Physical activity profile of Nigeria: implications for research, surveillance and policy

Appraising the status of physical activity surveillance, research and policy in Nigeria is relevant to national and regional public health actions on physical activity promotion and non-communicable disease control. This study aimed to 1) evaluate the physical activity profile of Nigeria and 2) propose strategies for improving physical activity in the country. The Global Observatory for Physical Activity-GoPA! with inputs from local experts systematically collected sociodemographic and physical activity surveillance, national policy and research indicators data for Nigeria in 2014. The Nigerian Country Card highlighting the status of these indicators was developed in 2015 and launched in 2016. Prevalence of physical activity among Nigerian adults was 78% (female=76%, male=79%). There was no physical activity surveillance system and national plan, and no empirical data on the proportion of all deaths directly due to physical inactivity in Nigeria. Few (n=7) articles related to physical activity and public health were published in 2013 and the country occupied the 38th position in the global research ranking, contributing about 0.24% to physical activity research worldwide. Implementing national physical activity plans and multi-sectorial collaborations between government and non-governmental partners are needed to improve physical activity surveillance, research and policy in Nigeria and other African countries with similar physical activity gaps.


Introduction
Physical inactivity-related non-communicable diseases (NCDs) are responsible for about 3 million deaths in sub-Saharan Africa [1].
These deaths are expected to increase up to 80% by 2020 if urgent actions are not taken [1][2][3]. In Nigeria, NCDs already account for at least one quarter and one third of all deaths in males and females, respectively [4]. Improving physical activity level is a recommended strategy for controlling NCDs [1]. However, for effective country specific intervention, it is important to first establish the status of surveillance system, national policy and research capacity on physical activity. Until now, there was no observatory dedicated to monitor physical activity at the country level and worldwide. The Global Observatory for Physical Activity-GoPA! was established to develop a physical activity card that could facilitate the need for country level data collection and monitoring to inform policy and planning of interventions at the population level for each country of the world [5,6]. Nigeria is the sixth largest country of the world and the most populated in Africa [7]. Thus, tracking the physical activity profile of this country is relevant to national, regional and international public health actions. Specifically, evaluating the physical activity profile of Nigeria could help identify research, surveillance and policy gaps and provide information on data needed for effective public health planning and action in the country. The aims of this study were to 1) evaluate the physical activity profile of Nigeria and 2) propose strategies for improving physical activity in the country.

Methods
The Nigerian Country Card (physical activity profile) was systematically created as part of the first set of physical activity country cards developed by the Global Observatory for Physical Activity-GoPA! in 2014. The methods and design of the GOPA! study have been described fully elsewhere [5,6,8]. Briefly, using a standardized methodology and indicators (to warrant comparability over time), GoPA! in 2014 collected data on country characteristics, surveillance, national policy, and research metrics for the world countries and summarized them in accessible and all-inclusive public physical activity country profiles called the "Country Cards". Physical activity data and statistics were collected from recognized and acknowledged sources of information including the World Health's organization Global Health Observatory Data [9], World Bank [10][11][12][13], United Nations [14]. The Lancet 2012 physical activity series [15] and PubMed. Country contacts were selected based on a  Table 1. The detailed description of scoring methods and calculations of the estimated values for the indicators are available on the GOPA's website [16].

Results
The results for the Nigerian Country profile on the five indicators about physical activity are shown in Figure 1.

Discussion
There is no data on the prevalence of deaths due directly to physical inactivity in Nigeria. However, a population prevalence of about one-quarter of all deaths due to physical inactivity-related NCDs is an urgent call to prioritize physical activity as a public health agenda in Nigeria. To scale up effective physical activity interventions against NCDs in Nigeria, there is a need to develop bold initiatives and implement policies that will increase physical activity across all sectors including transportation, urban planning, sports and recreation and workplaces and schools. Although the proportion of Nigerian adults (78%) that met the health recommendations of at least 150 minutes of moderate-intensity or 75 minutes of vigorousintensity physical activity per week, or an equivalent combination [17] was more than the global average of 76.7% [18], about 22% of adults' population in Nigeria still remain inactive. Moreover, it should be noted that the present physical activity estimate for Nigeria was from a subnational study conducted about 2 decades ago [19]. Thus, the Ministry of Health in Nigeria should prioritize the implementation of a national physical activity survey for accurate prevalence estimate for the country. Also, our finding reflects the prevalence estimate for Nigeria; it was derived from a subnational sample of adults in only one of the 37 states of the country [19].
Also, the review of evidence for the research characteristic indicator was done using mainly PubMed search. It is possible that many evidence relevant to Nigeria was omitted using this approach.
However, other available country cards for 140 countries used similar search strategy making the process comparable worldwide.

Conclusion
This study highlights the need to improve the physical activity status

Competing interests
The authors declare no competing interests.