Risk Factors Associated with Non-Communicable Diseases: Trends and Policy Implications in Nepal

Objective: To determine the trends in the prevalence of non-communicable diseases associated risk factors and implications for policies and strategies. Background: Non-Communicable Diseases (NCDs) contribute increasingly to disease burden in Nepal. The main drivers to this situation are the NCD related risk factors; and to determine their prevalence the Nepal Ministry of Health and Population conducted WHO Stepwise Approach to NCD Risk Factor Surveillance (STEPS) surveys in 2007, 2012 and 2019. This paper, by using results of STEPS surveys, explores the trends of NCD related risk factors and their implications for policies and strategies. Methods: This paper relies on the desk review of literature and secondary data, collected from the unpublished grey literature, mainly reports of the STEPS surveys. In addition, to corroborate findings, the evidence and experience from other countries available as published literature was brought. The data were analysed manually. Findings: Overall, during the period from first survey in 2007 to the last survey in 2019, there has been an increasing prevalence of NCDs associated lifestyle and behavioural, physical, and biochemical risk factors. Taking cognisance of these, several policies, and strategic documents, some of which generic, while others targeting the specific risk factors were produced. However, indicators and techniques used, across three STEPS surveys, were not consistent, thus limiting the comparison and analysis of data. Conclusions: The study concludes that different STEPS surveys did not use standard set of indicators and techniques. Yet, an increased prevalence of NCDs associated risk factors was noted. Several policies and strategic documents, generic as well as specific, were produced. But there is a need to define methodology, as to how results feed into the framing of policies and strategic, and their impact is monitored.