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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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Malawi Country Operational Plan 2021 Strategic Direction Summary May 19, 2021

U.S. President's Emergency Plan for AIDS Relief (2021) CC2

PEPFAR Malawi’s Country Operational Plan (COP) 2021 reflects a culmination of strong interagency collaboration between the PEPFAR Malawi team, Government of Malawi (GoM), and civil society organizations (CSOs) to mitigate the devastating impacts of COVID-19 and sustain progress achieved over the l... more

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Sudan - Country Refugee Response Plan (CRP) - (January - December 2021)

UN High Commissioner for Refugees UNHCR (2021) CC

Sudan has a long history of hosting refugees and asylum seekers with 991,787 individuals, 51 per cent female and 53 per cent children, expected to live in Sudan by the end of 2020.

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Policy statement and recommended actions for early detection of breast, cervical, colorectal, oral and prostate cancers in the Eastern Mediterranean Region

World Health Organization WHO; Eastern Mediterranean Region (2022) C_WHO

Policy Statement

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WHO Country Cooperation Strategy 2008-2013 Malawi

World Health Organization (2009) C_WHO

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Blueprint for a Public Health and Safety Approach to Drug Policy

Tracy Pugh, Julie Netherland, Ruth Finkelstein The New York Academy of Medicine, Drug Policy Alliance (2013) C2

"Some of the problems with our current drug policies stem from the fact that these policies have been largely bifurcated between two different and often contradictory approaches. One treats drug use as a crime that cannot be tolerated and should be punished; the other views addiction as a chronic re... more

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Policy statement and recommended actions for early detection of cervical cancer in the Eastern Mediterranean Region

World Health Organization WHO; Eastern Mediterranean Region (2022) C_WHO

Policy Statement

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Worldwide country situation analysis: response to antimicrobial resistance

World Health Organization (2015) C_WHO

A survey was conducted in countries in all six WHO regions and focused on the building blocks that are considered prerequisites to combat antimicrobial resistance: a comprehensive national plan, laboratory capacity to undertake surveillance for resistant microorganisms, access to safe, effective ant... more

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Policy brief: analysing the effectiveness of targeting under AB PM-JAY in India

World Health Organisation (WHO) (2022) C_WHO

This report presents key findings from a study on ‘assessing the effectiveness of targeting mechanisms under PMJAY’. It provides a detailed analysis of potential inclusion and exclusion errors in two select states in India (Haryana and Uttarakhand) to inform National Health Authority’s (NHA) p... more

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HIV Country Profile: 2017 - Zimbabwe

World Health Organization (WHO) (2017) C_WHO

HIV Country Intelligence - HIV Country Profiles

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Country overview: Georgia

J.D. Javakhishvili; L. Sturua; I. Kirtadze; et al. European Monitoring Centre for Drugs and Drug Addiction (2015) C2

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Policy Paper The Inclusion of Persons with Disabilities in Financing for Development

International Disability Alliance (IDA) & International Disability Development Consortium (IDDC) (2014) C1

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HIV Country Profile: 2017 - Nepal

World Health Organization (WHO) (2017) C_WHO

HIV Country Intelligence - HIV Country Profiles

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Policy statement and recommended actions for early detection of colorectal cancer in the Eastern Mediterranean Region

World Health Organization WHO; Eastern Mediterranean Region (2022) C_WHO

Policy Statement

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OCHA Policy Brief on Gendered Drivers, Risks and Impacts of Food Insecurity in the Sahel and the Horn of Africa

UN Office for the Coordination of Humanitarian Affairs (2023) CC

It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency. Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls. An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is: A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes). An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa. The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions. Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward. more