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PROMOTING PHYSICAL ACTIVITY IN URBAN SETTINGS
THROUGH EQUITABLE ACTION
IN THE EASTERN MEDITERRANEAN REGION
DRAFT
An Internship Report by: Sami Hasni
For the Health Education and Promotion Unit

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Background
Physical inactivity in the Eastern Mediterranean Region ranges from 30% of the population in
some countries, to as high as 70% in others. Of all the WHO’s regions, ours has the highest
levels of physical inactivity worldwide among young adults and females, and the second highest
among adults after the Americas. Physical inactivity is a major contributor to the contraction of
non-communicable diseases (NCDs), and therefore addressing physical inactivity can result in
greater health and productivity, especially in urban areas.
Physical inactivity is nowadays a predominantly urban rather than rural issue. The WHO Health
Survey of 2002 and 2003 (Figure 1) has revealed that men and women are more likely to be
physically inactive compared to their rural
counterparts. The results in Figure 1 are taken
from a 51 sample country study, Worldwide
Variability in Physical Inactivity, and includes
figures from Pakistan, Tunisia and the United
Arab Emirates. Whilst the aforementioned
study does not offer specific figures regarding
levels of physical inactivity in urban versus
rural areas, the issue is exemplified in Saudi
Arabia for example, where higher obesity rates
are recorded in urban areas than in rural
regions. A study entitled ‘The Prevalence of
Physical Activity and Sedentary Behaviours
Relative to Obesity among Adolescents from
Al-Ahsa, Saudi Arabia: Rural versus Urban
Variations’ found that 21.2% of urban students
in Saudi Arabia are obese as opposed to 12.7%
of rural students.
This issue of physical inactivity becomes even more of a pressing concern due to rapid
urbanisation, which has become a distinct characteristic of many of the region’s Member States.
Rapid urbanisation is driven by rapid population growth and by economic and development
policies that have encouraged a change from agrarian to urban-based economic activities. The
urban population in the region has increased to over 332 million people in 2015, according to the
World Bank, meaning that 51.25% of the region’s population lives in urban areas; this includes 2
megacities, Cairo with 22 million people, and Karachi with 23.5 million citizens. These figures
will continue to increase in the coming years, as 14 of the 22 Member States have an annual
urban population growth rate of between 2.2% and 8.4%.
The ever-increasing rural-to-urban migration flows and rapid population growth can result in:
Figure 1: Prevalence of inactivity in 51 sample countries, by age group and
urbanity for men and women, WHO World Health Survey 2002-2003.

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 The unplanned expansion and proliferation of urban slums and low-income settlements,
rife with crime, violence, and feelings of unsafety.
 Excessive amounts of pressure on municipalities, infrastructure and national budgets.
 A reduced capacity for adequate urban planning, particularly in low-income countries
where there is a lack of resources and economic opportunities.
 Uncontrolled urban development.
 High levels of pollution and poor public transportation systems.
The health, social and environmental impacts of urbanisation can therefore discourage physical
activity and provide a powerful argument for city planners, municipal authorities, NGOs and
civil societies in their efforts to increase physical activity, and thus improve urban health.
Lack of safety in the EMR’s urban areas:
The aforementioned processes of urbanisation have created cause for concern for pedestrians and
cyclists in the region, with many factors threatening their safety and thus hindering their
incentives to become physically active.
Harassment:
This is a pressing issue in the region, especially for women. Data compiled from the Thompson
Reuters Foundation, the World Report 2014 and the Foundation for Sustainable Development
revealed the 10 most dangerous countries to be a women. Amongst the top 10, 4 countries
(Afghanistan, Egypt, Somalia and Pakistan) were from our region. Another study by Stop the
Street Harassment has shown that several countries from the region are amongst the world’s
worst offenders in terms of sexual harassment.
 Egypt: In 2008 the Egyptian Centre for Women’s Rights surveyed 2,000 Egyptian men and
women and 109 foreign women in four governorates in the country, including Cairo and
Giza, about sexual harassment on Egyptian streets. 83% of Egyptian women reported
experiencing sexual harassment on the street at least once and nearly 50% of the women said
they experience it daily. 98% of the foreign women surveyed reported experiencing sexual
harassment while in Egypt. Wearing a veil did not appear to lessen a woman’s chances of
being harassed. About 62% of Egyptian men admitted to perpetrating harassment. Egypt has
also been considered the Arab country that is the ‘worst for women’ according to a Trust
study.
 The United Nations Entity for Gender Equality and the Empowerment of Women published a
report in 2013 showing that 99.3% of Egyptian women have experienced some form of
sexual harassment. The study indicates that “96.5% of women in their survey said that sexual
harassment came in the form of touching, which was the most common manifestation of

