United Republic of Tanzania Guidelines on Physical Activity and Sedentary Behaviour

Objectives

Tanzania’s National Physical Activity Guidelines provide evidence-based recommendations on physical activity and sedentary behaviour for people aged five years and over, irrespective of gender, cultural background, socioeconomic status or ability. They aim to make physical activity a fundamental part of health and wellbeing, encourage people to incorporate activity into everyday life, reduce barriers to participation, and strengthen prevention of non-communicable diseases.[1][2][3]The guidelines support Tanzania’s adoption of the Global Action Plan on Physical Activity 2018–2030, including its target to reduce physical inactivity by 15% by 2030.[1]

• Promote regular activity across the life course to improve physical fitness, cardiometabolic health, bone health, mental health, cognitive function, sleep, functional capacity and healthy adiposity.[4][5][6]
• Address physical activity undertaken through work, domestic tasks, education, transport and leisure, rather than treating exercise as the sole form of activity.[7][2][8]
• Reduce sedentary behaviour, particularly recreational screen time among children and adolescents, by replacing sedentary time with physical activity of any intensity, including light activity.[4][5][9]
• Support children and adolescents aged 5–17 years to undertake an average of at least 60 minutes daily of moderate-to-vigorous, mainly aerobic activity, with vigorous aerobic and muscle- and bone-strengthening activities on at least three days weekly.[4]
• Support adults to undertake 150–300 minutes of moderate-intensity, or 75–150 minutes of vigorous-intensity, aerobic activity weekly, or an equivalent combination, and muscle-strengthening activity involving major muscle groups on at least two days weekly.[5]
• Enable older adults to follow adult aerobic and strengthening recommendations while undertaking varied multicomponent activity emphasising functional balance and strength on at least three days weekly, to maintain functional capacity and prevent falls.[6]
• Support pregnant and postpartum women without contraindications to undertake regular activity, including at least 150 minutes of moderate-intensity aerobic activity each week.[10]
• Tailor recommendations for people living with chronic conditions or disability according to ability, health status, physical function, limitations, complications, medication and treatment plans.[11][9][12]
• Encourage inactive people to begin with small amounts of activity and progressively increase frequency, duration and intensity, while ensuring opportunities are safe, equitable, enjoyable, varied and appropriate to age and ability.[4][5][9]

Implementation

The guidelines adapt World Health Organization recommendations on physical activity and sedentary behaviour to the Tanzanian context through a multisectoral, evidence-informed process.[1]They are intended to inform national and subnational planning, as well as health-care, education, workplace and community programmes, recognising that publication of recommendations alone will not change population activity levels.[13][14]Implementation therefore combines policy integration, communication, accessible opportunities for activity, stakeholder collaboration and locally appropriate programmes.[14][15]

• Coordinate implementation through the Ministry of Health, Community Development, Gender, Elderly and Children, particularly its Non-Communicable Diseases units, with stakeholders from Zanzibar and Tanzania Mainland engaged through a multisectoral steering committee.[16][17]
• Engage ministries, regional and local government, education, infrastructure, urban planning, sport, disability affairs, universities, professional bodies, civil society, disability organisations, physical-activity groups, health-care providers, the private sector and research organisations.[1][17][14]
• Use evidence from Mainland Tanzania and Zanzibar, existing surveys, literature reviews and a physical-activity situational analysis undertaken with the Global Action Plan on Physical Activity Situation Analysis Tool.[17]
• Apply a rigorous evidence-review process, supported by methodological and exercise-science expertise, to interpret evidence and develop recommendations aligned with World Health Organization procedures.[2]
• Disseminate simplified guidance through annexes, flyers, posters and other accessible platforms, targeting the public, policymakers, health professionals and stakeholders who promote activity in health, education, workplaces and communities.[1][18]
• Develop sustained communication campaigns alongside supportive policies and locally appropriate activity opportunities; use formative research to identify audiences, barriers, values, needs and preferences, and test messages and materials before selecting formats and channels.[15]
• Use traditional and digital media, including television, radio, billboards, printed materials, websites, mobile phones, applications, infographics and short animated videos, tailoring messages for population groups with differing needs.[15]
• Deliver activity through broad and culturally relevant options, including walking, dancing, cycling, swimming, resistance exercise, balance and flexibility activities, classes, community programmes, traditional games and sports.[8][19]
• Provide practical safety support, including gradual progression, warm-up and cool-down, hydration where appropriate, protective equipment, recognition of concerning symptoms, and avoidance of painful stretching.[8]
• Seek advice from health-care professionals, physical-activity specialists or disability specialists where individual circumstances require tailored support, especially for pregnancy, chronic conditions and disability.[10][11][9]
• Validate the physical-activity questionnaire and evaluate recommendations every five years; update the guidelines after five years, or earlier where advances in measurement or evidence on sedentary behaviour justify revision.[15][20]
• Mobilise investment in coordinated national and local action and provide human and financial resources for communication, while noting that the source does not specify budgets, financing sources, costings, funding allocations or a detailed accountability framework.[14][15]

