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Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 39787

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Special Issue Editors

Dr. Tracy Kolbe-Alexander

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Guest Editor

School of Health and Wellbeing, University of Southern Queensland, West St, Darling Heights QLD 4350, Аustralia

Dr. Gregore Iven Mielke

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Guest Editor

School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia QLD 4067, Australia

Special Issue Information

Dear Colleagues,

Although 85% of premature deaths caused by non-communicable diseases (NCDs) occur in low-middle income countries, most of the current knowledge about lifestyle behaviors and prevention of NCDs is still generated in studies conducted in high-income countries. Improving understanding of the role of healthy lifestyle behaviors (physical activity, sedentary behavior, sleep and diet) in the prevention and treatment of NCDs in LMIC is urged, albeit challenging. In LMIC, infectious diseases and injuries still account for much of the health burden, and lifestyle behavior research may not be a priority. Additionally, some LMICs are constantly threatened by humanitarian crises, economic and sociopolitical instability, with a substantial proportion of the population facing underemployment and informal housing, important macro determinants of behaviors.

Authors are invited to submit systematic reviews/meta-analyses and original studies including novel and innovative research that focus on surveillance, determinants, health consequences and interventions addressing healthy lifestyle behaviors (including physical activity, sedentary behavior, sleep and diet) to reduce the risk of non-communicable diseases and improve wellbeing in low- and middle-income countries.

Dr. Tracy Kolbe-Alexander
Dr. Gregore Iven Mielke
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

non-communicable disease
low-middle-income countries
physical activity
sedentary behaviour
diet
sleep

Published Papers (14 papers)

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Research

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17 pages, 1547 KiB

Open AccessArticle

An Evaluation of Community Health Workers’ Knowledge, Attitude and Personal Lifestyle Behaviour in Non-Communicable Disease Health Promotion and Their Association with Self-Efficacy and NCD-Risk Perception

by Melaku Kindie Yenit, Tracy L. Kolbe-Alexander, Kassahun Alemu Gelaye, Lemma Derseh Gezie, Getayeneh Antehunegn Tesema, Solomon Mekonnen Abebe, Telake Azale, Kegnie Shitu and Prajwal Gyawali

Int. J. Environ. Res. Public Health 2023, 20(9), 5642; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20095642 - 25 Apr 2023

Viewed by 2980

Abstract

Community health workers, also known as health extension workers (HEWs), play an important role in health promotion. This study evaluates HEWs’ knowledge, attitude, and self-efficacy for non-communicable diseases (NCD) health promotion. HEWs (n = 203) completed a structured questionnaire on knowledge, attitude, behaviour, self-efficacy and NCD risk perception. Regression analysis was used to determine the association between self-efficacy and NCD risk perception with knowledge (high, medium, low), attitude (favourable/unfavourable) and physical activity (sufficient/insufficient). HEWs with higher self-efficacy were more likely to have high NCD knowledge (AOR: 2.21; 95% CI: 1.21. 4.07), favourable attitude towards NCD health promotion (AOR: 6.27; 95% CI: 3.11. 12.61) and were more physically active (AOR: 2.27; 95% CI: 1.08. 4.74) than those with lower self-efficacy. HEWs with higher NCD susceptibility (AOR: 1.89; 95% CI: 1.04. 3.47) and perceived severity (AOR: 2.69; 95% CI: 1.46, 4.93) had higher odds of NCD knowledge than their counterparts. Moreover, sufficient physical activity was influenced by HEWs’ perceived NCD susceptibility and perceived benefits of lifestyle change. Therefore, HEWs need to adopt healthy lifestyle choices to become effective role models for the community. Our findings highlight the need to include a healthy lifestyle when training HEWs, which might increase self-efficacy for NCD health promotion. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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17 pages, 592 KiB

Open AccessArticle

The Feasibility of a Text-Messaging Intervention Promoting Physical Activity in Shift Workers: A Process Evaluation

by Malebogo Monnaatsie, Stuart J. H. Biddle and Tracy Kolbe-Alexander

Int. J. Environ. Res. Public Health 2023, 20(4), 3260; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20043260 - 13 Feb 2023

