It is recommended that children aged 5 to 17 years should accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity (MVPA) daily.1,2 However, there is limited empirical evidence on how much physical activity Ghanaian children and youth engage in. Although the Ghana Education Service requires at least 80 minutes per week of physical education3 in schools, in practice, this is often not achieved. When children and youth fail to achieve the minimum recommended physical activity levels, they are at risk of adverse health consequences. The purpose of this short paper is to summarize the results of the 2018 Report Card (Figure 1).
Experts from various sectors related to physical activity were identified and formed the Ghana Report Card Working Group that gathered data and information. A combination of manual literature search, document review, and systematic evidence gathering for relevant information spanning 2016 to 2018 was conducted. Grades were based on the best available evidence. Sources included policy guidelines, peer-reviewed published literature, and gray literature including reports of government and nongovernment institutions.
The data were aggregated and consolidated following a harmonized process (Tremblay, et. al 2016).4 Grades (A = excellent, to F = failing) were assigned to each of ten common indicators using a standardized grading rubric. The ten common indicators were: Overall Physical Activity, Organized Sport and Physical Activity Participation, Active Play, Active Transportation, Sedentary Behaviours, Physical Fitness, Family and Peers, School, Community and Environment, and Government. Experts in the working group appraised the available evidence, discussed discrepancies, and reached consensus, before awarding a grade for each indicator. Assigned grades and justifications, were submitted, and audited by the scientific sub-committee of the Active Healthy Kids Global Alliance (www.activehealthykids.org).
Results and Discussion
While all 10 indicators were assigned a grade in the 2018 Ghana Active Healthy Kids Report Card, research gaps, policy and monitoring issues remain to be addressed to better inform the grades. A more robust assessment, for example, keepfit club membership statistics, would assist in providing a more complete picture of the physical fitness of children and youth in Ghana. At present, many keepfit clubs abound in the country but without an objective monitoring or surveillance system. Grades and justifications for all 10 indicators are shown in Table 1.
Grades and rationales for Ghana’s 2018 Report Card
|Overall Physical Activity||C||Literature and documentation of physical activity levels is still minimal as reported in earlier Report Cards. However, expert observations of various forms of physical activities that children and youth engage in (for example, school sports and physical education, walking and cycling to school, weekend keepfit activities, games) revealed approximately 48% of children and youth engage in some form of MVPA.|
|Organized Sport and Physical Activity Participation||C+||54% - 59% of children and youth are engaging in organized school-based sports classified as inter-zonal, inter-district, inter-regions and national sports festivals. These are in addition to recreational sports organized by non-government organizations and communities.|
|Active Play||B-||Based on the 2017 Right to Play report, it is estimated that 60% of Ghanaian children and youth engage in various forms of play-based activities at school, home and in open spaces around the 216 districts in the country.|
|Active Transportation||C+||About 54% of children and youth, especially those in the rural areas, walk to school and back home covering about 2km.|
|Sedentary Behaviours||INC||There was no data to describe children and youth’s sedentary behaviour and/or screen time per day. Hence, the indicator was graded as incomplete (INC).|
|Physical Fitness||INC||There are over 500 keepfit clubs in Ghana. Although many children and youth participate in their activities, there are no data to describe children and youth’s physical fitness levels. The indicator was graded as incomplete (INC).|
|Family and Peers||F||No additional data exist to support grade adjustment, so the 2016 grade was maintained.|
|School||D||There is an evidence of progress with the Physical Education and Sport as indicated in the National Teacher Education Curriculum Framework 20185 and the Physical Education and Sport Implementation Guidelines endorsed by government. This framework seeks to improve physical activity and sports in the country among children and youth.|
|Community and Environment||D+||Creation of 46 community day senior high schools in 2017 resulted in provision of modern school infrastructure that provides a safe environment and promotes physical activity for the school children.|
|Government||D||The Physical Education and Sports implementation guideline 2018, the Physical Education and Sport Strand 2018, the National Teacher Education Curriculum Framework 2016, and the new Physical Education and Sports curriculum has been developed to be implemented in the 2018/2019 academic year in the Colleges of Education in Ghana, constituting some evidence of government strategies.|
Expert observations reveal that the proportion of Ghanaian children who achieve the World Health Organization recommended amount of physical activity1 is low. The mandate of the Ghana Education Service of at least 80 minutes per week of physical education in schools must be enforced, monitored and schools held accountable for compliance. Due to the associated health consequences, particularly in adulthood, a more coordinated strategic approach to physical activity promotion is necessary to increase physical activity levels for better health.
World Health Organization. (2010). Global Recommendations on Physical Activity for Health. Geneva, Switzerland: WHO Library. http://www.who.int/dietphysicalactivity/factsheet_recommendations/en.
Word Health Organization. (2016). Report of the Commission on Ending Childhood Obesity. Geneva, Switzerland: WHO Library. http://www.who.int/end-childhood-obesity/en.
Ghana Education Service. Ghana Education Service: Physical Education and Sport Implimentation Guidelines. Physical Education and Sport Guide. Accra, Ghana: Ghana Education Service; 2018.
Tremblay MSBarnes JDGonzalez SAet al. Global Matrix 2.0: Report card grades on the physical activity of children and youth comparing 38 countries. J Phys Act Health. 2016;13(suppl 2):S343–S366. doi:10.1123/jpah.2016-0594