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sexual harassment. Verbal sexual harassment had the second-highest rate experienced by
women with 95.5% of women reporting cases.”
 Yemen: In Yemen, the Yemen Times conducted a survey on teasing and sexual harassment in
Sana’a in 2009. 90% of the 70 interviewees from Sana’a said they had been sexually
harassed in public. 72% of the women said they were called sexually-charged names while
walking on the streets and 20% of this group said it happens on a regular basis. About 37%
of the sample said they had experienced physical harassment. Like those in Egypt, these
survey results implied that being veiled did not lessen the harassment, because wearing a veil
in public is so common.
 Saudi Arabia: Nearly 80% of women ages 18 to 48 said they had experienced sexual
harassment, including street harassment, in a study reported in Al-Monitor in 2014.
 Pakistan: In a study by Bargad of more than 200 youth in Gujranwala, Pakistan, 96 percent
of the girls experienced street harassment.
Road Traffic Injuries:
Another pressing issue in the region, the increasing risk of road traffic injuries discourages forms
of physical activity in urbanising cities. Road traffic crashes remain a major public health
concern, and the WHO Global Status Report on Road Safety 2015 reveals that the Region is
responsible for 10% of the world’s road traffic deaths with a fatality rate of 19.9 per 100,000
population compared to a global rate of 17.6 per 100,000. The region also has the second highest
fatality rate after the African Region. Globally, pedestrians and cyclists are extremely vulnerable
from road traffic injuries, with 49% of total traffic of all road traffic deaths affecting these
physically active groups. Figure 2 shows distribution of road traffic fatalities, focusing on
pedestrians and cyclists in featured countries from the East Mediterranean Region, from the
WHO Global Health Observatory.
Table 1: Distribution of road traffic deaths by typeof road user, WHO Global Health Observatory2010; WHO Global Status
Report on Road Safety 2015
Country Reported Fatalities/WHO estimates Pedestrians (%) Cyclists (%)
Bahrain 86 / 107 38.7 10.7
Iran 17,994 / 24,896 28.6 No data
Jordan 768 / 1913 32.5 No data
Lebanon 649 / 1088 32.8 0.6
Morocco 3832 / 6870 26.3 5.8
Oman 913 / 924 23.4 3.2
Pakistan 7636 / 25,781 40.9 No data
Qatar 204 / 330 32.5 0.9
Sudan 2349 / 9221 33.0 No data

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Syria 3122 / 5091 30.4 No data
Tunisia 1505 / 2679 27.7 3.8
UAE 651 / 1021 28.7 0.9
Violence and Conflict:
Several of the region’s Member States have suffered from ongoing conflict for many years now.
Palestine, Syria, Iraq, Libya and Afghanistan are particular countries where the fear from conflict
and violence discourages urban populations to go out and partake in physical activity.
 Palestine: BioMed Central in 2012 found that although 63% of surveyed Palestinian men
met physical activity recommendations, this was rather from domestic and occupational
chores, rather than actually going out and enjoying exercise. Only 39% of Palestinian women
were found to be physically active, mainly due to cultural norms and their domestic roles in
society. Palestinian women also have lower rates of walking than their Israeli counterparts,
with the fear of violence proving a key factor in their decisions to stay at home.
Although the above issues appear to be major challenges to the safety of pedestrians and cyclists
in some countries, there are other factors examined in the following section.
Regional gaps and challenges
The review showed that existing regional policies and programmes dealing with physical activity
and active living in the urban settings of the Eastern Mediterranean’s Member States are severely
lacking by way of addressing the aforementioned issues of physical activity in urban areas. Very
few countries in the region have programmes and policies in place to increase and support
participation in physical activity, and even less address the need for built and social
environments conducive to promoting physical activity. For example, within the region, only
Iran and the UAE have implemented national policies that promote walking and cycling. In
addition, only 10 out of the 22 countries have national policies that promote public transport over
cars. Whilst many Member States have national policies and laws geared at improving
healthcare, promoting sports and implementing physical education curriculums, there remains a
policy gap regarding providing environments that are conducive to physical activity. Therefore,
although countries have taken steps towards more active and healthy populations, these count for
nothing when the environment is not conducive and does not allow for greater physical activity.
The fact that only 2 of the region’s countries have national policies to separate road users and
protect vulnerable road users (Figure 3) is testament to this.
Furthermore, the region’s rapid urbanisation has not been accompanied by much government,
urban or transport planning. In Cairo for example, around 60% of the 20 million metropolitan

