Indicators of physical activity and nutritional status among children and adolescents in Zimbabwe: Findings from three global matrix initiatives.

Background: Regular physical activity is associated with several benefits among children and adolescents. Globally, only limited surveillance data, collected using harmonized approaches to accurately compare levels of physical activity among children and adolescents are available. Through its Global Matrix initiatives, Active Health Kids Global Alliance provides an opportunity for participating countries/jurisdictions to compare physical activity levels of children and adolescents based on ten common indicators. The 2022 Zimbabwe Report Card summarizes the best available evidence and assigns grades on these ten indicators of physical activity for children and adolescents. Methods: Through an iterative process, a team of national experts working in various sectors of physical activity used Active Healthy Kids Global Alliance's Global Matrix benchmarks and grading rubric, to assign Report Card grades on 10 indicators of physical activity (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviours, Physical Fitness, School, Family and Peers, Community Environment, and Government) among 5-17-year-old children and adolescents in Zimbabwe. Published and unpublished data as well as policy documents informing grades for each indicator were summarized. An unweighted average of all studies with data for an indicator was used to inform the grade assignment. Where data were unavailable or insufficient to provide accurate estimates, an incomplete grade was assigned. The primary purpose of the present study was to synthesize and summarize the best available data and assign grades on 10 common indicators of physical activity for children and adolescents. The secondary objective was to compare Report Grades across three Global Matrix initiatives. Results: Grades for the ten common indicators for Global Matrix 4.0 plus Nutritional Status (B+) were assigned as follows: Overall Physical Activity (C+), Organized Sport and Physical Activity (B-), Active Play (C+), Active Transportation (B), Sedentary Behaviours (C), Physical Fitness (Incomplete), Family and Peers (Incomplete), School (C), Community and Environment (C-), Government (D). Generally, grades for individual behaviours (Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviours) were higher than for sources of influence (Family and Peers, School, Community and Environment, Government). Across 3 Global Matrices, the grade for Overall Physical activity (C+) did not change, Community and Environment (F, D, C-) steadily improved over time; while those for Active Transportation, Sedentary Behaviours and Sports were unchanged for Global Matrix 2.0 and 3.0, but declined for Global Matrix 4.0. Conclusion: Although grades for individual behaviours were higher than those for sources of influence, overall, our findings show that the levels of physical activity among children and adolescents in Zimbabwe were lower than recommended. Robust surveillance data with large and representative samples are required to provide accurate estimates of physical activity participation among children and adolescents in Zimbabwe. Furthermore, policies and initiatives that promote equitable physical activity participation among children and adolescents are urgently needed in Zimbabwe.

Inventory on the dietary assessment tools available and needed in africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research, and prevention of diet-related non-communicable diseases.

OBJECTIVE: To carry out an inventory on the availability, challenges, and needs of dietary assessment (DA) methods in Africa as a pre-requisite to provide evidence, and set directions (strategies) for implementing common dietary methods and support web-research infrastructure across countries. METHODS: The inventory was performed within the framework of the "Africa's Study on Physical Activity and Dietary Assessment Methods" (AS-PADAM) project. It involves international institutional and African networks. An inventory questionnaire was developed and disseminated through the networks. Eighteen countries responded to the dietary inventory questionnaire. RESULTS: Various DA tools were reported in Africa; 24-Hour Dietary Recall and Food Frequency Questionnaire were the most commonly used tools. Few tools were validated and tested for reliability. Face-to-face interview was the common method of administration. No computerized software or other new (web) technologies were reported. No tools were standardized across countries. CONCLUSIONS: The lack of comparable DA methods across represented countries is a major obstacle to implement comprehensive and joint nutrition-related programmes for surveillance, programme evaluation, research, and prevention. There is a need to develop new or adapt existing DA methods across countries by employing related research infrastructure that has been validated and standardized in other settings, with the view to standardizing methods for wider use.

Evaluation of the international standardized 24-h dietary recall methodology (GloboDiet) for potential application in research and surveillance within African settings.

