2006-12-31-世界卫生组织-2007_STEPS_Country_Report_Nepal_163页_2mb

Summary of the Nepal Non-Communicable Disease Risk Factors Survey 2007/08

Core Content

The Nepal Non-Communicable Disease (NCD) Risk Factors Survey 2007/08 was conducted as part of the WHO STEPS surveillance program, aimed at collecting standardized data on major NCD risk factors. This survey was the first nationally representative study in Nepal, following earlier regional surveys that were not comprehensive. The survey covered adults aged 15-64 years from 15 districts across five developmental and three ecological regions, using a multi-stage stratified sampling approach. A total of 4328 individuals participated, with an overall response rate of 98.4%.

The survey focused on key risk factors including tobacco use, alcohol consumption, fruit and vegetable intake, physical activity, and blood pressure and diabetes history. It also included physical measurements such as BMI, waist and hip circumference, and blood pressure levels.

Main Findings

Tobacco Use

• Current tobacco users: 37.1% of the population (53.3% men, 19.2% women).
• Current smokers: 26.2% of the population (35.5% men, 15.9% women).
  • Daily smokers: 23.8% (31.2% men, 15.5% women).
  • Mean age of initiation: 18.8 years for men, 12.9 years for women.
  • Mean duration of smoking: 21.6 years (21.1 for men, 22.8 for women).
  • Ex-smokers: 11.7% (14.5% men, 9.2% women).
• Smokeless tobacco users: 18.6% of the population (26.9% men, 4.7% women).
  • Daily users: 16.2% (23.8% men, 4.6% women).
  • Ex-users: 3.4% (6.1% men, 1.2% women).
• Dual users (smoke and smokeless): 7.7% of the population.

Alcohol Consumption

• Current drinkers: 28.5% (39.3% men, 16.5% women).
• Daily drinkers: 31.3% of men vs. 13.3% of women.
• Mean standard drinks per day: 4.5 (men: 4.8, women: 3.6).
• Harmful drinking: 32.3% of men and 10% of women consumed harmful amounts (>60gms of ethanol).

Fruit and Vegetable Consumption

• Mean days of fruit consumption per week: 2.1 days (men: 2.1, women: 2.1).
• Mean days of vegetable consumption per week: 5.1 days for men and 5.3 days for women.
• Mean servings per day: 1.8 for men, 1.6 for women (fruit); 2.5 servings for both sexes (vegetables).
• Consumption below 5 servings per day: 60.5% of men and 63.5% of women.

Physical Activity

• High and moderate activity: 95% of the population engaged in either high or moderate physical activity.
• Low activity: <6% of both sexes.
• Mean minutes per day: 270.6 for men, 291.7 for women, and 280.6 for both sexes combined.
• Physical activity levels: Work and transport-related activities exceeded the recommended level, while recreational activity was below.

Blood Pressure and Diabetes

• Reported high blood pressure: 9% of the population (10.2% women, 8.4% men).
• Medication use for high blood pressure: Only 50% of those with high blood pressure were on antihypertensive medication.
• Lifestyle advice received: 90% of those with high blood pressure received lifestyle advice, with women more likely to receive it.
• Diabetes prevalence: ~10% of the population (more women than men).
• Insulin use: 14.1% of diabetics.
• Oral hypoglycaemic drugs: 59.1% of men and 56.8% of women.
• Traditional care use: ~10% of diabetics sought care from traditional healers or used herbal medicine.

Key Risk Factors Identified

• Tobacco use: High prevalence, especially among men.
• Alcohol consumption: Excessive among men, with harmful levels noted.
• Poor diet: Low fruit and vegetable intake.
• Physical inactivity: Low levels in both sexes, though work and transport activity was high.
• High blood pressure and diabetes: Significant prevalence with low medication adherence and lifestyle intervention rates.

Recommendations

• For Ministry of Health and Population (MoHP): Strengthen NCD prevention programs, improve awareness, and expand surveillance to ensure sustainability.
• For DOHS (Department of Health Services): Implement targeted interventions based on risk factor data, improve data collection systems, and promote health education.
• For Hospitals and Health Care Facilities: Enhance treatment and follow-up for NCDs, provide lifestyle advice, and integrate traditional health practices into modern systems.

Conclusion

The survey highlights the high prevalence of NCD risk factors in Nepal, particularly tobacco and alcohol use, low fruit and vegetable consumption, and inadequate physical activity. These factors contribute significantly to the burden of NCDs, including cardiovascular diseases, diabetes, and chronic respiratory conditions. The findings serve as a baseline for future NCD prevention and control efforts, emphasizing the need for comprehensive, integrated, and sustainable interventions. The survey also underscores the importance of improving health awareness and data collection systems to effectively address NCDs in the country.