| Autor: |
Thondoo M; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.; Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain., Mogo ERI; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.; Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain., Tatah L; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK., Muti M; SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa., van Daalen KR; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.; Barcelona Supercomputing Center (BSC), Department of Earth Sciences, Barcelona, Spain., Muzenda T; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK., Boscott R; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK., Uwais O; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK., Farmer G; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK., Yue A; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK., Dalzell S; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK., Mukoma G; SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.; Department of Biokinetics, Recreation and Sport Science, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa., Bhagtani D; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK., Matina S; SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa., Dambisya PM; Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.; Centre for Innovation in Learning and Teaching, University of Cape Town, Cape Town, South Africa., Okop K; Chronic Disease Initiative for Africa (CDIA), Department of Medicine, University of Cape Town, Cape Town, South Africa., Ebikeme C; LSE Health, Department of Health Policy, London School of Economics and Political Science, London, UK., Micklesfield L; SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa., Oni T; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK. |
| Abstrakt: |
Increasing evidence suggests that urban health objectives are best achieved through a multisectoral approach. This approach requires multiple sectors to consider health and well-being as a central aspect of their policy development and implementation, recognising that numerous determinants of health lie outside (or beyond the confines of) the health sector. However, collaboration across sectors remains scarce and multisectoral interventions to support health are lacking in Africa. To address this gap in research, we conducted a mixed-method systematic review of multisectoral interventions aimed at enhancing health, with a particular focus on non-communicable diseases in urban African settings. Africa is the world's fastest urbanising region, making it a critical context in which to examine the impact of multisectoral approaches to improve health. This systematic review provides a valuable overview of current knowledge on multisectoral urban health interventions and enables the identification of existing knowledge gaps, and consequently, avenues for future research. We searched four academic databases (PubMed, Scopus, Web of Science, Global Health) for evidence dated 1989-2019 and identified grey literature from expert input. We identified 53 articles (17 quantitative, 20 qualitative, 12 mixed methods) involving collaborations across 22 sectors and 16 African countries. The principle guiding the majority of the multisectoral interventions was community health equity (39.6%), followed by healthy cities and healthy urban governance principles (32.1%). Targeted health outcomes were diverse, spanning behaviour, environmental and active participation from communities. With only 2% of all studies focusing on health equity as an outcome and with 47% of studies published by first authors located outside Africa, this review underlines the need for future research to prioritise equity both in terms of research outcomes and processes. A synthesised framework of seven interconnected components showcases an ecosystem on multisectoral interventions for urban health that can be examined in the future research in African urban settings that can benefit the health of people and the planet.Paper Context Main findings: Multisectoral interventions were identified in 27.8% of African countries in the African Union, targeted at major cities with five sectors present at all intervention stages: academia or research, agriculture, government, health, and non-governmental. Added knowledge: We propose a synthesised framework showcasing an ecosystem on multisectoral interventions for urban health that can guide future research in African urban settings. Global health impact for policy and action: This study reveals a crucial gap in evidence on evaluating the long-term impact of multisectoral interventions and calls for partnerships involving various sectors and robust community engagement to effectively deliver and sustain health-promoting policies and actions. |
