Malawi 2009 STEPS Report PDF

Malawi National STEPS Survey for
Chronic Non-Communicable Diseases and

their Risk Factors
Final Report
COLLABORATION OF
Ministry of Health ADL House

Capital Hill City Centre
P.O. Box 30377 P.O. Box 30390
Lilongwe 3 Lilongwe 3
Malawi Malawi
Tel: +265 1 789 4000 Tel: +265 1 772 755
Fax: +265 1 789 431 Fax: +265 1 1772 350
June 2010
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TABLE OF CONTENTS
Content Page(s)
Cover page………………………………………………………………………………………………..1
Table of content…………………………………………………………………………………………..2
List of abbreviations………………………………………………………………………...3
Acknowledgement…………………………………………………………………………..3
Executive summary……………………………………………………………………….4-5
Introduction and literature review……………………………………………………….6-12
Survey protocol…………………………………………………………………………13-21
Results………………………………………………………………………………….21-26
Discussion………………………………………………………………………………27-29
References……………………………………………………………………………...29-30
Appendices……………………………………………………………………………..31-66
Attachment: Malawi NCD STEPS Survey Data Book
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LIST OF ABBREVIATIONS
AIDS: Acquired –Immuno-deficiency Syndrome
BMI: Body Mass Index
CI: Confidence interval
CVDs: Cardiovascular Diseases
DHS: Demographic Health Survey
GTT: Glucose Tolerance Test
HDL-C: High Density Lipoprotein-Cholesterol
HIV: Human-Immuno Deficiency Virus
LDL-C: Low Density Lipoprotein-Cholesterol
NCDs: Non-Communicable Diseases
NSO: National Statistical Office
PPS: Probability Proportion to Size
QA/QC: Quality Assuarance/ Quality Control
SWAp: Sector Wide Approach
SI: Systematic Interval
VLDL-C: Very Low Density Lipoprotein-Cholesterol
WHO: World Health Organization
ACKNOWLEDGEMENTS
Special thanks go to the following members of the technical working group who developed
the survey protocol, adapted and translated the STEPS Survey Questionnaire and Consent
forms, participated in data collection and contributed in writing up the report: Dr Bagrey
Ngwira (College of Medicine, Mrs Neema Kandoole (MoH- HEU), Mr Chimwemwe
Mvula (MoH- Clinical Services), Mr B. Muwalo (OPC- HIV & Nutrition Unit), Dr Kelias
Msyamboza (WHO), Mr George Chitimbe (MoH-Environmental), Mrs Mabel Chikhata
(MoH- Nursing), Mr Hudson Kubwalo (WHO), Mr Y. Mwase (KCH), Mr Kelvin Saukila
(HMIS), Mr Humphreys Masuku (MoH- Environmental), Mr R. Mwenda (MoH-
Diagnostics), Mr D. Zanera (NSO) and Dr Dan Namalika (KCH). Special thanks should
also go to the Director of Clinical Services, Dr George Chinthope- Mwale for the overall
guidance and WHO for financial and technical support.
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EXECUTIVE SUMMARY
Introduction/background: With changes in life styles, chronic non-communicable

diseases (NCDs) namely hypertension, heart diseases, stroke, cancer, diabetes, chronic
respiratory condition such as asthma which used to be regarded as “diseases of the west,
affluent, rich, or urban people” are increasingly becoming significant causes of morbidity
and mortality in adults in developing countries. In Malawi, community data particularly on
risk factors (tobacco smoking, overweight/obesity, excessive alcohol intake, physical
inactivity etc) is scarce. Ministry of Health in collaboration with WHO therefore conducted
a country wide population based survey to determine the magnitude of NCDs and their risk
factors. The survey was conducted from July to September 2009.
Objectives/rationale: The Specific objectives of the survey were to determine the

prevalence of hypertension, diabetes and raised total cholesterol levels and their risk factors
(tobacco smoking, alcohol consumption, physical inactivity, overweight/obesity and
inadequate vegetable and fruit intake).
Materials and methods: A multi-stage cluster sampling design was used to produce a
national representative sample. Participants were people aged 25-64 years. Data was
collected in steps 1, 2 and 3 using personal digital assistants (PDAs). Socio demographic
and behavioural information was collected in Step 1. Physical measurements such as
height, weight, blood pressure and waist and hip circumference were collected in Step 2.
Biochemical measurements were collected to assess total cholesterol levels and fasting
blood glucose in Step 3. Data was weighed for age, gender and population size for Malawi
and analysed using WHO STEPS Survey software.
Results: A total of 5,206 participants were enrolled in the survey of which 67.5% were
females. The overall response rate was 95.5%. About one third (32.9%) of the participants
had raised blood pressure (BP) or currently on medication for raised BP. High blood
pressure was significantly more common in males than females (37.2% vs 29.2%, p<0.05).
Majority (94.9%) of the people with high blood pressure were not on medication and or
were not aware that they were hypertensive. The prevalence of diabetes was estimated to
5.6%. There were no significant differences observed between males and females (6.5% vs
4.7%). The magnitude of raised cholesterol in Malawi in adults aged 25-64 years was
estimated at 8.7%. Raised cholesterol was significantly more common among females
compared to males (11.0% vs 6.3%, p<0.05). In terms of risk factors, tobacco smoking and
alcohol consumption were significantly more common in males than in females (25.9% vs
2.9%, 30.1% vs 4.2% respectively). Physical inactivity and overweight were significantly
more common in females than males (12.6% vs 6.3%, 28.1% vs 16.1%). The overall (both
sexes) national estimates of tobacco smoking, alcohol consumption, physical inactivity and
overweight among adults aged 25-64 years were 14.1%, 16.9%, 9.5% and 21.9%
respectively. About 16.5% of the participants had 3 or more NCD risk factors.
Conclusion/recommendations:
This survey demonstrated that NCDs and their risk factors were public health problems in
Malawi. In addition, it also revealed that majority of people with hypertension were not
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aware that they had a problem. Establishing NCD Control Programme within the Ministry
of Health, developing multi-sectoral Action Plan and strengthening the existing efforts may
help to reduce NCDs and their risk factors and promote health life styles.
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1.0: INTRODUCTION AND LITERATURE REVIEW
1.1: Global perspective
The global burden of disease is shifting from infectious to non-communicable diseases.

Non-communicable diseases, principally cardiovascular diseases, diabetes, cancers, and
chronic respiratory diseases, caused an estimated 35 million deaths (60% of all deaths)
world wide in 2005. Majority (80%) of deaths due to non-communicable diseases occur in
low- and middle income countries. It is projected that the total number of deaths due to
NCDs will increase from 60% in 2002 to 73% in 2020 (WHO 2008, Harries AD et al.
2008, Nigel U et al. 2001b). Non-communicable diseases may be prevented and their risk
factors are well documented. These include tobacco smoking, harmful use of alcohol,
physical inactivity, obesity and diets high in saturated fat and sodium and low in fruit and
vegetables intake (Nigel U et al. 2001a).
1.2 Developing countries

Most developing countries are affected by a double burden of communicable/infectious and
non-communicable/non-infectious diseases (WHO 2000). Until recently, non-
communicable diseases were considered as a significant health problem for developed and
not for developing countries hence were sometimes referred to as “diseases of the affluent,
diseases of the west, or diseases of urbanisation”. This is a misleading notion because it
suggested that NCDs were not a public health problem in resource-poor countries or in
rural areas (Nigel U 2001a, WHO 2000, Nigel U 2001b, Fourie J et al. 1995). This may be
one of the reasons why in many developing countries NCDs were and are still not on the
priority list of the public health problems. In the World Health Report of 2002 it was shown
that even in the poorest regions of the world, NCDs and their risk factors are now causing a
rising burden of serious disease and untimely deaths (WHO, 2003). In addition, a study in
Tanzania showed that in the adult population, the probability of death from non-
communicable diseases was higher than in developed countries Nigel U 2001a, Setel P et
al. 2000).
1.3 Sub-Saharan Africa

In sub-Saharan Africa (SSA), communicable diseases, particularly HIV/AIDS, tuberculosis
(TB) and malaria are still responsible for the greatest burden of morbidity and mortality.
However, non-communicable diseases (NCDs) are increasingly becoming a significant
public health problem (Bainngana FK et al. 2006). The Global Burden of Disease Study,
conducted in 2001, showed that 20% of deaths in SSA were due to NCDs (Lopez AD et al.,
2006), and this burden is predicted to rise to 40% by 2020 (Murray C et al. 1996). Non-
communicable diseases are making significant demands on health care resources in this
region (Nigel U, 2001b, Murray CJL 1996). Data from some African countries suggests
that in urban settings, the prevalence of diabetes and hypertension has increased markedly
over the past ten years Nigel U, 2001b). In South African townships about 8% of the
populations have diabetes and between 20-33% have hypertension using the cut-of point >
160/95mmHg (Fourie J, at al., 1995). NCD STEPS survey conducted in some of the
countries in this region like Mozambique, Zimbabwe, Botswana showed that 8% of adult
population aged 25-64 years has diabetes, 28-33% has hypertension, 7-16% has obesity,
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12-20% smoke tobacco and 27-77% take alcohol (WHO 2008). It is also well documented
that patients with NCDs are badly managed in sub-Saharan Africa (Harries AD et al.,
2008). Table one below, shows the STEPS Survey findings on NCD risk factors from some
countries in the sub-Saharan region.
Table one: Prevalence of NCD risk factors in some countries in the sub-Saharan regions-
STEPS data
% MAU DZA COG ERI CMR MDG MOZ CIV ZWE BTW ETH
Tobacco 18.9 12.8 14.4 8 4 20 18.7 9.5 12.1 19.5 4.6
Alcohol - 5.1 62.5 39.6 11 42.5 77.2 71 74.7 27.4 61.6
Obesity 20.9 16.4 8.6 3.3 18 2.4 7.1 9.1 14.1 15.7 7.1
EBP 22.4 29.1 32.5 16 25 17.6 33.1 21.7 27.6 32.1 30.9
EBS 4.9 6 - - 6 14 10 - -
Source: WHO 2004
Key: EBS= elevated blood sugar, EBP= elevated blood pressure, MAU= Mauritius, DZA=
Algeria, COG= Congo Brazzaville, ERI= Eritrea, CMR= Cameroon, CIV= Cote d’voire,
MDG= Madagascar, MOZ= Mozambique, ZWE= Zimbabwe, BTW= Botswana, ETH=
Ethiopia.
1.4 Malawi
1.4.1: Geographic location

Malawi is a land-locked country in Southern-Central Africa. It has a land area of about
118,484 square kilometres, one-third of which is occupied by Lake Malawi. According to
the 2008 Population and Housing Census, the estimated population of Malawi is about 13
million, 85% of which lives in rural areas. The country shares boarders to the north and
northeast with Tanzania, to the Southeast, South and southwest with Mozambique and to
the west with Zambia. It is divided into three regions, Northern, Central and Southern
regions. The regions are further divided into districts and they are 28 districts in total.
Figure one below is the map of Malawi showing bordering countries, regions and districts.
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1.4.2: Health services delivery
The Malawi Ministry of Health has the overall responsibility of providing leadership,
coordination of policy development and provision of health services in the country. It is the
largest provider of health services and accounts for 60% of health facilities. The health care
delivery system is organized at three levels namely: primary, secondary and tertiary levels
linked through a referral system. Primary health care is provided through community based
out reach programmes, dispensaries/health posts, health centres as well as community
hospitals. Secondary level care is provided through district and Christian Health
Association of Malawi (CHAM) hospitals. Finally, Central Hospitals provide tertiary level
care. However, this categorization is only a guide since, for instance, a large volume of
services currently being provided by district, CHAM and central hospitals are primary level
care due to unavailability of alternative facilities within the catchment areas of these
facilities. Table two below shows the number of health facilities by level of care and
provider/owner in the country.
For purposes of health administration, districts in Malawi are grouped into Health Zones.
They are five zones, one in the Northern, two in the Central and two in Southern Region.
Figure two below is the Map of Malawi showing the Health Zones.
Table two: Health facilities by type and ownership

Level of care
Ownership Primary Secondary Tertiary Others Total
Total 901 100 6 52 1059
Government 493 53 5 24 575
CHAM 96 42 1 8 147
NGO 56 1 0 13 70
Private for profit 196 4 0 0 200
Statutory Organisation 13 0 0 7 20
Company 47 0 0 0 47
Source: MoH 2008. Malawi Health Sector Employee Census Report

Key: CHAM= Christian Health Association of Malawi, NGO= Non-governmental organisation
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Figure two:Quarterly
Map Report
of Malawi
January -showing
March 2007 Health Zones Zonal Health Support Office South West
Chitipa
Karonga
NORTHERN ZONE
Zone 1 (HQ Mzuzu)
1. Chitipa
2. Karonga Rumphi
3. Nkhata Bay
4. Rumphi
Lake Malawi
5. Mzimba
6. Likoma Island
Nkhata Bay
CENTRAL EASTERN ZONE
Zone 2 (HQ Salima)
1. Kasungu Mzimba Likoma
2. Nkhotakota
3. Ntchisi
4. Dowa
5. Salima Nkhotakota
Kasungu
CENTRAL WESTERN ZONE Ntchisi

