 2017). The process in itself is educative, as participants experientially learn to be self-reflective and self-directed learners (Smith et al., 2014) and are afforded opportunity to develop life skills such as communication, problem-solving, group work, planning and organization that are of value throughout their lives (Anyon et al., 2018). YPAR is not without its challenges, as it may give rise to ethical dilemmas or threaten existing power relations, as we discuss later. However, since the adults in this particular school did not seem to be aware of/concerned about the holistic health of learners, and indeed were seen at times to aggravate emotional distress, we decided that we had no option but to use YPAR to expose the hidden curriculum (WHO, 2020) that threatened the wellbeing of learners. We now discuss the specific methods used to generate and analyse data in this second cycle of the research.

Methodology
The research was conducted in the rural school in which the first author teaches 1 . It is a no-fee school and learners have access to the National School Nutrition Programme since almost all families in the area the school serves live in poverty. The first author requested the Teacher Liaison Officer (TLO) to purposefully select possible participants whom she deemed to have leadership potential and who were able to communicate well with other learners. Participants were recruited from Grade 10, based on the argument that they are over the age of 16, thus possessing a certain degree of maturity and will remain in the school for two more years to improve the sustainability of any change effected. The TLO recruited 14 volunteers to participate (7 male;7 female). Cycle one was conducted in 2016, and cycle two spanned the whole of 2017. The aim of the research was to evaluate the influence that the youth advocacy in cycle two had in terms of bringing about positive change in relation to their own attitudes and responses, and those of their peers, the teachers and the school in general. Therefore, we generated data through transcriptions of the audio-recorded weekly meetings of the participants and facilitator, analysis of learner and teacher responses to the visual displays of the photographs and drawings created in cycle one by participants, responses of the School Governing Body (SGB) to the presentation of the policy brief, and the reflections of the first author on other initiatives begun in the school, as recorded in her field diary. Table 1 outlines the process of data generation in this cycle.
Thematic analysis allowed us to identify, examine and record patterns in the different data sets (Guest et al., 2012). Data were initially analyzed within the PAR group to guide their actions and we adult researchers later analyzed the data from a theoretical perspective.
Process validity (how well the research was conducted) was enhanced by teamwork and triangulation of methods (Anney, 2014). Dialogic validity refers to the degree to which the research data, methods and interpretations are subjected to peer review (Herr & Anderson, 2005), which took place in group discussions, by presenting findings to other learners and asking for feedback and by the collaborative decision-making on what research methods and intervention strategies to use. We present sufficient evidence to support our claims about the outcomes of the study, and its catalytic effect in bringing about change. Democratic validity was central to the purpose of the study, and the process was facilitated so that all participants were able to contribute their opinions and ideas at each stage of the research process.
An important ethical consideration in PAR is to conduct the research so that participants benefit directly from participation in the project (Wood, 2020) and are protected from any victimization. The YPAR had inherent ethical tensions, since raising awareness of the experiences of the participants would necessarily highlight the failure of teachers and management to provide an enabling environment. The study met the stringent requirements of the Ethics Committee of the University, indicating that it fulfilled the Belmont Report principles of justice, beneficence and respect of persons (National Commission for the Protection of Human Subjects of Biomedical and Behavioural Research, 1979). We now explain how the YPAR process evolved in the second cycle, based on findings generated in cycle one. Table 1 explains how participants used the data generated in Cycle One to determine what actions to take in Cycle Two to make their school a more enabling and health promoting environment. We now discuss in more detail the actions the particpants took to make their school a healthier, more enabling environment, indicating how these contributed to change on several levels.

