Randall Lee, Brugulat-Panés Anna, Woodcock James, Ware Lisa Jayne, Pley Caitlin, Abdool Karim Safura, Micklesfield Lisa, Mukoma Gudani, Tatah Lambed, Dambisya Philip Mbulalina, Matina Sostina Spiwe, Hambleton Ian, Okello Gabriel, Assah Felix, Anil Megha, Kwan Haowen, Awinja Alice Charity, Pujol-Busquets Guillén Georgina, Foley Louise
SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS-SA, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
J Transp Health. 2023 Jan;28:101558. doi: 10.1016/j.jth.2022.101558.
Active travel, as a key form of physical activity, can help offset noncommunicable diseases as rapidly urbanising countries undergo epidemiological transition. In Africa a human mobility transition is underway as cities sprawl and motorization rises and preserving active travel modes (walking, cycling and public transport) is important for public health. Across the continent, public transport is dominated by paratransit, privately owned informal modes serving the general public. We reviewed the literature on active travel and paratransit in African cities, published from January 2008 to January 2019. We included 19 quantitative, 14 mixed-method and 8 qualitative studies (n = 41), narratively synthesizing the quantitative data and meta-ethnographically analysing the qualitative data. Integrated findings showed that walking was high, cycling was low and paratransit was a critical mobility option for poor peripheral residents facing long livelihood-generation journeys. As an indigenous solution to dysfunctional mobility systems shaped by colonial and apartheid legacies it was an effective connector, penetrating areas unserved by formal public transport and helping break cycles of poverty. From a public health perspective, it preserved active travel by reducing mode-shifting to private vehicles. Yet many city authorities viewed it as rogue, out of keeping with the 'ideal modern city', adopting official anti-paratransit stances without necessarily considering the contribution of active travel to public health. The studies varied in quality and showed uneven geographic representation, with data from Central and Northern Africa especially sparse; notably, there was a high prevalence of non-local authors and out-of-country funding. Nevertheless, drawing together a rich cross-disciplinary set of studies spanning over a decade, the review expands the literature at the intersection of transport and health with its novel focus on paratransit as a key active travel mode in African cities. Further innovative research could improve paratransit's legibility for policymakers and practitioners, fostering its inclusion in integrated transport plans.
积极出行作为身体活动的一种关键形式，在快速城市化的国家经历流行病学转变之际，有助于抵消非传染性疾病的影响。在非洲，随着城市扩张和机动车化程度上升，一场人口流动转变正在发生，保留积极出行方式（步行、骑自行车和公共交通）对公众健康至关重要。在整个非洲大陆，公共交通以辅助公交为主，即由私人拥有的服务大众的非正式交通方式。我们回顾了2008年1月至2019年1月发表的关于非洲城市积极出行和辅助公交的文献。我们纳入了19项定量研究、14项混合方法研究和8项定性研究（n = 41），对定量数据进行叙述性综合分析，对定性数据进行元民族志分析。综合研究结果表明，步行出行比例高，骑自行车出行比例低，对于面临漫长生计旅程的贫困边缘居民来说，辅助公交是一种关键的出行选择。作为对由殖民和种族隔离遗留问题塑造的功能失调的交通系统的本土解决方案，它是一种有效的连接方式，深入到正规公共交通未覆盖的地区，有助于打破贫困循环。从公共卫生的角度来看，它通过减少向私人车辆的出行方式转变来保留积极出行。然而，许多城市当局认为它是违规的，与“理想的现代城市”不符，采取官方的反辅助公交立场，而不一定考虑积极出行对公众健康的贡献。这些研究质量参差不齐，地理代表性不均衡，来自中非和北非的数据尤其稀少；值得注意的是，非本地作者和国外资金的比例很高。尽管如此，通过汇集跨越十多年的丰富跨学科研究，本综述扩展了交通与健康交叉领域的文献，其新颖之处在于将辅助公交作为非洲城市关键的积极出行方式进行重点研究。进一步的创新性研究可以提高辅助公交对政策制定者和从业者的清晰度，促进其纳入综合交通规划。
