2006-12-31-世界卫生组织-2007-08_STEPS_Country_report_Papua_New_Guinea_81页_3mb

Papua New Guinea NCD Risk Factors STEPS Report Summary

Core Content

The Papua New Guinea NCD Risk Factors STEPS Report is a comprehensive assessment of non-communicable disease (NCD) risk factors among adults aged 15-64 years. It was conducted by the National Department of Health (NDOH), HOPE Worldwide, and the World Health Organization (WHO) between March 2007 and March 2008. The report provides critical data to inform NCD prevention and control strategies in PNG and highlights the high prevalence of NCDs and their associated risk factors.

Main Objectives

• Document the prevalence and magnitude of key NCDs and their behavioral risk factors among adults aged 15-64 years.
• Identify major modifiable risk factors such as tobacco and betel nut use, harmful alcohol consumption, poor dietary habits, physical inactivity, overweight/obesity, raised blood pressure, and raised blood glucose.
• Compare NCD risk factors across different age groups and between men and women.

Key Findings

Behavioral Risk Factors

• Tobacco use: 44.0% of the population were current smokers, with 43.7% smoking daily. Men (59.9%) were more likely to smoke than women (26.6%).
• Betel nut use: 79.0% of the population chewed betel nut in the past 12 months. Men (80.3%) and women (77.8%) had similar rates.
• Alcohol consumption: 22.2% of adults consumed alcohol in the past 12 months, with 7.1% being current drinkers. Men (12.8%) were significantly more likely to drink than women (1.6%).
• Physical activity: 9.9% of the population reported low levels of physical activity (<600 MET minutes per week). The majority (76.1% of men and 70.6% of women) engaged in high levels of physical activity (>1500 MET minutes per week).
• Dietary habits: Only 1.5% of the population met the recommended intake of 5 combined servings of fruit and vegetables per day. 98.9% consumed less than 5 servings.

Physical Risk Factors

• Overweight and Obesity: 32.1% of adults were overweight (BMI ≥25 kg/m²), with 6.8% being obese (BMI ≥30 kg/m²). Women had higher rates of overweight (33.9%) than men (30.3%), but both groups had similar obesity rates (8.7% for women and 5.1% for men).
• Body fat: Average body fat was 16.9% for men and 22.9% for women, with an overall average of 19.8%.
• Blood pressure: 8.8% of adults had hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg or on medication). Men had a higher prevalence (10.2%) than women (7.2%).

Biochemical Risk Factors

• Blood glucose: 14.4% of adults had raised fasting blood glucose (≥6.1 mmol/L). 20.5% had impaired fasting glycaemia. 15.3% had impaired glucose tolerance after an oral glucose tolerance test.
• Fasting blood glucose and diabetes: 14.4% of adults had raised fasting blood glucose, and 15.3% had impaired glucose tolerance. 15.3% of adults had diabetes or were on medication for it.

Combined Risk Factors

• Risk categories: The population was classified into three risk categories based on the number of NCD risk factors:
  • Low risk: 0.4% of adults had no risk factors.
  • Moderate risk: 77.7% of adults had 1-2 risk factors.
  • High risk: 21.9% of adults had 3-5 risk factors.
• Gender differences: Men had a higher proportion of high-risk individuals (28.1%) than women (15.3%).

Key Recommendations

Addressing Policy, Organizational, and Environmental Factors

• Recognize NCDs as a national priority and take urgent actions, given that 99.6% of the population is at high or moderate risk.
• Increase resources to implement the WHO Framework Convention on Tobacco Control.
• Develop betel nut control policies.
• Support local production and consumption of fruit and vegetables.
• Review policies on importation of healthy foods.
• Strengthen the health care system for early detection and management of chronic diseases.
• Establish sustainable government funding and health infrastructure for NCD strategy implementation and monitoring.
• Develop coalitions, networks, and partnerships for NCD prevention and management.

Addressing NCD Behavioral Risk Factors

• Conduct comprehensive anti-smoking campaigns to reduce smoking rates, especially among youth.
• Implement smoking cessation programs.
• Launch health promotion campaigns to reduce alcohol consumption, with a focus on binge drinking.
• Promote recommended fruit and vegetable consumption and raise awareness of the adverse effects of unhealthy diets.
• Develop culturally appropriate physical activity programs in urban areas.
• Implement comprehensive strategies to reduce the five critical NCD risk factors: smoking, overweight/obesity, raised blood pressure, low fruit and vegetable intake, and low physical activity.

Establishing a Coordinated Approach to NCD Management

• Increase public awareness of the importance of regular monitoring and screening for blood pressure, cholesterol, and blood sugar.
• Strengthen coordinated care for individuals with diagnosed chronic diseases, integrating primary and clinical care.
• Support patient self-management and self-monitoring of conditions, medications, and lifestyle changes.
• Encourage screening for hypertension and diabetes, especially for high-risk individuals and through opportunistic screening.

Maintaining Quality Surveillance and Public Health Information

• Ensure strong leadership and political and financial commitment to maintain a systematic STEPS data collection process.
• Develop a sustainable STEPS surveillance system in PNG, supported by trained workforce, infrastructure, and financial capacity.

Conclusion

The STEPS survey demonstrates that NCDs are a major public health issue in PNG, with the majority of adults at heightened risk. The findings provide a baseline for future health planning and emphasize the need for multi-sectoral action to address the epidemic. The report is a milestone in the fight against NCDs and highlights the importance of surveillance and policy intervention in improving health outcomes.