Raising Awareness of the Unhealthy Ethos and Environment within the School
Participants displayed the photographs, drawings and narratives that depicted how they experienced the school environment as an advocacy tool to raise awareness and to find out if other learners had similar experiences. They made posters that were displayed on the wall for three days for learners and teachers to view at the spot where assembly was held. Figure 1 shows learners looking at this display. Although it was obvious to all that the physical infrastructure was in a dilapidated state, the photographs and drawings generated by learners graphically depicted how this impacted them on an emotional, relational and cognitive level; the explicit representations of the bullying by peers and the emotional and physical abuse by teachers were accompanied by short, but heartrending narratives. Their appeals for change, backed up by the visual data, were compelling and difficult to ignore. As author one reflected in her diary: I was not aware of what these learners were going through as we educators only move from staffroom to the classrooms, and do not concern ourselves with what lies beyond the limits of the main school building. I only saw the conditions of the pit latrines for the first time in the pictures that the participants took. This has stopped me from being harsh to learners when they go to toilets in groups because I now understand that they need to provide safety for one another (12/6/2016).
Participants put a suggestion box and cards next to the display to allow learners and members of the staff who visited the display anonymously to write down their reactions and ideas for improvement. Only two teachers respondedperhaps because the display provided so much evidence of teacher unprofessional behaviour. In contrast, 578 learners wrote responses that indicated agreement with the experiences displayed in the photographs and drawings Something must be done with the animals in the school because they leave their dung everywhere and this makes our classrooms filthy. Some of us are having sinuses, so dirty environment is not good for our health [Learner 56] Shortage of water is a big problem to us because we cannot stay the whole day without drinking water. We get tired and fall asleep in class [Learner 78].
They also made suggestions for improvement e.g. having a tuck shop on the school premises for learners who can afford to buy food; that the number of water tanks at school should be increased to provide enough drinking water. Some indicated that they realized they needed to behave differently to improve the environment, e.g. by not littering in the playground. Learners also agreed that they needed an opportunity for sport and exercise, a foundational principal of health promoting schools (WHO, 2020). Many thought that the teachers were not interested in their wellbeing, indicative of poor relational wellness: We want to play sport but problem is that we don't have good grounds. Teachers think it is none of their business because they don't say anything. We cannot play there because we can be bitten by thorns or injure our feet. Teachers must please help us with this problem [Learner 216].
Most disturbingly, learners also supported the participants' claims about cases of sexual exploitation, discrimination, stigmatization and bullying on the school premises. Some teachers make learners to change school. If they propose love and you don't agree, every time you make a small mistake, they punish you or they say get out of my class. This is hurting because you don't enjoy at school. I say # sexual abuse must fall [Learner 397].
Instead of fostering "health and learning with all the measures at its disposal" (WHO, 2020, p. 1), the teachers in this school were adding to the risk factors for poor health outcomes (Magwa, 2015). Although HPS are supposed to focus on "building capacities for peace, shelter, education, food, income, a stable ecosystem, equity, social justice, sustainable development" (WHO, 2020, p.1) and developing a caring climate, teachers were perceived to have little empathy for the family situation of the learners: Please tell teachers not to lock us outside the gate because a person like me must take the child to the preschool before we come to school and they open at half past seven. If I come to school early it means I must leave the child stranded at home [Learner 274].
The findings of the participants in Cycle One (i.e. poor infrastructure, teacher-learner relations, lack of sport were negatively impacting on their holistic wellbeing and sense of belonging in school) were thus validated by their peers, and by sharing the findings they also inspired other learners to become involved in making changes or lobbying management to do so. This motivated the participants to take further action. With the help of author 1, they developed a policy brief summarizing their findings and recommendations for change in school policies to better support the holistic health of learners.

Presentation of Policy Brief to the School Governing Body
Participants requested permission from the Principal to present their findings to the members of the SGB, but they were limited to merely handing it over and not allowed to engage in discussion. We interpreted this as a power play by school management to remain in control, a frequent response to YPAR by authority figures (Baggett & Andrzejewski, 2017). Participants gave cards to the parent members and asked them to respond in writing how they felt about the problems presented and what they thought could be done to improve the situation. The responses of the parent members indicated shock, shame and surprise, as indicated below: We have heard and seen. We are very ashamed to be made aware of the school's condition by children. We promise to fix the problem of toilets immediately [SGB parent 1].
