Integrating wearable technologies into age- and equity-responsive surveillance of physical activity, sedentary behaviour, and healthy ageing in Ghana

Abstract Ghana is experiencing rapid population ageing alongside rising noncommunicable diseases, yet existing surveillance systems provide limited age-sensitive and objective information on physical activity and sedentary behaviour among older adults. This narrative review synthesises Ghanaian and relevant international evidence on physical activity, sedentary behaviour, functional health and surveillance, identifies limitations of existing platforms, and proposes a four-layer framework for integrating wearable-generated movement data with established surveillance systems. Evidence was identified through searches of PubMed, Scopus and Google Scholar, supplemented by reference-list screening and relevant WHO and institutional reports. Existing systems provide valuable demographic, health and ageing information but rely substantially on self-report, have limited coverage of adults aged 70 years and older, and provide little information on sedentary accumulation, movement intensity and daily movement patterns. Wearable technologies can complement these systems by providing objective acceleration-based measures and derived movement indicators, although feasibility, validation, cost, data management and scalability require further evaluation in Ghana, particularly among older adults with mobility limitations. An integrated, ethically governed and equity-centred approach could strengthen age- and gender-responsive surveillance and inform policies, services and interventions for healthy ageing.