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

2. NCD Surveillance tools at WHO
NCD global monitoring framework, indicators and targets
NCD Country Capacity Survey (CCS)
STEPS (adults)
GSHS (adolescents)
Service availability and readiness assessment (SARA)
Comparable estimates for key risk factors

3. Monitoring Framework for NCD surveillance
Outcomes
Mortality: NCD-specific mortality
Morbidity: cancer incidence and type
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
National System Response
Interventions and health system capacity: infrastructure, policies and plans, access to key health care interventions and treatments, partnerships.

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

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

6. Questionnaire Overview
Different levels of risk factor assessment:
STEP 1 – questionnaire
STEP 2 – physical measurements
STEP 3 – blood samples
Three modules per Step:
Core
Expanded
Optional

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

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

9. Current Activity STEPS
Worldwide, nearly 140 countries across all six WHO regions have been trained and over 100 have finished at least one STEPS survey.
Over 30 countries have completed one or more repeat surveys.

10. STEPS Current Status

11. Global School-based Student Health Survey (GSHS)

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

13. GSHS: Methods Self-administered questionnaire and generic answer sheet
Targets grades with students aged 13 – 17 years
Completed by students during one classroom period
Anonymous and confidential
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

14. GSHS: Current Implementation
Worldwide, 106 countries across all six WHO regions have been trained and 96 have finished GSHS data collection (including 17 countries with repeat surveys).

16. Comparable estimates for selected NCD Risk Factors
New comparable estimates for NCD risk factors produced in late 2014 by WHO.
Metabolic risk factors – Overweight/obesity (adults and children), Blood pressure, Blood Glucose, Blood Cholesterol.
Behavioural risk factors – physical inactivity, tobacco, alcohol
Country consultation for selected indicators conducted in Sept-Oct 2014 – additional data sources requested to improve estimates.
Previous estimates included in the NCD Global Status Report 2010, and NCD Country Profiles 2011 and 2014, new updates will be in GSR2 in January 2015.
GSR2 will provide 2010 baseline data for GMF and targets.

17. Compiling and storing NCD data

19. NCD Country Profiles

20. Questions?