Promoting co-designed sustainable health interventions with young changemakers for reduced risk of non-communicable diseases (NCDs) in urban Burkina Faso, Kenya and Tanzania 

Changemaker objective: To implement & evaluate a sustainable health intervention program on health, nutrition, & environmental outcomes for the primary prevention of adolescent obesity & related non-communicable diseases (NCDs) together with adolescents in three rapidly urbanizing cities in Burkina Faso, Kenya, Tanzania. Background: There is an increasing epidemic of adolescent obesity that can contribute to adult obesity, morbidity & NCDs in a broader sense. Sustainable health interventions in urban low- and middle-income countries are critical in addressing lifestyle factors that contribute to obesity, diabetes & hypertension in later life, such as unhealthy dietary habits, inactivity & sedentary behaviors while shaping urban environments. Considering obesity is a complex issue that is influenced by wide range of interconnected factors, such as policy, environment, social, economic, cultural, behavioral, commercial, & biological determinants, a whole-systems approach that converges multiple sectors (i.e., health, education, environment, and agriculture) and stakeholders (i.e., adolescents, caregivers, staff, local government, communities, policymakers & implementers) are needed for obesity prevention in LMICs. Our strategy: Four evidence-based strategies, which will be adapted to context through a co-design process: 1) urban farming in schools with satellite farms and organic waste composting, 2) sustainable health modules for classrooms, 3) linking to healthcare workers through health talks using motivational interviewing techniques and 4) WHO Best Buys: Mass media campaign. Our evaluation: 3 cluster-RCTs in secondary schools, within the framework of urban Health & Demographic Surveillance Systems, implementation, process evaluation & cost-effective evaluation. Our expected results: Evidence of how to implement and scale a sustainable health intervention. Estimate a mean difference in BMI of 0.175 which could lead to reduction of 5% in the prevalence of obesity.