Physical activity and exercise during pregnancy in Africa: a review of the literature

  • BMC Pregnancy and Childbirth, Volume 20, No. 1, Year 2020

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Study Justification:
– Pregnancy is a crucial phase in a woman’s life, and the health status during this period affects both the woman and her child.
– Global evidence suggests that many pregnant women engage in low levels of physical activity and exercise, despite the known benefits.
– This review focuses on the levels of physical activity and exercise among pregnant women in Africa, where there is limited data available.
Highlights:
– Limited data suggests that pregnant women in Africa do not adhere to the recommended levels of physical activity during pregnancy compared to the Western world.
– Participation in physical activity during pregnancy is low and declines as the pregnancy progresses.
– Personal and environmental factors such as lack of time, knowledge, information from healthcare providers, tiredness, and lack of social support are barriers to physical activity during pregnancy.
– The types of physical activity participation among pregnant women vary across studies and geographical settings.
Recommendations:
– Conduct more studies to examine the dynamics of physical activity during pregnancy in Africa.
– Develop contextual interventions to improve and promote maternal health by addressing the barriers to physical activity during pregnancy.
Key Role Players:
– Researchers and academics specializing in maternal health and physical activity.
– Healthcare providers, including obstetricians, gynecologists, and midwives.
– Policy makers and government officials responsible for healthcare and maternal health programs.
– Non-governmental organizations (NGOs) working in the field of maternal health.
Cost Items for Planning Recommendations:
– Research funding for conducting additional studies on physical activity during pregnancy in Africa.
– Training and capacity building for healthcare providers to provide appropriate advice and counseling on physical activity during pregnancy.
– Development and implementation of contextual interventions, including educational materials, awareness campaigns, and support programs for pregnant women.
– Monitoring and evaluation of the effectiveness of interventions.
– Collaboration and coordination between stakeholders, which may require resources for meetings, workshops, and communication.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong, but there are some areas for improvement. The review is based on a comprehensive search of multiple databases, which increases the likelihood of capturing relevant studies. The inclusion of 27 studies provides a reasonable sample size. However, the abstract does not provide specific details about the methodology used in the review, such as the criteria for study selection or the quality assessment of included studies. Additionally, the abstract mentions that few studies exist on PA during pregnancy in Africa, which suggests a limited evidence base. To improve the strength of the evidence, it would be beneficial to provide more information about the methodology and to conduct a more thorough search to identify additional relevant studies. Furthermore, conducting a quality assessment of the included studies would enhance the reliability of the findings.

Background: Pregnancy is an important phase in a woman’s life, with health status at this stage affecting both the woman and her child’s life. Global evidence suggests that many women engage in low levels of physical activity (PA) and exercise during pregnancy despite its beneficial effects. This is particularly the case in Africa. Methods: This article reviews the literature on levels of PA and exercise among pregnant women in Africa, highlighting the level of PA or exercise participation during pregnancy in Africa, including types of PA, factors affecting PA, beliefs about and benefits of prenatal activity, advice or counselling on PA during pregnancy in Africa, and PA interventions proposed to promote the uptake of prenatal PA. Electronic search databases used were Google Scholar, Science Direct, Scopus, EMBASE, ERIC, Medline, Web of Science, EBSCOhost, PubMed, BIOMED Central, and African Journal Online. The basic search terms were: ‘Physical activity’, ‘Exercise’, ‘Pregnancy’, ‘Pregnant women’ and ‘Africa’. A total of 40 references were found. On the basis of an analysis of titles, abstracts and the language of publication (other than English), 11 articles were rejected, and 29 articles were fully read, although two had to be rejected due to a lack of access to the full version. Finally, 27 references were included in the review. Results: Few studies exist on PA during pregnancy in Africa. The limited data available suggests that, compared to the Western world, pregnant women in Africa do not adhere to the recommendations for PA during pregnancy. Levels of participation in PA during pregnancy are low and decline as the pregnancy progresses. The majority of the studies used direct, objective measures to assess PA during pregnancy. Personal and environmental factors such as lack of time, lack of knowledge, inadequate information from healthcare providers, feelings of tiredness and an absence of social support constituted the main barriers to PA during pregnancy. The types of PA participation among pregnant women varied across studies and geographical settings. Conclusions: While published data is limited, it seems clear that the participation of pregnant women in PA during pregnancy in Africa is low and declines with advancing pregnancy. There is a need for more studies to examine the dynamics of PA during pregnancy in Africa to guide contextual interventions to improve and promote maternal health on the continent.

