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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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Quality of stroke guidelines in low- and middle-income countries: a systematic review

Yaria, J.; Gil, A.; Makanjuola, A. et al. Bulletin of the World Health Organization (2021) C_WHO

Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries. Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations. Co... more

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Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors

Budreviciute, A.; Damiati, S.; Khdr Sabir, D. et al. (2020) CC

Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified into the categories of self-management, genetic factors, environmental factors, factors of medical co... 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

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

Global report on diabetes World Health Organization 2016

World Health Organization WHO (2016) C_WHO

Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood sugar, or glucose), or when the body cannot effectively use the insulin it produces. Diabetes is an important public health problem, one of four priority noncom... 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

Violence against women 60 years and older: Data availability, methodological issues, and recommendations for good practice

UN Women (2024) CC

This briefing note summarizes work undertaken by UN Women and WHO to inform the development of a module on violence against women 60 years and older that can be included in dedicated surveys on violence against women. It provides an overview of the challenges in the availability, measurement, and co... more

Global Report on Diabetes World Health Organization 2016 1. Diabetes Mellitus – epidemiology. 2. Diabetes Mellitus – prevention and control. 3. Diabetes, Gestational. 4. Chronic Disease.

World Health Organization WHO (2016) C_WHO

The document "Global Report on Diabetes" by the World Health Organization (WHO) provides an in-depth analysis of diabetes as a global health challenge. It covers the rising prevalence of the disease, the associated risk factors, and the increasing burden on healthcare systems, particularly in low- a... more

Global report on diabetes 1. Diabetes Mellitus – epidemiology. 2. Diabetes Mellitus – prevention and control. 3. Diabetes, Gestational. 4. Chronic Disease

World Health Organization WHO (2016) C_WHO

Population and Individual Approach to the Prevention and Management of Diabetes and Obesity

Pan American Health Organization PAHO (2011) C_WHO

The Resolution Population and Individual Approaches to the Prevention and Management of Diabetes and Obesity was approved by the 48th Directing Council of the Pan American Health Organization, September 29- October 3, 2008, in response to the epidemic of obesity and diabetes currently affecting the ... more

1 Global Heart & Circulatory Diseases Factsheet

British Heart Foundation (2024) CC

Heart and circulatory diseases is an umbrella term for all diseases of the heart and circulation. It includes everything from conditions that are inherited or that a person is born with, to those that develop later, such as coronary heart disease, atrial fibrillation, heart failure, stroke and vascu... 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

South American guidelines for cardiovascular disease prevention and rehabilitation

Herdy, A.H.; López-Jiménez, F.; Terzic, C.P. et al. Arquivos Brasileiros de Cardiologia (2014) CC

In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR). In the context of the imple... more

Diabetes prevention, screening and management

International Pharmaceutical Federation (2021) CC2

Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 202... more

MEPs Mobilising for Diabetes Blueprint for Action on Diabetes in the European Union by 2030

MEPs Mobilising for Diabetes (2021) CC2

Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people with diabetes (PwD), notably reducing the daily burden of its management. Newer technologies, including those driven by artificial intelligence, have the potentia... more

DIRECTIVES POUR LA PRISE EN CHARGE DES ENFANTS AYANT SUBI DES VIOLENCES SEXUELLES

UN Children's Fund UNICEF (2024) CC

Produced by UNICEF and IRC, with the support of the German Corporation for International Cooperation GmbH (GIZ) and the generous funding from the German Federal Ministry of Economic Cooperation and Development (BMZ), the Caring for Child Survivors of Sexual Abuse (CCS) Resource Package (Second Editi... 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

Population and Individual Approaches to the Prevention and Management of Diabetes and Obesity

Pan American Health Organization PAHO (2011) C_WHO

Obesity and diabetes are affecting the peoples of the Americas at high and increasing rates. National surveys demonstrate that obesity is increasing in prevalence among all age groups; 7% to 12% of children under 5 years old and one-fi fth of adolescents are obese, while rates of overweight and obe... more