Association between transport-related physical activity and wellness in sub-Saharan Africa: A systematic literature review

Introduction: This systematic review is based on concerns about the rapid urbanization in Sub-Saharan Africa (SSA) that has raised sedentary lifestyles and the need to understand the role of transport-related physical activity (TRPA) in wellness promotion, to explore the association between TRPA and wellness in SSA. Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Transport Research International Documentation (TRID), Scopus, Science Direct, and Web of Science electronic databases for 2009 to 2023 were searched for peer-reviewed English-language studies. The population of focus was TRPA and wellness studies. Two authors independently conducted screening, data extraction, and critical appraisals. Results: 22 studies covering TRPA prevalence, health outcomes, and sociocultural context across eight SSA countries were included in the review. Sample sizes ranged from 32 participants to as many as 14,585 participants. The variation in data collection methods, sample size, and geographical scope provided a comprehensive understanding of TRPA patterns and influences across different contexts. Walking and cycling were prevalent TRPA modes as influenced by cultural and contextual factors. TRPA was positively associated with improved cardiovascular health, prevention of NCDs, and healthier aging. Conclusions: Although there were variations in sample sizes, a consistent body of evidence demonstrated the link between TRPA and wellness in SSA. This review underscores the prevalence of walking and cycling as essential TRPA modes in SSA, influenced by cultural and infrastructural factors. Pedestrian-friendly infrastructure, targeted interventions, and culturally sensitive strategies can potentially promote TRPA and enhance wellness in SSA.