Zone 3 (HQ Lilongwe)
1. Lilongwe Dowa
2. Mchinji Mchinji Salima
3. Dedza
4. Ntcheu Lilongwe
Dedza
SOUTH EASTERN ZONE Mangochi
Zone 4 (HQ Zomba)
1. Mangochi
Ntcheu
2. Machinga
Balaka Machinga
3. Balaka
4. Zomba
5. Mulanje Mwanza Zomba
6. Phalombe
Blantyre
Chiradzulu Phalombe
SOUTH WESTERN ZONE Thyolo

Mulanje
Zone 5 (HQ Blantyre) Chikwawa
1. Chiradzulu
2. Blantyre
3. Mwanza
Nsanje
4. Thyolo
5. Chikwawa
6. Nsanje
7. Neno (From FY 2007/08)
Zonal Grouping of Districts of Malawi (January 2007)

Five Zonal Health Support Offices (ZHSO)
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1.4.3: Disease Burden in Malawi
The burden of disease in Malawi has been dominated by the raging epidemic of HIV/AIDS.
Meanwhile HIV/AIDS, Malaria and TB are the leading health concern in the country.
Other infectious diseases, perinatal and nutritional disorders are also of major importance.
The increasing burden of non-communicable disease in Malawi just like in most
developing countries is a major setback for health systems that are already overburdened
and under-funded (Murray and Lopez, 1997b). It is estimated that non-communicable
diseases accounts for at least 12% of total Disability Adjusted Life Years (DALYs). As
shown in figure 3 below, NCDs are fourth cause of all DALYs after HIV/AIDS, other
infections and parasitic diseases and respiratory diseases. Non-communicable diseases are
probably the second leading cause of deaths in adults after HIV/AIDS. World Health
Survey- Malawi study conducted in 2003 estimated that 15% of adults smoke tobacco, 22%
take alcohol and about 40% do not take sufficient fruits and or vegetables (WHS, Malawi
Report 2003). These are the well known risk factors for non-communicable diseases.
Figure three, table three and table four below show the estimated DALYS, common causes
of deaths and prevalence of selected non-communicable diseases and their risk factors
respectively in Malawi.
Figure three: Malawi estimated total DALYs by cause
Injuries
5%
Non-communicable diseases
12%
HIV/AIDS
31%
Nutritional deficiencies
3%
Perinatal conditions
4%
Maternal conditions
5%
Respiratory infections
11% Malaria
9%
Tuberculosis
2%
Other infectious & parasitic
18%
Source: WHO 2004
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Table three: Common causes of deaths in Malawi
Cause %all deaths (children & adults)
HIV/AIDS 33.6
Lower respiratory infections 11.3
Malaria 7.8
Diarrhoea 7.6
Cardiovascular diseases 5.4
Perinatal 3.2
Tuberculosis 2.6
Road Traffic Accident 1.3
Malnutrition 1.0
Source: Health Management Information System, 2003
Table four: Prevalence of the selected non-communicable diseases (self-reported) and risk
factors in Malawi
NCD/Risk factor Prevalence
Angina 13.7
Osteo-arthritis 32.2
Asthma 5.1
Diabetes 0.2
Mental disorder 2.4
Smoking 15.2
Alcohol intake 22.2
Insufficient fruit and vegetable intake 39.9
Insufficient physical activity 7.7
Source: World Health Survey Malawi Report 2003
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1.5: SIGNIFICANCE AND RATIONALE OF SURVEY
In most developing countries including Malawi diabetes and cardiovascular diseases in

concert with other non-communicable diseases have not been addressed under specific
control programmes such as those that exist for several infectious and communicable
diseases. However, non-communicable diseases are now increasingly being prioritized and
therefore well collected systematic nation-wide data is required to determine the right
balance of resource allocation between prevention and care.
The World Health Organization has developed a standardized approach (the Stepwise
approach) to enable comparisons of data across regions over time. The risk factors
surveillance approach has been sited as the most efficient means of providing evidence
based data to plan for control and reduction of the impact of non-communicable conditions
(Jadue L. et al., 2000).
This survey will therefore provide evidence to inform policy and advocate for resource
allocation for treatment and prevention of non-communicable diseases in Malawi.
2.0: OBJECTIVES OF THE STUDY
2.1: GENERAL OBJECTIVE
To determine the magnitude of non-communicable diseases and their risk factors in

Malawi.
2.2: SPECIFIC OBJECTIVES
2.2.1 To assess the distribution of life-style factors (physical activity, tobacco and alcohol
use), and anthropometric measurements (body mass index and central obesity) which may
impact on diabetes and cardiovascular risk factors.
2.2.2 To determine the prevalence and determinants of hypertension, diabetes and raised
cholesterol levels.
3.0: MATERIALS AND METHODS
3.1: Survey design

This was a national community based cross-sectional survey. STEPwise approach for
assessing risk factors for chronic non-communicable diseases was used as described below.
3.2: STEPwise (STEPS) Approach

STEPS is a sequential process starting with gathering information on key risk factors by the
use of questionnaires (Step 1), then moving to simple physical measurement (Step 2) and
then collection of blood samples for biochemical assessment (Step 3). (Bonita R, et al,
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2002). In addition to the three steps used in risk factor assessment the conceptual
framework of STEPS also includes three modules in the assessment of each risk factor,
namely core, expanded and optional.
3.3: Adaptation of survey methods and tools

For this survey all the core, expanded and selected optional variables were collected.
3.4 Survey participants

Eligible participants for the survey were all adult males and females aged 25-64 years
3.5 Sample size

The sample size was calculated by using the formula: N= Z2 P(1-P)
e2
Where N= sample size, Z= level of confidence, P= baseline level of the selected indicator
and e= margin of error
Given the estimated prevalence risk factors, P= 0.50, Z= 1.96 (at 95% confidence
interval), e= 0.05, the initial estimated sample size was:
n= 1.9620.5(1-0.5)= 384
0.052
Adjusting for:
Design effect for complex sample design= 1.50 (multiply)
Age-sex estimates 24-64 age range (8, 10 year- intervals)= 8 (multiply)
The estimated required sample size was therefore adjusted for design effect and age-sex
estimates to:
N=384* 1.5* 8= 4,608
Assuming a non-response rate of 20%, the final sample size was therefore adjusted to:
4,608/0.8= 5,760
The final minimum required sample size was therefore 4,608 participants aged 25-64 years
after adjusting for design effect and age-sex estimates. This sample size was further
adjusted upward to 5,760 for 20% non-response rate.
3.6: Sample design

This survey was designed to obtain data that would be a representation of the whole
Malawi. To achieve this, a multi-stage sampling method was used to select enumeration
areas (EAs), households and eligible participants (three stages).
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Stage 1: Selection of enumeration areas (EAs):
Sampling frame:
Administratively, Malawi is divided into twenty-eight districts. In turn, each district is
subdivided into smaller administrative units. Each administrative unit is sub-divided into
enumeration areas (EAs) by the National Statistical Office (NSO). Enumeration areas are
classified as urban or rural. Each EA has a sketch map drawn by NSO. The sketch map
shows the EA boundaries, location of buildings, and other landmarks. The list of EAs in
Malawi from the latest population and housing census conducted in June 2008 was
obtained from NSO. This list was used as a sampling frame for random selection of EAs
for the NCD STEPs Survey as described below.
Number of enumeration areas selected:

In accordance with WHO STEPS Manual Part 2 Section 2, the recommended number of
participants to be selected at each primary sampling unit (in our case in each EA) was 30-
50 (WHO 2005). For this survey it was decided that at least 40 participants in each
enumeration area were to be recruited. Given that the estimated required sample size was
5,760 (including the 20% non-response rate), the total number of EAs selected was
therefore 5,760/40= 144.
Thus a total of 144 EAs were randomly selected from the list of all EAs in Malawi.
Sampling method for EA selection:

Probability Proportional to Size (PPS) sampling method was used to randomly sample the
144 EAs from the whole country as follows:
The EAs in Microsoft Excel® were first sorted in descending order of population (largest to
the smallest).
• Then the total population of all EAs in Malawi were calculated.
• A column of cumulative total population of EAs was then created.
• Then the sampling interval was calculated by dividing total population by 144 (total
number of EAs to be selected).
• Random number (the seed) was generated by computer in the excel® using the
formula RANDBETWEEN(sampling interval).
• The EA whose cumulative total contained the seed was the first to be selected.
• The 2nd, 3rd, …….., 144th EA was selected by systematically adding the random
number to the sampling interval.
•
Appendix 1 is the list of EAs that were selected.
Stage 2: Selection of households

The EA sampling frame obtained from NSO had information on the total number of
households in each EA. Forty households were to be selected from each EA (as described
above under of number of EAs to be selected). The sampling interval for household
selection in each EA was therefore determined by dividing total EA population by 40.
Systematic sampling method (every nth household) was then used to randomly select the
required 40 households.
Stage 3: Selection of eligible participants at household level
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Only one eligible participant (an adult aged 25-64 years) in the selected households was
enrolled in the survey. In households with more than one eligible participant, Kish Method
sampling method was used to randomly select one. By Kish Method, eligible participants
in each household were ranked in order of decreasing age, starting with males then females.
3.7: Conduct of the survey
3.7.1: National Team

The national team consisted of representatives from Department of Clinical Services
(MoH), Health Education Unit (MoH), Health Management Information System (MoH),
HIV and Nutrition Unit (OPC), Laboratory Diagnostics (MoH), Environment Health
(MoH), Kamuzu Central Hospital (MoH), National Statistical Office, College of Medicine
and World Health Organisation. The members of the team jointly developed the research
proposal, conducted the adaptation of the survey tools, approached stakeholders for
awareness and resource mobilisation and participated in the training of the data collectors.
The survey was housed in the Department of Clinical Services, MoH.
3.7.2: Field Team

They were 7 teams of 10 people as follows: 1 supervisor (planning and checking the
completeness of questionnaires), 4 enumerators (for STEP 1 and STEP 2), 2 trained health
workers (STEPS 3- dry chemistry), 1 Health Surveillance Assistant (notifying the village
heads of the selected villages about the survey, day and time when the survey team will be
coming to their villages and guiding the survey team to the selected villages), 1 Village
Guider (to introduce the team to households) and 1 driver (transport).
3.7.3: Adaptation of survey tools and training manuals

The generic WHO STEPS survey protocol and tools was adapted by the National Team at a
workshop. The objectives of this workshop were to: (a) adopt the WHO STEPwise
approach and training manuals (b) map out fieldwork activities (c) identify field team
members (d) translate the tools into Chichewa and Tumbuka (the two main vernacular
languages spoken in Central and Southern and Northern Regions respectively).
3.7.4: Training of Interviewers

A 3-day training workshop for data collectors and supervisors was held. The objectives of
the workshop were: (a) overview of the study-what the study is all about (b) how to gain
entry into the study areas and households (c) how to conduct interviews (d) how to observe
research ethics (e) how to data using personal digital assistant (PDA) (f) how to collect
blood samples (g) how to keep records (h) how to ensure quality control of all field
processes.
Interviewers conducted mock interviews and practiced taking both physical measurements
and collection of blood samples. Team supervisors were further trained on: (a) checking
and correcting interview data (b) editing questionnaires in the PDA (c) problem solving in
the field.
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3.7.5: Data collection
Data was collected using personal digital assistants (PDAs). Ten PDAs were programmed
for blood pressure biochemistry measurements. Forty PDAs were programmed for
interviews and some physical measurements.
3.7.6: Field Activities

Immediately after training, data collectors were into teams. Each team was provided with a
field kit containing: a carrier bag, letters to the relevant authorities (Road blocks, Zone
Managers, DHOs and local leaders), referral letter for those with abnormal results, consent
forms, checklist, list of the selected EAs, EA maps, team field log book, operational
manual, pens, pencils, clipboards, notebooks, tapes for measuring height and girth, scales
for weight, blood pressure machines, lancets for finger pricks, sharp containers, gloves and
PDAs. Each member of the research team had project bag, identity card and a unique code.
3.7.7: Survey period

Data was collected over a period of 30 days from July to September 2009.
3.7.8: Ethical clearance

Ethical clearance was granted by the Malawi National Research & Ethics Committee
3.7.9: Survey flow

The flow of events will be as follows:
Obtaining informed written consent

Informed written consent was obtained from eligible selected participant. Consent forms
were in English, Chichewa and Tumbuka (please appendix 2A, 2B and 2C) and participants
the language most convenient to them.
Step1: Questionnaire-based assessment:

The survey questionnaire was programmed on the PDAs. It consisted of core (age, sex and
education in years and current exposure to tobacco and alcohol, diet and physical activity),
expanded (rural/urban setting, occupation, average household income) and optional
(marital status, medical and health history, past history of smoking and alcohol
consumption) variables. The medical and health history component included questions on
medication, cigarette use, diabetes, hypertension and other cardiovascular conditions. The
English questionnaire was translated into Chichewa and Tumbuka (please see appendix
(3A, 3B)
Step 2: Physical measurements

