Non-Communicable Diseases Risk Factors: STEPS Survey 2017
Tonga, 2017
Identification
SPC_TON_2017_STEPS_v02_M
Non-Communicable Diseases Risk Factors: STEPS Survey 2017
| Name | Country code |
|---|---|
| Tonga | TON |
World Health Survey [hh/whs]
STEPwise approach to non-communicable disease risk factor surveillance (STEPS).
The WHO STEPwise approach to Surveillance (STEPS) is a simple, standardized method for collecting, analysing and disseminating data in WHO member countries. By using the same standardized questions and protocols, all countries can use STEPS information not only for monitoring within-country trends, but also for making comparisons across countries. The approach encourages the collection of small amounts of useful information on a regular and continuing basis.
The STEPS approach focuses on obtaining core data on the established risk factors that determine the major disease burden. It is sufficiently flexible to allow each country to expand on the core variables and risk factors, and to incorporate optional modules related to local or regional interests. The survey is undertaken to determine the distribution of modifiable behavioural risk factors (NCD risk factors) among the population.
This is the 3nd-round Nationwide NCD STEPS survey undertaken in Tonga, Round 1 and Round 2 were previously undertaken in 2004 and 2012 respectively.
The Tongan NCD Risk Factors STEPS survey was a nation wide cross sectional assessment of 18 to 64 year olds carried out in from 12th of March to the 5th of May 2017 using WHO STEPS surveillance methodology and instruments.
Purpose
The WHO STEPwise approach to noncommunicable disease (NCD) risk factor surveillance is designed to help countries build and strengthen their surveillance capacity. STEPS is the WHO's recommended tool for surveillance of NCDs and their risk factors. It provides an entry point for low and middle income countries to get started on NCD surveillance activities. It is also designed to help countries build and strengthen their capacity to conduct surveillance.
The key objectives of the 2017 STEPS survey were to:
• To investigate and document the prevalence of key NCDs in Tonga.
• To determine the prevalence of and better understand the major risk factors and their associations for common NCDs in Tonga.
document the prevalence and magnitude of major modifiable risk factors for NCDs, including tobacco use, alcohol consumption, fruit and vegetable consumption, physical activity, overweight and obesity, blood pressure, blood glucose and cholesterol levels.
• To document the prevalence of key NCDs among adults in Tonga.
• To monitor trends in major NCD risk factors and key NCDs across age groups and gender.
Common, preventable risk factors underly most NCDs. The leading risk factor globally is raised blood pressure, followed by tobacco use. Other major risk factors, accounting for a large fraction of the global mortality and morbidity from NCDs include alcohol use, unhealthy diet (such as low fruit and vegetable intake, or high salt intake), insufficient physical activity, overweight/obesity, raised blood glucose, and raised cholesterol.STEPS is a sequential process. It starts with gathering key information on risk factors with a questionnaire, then moves to simple physical measurements and then to more complex collection of urine and blood samples for biochemical analysis. STEPS emphasizes that small amounts of good quality data are more valuable than large amounts of poor data.
Sample survey data [ssd]
- Individual
Version
v01: edited data of the Master file (labelled and cleaned). This is not the final dataset. Therefore, all observations were removed from the dataset due to sensitivity of the data and for not being the final version.
2017-03-02
The dataset held at Pacific Community by the documentation team is not the final one hence the absence of the dataset in this documentation.
Scope
INDIVIDUAL: Socio demographic and behavioural information (tobacco use, alcohol consumption, diet and physical activity); Tobacco use; Alcohol consumption; Low intake of fruit and vegetables; Diet high in salt; Physical inactivity; Physical measurements such as height, weight and blood pressure; Obesity; Raised fasting blood glucose; High levels of fat in the blood; Medical history; Cervical cancer screening; Biochemical measurements were collected to assess salt intake, blood glucose and cholesterol; Health care; Access to services.
| Topic | Vocabulary |
|---|---|
| General Health | WHO WB Modified |
| Non-communicable diseases | WHO WB Modified |
| Alcohol and drug abuse | WHO WB Modified |
| Tobacco/smoking | WHO WB Modified |
| Nutrition | WHO WB Modified |
| Health behaviors and attitudes | WHO WB Modified |
Coverage
National coverage.
