2011-12-31-世界卫生组织-2012-2013_STEPS_Country_Report_Rwanda_113页_2mb

报告摘要

Background: Rwanda recognized NCDs as a major threat to health and development, prompting the 2009 Health Sector Strategic Plan (HSSP-2) to include a national risk factor survey.
Survey Findings: The STEPs survey, covering 7,240 individuals aged 15–64, revealed key risk factors, with hypertension being the most prevalent (15%). High physical activity levels were reported, but dietary habits (low fruit/vegetable intake) and alcohol consumption were areas of concern.
Recommendations: Strengthen prevention strategies, improve early diagnosis/treatment, and scale up surveillance for future NCD planning.

Approach: Used WHO’s STEPs (Stepwise Approach to Chronic NCD Surveillance) methodology covering behavioral, physical, and biological risk factors.
Sample Size: Targeted 7,200 participants to detect statistical differences across demographics.

Tobacco Use: 19.1% of men (7.1% of women) smoked daily; most users started in adolescence.
Alcohol Consumption: ~55% of survey respondents drank alcohol; half were classified as heavy drinkers (>5 drinks/day for men, >4 for women).
Diet: Only 1% consumed ~5 servings of fruits/vegetables daily (conflicting with WHO guidelines), though overall dietary patterns were healthy.
Physical Activity: 61.5% had high activity levels, primarily driven by work; sedentary time was low.

Hypertension: 15% of Rwandans had high BP; prevalence increased with age (40% in 55–64-year-olds).
Diabetes: Only 3.1% had elevated fasting glucose; improved diagnosis is needed.
Cholesterol/Obesity: Low, but HDL deficiency and waist circumference increases were noted in younger populations.
Kidney Health: 10.5% had albuminuria, particularly in semi-urban and rural areas.

Low traffic-related injuries, but unsafe practices like seatbelt/helmet non-use contributed to risks.

Combined Risk Factors:
- Men (84.6%): 55–64-year-olds had higher NCD risk (~25%).
- Women (82.0%):
- Young women were at lower immediate risk but face rising concerns in older age.
Overall, 83.2% at moderate risk, 16.4% at high risk.

Governments should implement laws for tobacco control (advertising, taxation, smoke-free areas).
Enhance nutrition strategies to improve fruit/vegetable access and reduce harmful alcohol use.
Scale up physical activity promotion through social marketing.

Improve screening and follow-up for hypertension, diabetes, and kidney disease.
Focus primary care on high-risk populations (older adults, multiple risk factors).

Conduct repeat STEPs surveys (e.g., 2028) to track trends and policy effectiveness.

Rwanda's smoking rates align with African averages.
NCD strategies should prioritize upstream prevention aligned with global voluntary targets by 2025.

Risk Factor	Key Prevalence/Key Concern	Priority Actions
Hypertension	15% of population; higher in urban/rural divides by province	Improve early diagnosis and treatment.
Diet	Very low fruit/veg intake (median <2 servings/day)	Increase fruit/veg availability and consumption strategies
Tobacco Use	>20% current daily smokers, with early initiation among men	Anti-smoking campaigns; support for quitting.
Alcohol Use	High frequency but risky consumption among some groups	Regulate alcohol marketing; promote responsible use.
Physical Activity	High work-related activity, lower recreational activity in women	Promote physical activity among women and youth.
All NCDs	Highest risk clustered among older adults (55–64 age group)	Target interventions for NCDs in middle–old age populations.