Physical assessment included blood pressure, height, weight, waist and hip circumference
measurements.
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Blood pressure
Blood pressure measurements were taken using battery powered digital blood pressure
machine (Omron® M4-I). Three readings were taken 3-5 minutes apart. During the analysis
the average of the last two readings was as the final blood pressure leading.
Waist Circumference
The waist circumference was measured using a tape-measure in centimetres. Measurement
was made in the mid-axillary line midway between the last rib and the superior iliac crest.
Measurements were made to the nearest 0.1 cm.
Hip measurement
Hip measurement was also made using a tape-measure placed horizontally at the point of
maximum circumference over the buttocks. Measurements were taken to the nearest 0.1
cm.
Height
Height was measured with the participant standing upright against a wall on which a height
mark was made. Measurements were taken with the participant in barefoot, standing with
the back against the wall and head in the Frankfort position with heels together. The
participant was asked to stretch to the fullest. After being appropriately positioned, the
participant was asked to exhale and a mark with a white chalk was made to mark the
height. The height was then measured in centimetres from the mark to the floor using the
tape measures. Measurements were taken to the nearest 0.1 cm.
Weight
Weight measurements were taken on a pre-calibrated weighing scale (bathroom scale). The
scales were calibrated daily using a known weight (1kg packet of sugar). Participants were
weighed dressed in light clothing and barefoot. Measurements were taken to the nearest 0.1
kg.
Step 3: Biochemical assessment

On the first day of the survey after STEP 1 and part of STEP 2, participants were asked to
starve overnight of that day. i.e. people were asked not to consume any food except for
clear water after taking super/dinner of that day until the survey team came again in
morning of the following day (day 2). People in the selected EA converged at the agreed
place in the EA where finger blood samples for biochemistry tests were taken. Those that
complied with advice (starving overnight) were eligible for finger prick blood sample
collection. Total cholesterol and fasting blood glucose were measured using Accutrend®
Plus machines.
3.8.0: DEFINITIONS
3.8.1: Overweight and Obesity
Table 3.1: Body mass index (BMI) was calculated as follows: weight in kg/height in
square meters.
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Category of relative weight BMI
Underweight <18.5
Normal 18.5-24.9
Overweight 25.0-29.9
Obesity ≥ 30.0
3.8.2: Central Obesity

Central obesity was defined as waist hip ratio (waist circumference/hip circumference):
>0.85 in women and >0.95 in men.
3.8.3: Hypertension
Hypertension was be defined as summarized in table 3.2 below. Participants on regular
antihypertensive (documented) treatment were regarded as having hypertension regardless
of their blood pressure readings.
Table 3.2: Definition of hypertension

Category Systolic Diastolic
(mmHg) (mmHg)
Optimal <120 <80
Normal <130 <85
High – Normal 130-139 85-89
Subgroup: Borderline 140-149 90-94
Grade 1 Hypertension (mild) 140-159 90-99
Grade 2 Hypertension 160-179 100-109

(moderate)
Grade 3 Hypertension ≥ 180 ≥ 110
(Severe)
Isolated Systolic ≥ 140 <90
Hypertension
19
3.8.4: Diabetes and Impaired Glucose Tolerance
Diabetes was defined as fasting blood glucose level >7.0 mmol/L (WHO guidelines, 1999).
3.8.5: Cholesterol
Table 3.3: Total cholesterol was defined as summarized in the table below.
Profile Levels(mmol/L)
Total Cholesterol:
Level A Hypercholestrolaemia ≥5.0 mmol/l
Level B Hypercholestrolaemia ≥6.2 mmol/l
4.0: DATA MANAGEMENT
4.1 Downloading and Merging of data

Data was collected using PDAs. There were two groups of PDAs used to collect data: one
set of PDAs was used to collect data for Step 1 (questionnaire) and part of Step 2 (height,
weight, waist and hip circumference) and another set of PDAs was used to collect Step 3
(biochemical measures) and the remainder of Step 2 (blood pressure). A total of 50 PDAs
were used. Data on the PDAs were downloaded into the computer installed with NCD
STEPS software. The files of each participant (questionnaire, body measurements,
biochemistry tests and Kish data) were then merged using the participant identity (PID)
number cross checked with participant name, EA number or village/township name and
other particulars where necessary.
4.2: Data cleaning

After merging, data was cleaned. Common variables in the dataset were matched and
inconsistencies were corrected.
4.3. Weighting of data

Sample weights were calculated for all records using the probability of selection at each
stage of sampling. Thus, for each participant his/her weight was calculated by first
multiplying the probability of EA selection, the probability of household selection, the
probability of selection within their household and age-sex distribution of the population in
Malawi. The participant's weight would then be equal to the inverse of this product. It was
not possible to determine the size of the household for each person due to difficulties with
the participant IDs in the Kish Method data. Thus, the mean household size across all
participants was used in calculating the weight for each participant.
20
4.6: Data Analysis
Data analysis was conducted in Epi Info, version 3.5.1. Preliminary survey report
employed simple descriptive statistics with means, proportions and frequency distributions.
95% Confidence Intervals (CI) were used as a measure of precision on the estimated
population parameters. Appropriate analyses were done to take into consideration the
complex sample design of the survey.
In the full report, further analysis was performed as follows: T-tests to compare continuous
data such as systolic Blood Pressure, cholesterol level between groups. Chi-square tests
were used to assess relationships between variables and analysis of variance (ANOVA) for
continuous variables for comparisons across more than two groups. In situations where the
normality assumptions were not met, the non-parametric equivalents of the above tests
were used (Fisher’s exact test, Kruskal Wallis test, etc). Logistic regression analysis was
employed to assess predictors of diabetes and hypertension in each particular group
controlling for potential confounders.
5.0: Funding
The survey was co-funded by WHO and Ministry of Health. The actual cost for the survey
including maps, lab materials and supplies, training, data collection was about MK20
million.
6.0: Results
6.1: Characteristics of participants enrolled in the survey

Of the 144 EAs that were selected, 143 were reached and data was collected. Only one EA
was not reached and data was not collected because it was a high security area. A total of
5,451 eligible adults were selected and approached to participate in the survey. Of these,
245 (5.5%) refused while 5,206 (95.5%) consented to take part in the survey. Of the 5,206
participants that took part in the survey, about two thirds (67.5%) were females, 87.4%
were from rural areas and about one in four (24.6%) had no formal education. Table 6.1
below shows characteristics of participants enrolled in the survey.
21
Table 6.1: Characteristics of participants enrolled in the survey
Characteristic Male Female Total
n % n % n %
Age (years):
25-34 719 42.5 1,616 46.0 2,335 44.9
35-44 459 27.2 862 24.5 1,321 25.4
45-54 296 17.5 604 17.2 902 17.2
55-64 216 12.8 434 12.3 650 12.5
25-64 1,690 100.0 3,516 100.0 5,206 100.0
Marital status:
Never married 91 5.4 70 2.0 161 3.1
Currently married 1,475 87.4 2,344 66.8 3,819 73.5
Separated/divorced 99 5.9 655 18.6 754 14.5
Widowed 22 1.2 442 12.6 464 8.9
Total 1,687 100.0 3,511 100.0 5,198 100.0
Education:
None 237 14.0 1,048 29.8 1,285 24.7
Standard 1-5 558 33.0 1,249 35.6 1,807 34.8
Standard 6-8 539 31.9 852 24.2 1,391 26.7
Secondary and above 355 21.1 365 10.4 720 13.8
Total 1,689 100.0 3,514 100.0 5,203 100.0
n= number of respondents in the group
22
Fact sheet for Malawi NCD STEPS Survey findings
Tobacco smoking, alcohol consumption, and excessive alcohol (harmful use of alcohol)
were significant risk factors in males compared to females while overweight and physical
inactivity were more significant in females than males. About one in three (32.9%) adult
Malawian aged 25- 64 years had raised blood pressure or currently on medication. Raised
blood pressure was significantly more common in males compared to females (37.2% vs
29.2%). Majority (94.9%) of the people with raised blood pressure were not on medication
and or did not know that they a problem. Table 6.2 shows the fact sheet for Malawi NCD
STEPS Survey findings.
Table 6.2: Fact Sheet for Malawi NCD STEPS Survey findings
Malawi STEPS Survey 2009

Fact Sheet
The STEPS survey of chronic disease risk factors in Malawi was carried out from July 2009 to September 2009. Malawi
carried out Step 1, Step 2 and Step 3. Socio demographic and behavioural information was collected in Step 1. Physical
measurements such as height, weight and blood pressure were collected in Step 2. Biochemical measurements were
collected to assess blood glucose and cholesterol levels in Step 3. The STEPS survey in Malawi was a population-based
survey of adults aged 25-64. A multi-stage cluster sample design was used to produce representative data for that age
range in Malawi. A total of 5,206 adults participated in the Malawi STEPS survey, of which 67.5% were female. The
overall response rate was 95.5%.
Results for adults aged 25-64 years (incl. 95% CI) Both Sexes Males Females
Step 1 Tobacco Use n=5,206 n= 1,690 n=3,516
Percentage who currently smoke tobacco 14.1% 25.9%* 2.9%

(12.7 – 15.6) (23.3 – 28.5) (2.1 – 3.8)
Percentage who currently smoke tobacco daily 12.4% 22.8%* 2.4%

(11.0 – 13.7) (20.5 – 25.2) (1.7 – 3.2)
For those who smoke tobacco daily
Average age started smoking (years) 22.1 21.9 24.6

(21.4 – 22.9) (21.2 – 22.7) (21.5 – 27.7)
Percentage of daily smokers smoking manufactured cigarettes 46.4% 49.9%* 14.6%

(40.3 – 52.4) (43.3 – 56.4) (7.8 – 21.4)
Mean number of manufactured cigarettes smoked per day (by smokers of 2.8 3.0 1.5
manufactured cigarettes) (2.4 – 3.3) (2.5 – 3.5) (0.1 – 3.0)
Step 1 Alcohol Consumption n=5,206 n= 1,690 n=3,516
Percentage who are lifetime abstainers 68.1% 47.4% 87.8%*

(65.8 – 70.4) (43.9 – 50.9) (86.1 – 89.6)
Percentage who are past 12 month abstainers 10.5% 15.3%* 6.0%

(9.3 – 11.7) (13.1 – 17.3) (5.0 – 7.0)
Percentage who currently drink (drank alcohol in the past 30 days) 16.9% 30.1%* 4.2%
(15.1 – 18.7) (27.2 – 33.1) (3.2 – 5.2)
Percentage who engage in heavy episodic drinking (men who had 5 or -- 19.0%* 2.3%
more / women who had 4 or more drinks on any day in the past 30 days) (16.5 – 21.5) (1.6 – 3.1)
23
Step 1 Fruit and Vegetable Consumption (in a typical week) n=5,177 n=1,679 n=3,498
Mean number of days fruit consumed 2.0 2.0 2.0

(1.8 – 2.1) (1.8 – 2.1) (1.8 – 2.2)
Mean number of servings of fruit consumed on average per day 0.5 0.5 0.5
(0.4 – 0.5) (0.4 – 0.5) (0.4 – 0.6)
Mean number of days vegetables consumed 5.6 5.5 5.7

(5.5 – 5.7) (5.3 – 5.6) (5.6 – 5.9)
Mean number of servings of vegetables consumed on average per day 1.6 1.6 1.7
(1.6 – 1.7) (1.5 – 1.6) (1.6 – 1.8)
Percentage who ate less than 5 servings of fruit and/or vegetables on 97.5% 98.0% 97.1%
average per day (96.8 – 98.2) (97.2 – 98.7) (96.2 – 98.0)
Step 1 Physical Activity n=4,057 n=1,355 n=2,702

Percentage with low levels of activity (defined as < 600 MET-minutes per 9.5% 6.3% 12.6%*
week)* (8.0 – 10.9) (4.8 – 7.8) (10.6 – 14.7)
Percentage with high levels of activity (defined as ≥ 3000 MET-minutes per 83.7% 88.0% 79.4%
week)* (81.5 – 85.9) (85.8 – 90.2) (76.6 – 82.2)
Median time spent in physical activity on average per day (minutes) 261.4 300.0 231.4
(presented with inter-quartile range) (150.0 – 385.7) (188.6 – 428.6) (120.0 – 342.9)
Percentage not engaging in vigorous activity 17.8% 13.2% 22.3%*

(15.5 – 20.1) (10.9 – 15.5) (19.3 – 25.3)
Step 2 Physical Measurements:

Body mass index (BMI): n=4,845 n=1,664 n=3,181
Mean body mass index - BMI (kg/m )

2 23.0 22.4 23.5
(22.8 – 23.1) (22.3 – 22.6) (23.3 – 23.7)
Percentage who are overweight (BMI ≥ 25 kg/m )

2 21.9% 16.1% 28.1%*
(20.4 – 23.5) (14.1 – 18.0) (25.9 – 30.2)
Percentage who are obese (BMI ≥ 30 kg/m )

2 4.6% 2.0% 7.3%*
(4.0 – 5.3) (1.3 – 2.6) (6.3 – 8.4)
Mean waist circumference (cm) -- 77.3 78.6

(76.6 – 78.0) (77.8 – 79.4)
Blood pressure (BP): n=3,910 n=1,183 n=2,727
Mean systolic blood pressure - SBP (mmHg), including those currently on 132.8 135.8 130.3
medication for raised BP (131.8 – 133.8) (134.4 – 137.2) (129.2 – 131.4)
Mean diastolic blood pressure - DBP (mmHg), including those currently on 79.1 79.1 79.1
medication for raised BP (78.5 – 79.8) (78.3 – 80.0) (78.4 – 79.8)
Percentage with raised BP (SBP ≥ 140 and/or DBP ≥ 90 mmHg or 32.9% 37.2%* 29.2%
currently on medication for raised BP) (30.6 – 35.2) (33.6 – 40.8) (27.1 – 31.3)
Percentage with raised BP (SBP ≥ 140 and/or DBP ≥ 90 mmHg) who are 94.9% 96.4% 93.3%
not currently on medication for raised BP (93.5 – 96.3) (94.7 – 98.1) (91.1 – 95.5)
Step 3 Biochemical Measurement