Soon after the presentation, they went to the Department of Basic Education personally to apply for portable toilets, taking pictures of the participants' photographs to convince the Department about the urgency of the matter. The Department responded within two weeks and the school was promised 38 toilets and an additional block of three classrooms. In the meantime, the SGB planned to rehabilitate a few flushing toilets. To address the learners' frustrations about the lack of water for drinking and washing hands, they also upgraded the borehole to improve the water supply to the school (See Figure 2). The SGB also organized the Community Workers Project to clean the school grounds monthly at no cost. They hired a local person to cut the grass and level the sports field.
The participants were encouraged by this positive response but noted that the SGB did not address the other two themes the lack of sports and the poor social and emotional climate of the school. However, the Deputy Principal discussed the policy brief at a morning session with teachers. Teachers supported some of the concerns raised in the policy brief and raised more concerns of their own.
Locking learners outside the gate during lessons hits us back as subject teachers because we expect them to write and pass tests on the subject matter they missed [Teacher A].
We are unable to deal with issues of substance abuse in the school because there is no clear policy about the sanctions if a learner is caught in possession of drugs on the school premises [Teacher B].
However, it appeared that not all teachers agreed with the contents of the policy brief although they did not say anything during the discussion. They gave the lead author the nickname "Section 10" (reference to code of conduct which prohibits unfair discrimination of learners) to mock her connection with the policy brief, indicating a lack of a supportive professional relationship among teachers.

Harnessing the Support of Other Learners
Participants agreed in their meeting that they themselves could do something about the cleaning up of the schoolyard, organizing a sports event, starting a campaign to obtain sanitary pads for girls and beginning to address the hurtful behaviour by teachers. They decided to involve other learners in these activities to build support for their efforts to effect and lobby for change.
They requested permission for learners to bring garden tools to clean the grounds and for supervision by teachers to avoid fights or injuries. Of 27 teachers, 19 came to supervise. However, 15 teachers subsequently left, saying that they were not going to help Author 1 complete her thesis (she was conducting the YPAR project as her PhD study). This was a clear indication of poor relational wellness (Osher et al., 2019) among the teachers, as they were not willing to assist learners if they felt a colleague was benefitting in some other way.
The positive response from other learners and the success of the cleaning campaign encouraged participants to organize a sports event. They did this without the direct leadership of the first author, who was on leave. This selfinitiated action was evidence of their growing confidence, teamwork, organizational and problem-solving skills, all markers of emotional and relational wellness (White, 2017). They borrowed balls and a volleyball net from neighbouring primary schools. For soccer, they used vandalized table frames as goal posts. They asked for donations from people in the community to buy prizes and refreshments and raised enough money to buy medals, bread and drinks. They also secured a donation of two tog bags, with sport accessories. They were able to collect close to 500 packets of sanitary towels from parents, local business people and those who attended. Based on the success of this event, the SGB eventually agreed to purchase sport equipment. Wednesday afternoons are now used for sport and other extramural activities, thereby reducing the number of learners hanging around with nothing to do. Hopefully, this will decrease the risk of anti-social and unhealthy behaviour and improve the relations between learners and teachers as they participate in healthy activities (Claessens et al., 2016).
Participants decided to create a short drama to highlight the issues of stigma, discrimination and abusive behaviours of teachers, and bullying and violence by other learners. The title of the drama was "Rising from the ground: troubled youth's voices are echoing" (https://youtu.be/5Bnwmjckcz8 shows a rehearsal for this). Participants recruited other learners whom they knew were good actors so that the message could be clearly conveyed. The drama featured learners who were tired of being constantly insulted by teachers and mocked by other learners. At the end, they agreed that they should take care of one another to break the silence on issues that make learners uncomfortable. The drama was presented to the parents, teachers and other learners.
The first author had already reported the alleged abuse of learners to the principal, as required by policy, but she was not informed of any action that was taken at this stage. We were very concerned about how teachers would react and were fearful of possible victimization of learners, but fortunately this did not happen. Instead, the exposing of the injustices, through the drama described above, seemed to act as a catalyst for the introduction of policy and practices to improve the physical, emotional and social wellbeing of learners.

