Macedonia: A physical activity country card – Assessing and monitoring physical activity prevalence, research and policy

Background We start to create a physical activity country cart in 2014 as the baseline for future evaluation of physical activity status of the adult population in Macedonia associated with national public health priority given the significant impact on chronic diseases, general health, development and well-being. The national evidence base for future physical activity strategy, program and action plans that government, communities and families can implement to prevent and promote health had been accumulating, and remains revision every second year. The purpose was to create physical activity profile of the Republic of Macedonia as a member of a Global Observatory for Physical Activity (GoPA).

The prevalence of physical activity in Macedonia It was estimated that only 36% [1] of the Macedonian’s adult population was physically active. Age-standardized prevalence of insufficient physical activity in persons aged 18 years and over are defined as not meeting any of the following recommendations: 150 minutes per week of moderate-to vigorous intensity physical activity per week or 75 minutes per week of vigorous intensity aerobic physical activity or an equivalent combination of both activities [2]. Macedonia has 64% of physical inactivity estimated in the population aged 15 years and over, with women being more inactive compared to men [3]. Prevalence of insufficient physical activity in young adolescents is defined as less than 60 minutes of physical activity of moderate to vigorous intensity daily. The data of adult population is similar to the study of young adolescents aged 16-18 years (Global School-Based 2008 Student Health Survey, GSHS, 2007, IBRef: 102773a1) (4). 86.4% of girls was inadequately active (including inactive) during leisure time versus 76.6% of boys. Regarding to sitting time, 44.9% of youth, both, urban and rural, aged 16-18 years old spent 3 or more hours. 42.2% of girls were sedentary versus 47.5% of boys [4, 5].

Methods Following a standard format GoPA, the review included research data from physical activity prevalence, health burden, surveillance and monitoring of sociodemographic characteristic, policy and prevention studies conducted in Macedonia as cross-section studies. A country representative, the review author, Vera Simovska, extracted and approved the data presented as a country card for physical activity.

Results It is critical to develop a national physical activity for health action plan and convene a national physical activity for health committee or task force with high-level support and resources and with representation from multiple sectors, agencies, NGOs and the private sector to provide leadership and guidance in implementing the Health-Enhancing Physical Activity Plan. A comprehensive set of policy options to improve physical activity is listed in the Global NCD Action Plan. The First Macedonian “Move for Health” Council was established within the WHO CINDI program (World Health Organization Countrywide Integrated Noncommunicable Disease Intervention program) in 2003 ( . In 2010, WHO developed global recommendations on physical activity for health [6]. The Agency for Sport and Youth was established the Program for Sport development during the period of 2013-2017 years focused on development of sport in Macedonia. Regarding to the “Physical Activity for Health” action plan and national policy documents, its existence Declaration “Move for Health” (2004), national recommendation on HEPA, counseling on physical activity as part of primary health care activities and mandatory physical education in primary and secondary schools. NGOs HEPA Macedonia [7] also contributes to developing education and health policy, research, monitoring and other national activities related to physical activity for health [8]. Our synthesis indicates the following to be promising policies and strategies: -School curriculum that includes healthy eating, physical activity and body image; -Increased sessions for physical activity and the development of fundamental movement skills throughout the school week; -Environments and cultural practices that support children being active throughout each day; -Support for teachers and other staff to implement health promotion strategies and activities (e.g. professional development, capacity building activities); -Parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen based activities.

REFERENCES 1. Simovska-Jarevska V., Martinovski S., Damjanovski D. et al.: MONITORING OF EATING HABITS AND PHYSICAL ACTIVITY LEVELS AS A BASIS FOR A NEW NONCOMMUNICABLE DISEASE PREVENTION PROGRAMME IN THE REPUBLIC OF MACEDONIA. Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences 2013; 67(4-5): 357–362, ISSN (Print) 1407-009X, DOI: 10.2478/prolas-2013-0072. Accessed 2013, December 1. 2. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2008. URL: 3. Simovska-Jarevska V., Martinovski S., Antoska-Knights V. et al: DISPARITIES IN FOOD HABITS AND PHYSICAL ACTIVITY LEVELS IN ADULT POPULATION IN THE REPUBLIC OF MACEDONIA AND DEVELOPING A NEW HEALTH PROMOTION MODEL. The Journal “Research in Kinesiology” International Journal of Kinesiology and other related sciences 2015; 43(2):24-29. 4. Country-reported national youth data. Survey title: Macedonia Global School-Based 2008 Student Health Survey (GSHS): 2007 (IBRef: 102773a1). 5. Simovska V.: EVALUATION OF THE INFLUENCE OF SPORTING ACTIVITIES ON CARDIORESPIRATORY FITNESS OF YOUTH IN CREATING NATIONAL STANDARDS. Symposium Proceedings of the Scientific Satellite Symposium for Euro Global Summit & Medicare Expo on Weight Loss: ADVANCED PERSPECTIVES FOR BETTER FITNESS IN PUBLIC HEALTH NUTRITION TO REDUCE OBESITY AND RELATED CHRONIC DISEASES, 26-27 June, 2015. Symposium Proceedings 2015, Bitola, Republic of Macedonia. Skopje: Menora, 2015:38.ISBN: 978-608-200-298-9. 6. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010 (…/…/9789241599979_eng.pdf , accessed 4 November 2014). 7. HEPA Macedonia – URL< 8. Ministry of Health of the Republic of Macedonia: Simovska V. et al. (Ed) Chapter I: GOOD GOVERNANCE. In. Green Book (unpublished). Committee for Advancement of Healthcare System at the Ministry of Health 2010. URL<
President of HEPA Macedonia, Vera Simovska, MD., PhD.