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population are living in informal settlements according to the EU Commission Annual Action
Programme, and therefore areas such as Baten El Bakra are rife with poverty, crime and
illiteracy. All these factors hinder physical activity promotion.
Table 2: Policy gaps regarding physicalactivity and road safety in the Region, WHO Global Status Report on Road Safety 2015
Social Determinants of Physical Inactivity in urban settings:
 Lack of affordable leisure facilities – 24.1% of Mansoura University students responded
that high costs of leisure facilities were a barrier to their participation in physical activity.
 Lack of outdoor spaces (e.g. public parks and other green spaces) – 35.5% from the same
survey responded that they lacked accessible and suitable sports places, and 31.9% said they
lacked safe spaces for physical activity.
 Rapid urbanisation, inadequate public transport systems and heavy reliance of cars – in
Egypt car ownership increases by 4.2% per annum as new towns with huge investments
involve large travel distances; the lack of sidewalks and scarcity of facilities has reduced the
desire to walk or cycle and increased the need for cars.
Country
Has an operational policy,
strategy or action plan to
reduce physical inactivity
and/or promote PA
Policies to promote
walking and
cycling
Regular
inspections of
existing road
infrastructure
Policies to
encourage
investment in
public transport
Policies to separate
road user and
protect VRUs
Afghanistan No No No No No
Bahrain Yes No Yes Yes No
Djibouti No No No No No
Egypt No No Yes No No
Iran Yes Subnational Yes Yes Subnational
Iraq Yes Yes No Yes No
Jordan Yes No Yes Yes No
Kuwait No No Yes Yes No
Lebanon No No Yes No No
Libya No No No data Yes No data
Morocco No Yes Yes Yes Yes
Oman Yes Subnational Yes Yes Subnational
Palestine No No Yes No No
Pakistan No No No Subnational No
Qatar Yes Yes Yes Yes Yes
Saudi Arabia Yes Subnational Yes Yes No
Somalia No No No No No
Sudan Yes Subnational Yes Subnational Subnational
Syria No Yes Yes Yes No
Tunisia No No No Yes No
UAE No Subnational Yes Yes Subnational
Yemen No No Yes Yes No

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o Limited, congested, unsecured and ill maintained transportation means constitute a
major reason for people to prefer using private transportation.
o The use of motorized transportation is associated with higher socio economic status
and change in lifestyle increasing the risks of NCDs.
o Current public transportation systems/means are not always accessible to a vast
majority of people age, gender and social status
o Meeting the global recommendations is as simple as engaging in about 150 minutes
per week of moderate physical activity requires structural adaptation of the transport
systems together with change in individual behaviour.
o Aspirations of emerging middle class to have more motorized vehicles per household
as a means of new life style in high and middle countries of the EMR.
 Lack of ‘walkable’ neighbourhoods, feelings of unsafety (especially for women) – e.g.
96% of surveyed girls in Gujranwala, Pakistan experienced street harassment; 83% of
surveyed Egyptian women and 90% of surveyed foreign women in Egypt experienced sexual
harassment; 70% of surveyed women in Sana’a, Yemen had been sexually harassed in
public; nearly 80% of surveyed women aged 18-48 in Saudi Arabia experienced sexual
harassment.
 Traffic, congestion, noise pollution, and CO2 emissions – cyclists and pedestrians
amounted to 49.4% of road traffic deaths in Bahrain in 2010.
 Poor (or no) urban planning - 20 million people live in the Greater Cairo region, and
around 60% of that population lives in informal, underserved and densely built areas with a
lack of basic physical infrastructure. Generally residents develop their habitat independently
without obtaining building permits.
o Rapid and unplanned urbanisation stemming from the quest for job opportunities
results in more pressure on the already weak transport systems in the main cities and
the formation of informal settlements.
o Limited involved of civil society in the policy and program development of urban
planning/design.
 Socio-economic status, income, and education levels - in Dubai, the 17.4% of men who get
‘moderate’ to ‘vigorous’ physical activity, come prominently from the highest 20% of
income earners (43.2%) and are mostly university educated or above (26.5%); Indians and
other Asians in Dubai, who tend to partake in underpaid labour have the lowest levels of
physical activity of all races (17.8% Indians, 13.8% other Asians).
 Culture and traditions – Only 27% of Qatari women are physically active and this level is
shaped by cultural and social norms around women’s domestic roles in society; 27.8% of
Europeans in Dubai get moderate to vigorous levels of physical activity as opposed to only
19.2% of Emirati nationals.
 Conflict – in Palestine, Syria, Iraq, Libya and Afghanistan the fear from conflict discourages
urban populations to go out and partake in physical activity.
o The region is living unprecedented unrest and the flow of refugees together with
populations in quest of job opportunities results in more pressure on the already weak
living systems in the main cities due to the formation of informal settlements.

