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Rationale

Non-communicable diseases (NCDs) have become a major source of consternation for public health officials in low- and middle-income countries (LMICs) endowed with vast deposits of natural resources. Cardiovascular diseases, cancers, diabetes, and respiratory diseases, are responsible for 80% of all NCDs deaths. In Ghana, NCDs account for 42% of all deaths, owing primarily to changing lifestyles and nutritional habits. The detrimental effects of non-communicable diseases include poverty due to high medical expenditure, pressure on the already stretched health system, a decrease in economic productivity, and mental health disorders. Harmful use of alcohol, physical inactivity, tobacco use and unhealthy diet are identified as the main modifiable risk factors attributed to NCDs. These modifiable risk factors have also been identified as the leading causes of NCDs among Ghanaians in the adult population.

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The World Health Assembly agreed on a set of global voluntary targets to prevent and control NCDs by 2025, including a target to reduce premature mortality from the 4 main NCDs by 25%, and targets for the main behavioural and metabolic NCD risk factors. Furthermore, the 2030 Agenda for Sustainable Development recognizes the importance of addressing NCD issues with a target to reduce the number of premature deaths from NCDs by one-third by 2030. The key to controlling the global epidemic of NCDs and meeting these ambitious but achievable NCD targets is primary prevention based on comprehensive population-wide programs.

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The National NCD control strategy prioritizes approaches to reduce the prevalence and incidence of modifiable risk factors for NCDs. In accordance with this strategy, surveys to measure the status and trends of behavioural and biological risk factors need to be conducted at regular intervals in order to plan public health priorities, estimate future caseloads, and monitor and evaluate population-wide prevention and control strategies. Having population-based estimates of cardiovascular risk factors is crucial to understanding the distribution and types of risk factors present in the region and for policy and planning to address the burden of CVD. Such population data on CVD risk factors are ominously lacking in sub-Saharan Africa.

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Therefore, in 2021, in response to a dearth of population-level data on NCDs in the sub-Saharan Africa Region, the Screen-and-Treat Research Group at the Centre for Research in Applied Biology, Sunyani partnered with key stakeholders to develop a strategy to conduct periodic community surveillance studies to identify and assess risk variables in the Sunyani Area and map at-risk individuals to care in order to contribute to the national NCD control efforts. This collaborative effort was called the Screen-and-Treat NCD Survey of Sunyani.

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Objectives

1. To describe the current levels of behavioural risk factors (tobacco use, harmful use of alcohol, unhealthy diet, and physical inactivity) in the adult population of Sunyani.

2. To measure the prevalence of biological risk factors (raised blood pressure, overweight, obesity, raised blood glucose, raised cholesterol).

3. To assess the coverage, availability, and use of cervical cancer screening/testing services and reasons for not getting screened or treated.

4. To explore community-centred strategies for improving health-seeking behaviour in low-resource settings

 

STEPwise strategy

Recognizing a global need for data on key NCD risk factors, the WHO initiated the STEPwise approach to surveillance (STEPS). The key goals of STEPS are to guide the establishment of risk-factor surveillance systems in countries by providing a framework and approach; to strengthen the availability of data to help countries inform, monitor, and evaluate their policies and programs; to facilitate the development of population profiles of NCD risk-factor exposures; to enable comparability across populations and across time frames; and to build human and institutional capacity for NCD surveillance.

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