Abstract
Childhood obesity is of increasing concern in many parts of Africa. We conducted a systematic search and review of published literature on behavioural childhood obesity prevention interventions. A literature search identified peer-reviewed literature from seven databases, and unindexed African journals, including experimental studies targeting children age 2–18 years in African countries, published in any language since 1990. All experimental designs were eligible; outcomes of interest were both behavioural (physical activity, dietary behaviours) and anthropometric (weight, body mass index, body composition). We also searched for process evaluations or other implementation observations. Methodological quality was assessed; evidence was synthesised narratively as a meta-analysis was not possible. Seventeen articles describing 14 interventions in three countries (South Africa, Tunisia and Uganda) were included. Effect scores indicated no overall effect on dietary behaviours, with some beneficial effects on physical activity and anthropometric outcomes. The quality of evidence was predominantly weak. We identified barriers and facilitators to successful interventions, and these were largely resource-related. Our systematic review highlights research gaps in targeting alternative settings to schools, and younger age groups, and a need for more rigorous designs for evaluating effectiveness. We also recommend process evaluations being used more widely.
Highlights
Childhood obesity is an urgent global public health concern, with implications both for the physical and emotional wellbeing of children, as well as risks for health later in life [1,2].overweight or obesity in childhood is likely to persist into later life, and to lead to health problems such as hypertension, heart disease, and type 2 diabetes [3–7]
Considering the diversity of countries classified as low- and middle-income, this review focuses on a specific geographical region, while recognising that findings may still not be applicable across the region due to the complexities and contextual factors of different health systems and communities
The aim of this paper is to review existing evidence on the effectiveness of behavioural childhood obesity prevention interventions in African countries on anthropometric and behavioural outcomes in children ages 2–18 years
Summary
Childhood obesity is an urgent global public health concern, with implications both for the physical and emotional wellbeing of children, as well as risks for health later in life [1,2]. Overweight or obesity in childhood is likely to persist into later life, and to lead to health problems such as hypertension, heart disease, and type 2 diabetes [3–7]. It is associated with adverse psychosocial effects [8], and lower educational attainment [9]. The within-country proportion of children with overweight and obesity is higher in high-income countries than low- and middle-income countries (LMICs), the vast. Public Health 2019, 16, 1212; doi:10.3390/ijerph16071212 www.mdpi.com/journal/ijerph
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