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CASE EXAMPLES OF LOCAL INTERVENTIONS TO PROMOTEPA IN URBANSETTINGS
Evidence has shown that urban settings that have conducive environments include:
 Available, safe and functional public transport that is gender-sensitive and age friendly.
 Enforced legislations on road traffic accidents/injury and street violence.
 Enforced legislation to control the negative impacts of rapid urbanisation, industrial
development and the creation of informal illegal settlements.
 Availability of green spaces, pedestrian zones ….
Global
Woonerf:
The woonerf (a Dutch word that means ‘street space for living’) is a common space shared by
pedestrians, cyclists and low-speed motor vehicles. They are usually streets raised to the same
grade as curbs and sidewalks, and vehicles are slowed by placing trees, planters, parking areas
and other obstacles in the street. Motorists are treated as intruders and must travel at walking
speed. A woonerf identification sign is placed at each street entrance. This shared street
approach, which has been successfully applied in Germany, the Netherlands and other
countries in northern Europe, may be particularly useful to cities that have restricted
access to green space.
York:
The City of York has won numerous awards for developing an integrated transport network
that does not rely on private cars and meets local air quality objectives. An integral part of
that strategy promotes sustainable active alternatives to the private car that are both
convenient and reliable by using public transport, walking and cycling. York was one of the
first local authorities to adopt a hierarchy of transport users when making decisions related to
land use and transport and in implementing transport measures. The order of priority is:
1. Pedestrians 6. Commercial or business users
2. People with mobility problems 7. Car borne shoppers and visitors
3. Cyclists 8. Car borne commuters
4. Public transport users
SR2S California:
Safe routes to school generally involve improvements to the walking environment connecting
residential areas with local schools in order to facilitate children travelling to school on foot or
by bicycle as opposed to by car. The California Safe Routes to School programme included the

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improvement or creation of footways, traffic signals, pedestrian crossings and bicycle
paths. An evaluation of the programme at ten nearby schools found that 21% of children
walked or cycled to school and those who passedthe SR2S were more than three times
more likely to have increased their active travel to school than those who did not. Changes
to footways and traffic signals appeared to correspond with increased active travel more than
changes to crossings. In the UK, the National Institute for Health and Clinical Excellence
recommended creating and maintaining safe routes to school as one of the effective approaches
to promoting physical activity through environmental changes.
Portsmouth speed limit areas and zones:
Portsmouth City Council’s area-wide 20mph speed limit zone scheme, which covers 94% of
roads in Portsmouth, is the first extensive example in England of area-wide speed limit
reduction. The proportion of children walking to school in the Portsmouth local authority
area increased from 67.5% to 72.5% in the first year after implementation with an
associatedreduction in the proportion travelling by car. Public perception was generally
good, with 40% of respondents believing that vehicle speeds had reduced and 43% agreeing that
the environment was safer for walking and cycling.
Regional
Bicycle Hire, Tehran:
Tehran has introduced a bicycle sharing scheme funded by Tehran’s municipal government. The
scheme aims to reduce congestion of the streets of Tehran and decrease pollution. Twelve
bicycle ‘hubs’ are positioned across the city, each housing around 40 bikes. Over 6000 people
have subscribed to the scheme which allows the use of a bicycle for up to 4 hours at a time. The
city of Isfahan has developed a similar scheme and the city-wide travel card includes the option
of bicycle hire, along with the use of train, tram and busses.
In London, with the introduction of ‘Boris Bikes’, cycling amongst Londoners has almost
trebled in the past decade, and cyclists now account for a fifth of all road based traffic in the
centre. The scheme has been heralded as an environmental and health success, with congestion
reducing and levels of physical activity increasing.
Sayeb El Trottoir, Tunisia:
In Sfax, Tunisia’s second city, Zied Mallouli and fellow young Tunisians created a social media
campaign to raise awareness and sensitise the issue of disrespecting traffic and parking
rules. The campaign, ‘Sayeb el Trottoir’ (liberate the pavement), has an objective to preserve
the pedestrians’ rights to the pavement, and to report those who do not respect these rights by
calling the authorities to battle against the issue of cars abusively exploiting pavements in Sfax.