Cited by 1 | Viewed by 1809

Abstract

Workplace health promotion programs (WHPPs) can improve shift workers’ physical activity. The purpose of this paper is to present the process evaluation of a text messaging health promotion intervention for mining shift workers during a 24-day shift cycle. Data collected from intervention participants with a logbook (n = 25) throughout the intervention, exit interviews (n = 7) and online surveys (n = 17) examined the WHPP using the RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) framework. The program reached 66% of workers across three departments, with 15% of participants dropping out. The program showed the potential to be adopted if the recruitment strategies are improved to reach more employees, especially when involving work managers for recruitment. A few changes were made to the program, and participant adherence was high. Facilitators to adopt and implement the health promotion program included the use of text messaging to improve physical activity, feedback on behaviour, and providing incentives. Work-related fatigue was reported as a barrier to implementing the program. Participants reported that they would recommend the program to other workers and use the Mi fitness band to continue monitoring and improving their health behaviour. This study showed that shift workers were optimistic about health promotion. Allowing for long-term evaluation and involving the company management to determine scale-up should be considered for future programs. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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24 pages, 941 KiB

Open AccessArticle

If You Build It Will They Come? Park Upgrades, Park Use and Park-Based Physical Activity in Urban Cape Town, South Africa—The SUN Study

by Clare A. Bartels, Estelle V. Lambert, Marié E. M. Young and Tracy Kolbe-Alexander

Int. J. Environ. Res. Public Health 2023, 20(3), 2574; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20032574 - 31 Jan 2023

Cited by 2 | Viewed by 1801

Abstract

The development and upgrade of recreational public spaces are key government strategies to increase opportunities for physical activity (PA) and enhance social interaction and community cohesion. This study aimed to evaluate differences in park use and park-based PA in recently upgraded/developed parks (intervention, n = 4) against established parks (control, n = 4) and in regional parks in high- and low-income settings (n = 2). Additionally, associations between target area features, park use and PA were identified. Direct observation of park use and attributes was conducted using the System for Observing Play and Recreation in Communities (SOPARC) over four months. Despite more park users in intervention parks (2519 vs. 1432), control park visitors were 48% more likely to be engaged in PA (p < 0.001). Similarly, while high-income park users attracted more visitors (2135 vs. 1111), they were 79% less likely to be engaged in any PA compared with low-income park visitors. The likelihood of both use of and PA by gender and age differed by features. Active recreation features in intervention parks attracted more users than the same features in control parks. In this study, upgraded or newly developed parks attracted more visitors but not necessarily overall greater levels of physical activity. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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15 pages, 2034 KiB

Open AccessArticle

Use of an Elevated Avenue for Leisure-Time Physical Activity by Adults from Downtown São Paulo, Brazil

by Eduardo Quieroti Rodrigues, Leandro Martin Totaro Garcia, Evelyn Helena Corgosinho Ribeiro, Ligia Vizeu Barrozo, Regina Tomie Ivata Bernal, Douglas Roque Andrade, João Paulo dos Anjos Souza Barbosa, Ana Paula de Oliveira Barbosa Nunes, Rogério César Fermino and Alex Antonio Florindo

Int. J. Environ. Res. Public Health 2022, 19(9), 5581; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095581 - 04 May 2022

Cited by 2 | Viewed by 1921

Abstract

Leisure-time physical activity (LTPA) is associated with access and use of public open spaces. The President João Goulart Elevated Avenue, currently denominated Minhocão, is a facility for leisure activities that is open for people during the night and weekends. The aim of this study was to examine if the prevalence of LTPA among individuals living in the surroundings of Minhocão is different according to proximity to, and use of, the facility. We conducted a cross-sectional study with cluster sampling with people aged ≥18 years who lived in households up to 500 m, and between 501 m and 1500 m of Minhocão. The survey was conducted between December 2017 and March 2019 using an electronic questionnaire. We conducted a bivariate analysis and Poisson regression to examine possible differences in LTPA according to the proximity of residences and use of Minhocão. The analysis used post-stratification weights. A total of 12,030 telephone numbers of people were drawn (≤500 m = 6942; and >500 m to ≤1500 m = 5088). The final sample included 235 residents who returned the questionnaires. There was a higher prevalence of individuals engaging in at least 150 min per week of LTPA among users than non-users (Prevalence Ratio = 2.19, IC95% 1.66 to 2.90), independently of sex, age, education, the distance of houses to nearest accesses and number of barriers. The main five barriers related to the usage of the Minhocão were safety issues in and around the Minhocão, rainy weather, lack of vegetation, and lack of facilities. People who used the park had higher prevalence of all types of LTPA than non-users. The results can serve to inform government decision-making on the future of Minhocão. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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12 pages, 642 KiB

