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REVIEW ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 47-53

Prevalence of overweight and obesity among health-care workers in Ghana: A systematic review


Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodiyo University; Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Nigeria

Date of Submission21-Sep-2020
Date of Acceptance25-Nov-2020
Date of Web Publication20-May-2021

Correspondence Address:
Dr. Murtala Bello Abubakar
Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodiyo University, PMB 2254, Sokoto; Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, PMB 2254, Sokoto
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njecp.njecp_39_20

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  Abstract 


Background: Obesity and overweight are among the major problems faced by the health sector with their prevalence increasing at an alarming rate and health-care professionals play a major role in mitigating these conditions. We, therefore, sought to identify and discuss available epidemiological data on the prevalence of overweight and obesity among health workers in Ghana. Methods: We retrieve articles available in PubMed/Medline, African Journal Online, ScienceDirect, and Google Scholar. The keywords combination used to search the databases were (((overweight) AND (obesity)) AND (healthcare workers)) AND (Ghana) and (((overweight) OR (obesity)) AND (healthcare workers)) AND (Ghana) and (((overweight) AND (obesity)) AND (health workers)) AND (Ghana) without the restriction of date or type of articles. Four studies were eligible and were used to systematically review the prevalence of overweight and obesity among health-care workers in Ghana. Results: The prevalence of overweight and obesity among health-care workers in Ghana ranged from 25.3% to 38.39% and 12.5% to 28.9%. Conclusion: There is a high prevalence of overweight and obesity among health workers in Ghana. Thus, it is imperative to create more awareness of the imminent dangers posed by these conditions and promote a healthy lifestyle through regular exercise regimens and dietary choices.

Keywords: Body mass index, Ghana, health-care workers, obesity, overweight


How to cite this article:
Abubakar MB, Uthman YA, Ibrahim KG. Prevalence of overweight and obesity among health-care workers in Ghana: A systematic review. Niger J Exp Clin Biosci 2021;9:47-53

How to cite this URL:
Abubakar MB, Uthman YA, Ibrahim KG. Prevalence of overweight and obesity among health-care workers in Ghana: A systematic review. Niger J Exp Clin Biosci [serial online] 2021 [cited 2021 Jun 14];9:47-53. Available from: https://www.njecbonline.org/text.asp?2021/9/1/47/316528




  Introduction Top


Overweight and obesity refer to an excessive or abnormal accumulation of fat in the body that can cause impairment of health and that can be measured on a scale of high body mass index (BMI).[1] There is an increased risk of developing noncommunicable diseases (NCDs) globally,[2],[3] with overweight and obesity. Such diseases include cardiovascular related diseases, insulin and cholesterol resistance and cancer. Other conditions are depression, anxiety, sleep disorders, and above all, diabetes mellitus.[2],[4] Annually, the recorded 2.3% of global disability-adjusted life years loss and 2.8 million estimated deaths are attributable to overweight and obesity worldwide.[5] There has been a substantial rise in the prevalence of overweight and obesity both in developed and developing countries.[6],[7] In 2014, the WHO estimated that approximately two billion adults were overweight and obese, i.e., 39% of men and women were either obese or overweight.[7] According to the WHO, the combined prevalence of overweight and obesity almost doubled from a baseline of 22% in 1975 and 40% in 2016.[8],[9],[10]

The Republic of Ghana is a country located centrally in West Africa. It has a population of 22 million citizens and about 43.8% live in urban areas. The gross national per capita income is $590 per year.[11] In Ghana, it has been recognized that obesity and overweight have been a problem in the public health system. In 2008, the WHO estimated that about 7.5% of the Ghanaian population were obese and there was a higher prevalence (10.9%) among the women than in men (4.1%).[12] Also, in 2016, Ofori-Asenso et al.[13] reported in their systematic review and meta-analysis on the epidemic of overweight and obesity in Ghana that about 43% of the Ghanaian adults are either overweight or obese. They estimated that the national prevalence of obesity and overweight was 17.1% (95% confidence interval [CI] = 14.7%–19.5%) and 25.4% (95% CI = 22.2%–28.7%). According to their report, the prevalence of overweight and obesity was higher in women compared to men (27.8% vs. 21.8%) and (20.6% vs. 8.0%). They assert that based on previous studies, there has been a consistent increase in the prevalence of overweight and obesity in Ghana over the years.[13]

