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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
The article explores the underlying factors influencing unhealthy diets and sedentary lifestyles among adolescents in Kilifi County, Kenya. Using a qualitative approach, the study involved interviews and focus group discussions with adolescents, stakeholders, and young adults. Key findings include a
...
preference for unhealthy, carbohydrate-rich, and sugary foods over traditional and nutritious options, exacerbated by factors like low socioeconomic status, urbanization, and poor farming practices.
Sedentary behavior, such as gambling and extensive technology use, was prevalent, often replacing physical activity. Protective factors like school attendance, community-based services, and parental engagement were identified as mitigating risks. The study highlights the importance of ecological intervention strategies targeting intrapersonal, interpersonal, and community factors to address unhealthy behaviors and promote better health outcomes in adolescents.
more
Action Plan for Implementation of Recommendations from the Evaluation of PAHO's Response to COVID-19
An external team evaluated PAHO’s response to COVID-19 to provide an independent assessment of the Pan American Sanitary Bureau’s (PASB) performance regarding preparedness for and response to the COVID-19 pandemic. The evaluations’ final report culminates with eight recommendations for actions
...
to future response to health emergencies. The final report of EPRC culminates with eight evidence-based recommendations of actions to strengthen future pandemic responses, while building a resilient recovery in the Region. The recommendations by the external team focus on PAHO’s governance and management, on specialized regional mechanisms, diversified funding models, and use of new technologies, among others.
more
Diabetes is an increasingly prevalent yet under-recognised health crisis in Africa, driven by demographic and socioeconomic transitions. In 2021, 24 million adults in the region were living with diabetes, and this figure is expected to increase by 1
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29% by 2045.
more
Effective surveillance and monitoring of noncommunicable diseases (NCDs) and their risk factors are essential for informing evidence-based public health policies, addressing health inequities, and e
...
nsuring progress toward global and regional targets. By tracking trends in NCDs, their modifiable risk factors such as tobacco use, unhealthy diets, physical inactivity, harmful use of alcohol, and air pollution, along with biological risk factors such as overweight and obesity, high blood pressure (hypertension), and elevated blood glucose (diabetes), policymakers can identify emerging threats, target vulnerable populations, allocating resources efficiently. Reliable data also enable countries to evaluate interventions, adjust policies, and strengthen health systems to reduce the burden of NCDs.
more
The guide helps patients to understand their rights in relation to the care received and provides insights into the common legal and
human rights issues they may encounter, and encourages them to share these with the health care provider for su
...
pport. This booklet covers key issues that you might need to understand about ethical care, human rights and legal aspects. It aims to help people with serious illness as they face these issues, and give them guidance on how they can find solutions.
more
The goal of producing these Standard Operating Procedures (SOPs) was therefore targeted at fostering standardization across all levels of care to ensure HIV viral load monitoring remains a basic right offered to all people living with HIV (PLHIV) on lifelong antiretroviral therapy (ART) regardless o
...
f their location and place where they are accessing care.
These SOPs are designed to provide practical information to healthcare providers. They must be considered as supplementary and secondary to all guidelines issued by the MOH, including the Malawi Clinical Management of HIV in Children and Adults Guidelines and the Malawi HIV Testing Services (HTS) Guidelines.
more
Family planning: a global handbook for providers
recommended
4th edition 2022 of the Handbook includes new WHO recommendations that expand contraceptive choices. Also, guidance on starting ongoing contraception following emergency contraception is provided.
Drawing on lessons from recent outbreaks, this new edition details tangible me
...
asures for frontline health workers to protect access to family planning services during emergencies, such as wider access to self-administered contraceptives and the use of digital technologies by providers. It also expands guidance for women and young people at high risk of HIV.
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SITUATION ANALYSIS AND RECOMMENDATIONS
Globally, approximately 56.8 million people are in need of palliative care
services; 78% of them living in low and middle-income country yet only
about 12% have their needs being met causing great suffering for many.
Recommendations on the initiation and continuing use of nine common types of contraceptive methods are covered by the tool. In addition to looking at individual medical conditions or characteristics, users may also easily combine multiple conditions or characteristics and view the guidance on each c
...
ondition separately or in combination.
more
Globally, the cancer burden is rising, exerting significant strain on
populations and health systems at all levels of income. There are
concerted efforts towards enhancing access to comprehensive
cancer prevention and control initiatives.
In the mid-1980s, recognizing the limitations of traditional training and that the knowledge and skills acquired are not necessarily applied back in the workplace, MSH developed the Monitoring‐Training-Planning (MTP) approach to assist the Ecuadorian Ministry of
...
Health to implement its Child Survival Program. Using the MTP approach, staff me
mbers learn to mobilize their own resources and to improve, incrementally, the management of medicines and other pharmaceuticals at their own facility.
more