Indiduals aged between 18-69.
Producers and sponsors
| Name | Affiliation |
|---|---|
| Ministry of Health | Government of Tonga |
| Tonga Statistics Department | Government of Tonga |
| Name | Affiliation |
|---|---|
| World Health Organization | Logistical and technical support |
| Name | Role |
|---|---|
| World Health Organization | Shared funding |
| Government of Tonga | Shared funding |
Sampling
An initial sample of 4,500 individuals (respondents) between the ages of 18 to 69 years old was targeted to undertake the STEPS survey for 2017 in Tonga.
Because it is important to compare the results by island divisions (national level), it is required with importance to produce the estimates in the divisional level (National Level). Therefore the sampling fractions will be adjusted from its proportional to the size (number of households) to have higher sampling fraction (coverage) for the smaller size island division as shown in the following table:
Pop Census STEPS sampleIsland Total HH ideal sample size coverage Number of Selected Blocks
1 Tongatapu 12,953 3240 25.0'02 Vava'u 2,715 684 25.2W3 Ha'apai 1,179 288 24.4$4Eua 885 228 25.85 Niua 273 60 22.0% 5
Total 18,005 4,500 25.075
The final sample numbers presented in the table above were rounded such that they were divisible by 12 (an enumerators workload) to accommodate field logistics. As such the sample size is recorded to 4,500. The sample was selected independently within each of the 5 target areas.
The sampling in each area was then undertaken using a three-stage process. The first stage involved the selection of census blocks using Probability Proportional to Size (PPS) sampling, where the size measure was the expected number of households in that block. For the second stage, a fixed number (twelve) of households were selected from each selected census block using systematic sampling. The household lists for all selected blocks were updated just prior to the second stage of selection. Once the selected 12 households are found, then the list of household members age 15 to 64 by gender will be recorded. The final stage will be to use the Random Sample Generator (Android Application) to randomly select one person from the household to be enumerated so that it captures the required composition of the sample with specific age-group distribution and gender.
Survey instrument
The questionnaire was published in English with the Tongan translation under each question and answer. The questionnaire was developed using the World Bank software Survey Solutions and contained the following modules:
- Geographical ID
- Demographic information
- Tobacco use
- Alcohol consumption
- Diet
- Physical activity
- History
- Cervical cancer screening
- Physical measurements
- Biochemical measurements
- Difficulty
- Health care - Tokangaekina e mo'ui lelei
- Access to services
- GPS + photo
Appendices: Instructions and Options
Data collection
| Start |
|---|
| 2017-03-12 |
| Name | Affiliation |
|---|---|
| Ministry of Health | Government of Tonga |
Data Access
| Name | Affiliation | URL |
|---|---|---|
| Ministry of Health | Government of Tonga | www.health.gov.to |
| Tonga Statistics Department | Government of Tonga | http://tonga.prism.spc.int/links |
| Is signing of a confidentiality declaration required? | Confidentiality declaration text |
|---|---|
| yes | De-identified dataset. |
Licensed-use dataset.
"National Statistics Office of Tonga, Non-Communicable Diseases Risk Factors: STEPS Survey 2017 (STEPS 2017), Version 01 of the licensed datasets (March 2017), provided by the Pacific Microdata Library. http://pdl.spc.int/index.php/home"
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | URL |
|---|---|---|
| Ministry of Health | Government of Tonga | www.health.gov.to |
| Tonga Statistics Department | Government of Tonga | http://tonga.prism.spc.int/links |
Metadata production
DDI_SPC_TON_2017_STEPS_v02_M
| Name | Affiliation | Role |
|---|---|---|
| Statistics for Development Division | Pacific Community | Documentation of the study |
2019-01-28
Metadata version
Version 01 (January 2019): This is the first attempt at documenting the Tongan 2017 STEPS survey. Done by Statistics for Development Division (SDD) at Noumea, New Caledonia.