Health-care workers are certified medical personnel and other professionals whose work is mainly the maintenance of a healthy community. They are primarily physicians, nurses, medical scientists, pharmacists, medical technicians, administrative class, and other subordinate staff.[14] Health-care workers are expected to show a high level of knowledge and awareness concerning the health consequences of changes in lifestyle including cardiovascular diseases and diabetes.[15] It will be assumed that because of their knowledge about health and well-being and proximity to health-care delivery, the prevalence of cardiometabolic diseases and their risk factors would be relatively low among the health-care workers.[14],[16] Work-related risk factors such as physical and mental stress, shift work, and other factors that are characteristic of the hospital environment, however, put these workers among occupational risk groups affected by certain disease conditions.[17]

These health-care workers are mostly seen as role models by the general community and usually render advice for healthy living and encourage appropriate changes in lifestyle that can lead to the prevention of these diseases.[14],[18] It has been shown that there is a strong relationship between the choices of the health-care workers and the recommendations they offer to their patients.[19] Therefore, the prevention of these metabolic diseases and their risk factors among this group of workers is a major strategy in bringing together a healthy workforce in the workplace and the community at large.[20]

There is a need for comprehensive information on the prevalence and risks associated with overweight and obesity among health-care workers to find a lasting solution to overweight and obesity and their sequelae among health-care workers.[21] To achieve this, we sought to review all existing literature on overweight and obesity among health workers in Ghana systematically and establish the trends and prevalence of obesity.


  Methods Top


This systematic review was carried out on studies that have been published on the prevalence of overweight and obesity among health-care workers in Ghana.

Eligibility criteria (inclusion and exclusion criteria)

The studies reviewed in this article were available full texts published from inception until 2019. All published studies that assessed the prevalence of overweight and obesity among health-care workers in Ghana were considered. However, studies on the general prevalence of obesity, children, and the elderly, as well as other parastatals were not considered. Only studies that reported overweight and obesity prevalence using BMI as the major criteria for defining overweight and obesity were considered. BMI was classified for overweight and obesity as 25–29.9 kg/m[2] and ≥30 kg/m[2], respectively.

Search strategy

Databases including PubMed, ScienceDirect, African Journal Online, and Google Scholar were used to search for relevant articles. The search terms and keywords combination with Boolean operators used to search the databases were (((overweight) AND (obesity)) AND (healthcare workers)) AND (Ghana) and (((overweight) OR (obesity)) AND (healthcare workers)) AND (Ghana) and (((overweight) AND (obesity)) AND (health workers)) AND (Ghana) without the restriction of date or type of articles. Five articles were displayed on the “legacy PubMed” interphase, and the “similar articles” link to relevant articles were followed to access similar relevant articles. We manually vet the reference lists of relevant articles to extract related articles that are not captured in the original search.

Study selection

Mendeley Reference Manager was used to sort the results of the searches made on the various databases. We used the Mendeley Reference Manager to remove the duplicates detected, after which titles and abstracts were screened for eligibility. To ensure that relevant data for this review was collected, a structured table containing the following information was created: reference, age, sample size, percent (%) overweight, % obese, study location, and period of the study [Table 1].
Table 1: Summary of findings from the studies used in this review

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  Results Top


Search results

The cumulative result from bibliographic database searches was 541. A total number of 508 non-relevant and duplicate articles were removed, with the remaining 33 records screened for the title and abstract eligibility. From these (33) records, only 4 studies met the criteria, and the full-text articles retrieved and further screened. Three articles were discovered by vetting reference lists manually but were later discarded as they were duplicates of the articles earlier seen. Therefore, only four articles were selected for this review as shown in [Figure 1].
Figure 1: Flow chart of the studies selections

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Study characteristics

The four studies reviewed are from different regions of the country. Two of these studies were conducted in Kadjebi District and Hohoe Municipal in the Volta Region, one from Tamale in the northern part, while the last was conducted in Sefwi-Wiawso Municipal in the Western part of the country respectively [Figure 2]. One of the studies assessed the prevalence of overweight and obesity among the nurses and midwives, one studies assessed the prevalence of overweight and obesity among the various health-care professionals including the nurses, anesthetists, pharmacists, prescribers, supporting staff, and technical staff respectively. Whereas, two studies did not characterize the classes of health-care professionals recruited for their studies. Three studies stratified the prevalence of overweight and obesity based on age, and sex while one study did not clearly define the stratification.
Figure 2: Map of Ghana showing the different regions where the studies were conducted. Source: https://www.google.com/url?sa=i&url=https%3A %2F%2Fghanaembassyharare.org%2Fregio ns%2F&psig=AOvVaw2ADZxt2LrunBcdgpkS95EE&ust=1600633643734000&source=ima ges&cd=v fe&ved=0CAIQjRxqFwoTCMi4vpGH9usCFQAAAAAdAAAAABAI

