The South African 24-Hour Movement Guidelines for Birth to 5 Years: An Integration of Physical Activity, Sitting Behavior, Screen Time, and Sleep.

BACKGROUND: In December 2018, the South African 24-hour movement guidelines for birth to 5 years were released. This article describes the process used to develop these guidelines. METHODS: The Grading of Recommendations Assessment, Development, and Evaluation-ADOLOPMENT approach was followed, with some pragmatic adaptions, using the Australian guidelines for the early years as a starting point. A consensus panel, including stakeholders in early childhood development and academics, was formed to assist with the development process. RESULTS: At a face-to-face meeting of the panel, global and local literatures were considered. Following this meeting, a first draft of the guidelines (including a preamble) was formulated. Further reviews of these drafts by the panel were done via e-mail, and a working draft was sent out for stakeholder consultation. The guidelines and preamble were amended based on stakeholder input, and an infographic was designed. Practical "tips" documents were also developed for caregivers of birth to 5-year-olds and early childhood development practitioners. The guidelines (and accompanying documents) were released at a launch event and disseminated through various media channels. CONCLUSIONS: These are the first movement guidelines for South African and the first such guidelines for this age group from a low- and middle-income country.

The South African 24-Hour Movement Guidelines for Birth to 5 Years: Results From the Stakeholder Consultation.

BACKGROUND: In 2018, South Africa developed 24-hour movement behavior guidelines for children from birth to 5 years. This study reports on the stakeholder consultation as part of this development process. METHODS: An online survey was completed by 197 participants; 9 focus groups (with parents/caregivers, early childhood development practitioners, and community health workers, total n = 70) were conducted, and a meeting with stakeholders from government and nongovernment organizations (n = 15) was held. RESULTS: In the online survey, stakeholders overwhelmingly agreed with the guidelines (97.0%) and recognized the benefit of putting the guidelines into practice (88.8%). Most online survey respondents (88.3%) reported that the guidelines would benefit all South African children equally. Responses to open-ended questions in the online survey and focus group discussions revealed issues including safety and nutrition of children, perceived parental barriers to using the guidelines, and education. Training and provision of educational materials were identified from all stakeholders as key in the dissemination and implementation of the guidelines. CONCLUSIONS: The findings informed the development of the South African 24-hour movement behavior guidelines and revealed several important factors to address in the dissemination and implementation of the guidelines to ensure that they are applicable and equitable in South Africa.