WHO Surveillance Tools for NCD Risk Factors Instruments

WHO Surveillance Tools for NCD Risk Factors – Instruments and Data Sources Surveillance and Population-based Prevention Unit Department for Prevention of Noncommunicable Diseases Surveillance and Population-based Prevention of NCDs Department

NCD Surveillance tools at WHO l NCD global monitoring framework, indicators and targets l NCD Country Capacity Survey (CCS) l STEPS (adults) l GSHS (adolescents) l Service availability and readiness assessment (SARA) l Comparable estimates for key risk factors Surveillance and Population-based Prevention of NCDs Department

Monitoring Framework for NCD surveillance l Outcomes – Mortality: NCD-specific mortality – Morbidity: cancer incidence and type l Exposures – Behavioural risk factors: tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet – Metabolic risk factors: raised blood pressure, overweight/obesity, raised blood glucose, and raised cholesterol. – Social determinants: education, material well being, access to health care l National System Response – Interventions and health system capacity: infrastructure, policies and plans, access to key health care interventions and treatments, partnerships. Surveillance and Population-based Prevention of NCDs Department

NCD Country Capacity Survey l To gather information about individual country capacity to respond to the burden of NCDs. l Periodic monitoring of national progress would assist countries in identifying gaps in prevention and control efforts and assist with future planning. l Assessment focused on current strengths and weaknesses related to: NCD infrastructure and partnerships, policy response, surveillance, and health systems capacity. l 4 th wave of surveillance conducted in 2013 – previous surveys in 2000, 2005, and 2010. A 5 th planned for 2015. l Generally a high response rate from Member States. Surveillance and Population-based Prevention of NCDs Department

STEPS- adult risk factor surveillance Objectives l Empower Member States to gather information on chronic disease risk factors for use in planning health programmes and interventions. l Provide standardized questionnaire that allows for comparisons, but is flexible to meet Member States' needs. l Build capacity in Member States in all aspects of national survey implementation; in particular, develop skills in sample design, data collection and data analysis. l STEPS provides countries with data to monitor 7 of the 9 global targets for NCD. Surveillance and Population-based Prevention of NCDs Department

Questionnaire Overview Different levels of risk factor assessment: l STEP 1 – questionnaire l STEP 2 – physical measurements l STEP 3 – blood samples Three modules per Step: l Core l Expanded l Optional Surveillance and Population-based Prevention of NCDs Department

Questionnaire Overview, cont. l Behavioural Risk Factors – – Tobacco use Harmful alcohol consumption Unhealthy diet (low fruit and vegetable consumption and salt intake) Physical inactivity l Biological Risk Factors – – – Overweight and obesity Raised blood pressure Raised blood glucose Abnormal blood lipids Urinary sodium and creatinine l Optional Modules on Health Care, Injury and Violence, Mental Health (suicide), Oral Health, Salt intake, Sexual Health, and Tobacco Policy Surveillance and Population-based Prevention of NCDs Department

STEPS Methodology l Targets a nationally representative sample of adults aged 18 – 69. l STEP 1 (questionnaire) and STEP 2 (physical measures) are conducted in the household by trained interviewers. l STEP 3 (biochemical measures) is typically clinic or health centrebased. l Pocket PCs (PDAs*) are used for data collection: "e. STEPS" l Repeat survey should be done every 3 - 5 years. *(Personal Digital Assistant) Surveillance and Population-based Prevention of NCDs Department

Current Activity STEPS l Worldwide, nearly 140 countries across all six WHO regions have been trained and over 100 have finished at least one STEPS survey. l Over 30 countries have completed one or more repeat surveys. Surveillance and Population-based Prevention of NCDs Department

STEPS Current Status Surveillance and Population-based Prevention of NCDs Department

Global School-based Student Health Survey (GSHS) Surveillance and Population-based Prevention of NCDs Department

Global School Based Student Health Survey (GSHS) Overview & Objectives l System for surveillance of behavioural risk factors and protective factors in school-aged children l Help countries develop priorities, establish programmes, and advocate for resources l Establish trends in the prevalence of health behaviors and protective factors by country l Allow countries and international agencies to make comparisons across countries Surveillance and Population-based Prevention of NCDs Department

GSHS: Methods l Self-administered questionnaire and generic answer sheet l Targets grades with students aged 13 – 17 years l Completed by students during one classroom period l Anonymous and confidential l 10 Question Modules are available, from which countries can select a minimum of 6: – Alcohol, diet, drugs, hygiene, mental health, physical activity, protective factors, sexual behaviours, tobacco, violence & injury Surveillance and Population-based Prevention of NCDs Department

GSHS: Current Implementation l Worldwide, 106 countries across all six WHO regions have been trained and 96 have finished GSHS data collection (including 17 countries with repeat surveys). Surveillance and Population-based Prevention of NCDs Department

Department of Chronic Diseases and Health Promotion

Comparable estimates for selected NCD Risk Factors l New comparable estimates for NCD risk factors produced in late 2014 by WHO. l Metabolic risk factors – Overweight/obesity (adults and children), Blood pressure, Blood Glucose, Blood Cholesterol. l Behavioural risk factors – physical inactivity, tobacco, alcohol l Country consultation for selected indicators conducted in Sept-Oct 2014 – additional data sources requested to improve estimates. l Previous estimates included in the NCD Global Status Report 2010, and NCD Country Profiles 2011 and 2014, new updates will be in GSR 2 in January 2015. l GSR 2 will provide 2010 baseline data for GMF and targets. Surveillance and Population-based Prevention of NCDs Department

Compiling and storing NCD data Surveillance and Population-based Prevention of NCDs Department

NCD Country Profiles

Questions? Surveillance and Population-based Prevention of NCDs Department