Implementing the WHO Global Strategy for physical activity in

developing countries: South Africa

Implementing the WHO Global Strategy for physical activity in

developing countries: South Africa

Muscle Muscle Research Research

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Metabolic Metabolic Research Research

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Neurobiology Research

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Molecular Research

Group

The The ESSM ESSM TeamTeam

The The ESSM ESSM TeamTeam

Physical

Activity & Lifestyle Research Group

Clinical Clinical Sports Medicine Sports Medicine

Research Research GroupGroup

Thermo-Thermo-regulation regulation

Research Research Group Group

Marilyn Anne Noakes 2002.Marilyn Anne Noakes 2002.

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sInitial Burden of Disease Estimates for South Africa, 2000Initial Burden of Disease Estimates for South Africa, 2000

Bradshaw et al. 2003: MRC Report

What are South Africans doing to address What are South Africans doing to address physical activity for prevention of NCD’s?physical activity for prevention of NCD’s?

Status of NCD prevention, health promotion Status of NCD prevention, health promotion and and physical activity promotion in South Africaphysical activity promotion in South Africa

Dept of HealthDept of Health Dept of EducationDept of Education

Government Sector:Government Sector:

- Consultative Guidelines Consultative Guidelines process process for Ageing, Diabetes, for Ageing, Diabetes, Hypertension, Hypertension, , , ObesityObesity Hyper-Hyper- lipidaemia & Food Based lipidaemia & Food Based Dietary Dietary Guidelines (all include PA)Guidelines (all include PA)

- Surveillance (National Youth Surveillance (National Youth Risk Behaviour Survey 2002, Risk Behaviour Survey 2002, & & Demographic and Health Demographic and Health Survey Survey 2003)2003)

- Development of a national Development of a national strategy for Promoting strategy for Promoting Healthy Healthy Lifestyles (2004-present)Lifestyles (2004-present)

Partnered and supported by government funded MRC units (NCD and Epi Units), and tertiary institutions

Partnered and supported by government funded MRC units (NCD and Epi Units), and tertiary institutions

• Life Skills Curriculum

• SA Qualifications Authority framework for fitness industry

• Life Skills Curriculum

• SA Qualifications Authority framework for fitness industry

Dept of Sport &Dept of Sport & RecreationRecreation

Model projectsSuch as Mass Participation & Indigenous Games

Model projectsSuch as Mass Participation & Indigenous Games

Status of NCD prevention, health promotion Status of NCD prevention, health promotion and and physical activity promotion in South Africaphysical activity promotion in South AfricaNon-Government Sector:Non-Government Sector:

InternationalInternational National/localNational/local ParastatalParastatal

•Sport for All;Sport for All;•ICSSPE;ICSSPE;•Health Promoting Schools;Health Promoting Schools;•Heart Foundation;Heart Foundation;•Laureus Sport for Good;Laureus Sport for Good;

•SCORESCORE•CHIPs;CHIPs;•Little Champs;Little Champs;•SA Diabetes Association;SA Diabetes Association;•CANSA;CANSA;•SA Diabetes Association;SA Diabetes Association;•Proposed Youth Charter for Sport and Physical Proposed Youth Charter for Sport and Physical Activity Participation NetworkActivity Participation Network

(Lack of coordination, message is not uniform; competing for (Lack of coordination, message is not uniform; competing for similar and limited funding; few measures of effectiveness in similar and limited funding; few measures of effectiveness in placeplace

Status of NCD prevention, health promotion Status of NCD prevention, health promotion and and physical activity promotion in South Africaphysical activity promotion in South AfricaPrivate Sector:Private Sector:

Medical and healthMedical and health insurersinsurers Food industryFood industry Wellness industryWellness industry

•Incentivised lifestyle programmes including physical activity, and wellness campaigns.

•Measurement started on both process and outcomes

•Incentivised lifestyle programmes including physical activity, and wellness campaigns.

