Covid-19 pandemic drives need for policy brief on physical activity for health in Africa

21 October 2020 - Wits University

More than ever, the Covid-19 pandemic has highlighted the need to prioritise physical activity as an imperative for public health in Africa.

Wits physical activity experts in the African Academic Consortium for Physical Activity for Health in Africa and the African Physical Activity Network (AFPAN) have contributed policy briefs to guide decision-making during the pandemic and beyond.

Government’s lockdown to restrict population mobility to minimise transmission of Covid-19 created a window of opportunity. Restrictions were met with resistance from civil society, fitness centres, gyms, and community organisations, clamoring to be allowed responsible access for physical activity and to create “activity-supportive” environments.

The need to message and provide guidance to governments and civil society, to implement national plans, policies and programmes to promote physical activity in the African region, both during Covid-19 and beyond, became critical.

The consortium, which comprises more than 40 academics, researchers and implementation partners from nine countries in Africa, prepared two policy briefs: one for the general public and one aimed at children in three environments – home, school, and in communities.

Exercise saves lives

Nearly 30% of the disease burden in sub-Saharan Africa is attributable to non-communicable diseases (NCDs). Some of the very diseases that place individuals with Covid-19 at much higher risk of being hospitalized or dying are the same lifestyle-related diseases that are associated with being physically inactive. In fact, the risk from dying from Covid-19 is 1.5 to 3.5 times higher for people with diseases such as Type 2 diabetes, high blood pressure or cancer - and approximately 18% of men and 25% of women in Africa are still insufficiently physically active to protect them from NCDs.

Research has shown that regular, moderate physical activity has been associated with reduced death from infectious diseases, a strengthened immune response, reduced inflammation and a lower incidence of viral respiratory infections. It also reduces depression and anxiety, both of which have escalated during the Covid-19 pandemic.

“The easing of lockdown measures and reintroduction of economic activity has helped to regain some sense of normality, despite the ongoing impact of the disease. The recent reopening of parks and recreation settings to the public has created obvious opportunities for leisure-time physical activity and exercise in a safe manner”, says Associate Professor Philippe Jean-Luc Gradidge in the Centre for Exercise Science and Sports Medicine (CESSM) in the School of Therapeutic Sciences at Wits and a member of the African Academic Consortium for Physical Activity for Health in Africa and AFPAN.

Gradidge, along with Wits scientists Dr Georgia Torres in the CESSM, Professor Lisa Micklesfield, Deputy Director of the South African Medical Research Council- Developmental Pathways for Health Research Unit (DPHRU), and postdoctoral researcher in the DPHRU, Dr Caylee Cook were part of the consortium’s policy core writing group. 

Get M.O.V.I.N.G after lockdown lethargy

The policy briefs  firstly address five major challenges that need to be tackled to minimise the risk of community transmission while exercising during the pandemic:

1. Ensuring social distancing (2m)
2. Wearing masks (non-medical, cloth masks)
3. Exercising in small groups (outdoors, with social distancing)
4. Exercising indoors (only with proper ventilation)
5. Avoiding the use of shared equipment or sanitising in between users.

These apply to children as well, and to children in school settings in particular.

Secondly, the briefs adopt a policy framework created by the World Cancer Research Fund, known as M.O.V.I.N.G, which recognises that these policy actions can take place within three different domains: Active societies, active environments, and active people.

M.O.V.I.N.G is:

• making physical activity programmes a priority in communities and schools
• offering training to promote physical activity for health champions in community-based programmes, health-care providers in primary health care settings and educators in schools
• visualising and enacting “active design” principles for structures and surroundings
• implementing urban and rural transport plans that support active societies
• normalizing and increasing physical activity through mass public communication
• give physical activity education, assessment & counselling

 M.O.V.I.N.G is aligned with the WHO’S Global Action Plan for Physical Activity (GAPPA).

Thirdly, the policy briefs introduce a four-step policy recommendation for physical activity for the general public in the African region:

1. The development of a National Plan for physical activity for health and development, which would allow for input from multiple sectors and stakeholders resulting in co-benefits and shared responsibility.
2. Training a cadre of health professionals, educators, sports coaches and community members to promote physical activity for health, such as the Western Cape on Wellness (WoW!) lifestyle programme, which has trained more than 600 community health champions in under-served areas.
3. Ensuring safe and enjoyable opportunities for physical activity through urban planning, provision of parks or public spaces and low-cost programmes close to where people live. This is particularly critical in communities that lack safe and accessible facilities where they can be physically active.
4. Adopting a “whole of government” systems approach towards physical activity embedded in multiple sectors, devising flexible, agile and cost-effective solutions. Critical to this is recognising physical activity as a vital component both in preventive health care and a means to build social cohesion in communities.

“We are witnessing an exciting era where for the first time, healthcare providers and policy- makers are acknowledging the importance of physical activity for health and development in the African region. Regular physical activity saves lives, improves quality of life, physical and mental well-being, and boosts the immune system,” says Catherine Draper, Associate Professor in the DPHRU at Wits and a member of the consortium's expert advisory panel. 

Professor Vicki Lambert from the University of Cape Town Research Centre for Health through Physical Activity, Lifestyle and Sport, and Associate Professor Rowena Naidoo, from the College of Health Sciences at the University of KwaZulu-Natal spearheaded the policy briefs, which are endorsed by the African Physical Activity Network (AFPAN) and supported by the Western Cape Government Department of Health, which hosted a Physical Activity for Health in Africa public webinar on 22 September.