Health system response and capacity to address and respond to NCDs
Situation and trends
Surveillance for NCDs should cover monitoring of risk factors, health outcomes (mortality and morbidity) and system capacity. Based on the WHO Global NCD Country Capacity Survey undertaken in 2010, more than 80% of countries reported NCD mortality as part of their national health reporting systems. A similar percentage reported that morbidity related to NCDs is included, but only 21% of countries reported that such data was population based. 16% of countries have no mortality or morbidity surveillance at all. Significantly, far fewer countries reported that they had population-based mortality data for NCDs.
Significant progress has been made over the past ten years on risk factor surveillance, including population-based data on the behavioural (harmful use of alcohol, unhealthy diet, insufficient physical activity and tobacco use) and biological risk factors (raised blood glucose, raised blood pressure, abnormal blood lipids and overweight/obesity). However, only about a third of countries globally reported that they had produced a report of such data in 2007 or later.
For both the behavioural and the metabolic risk factors, the WHO European Region was the one with the highest percentage of countries that undertook surveys in 2007 or later. Across all regions, tobacco use was the behavioural risk factor that was most surveyed, while the biological risk factor abnormal blood lipids was least surveyed.
Analysis suggested that lower income countries are catching up with higher income groups in risk factor surveillance. Across all income groups, data on NCD risk factors are still less likely to be included in a country’s national health reporting system than mortality and morbidity data.