•Measurement started on both process and outcomes

Advocacy at an expert panel level; research funding support; campaigns (Special K 10000 Steps)

Advocacy at an expert panel level; research funding support; campaigns (Special K 10000 Steps)

•Slimming support groups;

•Run/walk programme support groups;

•Fitness industry;

•Telementoring and IT support platforms for fitness evaluation and health risk appraisal

•Slimming support groups;

•Run/walk programme support groups;

•Fitness industry;

•Telementoring and IT support platforms for fitness evaluation and health risk appraisal

Barriers and opportunities to implementation of Global Strategy for PA:

Barriers and opportunities to implementation of Global Strategy for PA:

Opportunities:Opportunities:

•Demonstrated capacity;Demonstrated capacity;•Sustainability of programmes in the NGO Sustainability of programmes in the NGO sector;sector;•Participation by the private sector;Participation by the private sector;

Barriers:Barriers:

• Competing priorities (redress and inequity, Competing priorities (redress and inequity, poverty, poverty, violence, communicable diseases, violence, communicable diseases, unemployment, unemployment, lack of housing, undernutrition, cultural lack of housing, undernutrition, cultural constraints)constraints)

• Lack of central coordination to mobilise existing Lack of central coordination to mobilise existing networks; across different effector arms;networks; across different effector arms;

• Funding and sponsorship,Funding and sponsorship,

•Lack of and reluctance for intra-sectoral Lack of and reluctance for intra-sectoral cooperationcooperation

Youth Fitness CharterYouth Fitness Charter

Insufficient school

participation

High rates of inactivity

Unsafe sporting facilities

Mass sport spectatorship

Family attitudes

30.6% of black South African children are offered physical education lessons at school (Birth to Twenty)

40% of the South African youth (grades 4-5) do not regularly engage in vigorous physical activity (Birth to Twenty)

20% of South African children (aged 6-12) are classified as obese or overweight (Health of the Nation, 2004)

Youth Fitness CharterYouth Fitness Charter

4. All children have the right to be physically active

5. Collaboration between key role players (national and local government, tertiary institutions, NGOs, schools, teachers, parents, the private sector and the media) must occur to ensure adequate opportunities for all children and youth

6. Equality of access and opportunity to participate should be made available to all children and youth

7. Protection of children and youth participating in physical activity, including those performing at a high level, is essential

8. Economic, social, religious and cultural diversity should be acknowledges yet embraced. Sport should be used as a tool for encouraging positive attitudes, bridging barriers and accommodating individual differences and abilities.

Move for HealthMove for Health

High prevalence of NCD’s in Brazil, coupled with low High prevalence of NCD’s in Brazil, coupled with low prevalence of physical activity. prevalence of physical activity.

Dr Victor Matsudo initiated and implemented Agita Sao Dr Victor Matsudo initiated and implemented Agita Sao PauloPaulo

Agita Sao Paulo expanded to become Agita BrazilAgita Sao Paulo expanded to become Agita Brazil

Move for HealthMove for Health

Based on the success of Agita Sao Paulo, WHO Based on the success of Agita Sao Paulo, WHO recommended that World Health Day in 2002, focus recommended that World Health Day in 2002, focus on Move for Health.on Move for Health.

World Health Assembly proposed that all WHO member states World Health Assembly proposed that all WHO member states celebrate Move for Health Day ANNUALLY, in its resolution on Diet, celebrate Move for Health Day ANNUALLY, in its resolution on Diet, Physical Activity and Health.Physical Activity and Health.

ESSM, together with the Department of Health and other ESSM, together with the Department of Health and other stakeholders are driving Move for Health in South Africa. stakeholders are driving Move for Health in South Africa.

Proposed Move for Health year,Proposed Move for Health year, “ “Vuka South Africa, Move for your HealthVuka South Africa, Move for your Health

““Move for Health…South Africa!”Move for Health…South Africa!”““Move for Health…South Africa!”Move for Health…South Africa!”