The World Health Organization STEPwise Approach to Noncommunicable Disease Risk-Factor Surveillance: Methods, Challenges, and Opportunities

Abstract

Objectives: We sought to outline the framework and methods used by the World Health Organization (WHO) STEPwise approach to noncommunicable disease (NCD) surveillance (STEPS), describe the development and current status, and discuss strengths, limitations, and future directions of STEPS surveillance.

Methods: STEPS is a WHO-developed, standardized but flexible framework for countries to monitor the main NCD risk factors through questionnaire assessment and physical and biochemical measurements. It is coordinated by national authorities of the implementing country. The STEPS surveys are generally household-based and interviewer-administered, with scientifically selected samples of around 5000 participants.

Results: To date, 122 countries across all 6 WHO regions have completed data collection for STEPS or STEPS-aligned surveys.

Conclusions: STEPS data are being used to inform NCD policies and track risk-factor trends. Future priorities include strengthening these linkages from data to action on NCDs at the country level, and continuing to develop STEPS' capacities to enable a regular and continuous cycle of risk-factor surveillance worldwide.

FIGURE 1—

Status of the World Health Organization’s STEPwise Approach to Noncommunicable Disease Surveillance Implementation in 2015 Note. The boundaries and names shown and the designations used on this map do not imply the expression of any option whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines represent approximate border lines for which there may not yet be full agreement. Source. Data are from the World Health Organization. Map production by Health Statistics and Information Systems.