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Prevalence of overweight and obesity

According to [Table 1], the prevalence of overweight among health-care workers in all the studies was between 25.3% and 38.39%. The highest prevalence of overweight was 38.39% and was recorded at Sefwi-Wiawso Municipal Hospital, Western Region of Ghana.[15] The lowest prevalence of overweight was 25.3% and was observed at the Kadjebi District of Ghana.[22] On the other hand, the prevalence of obesity among health-care workers in all the studies was between 12.5% and 28.9%. The highest prevalence of obesity (28.9%) on the other hand was recorded at the Hohoe Municipality of the Volta Region of Ghana,[23] whereas, the lowest prevalence of overweight was 25.3% that was observed at the Kadjebi District of Ghana.[22]

Osei-Yeboah et al.[15] conducted a hospital-based cross-sectional study that involved 112 employees of the Sefwi-Wiawso Municipal Hospital for cardiometabolic risk factors among health-care workers in the Sefwi-Wiawso Municipality, Western Ghana. The study was conducted between the 11th and 13th of May 2016. In this study, there were 48 (42.86%) male and 64 (57.14%) female subjects. They were classified into different age groups as follows: 22–30, 31–40, 41–50, and 51–59 respectively. The prevalence of overweight among the subjects was 38.39% with prevalence among the males being 37.50% and that of the females being 39.06%. The prevalence of obesity on the other hand was 12.50% (20.31% in female subjects and 2.08% in male subjects). The rate of obesity was lowest among the age group of 22–30 years (7.14%), while it was highest in the age range of 51–59 years (22.22%) respectively.[15]

In another cross-sectional study carried out among health workers in Kadjebi district located in the Volta Region of Ghana, by Kasu et al.,[22] the health workers that participated in this study were systematically recruited from different health facilities in the district as the majority of the participants emerged from the Mary Theresa Hospital and was conducted in March 2013. This study was similar to that of Osei-Yeboah et al.[15] as it stratified the prevalence of overweight and obesity based on age and sex. A total of 158 health-care workers of different professional classes including nurses, anesthetists, pharmacists, prescribers, supporting staff, and technical staff respectively. There were 73 (46.2%) male participants and 85 (53.8%) female participants. The age groups were classified as 19, 20–29, 30–39, 40–49, and 50–59 respectively. The overall prevalence of overweight among the health workers of Kadjebi District was 25.3%, with the prevalence among male and female workers being 23.3% and 27.1% respectively. Obesity, on the other hand, had an overall prevalence of 12.7% with male and female workers having a ratio of 9.6% and 15.3% respectively. Additionally, the prevalence of overweight was highest among the age group of 19 years (50.0%) and lowest among the age range of 20–29 years (15.9%) while obesity was lowest among the age range of 19 years (0.00%) and highest among the age group of 40–49 years (40.0%).[22]

Duodu et al.[23] also conducted a cross-sectional analytical study at Hohoe Municipality in the Volta Region of Ghana and assessed the prevalence of overweight and obesity among practicing nurses and midwives. The study was conducted from May to June 2015. The study used 135 nurses and midwives of which there were 26 (19.3%) male respondents and 109 (80.7%) female respondents. Also, the study comprised of 77.8% nurses and 22.2% midwives. Age was stratified as 18–30, 31–40, 41–50, and 51+ with the age range of 18–30 being the modal group with 51.9% of the population while age group 41–50 were the least with 6.7% of the population. The prevalence of overweight and obesity was 31.8% and 28.9% respectively and was seen to be higher in females than their male counterparts. The prevalence of overweight was 6.7% in males and 25.1% in females, while obesity was only seen in females at a prevalence rate of 28.9%. The prevalence of overweight and obesity was not stratified based on age range.[23]

