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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

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Experience of living with type 1 diabetes in a low-income country: a qualitative study from Liberia

Adler, A.J.; Trujillo, C.; Schwartz, L.; et al. BMJ Journals (2021) CC

While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng... more

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Communicating on air quality and health – Inspiring practices, challenges and tips

Health and Environment Alliance (2018) CC

In spite of the work carried out by the EU institutions, the Member States, many cities and grassroot movements in Europe, the general public is still not engaging enough in air quality policy initiatives and the level of awareness and knowledge of the effects of poor air quality on health is often ... more

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Policy statement and recommended actions for reducing fat intake and lowering heart attack rates in the Eastern Mediterranean Region

World Health Organization (WHO) World Health Organization (WHO) (2014) C_WHO

The materials focus on promoting healthy eating habits and reducing risk factors for non-communicable diseases such as obesity, diabetes, and heart disease. They emphasize actions to limit sugar, salt, and fat intake, including policy recommendations for eliminating trans-fats, reducing saturated fa... more

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Policy statement and recommended actions for lowering sugar intake and reducing prevalence of type 2 diabetes and obesity in the Eastern Mediterranean Region

World Health Organization (WHO) World Health Organization (WHO) (2016) C_WHO

The documents focus on promoting healthier nutrition by addressing issues like sugar, salt, and fat intake, emphasizing their role in non-communicable diseases such as obesity, diabetes, and heart diseases. They include educational tools for children and adults to support balanced diets and public h... more

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Ready to Use Therapeutic Food (RUFT) and the WHO Essential Medicines List

CMAM Forum (2018) CC

Severe Acute Malnutrition (SAM) is one of the greatest child survival challenges in the world today and reportedly affects more than 16.2 million children each year1. High impact, proven treatment interventions exist yet sadly approximately only 3.2 million children with SAM have access to treatme... more

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The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study

Khuluza, F.; Haefele-Abah, C. PLoS ONE (2019) CC

The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... more

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Time to align: development cooperation for the prevention and control of non-communicable diseases

Collins, T.E.; Nugent, R.; Webb, D.; et al. The British Medical Journal (BMJ) (2019) CC2

The article "Time to Align: Development Cooperation for the Prevention and Control of Non-Communicable Diseases" argues for greater international cooperation and investment in addressing non-communicable diseases (NCDs), especially in low- and middle-income countries. Traditionally, global health fu... more

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General Assembly: Progress on the prevention and control of non-communicable diseases

United Nations Secretary-General United Nations General Assembly (2017) C_WHO

The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights ... more

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Avances en la prevención y el control de las enfermedades no transmisibles - Informe del Secretario General

United Nations Secretary-General United Nations General Assembly (2017) C_WHO

El documento, "Progreso en la prevención y el control de las enfermedades no transmisibles" (ENT), informa sobre los esfuerzos globales para reducir el impacto de las ENT, como las enfermedades cardíacas, el cáncer, la diabetes y las enfermedades respiratorias crónicas, siguiendo los compromisos... more

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Progrès accomplis en matière de prévention et de maîtrise des maladies non transmissibles - Rapport du Secrétaire général

United Nations Secretary-General United Nations General Assembly (2017) C_WHO

Le document, intitulé « Progrès dans la prévention et le contrôle des maladies non transmissibles », rend compte des efforts mondiaux pour réduire l’impact des MNT (maladies non transmissibles), telles que les maladies cardiaques, le cancer, le diabète et les maladies respiratoires chroniq... more

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Advancing the global agenda on prevention and control of noncommunicable diseases 2000 to 2020

World Health Organization (WHO) World Health Organization (WHO) (2023) C_WHO

This document highlights landmarks and key milestones in the development and implementation of the global agenda for noncommunicable diseases (NCDs) over the last two decades. It summarizes where the world was in 2000, where it is in 2022, and where the world wants to be in terms of NCD prevention a... more

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WHO package of essential noncommunicable (PEN) disease interventions for primary health care

World Health Organization (WHO) World Health Organization (WHO) (2020) C_WHO

The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers. Designed ... more

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The efects of extreme heat on human health in tropical africa

Kunda J., Gosling S., Foody G. et al. (2024) C2

This review examines high-quality research evidence that synthesises the efects of extreme heat on human health in tropical Africa. Web of Science (WoS) was used to identify research articles on the efects extreme heat, humidity, Wet-bulb Globe Temperature (WBGT), apparent temperature, wind, Heat ... more

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Epidemiology and Challenges of Managing COPD in sub-Saharan Africa

Magitta, N.F.; Sciences, A. Acta Scientific Medical Sciences (2018) CC2

There is paucity of data on the burden and specific drivers operative in the pathogenesis of chronic obstructive pulmonary disease (COPD) in the African setting and populations. Lack of awareness and inadequate knowledge on the aetio-pathogenesis of the disease together with inadequate capacity for ... more

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Победить жару: здоровье детей на фоне тепловых волн в Европе и Центральной Азии

UN Children's Fund UNICEF (2024) CC

Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months. "Around half of children across Europe and Central Asia – or 92 million children –... are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia. Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region. As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to: - Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans Invest in heat health action plans and primary health care to more adequately support heat-related illness among children - Invest in early warning systems, including heat alert systems - Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress - Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure - Secure the provision of safe water, particularly in countries with deteriorating water quality and availability. UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress. more

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Risk factors for asthma among schoolchildren who participated in a casecontrol study in urban Uganda

Mpairwe, H.; Namutebi, M.; Nkurunungi, G. et al. eLife (2019) CC

Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia... more

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The Global Asthma Report 2022

Global Asthma Network (2022) CC2

The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T... more

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Desktop Helper No.2 - A practical guide to improve difficult-to-manage asthma in primary care

International Primary Care Respiratory Group IPCRG (2024) CC

This guide provides a systematic, practical approach to support primary care and other healthcare professionals to improve the care of peopel over the age of 18 years with difficult to manage asthma.

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Access to essential respiratory medications remains elusive in LMICs

Karmali, D.; Siddharthan, T. (2022) CC

Over 90% of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) and asthma occurs in low-income and middle-income countries (LMICs) due to well documented factors including decreased access to screening, trained health professionals, and therapies for disease manageme... more