Prevalence and determinants of physical inactivity among adults in Africa: A multicountry analysis using World Health Organization STEPwise approach to surveillance surveys (2014–2019)
Mwewa M. Chisanga, Wingston Felix Ng’ambi, Samuel Mutasha, Adoration Chigere, Cosmas ZyamboBackground:
Physical inactivity (PI) is a major global risk factor for noncommunicable diseases (NCDs), causing around 5 million deaths annually. PI is defined by the World Health Organization as insufficient physical activity to meet current health recommendations, namely <150 min of moderate-intensity or 75 min of vigorous-intensity physical activity per week among adults. In Africa, rapid urbanization and lifestyle transitions have fueled increasing inactivity, particularly in urban settings. This study examined the prevalence and determinants of PI among adults in Africa.
Methods:
This cross-sectional study analyzed World Health Organization STEPwise approach to surveillance (STEPS) survey data collected between 2014 and 2019 from twelve African countries, focusing on adults aged 15–69 years. Weighted logistic regression was used to explore associations between PI and sociodemographic, behavioral, and biomedical factors while accounting for complex survey design to ensure national representativeness.
Results:
The study found an overall PI prevalence of 16.7% (95% confidence interval [CI]: 15.9–17.5), with higher rates among women (20.8%) than men (10.6%) and in urban (20.3%) versus rural residents (12.1%). A pronounced age gradient was observed, with inactivity increasing steadily from 9.1% among those aged 15–19 years to 31.0% among adults aged ≥65 years. This age-related increase was evident in both sexes; however, females consistently exhibited higher levels of PI than males across all age groups. Overall, PI was nearly twice as prevalent among females (20.8%) compared with males (10.6%; 95% CI: 9.8–12.0), indicating a clear gender-based disparity superimposed on the age trend. Higher education, self-employment, and chronic conditions such as hypertension (25.9%) and diabetes (20.7%) were associated with PI. Predicted probabilities confirmed a sharper rise among older women, highlighting key high-risk groups.
Conclusion:
PI affects one in six African adults, rising with age and disproportionately higher among women, urban residents, and those with higher education. It is strongly associated with hypertension, diabetes, and poor dietary habits, highlighting its contribution to the growing burden of NCDs. Targeted, context-specific interventions are needed, including gender-sensitive programs, life-course approaches, urban planning for active living, and integration with NCDs prevention. Such strategies can reduce sedentary behavior and support healthier, more active populations across Africa.