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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

Issue Brief Marburg virus disease (MVD)
recommended

The MEDBOX Team (2024) CC

Issue Brief No. 40 provides healthcare professionals with the most relevant treatment guidelines, prevention measures and training material on MVD

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Common Skin Diseases In Africa: An Illustrated Guide
recommended

Colette van Hees and Ben Naafs (2004) C1

Kuwasaidia Wamama Wazazi kuishi. Utokwaji damu baada ya kujifungua. Mwongozo kwa watoa Huduma

Jhpiego; UNFPA; International Confideration of Midwives; et al. Jhpiego; UNFPA; International Confideration of Midwives (2013)

This guide supports the low-dose, high-frequency practice of scenerios needed to maintain competency in prevention and management of postpartum hemorrhage. The document is learner centered and is directly linked to service delivery standards. It is part of the Helping Mothers Survive Bleeding After ... more

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Lifestyle and non communicable diseases/Mtindo wa maisha na magonjwa yasiyo ya kuambukizwa

Tanzania Diabetes Association (2014) C1

For full publication see: http://hesperian.org/wp-content/uploads/pdf/sw_hmx/sw_lifestylemanual_Abmswai_2014.doc Accessed October 2014.

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Liberia Ebola Virus Disease Clinical Management Manual

Ministry of Health and Social Welfare, Liberia (2014)

This clinical management manual for Ebola Viral Disease in Liberia was developed after several ETUs were established in the country following the outbreak early this year. As the outbreak evolved, it became evident that different SOPs were being used by clinicians across these treatment facilities. ... more

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Uganda Clinical Guidelines. National Guidelines on Management of Common Conditions
recommended

Ministry of Health, Uganda (2016) C1

This new edition and fully updated publication replaces the 2012 UCG and is being circulated free of charge to all public and private sector prescribers, pharmacists, and regulatory authorities in the country

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Uganda National Communication Strategy for Promoting Rational Use of Medicines

Federal Ministry of Health, Uganda (2009) C1

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2014-2016 Plan de Réponse Stratégique Mali, Janvier 2015

UN Office for the Coordination of Humanitarian Affairs (2015)

External Link

Migration in Kenya: A Country Profile 2015

International Organization for Migration IOM (2015) C1

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Guidelines for home based care services in Tanzania

Ministry of Health and Social Welfare, National AIDS Control Programme, Tanzania (1999) C1

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Uganda: Health Facilities Inventory July 2012

Ministry of Health, Republic of Uganda (2012) C1

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Kiongozi cha mtoa hutuma za kifu kikuu (TB) ngazi ya Jamii

WIZARA YA AFYA MAENDELEO YA JAMII JINSIA, WAZEE NA WATOTO Ministry of Health and Social Welfare, Tanzania (2016) C1

Community TB care handbook for community health workers

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Mafunzo ya Huduma za Kifua Kikuu Ngazi ya Jamii

JAMUHURI YA MUUNGANO WA TANZANIA Wizara ya Afya, Maendeleo ya Jamii, Jinsia, Wazee na Watoto National Tuberculosis and Leprosy Programme; Ministry of Health and Social Welfare, Tanzania (2016) C1

Kiongozi cha Muwezeshaji