Our electronic search crossed six databases: Google Scholar, Science Direct, Scopus, EMBASE, ERIC, Medline, Web of Science, EBSCOhost, PubMed, BIOMED Central and African Journal Online databases. These were consulted for any published review articles or original research articles, regardless of year of publication that yielded information on the levels and correlates of PA participation during pregnancy, including the beliefs, perceived benefits, barriers and attitudes of pregnant women concerning PA and exercise participation during pregnancy in Africa. In addition, we extended the search for articles so as to include references of the identified publications in this narrative review. The search terms used were: ‘Physical activity’, ‘Exercise’, ‘Pregnancy’, ‘Pregnant women’ and ‘Africa’. The search excluded research articles published in languages other than English and whose full texts were not accessible. A total of 40 original articles and review articles on physical activity during pregnancy in Africa were included in this narrative review. Of these, 27 studies were finally considered for the analysis [55, 56, 58, 59, 86–88, 91–110]. Figure 1 presents a flow diagram of the procedure that resulted in the final list of articles considered for analyses. Flow diagram of articles searched

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Based on the information provided, it seems that the article is a review of the literature on physical activity and exercise during pregnancy in Africa. The review highlights the low levels of physical activity and exercise among pregnant women in Africa and identifies factors that contribute to this, such as lack of time, knowledge, and social support. The article also suggests the need for more studies to examine the dynamics of physical activity during pregnancy in Africa and to guide interventions to improve maternal health on the continent.

Based on this information, here are some potential innovations that could be recommended to improve access to maternal health in Africa:

1. Education and Awareness Campaigns: Develop and implement educational programs and awareness campaigns to educate pregnant women about the importance of physical activity and exercise during pregnancy. These campaigns can provide information on the benefits of physical activity, address common misconceptions, and provide practical tips and guidelines for safe and effective exercise during pregnancy.

2. Healthcare Provider Training: Provide training and education for healthcare providers, including doctors, nurses, and midwives, on the importance of physical activity during pregnancy. This training can equip healthcare providers with the knowledge and skills to effectively counsel and support pregnant women in incorporating physical activity into their prenatal care.

3. Community Support Programs: Establish community-based support programs that provide pregnant women with access to resources, information, and social support for engaging in physical activity during pregnancy. These programs can include group exercise classes, walking groups, and peer support networks to encourage and motivate pregnant women to be physically active.

4. Mobile Health (mHealth) Interventions: Utilize mobile technology, such as smartphone apps or text messaging, to deliver personalized exercise programs, reminders, and educational content to pregnant women. These mHealth interventions can help overcome barriers such as lack of time and knowledge by providing convenient and accessible resources directly to women’s smartphones.

5. Policy and Infrastructure Support: Advocate for policies and infrastructure improvements that promote physical activity during pregnancy. This can include creating safe and accessible spaces for exercise, such as parks or walking paths, and incorporating physical activity guidelines into healthcare policies and guidelines.

These are just a few potential innovations that could be considered to improve access to maternal health in Africa. It is important to note that the implementation of these innovations would require careful planning, collaboration between various stakeholders, and ongoing evaluation to ensure their effectiveness and sustainability.
AI Innovations Description
Based on the description provided, the recommendation to improve access to maternal health in Africa is to conduct more studies on physical activity (PA) and exercise during pregnancy. The existing literature review suggests that pregnant women in Africa do not adhere to the recommendations for PA during pregnancy, and their levels of participation in PA decline as the pregnancy progresses. The main barriers to PA during pregnancy in Africa include lack of time, lack of knowledge, inadequate information from healthcare providers, feelings of tiredness, and absence of social support.

