This document summarizes findings from an ongoing systematic review of public space interventions for non-communicable disease prevention in African cities. The review found that few such interventions have been implemented across Africa, with most located in South Africa. Common types of interventions included urban gardens, parks, and recreational facilities. Partnerships between community groups, governments, and other organizations were important for delivering and sustaining public health infrastructure. Potential benefits included increased physical activity, better nutrition, and social impacts. Considerations for implementation and long-term success include supportive policies, inclusive access, and involvement of local organizations.

1. Public Spaces as
Public Health
Infrastructure
Findings from an ongoing
systematic review
Dr. Ebele R. I. Mogo
Global Diet and Activity
Research Group and Network,
MRC Epidemiology Unit,
University of Cambridge

2. How we define
public space
interventions for
public health
Initiatives focusing on dimensions of the
physical environment in communal
spaces shared at the street,
neighbourhood or city level
Examples include infrastructure to
improve neighbourhood walkability,
urban green spaces, recreational
facilities, public gardens, streets,
beaches, parks, amongst others.
We looked specifically for interventions
with implications for non-communicable
disease (NCD) prevention

3. What we included
Existing evidence in academic and grey literature on public space activities
+
Studies focusing on non-communicable disease prevention particularly leisure physical activity
promotion in urban contexts
+
Studies conducted in member countries of the African Union
+
Studies published since 1990 as it coincides with the period when the promotion of the concept of
healthy cities began
+
Studies using primary or secondary data.

4. Public space
interventions
focused on NCDs
do not appear to be
widely distributed in
Africa
0
5
10
15
20
25
30
35
Interventions per country
Spread of interventions

5. Common settings for public
space interventions in African
cities addressing NCDs

6. Example
Growing or connecting? An
urban food garden in
Johannesburg by Will (2010)
Urban food gardening in
Johannesburg carried out by
different NGOs made up of women
ranging from 40-68 years with a
focus on increasing healthy eating
habits by cultivating fruits,
vegetables and herbs. Participants
reported better nutrition, self-
confidence and gardening skills.

7. How people navigate public
spaces for public health
Adhoc activities: e.g. gardening in residences and
community owned plots in "My garden is a great help”:
Gender and urban gardening in Buea, Cameroon by
Ngome (2012)
Scheduled events: e.g a structured soccer program
facilitated by coaches and life skills facilitators in
"There's just something about this club. It's been my
family." An analysis of the experiences of youth in a
South African sport-for-development programme” by
Draper (2016)

8. Common partners
cited as
collaborating to
deliver public
space health
infrastructure
Sport associations
Academic organisations
International organisations
Community groups
Government

9. Example
“Conceptualisation and use of green spaces
in peri-urban communities: Experiences
from Inanda, KwaZulu-Natal, South Africa”
by Munien, 2015
Initiative: Conservation of biologically diverse sites as green
spaces for aesthetics, conservation, and recreation
Partners: Durban Research Action Partnership for
Biodiversity, Climate and People Research Group and the
Environmental Protection, Climate Control Department
Noted that green spaces were used by local community
members for a range of recreational and livelihood purposes
such as relaxation, hiking, biking, playing sport. Green
spaces promoted conservation practices, enhanced
community participation and improved physical activity.

10. Commonly cited impacts of
public space infrastructure as
health interventions

11. Example
“Using soccer to build confidence and increase HCT
uptake among adolescent girls: A mixed-methods
study of an HIV prevention programme in South
Africa”, by Hershow 2015
Use of sports (soccer) to increase HIV counselling and
testing among girls without fear or stigmatization. It was
also a means to change the perception of girls that
soccer is a male-only sport.

12. Considerations in
implementing and
sustaining public
space
interventions for
health
• Public space interventions can serve multiple
wellbeing needs ranging from disease prevention,
health behaviours, socioeconomic empowerment,
life skills development, social cohesion and
community participation
• Need for supportive policies, legislations and
accountability mechanisms to manage them
• Governance that ensures inclusive access, safety
& representative decision making e.g. to prevent
conflicts between urban practitioners and
managers around use of land for urban agriculture
• Support from relevant local organizations e.g.
football associations, non-government
organizations, teachers, community leaders
needed for short & long-term success
• Local public space activities e.g gardening, sports
can benefit from being connected to networks &
funding to help them plan long-term and sustain
their activities