Promoting physical activity among women during pregnancy – an innovative approach in Turkmenistan

Turkmenistan will promote physical activity among women during their pregnancy as an innovative approach to tackle the physical inactivity of women and high levels of childhood obesity. Both of these factors are major health risks for the country, according to results from the latest WHO STEPwise approach to surveillance (STEPS) survey, an internationally comparable, standardized and integrated surveillance tool through which countries can collect, analyse and disseminate core information on noncommunicable diseases (NCDs).

Evidence indicates that the excessive weight gain of a mother during pregnancy increases her child’s risk of obesity during childhood, and that a life-course approach, starting as early as possible, is critical.

Physical activity during pregnancy has many proven benefits for a mother. It can help to control weight gain, reduce blood pressure problems and prevent gestational diabetes while improving fitness, sleep and mood. Encouraging the physical activity of expectant mothers may also lead to a change in lifetime physical activity habits which could have additional benefits for the child, their families, and the broader community.

In Turkmenistan, nearly half of all women are overweight

Results from the latest WHO STEPS survey, conducted in 2018, showed that nearly half of all women in Turkmenistan were overweight and 17% were obese.

The survey also showed that one in four respondents (25.9%) had hypertension or took medication that lowers blood pressure, and that women were more likely to be physically inactive than men. Alongside the STEPS survey, the WHO Childhood Obesity Surveillance Initiative (COSI) found that 9.1% of girls and 7.9% of boys were overweight in Turkmenistan.

In response to these alarming trends, the Ministry of Health and Medical Industry of Turkmenistan requested support from WHO.

Guidance on physical activity during pregnancy for all women

The WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCDs) and the Ministry of Health and Medical Industry of Turkmenistan have been working together to develop and implement The Turkmenistan National Strategy for Physical Activity 2018–2025. This strategy contains specific measures that focus on mothers during pregnancy. Turkmenistan’s case is a good example of a comprehensive approach to addressing the issue of physical inactivity among a specific population.

For example, guidance on physical activity is to be included in the pregnancy booklet given to all women during antenatal care visits. These materials are based on the latest scientific evidence which has significant potential to reach a large proportion of this population at a critical time.

Recommendations also include building the capacity of all primary health care workers in the country, through a ‘training of trainers’ approach, to safely recommend and prescribe physical activity to women during pregnancy.

STEPS and COSI – triggers for action

The STEPS and COSI surveys collect, analyse and disseminate core information on noncommunicable diseases and measure trends in being overweight and obesity among primary school-aged children. These are important tools which help to identify and understand the scale of health issues in a given country and, accordingly, to design a response.

In Turkmenistan, the national programme for the promotion of physical activity during pregnancy was developed as a response to the findings of the surveys in line with the WHO Physical Activity Strategy for the European Region. The strategy encourages policy action guided by effective monitoring and surveillance, and calls for high-level leadership by the health sector.