Fasting blood sugar: n=3,056 n=911 n=2,144
Mean fasting blood glucose, including those currently on medication for 76.9 77.9 76.0
raised blood glucose (mg/dl) (74.6 – 79.2) (75.0 – 80.7) (74.0 – 78.0)
Percentage with impaired fasting glycaemia as defined below

• plasma venous value ≥6.1 mmol/L (110 mg/dl) and <7.0 mmol/L (126 mg/dl) 4.2% 5.7% 2.7%
• capillary whole blood value ≥5.6 mmol/L (100 mg/dl) and <6.1 mmol/L (110 (3.0 – 5.4) (3.9 – 7.5) (1.6 – 3.8)
mg/dl)
Percentage with raised fasting blood glucose as defined below or
currently on medication for raised blood glucose 5.6% 6.5% 4.7%
• plasma venous value ≥ 7.0 mmol/L (126 mg/dl) (2.6 – 8.5) (2.6 – 10.3) (2.4 – 7.0)
• capillary whole blood value ≥ 6.1 mmol/L (110 mg/dl)
24
Total cholesterol: n=2,587 n=775 n=1,812
Mean total blood cholesterol, including those currently on medication for 168.6 166.9 170.3
raised cholesterol (mg/dl) (167.0 – 170.3) (164.9 – 168.9) (168.7 – 171.9)
Percentage with raised total cholesterol (≥ 5.0 mmol/L or ≥ 190 mg/dl or 8.7% 6.3% 11.0%*
currently on medication for raised cholesterol) (7.4 – 10.0) (4.6 – 8.1) (9.4 – 12.6)
Summary of combined risk factors

2
• current daily smokers • overweight (BMI ≥ 25 kg/m )
• less than 5 servings of fruits & vegetables per day • raised BP (SBP ≥ 140 and/or DBP ≥ 90 mmHg
• low level of activity or currently on medication for raised BP)
n=2,842 n=940 n=1,902
1.0% 0.3% 1.6%
Percentage with none of the above risk factors (0.6 – 1.4) (0.0 – 0.7) (1.0 – 2.3)
Percentage with three or more of the above risk factors, 13.0% 15.3% 10.7%
aged 25 to 44 years (11.1 – 14.9) (12.2 – 18.4) (8.6 – 12.7)
aged 45 to 64 years (20.6 – 26.9) (17.6 – 27.5) (20.6 – 28.9)
aged 25 to 64 years (14.7 – 18.4) (14.8 – 20.4) (13.5 – 17.6)
CI= Confidence interval, BP= Blood Pressure, n= number of participants in the group
*statistically significant, p<0.05; males vs females
6.3: Summary of the Malawi NCD STEPS Survey (2009) findings

Table 6.3 below shows the summary of the Malawi NCD STEPS Survey findings. The
attached data book shows the detailed tabulations of NCD STEPs Survey findings.
25
Table 6.3: Summary of Malawi NCD STEPS Survey (2009) findings
Total Male Female Urban Rural
n % n % 95%CI n % 95%CI n % 95%CI n % 95%CI
Raised BP 3,910 32.9 1,183 37.2* 34.3 – 2,727 29.2 26.8 – 408 27.9 67.9-76.3 3502 32.0 65.8-
or currently 41.6 30.9 70.3
on medication
Raised fasting 3,056 5.6 911 6.5 2.8 – 2,144 4.7 2.5 – 371 7.4 1.0-5.9 2685 9.2 2.4-8.4
blood glucose 10.3 7.1
Raised 2,587 8.7 775 6.3 5.2 – 1,812 11.0* 9.7 – - - - - - -
cholesterol 8.9 12.9
Overweight 4,845 21.9 1,664 16.1 14.1 – 3,181 28.1* 25.9 – 603 38.6* 32.8-44.4 4242 21.9 20.3-
(BM≥25kg/m2) 18.0 30.2 23.6
Obesity 4,845 4.6 1,664 2.0 1.3 – 3,181 7.3* 6.3 – 603 13.6* 20.7-29.4 4242 4.4 3.7-5.1
BM≥30kg/m2 2.6 8.4
Tobacco 5,206 14.1 1,690 25.9* 23.3 – 3,526 2.9 2.1 – 655 6.6 4.4-8.7 4551 10.9* 9.7-
smokers 28.5 3.8 12.1
Smokeless 5,206 3.5 1,690 1.9 1.3-2.9 3,526 5.0* (4.0- - - - - - -
tobacco users 6.0)
Alcohol 5,206 16.9 1,690 30.1* 27.3 – 3,526 4.2 3.2 – 655 13.4 10.2=16.5 4551 12.5 10.9-
drinkers 33.4 5.1 14.1
Excessive 5206 7.7 1,690 19.0* 16.5- 3,526 2.3 1.6-3.1 - - - - - -
alcohol 21.5
drinkers
Physical 4,057 9.5 1,355 6.3 4.8 – 2,702 12.6* 10.6 – 519 24.1* 18.0-30.1 3538 8.7 7.0-
inactivity 7.8 14.7 10.3
Three or more 2,842 16.5 940 17.6 15.2 – 1,902 15.4 13.3 – 281 22.6 16.6-28.6 2561 15.5 13.8-
risk factors 20.8 17.4 17.3
CI= Confidence interval, BP= Blood Pressure, n= number of participants in the group, *statistically significant, p<0.05; males vs
females
26
7.0: Discussion
7.1: Validity of the Malawi NCD STEPS Survey

The total number of participants enrolled in this survey (5,206) was beyond the minimum
calculated sample size of 4,608 adjusted for design effect and age-sex estimates. During the
planning, it was thought finger prick blood collection for and or fasting would cause high
refusal rate and hence non-response rate was set at 20%. This made the calculated sample
size to be adjusted further to 5,760. However, the actual non-response rate was only 5%.
There was an overwhelming demand even from people to know their body weight, blood
pressure, blood sugar and cholesterol levels.
Of the 144 EAs selected nationally, only one was not visited because it was a high security
area. There was no replacement because the survey was designed as such. We could not
redraw the sample because it was probable that another high security area would still be
one of the selected EAs. We therefore believe, despite missing one EA, the data was
national representative data for Malawi.
More women (67.5%) than men were enrolled in this survey. This was not by design/plan.
One eligible participant at household level was randomly selected using the Kish method as
described above. This was also noted in a similar survey done in Zimbabwe in 2005 where
75% of participants selected by the same method were females (Zimbabwe NCDs Risk
factors Surveillance Report 2005). The overall estimates (both sexes) therefore may have
been skewed towards females. However, since the data was weighted for age-sex
distribution, probability of EA selection, participant selection at household level and non-
response skewing was less likely. But all the same this notable short fall of Kish method
has been raised to WHO, the authors of NCD STEPS tools.
We therefore strongly believe that because of the adequate survey sites that were reached,
sample size, low non-response rate and data weighting, our survey results were valid
national estimates.
7.2: Magnitude of NCDs and their Risk factors

In agreement with other surveys, this surveyed showed that NCDs and their risk factors are
gender related. The overall estimates (both sexes) might suggest that NCDs and their risk
factors are insignificant public health problem. However, the problem is more conspicuous
by conducting gender analysis. Thus although the overall estimates of smokers and alcohol
drinkers were about 15%, in males these were important risk factors where at least one in
four were either a smoker or a drinker or both. Similarly, overweight, obesity and physical
inactivity were more common in females than males. Likewise, high blood pressure was
significantly more common in males than females while raised total cholesterol was more
common in females than males. This emphasises the point that gender should be considered
when designing interventions to address NCDs.
This survey was also in agreement that the notion that NCDs and their risk factors are
problems of urban people is a misconception. The prevalence of raised blood pressure and
diabetes in rural areas was just as high as urban areas. In fact the prevalence of raised blood
27
pressure, diabetes and smoking were apparently higher in rural than urban areas but the
differences were not statistically significant. Overweight, obesity and physical inactivity
were indeed significantly higher in urban compared to rural areas.
Vegetable intake was not a problem but fruit intake. However, fruits are seasonal, common
in rain than dry season. This survey was done during dry season between July and
September. The results of fruit intake were likely to have been different if the survey was
done during the rain season.
Another important finding from this survey was that majority (94%) of the people with
raised blood pressure did not know that they had the problem. Only 6% were on treatment
or were once told by a health worker that they had a raised blood pressure. This may
suggest that what we are seeing at health facilities is just 6% of the problem of
hypertension.
It should also be mentioned here that false high blood readings due to nervousness were
controlled by taking three readings 3-5 minutes apart. The final reading was the mean of
the last two readings after the participants had settled down.
Comparing the findings of this survey to other similar population based survey, World
Health Survey done 2005, the estimates and trends are similar. For example, the 2005
World Health Survey estimated that overall 12.3%, 22.2% and 7.7% of adults aged 18
years or more were smokers, alcohol drinkers and physically inactive respectively (World
Health Survey 2005, Malawi Report). The trends by gender are similar even in physical
activity. In the 2005 study, 9.8% of females compared to 5.5% of males were physically
inactive. In this study, 12.6% of females compared to 6.3% of males were physically
inactive. This may not be in agreement with the common knowledge where it is generally
perceived that females do more physical household cores than men.
7.3: Conclusion
NCDs and their risk factors are major public health problem in Malawi. Majority of the
people with NCDs in general, raised blood pressure in particular do not know that they
have a problem. There is urgent need to have health facility and community based
programmes for treatment, prevention and control of NCDs and promotion of health life
styles.
7.4 Recommendations
1. There is need to establish NCD Control Programme within the Department of
Clinical Services – MoH (just like there are programmes for malaria, TB,
HIV/AIDS, neglected tropical diseases etc) for strong leadership and coordination
of NCD interventions, strategies, policies and guidelines.
2. There is need to develop multi-sectoral comprehensive Plan of Action for NCDs

and their risk factors
28
3. There is need to allocate resources for NCDs within and outside Sector Wide
Approach (SWAp)
4. There is need to utilise the opportunity of people visiting health facilities to check
their blood pressure, body mass index (BMI) and advise accordingly
5. There is need to support or strengthen the existing efforts such as:

• Drinking and driving law
• Opening and closing hours for selling alcoholic drinks
• Age limit to buy or drink alcohol
• Ban on public smoking and workplaces
• Age limit for tobacco smoking
• Ban on tobacco advertising, promotion and sponsorship
• Taxation on alcohol, cigarettes and other tobacco products (though impact
may be minimal or none at all since majority of people take traditional beer
and hand- rolled cigarettes)
• The development of Alcohol Policy
8.0: Reference:
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editors. Disease and mortality in sub-Saharan Africa. Second Edition. World Bank 2008,
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for noncommunicable disease: The WHO STEPwise approach. Geneva, World Health
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for noncommunicable diseases: The WHO STEPwise approach. Summary. Geneva, World
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Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL Global Burden of Disease
and risk factors. The World Bank and Oxford University Press, 2006. Available:
http://www.dcp2.org/pubs/GBD. Accessed 1 May 2008.
Murray C, Lopez A. The Global Burden of Disease: A comprehensive assessment of

mortality and disability from diseases, injuries, and risk factors in 1990 and projected to
2020, Volume 1. Geneva: World Health Organization 1996. Available:
http://www.hsph.harvard.edu/organizations/bdu/GBDseries.html. Accessed 2 May 2008
Nigel U et al. Theme Papers. Non-Communicable diseases in Sub-Saharan Africa: Where

do they feature in health research agenda? Policy and Practice. Bulletin of the World
Health Organization. Volume 79. Number 10. Geneva 2001b.
Nigel U et al. Theme Papers. Non-Communicable diseases in Sub-Saharan Africa: Where

do they feature in health research agenda? Policy and Practice. Bulletin of the World
Health Organization. Volume 79. Number 10. Geneva 2001a.
Setel P et al. Cause-specific adult mortality: evidence from community based surveillance
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World Health Organization. WHO STEPS Surveillance Manual: The WHO STEPwise
approach to chronic disease risk factor surveillance. WHO, Geneva. 2005.
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noncommunicable diseases. Report by the Director General. A53/4. Fifty-third World
Health Assembley, May 2000. World Health Organisation, Geneva. 2000.
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30
Appendix 1: List of 144 Selected EAs
HH
Sampling
EA interval urb_rural
ID REGIO (Total (Urb 1,
No. N DISTRICT TA EA HHs HHs/40) Rural 2) Population
1 Centre Dedza Dedza Town 708 358 9 1.00 1,554.00
2 Centre Dedza Kachindamoto 47 458 11 2.00 2,329.00
3 Centre Dedza Kachindamoto 49 248 6 2.00 1,232.00
4 Centre Dedza Kasumbu 9 411 10 2.00 1,707.00
5 Centre Dedza Pemba 75 329 8 2.00 1,371.00
6 Centre Dedza S/C Kaphuka 804 304 8 2.00 1,266.00
7 Centre Dowa Chiwere 62 342 9 2.00 1,727.00
8 Centre Dowa Dzoole 16 407 10 2.00 1,987.00
9 Centre Dowa Msakambewa 39 342 9 2.00 1,595.00
10 Centre Dowa S/C Chikhadza 48 585 15 2.00 2,676.00
13 Centre Dowa S/C Kayembe 25 315 8 2.00 1,529.00
14 Centre Dowa S/C Mponela 5 291 7 2.00 1,436.00
15 Centre Kasungu Kaluluma 37 203 5 2.00 941.00
16 Centre Kasungu Kapelula 24 428 11 2.00 2,161.00
17 Centre Kasungu Kasungu Town 728 349 9 1.00 1,774.00
18 Centre Lilongwe Chadza 44 190 5 2.00 909.00
19 Centre Lilongwe Chadza 22 85 2 2.00 353.00
20 Centre Lilongwe Chiseka 157 545 14 2.00 2,536.00
21 Centre Lilongwe Chiseka 32 318 8 2.00 1,284.00
31
22 Centre Lilongwe Chitukula 18 261 7 2.00 1,249.00
23 Centre Lilongwe Kabudula 21 324 8 2.00 1,493.00
24 Centre Lilongwe Kabudula 55 218 5 2.00 1,071.00
25 Centre Lilongwe Kalolo 801 309 8 2.00 1,329.00
26 Centre Lilongwe Kalumbu 59 339 8 2.00 1,460.00
27 Centre Lilongwe Khongoni 23 252 6 2.00 1,311.00
28 Centre Lilongwe Khongoni 39 205 5 2.00 1,054.00
29 Centre Lilongwe Malili 12 490 12 2.00 2,106.00
30 Centre Lilongwe Malili 84 199 5 2.00 873.00
31 Centre Lilongwe Mazengera 12 148 4 2.00 627.00
32 Centre Lilongwe Njewa 32 255 6 2.00 1,200.00
33 Centre Lilongwe S/C Mtema 4 187 5 2.00 883.00