Monitoring & Evaluation

Monitoring and evaluation provisions are limited but include a national target to reduce physical inactivity by 15% by 2030, use of the Global Action Plan on Physical Activity self-assessment and situation-analysis tools, and planned evaluation of the recommendations every five years.[1][17][15][20]The guideline does not set out a comprehensive implementation monitoring or accountability framework.[17][2]

• Use the Global Action Plan on Physical Activity Self-assessment Tool during guideline development; the resulting report is identified as an indicator of how Tanzania will implement the guidelines.[1]
• Conduct situational analysis using the Global Action Plan on Physical Activity Situation Analysis Tool, review evidence and existing survey findings, and document findings in a report following World Health Organization procedures.[17]
• Track progress towards reducing physical inactivity by 15% by 2030, consistent with Tanzania’s adoption of the Global Action Plan on Physical Activity 2018–2030.[1]
• Use the 2012 Step Survey as a baseline reference, which reported that 36% of Tanzanian men and women had sufficient physical activity.[21]
• Validate the physical activity questionnaire and use it to evaluate the recommendations every five years.[15][20]
• Update the guidelines after five years, or sooner where advances in device-based activity measurement or rapidly evolving sedentary-behaviour evidence justify earlier revision.[15][20]
• Assess activity through mode, frequency, duration and intensity; intensity can be measured through oxygen consumption or heart rate, or estimated through perceived exertion and the walk-and-talk test.[4]
• Use physical-activity domains, including occupational, domestic, transport and leisure activity, as relevant measurement concepts.[8][4]
• Consider health outcomes identified in the evidence base, including mortality, cardiovascular disease, hypertension, cancer, type 2 diabetes, mental health, cognitive health, sleep, adiposity, functional capacity and falls.[5][6]
• Apply recommendation-strength and evidence-certainty ratings, including strong and conditional recommendations supported by low, moderate or higher certainty evidence depending on the population and activity recommendation.[11][9][12]
• Strengthen research on dose-response relationships, light-intensity activity, sedentary-time interruption, activity domains, combined activity and sedentary effects, and evidence from low- and middle-income countries and underserved populations.[13]
• Improve future evidence reviews by addressing unpublished evidence, publication-bias assessment and reporting of excluded studies.[13]

The supplied material does not specify indicator definitions beyond the implementation report, physical-activity measures and the 2030 inactivity target.[1][4]It also does not specify routine reporting schedules, surveillance data sources, responsible reporting bodies, performance thresholds, corrective-action procedures or formal accountability mechanisms.[17][2][15]

Costing & Financing

No budget, costing methodology, financing arrangement or quantified resource requirement is provided for implementation of the National Physical Activity Guidelines.[1][22][17][2]

• Recognise that scaled-up, coordinated national and local action requires investment, although the source provides no amount, funding source, allocation or financing mechanism.[14]
• Provide human and financial resources for communication strategies, without specifying the required level of resources or how they will be financed.[15]
• Address no stated funding gap, resource-mobilisation plan, economic appraisal, cost-effectiveness analysis, economic assumption or implementation cost by population group, sector or activity.[3][13][14][15]

The source therefore does not permit estimation of programme costs, total budget needs, donor or domestic financing shares, or the financial implications of dissemination, surveillance, implementation and periodic guideline updates.[15][20]