BACKGROUND: Collection of reliable and comparable individual food consumption data is of primary importance to better understand, control and monitor malnutrition and its related comorbidities in low- and middle-income countries (LMICs), including in Africa. The lack of standardised dietary tools and their related research support infrastructure remains a major obstacle to implement concerted and region-specific research and action plans worldwide. Citing the magnitude and importance of this challenge, the International Agency for Research on Cancer (IARC/WHO) launched the "Global Nutrition Surveillance initiative" to pilot test the use of a standardized 24-h dietary recall research tool (GloboDiet), validated in Europe, in other regions. In this regard, the development of the GloboDiet-Africa can be optimised by better understanding of the local specific methodological needs, barriers and opportunities. The study aimed to evaluate the standardized 24-h dietary recall research tool (GloboDiet) as a possible common methodology for research and surveillance across Africa. METHODS: A consultative panel of African and international experts in dietary assessment participated in six e-workshop sessions. They completed an in-depth e-questionnaire to evaluate the GloboDiet dietary methodology before and after participating in the e-workshop. RESULTS: The 29 experts expressed their satisfaction on the potential of the software to address local specific needs when evaluating the main structure of the software, the stepwise approach for data collection and standardisation concept. Nevertheless, additional information to better describe local foods and recipes, as well as particular culinary patterns (e.g. mortar pounding), were proposed. Furthermore, food quantification in shared-plates and -bowls eating situations and interviewing of populations with low literacy skills, especially in rural settings, were acknowledged as requiring further specific considerations and appropriate solutions. CONCLUSIONS: An overall positive evaluation of the GloboDiet methodology by both African and international experts, supports the flexibility and potential applicability of this tool in diverse African settings and sets a positive platform for improved dietary monitoring and surveillance. Following this evaluation, prerequisite for future implementation and/or adaptation of GloboDiet in Africa, rigorous and robust capacity building as well as knowledge transfer will be required to roadmap a stepwise approach to implement this methodology across pilot African countries/regions.

A cross-sectional study to determine the use of alternative medicines during pregnancy in the district hospitals in Manicaland, Zimbabwe.

BACKGROUND: Traditional medicines are widely used in the rapidly growing health system and are of economic importance. The study aimed at determining the frequency, pattern of use and factors that influence traditional medicines use during pregnancy. MATERIALS AND METHODS: A cross-sectional study was carried out at four district hospitals in Manicaland, Zimbabwe, using questionnaire based convenience sampling. RESULTS: Traditional medicines use was found to be high with 54% (n = 337) of pregnant women using traditional medicines during pregnancy. The major purpose of use of traditional medicine was found to be preparation for delivery; cervical dilation in particular. The following factors showed a significant statistical association for use of traditional medicines: previous mode of delivery (p = 0.006), level of education (p = 0.016), family income (p = 0.007), and residential settlement (p =0.026). Some of the common traditional medicines used during pregnancy include Camellia sinensis, Aloe, Spirostachys Africana, Thumbergia lancifolia, Dalbergiella nyasae, Steganotaenia oraliacea, Stomatostemma monteiroae and Cussonia arborea. CONCLUSION: A number of pregnant women use traditional medicines as partus preparators (labour aids) throughout the entire pregnancy period. This calls for obstetricians, general practitioners and midwives to inquire about use of traditional medicine in history.

Results From Zimbabwe's 2016 Report Card on Physical Activity for Children and Youth.

BACKGROUND: The report card was a synthesis of the best available evidence on the performance of Zimbabwean children and youth on key physical activity (PA) indicators. The aim of this article was to summarize the results from the 2016 Zimbabwe Report Card. METHODS: The Report Card Working Group gathered and synthesized the best available evidence, met, discussed and assigned grades to 10 indicators based on the Active Healthy Kids Global Alliance global matrix grading system. RESULTS: The indicators were graded as follows: overall PA (C+), organized sport participation (B), active play (D+), active transportation (A-), sedentary behaviors (B), school (D), family and peers (Incomplete), community and the built environment (F), government (D) and nongovernmental organizations (Incomplete). CONCLUSIONS: Although the majority of children used active transport, played organized sports and engaged in acceptable levels of PA, most of them did not meet the recommended hours of unstructured/unorganized play per day. At present, there are limited data to accurately inform the Zimbabwe Report Card therefore studies employing robust research designs with representative samples are needed. Zimbabwe also needs to prioritize policies and investments that promote greater and safe participation in PA among children and youth.

Comparison of exercise-induced hypertension in low birth weight and normal birth weight young black adults in Zimbabwe.

AIM: The objective of the study was to compare blood pressure changes during exercise between low and normal birth weight young Black adults. METHODS: Eighty medical students in their first and second year who had neonatal clinic cards as proof of birth weight were included in the study. Resting blood pressures and heart rates were recorded. Participants then underwent a multistage 9-minute exercise stress test while blood pressure responses were recorded at 3-minute intervals. The study was conducted in the Department of Physiology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe. RESULTS: Of the 80 subjects recruited, 34 had low birth weight (LBW), 26 of these were female and 8 were male. The proportion of LBW individuals, 62% (n = 21), who developed exercise-induced hypertension (EIH) was significantly higher (p < 0.05) than the proportion of those with normal birth weight (NBW), 32% (n = 11). In addition to LBW being significantly associated with EIH (χ2 test p < 0.05, odds ratio 7.5) compared with NBW, the LBW group had a significantly higher (p < 0.05) and exaggerated systolic and diastolic response in stages I and II of the exercise protocol compared with the NBW group. CONCLUSION: LBW was associated with EIH in these young Black adults.