**5.2 Physical inactivity and sedentary lifestyles in cities**

Physical activity (PA) has many health-promoting effects and is associated with reduced risk of cardiovascular and metabolic diseases, obesity, and some cancers [57]. Insufficient physical activity is a leading risk factor for NCDs and has a negative effect on mental health and quality of life. Levels of physical activity in many African countries vary widely across geographic regions and population subgroups. For instance, country level prevalence of PA ranged from 46.8% in Mali to 96.0% in Mozambique [58]. While current data shows that SSA has the least prevalence of insufficient physical activity compared to the rest of the world [59], trend data shows decreasing levels of physical activity and increasing levels of sedentary lifestyles across all age groups [60]. Country-specific population-based data on physical activity prevalence show lower levels of PA in urban environments attributed to built-up environment leaving no green spaces for physical activity [61]. In addition, congestion in cities, availability of motorized transport and absence of paved walk-ways makes it impractical for physical activity to happen in African cities. In low income informal settlements in African cities, several physical barriers and insecurity limit physical activity [46]. In Kenya for instance, young adults in rural areas were found to be more physically active compared to those in urban areas. A study conducted by Mashili et al. (2018) in Tanzania also found that being employed, higher education and wealth status (mainly among urban residents) were associated with less physically activity [62].
