Summary of a case study published in 2019
In January 2007 the Ministry of Health in Benin acknowledged the growing burden of noncommunicable diseases (NCDs) in the country, and introduced a National Program for the Control of Noncommunicable Diseases. To support this work, a comprehensive risk factor survey was carried out in Cotonou, Benin’s largest city and economic capital.
The WHO STEPwise approach to noncommunicable disease risk factors surveillance (STEPS) was chosen for data collection. This standardized instrument for collecting, analysing and disseminating data on NCD behavioural and metabolic risk factors has three components: demographic and behavioural data, physical health measurements, and urine and blood samples. The flexible design of the instrument enabled the Ministry of Health to gather demographic and behavioural data on specific indicators of interest, including tobacco and alcohol use, dietary behaviour, physical activity and history of NCD conditions.
Conducting the survey in the city was an opportunity to understand some of the challenges that using it elsewhere might face. These included participant access issues, such as the relative mobility of urban residents which made people difficult to locate; difficulties in following up for blood sample collection, and people’s willingness to participate overall. Other practical difficulties included understanding of the survey, and restricted access to some neighbourhoods because of flooding. However, once completed, the survey’s findings provided valuable new insights into the prevalence of key NCD risk factors. The city-level survey also led to important recommendations, including its expansion to the rest of the country, the introduction of national screening for risk factors, and greater multisectoral collaboration to address the risk factors themselves.
A national survey was carried out in 2008 and formed part of a wider examination of the status of NCD risk factors in Benin and the provisions in place for diagnosis and treatment. Ultimately this work contributed to the development of the first national NCD policy, along with an integrated action plan for 2014–2018.
Collecting high-quality NCD risk factor data was instrumental in instigating long-term action to reduce the burden of NCDs, and Cotonou had acted as a catalyst for this work. Political will to tackle NCDs was significantly strengthened by the experience, and routine national surveillance on NCDs is now planned for every 5 years.