Non Communicable Disease Risk Factors Survey, 2007/08 Nepal

Abstract

EXECUTIVE SUMMARY BACKGROUND: Common and easily modifiable risk factors underlie most of the Non-Communicable Diseases (NCDs) and explain the vast majority of deaths at all ages relating to NCDs among men and women in all parts of the world. They include tobacco use, excessive alcohol consumption, physical inactivity and low intake of fruits and vegetables. These common behavioral risk factors contribute largely to high blood pressure, obesity, high blood glucose and cholesterol levels, which in turn cause major NCDs such as cardiovascular disease, cancer, diabetes mellitus and chronic lung diseases. Nearly 52 percent of deaths and 44 percent of Burden of Diseases (BOD) in South-East Asia Region (SEAR) are related to NCDs. The major NCDs in the region are cardiovascular disorders, cancer, diabetes mellitus, chronic lung diseases and conditions arising from accidents and injuries. Nepal has had opportunity to assess the burden of NCDs risk factors three times during a period of six years. First assessment was confined to capital city, Kathmandu. The survey clearly indicated that Nepal has high prevalence of risk factors for NCDs. Since the first survey was centered to the capital city, second survey was directed towards townships as well as rural areas. The second survey also indicated the same level of risk factors for NCDs. However, these findings of the survey could not represent national prevalence of the risk factors. Therefore, the third survey had been carried out to embrace the whole nation. The third NCD risk factors survey, carried out in 2007/8, had objectives to estimate national distribution of NCD risk factors as a first step in a sequential process that aims to establish and maintain a comprehensive, integrated, systematic and sustainable population-based data collection system as part of the National Action Plan for the Prevention and Control of Non-communicable diseases in Nepal; to establish awareness and experience in NCD risk factors survey among different level of health managers and health workers that will improve the country capacity for NCD prevention and control program for the future, to develop plans and intervention as a follow up of FCTC ratification and to develop specific intervention in community mental health. A cross sectional survey of individuals belonging to 15-64 years age group from 15 districts representing five developmental and three ecological regions was carried out in a span of three months, supported by trained health supervisors and health workers from both governmental and non governmental sides. A multistage stratified sampling strategy was adopted to select the number of subjects required for the survey. A total of 4400 individuals were targeted for the survey but 4328 were covered in the entire survey. A response rate of 98.4 was achieved with a difference of 98.3 for men and 98.4 for women. Age and sex composition of the surveyed population was 44.1 for men and 55.9 for women. Weighing of the data was carried out as per the formula provided by the STEPS surveillance team, from WHO, Geneva. Ethno-graphically 39.2 percent were Bahun and chhetri, 22.3 percent Newar, 28.6 percent Janjatis and 10 percent others.