2011-12-31-世界卫生组织-2012_STEPS_Country_Report_United_Republic_of_Tanzania_154页_3mb

Tanzania STEPS Survey Report Summary

Core Content

The Tanzania STEPS Survey Report provides a comprehensive overview of the prevalence of non-communicable diseases (NCDs) and their associated risk factors among adults aged 25–64 years. The survey was conducted by the Ministry of Health and Social Welfare (MOH&SW), the National Institute for Medical Research (NIMR), and in collaboration with the World Health Organization (WHO). It aimed to collect up-to-date local data on NCDs and related behavioral and physical risk factors to support the development of targeted interventions and policy measures.

Main Goals and Objectives

Goals

• To describe the current levels of risk factors for chronic diseases in the Tanzanian population.
• To collect data from which to predict likely future demands for health services.

Objectives

1. Document the national prevalence and patterns of tobacco use, alcohol consumption, dietary behavior, physical activity, body mass index, elevated blood pressure, and biochemical markers among adults aged 25–64 years.
2. Generate country data on NCDs and related risk factors using WHO-recommended methods for global comparison.
3. Provide reliable and valid information for planning and evaluating public health interventions.
4. Generate baseline data to track trends in risk factors.
5. Adapt WHO STEPS tools and document data collection and fieldwork experiences for future surveys.

Methods

The survey followed the WHO STEPS approach, consisting of three steps:

• Step 1: Questionnaire-based data collection on socio-demographic characteristics, tobacco use, alcohol consumption, dietary habits, physical activity, and health history.
• Step 2: Physical measurements including blood pressure, height, weight, and waist circumference.
• Step 3: Biochemical measurements such as fasting blood glucose and total cholesterol.

The study employed a multistage cluster sampling method, with districts as primary sampling units (PSUs), enumeration areas (EAs) as secondary sampling units (SSUs), and households as tertiary sampling units (TSUs). A total of 5680 adults participated in the survey, with an overall response rate of 94.7%. The data was weighted to represent the total population of Tanzania aged 25–64 years.

Key Findings

• Tobacco Use: 15.9% of respondents were current tobacco users, with 22.0% of men and 2.6% of women smoking at least one cigarette per day. Smokeless tobacco use was also reported.
• Alcohol Consumption: 29.3% of the population were current alcohol drinkers.
• Diet: 97.2% of respondents consumed less than 5 servings of fruit and vegetables per day.
• Physical Activity: Low levels of physical activity were observed, with most respondents not meeting recommended activity levels.
• Obesity: 26% of respondents were overweight or obese, based on BMI.
• Blood Pressure: 25.9% of respondents had hypertension.
• Blood Glucose and Cholesterol: 9.1% of respondents had diabetes, and 26% had raised cholesterol. Raised triglycerides were reported in 33.8% of respondents.
• NCD Risk Factors: A significant proportion of the population had multiple NCD risk factors, with 33.8% having impaired fasting glucose and 26% with raised cholesterol.

Data Collection and Quality Control

• The survey was conducted across 119 districts, with 50 PSUs selected for sampling.
• The sample size was calculated to be 5770 individuals, with 5680 participants actually surveyed.
• A pilot study was conducted to test the instruments and procedures.
• Ethical considerations were taken into account, and the data was collected with informed consent.
• Quality control measures were implemented, including training of staff, data entry checks, and data analysis procedures.
• The data was weighted to represent the total population aged 25–64 years.

Importance of the Survey

This survey is crucial for:

• Establishing a national NCD risk factor surveillance system.
• Providing baseline data for future monitoring and evaluation.
• Supporting the development of targeted NCD interventions.
• Comparing data with other countries using standardized WHO tools.

Conclusion and Recommendations

The survey highlights a high prevalence of NCD risk factors in Tanzania, indicating a growing burden of chronic diseases. These findings emphasize the need for primary prevention strategies and targeted interventions to address the identified risk factors. The data collected will serve as a foundation for future NCD surveillance and policy development.

Key Information

• Survey Period: The survey was conducted in 2012–2014.
• Population Studied: Adults aged 25–64 years from both rural and urban areas.
• Data Collection Tools: Standardized WHO STEPS instruments.
• Key Risk Factors: Tobacco use, alcohol consumption, poor diet, low physical activity, obesity, hypertension, diabetes, and elevated cholesterol.
• Data Weighting: The results were weighted to represent the entire population aged 25–64 years.
• Response Rate: 94.7%.

Summary of Prevalence

Appendix Overview

• Appendix A: STEPS Instruments
• Appendix B: Show Cards
• Appendix C: Survey Implementation Plan
• Appendix D: Fact Sheet
• Appendix E: Data Book

References

The report references studies and data from the Adult Morbidity and Mortality Project (AMMP), the International Diabetes Federation (IDF), and other local and international health organizations. It also acknowledges the financial support from WHO, DANIDA, and the World Diabetes Foundation (WDF).

Acknowledgements

The report acknowledges the support of various institutions and individuals, including the Ministry of Health and Social Welfare, the National Institute for Medical Research, the World Health Organization, the Tanzania Food and Nutrition Centre, and the Tanzania Bureau of Statistics. It also thanks the community members and survey teams for their participation and contributions.