Professionalisation of Estonian health promotion field: opportunities and obstacles in local governments for developing core competencies

In response to global public health challenges and increasing demands for skilled practitioners, this study explores professionalisation and competency-based approaches among health promotion specialists in local governments in Estonia. The aim was to identify priority areas for competency enhancement and examine opportunities and barriers to additional training. Semi-structured interviews with local government leaders (N = 10) and health promotion specialists (N = 9) were conducted. The sample consisted of interviewees recruited in 2022‒2023 and represented three groups: local governments that had created or updated their health and well-being profile, those currently working on it, and those that had not yet begun updating the profile. Thematic analysis identified themes related to the role of health promotion specialists, training needs, awareness of learning opportunities, and the development of core competencies. The findings revealed considerable variation in how the role of health promotion specialists is understood, alongside limited awareness of the competency framework guiding the profession. Key challenges included inconsistent role definitions, resource constraints, and uneven institutional support for training. Priority areas for competency development were identified in needs assessment, planning, evaluation, and communication. Major barriers to professional development included lack of time, funding, organisational support, and awareness of training opportunities, while employer encouragement, flexible learning formats, and perceived relevance to daily work emerged as important enabling factors.