Open AccessArticle

Determinants of Physical Activity and Dietary Habits among Adults in Ghana: A Cross-Sectional Study

by Kingsley Agyemang, Amrit Banstola, Subhash Pokhrel and Nana Anokye

Int. J. Environ. Res. Public Health 2022, 19(8), 4671; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084671 - 13 Apr 2022

Cited by 3 | Viewed by 4068

Abstract

A critical understanding of the interrelationship between two behavioral decisions—participating in physical activity, and eating healthily—is lacking in Ghana. This study aimed to determine which factors affect each of the two behavioral decisions, jointly and separately, among adults aged 18 years or older in three metropolises (Kumasi, Accra, and Tamale) of Ghana. The data from the Ghana Obesity Survey 2021 were used. A bivariate probit model was fitted to estimate nonlinear models that indicate an individual’s joint decision to participate in physical activity and consume a healthy diet. A positive correlation (r = 0.085; p < 0.05) was found between these two decisions, indicating a relationship between these two behavioral decisions. The common correlates between these decisions were self-reported good health status, high income, and attitudes toward being overweight. Men were more likely to be physically active but less likely to eat well. Both religion and culture determined participation in physical activity, but not the consumption of a healthy diet. Marital status determined diet, but not physical activity. The new knowledge gained from this analysis around the nature and the extent of the interconnectedness between physical activity and diet is critical to devising targeted interventions for obesity prevention in Ghana. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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20 pages, 1609 KiB

Open AccessArticle

Three Growth Spurts in Global Physical Activity Policies between 2000 and 2019: A Policy Document Analysis

by Trish Muzenda, Maylene Shung-King, Estelle Victoria Lambert, Anna Brugulat Panés, Amy Weimann, Nicole McCreedy, Lambed Tatah, Clarisse Mapa-Tassou, Ishtar Govia, Vincent Were and Tolu Oni

Int. J. Environ. Res. Public Health 2022, 19(7), 3819; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19073819 - 23 Mar 2022

Cited by 3 | Viewed by 2819

Abstract

Non-communicable diseases (NCDs) contribute significantly to global mortality and are of particular concern in growing urban populations of low- and-middle income countries (LMICs). Physical inactivity is a key NCD determinant and requires urgent addressing. Laudable global and regional efforts to promote physical activity are being made, but the links between physical activity (PA), NCD reduction, and integrated intersectoral approaches to reducing obesogenic environments are not consistently made. This study applied a document analysis approach to global PA and NCD policies to better understand the current global policy environment and how this may facilitate integrated PA promotion. A total of 34 global policies related to PA, from different sectors, were analyzed. PA policy in mitigation of NCDs has evolved exponentially, with a progression towards addressing structural determinants alongside individual behavior change. The global PA agenda is primarily driven by the World Health Organization. Intersectoral collaboration is importantly regarded, but the contributions of other sectors, outside of health, education, transport, and urban planning, are less clear. Improving PA among key sub-populations—women, girls, and adolescents—requires greater policy consideration. It is imperative for PA-relevant sectors at all levels to recognize the links with NCDs and work towards integrated policy and practice in mitigation of the rising NCD pandemic. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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16 pages, 639 KiB

Open AccessArticle

Exercise Intervention Changes the Perceptions and Knowledge of Non-Communicable Disease Risk Factors among Women from a Low-Resourced Setting

by Sweetness Jabulile Makamu-Beteck, Sarah Johannah Moss, Francois Gerald Watson and Melainie Cameron

Int. J. Environ. Res. Public Health 2022, 19(6), 3474; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063474 - 15 Mar 2022

Cited by 1 | Viewed by 2244

Abstract

We employed the Health Belief Model (HBM) as a theoretical lens to explore the influence of an exercise intervention on the perceptions and knowledge of modifiable risk factors for non-communicable diseases (NCDs) among women from a low-resource setting in South Africa. We used a mixed-methods design, gathering qualitative and quantitative data at baseline (n = 95) and again after 12 weeks (n = 55) and 24 weeks (n = 44) of an exercise intervention. Qualitative data consisted of focus group discussions exploring the knowledge and perceptions of modifiable risk factors for NCDs at the three time points. We collected quantitative measurements of modifiable risk factors for NCDs (waist-to-hip ratio, body mass index, blood pressure, peripheral blood glucose, and cholesterol) as well as objective physical activity (PA) data over seven consecutive days. Surveys on coronary heart disease and PA knowledge were conducted at all three time points. Qualitative findings indicated that health exposures and cultural traditions influenced the participant’s perceptions about PA and NCDs. Waist circumference significantly decreased at 12 weeks compared to baseline MD = 4.16, p < 0.001. There was significant improvement at 12 weeks, compared to baseline, MD = 0.59, p = 0.009 for PA knowledge, and MD = 0.68, p = 0.003 for heart disease knowledge. There were reductions from baseline to 24 weeks in diastolic blood pressure (MD = 4.97, p = 0.045), waist circumference (MD = 2.85, p = 0.023) and BMI (MD = 0.82, p = 0.004). Significant heart disease knowledge improvements were found at 24 weeks compared to baseline (MD = 0.75, p < 0.001). Supervised exercise positively influenced Black African females′ health behaviours by understanding cultural perceptions of modifiable risk factors for NCDs. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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15 pages, 1351 KiB