Lilongwe
34 Centre City Area 18 8 410 10 1.00 3,325.00
Lilongwe
35 Centre City Area 23 13 237 6 1.00 1,158.00
Lilongwe
36 Centre City Area 35 1 1484 37 1.00 7,455.00
Lilongwe
37 Centre City Area 50 3 608 15 1.00 2,417.00
Lilongwe
38 Centre City Area 54 3 293 7 1.00 1,257.00
Lilongwe
39 Centre City Area 56 15 458 11 1.00 1,931.00
Lilongwe
40 Centre City Area 56 5 315 8 1.00 1,542.00
Lilongwe
41 Centre City Area 57 38 416 10 1.00 1,874.00
42 Centre Mchinji S/C Nduwa 44 424 11 2.00 2,253.00
43 Centre Mchinji S/C Nduwa 16 204 5 2.00 966.00
44 Centre Mchinji Zulu 26 278 7 2.00 1,380.00

Nkhotako
45 Centre ta Kanyenda 49 194 5 2.00 983.00
32
Nkhotako
46 Centre ta Malengachanzi 3 397 10 2.00 1,903.00
Nkhotako
47 Centre ta Malengachanzi 13 259 6 2.00 1,208.00
Nkhotako Nkhotakota
48 Centre ta Boma 701 176 4 1.00 781.00
Nkhotako
49 Centre ta S/C Mphonde 6 341 9 2.00 1,660.00
50 Centre Ntcheu Masasa 26 157 4 2.00 711.00
51 Centre Ntcheu Mpando 46 216 5 2.00 1,021.00
52 Centre Ntchisi Kalumo 35 307 8 2.00 1,471.00
53 Centre Ntchisi Kalumo 62 219 5 2.00 975.00
54 Centre Ntchisi S/C Chilooko 17 328 8 2.00 1,675.00
55 Centre Salima Khombedza 42 155 4 2.00 769.00
56 Centre Salima Khombedza 8 128 3 2.00 643.00
57 Centre Salima Maganga 44 362 9 2.00 1,746.00
58 Centre Salima S/C Kambalame 4 120 3 2.00 492.00
59 Centre Salima S/C Kambwiri 5 213 5 2.00 926.00
60 North Chitipa Mwenewenye 3 243 6 2.00 1,174.00
61 North Karonga Kilupula 46 201 5 2.00 1,012.00
62 North Karonga Kilupula 4 207 5 2.00 891.00
63 North Karonga Wasambo 17 103 3 2.00 516.00
64 North Mzimba Chindi 151 55 1 2.00 270.00
65 North Mzimba Mabulabo 25 212 5 2.00 1,038.00
66 North Mzimba Mabulabo 33 115 3 2.00 746.00
67 North Mzimba Mabulabo 5 179 4 2.00 557.00
68 North Mzimba Mtwalo 23 267 7 2.00 1,425.00
69 North Mzimba Mtwalo 84 247 6 2.00 1,416.00
33
70 North Mzimba Mzikubola 56 317 8 2.00 1,580.00
71 North Mzimba Mzikubola 26 210 5 2.00 1,191.00
72 North Mzimba Pherembe 39 194 5 2.00 994.00

S/C Kampingo
73 North Mzimba Sibande 22 106 3 2.00 596.00
S/C Khosolo
74 North Mzimba Gwaza Jere 7 153 4 2.00 822.00
Mzuzu
75 North City Chipula Ward 4 601 15 1.00 3,102.00
Mzuzu
76 North City Chipula Ward 12 364 9 1.00 1,689.00
Mzuzu
77 North City Lupaso Ward 7 565 14 1.00 2,854.00
Nkhataba
78 North y S/C Mkimbira 1 277 7 2.00 1,799.00
Nkhataba S/C
79 North y Nyaluwanga 802 116 3 2.00 613.00
Nkhataba
80 North y Timbiri 12 287 7 2.00 1,505.00
Chikulamayemb
81 North Rumphi e 47 336 8 2.00 1,612.00
82 North Rumphi S/C Mwalweni 5 202 5 2.00 917.00
83 South Balaka Kalemebo 4 385 10 2.00 1,566.00
84 South Balaka Kalemebo 70 208 5 2.00 901.00
85 South Balaka Nsamala 109 209 5 2.00 934.00
86 South Balaka Nsamala 77 157 4 2.00 700.00

Blantyre
87 South City Chilomoni Ward 12 998 25 1.00 4,046.00
Blantyre
88 South City Michiru Ward 11 1083 27 1.00 4,686.00
34
Chikwaw
89 South a Katunga 4 465 12 2.00 1,963.00
Chikwaw
90 South a Lundu 12 441 11 2.00 1,842.00
Chikwaw
91 South a Lundu 1 304 8 2.00 1,405.00
Chikwaw
92 South a Mankhwira 1 352 9 2.00 1,517.00
Chikwaw
93 South a Ngabu Urban 808 195 5 1.00 1,046.00
Chiradzul
94 South u Likoswe 47 282 7 2.00 1,643.00
Chiradzul
95 South u Mpama 12 196 5 2.00 833.00
Chiradzul
96 South u Mpama 40 190 5 2.00 723.00
Chiradzul
97 South u Mpama 41 142 4 2.00 686.00
Chiradzul
98 South u Nchema 37 355 9 2.00 1,321.00
Chiradzul
99 South u Nkalo 26 298 7 2.00 1,132.00
Chiradzul
100 South u Nkalo 38 276 7 2.00 1,116.00
Chiradzul
101 South u Nkalo 14 186 5 2.00 735.00
Maching
102 South a Kawinga 2 251 6 2.00 1,109.00
Maching
103 South a S/C Chiwalo 18 201 5 2.00 958.00
Mangoch
104 South i Chimwala 27 241 6 2.00 1,030.00
Mangoch
105 South i Jalasi 38 542 14 2.00 2,214.00
Mangoch
106 South i Makanjira 25 384 10 2.00 1,627.00
Mangoch
107 South i Mponda 801 290 7 2.00 1,449.00
Mangoch
108 South i Nankumba 29 471 12 2.00 2,059.00
Mangoch
109 South i Nankumba 64 262 7 2.00 1,124.00
35
Mangoch
110 South i S/C Chowe 60 224 6 2.00 1,004.00
Mangoch
111 South i S/C Chowe 33 216 5 2.00 951.00
Mangoch
112 South i S/C Chowe 47 90 2 2.00 437.00
Mangoch S/C M'bwana
113 South i Nyambi 4 252 6 2.00 1,149.00
114 South Mulanje Mabuka 38 312 8 2.00 1,241.00
115 South Mulanje Mabuka 30 258 6 2.00 1,090.00
116 South Mulanje Mabuka 108 213 5 2.00 854.00
117 South Mulanje Mabuka 171 133 3 2.00 577.00
118 South Mulanje Nkanda 59 284 7 2.00 1,080.00
119 South Mulanje Nkanda 5 240 6 2.00 1,063.00
120 South Neno Mlauli 11 131 3 2.00 540.00
121 South Neno Symon 3 279 7 2.00 1,304.00
122 South Nsanje Chimombo 13 208 5 2.00 803.00
123 South Nsanje Mlolo 9 325 8 2.00 1,351.00
124 South Nsanje Ndamera 16 212 5 2.00 1,100.00

Phalomb
125 South e Mnkhumba 199 398 10 2.00 1,362.00
Phalomb
126 South e Mnkhumba 75 209 5 2.00 863.00
Phalomb
127 South e Mnkhumba 10 167 4 2.00 657.00
Phalomb
128 South e Nazombe 56 188 5 2.00 673.00
Phalomb Phalombe
129 South e Boma 701 430 11 1.00 2,029.00
130 South Thyolo Bvumbwe 77 289 7 2.00 1,276.00
131 South Thyolo Bvumbwe 21 126 3 2.00 466.00
132 South Thyolo Chimaliro 51 332 8 2.00 1,294.00
36
133 South Thyolo Chimaliro 14 282 7 2.00 1,140.00
134 South Thyolo Chimaliro 13 202 5 2.00 793.00
135 South Thyolo Nchilamwera 60 211 5 2.00 844.00
136 South Thyolo Nsabwe 19 132 3 2.00 405.00
137 South Thyolo S/C kwethemule 20 246 6 2.00 1,184.00
138 South Thyolo S/C Mphuka 35 281 7 2.00 1,341.00
139 South Thyolo Thomas 2 216 5 2.00 813.00
140 South Zomba Kuntumanji 13 437 11 2.00 1,820.00
141 South Zomba Kuntumanji 23 284 7 2.00 1,216.00
142 South Zomba Mlumbe 80 184 5 2.00 758.00

Zomba Chirunga East
143 South City Ward 4 272 7 1.00 1,392.00
Zomba
144 South City Likangala Ward 6 298 7 1.00 1,166.00
Selec %sele
Populati ted cted
on %popultaion Eas Eas
13,066,3
Total 20 100 144 100
5,876,78
South 4 45.0 62 43.1
5,491,03
Centre 4 42.0 59 41.0
1,698,50
North 2 13.0 23 16.0
37
Appendix 2A: English Consent Form
NATIONAL SURVEY ON THE MAGNITUDE OF CHRONIC

NON-COMMUNICABLE DISEASES & THEIR RISK FACTORS
IN MALAWI
Dear Participant
______________________________________________________________
ID number
_______________________________________________________________
The aim of the Survey
The aim of this survey is to assess the magnitude of the chronic non-communicable
diseases such as hypertension, heart diseases, diabetes and factors associated with them.
This information will help Ministry of Health to plan on how to address these health
problems.
Random selection
You have been randomly selected to be part of this survey and this is why we would like to
interview you. This survey is conducted by the Ministry of Health. The survey is currently
taking place in several districts in the country.
Confidentiality
The information you provide is totally confidential and will not be disclosed to anyone. It
will only be used for purposes of the survey. Your name, address, and other personal
information will be removed from the questionnaire, and only a code will be used to
connect your name and your answers without identifying you. You may be contacted by
the survey team again only if it is necessary to complete the information on the survey.
Voluntary participation
Your participation is voluntary and you can withdraw from the survey after having agreed
to participate. You are free to refuse to answer any question that is asked in the
questionnaire. If you have any questions about this survey you may ask me or contact [The
District Health Office] or [Dr George Chithope Mwale, phone: 01789 400].
What is involved?
This survey involves answering some questions related the above mentioned diseases and
factors associated with them, then having your blood pressure, height, weight, hip and
waist circumference measured and finally being tested for Diabetes and cardiovascular
diseases. In order to test for Diabetes and cardiovascular diseases you will be asked to have
a small amount of blood taken from the tip of your finger as it is usually done for malaria.
This may cause some mild pain. You will be informed immediately the results of your
blood tests. The small blood that will be taken will be used there and then and will NOT be
used for any other test apart from Diabetes and cardiovascular diseases.
Consent to participate
Signing this consent indicates that you understand what will be expected of you and are
willing to participate in this survey.
Read by Participant Read by Interviewer
38
Agreed Refused
Signatures
I hereby provide INFORMED CONSENT to take part in the survey.
Participant Sign:
Name:
Witness: Sign:
39
Appendix 2B: Chichiwa Consent form
KAFUFUKU WA ZA UMOYO OKHUDZA MATENDA
OTHAMANGA MAGAZI, A NTIMA, A SHUGA NDI ENA
OTERO
Chikalata cha chibvomerezo
Okondeka
______________________________________________________________
ID Number
_______________________________________________________________
Cholinga cha kafukufuku

