Prevalence and determinants of Leisure Physical Inactivity among Tanzanians Aged 18–69 Years: Results from the 2023 STEPS survey

Background: Physical activity, encompassing occupational tasks, active transportation and leisure-time exercise, is a fundamental determinant of health and a key strategy for the prevention of non-communicable diseases. Despite its benefits, the maintenance of regular recreational physical activity, which confers substantial health advantages, remains limited in many low- and middle-income settings, including Tanzania. Objective: To quantify the distribution of physical activity across occupational, transport and leisure domains and to estimate the prevalence and socio-demographic determinants of leisure-time physical inactivity among Tanzanian adults aged 18 to 69 years. Methods: A national population-based household survey employed a three-stage cluster sampling design using the 2022 Tanzania Population and Housing Census as the sampling frame, with 4,320 participants, conducted from September 2022 to September 2023. Data on major NCD risk factors were collected using WHO STEPS methodology. Physical activity was measured using an adapted Global Physical Activity Questionnaire and expressed in metabolic equivalent task units (MET) units. Chi-square tests and modified Poisson regression were used to assess factors associated with leisure-time physical inactivity. Results: Among Tanzanian adults aged 18–69 years, physical activity was predominantly derived from occupational domains (75.0%), followed by transport-related activities (19.5%), with minimal contribution from leisure-time activity (5.5%). The prevalence of never engaging in leisure-time physical activity was 68.5% (95% CI: 63.7–72.9). Adjusted analyses indicated that female sex, older age (31–45 and 46–69 years), urban residence, selected zones, marital status, lower education, self-employment or other occupations and current alcohol use were significant determinants of leisure-time physical inactivity. Conclusion: Despite high overall physical activity driven by occupational and transport domains, leisure-time physical inactivity remains widespread among Tanzanian adults, particularly among socio-demographically disadvantaged groups. These findings highlight the need for targeted, equity-focused interventions to promote leisure-time physical activity and reduce future non-communicable disease risk.