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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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Prevention and management of CVD in LMICs: why do ethnicity, culture, and context matter?

Anand, S.; Bradshaw, C.; Prabhakaran, D. BMC Medicine (2020) CC

Background Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease. Main text While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc... more

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Building better immunity: A life course approach to healthy longevity

Pan American Health Organization PAHO (2023) C_WHO

As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt... more

Guidelines for developing inclusive water, sanitation and hygiene infrastructure

Arup; International Labour Organization ILO; UN Children's Fund UNICEF; UNOPS; WaterAid (2024) CC

Around the world, more than 2 billion people lack access to safely managed water, sanitation and hygiene services, with conflicts and climate change exacerbating the issue. Unsafe and insufficient WASH facilities, especially in rural and remote areas, can lead to increased health complications fo... more

Infection Prevention and Control Guidelines 3rd Edition 2023

Government of the Republic of Namibia (2024) CC

The Infection Prevention and Control (IPC) Guidelines aim to support healthcare workers improve quality and safety health care. The Guidelines further aim to promote and facilitate the overall goal of IPC by providing evidence-based recommendations on the critical aspects of IPC, focusing on the fun... more

Guidelines for the prevention, diagnosis, care and treatment for people with chronic hepatitis B infection (March 2024)

World Health Organization WHO (2024) C_WHO

Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease. The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment criteria for adults but now also for adolescents; expa... more

A New Agenda for Mental Health in the Americas: Report of the Pan American Health Organization High-Level Commission on Mental Health and COVID-19

Pan American Health Organisation PAHO (2024) C_WHO

Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest leve... more

Kenya National Guidelines for Cardiovascular Diseases Management

Ministry of Health Kenya Republic of Kenya (2018) CC

The Kenya Health Policy 2014-2030 aims at attaining the highest possible standard of health in a manner responsive to the health needs of our population. One of the major policy directions towards realizing the intentions of this policy is to halt and reverse the rising burden of non-communicable d... more

Air pollution and the noncommunicable disease prevention agenda: opportunities for public health and environmental science

Howse, E.; Crane, M.; Hanigan, I. et al. Environmental Research Letters (2021) CC

Air pollution is a major environmental risk factor and contributor to chronic, noncommunicable diseases (NCDs). However, most public health approaches to NCD prevention focus on behavioural and biomedical risk factors, rather than environmental risk factors such as air pollution. This article discus... more

Impact of climate change on non-communicable diseases due to increased ambient air pollution

Breitner-Busch, S.; Mücke, H.; Schneider, A. et al. Journal of Health Monitoring (2023) CC

Background: The impacts of air pollutants on health range from short-term health impairments to hospital admissions and deaths. Climate change is leading to an increase in air pollution.

Comprehensive Tobacco Control Programs

Centers for Disease Control and Prevention (2021) CC

The Public Health Burden of Commercial Tobacco Use The burden of disease and death from commercial tobacco* use in the United States is overwhelmingly caused by cigarettes and other combustible tobacco products.

Malawi’s Community-based Health System Model: Structure, Strategies, and Learning

Devlin, K.; Pandit-Rajani, T.; Egan, F.K. Advancing Partners & Communities (2017) CC

The Community-based Health System Model Series briefs identify and discuss critical health system inputs and processes that have contributed to the implementation and expansion of community-based service delivery in different countries. Countries were selected for their geographic diversity, type o... more

Access to health care for people with disabilities in rural Malawi: what are the barriers?

Harrison, J.A.K.; Thomson, R.; Banda, H.T. et al. BMC Public Health (2020) CC

People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experi... more

Malawi National Communication and Advocacy Strategy for Pre-Exposure Prophylaxis (PrEP)

United States Agency for International Development; President's Emergency Plan for AIDS Relief; National AIDS Commission MAlawi (2022) CC

Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasises the role of preexposure prophylaxis (PrEP) in ... more

Burden of fungal asthma in Africa: A systematic review and meta-analysis

Kwizera, R.; Musaazi, J.; Meya, D.B.; et al. PLOS ONE, which is part of the Public Library of Science (PLOS) (2019) CC2

Asthma is one of the neglected diseases in Africa with a high prevalence. Allergic fungal diseases have been reported to complicate asthma progression and treatment outcomes. However, data about fungal asthma and its associated complications are limited in Africa. We aimed to estimate the burden of ... more

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

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

The missing link: Rethinking and reprioritizing HIV and gender-based violence in fragile settings

UNAIDS (2024) CC

This report explores the extent to which evidence, policy, normative guidance and commitments on HIV and gender-based violence, and their interlinkages, is being translated into action on the ground in fragile settings. These issues are explored through the lens of training of peace support operatio... more

Recomendações para o manejo da asma da Sociedade Brasileira de Pneumologia e Tisiologia – 2020

Menezes Pizzichini, M. M.; de Carvalho-Pinto, R. M.; Delfini Cançado, J. E.; et al. (2020) CC2

The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... more

Addressing gender inequalities in national action plans on antimicrobial resistance

World Health Organisation (WHO) (2024) C_WHO

National action plans on antimicrobial resistance (AMR) often overlook the critical intersection of gender, despite evidence that exposure and susceptibility to infection, health-seeking behaviours, as well as antimicrobial prescribing and use patterns are all influenced by gender.