Cholinga cha kafukufuku ameneyu ndi kufuna kudziwa kuchuluka kwa anthu amene ali ndi
matenda othamanga magazi, a ntima, shuga ndi ena otero muno m’Malawi. Kuonjezela
apo, a unduna wa zaumoyo akufanso kudziwa zifukwa zomwe zimayambitsa matendawa.
Kafukufuku ameneyu athandiza unduna wa za umoyo kupeza njira zothandizira anthu
amene ali ndi matendewa komanso njira zopewera matendewa.
Kasankhidwe ka anthu olowa nkafukufuku

Si anthu onse dziko muno kapena kudera kwanu kuno amene alowe nkafukufukuyu ayi.
Tachita maula kuti tisankhe anthu oti alowe. Inu ndi amodzi amene mwasankhidwa
titachita maula amenwa. Ndi chifukwa chache takupezani . Kafukufukuyu akuchitikanso
maboma ena mdziko muno.
Chinsisi
Mayankho amene mutapeleke ndi achinsinsi ndipo sadzapelekedwa kwa wina aliyense.
Adzagwiritsidwa ntchito ya kafukufukuyu basi. Dzina lanu, malo okhala ndi zina zones
zokhudza inu zidzafufutidwa pa chipepala cha mafunso.
Ufulu otengapo mbali pakafukufuku ameneyu

Kafukufuku ameneyu ngosakakamiza. Muli ndi ufulu onse obvomela kapena kukana
kulowa nkafukufukuyu. Mulinso ndi ufulu okana kuyankha funso lirilonse limene
simukufuna kuyankha. Ngati muli ndi mafunso alionse mukhoza kufuna wa nkulu wa
zaumoyo mboma lino.
Zochitika mu kafukufukuyu
Kafukufukuyu ali ndi mbali zitatu. Mbali yoyamba ndi yoyankha mafunso osiyanasiyan
okhudza za umoyo. Mbali yachiwiri ndi yokuyesani matenda othamanga magazi, sikelo
yanu, kutalika kwanu ndi zina zotero. Mbali yachitatu ndiponso zomaliza ndi yokuseyani
matenda a shuga ndi ntima. Kuti tiyese matenda a shunga ndi ntima zifunika kuti
tikutengeni magazi pang’ono pachala monga m’mene zimakhalira poyesa malungo.
Kutenga magaziku monga mudziwa kumapweteka pang’ono. Mudzauzidwa za zotsatila za
kuyesa magazi. Kuyesa magazi anu kudzachitika nthawi yomweyo ndipo sipakhala
kutenga magazi kupita nawo kwina kapena kuyesa zina zimene sitinakuuzeni ndi
kugwirizana ayi.
Kuvomeleza kafukufuku
40
Mukasaina kapena kudinda kalatayi ndiye kuti mwamvetsetsa ndondomeko yonse ya
kafukufukuyu ndiponso mwabvomereza mwakufuna kwanu, mosakakamizidwa kutenga
nawo mbali.
Ndawerenga ndekha Achita kundiwerengera

Ndavomela Ndakana
Kusayina kapena kudinda

Ndabvomera mwakufuna kwanga, mosakakamizidwa kutenga nawo mbali pa
kafukufukuyu.
Dzina: Siginecha:
Mboni: Siginecha:
41
Appendix 2C: Tumbuka Consent form
NATIONAL SURVEY ON THE MAGNITUDE OF CHRONIC

NON-COMMUNICABLE DISEASES IN MALAWI
Wakutemweka Badada / Bamama ,
______________________________________________________________
Chakulata cha Kafukufuku

Kafukufuku uyu wanozgeka na ba Unduna wa Za Umoyo (Health) na chakulata chakuti wasange
nthowa iyo yingavwira kuvumbula za masuzgo gha nthenda za shuga, mtima, Kuchimbira kwa ndopa
(BP) na zinyake zinandi izo zikukoleranako mwantheura pathupi la muthu.
Chisankho
Kafukufuku uyu wakuchitika charu chose cha Malawi mu maboma ghakusankhika pachoko waka.
Unduna wa Za Umoyo ngwakukondwa kumumanyiskani imwe kuti ndimwe bamoza ba banthu bachoko
waka abo basankhika kuti bachite nabo kafukufuku uyu pakuzgola mafumbo agha ghachokowaka.
Muli banangwa kuchita nabo kafukufuku uyu panji kudapila ntheura mutiphalire chisankho chinu
pambele tindalutilire. Fundo izo tiyowoyeskanengepo zose zigwirisikenge nchito yinyake yapadera pa
kafukufuku uyu chara ndipo zisungikenge mwachisisi.
Vyakwenera kuchita
Malinga na nthenda izo mwazunula pakwamba apo, mutizgolenge mafumbo ghachoko waka,
mutiyezgekenge pachoko waka ndipo mutiphalilikenge panji mutimanyenge viyeszgo vinu vyose
usange mwakhumba ntheura. Mutipulikenge kugwaza kwa zingano pachoko usange bakutolapo tundopa
kuti bayezge shuga umo yilili muthupi linu.
Kuzomerezgana za kuchita nawo kafukufuku uyu

Mutilembenge zina linu pa malo agho ghapelekeka musi umo kulongola kuti mazomelezga kuchita nawo
kafukufuku uyu panji mwadapila pamaso pa kaboni wa Unduna wa Zaumoyo.
Ndabazga ndipo ndadapila Ndamumanyiska muthu uyu, wapulikiska ndipo

wadapila. “ Kaboni wa Unduna wa Zaumoyo”.
Ndazomela kuchita nawo kafukufuku uyu.
Participant Name: Sign:
Witness: Sign:
Participant Identification Number └─┴─┘ └─┴─┘└─┴─┘
Appendix 3A: English and Chichewa Questionnaire
Malawi STEPS Survey Questionnaire for

Chronic Non-Communicable Diseases
Malawi STEPwise approach to chronic disease risk factor surveillance- Instrument v2.1
Survey Information
Location and Date Response Code

1 District code
└─┴─┴─┘ I1
2 TA/Township/Village name
I2
3 Centre/Village code
└─┴─┴─┘ I3
4 Interviewer Identification
└─┴─┴─┘ I4
5 Date of completion of the instrument
└─┴─┘ └─┴─┘ └─┴─┴─┴─┘
dd mm year I5

Participant Id Number └─┴─┴─┴─┴─┴─┘

Consent, Interview Language and Name of respondent Response Code
6 Consent has been read out to participant Yes 1
I6
No 2 If NO, read consent
7 Consent has been obtained (verbal or written) Yes 1
No 2 If NO, END
I7
8 Interview Language [Insert Language] English 1
Chichewa 2
Tumbuka 3 I8
[Add others] 4
9 Time of interview
(24 hour clock) └─┴─┘: └─┴─┘ I9
hrs mins
10 Surname I10
11 First Name I11
Additional Information that may be helpful
12 Contact phone number where possible I12
13 Specify whose phone Work 1
Home 2
Neighbour
I13
3
Other (specify) 4
Other └─┴─┴─┴─┴─┴─┴ I13 other

─┘
Record and file identification information (I6 to I13) separately from the completed questionnaire.
Step 1 Demographic Information
CORE: Demographic Information

Questions Response Code
Sex (Record Male / Female as observed) Male 1
14 C1
Female 2
What is your date of birth?

15 Munabadwa chaka chanji/kasi mukababika pauli? └─┴─┘ └─┴─┘ └─┴─┴─┴─┘ If known, go to C4 C2
Don't Know 77 77 7777 dd mm year
How old are you?
16
Mulindizaka zingati/muli navyaka vilinga?
Years
└─┴─┘
C3
In total, how many years have you spent at school or
in full-time study (excluding pre-school)?
17
Kodi sukulu munayimbapo? Eya/ Ai
Years └─┴─┘ C4
Zaka zingati?
EXPANDED: Demographic Information Response Code

18 What is your ethnic group background? Chewa 1
Kodi ndinu a mtundu wanji? Tumbuka 2
Ngoni 3
C5
Yao 4
Other (Specify) 5
I don’t know/Refused 88
19 What is the highest level of education you have None 1
completed? Standard 1-5 2
Kodi sukulu munasiyira kalasi iti? C6
Standard 6-8 3
Secondary and above 4
20 Which of the following best describes your main work Government employee 1
status over the last 12 months? Non-government employee 2
Kodi ntchito yanu yeniyeni ndi yotani Self-employed 3
Non-paid 4
Student 5
C7
Homemaker 6
Retired 7
Unemployed (able to work) 8
Unemployed (unable to work) 9
21 How many people older than 18 years, including
yourself, live in your household? Number of people └─┴─┘ C8
Kodi pakhomo pano pali anthu angati opyola zaka 18?
22 Taking the past year, can you tell me what the Per week └─┴─┴─┴─┴─┴─┴─┘ Go to T1 C9a
average earnings of the household have been?
Kodi munapeza ndalama zochuluka bwanji pa
OR per month └─┴─┴─┴─┴─┴─┴─┘ Go to T1 C9b
mulungu kapena pa mwezi kapena pa chaka? OR per year C9c
└─┴─┴─┴─┴─┴─┴─┘ Go to T1
Step 1 Behavioural Measurements
Now I am going to ask you some questions about various health behaviours. This includes issues like smoking, drinking alcohol, eating fruits
and vegetables and physical activity. Let's start with tobacco.
CORE: Tobacco Use
23 Have ever smoked any tobacco products in your life? Yes 1
Kodi munasutapo fodya?
No 2 If no, go T6
24 Do you currently smoke any tobacco products? Yes 1
Mukanasutabe fodya? T1
No 2 If No, go to T6
25 If Yes, Yes 1
Do you currently smoke tobacco products daily? T2
Kodi mumasuta fodya tsiku lililonse?
26 How old were you when you first started smoking
Age (years)
daily? T3
Munayamba kusuta fodya muli ndi zaka zingati? Don’t remember 77 └─┴─┘ If Known, go to T5a
27 Do you remember how long ago it was? In Years

T4a
Papita nthawi yaitali bwanji mukusuta fodya? └─┴─┘ If Known, go to T5a
OR in Months
T4b
(RECORD ONLY 1, NOT ALL 3) └─┴─┘ If Known, go to T5a
OR in Weeks
Don’t remember 77 T4c
└─┴─┘
28 On average, how many of the following do you smoke
each day? Manufactured cigarettes T5a
└─┴─┘
Kodi mumasuta ndudu zingati za fodya patsiku?
Hand-rolled cigarettes T5b
└─┴─┘
(RECORD FOR EACH TYPE) Pipes full of tobacco T5c
└─┴─┘
Don’t remember 77 Cigars T5d

└─┴─┘
Other └─┴─┴─┘ If other, go to T5 T5e

other
Other (please specify): T5other
└─┴─┴─┴─┴─┴─┴─┘
EXPANDED: Tobacco Use

29 In the past, did you ever smoke daily? Yes 1
Kasutidwe kanu kanali bwanji m’mbuyomu patsiku ?
T6
30 If Yes, How old were you when you stopped smoking
Age (years)
daily?
Mudali ndi zaka zingati pamene munasiya kusuta └─┴─┘ If Known, go to T9 T7
Don’t know 77
mowirikiza?
31 How long ago did you stop smoking daily?
Munasiya liti kusuta fodya tsiku lililonse? Years ago └─┴─┘ If Known, go to T9 T8a
(RECORD ONLY 1, NOT ALL 3) └─┘ If Known, go to T9 T8b
OR Months ago
Don’t know 77
OR Weeks ago └─┘ If Known, go to T9 T8c
32 Do you currently use any smokeless tobacco such Yes 1
as [snuff, chewing tobacco]? Kodi mumadya fodya T9
opela? No 2 If No, go to T12
33 If Yes,
Yes 1
Do you currently use smokeless tobacco products T10
daily? Mumadya fodya opela tsiku lilolonse? No 2 If No, go to T12
EXPANDED: Tobacco Use, contd.