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The campaign works closely with local authorities, police and towers, who are mobilised to
take action when called upon.
Sharjah WHO Healthy City:
In 2015 Sharjah was declared a ‘Healthy City’ by the WHO. Key to achieving this status was the
continuous improvement of the physical environment and the expansion of community
resources available to residents. Sharjah has been systematically developing its infrastructure,
services and resources in order to ensure the well-being and success of the city and its residents.
There has been heavy investment in strategies to promote sustainable development
including investment in environmental and leisure initiatives that allow for more conducive
environments for physical activity. Based on Sharjah’s successful implementation of WHO
Healthy Cities’ criteria and its commitment to sustainable development and creating a
healthy urban environment, the city has become unique in the Eastern Mediterranean Region.
The emirate now plans to become a regional training centre for other cities in the Region that
engage in the WHO programme.
Moving the RegionalCall to Action on PA
In order to rectify the social determinants of physical inactivity, there is a need for urgent
interventions and a call for action. The call to action must have a clear vision and direction, and
this should be that:
Urban planners need to move towards a direction where they can create more ‘walkable’
cities in order to promote active living.
In order to do so, urban and transport planning must shift away from a logistics and material
mind-set to a more user experience one.
These are broad objectives that can be adapted depending on each country:
1. Design urban environment encouraging people to rely less on personal motorized vehicles
and supporting access to safe, gender-sensitive and age-friendly public transport, cycling and
walking.
2. Enforce security and road safety legislations reducing risks linked to road traffic
accidents/injury and street violence.
3. Develop and implement urban planning policy with natural and recreational spaces.
4. Raise community knowledge and awareness and shift social norms via public education and
media campaigns.
Improving urban design and transportation systems should be an integral part of the national plan
of action and be accompanied and followed by:

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a) A series of supportive programs to local municipalities.
b) Environmental changes to decrease reliance on motorized vehicles through better compliance
to pollution control programmes, road traffic injuries prevention, road building, etc.
c) National days to promote “no car days”
d) Subsidies to municipalities promoting safe and user friendly modes of transportation
e) ‘Active transport,’ when integrated into the daily schedule, is an effective strategy to increase
levels of physical activity through walking, cycling and other forms of non-motorized
transport.
POTENTIAL GLOBAL AND REGIONAL PARTNERS
WHO Collaborating Centre at UWE Bristol - The WHO Collaborating Centre for Healthy
Urban Environments promotes healthy and sustainable settlements through research, teaching,
consultancy, knowledge exchange and publications. They work closely with municipalities,
planning consultancies and health authorities in the UK, as well as with the wider WHO
European Healthy Cities network.
UN Habitat III - the United Nations Conference on Housing and Sustainable Urban
Development, to take place in Quito, Ecuador, from 17 – 20 October, 2016. The Conference will:
• Rethink the Urban Agenda: By embracing urbanisation at all levels of human settlements, more
appropriate policies can embrace urbanisation across physical space, bridging urban, peri – urban
and rural areas, and assist governments in addressing challenges through national and local
development policy frameworks.
• Integrate Equity to the Development Agenda: Equity becomes an issue of social justice, ensures
access to the public sphere, extends opportunities and increases the commons.
• Foster national urban planning and planned city extensions.
• Decide how relevant sustainable development goals will be supported through sustainable
urbanisation.
• Align and strengthen institutional arrangements with the substantive outcomes of Habitat III, so
as to ensure effective delivery of the New Urban Agenda.
• Revise and renew UN – Habitat’s mandate to ensure that it is fit for purpose. UN – Habitat is
ready to join efforts with Governments stakeholders to promote a new model of urban
development for the twenty – first century.
Living Streets – UK charity for everyday walking. They aim to create a walking nation where
people of all generations enjoy the benefits that walking brings, on streets fit for walking. Living

