2005-12-31-世界卫生组织-2006_STEPS_Country_report_Solomon_Islands_120页_2mb

Summary of the Solomon Islands NCD Risk Factors STEPS Report

Core Content

The Solomon Islands NCD Risk Factors STEPS Report is a comprehensive assessment of noncommunicable disease (NCD) risk factors among the population aged 15–64 years, conducted between December 2005 and November 2006. It provides baseline data on key NCDs and their associated risk factors, including tobacco use, betel nut chewing, alcohol consumption, physical inactivity, unhealthy diet, overweight, obesity, hypertension, and diabetes. The report was developed through a collaborative effort involving the Solomon Islands Ministry of Health and Medical Services (MHMS), the World Health Organization (WHO), and the Fiji School of Medicine (FSM), with support from AusAID and NZAID.

Main Objectives

• To document the prevalence and magnitude of key NCDs among adults
• To document the prevalence of major modifiable risk factors for NCDs
• To compare NCDs and their risk factors across different age groups and between men and women

Methodology

The survey used the WHO STEPwise Approach to Surveillance of NCD Risk Factors (STEPS), a standardized method for assessing risk factors at the population level. The survey was conducted in three locations: Honiara (Guadalcanal Province), Gizo (Western Province), and Auki (Malaita Province). The methodology included:

• Three steps:
  1. Behavioural Risk Factors (interviews on smoking, betel nut use, alcohol consumption, diet, and physical activity)
  2. Physical Risk Factors (measures of height, weight, and waist circumference)
  3. Biochemical Risk Factors (blood pressure, fasting blood glucose, and total cholesterol levels)

The sample size was 2,833 individuals, with the main analysis focusing on those aged 25–64 years (n=1,925). Additional results for those aged 15–24 years were also included.

Key Findings

1. Tobacco Use

• 39.8% of the population aged 25–64 smoked.
• 54.1% of men and 25% of women were current smokers.
• 30.6% smoked daily, with a 43.9% male and 16.9% female daily smoking rate.
• The mean age of smoking initiation was 21 years, with those aged 15–24 reporting initiation at 16 years.

2. Betel Nut Use

• 62.6% of the population chewed betel nut.
• 77.5% of men and 66.3% of women in the 15–24 age group chewed betel nut daily.
• The mean duration of betel nut use was 33 years for those aged 55–64, indicating a lifelong habit.

3. Alcohol Consumption

• 33.5% of the sample consumed alcohol in the past 12 months.
• 45.3% of the 15–24 age group and 42% of the 25–34 age group were current drinkers.
• 25.1% of men and 20.3% of women consumed 4 or more standard drinks per day, indicating binge drinking.
• 27.1% of men and 23.8% of women in specific age groups engaged in binge drinking.

4. Dietary Behaviours

• The average consumption of fruit and vegetables was 2.5 days per week for men and 4.7 days per week for women.
• On days when fruit and vegetables were consumed, the mean number of combined servings was 2.1.
• 93.6% of the population consumed less than 5 combined servings per day, far below the recommended levels.

5. Physical Activity

• 41.9% of the sample had low levels of physical activity (<600 METminutes per week).
• 557 METminutes per week for men and 455 METminutes per week for women.
• Work-related activities were the main source of physical activity, followed by transport and recreation.

6. Overweight and Obesity

• 67.4% of the population was overweight (BMI ≥25 kg/m²).
• 32.8% were obese (BMI ≥30 kg/m²).
• 72.7% of women and 62.5% of men were overweight.
• 40.4% of overweight women and 25.8% of overweight men were obese.
• 32.0% had a normal BMI (18.5–24.9), with 26.5% of women and 37.0% of men in this category.

7. Blood Pressure and Hypertension

• 10.7% of the population had hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg or on medication).
• Hypertension increased with age, with the highest prevalence in women aged 55–64.

8. Fasting Blood Glucose and Diabetes

• 13.5% of the sample had diabetes (fasting glucose ≥6.1 mmol/L or on medication).
• 15.3% of men and 11.7% of women were diabetic.
• The highest prevalence of diabetes was in men aged 55–64.

9. Total Cholesterol

• 24.6% of the sample had raised total cholesterol (≥5.0 mmol/L or ≥190 mg/dl).
• 28.5% of women and 19.6% of men had raised cholesterol.
• The highest rate was in women aged 55–64, with 50% of the sample affected.

10. Combined Risk Factors

• The population was classified into three risk categories:
  • Low Risk (no risk factors): <1%
  • Moderate Risk (1–2 risk factors): 53.3%
  • High Risk (3–5 risk factors): 46.0%
• The youngest age group (15–24 years) showed a higher prevalence of risk factors, suggesting early adoption of unhealthy behaviors.

Key Recommendations

1. Addressing Information Needs

• MHMS should organize national NCD risk factor reduction campaigns, focusing on adults and children.
• Compare sub-samples (Honiara, Gizo, Auki) to identify differences in risk behaviors.
• Conduct additional data analysis to find statistically significant associations.
• Establish strong leadership and political/financial commitment to maintain a systematic STEPS surveillance system.
• Repeat NCD STEPS surveys periodically to evaluate the impact of prevention programs.
• Participate in regional comparisons with other PICs to identify unique risk factors.

2. Addressing Policy, Organizational, and Environmental Factors

• Government should allocate funds for NCD strategy implementation and monitoring.
• Implement the WHO Framework Convention on Tobacco Control and the Regional Action Plan for the Tobacco-Free Initiative.
• Consider taxing tobacco and alcohol manufacturers to subsidize health services.
• Develop policies to support healthy food imports.
• Investigate improving the distribution, marketing, and availability of fruit and vegetables.
• Create physical activity-friendly environments, including walking tracks, parks, sports facilities, and workplace fitness programs.

3. Addressing NCD Behavioural Risk Factors

• Create and provide comprehensive anti-smoking campaigns, especially targeting teenagers and younger adults.
• Launch anti-alcohol campaigns, focusing on young people and binge drinking.
• Promote recommended fruit and vegetable consumption and raise awareness of the adverse effects of high-fat, high-salt, and high-sugar diets.
• Develop culturally-appropriate programs to encourage daily physical activity.
• Conduct public awareness campaigns on the importance of regular blood pressure monitoring and screening.

Conclusion

The STEPS survey underscores the high prevalence of NCD risk factors in the Solomon Islands, particularly among men and women aged 25–64 years. It highlights the early adoption of unhealthy behaviors by the youngest age group (15–24 years), indicating the need for targeted health education and prevention programs. The report serves as a baseline for national NCD strategy formulation, monitoring, and evaluation, and emphasizes the importance of a systematic surveillance system to address the growing NCD epidemic.