Open AccessArticle

Mediterranean Diet Adherence and Nutritional Status in Dalmatian Diabetic Hypertensive Patients Regarding Presence of Chronic Kidney Disease—Is There Any Difference?

by Dora Bučan Nenadić, Josipa Radić, Ela Kolak, Marijana Vučković, Ivana Novak, Marija Selak and Mislav Radić

Int. J. Environ. Res. Public Health 2022, 19(4), 2293; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19042293 - 17 Feb 2022

Cited by 1 | Viewed by 2059

Abstract

In recent years, the Mediterranean diet has emerged as one of the dietary patterns that could have positive effects on overall health as well in the treatment of non-communicable chronic diseases. The aim of this cross-sectional study was to determine differences in adherence to the Mediterranean diet (MeDi) and nutritional status in patients with type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) regarding the presence of chronic kidney disease (CKD). Two hundred and forty-eight Dalmatian diabetic hypertensive patients (DDHP) were included, and 164 (66.1%) of them had CKD. Data about anthropometric parameters, clinical and laboratory parameters, as well as lifestyle questionnaire and Mediterranean Diet Serving Score (MDSS) were collected for each study participant. Furthermore, body composition was assessed using MC-780 Multi Frequency Segmental Body Mass Analyzer (Tanita). Body mass index (BMI) as well as waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Results showed that only 8.9% of DDHP were adherent to the MeDi without significant differences regarding the presence of CKD. Therefore, only 9.1% of participants with CKD were adherent to the MeDi. Dietary recommendations were received by 52.8% of DDHP and 49.4% with CKD, while only 12.8% of those with CKD were adherent to the given recommendations. The results showed that 88.3% of DDHP and 87.8% of the DDHP with CKD were overweight or obese. Statically significant lower frequency of nut intake suggested by the MeDi was found in those participants with CKD (p = 0.02). Therefore, the significant associations between adherence to each MeDi component as well as MDSS score with the development of CKD among all study subjects were not found. In conclusion, the results showed a low level of nutritional care in our region and low adherence to MeDi among DDHP. According to the results, there is an urgent need to improve nutritional care in our region, with a special focus on the MeDi for this especially vulnerable population of patients. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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18 pages, 1105 KiB

Open AccessArticle

Analysis of Cameroon’s Sectoral Policies on Physical Activity for Noncommunicable Disease Prevention

by Lambed Tatah, Clarisse Mapa-Tassou, Maylene Shung-King, Tolu Oni, James Woodcock, Amy Weimann, Nicole McCreedy, Trish Muzenda, Ishtar Govia, Jean Claude Mbanya and Felix Assah

Int. J. Environ. Res. Public Health 2021, 18(23), 12713; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312713 - 02 Dec 2021

Cited by 6 | Viewed by 2826

Abstract

Physical inactivity is increasing in low- and middle-income countries (LMICs), where noncommunicable diseases (NCDs), urbanisation and sedentary living are rapidly growing in tandem. Increasing active living requires the participation of multiple sectors, yet it is unclear whether physical activity (PA)-relevant sectors in LMICs are prioritising PA. We investigated to what extent sectors that influence PA explicitly integrate it in their policies in an LMIC such as Cameroon. We systematically identified policy documents relevant to PA and NCD prevention in Cameroon; and using the Walt and Gilson policy triangle we described, analysed, and interpreted the policy contexts, contents, processes, and actors. We found 17 PA and NCD policy documents spanning from 1974 to 2019 across seven ministries. Thirteen (13/17) policies targeted infrastructure improvement, and four (4/17) targeted communication for behaviour change, all aiming to enhance leisure domain PA. Only the health sector explicitly acknowledged the role of PA in NCD prevention. Notably, no policy from the transport sector mentioned PA. Our findings highlight the need for intersectoral action to integrate PA into policies in all relevant sectors. These actions will need to encompass the breadth of PA domains, including transport, while emphasising the multiple health benefits of PA for the population. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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17 pages, 1526 KiB

