Chronic diseases now make the greatest proportion of the total burden of disease and injuries in the countries of Latin America and Caribbean. Many of these conditions are amenable to preventive measures. However, effective action to prevent and control disease depends on timely access to accurate and reliable information, both to inform where resources should best be targeted and to monitor and evaluate the impact of the actions taken. In the countries, many components needed for the surveillance of chronic noncommunicable diseases (CNCDs) and associated determinants are already in place. However, significant gaps remain. It is widely recognized that CNCD surveillance can be improved upon by building on, harmonizing and complementing existing systems. PAHO has been working at the subregional multi-sectoral governmental level to strengthen CNCD surveillance in the Caribbean, Central America, MERCOSUR, and the Andean Regions.
PAHO Position Paper on CNCD Surveillance
The purpose of this position paper is to present the aim and thinking of the Secretariat, i.e. PAHO/WHO, regarding the implementation of a line of action on surveillance from the Regional Strategy and Plan of Action on an Integrated Approach for the Prevention and Control of Chronic Diseases through its main vehicle, the CARMEN (Collaborative Action for Risk Factor Prevention and Effective Management of CNCDs) Network.
Country Profile of Capacity and Response to CNCDs
Surveillance is essential to prevent and control disease. As the specialized organization for health of the Inter-American System, our goal is to provide our Member States with the necessary tools to monitor CNCDs. The purpose of this Country Profile of Capacity and Response to CNCDs survey is to assess national level capacity and response to NCDs. The survey could also be applied at the sub-national level if the responsibility for health is decentralized. The results will ultimately allow the Member States, PAHO and the WHO HQ to improve the planning of future actions and technical cooperation required to address CNCDs.
Minimum, optimum and optional data set for CNCDs: This offered data set combines multiple data sources in one functional annual reporting system as the foundation for country-level surveillance. The incorporation of this data set within a country's surveillance system would facilitate its analysis at the Regional level and alleviate the currently fragmented country surveillance systems. It will also allow for the generation of more complex indicators for CNCDs in the future.
Risk-Factor SurveillancePanAm Steps: For adult risk-factor (RF) surveillance, PAHO has adapted the original instrument and methodology in the WHO Stepwise Approach to Risk-Factor (RF) Surveillance in PanAm STEPS. PanAm STEPS is a simple, standardized method for collecting, analyzing, and disseminating RF data within a country. By using the same standardized questions and protocols, all countries can use STEPS information, not only for monitoring trends within the country, 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 methodology offers the instrument itself, a detailed Manual, and software support for data entry, data processing, and reporting.
eSTEPS: WHO has created eSTEPS, a suit of softwares, to facilitate the synchronized preparation and implementation of data collection of PanAm STEPS using Personal Digital Assistants (PDAs). For more information, please click here.
Global School Health Survey: A special area of RF surveillance is related to youth. The Global School Health Survey (GSHS), student-based, is part of a global surveillance system designed to provide accurate data to periodically monitor the prevalence of important health risk behaviors and protective factors among students of 13–15 years of age. The GSHS is relatively low-cost and uses a self-administered questionnaire to obtain data from a representative sample of students. Countries implementing the GSHS receive technical assistance from the WHO HQ in collaboration with the CDC.
STEPS Stroke: The main methodology used for stroke registration is the WHO STEPwise Method to Stroke Surveillance, STEPS Stroke. STEPS Stroke is the framework for standardized surveillance, data collection and analysis of stroke cases. As the Regional Office for the Americas, PAHO encourages and facilitates its use among our Member States by providing techinal assistance and having the manual available in three different languages (English, Portuguese, and Spanish).
Chronic Disease Registries
Disease registries have an enormous potential for improving chronic disease management. In addition to providing support for individual follow-up, the results therein can be aggregated and analyzed on a population basis.
Regarding cancer registries, information can be found on the website of the International Agency for Research on Cancer (IARC) at CancerMondial. In our Region, PAHO has also partnered with IARC to provide technical cooperation to open, maintain, and improve cancer registries.
Sub Regional Activities
As a response to the need in the Region for capacity building the PAHO strategy to continue the support to our member states, partnerships, meetings, workshops, and taskforces are formed. For the most up-to-date information on these in each sub region, view CNCD Surveillance Sub Regional Activities.