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HST provides free electronic access to over 500 health systems research related reports, publications and papers. Close to 300 of these are publications that have been commissioned and funded by the Trust. Topics include among others district systems development, drug supply management, human resource development, informatics, legislation, finance, environmental health, mental health, lessons learnt, nutrition and sexually transmitted diseases / HIV/AIDS. The main publication of the HST is the annual South African Health Review. From 2005 all HST publications will be available in low resolution only. To explore the range of publications HST offers use the Advanced search to search using a variety of criteria.

To some extent this confusion has continued. For example, there still are very few training opportunities for South Africans in health promotion, although there is a recent national initiative through the Department of Health to establish a programme of health promotion training in tertiary institutions in South Africa. However, the slow development of training opportunity has lead to a capacity gap in health promotion in South Africa today. There are too few people in the health service who are adequately qualified to provide leadership in health promotion.

The national policy for health promotion practice in South Africa is based on the principles and approach of the 1986 Ottawa Charter for health promotion. It establishes five key action areas for health promotion practice. These are:

• To promote safe environments for people to live and work in. Many of the health problems facing South African communities are caused or made worse by living and working in poor conditions. For example, having poor water and sanitation facilities or working in dangerous conditions without any safety measures. 
• To develop healthy public policy. This is legislation and policy that protects health. For example, this can range from tobacco control legislation through to ensuring that housing policy protects the health of people by ensuring that, for example, it provides for adequate ventilation or sanitation facilities 
• To promote community action. Health problems are often best tackled through community action. This could include community clean-up campaigns or setting up an HIV/AIDS support group in a community 
• Develop personal skills. It is essential that each person is equipped with the information and skills to promote their health. For example in South Africa everyone needs to know about AIDS, and young people need to learn how to negotiate safe sex or how to say no to sex. 
• Re-orient the health service. Often the health service does not act in the best interest of peoples health. Clinics are often not open in the early evening when it may be easier for working people to get to them and environmental health officers may over emphasize the role of inspections and law enforcement rather than education for food traders. 

One outcome of this 5 pronged approach is that it is often more effective to promote health outside the health sector. For example, the government AIDS partnership strategy acknowledges that people are best reached through all channels in society and not just at the clinic. The health promoting schools project is a good example of a programme of health action outside the health sector. However this does not mean the health sector does not have a critical role to play in health promotion. The role of the health system should be:

• To provide leadership and strategy 
• To ensure there is adequate research and training capacity in the country 
• To set targets and guidelines for the practice of health promotion by health workers 
• To ensure the development of all 5 approaches to health promotion at the national, provincial and district level. 

Another outcome of the 5 pronged approach is the emphasis on the environment rather than personal behaviour change. The environmental health service has huge potential to meet these goals. A fundamental reform of the scope of practice of environmental health officers, revised legislation and curricula at the technikons will result in the service being focused on health development, health promotion and environmental management and away from the old model of inspection. Should the service fully manage this transition then it will be delivering on water and sanitation, waste management, pollution, tobacco control and food safety. The training of environmental health officers in health promotion is an urgent priority.

Finally health promotion demands a multidisciplinary approach. It requires the combined inputs of social scientists, health workers, communication specialists, policy analysts and others if it is to be successful. If the present capacity gap in health promotion is to be overcome it is essential that South Africa provide post graduate health promotion studies for people from a wide range of disciplines and sectors.