Global Public Health Volume 9, Issue 4, 2014

Global Public Health
Volume 9, Issue 4, 2014
http://www.tandfonline.com/toc/rgph20/current#.Uq0DgeKy-F9

Review of the epidemiological evidence for physical activity and health from low- and middle-income countries
DOI: 10.1080/17441692.2014.894548
Karen Miltona*, Rona Macnivenb & Adrian Baumanb
pages 369-381
Abstract
Almost 80% of deaths from non-communicable diseases (NCDs) occur in low- and middle-income countries. Physical inactivity is a key risk factor for NCDs. Enhancing understanding of the scientific evidence linking physical activity and health in low- and middle-income countries is important for supporting national efforts to promote physical activity and reduce NCDs in these countries. A systematic review of three electronic databases was conducted in July 2013, including large population-based epidemiological studies with adult participants, conducted in low- and middle-income countries, and published in the past 30 years. Physical activity was consistently associated with a reduced risk of all-cause mortality, cardiovascular disease (CVD), diabetes and several types of cancer. Positive associations were also found between physical activity and body composition (including overweight and obesity), blood pressure, cholesterol, metabolic indices and bone mineral density. Overall, the results confirm that the epidemiological research into the health benefits of physical activity in low- and middle-income countries is consistent with previous research conducted in high-income countries. This summary of the available research can be used as an advocacy tool in low- and middle-income countries to support greater prominence of physical activity in NCD policies.

La situación económica: Social determinants of contraceptive use in rural Honduras
DOI: 10.1080/17441692.2014.890238
Marissa G. Hallab*, Jenna J. Garrettc & Clare Barringtonab
pages 455-468
Abstract
Contraceptive use is an important determinant of unintended pregnancy, but little is known about the social and structural factors that determine women’s contraceptive use in rural Honduras. In this study, we aim to characterise the individual and social determinants of contraceptive use among women in rural Honduras. In 2011 and 2012, we conducted 14 interviews and 2 focus groups with women 18 years and older. In our analysis, we created a family-planning narrative for each participant and coded transcripts around key emergent themes related to these determinants. We found that social determinants – including poverty, gender dynamics and availability of family-planning methods – had a strong influence on contraceptive use among women in our sample. Study participants stated that they were faced with a difficult economic situation compounded by rising prices of basic goods and diminishing job opportunities. Paradoxically, at the same time that the economic situation led women to seek contraception, it also contributed to the structural barriers that limited their ability to obtain their method of choice and maintain continuous contraceptive use. Our findings suggest the need for multi-level efforts to create an enabling and sustainable environment for family planning among women in rural Honduras.