To address this issue and promote maternal health, it is recommended to:

1. Conduct more research: More studies need to be conducted to examine the dynamics of PA during pregnancy in Africa. This will provide a better understanding of the factors influencing PA participation and help guide contextual interventions to improve and promote maternal health on the continent.

2. Increase awareness and education: Healthcare providers should be equipped with adequate knowledge and information about the benefits of PA during pregnancy. They should provide counseling and advice to pregnant women on the importance of engaging in appropriate levels of PA. Public health campaigns can also be implemented to raise awareness among pregnant women about the benefits of PA and how to incorporate it into their daily routines.

3. Provide social support: Pregnant women in Africa may face challenges in finding time and motivation to engage in PA. Creating support networks, such as prenatal exercise classes or community groups, can help pregnant women connect with others who are going through similar experiences. This can provide encouragement, accountability, and a sense of community, making it easier for pregnant women to engage in PA.

4. Address environmental barriers: Lack of time and access to safe and suitable exercise facilities can hinder pregnant women from engaging in PA. Efforts should be made to create environments that are conducive to PA during pregnancy, such as providing safe walking paths, promoting active transportation, and ensuring the availability of prenatal exercise programs in healthcare facilities.

By implementing these recommendations, access to maternal health can be improved by promoting and supporting physical activity and exercise during pregnancy in Africa.
AI Innovations Methodology
Based on the provided information, here are some potential recommendations to improve access to maternal health:

1. Increase awareness and education: Develop targeted campaigns and educational programs to raise awareness about the importance of physical activity and exercise during pregnancy. This can include providing information on the benefits, types of activities, and safety guidelines.

2. Healthcare provider training: Provide training to healthcare providers on the benefits of physical activity during pregnancy and how to effectively counsel and support pregnant women in incorporating physical activity into their routine.

3. Community-based programs: Establish community-based programs that offer prenatal exercise classes or group activities specifically designed for pregnant women. These programs can provide a supportive environment and encourage social interaction among pregnant women.

4. Accessible facilities: Improve access to facilities that support physical activity during pregnancy, such as gyms or fitness centers that offer prenatal exercise classes. This can include ensuring these facilities are located in areas easily accessible to pregnant women and providing affordable options.

5. Mobile applications and online resources: Develop mobile applications and online resources that provide guidance, exercise routines, and tracking tools for pregnant women to engage in physical activity at their convenience.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Define the target population: Identify the specific population or region where the recommendations will be implemented. This could be a specific country or community within Africa.

2. Collect baseline data: Gather data on the current levels of physical activity during pregnancy, access to maternal health services, and any existing barriers or challenges.

3. Develop intervention scenarios: Create different scenarios based on the recommendations mentioned above. For each scenario, determine the expected changes in physical activity levels, access to maternal health services, and potential barriers that may be addressed.

4. Simulate the impact: Use modeling techniques to simulate the impact of each intervention scenario on improving access to maternal health. This can involve analyzing the potential increase in physical activity levels, changes in healthcare utilization, and improvements in maternal health outcomes.

5. Evaluate outcomes: Assess the outcomes of each intervention scenario, including the potential benefits, cost-effectiveness, and feasibility of implementation. This evaluation can help determine the most effective strategies for improving access to maternal health.

6. Refine and implement: Based on the simulation results and evaluation, refine the recommendations and develop an implementation plan. This may involve collaboration with stakeholders, policymakers, and healthcare providers to ensure successful implementation and sustainability of the interventions.

It is important to note that the methodology for simulating the impact may vary depending on the available data, resources, and specific objectives of the study.


Statistics:
Citations: 11
Identifiers:
DOI: 10.1186/s12884-020-03439-0
Research Areas:
Community Interventions, Disparities, Health System and Policy, Maternal Access, Maternal and Child Health, Sexual and Reproductive Health, Social Determinants
Study Design:
Narrative Study
Study Approach:
Qualitative
Participants Gender:
Female
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