Open AccessArticle

Intersectoral Action for Addressing NCDs through the Food Environment: An Analysis of NCD Framing in Global Policies and Its Relevance for the African Context

by Amy Weimann, Maylene Shung-King, Nicole McCreedy, Lambed Tatah, Clarisse Mapa-Tassou, Trish Muzenda, Ishtar Govia, Vincent Were and Tolu Oni

Int. J. Environ. Res. Public Health 2021, 18(21), 11246; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111246 - 26 Oct 2021

Viewed by 3205

Abstract

Noncommunicable diseases contribute the greatest to global mortality. Unhealthy diet—a prominent risk factor—is intricately linked to urban built and food environments and requires intersectoral efforts to address. Framings of the noncommunicable disease problem and proposed solutions within global and African regional diet-related policy documents can reveal how amenable the policy landscape is for supporting intersectoral action for health in low-income to middle-income countries. This study applied a document analysis approach to undertake policy analysis on global and African regional policies related to noncommunicable disease and diet. A total of 62 global and 29 African regional policy documents were analysed. Three problem frames relating to noncommunicable disease and diet were identified at the global and regional level, namely evidence-based, development, and socioeconomic frames. Health promotion, intersectoral and multisectoral action, and evidence-based monitoring and assessment underpinned proposed interventions to improve education and awareness, support structural changes, and improve disease surveillance and monitoring. African policies insufficiently considered associations between food security and noncommunicable disease. In order to effectively address the noncommunicable disease burden, a paradigm shift from ‘health for development’ to ‘development for health’ is required across non-health sectors. Noncommunicable disease considerations should be included within African food security agendas, using malnutrition as a possible intermediary concept to motivate intersectoral action to improve access to nutritious food in African low-income to middle-income countries. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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14 pages, 335 KiB

Open AccessArticle

Gender-Specific Prevalence of Risk Factors for Non-Communicable Diseases by Health Service Use among Schoolteachers in Afghanistan

by Sharifullah Alemi, Keiko Nakamura, Ahmad Shekib Arab, Mohammad Omar Mashal, Yuri Tashiro, Kaoruko Seino and Shafiqullah Hemat

Int. J. Environ. Res. Public Health 2021, 18(11), 5729; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115729 - 26 May 2021

Cited by 4 | Viewed by 3690

Abstract

Objectives of this study were: (1) to examine gender differences in biomedical indicators, lifestyle behaviors, self-health check practices, receipt of professional non-communicable disease (NCD)-related lifestyle advice, and the use of health services among teachers in Afghanistan; and (2) to seek the patterns of these indicators among users and non-users of health services among both male and female teachers. This cross-sectional study was carried out among 600 schoolteachers in Kabul city in February 2017. Gender differences in percentage distributions of abnormal biomedical indicators, lifestyle behaviors, self-health check practices, and receipt of professional lifestyle advice were examined. These patterns were further analyzed according to the use of health services in the previous 12 months by both genders. The results showed that male teachers had a higher prevalence of hypertension, increased serum triglycerides, physically active lifestyle, and tobacco use than female teachers (28.2/20.4, p = 0.038; 47.0/37.9, p = 0.040; 54.3/40.9, p = 0.002; 15.8/0.7, p < 0.001, respectively); female teachers had a higher prevalence of increased serum LDL cholesterol, overweight/obesity, and frequent consumption of fruits/vegetables than male teachers (61.3/50.8, p = 0.018; 64.7/43.5, p < 0.001; 71.4/53.8, p < 0.001, respectively). Female teachers were more likely to receive professional lifestyle advice related to NCDs than male teachers. Although users of health services practiced self-health checks and received professional lifestyle advice more frequently than non-users, abnormal biomedical indicators were similarly shown among users and non-users of health services in both genders. In conclusion, high prevalence of abnormal biomedical indicators was indicated in both male and female teachers, although the specific abnormal biomedical indicators differed by gender. Users and non-users of health services presented a similar prevalence of these abnormal indicators. Understanding the differences in patterns of NCD risk factors is essential when developing gender-informed policies. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

Review

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22 pages, 1529 KiB

Open AccessReview

Ghana’s Adherence to PASCAR’s 10-Point Action Plan towards Hypertension Control: A Scoping Review

by Francis Sambah, Bunmi S. Malau-Aduli, Abdul-Aziz Seidu, Aduli E. O. Malau-Aduli and Theophilus I. Emeto

