Recent evidence has shown that non-communicable diseases (NCDs) affect developing countries more than they do developed countries.  Being the leading cause of global mortality, NCDs are responsible for 38 million out of 57 million deaths per year, with low-middle-income countries experiencing 85% of these deaths. Approximately 75% of premature deaths occurring in adulthood emerged from behavioral risk factors developed during childhood and adolescence. Hence, there’s a need for adolescents to be aware of NCDs, risk factors, and the need to participate in a healthy lifestyle.

The common modifiable risk factors for NCDs are unhealthy diet, physical inactivity, air pollution, tobacco use, and excessive alcohol intake.  These risk factors are largely influenced by the environment. For example, an average traditional Nigerian meal contains a large amount of saturated fats, fibre-rich carbohydrates, and few vegetables. These meals are highly energy-dense and high in salt and sugar.  Also, with increasing urbanization, the use of bottled drinks are on the rise, and many adolescents prefer canned orange juices to fresh orange fruits.

Physical inactivity is on the rise among adolescents in Nigeria. The advancement of technology has also promoted sedentary activities. In Nigeria, the easy accessibility of computers and mobile phones means that people, particularly children in urban areas, participate less in physical activities. Computer gaming has replaced the active, outdoor play of the past, leading to increasing rates of overweight, obesity, and other related health implications among adolescents.

As adolescents spend most of their time in schools, a school-based intervention presents a good approach to creating awareness of NCDs and promoting healthy lifestyle practices among adolescents. The Adopt-a-School-NCDs Campaign organized by Slum and Rural Health Initiative and supported by the AstraZeneca Young Health Programme provides NCDs prevention education to adolescents in secondary schools in Nigeria.

The Adopt-a-School NCDs Campaign is unique in its use of a task-shifting approach where healthcare students (young people) in tertiary institutions are trained by healthcare professionals to serve as NCDs prevention ambassadors and deliver NCDs prevention education to adolescents using a structured curriculum designed for the purpose. The trained healthcare students go into their communities and adopt secondary schools where awareness about NCD prevention is taught to the students using innovative means like storytelling, drawings, role-play, illustrations, among others. The sessions are interactive and have fun activities for the students to participate in while learning about NCD prevention.

To motivate and encourage adolescents in making healthy lifestyle choices, they received rewards such as an NCD prevention diary. This diary focuses on tracking daily habits associated with healthy lifestyle practices, utilizing gamification to attract children and adolescents to fun challenges like number of steps required to take per day and time to spend exercising. In the diary, there are also sections for documenting meal plans, physical activities, screen time, and sleep patterns, and a dedicated part for self-reflection on setbacks and success.

Aminat, a 14-year-old girl, who raised her hand at the beginning of the session and answered NCDs stands for “Nigeria Communication Development,” can now confidently explain what NCDs are and their risk factors to her friends. It doesn’t end there; she now has an NCD prevention diary where she inputs details on her physical activity participation and diet intake every day (“keeping streaks”), and follows healthy tips on each page.

The fight against non-communicable diseases is not over yet; as a matter of fact, it has only begun. Our Adopt-a-School NCD project has shown that adolescents will adopt healthy lifestyle practices when there are innovative and motivating measures in place. We implore stakeholders in the Ministry of Education, Ministry of Health, policymakers, and school owners to adopt measures to promote healthy lifestyle practices among adolescents.