Low Level of physical activity and their determinants among adults aged 18-69 years in Tanzania: Results from the 2023 National STEPS survey

Background: Non-communicable diseases are the leading cause of mortality globally, accounting for approximately 74% of all deaths. Physical inactivity is a major modifiable behavioural risk factor, with an estimated 27.5% of adults worldwide not achieving sufficient levels to obtain health benefits, including the prevention of non-communicable diseases. Current nationally representative evidence on the prevalence of insufficient physical activity and its associated determinants remains limited. Objective: To estimate the prevalence of insufficient physical activity, defined as <600 MET-minutes per week, and to identify its socio-demographic and behavioural determinants among Tanzanian adults aged 18–69 years. Methods: A national population-based household survey employed a three-stage cluster sampling design using the 2022 Tanzania Population and Housing Census as the sampling frame, with 4,320 participants, conducted from September 2022 to September 2023. Data on major NCD risk factors were collected using WHO STEPS methodology. Physical activity was measured using an adapted Global Physical Activity Questionnaire and expressed in metabolic equivalent task units (MET) units. Chi-square tests and modified Classical logistics regression were used to assess factors associated with leisure-time physical inactivity. Results: Overall, 2.5% (95% CI: 1.6–3.8) of participants had insufficient physical activity. Older age (46–69 years) (aOR = 2.61, 95% CI: 1.38–4.92), urban residence (aOR = 1.71, 95% CI: 1.09–2.68), being married or cohabiting (aOR = 2.29, 95% CI: 1.03–5.09), having a college education (aOR = 2.44, 95% CI: 1.05–5.70) and being in the “other” occupation category (aOR = 1.63, 95% CI: 1.02–2.61) were independently associated with insufficient physical activity. Conclusion: Insufficient physical activity is relatively low but disproportionately affects older adults, urban residents, married individuals, those with higher education and certain occupations, highlighting emerging lifestyle transitions and the need for targeted prevention strategies to sustain adequate activity levels.