ABSTRACT
A key distinction is made in the literature between a setting as simply a place to reach people and target interventions the conventional approach and the more complex vision articulated by the WHO. The WHO has been instrumental in supporting take-up of a settings-based approach to public health through establishing a variety of global networks. Leadership from senior managers is essential if the entire setting is to be developed. Some workplaces have shown enlightened self interest in embracing settings-based approaches. In, for example, prison health services have been fully integrated with local primary health care services since 1987. The effectiveness of settings-based approaches has been extensively debated. As complex interventions, evaluating such approaches poses considerable methodological challenges. In some cases this has involved the incorporation of additional agendas such as those relating to sustainable development where there is considerable convergence of interests and values.