34 On average, how many times a day do you use Snuff, by mouth └─┴─┘ T11a
smokeless tobacco such as snuff, chewing tobacco
Kodi, patsiku mumadya fodya opela kangati? Snuff, by nose T11b
└─┴─┘
Chewing tobacco T11c
└─┴─┘
Don't Know 77
Other T11e
└─┴─┘ If Other, go to T11 other
Other (specify) └─┴─┴─┴─┴─┴─┴─┘ T11other
35 In the past, did you ever use smokeless tobacco such Yes 1
as [snuff, chewing tobacco, or betel] daily? T12
Zaka zapitazi mamadya fodya opela? No 2
CORE: Alcohol Consumption

The next questions ask about the consumption of alcohol. Tsopano tikambiranepo za mowa
36 Have you consumed alcohol (kachasu, masese, Yes
1
chibuku, mowa wabotolo, kazibeki) within the past 12
months? A1
Kodi, munamwapo mowa miyezi khumi ndi iwiri yapital No 2 If No, go to D1
?
37 In the past 12 months, how frequently have you had at Daily 1
least one drink? 5-6 days per week 2
Kodi chaka chapitachi, mumwama mowa mowilikiza 1-4 days per week 3 A2
bwanji?
1-3 days per month 4
Less than once a month 5
38 When you drink alcohol, on average, how many drinks
do you have in a day?
Number
Kodi mumamwa mowa wochuluka bwanji pa tsiku
Don’t know 77
└─┴─┘ A3
(mabotolo, mapaketi, zipanda)?
39 Have you consumed alcohol (such as beer, kachasu,

masese, chibuku etc) within the past month? Yes 1
A4
Kodi munamwapo mowa mwezi wapitawo?
No 2 If No, go to A 6
40 During each of the past 7 days, how many standard A5a
Monday
drinks of any alcoholic drink did you have each day? └─┴─┘
Mulungu wapitawo, munamwapo mowa wochuluka
Tuesday A5b
bwanji? └─┴─┘
Wednesday A5c
└─┴─┘
Thursday A5d
└─┴─┘
Don't Know 77 Friday A5e
└─┴─┘
Saturday A5f
└─┴─┘
A5g
Sunday
└─┴─┘
EXPANDED : Alcohol Consumption

41 In the past 12 months, what was the largest number of
drinks you had on a single occasion, counting all types
of standard drinks together? Largest number
└─┴─┘ A6
Kodi chaka chapitachi, tsiku lomwe mudamwa mowa Don't Know 77
kwambiri mudamwa mowa wochuluka bwanji?
(mabotolo, mapaketi, zipanda…)
42 For men only:
In the past 12 months, on how many days did you have
five or more standard drinks in a single day? Number of days └─┴─┴─┘ A7
Chaka chapitachi, kodi masiku angati omwe mudamwa Don't Know 777
mowa wochuluka mabotolo, mapaketi, zipanda..
zokwana zisanu kapena kupitilirapo?
43 For women only:
four or more standard drinks in a single day? Number of days └─┴─┴─┘ A8
Chaka chapitachi, kodi masiku angati omwe mudamwa Don't Know 777
mowa wochuluka mabotolo, mapaketi, zipanda..
zokwana zinayi kapena kupitilirapo?
CORE: Diet
The next questions ask about the fruits and vegetables that you usually eat. I have a nutrition card here that shows you some examples of local
fruits and vegetables. Each picture represents the size of a serving. As you answer these questions please think of a typical week in the last
year.
44 In a typical week, on how many days do you eat fruit? Number of days
Ndimasiku angati pamulungu amene mumadya └─┴─┘ If Zero days, go to D3 D1
zipatso? Don't Know 77
45 How many servings of fruit do you eat on one of those
Number of servings
days? └─┴─┘ D2
Don't Know 77
Pamasiku amenewa mumadya zipatso kangati?
46 In a typical week, on how many days do you
eat vegetables? Number of days
└─┴─┘ If Zero days, go to D5 D3
Ndimasiku angati pamulungu amene mumadya ndiwo Don't Know 77
zamasamba?
47 How many servings of vegetables do you eat on one of Number of servings
those days?
└─┴─┘ D4
Pamasiku amenewa mumadya ndiwo zamasamba Don't Know 77
kangati?
EXPANDED: Diet
48 What type of oil or fat is most often used for meal Vegetable oil 1
preparation in your household? Animal fat 2
Mumagwiritsa ntchito mafuta ophikila a antundu wanji? Butter or ghee 3
SELECT ONLY ON) Margarine 4 D5
Other 5 If Other, go to D5 other
None in particular 6
None used 7
Don’t know 77
Other └─┴─┴─┴─┴─┴─┴─┘ D5other

CORE: Physical Activity

Next I am going to ask you about the time you spend doing different types of physical activity in a typical week. Please answer these questions even
if you do not consider yourself to be a physically active person. Tsopano tikambirana za ntchito imene mumagwira.
Think first about the time you spend doing work. Think of work as the things that you have to do such as paid or unpaid work, study/training,
household chores, harvesting food/crops, fishing or hunting for food, seeking employment. [Insert other examples if needed]. In answering the
following questions 'vigorous-intensity activities' are activities that require hard physical effort and cause large increases in breathing or heart rate,
'moderate-intensity activities' are activities that require moderate physical effort and cause small increases in breathing or heart rate.
Activity at work
49 Does your work involve vigorous-intensity activity that causes
large increases in breathing or heart rate like [carrying or Yes 1
lifting heavy loads, digging or construction work] for at least
10 minutes continuously? P1
Kodi ntchito imene mumagwira ndi yokhetsa thukuta monga No 2 If No, go to P 4
kulima, kunyamula katundu, kukonola, kukumba mayenje ndi
zina zotero?
50 In a typical week, on how many days do you do vigorous-
intensity activities as part of your work? Number of days
└─┘ P2
Pamulungu, ndi masiku angati amene mumagwira ntchito yo
khetsa thukuta?
51 How much time do you spend doing vigorous-intensity
activities at work on a typical day?
└─┴─┘: └─┴─┘
P3
Pa tsiku, kodi mumagwira ntchito yo khetsa thukuta nthawi Hours : minutes (a-b)
hrs mins
yochuluka bwanji?
52 Does your work involve moderate-intensity activity that
causes small increases in breathing or heart rate such as Yes 1
brisk walking [or carrying light loads] for at least 10 minutes
continuously? P4
Kodi ntchito imene mumagwira ndi yopepukirapo monga
No 2 If No, go to P 7
kunyamula katundu wopepukirapo,kuyenda mwandawala zina
zotero?
53 In a typical week, on how many days do you do moderate-
intensity activities as part of your work?
Number of days └─┘ P5
Pamulungu, ndi masiku angati amene mumagwira ntchito
yopepukirapo?
54 How much time do you spend doing moderate-intensity
activities at work on a typical day?
└─┴─┘: └─┴─┘
P6
Pa tsiku, kodi mumagwira ntchito yopepukirapo nthawi Hours : minutes (a-b)
hrs mins
yochuluka bwanji?
Travel to and from places
The next questions exclude the physical activities at work that you have already mentioned.
Now I would like to ask you about the usual way you travel to and from places. For example to work, for shopping, to market, to place of worship.
55 Do you walk or use a bicycle (pedal cycle) for at least 10 Yes 1

minutes continuously to get to and from places? P7
Kodi mumayenda pansi kapena pa njira ya kapalasa popita No 2 If No, go to P 10
monga kuntchito, kutchalitchi, kumsika ndi kwina kotero?
56 In a typical week, on how many days do you walk or bicycle
for at least 10 minutes continuously to get to and from places?
Pamulungu, kodi ndi masiku angati amene mumayenda pansi
kapena pa njinga ya kapalasa?
57 How much time do you spend walking or bicycling for travel
on a typical day?
└─┴─┘: └─┴─┘
P9
Hours : minutes (a-b)
Pa tsiku, kodi ndi nthawi yotalika bwanji yimene mumayenda
hrs mins
pansi kapena pa njinga ya kapalasa?
Recreational activities
The next questions exclude the work and transport activities that you have already mentioned.
Now I would like to ask you about sports, fitness and recreational activities (leisure) Tsopano tikambirana za masewero olimbitsa thupi
58 Do you do any vigorous-intensity sports, fitness or recreational
(leisure) activities that cause large increases in breathing or Yes 1
heart rate like [running or football,] for at least 10 minutes
continuously? P10
Kodi mumapanga masewera oilimbitsa thupi kwa phindi khumi No 2 If No, go to P 13
mwakathithi?
intensity sports, fitness or recreational (leisure) activities?
Pa mulungu, kodi ndi masiku angati amene mumapanga
masewera olimbitsa thupi kwa phindi khumi?
60 How much time do you spend doing vigorous-intensity sports,
fitness or recreational activities on a typical day?
└─┴─┘: └─┴─┘
P12
Pa tsiku, kodi ndi nthawi yo chuluka bwanji imene mumatenga Hours : minutes (a-b)
hrs mins
kupanga masewera olimbitsa thupi?
61 Do you do any moderate-intensity sports, fitness or

recreational (leisure) activities that causes a small increase Yes 1
in breathing or heart rate such as brisk walking,(cycling,
swimming, volleyball)for at least 10 minutes continuously? P13
Kodi muchita masewela olimbitsa nthupi opepukilako No 2 If No, go to P16
monga kupalasa njinga, kusambila, kusewela volleyball pa
nthawi yopitilila 10 minitsi osapuma?
62 In a typical week, on how many days do you do moderate- Number of
intensity sports, fitness or recreational (leisure) activities? days └─┘ P14
Pamulungu mumachita masewela olimbitsa nthupi
opepukilako?
Hours :
sports, fitness or recreational (leisure) activities on a typical
day?
minutes └─┴─┘: └─┴─┘ P15
Pa tsiku, Kodi mumatenga nthawi yaitali bwanji mukuchita hrs mins
(a-b)
masewelawa?
Sedentary behaviour
The following question is about sitting or reclining at work, at home, getting to and from places, or with friends including time spent [sitting at
a desk, sitting with friends, travelling in car, bus, train, reading, playing cards or watching television], but do not include time spent sleeping.
64 How much time do you usually spend sitting or reclining on

Hours :
a typical day?
minutes
└─┴─┘: └─┴─┘
P16
Patsiku ndi nthawi yaitali bwanji mumangokhala pansi (a-b)
osachita china chilichonse mutakhala pampando hrs min s
(kumawelenga, kuonela ma filimu, kusewela bawo)
EXPANDED: History of Raised Blood Pressure

65 When was your blood pressure last measured by a Within past 12 months 1
health professional?
1-5 years ago 2 H1
Kodi ndi liti munayezetsa matenda othamanga magazi
(BP)? Not within past 5 years 3
66 During the past 12 months have you been told by a Yes 1
doctor or other health worker that you have raised blood
pressure or hypertension? H2
Kodi pa miyezi 12 yapita a dokotala anakupimaniko No 2
matenda othamanga magazi (BP?
67 Are you currently receiving any of the following treatments for raised blood pressure prescribed by a doctor or other health worker as well as any
advice? Kodi ndithandizo la mankhwala kapena langizo liti mukulilandila la matenda BP?
Drugs (medication) that you have taken in the last 2 Yes 1
weeks H3a
No 2
Special prescribed diet Yes 1
H3b
No 2
Advice or treatment to lose weight Yes 1
H3c
No 2
Advice or treatment to stop smoking Yes 1
H3d
No 2
Advice to start or do more exercise Yes 1
H3e
No 2
68 During the past 12 months have you seen a traditional Yes 1
healer for raised blood pressure or hypertension Kodi
munapita kwa a sing’anga mu miyezi 12 yapitai kukafuna
H4
No 2
mankhwala a BP
69 Are you currently taking any herbal or traditional remedy Yes 1
for your raised blood pressure? Kodi mukumwa H5
mankhwala alionse a BP azitsamba? No 2
EXPANDED: History of Diabetes

70 Have you had your blood sugar measured in the last 12 Yes 1
months? H6
No 2
Chaka chapitachi,Kodi munayezetsako matenda a shuga?
71 During the past 12 months, have you ever been told by a Yes 1
doctor or other health worker that you have diabetes?
H7
Chaka chapitachi, a dotolo anakuuzanipo kuti muli ndi matenda No 2
a shuga?
Are you currently receiving any of the following treatments for diabetes prescribed by a doctor or other health worker as well
72 as any advice?
Kodi mukulandila makhwala kapena malangizo a matenda a shuga monga:
Insulin Yes 1
H8a
obaya No 2
Oral drug (medication) that you have taken in the last 2 Yes 1
weeks H8b
No 2
akumwa
Special prescribed diet Yes 1
H8c
Malangizo a zakudya No 2
Advice or treatment to lose weight Yes 1
H8d
Malangizo kapena makhwala ochepetsa thupi No 2
Advice or treatment to stop smoking Yes 1
H8e
Malangizo kapena makhwala oletsa kusuta fodya No 2
Advice to start or do more exercise Yes 1
H8f
Malangizo oti muyambe masewera olimbitsa thupi No 2
healer for diabetes?
H9
Chaka chapitachi ,kodi munapitapo kwa a sing’anga No 2
kukapeza chithandizo cha matenda a shuga?
for your diabetes?
H10
Kodi pakali pano mukumwa makhwala a chikuda a No 2
matenda a shuga?
Step 2 Physical Measurements
CORE: Height and Weight Response Code

75 Interviewer ID
└─┴─┴─┘
M1
76 Device IDs for height and weight Height └─┴─┘ M2a
Weight └─┴─┘ M2b
77 Height in Centimetres (cm)
└─┴─┴─┘. └─┘
M3
78 Weight in Kilograms (kg)
If too large for scale, code 666.6 └─┴─┴─┘.└─┘
M4
79 For women: Are you pregnant? Yes 1 If Yes, go to M 8
Kodi Ndinu oyembekezera? M5
No 2
CORE: Waist
80 Device ID for waist
└─┴─┘
M6
81 Waist circumference
in Centimetres (cm)
└─┴─┴─┘.└─┘
M7
CORE: Blood Pressure
82 Interviewer ID
└─┴─┴─┘ M8
83 Device ID for blood pressure
└─┴─┘
M9
84 Cuff size used Small 1
Medium 2 M10
Large 3
85 Reading 1
Systolic ( mmHg) └─┴─┴─┘ M11a
Diastolic (mmHg) └─┴─┴─┘ M11b

86 Reading 2 └─┴─┴─┘
Systolic ( mmHg) M12a
(to be taken 5 minutes after taking Reading 1)
87 Reading 3 Systolic ( mmHg) └─┴─┴─┘ M13a
88 During the past two weeks, have you been treated for Yes 1
raised blood pressure with drugs (medication) prescribed
by a doctor or other health worker?
Pa milungu iwiri yapitai mwalandilako mankhwala a BP
M14
No 2
kuchokela kwa dokotala?
(verify in the health passport)
EXPANDED: Hip Circumference and Heart Rate