The Influence of the YPAR Project on Health Promotion in the School
This school clearly was the antithesis of what a health promoting school should be. The YPAR process initiated by learners and a concerned teacher was the catalyst for change needed to move it in that direction. We discuss this in terms of the improved holistic wellbeing of participants and other learners, the improvement in the physical environment, the change in teacher attitude and the systemic structures that were put in place to promote health.
Participants in this study were initially voiceless because they did not have adult support to guide them. Participation in YPAR helped them develop a sense of agency as they identified problems and navigated ways of improving the social and physical environment (Porter & Maddox, 2014). As one participant noted: I found it very light to express my emotions about how a male teacher harassed me sexually through drawings and writing but I think if I was expected to say it verbally in front of you, I would not be free to say everything. I feel relieved because my message will be delivered exactly how I wanted it to be [P3].
Participants also developed competence, relatedness and autonomy (Ozer et al., 2013), as they collaborated to initiate various projects and programmes. They continued this out of their own initiative after the official project ended. For instance, they launched the 'Keep a girl child at school' project for the ongoing collection of sanitary towels. Some parents now donate a packet of sanitary pads monthly. Participants also established a group called Youth Civilians of Patrol at school as an initiative for the prevention of substance abuse, gambling on the school premises and the vandalism of school property. They invited volunteers from outside the project group to lead the programme with the purpose of establishing a strong network of support amongst learners themselves.
The initiatives provide evidence of the potential of youth to bring about change if given support, as supported by other literature on YPAR (Anyon et al., 2018;Caraballo et al., 2017;Ozer, 2017). They learnt skills to make "healthy decisions and [take] control over life's circumstances" (WHO, 2020, p.1). In addition, they learnt and demonstrated many life skills, such as communication, organizing, planning, team work, assertiveness, commitment and problem solving, all outcomes reported in other YPAR projects (Lindquist & Abraczinskas, 2018;Livingood et al., 2017).
Another initiative concerned the problem of learners loitering outside when they were supposed to be in class. Participants decided to design permission cards to control the movement of learners during lesson time and the school management team gladly accepted this proposal. Although this issue was not highlighted in their initial findings, the fact that they later identified it, and took action to address it, could be seen as evidence of their new-found confidence to address problems and commitment to improving the social climate of the school.
The participants' actions aroused the interest of other learners. Some volunteered to help with the collection of sanitary towels from local businesses. Others requested the first author to establish a debating society. A female learner was motivated by the drama to start a support group for girls. The group meets every Wednesday during the time allocated for sport. A member of the newly formed School Based Support Team (SBST) (see more on this below), who is also a Life Orientation teacher trained in basic counselling skills, guides the group. The formation of this group is an indication of how other learners have been motivated by the actions of the YPAR group to find ways to encourage the adults in their social ecology to provide support to improve their wellness (Olowokere & Okanlawon, 2018). The support group provides young girls a much-needed space for sharing their problems and informs the SBST about support needs and circumstances that are violating learners' rights to dignity and safety.
In response to the drama, more learners came forward with accounts of emotional or physical abuse and unfair treatment by teachers. This was a difficult issue for us, especially for the lead author who could not confront the alleged perpetrators as it would have put the learners in danger of being victimized. She decided to discuss the issues with school management without mentioning the names of the teachers and to ask the Deputy Principal to use her authority as curriculum manager to address all teachers about the seriousness of unprofessional conduct. She did this and drew up a new code of conduct for all teachers to sign. Since the perpetrators were not mentioned by names, some of the teachers alleged that learners were making these issues up. However, we hoped that those who knew that they were involved would heed the warning. Coincidentally (or not), seven teachers either resigned or requested a transfer, which indicated to us that the Principal had taken some action to address their behaviour. The teachers appointed in their place have come into a different environment which is more supportive of learner needs and the incidences of teachers behaving unprofessionally seems to have been reduced, although not eradicated All schools in South Africa are supposed to have SBSTs, but none had existed prior to the project. After the presentations by participants, school management requested the lead author to organize training to set one up. The SBST has been functioning well to the benefit of the learners. For example, two teachers started remedial lessons in the afternoon to support learners with literacy problems. They also collaborate with the Community Development Worker to assist learners who lack official documentation (birth certificate, ID card etc.), without which they will face many barriers in life.
