A strategic action plan to improve youths' lifestyles and decrease non-communicable diseases in South-West Nigeria

Abstract

Young people between the ages of 15 and 24 years constitute over one-third of Africa’s population. This is the age where lifestyle behaviour patterns, such as healthy eating, moderate alcohol intake and regular physical activity are established, and can last a lifetime. If smoking, harmful alcohol consumption, physical inactivity and unhealthy dietary patterns, which are risk factors for non-communicable diseases (NCDs), continue into adulthood, it is challenging to change these unhealthy behaviours. Addressing the mentioned risk factors among young people through health interventions that support positive health attitudes and discourage negative ones can change the projected impact of NCDs in Africa. The aim of this research was to develop a strategic action plan that can be implemented to inform youths about non-risky lifestyles in an attempt to decrease their levels of exposure to risks and ultimately decrease NCDs in South-West Nigeria. A cross-sectional, sequential, mixed-methods design was employed over three phases to study risky lifestyle practices among youths, and developed a strategic action plan to improve lifestyle and prevent NCDs. Youths of both sexes, aged 15–24 years old, from six different tertiary institutions located within the six states of the south-west region of Nigeria, formed the population for this study. Pretesting of the questionnaire as well validation instrument were conducted. A combination of stratified convenient sampling and convenient sampling techniques were utilised to select 384 youth respondents in Phase 1 (quantitative phase) and 25 Delphi experts in Phase 3 (qualitative phase). A selfcompleted questionnaire was used for data gathering in Phase 1, and an embedded assessment validation tool, using the e-Delphi Delphi technique, in Phase 3. Descriptive statistics with frequency distribution tables were constructed and Chi-square tests were performed to identify possible associations between variables using the IBM SPSS version 22.0, in Phase 1. Data indicated that 50.5% of youths smoked, 54.7% consumed alcohol, 87.5% spent between 5 to 14 hours sitting daily; 71.9% (n=276) did not often consume fruits, while only 20.8% (n=80) regularly ate vegetables. It was identified that 24.2% of youths had already been diagnosed with lung disease, 18% with heart disease, 4.7% with cancer, 20.6% with uncontrollable weight gain, and 24.7% with diabetes. Of the respondents, 34.1% perceived that an unhealthy lifestyle would not cause NCDs; 10.7% had no idea that their lifestyle determined their health status, while 7.8% indicated that lifestyle cannot influence health status either positively or negatively. Of concern was that only 27.3% of youths were willing to quit smoking, 45.0 to stop drinking alcohol, 35.4% thought they could quit eating unhealthy food, while 37.5% thought they could exercise more. Youths’ indecision in quitting unhealthy lifestyle practices was attributed to peer influence, low self-esteem, poor governmental control, parental influence, as well as uncontrolled freedom. Consequently, it was suggested that strict rules and regulations be imposed, youths be introduced to counselling, and health values be instilled in young people to help improve youths’ quality of life and prevent NCDs. The draft strategic action plan, based on the findings of Phase 1 and the literature review in Phase 2, was validated in Phase 3. Consensus was reached after two rounds of e-Delphi, resulting in the final strategic action plan. The strategic action plan needs to be adopted by government in the south-west region in Nigeria, implemented and monitored by all stakeholders, namely academics, healthcare practitioners, government officials from the Ministry of Health, Ministry of Education, Ministry of Youth Development, Ministry of Agriculture, Ministry of Information, and officials in the government agencies from the National Agency for Food and Drug Administration and Control (NAFDAC), National Drug Law Enforcement Agency (NDLEA), the Nigerian Police Force (NPF) and Nigeria Customs Services (NCS), who were involved in the development and validation thereof.