Prioritizing Physical Activity in Ethiopia

Background

The term physical activity implies any movements that require expending or energies. It is broader than exercise and fitness. Physical activity can be performed in the form of brisk walk or bike during travels, as part of work at workplace or home, and as leisure enjoyments. It can be don in the form of unstructured and structured (exercise or fitness). Physical activity does not require special equipments, clothes and shoes. It is simple, easy and do not take much time. Make it funny and a part of our daily activities. It can be done in all age categories (from womb to tomb) [1].

Why prioritize physical activity?

Physical inactivity has a great contribution on the burden of non-communicable diseases (NCDs) and premature deaths. Different reports are showing that NCDs are rising spontaneously especially in Africa. Physical inactivity is one of the major risk factors for it. Evidences showed that inactivity is ranked as the fourth major cause of premature deaths from NCDs in the world http://www.who.int/mediacentre/factsheets/fs385/en/ [1, 2]. It was recognized as pandemic [3]. In other words, physical inactivity is a problem both developed and developing countries including Ethiopia. However, physical activity is still not prioritized as we can observe from the country report card http://www.globalphysicalactivityobservatory.com/card/?country=ET [4]. Many African countries are sharing this common problem.

So, how much is needed?

The minimum amount of physical activity needed for your health is depending on your age categories as follows.

0-5 years

Some countries have physical activity recommendations for infants from this age group. For example Australia has recommended as follows:-

• Infants should engaged in 3 hours of light- to vigorous- intensity activity every day
• Infants, toddlers and pre-schoolers should not be sedentary, restrained, or kept inactive, for more than one hour at a time, with the exception of sleeping.

These recommended physical activities are performed in the form of play, games, walk and parent assisted exercises [5].

5-17 years

As WHO recommended, children and adolescents aged from 5 to 17 years should be engaged in physical activity as the following guidelines:-

• Accumulate a minimum of 60 minutes moderate to vigorous-intensity aerobic physical activity daily.
• A greater than 60 minutes of daily performed physical activity can give additional health benefits.
• Physical activity that can strengthen muscles and bones should be included at least 3 times per week.

This recommended activity can be done in the form of play, games, sports, transportation, recreations, exercises and physical education at schools, within their families and communities. Vigorous intensity is any activities that can make you breathe much harder than normal breathing system. Whereas moderate intensity is activities that can make you breathe somewhat harder than normal [6].

18–64 years

Adults aged from 18 to 64 years should be engaged in the following recommended physical activity:-

• Perform a minimum of 150 minutes of moderate or 75 minutes vigorous intensity aerobic physical activity, or equivalent combinations of the two throughout the week.
• It should be increased to 300 minutes of moderate intensity aerobic physical activity or equivalent per week to get additional health benefits.
• Activities of muscle strengthening should be added with involving major muscle groups for 2 or more days per week.

These recommended physical activities can be done at work, during transportation, recreational time, in household chores, in the form of play, games, sports or exercises within the families and communities [6].

65 years and above

Physical activity for this age group is recommended as follows:-

• Perform a minimum of 150 minutes of moderate or 75 minutes vigorous intensity aerobic physical activity, or equivalent combinations of the two throughout the week.
• It should be increased to 300 minutes of moderate intensity aerobic physical activity or equivalent per week to get additional health benefits.
• Activities of muscle strengthening should be added with involving major muscle groups for 2 or more days per week.
• Elders with poor mobility should do activities related to balance and prevent falls for 3 or more days per week.
• Intensity of their activities can be varied but all activities should be performed at least in 10 minutes of durations at a time in order to be beneficial for cardio-respiratory health.

These recommended physical activities can be done for this age group during transportation, recreational time, gardening, exercises within family members and community [6].

What will be done?

First of all, everybody should aware the current burden of NCDs and physical inactivity. Also, it needs strong political commitment, financial support and trained human resources in this field. Barriers and facilitators of practicing physical activity should be identified through qualitative research according to country context. Those barriers will be removed and facilitators will be expanded. African countries should be collaborated to prioritize physical activity in the region. Every country should able to utilize available trained human power in this field and build the capacity of other related professions such as physiotherapists, physical education and sport science experts. Besides, inclusion of physical activity in all medical and sport field curriculums is essential. Then, expand as one major field of study at undergraduate, postgraduate and doctorate research level. Implementing community friendly physical activity programmes will be critical based on global action plan on physical activity. Additionally, country should have a separate national physical activity plan and surveillance policy. Researchers in this field should be well supported both technically and financially. Likewise, civil societies and private sectors those initiated to work in this area should be encouraged. On the other hand, UN organizations, NGOs, donors and charities should work in this area.

Summary

It is clear that physical inactivity is a major current public health issues that need urgent actions. But, it was not recognized well and gets attention in many African countries including Ethiopia. Currently, there is very limited trained human power in the field of physical activity in this region. So, initial task should be focus on expanding physical activity training in the country. Then, required financial support will be provided in order to implement community friendly physical activity programmes. All stakeholders such as governments, UN organizations, NGOs, donors, civil societies and private sectors should work and support physical activity. Therefore, prioritizing physical activity in Africa including Ethiopia is required to tackle rise of NCDs.

References

1. World Health Organization. Physical activity fact sheet. Available at http://www.who.int/mediacentre/factsheets/fs385/en/ Accessed on 24thJan, 2018.
2. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012; 219:219–229.
3. Kohl HW, Criag CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, Kahlmeier S. The pandemic of physical inactivity: global action for public health. Lancet physical activity series working group: The Lancet, London NW1 7BY, UK. 2012; 380:294–305.
4. Global Observatory for Physical Activity. Physical Activity Country Card: Ethiopia. Available at http://www.globalphysicalactivityobservatory.com/card/?country=ET
5. Victorian Health Promotion Foundation. National guidelines for physical activity and sedentary behavior: Evidence summary. VicHealth, Melbourne. 2016. https://www.vichealth.vic.gov.au/media-and-resources/publications/physical-activity-and-sedentary-behaviour Accessed on 24thJan, 2018.
6. World Health Organization. Global Recommendations on Physical Activity for Health. WHO Press, Geneva, Switzerland. 2010.

Abou Author

Chalchisa Abdeta is certified with different global level trainings on physical activity to tackle non-communicable diseases (NCDs). He obtained Master of Public Health from Haramaya University on July 2016 and Bachelor of Science degree in Physiotherapy from University of Gondar on July 2009. He has practiced for 8 years as physiotherapist in both public and private hospitals in the eastern Ethiopia. Currently, he is working volunteer as country contact for Ethiopia at the Global Observatory for Physical Activity and Active Healthy Kids Global Alliance since 2016. He created online network of physical activity advocate (Ethiopian Physical Activity Network) that aimed to increase awareness of physical activity in Ethiopia and beyond. He is passionate physical activity advocate on social media since 2015. You can follow him on Twitter @caaphysio or @EthioPAnetwork