To address the problem of school nutrition, the Principal appointed a member of the SGB to control and monitor the feeding of learners at school. The Department of Basic Education supplies enough food to the school according to learner enrolment but the people preparing it were stealing it.
Learners are now getting enough food and surplus is given to learners who do not have parents who provide for them.
The evidence of these additional initiatives, emanating from the YPAR group advocacy, indicates the value of the YPAR project as a catalyst for mobilizing the various stakeholders to take action to improve health promotion within the school. However, it is not without its challenges.

Challenges of YPAR
YPAR is an effective methodology to engage youth in improving their own lives and circumstances, however it does have potential to create ethical tensions. In this case, participants wanted to expose abusive behaviour by naming individuals and when they were told they could not, they felt that their voices were being subdued. This may be paradoxical, given that YPAR aims to enable youth to openly address injustices. However, calling out specific teachers would not have been in the best interests of the learners, due to possible victimization, and the risk of making false accusations. When they understood this, they were happy to expose the issues without naming the perpetrators.
Since YPAR sets out to change and challenge existing structures, those in power may try to stop the process, victimize the youth or just ignore them totally (Kohfeldt et al., 2011). To avoid this, the project facilitator had to gain the support of management, while simultaneously exposing the need for change, yet maintaining cordial relations with her colleagues. This required her to juggle her different roles as teacher, colleague and YPAR facilitator, and points to the need for YPAR facilitators to be skilled in negotiating such complex relationships. In the context of rural South Africa, where children are not expected to voice their opinions, YPAR may be the catalyst needed to change the hierarchic culture within schools.

Conclusion
The findings of this study indicate that a YPAR process has the potential to make disempowering and unsupportive school environments more inclusive and health promoting. By disseminating their findings to the school community, participants exposed the realities that threatened their holistic wellbeing and gained support in their actions to address these threats. Their initial actions served as a catalyst for subsequent action by other stakeholders that led to the fostering of a healthy environment on several levels. In line with the features of a HPS as suggested by the WHO (2020, p.1), healthy school policies (e.g. SBST, management of nutrition scheme) were initiated; the physical school environment (e.g. toilets, sports grounds) were improved; the social environment (e.g. measures to reduce bullying/abuse) was enhanced; links with parents and community (e.g. police, local businesses, CHW) were established; and steps were taken to protect the dignity and emotional wellbeing of learners (e.g. toilets improved, campaign for sanitary towels, support group). These initiatives can only improve the emotional and relational wellness of learners, and ultimately of teachers as well.
The SGB, teachers and school management were (we think) initially shamed into taking action, but once begun, the change process gathered momentum and is continuing to date. This article has shown how YPAR can empower youth to improve the schooling system from the ground up. This is especially significant in contexts such as South Africa, where the public schooling system is in crisis and little to no sustainable support can be expected from government or external stakeholders. Based on the findings of this study, we argue that if YPAR were to be established in such schools, either as a curricular activity, or through specific projects, then learners and teachers could take hands to transform the school-going experience of learners. This would create a supportive environment for teaching and learning where the holistic wellness of everyone would be improved, benefitting learners, teachers, parents and ultimately society as a whole.

1
The second author worked closely with the first author in designing the research project, advising throughout and analyzing the data, as well as conceptualizing the article and writing it. This research was funded in part by the National Research Foundation (Grant No. 116261). All opinions, findings and conclusions are those of the authors and the NRF accepts no responsibility thereof problematic teacher-student relationships. Teaching and Teacher