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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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Sanitary inspection packages – A supporting tool for the Guidelines for drinking water quality: Small water supplies

World Health Organization WHO (2024) C_WHO

A sanitary inspection is a simple, on-site evaluation (traditionally using a checklist) to help identify and support the management of priority risk factors that may lead to contamination of a drinking-water supply. Sanitary inspections are a well-established and widely-applied practice. They can su... more

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Guidelines for drinking-water quality: Small water supplies

World Health Organization WHO (2024) C_WHO

Small drinking-water supplies commonly experience operational, managerial, technical and resourcing challenges that impact their ability to deliver safe and reliable services. The needs and opportunities associated with these supplies therefore warrant explicit consideration in policies and regulati... more

Panorama of Diabetes in the Americas by Pan American Health Organization

Pan American Health Organization PAHO (2022) C_WHO

The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The... more

Preparedness and Resilience for Emerging Threats Module 1: Planning for respiratory pathogen pandemics

World Health Organization WHO (2024) C_WHO

Through technical consultations with countries and partners, WHO has led the development of Preparedness and Resilience for Emerging Threats Module 1: Planning for respiratory pathogen pandemics. Version 1.0. The Module, currently available as an advanced draft, builds on previous pandemic lessons a... more

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

Community conversation kit: everyday conversations to protect community health against infectious diseases

World Health Organization WHO (2024) C_WHO

This Community Conversation Kit (CCK) is designed to help people who have a leadership role speak with people in their community about how to protect themselves and those they care about from becoming ill with an infectious disease. This kit will help lead conversations that get people talking with ... more

The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2017

British Association for Cardiovascular Prevention and Rehabilitation (2017) CC

This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards... more

Regional capacity-building workshop for management and care of substance use disorders

World Health Organization (WHO) World Health Organization (WHO) (2019) C_WHO

The document is a summary report by the World Health Organization (WHO) Regional Office for the Eastern Mediterranean, focusing on a capacity-building workshop held in Abu Dhabi in 2019. The workshop addressed the management and care of substance use disorders, aiming to improve technical and manage... more

Strengthening pandemic preparedness and response through integrated modelling

OECD; World Health Organization WHO; World Bank (2024) CC

The far-reaching impacts of the COVID-19 pandemic underscore the critical need for evidence-informed, transparent and inclusive decision-making. Policy-makers have grappled with complex choices amidst uncertainty. They have constantly reassessed response measures while navigating their economic impl... more

WHO competency framework, risk communication and community engagement

World Health Organization WHO (2024) C_WHO

The risk communication and community engagement (RCCE) competency framework is a resource that details the essential behaviours and activities necessary for effective communication and engagement with communities before, during and after public health emergencies. The purpose of this framework is to... more

Report of the workshop for implementing the WHO South-East Asia Regional NCD Roadmap, 2022-2030 WHO

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

The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and diabetes, identifying the most impactful NCD interventions within their context, closing the gaps in ca... more

Intention to action series: Regional reflections. Analysis from informal regional consultations with people living with noncommunicable diseases and mental health conditions 2023 WHO

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

This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-East Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarit... more

Invisible numbers; The true extent of noncommunicable diseases and what to do about them 2022

World Health Organization (WHO) World Health Organization (WHO) (2022) C_WHO

Noncommunicable diseases (NCDs) – chief among them, cardiovascular diseases (heart disease and stroke), cancer, diabetes and chronic respiratory diseases – along with mental health, cause nearly three quarters of deaths in the world. Their drivers are social, environmental, commercial and geneti... more

Report - Invisible numbers: the true extent of noncommunicable diseases and what to do about them

World Health Organization (WHO) World Health Organization (WHO) (2022) C_WHO

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

The ISN framework for developing dialysis programs in low-resource settings

International Society of Nephrology (2021) CC2

Chronic kidney disease (CKD) is an important contributor to mortality from noncommunicable diseases. No decrease has been seen for CKD mortality contrary to many other important non-communicable diseases (e.g., cardiovascular disease). The prevalence of CKD and kidney failure are increasing all over... more

Asia Pacific Health Security Action Framework

World Health Organization WHO (2024) C_WHO

Public health emergencies, including pandemics, highlight the need for health systems and services that are prepared, resilient and ready to respond to health security threats. Endorsed by Member States in 2023, the Asia Pacific Health Security Action Framework (‎APHSAF)‎ is designed to engage m... more

Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review

Mphahlele, R.E.; Kitchin, O.; Masekela, R. BMJ Open (2021) CC

The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria, Uganda, and South Africa, the review identifies key... more

Barriers to childhood asthma care in sub-Saharan Africa: a multicountry qualitative study with children and their caregivers

Naidoo, K.L.; Dladla, S.; Mphahlele, R.E. et al. BMJ Open (2023) CC

This study identifies barriers and provides recommendations to improve asthma care in children across sub-Saharan Africa, where qualitative data is lacking despite high rates.