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Randall L, Brugulat-Panés A, Woodcock J, Ware LJ, Pley C, Abdool Karim S, Micklesfield L, Mukoma G, Tatah L, Dambisya PM, Matina SS, Hambleton I, Okello G, Assah F, Anil M, Kwan H, Awinja AC, Pujol-Busquets Guillén G, Foley L. Active travel and paratransit use in African cities: Mixed-method systematic review and meta-ethnography. J Transp Health 2023; 28:101558. [PMID: 36776485 PMCID: PMC9902334 DOI: 10.1016/j.jth.2022.101558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 11/02/2022] [Accepted: 12/12/2022] [Indexed: 06/18/2023]
Abstract
Active travel, as a key form of physical activity, can help offset noncommunicable diseases as rapidly urbanising countries undergo epidemiological transition. In Africa a human mobility transition is underway as cities sprawl and motorization rises and preserving active travel modes (walking, cycling and public transport) is important for public health. Across the continent, public transport is dominated by paratransit, privately owned informal modes serving the general public. We reviewed the literature on active travel and paratransit in African cities, published from January 2008 to January 2019. We included 19 quantitative, 14 mixed-method and 8 qualitative studies (n = 41), narratively synthesizing the quantitative data and meta-ethnographically analysing the qualitative data. Integrated findings showed that walking was high, cycling was low and paratransit was a critical mobility option for poor peripheral residents facing long livelihood-generation journeys. As an indigenous solution to dysfunctional mobility systems shaped by colonial and apartheid legacies it was an effective connector, penetrating areas unserved by formal public transport and helping break cycles of poverty. From a public health perspective, it preserved active travel by reducing mode-shifting to private vehicles. Yet many city authorities viewed it as rogue, out of keeping with the 'ideal modern city', adopting official anti-paratransit stances without necessarily considering the contribution of active travel to public health. The studies varied in quality and showed uneven geographic representation, with data from Central and Northern Africa especially sparse; notably, there was a high prevalence of non-local authors and out-of-country funding. Nevertheless, drawing together a rich cross-disciplinary set of studies spanning over a decade, the review expands the literature at the intersection of transport and health with its novel focus on paratransit as a key active travel mode in African cities. Further innovative research could improve paratransit's legibility for policymakers and practitioners, fostering its inclusion in integrated transport plans.
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Affiliation(s)
- Lee Randall
- SAMRC/Wits Centre for Health Economics and Decision Science – PRICELESS-SA, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | | | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Lisa Jayne Ware
- SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Caitlin Pley
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Safura Abdool Karim
- SAMRC/Wits Centre for Health Economics and Decision Science – PRICELESS-SA, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Lisa Micklesfield
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Gudani Mukoma
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Lambed Tatah
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Philip Mbulalina Dambisya
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Sostina Spiwe Matina
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Ian Hambleton
- George Alleyne Chronic Disease Research Centre, Caribbean Institute of Health Research, The University of the West Indies, Bridgetown, Barbados
| | - Gabriel Okello
- Cambridge Institute for Sustainability Leadership, University of Cambridge, Cambridge, United Kingdom
| | - Felix Assah
- Health of Populations in Transition (HoPiT) Research Group, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Megha Anil
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Haowen Kwan
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Georgina Pujol-Busquets Guillén
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), Barcelona, Spain
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Muzenda T, Dambisya PM, Kamkuemah M, Gausi B, Battersby J, Oni T. Mapping food and physical activity environments in low- and middle-income countries: A systematised review. Health Place 2022; 75:102809. [PMID: 35508088 DOI: 10.1016/j.healthplace.2022.102809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/06/2021] [Accepted: 04/15/2022] [Indexed: 12/27/2022]
Abstract
This systematised literature review synthesised evidence on approaches to mapping food and physical activity (PA) environments in low- and middle-income countries (LMICs). Of the 60 articles included, 25 and 35 mapped food and PA environments respectively. All studies were cross-sectional with researcher-led data collection. Three types of mapping tools were identified - maps (n = 18), GPS (n = 10), and GIS (n = 37). Our findings point to a paucity of research mapping food and PA environments, overall and particularly subjective domains. We highlight a need for future studies that utilise innovative, inexpensive and participatory research methods to understand dynamic exposures to obesogenic environment features in resource-constrained contexts undergoing rapid urbanisation.
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Affiliation(s)
- Trish Muzenda
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
| | - Philip Mbulalina Dambisya
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa
| | - Monika Kamkuemah
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa; Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa
| | - Blessings Gausi
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa
| | - Jane Battersby
- African Centre for Cities, University of Cape Town, Cape Town, 7945, South Africa
| | - Tolu Oni
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
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