Int. J. Environ. Res. Public Health 2023, 20(2), 1425; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20021425 - 12 Jan 2023

Viewed by 1957

Abstract

The continuous increase in the prevalence of hypertension in Ghana has led to various interventions aimed at controlling the disease burden. Nonetheless, these interventions have yielded poor health outcomes. Subsequently, the Pan-African Society of Cardiology (PASCAR), established a 10-point action plan for inclusion in policies to aid control of hypertension. This scoping review assessed the adherence of health policies to the 10-point action plan towards hypertension control/reduction in Ghana. Eight health policies met the inclusion criteria and were assessed. The programme evaluation and policy design framework were used for synthesis and analysis of extracted data. Overall, there was poor adherence to hypertension control observed in the policies. Specifically, there were low levels of integrating hypertension control/reduction measures, a poor task-sharing approach, and poor financial resource allocations to tackle hypertension control/reduction in most of the policies. There was also low support for research to produce evidence to guide future interventions. For Ghana to achieve the global target of reducing hypertension by the year 2025, its health policies must adhere to evidence-based interventions in hypertension management/control. The study recommends a follow-up study among hypertension patients and healthcare professionals to evaluate the factors militating against hypertension management/control in Ghana. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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19 pages, 972 KiB

Open AccessReview

Reducing Sugar Intake in South Africa: Learnings from a Multilevel Policy Analysis on Diet and Noncommunicable Disease Prevention

by Nicole McCreedy, Maylene Shung-King, Amy Weimann, Lambed Tatah, Clarisse Mapa-Tassou, Trish Muzenda, Ishtar Govia, Vincent Were and Tolu Oni

Int. J. Environ. Res. Public Health 2022, 19(18), 11828; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191811828 - 19 Sep 2022

Cited by 1 | Viewed by 3054

Abstract

High sugar intake contributes to diet-related excess weight and obesity and is a key determinant for noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The World Health Organization (WHO) gives specific advice on limiting sugar intake in adults and children. Yet, to what extent have policy ideas on sugar intake reduction originating at the global level found expression at lower levels of policymaking? A systematic policy document analysis identified policies issued at the African regional, South African national and Western Cape provincial levels between 2000 and 2020 using search terms related to sugar, sugar-sweetened beverages (SSBs), and NCDs. Forty-eight policy documents were included in the review, most were global and national policies and thus the focus of analysis. A policy transfer conceptual framework was applied. Global recommendations for effectively tackling unhealthy diets and NCDs advise implementing a mix of cost-effective policy options that employ a multisectoral approach. South African country-level policy action has followed the explicit global guidance, and ideas on reducing sugar intake have found expression in sectors outside of health, to a limited extent. As proposed in this paper, with the adoption of the SSB health tax and other policy measures, South Africa’s experience offers several learnings for other LMICs. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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Other

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13 pages, 5689 KiB

Open AccessStudy Protocol

Protocol for a Multi-Level Policy Analysis of Non-Communicable Disease Determinants of Diet and Physical Activity: Implications for Low- and Middle-Income Countries in Africa and the Caribbean

by Maylene Shung-King, Amy Weimann, Nicole McCreedy, Lambed Tatah, Clarisse Mapa-Tassou, Trish Muzenda, Ishtar Govia, Vincent Were and Tolu Oni

Int. J. Environ. Res. Public Health 2021, 18(24), 13061; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182413061 - 10 Dec 2021

Cited by 3 | Viewed by 3387

Abstract

Non-communicable diseases (NCDs) are the leading cause of death globally. Despite significant global policy development for addressing NCDs, the extent to which global policies find expression in low-and-middle income countries’ (LMIC) policies, designed to mitigate against NCDs, is unclear. This protocol is part of a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of NCDs in LMICs, with a specific focus on Kenya, Cameroon, South Africa and Jamaica. This paper outlines the protocol for a study that seeks to explore the current policy environment in relation to the reduction of key factors influencing the growing epidemic of NCDs. The study proposes to examine policies at the global, regional and country level, related to the reduction of sugar and salt intake, and the promotion of physical activity (as one dimension of healthy placemaking). The overall study will comprise several sub-studies conducted at a global, regional and country level in Cameroon, Kenya and South Africa. In combination with evidence generated from other GDAR workstreams, results from the policy analyses will contribute to identifying opportunities for action in the reduction of NCDs in LMICs. Full article

(This article belongs to the Special Issue Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries)

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Non-communicable Diseases and Healthy Lifestyle Behaviors in Low- and Middle-Income Countries

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