Similarly, a cross-sectional analytical study was carried out by Aryee et al.,[24] in which a total of 220 nurses were selected from four major hospitals in Tamale Metropolis (located in the Northern region of Ghana); Tamale teaching hospital, Seventh Day Adventist hospital, West, and Central Hospitals of Tamale. The prevalence of overweight and obesity was not classified into different age groups but was classified based on sex. The male respondents constituted 33.6% while their female counterparts formed 66.4% of the study population. The prevalence of overweight was 26.4% (8.2% males and 18.2% females), whereas, 16.9% (1.4% males and 15.5% females) were obese.[24]


  Discussion Top


Only four of the studies consulted met the inclusion criteria for this review. One of these studies was conducted at Sefwi-Wiawso Municipal in the Western Region of Ghana; two studies were carried out at Kadjebi district and Hohoe Municipality, both in the Volta Region of Ghana; one study was conducted at Tamale Metropolis in the Northern Region of Ghana. From these studies, this review was able to show that the overweight and obesity prevalence among the health-care workers in Ghana ranged from 25.3% to 38.39% and 12.5% to 28.9% respectively.

This review has highlighted the high prevalence of overweight and obesity among health-care workers in Ghana. From this review, it can also be said that classifying BMI based on the WHO criteria for overweight and obesity, the prevalence of overweight and obesity varies among health-care workers across various health facilities. This high prevalence among health-care workers is in line with the report of Ofori-Asenso et al.,[13] in a systematic review and meta-analysis on the overweight and obesity epidemic in Ghana, with a prevalence of overweight and obesity of 25.4% and 17.1% respectively. Besides, among employees of a tertiary health institution in Accra, Ansong and Aryeetey reported that 43% of the employees were overweight while 13% were obese.[25] Reports from other African countries also confirm the high prevalence of overweight and obesity. In Nigeria, the prevalence of overweight and obesity among health-care employees was reported to be between 31.4% to 44.7% and 23.25% to 27.35%, respectively.[16],[26],[27] It was also reported from South Africa by Skaal and Pengpid that overweight and obesity were 26.5% and 47%[28] and by Ondicho et al. from Kenya (30.9% overweight and 27.9% obese)[21] among the health-care workers.

Some of the possible predisposing factors of overweight and obesity were also identified by the studies mentioned above and these include female sex, sedentary lifestyle, age, dietary habits, and high socioeconomic and sociodemographic statuses among others.[15],[22],[23],[24] Osei-Yeboah et al.[15] showed in their study that increased rate of absenteeism, weight discrimination, occupational injury, reduced productivity, short-term disability, and presenteeism (work health-related limitations) are associated with obesity and overweight. They also argued that there is a relationship between obesity and early retirement.[15] In their study, Duodu et al.[23] stated that age above 41 years was a risk factor for overweight and obesity, likewise female gender, parity of more than four, and dietary habits especially not eating fruits and vegetables as well as eating late beyond 6 pm.[23]

Other studies and systematic reviews of literature that were carried out in different parts of the world on overweight and obesity both among health-care workers and in the general population also showed a high prevalence of overweight and obesity.[14],[15],[19],[21],[29],[30],[31] It can, therefore, be deduced from these works that the problems of overweight and obesity are not limited to health-care workers in Ghana alone, but they are global issues that need to be addressed in the respective countries.


  Conclusion Top


It is indicative in this review that the prevalence of overweight and obesity among health-care workers in Ghana is increasing. Attention is needed from the government and relevant agencies involved in health-care management in the country toward combating this menace. Most of the predisposing factors mentioned in this review are from indigenous studies. There is a need for awareness and education of the health-care workers on the risks of these predisposing factors and their implications on health through media, the internet, and other channels of communication. Similarly, there is a need for the provision of modern health-care facilities, sports facilities, and other amenities that can improve the health of the health-care workers and the general community, which may eventually contribute to reducing the incidence of overweight and obesity among the health-care workers and the general community. The costs of addressing these health problems are enormous; however, the substantial benefits can be achieved by the individuals involved, especially the health-care providers as well as the country.

Strength and limitation

Only four studies met the criteria set for this review. A larger number of studies would have provided more information on the magnitude of the problems. Nevertheless, this systematic review was able to highlight the range of the prevalence of overweight and obesity among health-care workers in Ghana. Studies are, therefore, recommended to fill this void.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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