12. 12
Streets is an organisation which advocates for the rights and interests of pedestrians and aims to
'create safe, attractive and enjoyable streets, where people want to walk'.
Sustrans – A leading UK charity enabling people to travel by foot, bike or public transport for
everyday journeys. Sustrans work with families, communities, policy-makers and partner
organisations so that people are able to choose healthier, cleaner and cheaper journeys, with
better places and spaces to move through and live in.
The aforementioned organisations share similar visions and objectives to those proposed in this
report. The call to action has called for a shift towards more ‘walkable cities’ to promote active
living. Likewise the International Society for Physical Activity and Health seek to advance and
promote physical activity as a global health priority through research, education, capacity
building and advocacy. On an urban level the WHO Healthy Cities Network works with
municipalities, planning consultancies and other health and planning stakeholders and
communities with objectives to promote healthy urban environments and education, and to
develop and promote tools for the built environment to aid decision making. Both these
organisations share very similar objectives to us, and both actively seek to partner in global
collaborations with key organisations at national and international level to advance physical
activity and healthy urban planning. In addition, the UN Habitat III programme aim to foster
sustainable urban development and develop new models of sustainable cities through
implementing urban rules and regulations, re-evaluating urban planning and design, investment
in basic urban services and to ensure equitable municipal finance budgets and systems
This year, two key events shall take place:
 17-20 October 2016 - UN Habitat III Conference on Housing and Sustainable Urban
Development in Quito, Ecuador
o Goal: To rethink the urban agenda.
o Objectives include:
o To foster national urban planning and planned city extensions.
o To decide how to support Sustainable Development Goals through sustainable
urbanisation.
 16-19 November 2016 – ISPAH International Congress on Physical Activity and Public
Health in Bangkok, Thailand
o Goal: Active Living for ALL: Active People- Active Place-Active Policy.
o Objectives include:
o To generate enabling environments and infrastructures to promote the hybrid life that
enhances healthy outdoor physical activity on-the-go.
o To develop national policy alignment for equal and economically sustainable active
living for all.

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Considering the timing and objectives of these events, and the everyday effects of rapid
urbanisation on the region, this is a vital time to collaborate and work together with the
aforementioned organisations and conferences on equitable and sustainable interventions. Such
conferences have the convening power to bring together key actors needed to achieve the shared
objectives. Solutions can only be found by bringing together Member States, multilateral
organisations, local governments, the private sector and civil society. Collaboration with these
sectors will serve as a tremendous boost, and could result in the achievement of the regional
objectives, and of the following Sustainable Development Goals:
Goal 3: Ensure healthy lives and promote well-being for all at all ages.
SDG 3.6: By 2020 halve the number of global deaths and injuries from road traffic injuries.
Goal 11: Make cities and human settlements inclusive, safe, resilient and sustainable.
SDG 11.2: By 2030, provide access to safe, affordable, accessible and sustainable transport
systems for all, improving road safety, notably by expanding public transport, with special
attention to the needs of those in vulnerable situations, women, children, persons with disabilities
and older persons
SDG 11.3: By 2030, enhance inclusive and sustainable urbanization and capacity for
participatory, integrated and sustainable human settlement planning and management in all
countries.
SDG 11.7: By 2030, provide universal access to safe, inclusive and accessible, green and public
spaces, in particular for women and children, older persons and persons with disabilities.

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Methodology
 Review of key WHO documents offering insight of the current situation of the region, global
case studies and priority actions for promoting physical activity in urban settings:
 Move for Health: Promoting physical activity in the Eastern Mediterranean Region
through a life-course approach - EMRO
 Promoting physical activity through the life course: a regional call to action – EMRO
 Promoting physical activity and active living in urban environments: the role of local
governments – EURO
 Urbanisation and health: health equity and vulnerably populations. Case studies from the
Eastern Mediterranean Region - EMRO
 Global Status Report on Road Safety 2015
 Pedestrian Safety: A road safety manual for decision-makers and practitioners
 Reviewed regional policy and programme mapping exercises.
 Conducted a web search, collecting numerous journals and case studies on community and
government led interventions and actions.
 Addressed social determinants of physical activity using an ecological model adapted from
Sallis et al’s ecological model of physical activity domains (below), which referred to the 7
best investments for achieving physical activity referred to in the Toronto Charter for
Physical Activity.

