Catherine Draper, University of the Witwatersrand; Charlie Foster, University of Bristol; Dr Lindsey Reece, University of Sydney; Jacqueline Mair, Swiss Federal Institute of Technology Zurich; Jasper Schipperijn, University of Southern Denmark; Karen Milton, University of East Anglia; Matthew Mclaughlin, University of Newcastle; Simone Tomaz, University of Stirling; Sjaan Gomersall, The University of Queensland, and Trevor Shilton, Curtin University
Research on physical inactivity trends in Africa is limited. But evidence suggests that as countries undergo transitions such as increased urbanisation, physical activity levels may decline.
But in Africa, the health agenda is dominated by pressing issues such as infectious diseases and food insecurity. Given these competing priorities and the absence of physical activity policies, African countries need to know which strategies to invest in.
Encouraging physical activity should be a priority. Being physically active is not entirely an individual choice, but a result of what funds, spaces, places and opportunities are available to the individual and communities. This is why governments and leaders have a role to play.
To assist governments looking to boost physical activity, we at the International Society for Physical Activity and Health, offer eight key areas for investment. These are based on global evidence of what works. Our aim is to assist governments to meet targets set by the World Health Organisation (WHO).
Decades of research highlight that no single solution will increase population levels of physical activity, which have declined and stagnated over the last 50 years. That’s why our reinvestment suggestions cover a range of settings and government departments. Multiple departments, including transport, education, sport and health, need to work together.
1: School Programmes: Physically active children are likely to be physically active as adults. Physical activity also contributes positively to academic achievement and classroom behaviour. School environments and programmes that keep students active before, during and after school are recommended. One of the best known and successful multi-component programmes is Finland’s “Schools on the Move”. Flexibility around the implementation of these programmes is necessary as schools navigate a post-COVID-19 reality.
2: Active travel: Funded transport policies that support walking, cycling and public transport encourage more active modes of travel. These policies should address safety as well. Most city-based journeys are short enough to walk, cycle or roll. Replacing car trips with active transport trips improves health, reduces injury and road trauma, and reduces harmful emissions, along with other benefits. This has been done in many European cities. For those who live far from work, public transport can encourage more active modes of travel, such as walking to and from a bus or train station.
3: Active urban design: People are active in locations that feel safe and enticing to use. Spaces can be designed to support physical activity, such as buildings where the stairs are visually appealing. Providing access to parks is another clear example, but there are nuances, such as the type and quality of amenities provided at the parks. Active urban design allows for many of the things people need to be near to home or work, within walking distance. Funded policies that support equitable access to parks, local amenities and better walking, cycling and public transportation infrastructure make being active more appealing, accessible and equitable.
These planning considerations are particularly pertinent in African countries undergoing rapid urbanisation. There is evidence to show that these endeavours are worth pursuing. For example, features of the built environment contribute to increased physical activity among adults in Uganda, and among Nigerian adults and adolescents.
4: Healthcare: Health professionals are in a position to advise patients on how and why they should be physically active. But some health professionals need additional training and support to promote physical activity. There are indications of success in some high-income countries such as Australia. But there’s room for improvement in African countries, and strategies can draw on the global “Exercise is Medicine” initiative.
5: Public education and the media: Social media, digital media and mass media campaigns can transmit clear messages about physical activity. These platforms can cost-effectively reach large populations and increase awareness of the importance of physical activity and opportunities to be more active, and lead to behaviour change.
6: Sport and recreation for all: Providing a variety of sporting opportunities across the lifespan is key to keeping people engaged in sport. Given the high cost of some sports, government subsidies may be one way to increase participation. Sport has specifically been linked to the attainment of the Sustainable Development Goals, with a “Tool Kit for Action” for countries to draw on. Sport and recreation for all has been attained in high-income countries such as Canada. Progress has also been made in some African countries, such as Zambia, where national sport policy has more explicitly recognised the contribution of sport to the achievement of sustainable development priorities including skills development and job creation.
7: Workplaces: For sedentary occupations, workplace-based physical activity programmes will have physical, mental, and social benefits, while also reducing absenteeism and burnout and increasing productivity. An example is providing pedometers to employees so that they can monitor (and increase) their daily steps.
8: Community-wide programmes: Community-wide programmes to promote physical activity will have benefits beyond health. These have shown to be successful in Brazil, particularly in terms of scaling-up interventions with political support, and Japan where population-level physical activity was increased. But these have yet to be implemented effectively in any African country.
Now is the time to invest in these eight areas, to assist COVID-19 recovery, reduce the impact of noncommunicable diseases and promote mental health. These investments are critical to reach the WHO’s targets to reduce physical inactivity by 10% by 2025 and 15% by 2030.
Catherine Draper, Associate Professor, University of the Witwatersrand; Charlie Foster, Reader in Physical Activity & Public Health, Chair of UK CMOs Expert Group for Physical Activity, University of Bristol; Dr Lindsey Reece, Senior Research Fellow in Physical activity , University of Sydney; Jacqueline Mair, Senior Scientist, Swiss Federal Institute of Technology Zurich; Jasper Schipperijn, Professor of Active Living Environment, University of Southern Denmark; Karen Milton, Associate Professor in Public Health, University of East Anglia; Matthew Mclaughlin, PhD Candidate, School of Medicine and Public Health, University of Newcastle; Simone Tomaz, Post-doctoral research fellow, University of Stirling; Sjaan Gomersall, Senior Lecturer, The University of Queensland, and Trevor Shilton, Adjunct Professor, School of Public Health, Curtin University