Insufficient physical activity and its associated factors among adults in Eastern African countries: a systematic review and meta-analysis

Introduction Insufficient Physical Activity (IPA) is a major global public health concern linked to non-communicable diseases. East Africa is experiencing rapid urbanization and lifestyle changes, yet evidence on IPA prevalence and its predictors remains limited. This study aimed to determine the pooled prevalence of IPA and its determinants among adults in Eastern African countries. Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. A comprehensive search was conducted in PubMed, Scopus, CINAHL, ScienceDirect, and Google Scholar. Population-based observational studies meeting the eligibility criteria were included and assessed using the Joanna Briggs Institute tool. Heterogeneity was assessed using the I2 statistic, and a random-effects model was used for pooled analysis. Publication bias, subgroup, sensitivity, and meta-regression analyses were performed. Results A total of 41,522 adults from fifteen studies were included. The pooled prevalence of IPA in East African countries was 27% (95% CI: 22.0–32.0%). Domain-specific prevalence was 31%, 25%, and 65% for work, travel, and leisure time, respectively. IPA was associated with age > 45 years (OR = 1.65; 95% CI: 1.27–2.15), female sex (OR = 1.99; 95% CI: 1.43–2.76), urban residence (OR = 2.36; 95% CI: 1.91–2.92), unemployment (OR = 2.66; 95% CI: 1.48–4.78), and overweight/obesity (OR = 1.60; 95% CI: 1.30–1.98). Conclusions More than one in four adults in East African countries did not meet WHO physical activity recommendations. IPA was most prevalent during leisure time, followed by work and travel. Older adults, women, urban residents, unemployed individuals, and those with overweight or obesity were more likely to have IPA. Targeted public health interventions are needed to promote physical activity among these populations.