15. 15
Sources
- Active Living for All – A Framework for Physical Activity in WA 2012-2016 – Government of Western
Australia
- Cairo – World Population Review 2015
- Country Profiles:
http://www.who.int/violence_injury_prevention/road_safety_status/country_profiles/tunisia.pd
- Dubai Household Health Survey 2009; Preliminary Summary of Results Related to Exercise and Physical
Activity 2010 – Government of Dubai
- Distribution of road traffic deaths by type of road user. Data by Country – WHO
- Global Status Report on Road Safety 2015 - WHO
- Grignaffi et al. (2008) ‘Visualising sustainability in urban conditions’ in WIT
- http://www.inkit.ca/getactive/defintion.html
- Karachi – UN Habitat 2014
- Legislations for the prevention of NCDs in EMR Member States: Situation analysis and remedial
propositions – WHO EMRO
- Move For Health: Promoting physicalactivity in the EMR through a life-course approach – WHO EMRO
- Pedestrian Safety: A Road Safety Manual for Decision Makers and Practitioners – WHO, FIA Foundation,
Global Road Safety Partnership,World Bank
- Physical Activity Profile of Students in Mansoura University, Egypt – WHO EMRO
- Promoting Physical Activity Among Arab Women
http://www.aspetar.com/journal/viewarticle.aspx?id=232#.VlGBO3YrLcs
- Promoting physicalactivity and active living in urban environments – WHO Europe
- Role of Built Environments in Physical Activity, Obesity and Cardiovascular Diseases – J. Sallis et al
(2012)
- Socioeconomic Determinants and Health Status of People Living in Ariana, Tunisia – WHO EMRO 2012
- http://www.stopstreetharassment.org/resources/statistics/statistics-academic-studies/
- The New Generation of Participatory Planning of Today’s Cities – Prateek Mittal
- The Prevalence of Physical Activity and Sedentary Behaviours Relative to Obesity among Adolescents
from Al-Ahsa, Saudi Arabia: Rural versus Urban Variations
- http://www.touregypt.net/cairo/cairostatistics.htm
- Transactions on Ecology and the Environment
- UNDP Governance and Sustainable Human Development (1997)
- Upgrading Informal Areas Infrastructures – EU Commission Annual Action Programme 2015
- Urban Transport Issues in Egypt – Khaled el Araby
- Urbanisation and Health: Health Equity and Vulnerable Populations. Case Studies from the EMR – WHO
EMRO
- Walkability Improvements: Strategies to Make Walking Convenient, Safe and More Pleasant -
http://www.vtpi.org/tdm/tdm92.htm
- World Health Organisation Global Health Survey 2002-2003
- World Population Prospects 2015 – United Nations Department of Economics and Social Affairs,
Population Division
- World Urbanisation Prospects 2014 – United Nations Department of Economics and Social Affairs,
Population Division
- Worldwide Variability in Physical Inactivity, a 51 country study
-

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Annex 1
Terms of Reference and Deliverables
Background
The programme is currently focusing on 4 main areas: 1) Strengthening health promotion
capacity at Ministry of Health and community levels; 2) Promoting healthy lifestyles with
special focus on promoting physical activity and healthy diet through regulating marketing of
food rich in sugar; 3) Improving literacy among general public through enhancing health
promotion in media, and through civil society; 4) Communication capacity among EMR Member
States with special focus on community engagement pillar.
Scope of the Assignment
The assignment for the internship concerned mainly the area of promotion of physical activity
and active living in urban settings, including transportation, built infrastructure and social
factors.
Specific Tasks
Under the supervision of the Regional Advisor for Health Education and Promotion, the
incumbent:
 Reviewed existing policies/programmes dealing with physical activity and active living
(PA/AL) in urban settings of Member States of the EMR.
 Identified key local leadership requirements that facilitate the promotion of PA/AL.
 Identified evidence-based education interventions to increase the literacy of the general
public and social mobilisation that are culturally sensitive.
Deliverables
An internship report including:
 A review of existing policies/programmes dealing with PA/AL in urban settings in
countries in EMR.
 Key requirements for local leadership commitments to promote PA/AL by mayors,
governors.
 Key education messages that could be used for mass media campaigns and social
mobilisation that are culturally sensitive.
Duration: 12 weeks