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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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The Global Burden of Disease Study at 30 years

Murray, C.J.L. nature medicine (2022) CC

The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases... more

The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health

Vaduganathan, M.; Mensah, G.A.; Turco, J.V. et al. Journal of the American College of Cardiology (2022) CC

Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 a... 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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Global Fund Board discusses the lessons learned from the Seventh Replenishment and the action plan for the Eighth Replenishment

Independent Observer of Global Fund Aidspan (2023) CC

The Global Fund’s Board meeting on 14-16 November 2023 was its 50th; and among the many issues for information was on resource mobilization. The Board document provided an update on the status of the conversion of pledges and the signing of donor agreements. In addition, it presented the results... more

Engaging the private sector in delivering quality maternal, newborn and child health services

World Health Organization WHO (2024) C_WHO

The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing seg... more

Medicines for HIV, viral hepatitis and sexually transmitted infections in low- and middle- income countries: forecasts of global demand for 2022–2026

World Health Organization WHO (2024) C_WHO

For the global community to be able to achieve ambitious targets relating to the prevention and treatment of HIV, viral hepatitis and sexually transmitted infections (STIs), multiple types of medicines must be widely accessible to all affected populations in all countries. The purpose of this rep... more

Burden of diabetes mellitus type 2 and its risk factors in Asia from 1990 to 2019: Updates from the 2019 Global Burden of Disease study

Khazaei, Z.; Momenabadi, V.; Badrizadeh, A.; et al. Research Square (2023) CC

The mounting burden of type 2 diabetes is a major concern in healthcare systems worldwide. The purpose of this study is to investigate the trend of type 2 diabetes from 1990 to 2019 in Asia.

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

Hypertension - Screening, Diagnosis, Assessment, and Management of Primary Hypertension in Adultd in India

Ministry of Health & Family Welfare India Government of India (2017) CC

Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven ... more

Type 2 diabetes in adults: choosing medicines

National Institute for Health and Care Excellence (2022) CC2

Factors to take into account when choosing, reviewing and changing medicines. Rescue therapy: For symptomatic hyperglycaemia, consider insulin or a sulfonylurea and review when blood glucose control has been achieved. Diet and lifestyle advice: At each point reinforce advice about diet and life... more

Air pollution exposure—the (in)visible risk factor for respiratory diseases

Bălă, G.P.; Râjnoveanu, R.M.; Tudorache, E. et al. Environmental Science and Pollution Research (2021) CC

There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... more

Guidelines for the prevention, management and care of diabetes mellitus

World Health Organization WHO (2006) C_WHO

Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of ... more

Interim Guidlines for the clinical management of diabetes in Jamaica

Ministry of Health and Wellness (2020) CC2

Diabetes mellitus, also called diabetes, is a chronic metabolic condition in which the hormone insulin is not produced by the pancreas in sufficient quantities or is not utilized effectively by the body to control blood glucose levels. As a result, blood glucose levels are abnormally high (hypergl... 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

Guidance on the use of mpox vaccines. Revised edition

Pan American Health Organisation PAHO (2024) CC

Smallpox eradication was certified in 1980. Mpox has been endemic in Central and West African countries since it was first detected in 1958 . It is a zoonosis; cases are often found close to tropical rainforests where various animals carry the orthopoxvirus that causes the disease. In endemic countr... more

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

Moving to a strong(er) community health system: analysing the role of community health volunteers in the new national community health strategy in Malawi

Angwenyi, V.; Aantjes, C.; Kondowe, K. et al. BMJ Global Health (2018) CC

Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue... more

Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan

Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al. International Journal for Equity in Health (2021) CC

Background Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Met... more