89 └─┴─┴─┘.└─┘
Hip circumference in Centimetres (cm) M15
90 Heart Rate (Record if automatic blood pressure device is used)
Reading 1 Beats per minute └─┴─┴─┘ M16a
Reading 2 Beats per minute └─┴─┴─┘ M16b
Reading 3 Beats per minute └─┴─┴─┘ M16c
Step 3 Biochemical Measurements
CORE: Blood Glucose Response Code

91 During the last 12 hours have you had anything to eat or Yes 1
drink, other than water? B1
No 2
92 Technician ID
└─┴─┴─┘ B2
93 Device ID
└─┴─┘ B3
94 Time of day blood specimen taken (24 hour clock)
Hours : minutes └─┴─┘: └─┴─┘ B4
hrs mins
95 Fasting blood glucose mmol/l
└─┴─┘. └─┴─┘
B5
CORE: Blood Lipids

96 Device ID B6
└─┴─┘
97 Total cholesterol mmol/l B7
└─┴─┘. └─┴─┘
EXPANDED: Triglycerides and HDL Cholesterol

98 Triglycerides mmol/l B8
└─┴─┘. └─┴─┘
99 HDL Cholesterol B9
mmol/l
└─┘. └─┴─┘
Ministry of Health
Appendix 3B: English and Tumbuka

Questionnaire
Malawi STEPS Survey Questionnaire for Chronic

Non-Communicable Diseases
Survey Information
Location and Date Response Code

1 District code
└─┴─┴─┘ I1
2 TA/Township/Village name
I2
3 Centre/Village code
└─┴─┴─┘ I3
4 Interviewer Identification
└─┴─┴─┘ I4
5 Date of completion of the instrument
└─┴─┘ └─┴─┘ └─┴─┴─┴─┘
dd mm year I5

Participant Id Number └─┴─┴─┴─┴─┴─┘

Consent, Interview Language and Name of respondent Response Code
6 Consent has been read out to participant Yes 1
No 2
I6
If no, read out
consent
7 Consent has been obtained (verbal or written) Yes 1
No 2 If NO, END
I7
8 Interview Language [Insert Language] English 1
Chichewa 2
Tumbuka 3 I8
[Add others] 4
9 Time of interview
(24 hour clock) └─┴─┘: └─┴─┘ I9
hrs mins
10 Surname I10
11 First Name I11
Additional Information that may be helpful
12 Mafoni ghinu agho tingayowoyeskeranapo I12

13 Panikigzani ni foni yanjani? Kuntchito 1
Kunyumba 2
Muzengigzani 3 I13
Yinyakeso 4
(panikizgani)
I13
Other └─┴─┴─┴─┴─┴─┴─┘ other
Record and file identification information (I6 to I13) separately from the completed questionnaire.
Step 1 Demographic Information
CORE: Demographic Information

Sex (Record Male / Female as observed) Male 1
14 C1
Female 2
What is your date of birth?

15 Munabadwa chaka chanji /Kasi mukababika pauli? └─┴─┘ └─┴─┘ └─┴─┴─┴─┘ If known, go to C4 C2
Don't Know 77 77 7777 dd mm year
How old are you?
16
Mulindizaka zingati / Muli navyaka vilinga?
Years
└─┴─┘
C3
In total, how many years have you spent at school or
in full-time study (excluding pre-school)?/ Kasi
17
mwataya vyaka vilinga muli pa sukulu?
Years └─┴─┘ C4
EXPANDED: Demographic Information Response Code

18 What is your ethnic group background? / Kasi ndimwe Chewa 1
wa mtundu uli? Tumbuka 2
Ngoni 3
C5
Yao 4
Other (Specify) 5
Nkhumanya chara / Nakana 88
19 What is the highest level of education you have None 1
completed? Kasi masambilo ghinu ghapachanya Standard 1-5 2
chomene agho mwafikapo ni nga? C6
Standard 6-8 3
Secondary and above 4
20 Which of the following best describes your main work Government employee 1
status over the last 12 months? Kasi ni ndondomeko Non-government employee 2
uli mwa izi tazunula apa iyo yikulongosola makora za
ntchito yeneko iyo mwachitanga mu myezi 12 iyo Self-employed 3
yajumpha? Non-paid 4
Student 5
[INSERT COUNTRY-SPECIFIC CATEGORIES]
C7
Homemaker 6
(USE SHOWCARD) Retired 7
Unemployed (able to work) 8
Unemployed (unable to work) 9
21 How many people older than 18 years, including
yourself, live in your household? Kasi munyumba iyi
Number of people └─┴─┘ C8
mukukhalamo mwawanthu walinga imwe muli na
vyaka vyakufikira 18 kuluta munthazi?
22 Taking the past year, can you tell me what the Per week └─┴─┴─┴─┴─┴─┴─┘ Go to T1 C9a
average earnings of the household have been?
Malinga na chaka chamara ichi chajumphapo, kasi OR per month └─┴─┴─┴─┴─┴─┴─┘ Go to T1 C9b
mungayezgelera kuti munthu yumoza wamunyumba
yinu wakusanga ndalama zilinga pa chaka?
OR per year └─┴─┴─┴─┴─┴─┴─┘ Go to T1 C9c
Refused 88 C9d
(RECORD ONLY ONE, NOT ALL 3)
Step 1 Behavioural Measurements
Now I am going to ask you some questions about various health behaviours. This includes issues like smoking, drinking alcohol, eating fruits
and vegetables and physical activity. Let's start with tobacco.
CORE: Tobacco Use
23 Have ever smoked any tobacco products in your life?/ Yes
Kasi muli kuhwewapo hona mu nyengo zajumpha izi? 1
No
24 Do you currently smoke any tobacco products? Kasi Yes 1
mukukhwewa hona pa nyengo ya sono? T1
25 If Yes, / Usange ni nthena, Yes 1
Do you currently smoke tobacco products daily? Kasi T2
panyengo yasono, mukukhwewa zuwa lililose? No 2 If No, go to T6
26 How old were you when you first started smoking
Age (years)
daily?/ Kasi mukawa na vyaka vilinga T3
apomukayambira kukhwewa hona? Don’t remember 77 └─┴─┘ If Known, go to T5a
27 Do you remember how long ago it was? Kasi In Years

T4a
mukukumbukira kuti vikawa vyaka vilinga ivyo └─┴─┘ If Known, go to T5a
vyajumphapo kufuma apo mukambira kukhwewa? OR in Months
T4b
└─┴─┘ If Known, go to T5a
OR in Weeks
(RECORD ONLY 1, NOT ALL 3)
T4c
└─┴─┘
Don’t remember 77
28 On average, how many of the following do you smoke
each day? / Pakusachizga waka, kasi ni ndudu zilinga Manufactured cigarettes T5a
└─┴─┘
za hona uyo tazunula apa izo mukukhwewa pa zuwa
limoza? Hand-rolled cigarettes T5b
└─┴─┘
Pipes full of tobacco T5c
└─┴─┘
(RECORD FOR EACH TYPE)
Cigars T5d
└─┴─┘
Don’t remember 77
Other └─┴─┴─┘ If other, go to T5 T5e
other
Other (please specify): T5other
└─┴─┴─┴─┴─┴─┴─┘
EXPANDED: Tobacco Use

29 In the past, did you ever smoke daily? Munyengo Yes 1
zajumpha izi, kasi mulikukhwewapo zuwa na zuwa? T6
30 If Yes, How old were you when you stopped smoking
Age (years)
daily?
└─┴─┘ If Known, go to T9 T7
Don’t know 77
31 How long ago did you stop smoking daily? Muli kuleka
pauli kukhwewa zuwa na zuwa? Years ago └─┴─┘ If Known, go to T9 T8a
OR Months ago └─┘ If Known, go to T9 T8b

(RECORD ONLY 1, NOT ALL 3)
Don’t know 77 OR Weeks ago └─┘ If Known, go to T9 T8c

32 Do you currently use any smokeless tobacco such Yes 1
as [snuff, chewing tobacco]? / Kasi panyengo ya sono,
mukukhwewa hona wambula josi (wmumphuno, No T9
2 If No, go to T12
wakusumba, wapasi pa lulime)?
33 If Yes,
Yes 1
Do you currently use smokeless tobacco products
daily? / Panyengo ya sono, Kasi mukukhwewa No T10
hona wambula josi? 2 If No, go to T12
EXPANDED: Tobacco Use, contd.

34 On average, how many times a day do you use Snuff, by mouth └─┴─┘ T11a
smokeless tobacco such as snuff, chewing tobacco
Mwakuyezgelera waka, kasi hona wambula josi
mukumukhwewa kalinga pa zuwa?/
Snuff, by nose
└─┴─┘
T11b
Chewing tobacco T11c

└─┴─┘
Don't Know 77
Other T11e
└─┴─┘ If Other, go to T11 other
Other (specify) └─┴─┴─┴─┴─┴─┴─┘ T11other
35 In the past, did you ever use smokeless tobacco such Yes 1
as [snuff, chewing tobacco, or betel] daily? / Muvwyaka
vyamumanyuma umu, kasi muli kukhwewapo hona
T12
No 2
wambula josi?
CORE: Alcohol Consumption

The next questions ask about the consumption of alcohol.
36 Have you consumed alcohol (such as beer, kachasu, Yes
1
masese, chibuku etc) within the past 12 months? /
Kasimuli kumwapo mowa (wamasese, kachasu, A1
chibuku, wamabotolo) mummiyezi 12 yajumpha iyo? No 2 If No, go to D1
37 In the past 12 months, how frequently have you had at Daily 1

least one drink? / Mu myezi 12 yajumpha iyo, Nkhalinga 5-6 days per week 2
apo mwamwapobwanji, zuwa-----?
1-4 days per week 3 A2
(READ RESPONSES
1-3 days per month 4
USE SHOWCARD)
Less than once a month 5
38 When you drink alcohol, on average, how many drinks
do you have in a day? / Kasi mukumwa mabotolo Number
ghalinga pa zuwa usange mwayamba kumwa mowa? Don’t know 77
└─┴─┘ A3
39 Have you consumed alcohol (such as beer, kachasu,

masese, chibuku etc) within the past month? / Kasi mui Yes 1
kumwapo mowa ngati wamabotolo, kachasu, masese, A4
chibuku mu mwezi wamala uwu?
No 2 If No, go to A 6
(USE SHOWCARD OR SHOW EXAMPLES)
40 During each of the past 7 days, how many standard A5a
Monday
drinks of any alcoholic drink did you have each day?/ Mu └─┴─┘
mazuwa 7 ghajumpha agho, kasi mukumwapo mowa
unandi uli pazuwa (pendani mabotolo panji nthembe za Tuesday A5b
└─┴─┘
mowa pazuwa lililose)?
Wednesday A5c
└─┴─┘
Thursday A5d
└─┴─┘
(RECORD FOR EACH DAY
Friday A5e
USE SHOWCARD) └─┴─┘
Saturday A5f
└─┴─┘
Don't Know 77 A5g
Sunday
└─┴─┘
EXPANDED : Alcohol Consumption

41 In the past 12 months, what was the largest number of
drinks you had on a single occasion, counting all types
of standard drinks together?/ Pala mwakumbukila Largest number
└─┴─┘ A6
makora mu myezi 12 iyo yajumphapo, Kasi mwamapo Don't Know 77
mabotolo panji nthembe zilinga za mowa pazuwa limoza
ilo mukamwa chomene?
42 For men only:
Number of days └─┴─┴─┘ A7
five or more standard drinks in a single day? Pa myezi
Don't Know 777
12 yajumpha iyo, kasi mwamwapo mabotolo ghalinga pa
zuwa limoza ghakujumpha 5: mwakusachizga?
43 For women only:
Number of days └─┴─┴─┘ A8
four or more standard drinks in a single day? Pa myezi
Don't Know 777
12 yajumpha iyo, kasi mwamwapo mabotolo ghalinga pa
zuwa limoza ghakujumpha 4: mwakusachizga?
CORE: Diet
Mafumbo gha kulya vipaso na mphangwe: nili na nutrition card apa, sono nilongolenge vipaso na mphangwe kuti musankhepo ivyo mukulya
panyeno yimoza yakulyela.
44 In a typical week, on how many days do you eat fruit? / Number of days
Pasabata yimoza, nimazuwa ghalinga agho mukulya
└─┴─┘ If Zero days, go to D3 D1
vipaso?
Don't Know 77
45 How many servings of fruit do you eat on one of those Number of servings
days? / Kasi mukupereka kalinga vipaso vyakuti mulye └─┴─┘ D2
nyengo yimoza pala nyengo yakulyera yakwana? Don't Know 77
46 In a typical week, on how many days do you
eat vegetables?/ Kasi vyakulya vya mphangwe, Number of days
mukulya mazuwa ghalinga pa sabata? └─┴─┘ If Zero days, go to D5 D3
Don't Know 77
47 How many servings of vegetables do you eat on one of Number of servings

those days? / Kasi mukuwerezga kalinga kujigawira
└─┴─┘ D4
mphangwe yakulya nyengo yimoza ?
Don't Know 77
EXPANDED: Diet
48 What type of oil or fat is most often used for meal Vegetable oil 1
preparation in your household? / Kasi ni mtundu uli wa Animal fat 2
mafuta uwo mukugwiriska ntchito kunyumba kwinu
pakuphika vyakurya? Butter or ghee 3
Margarine 4 D5
Other 5 If Other, go to D5 other
SELECT ONLY ON)
None in particular 6
None used 7
Don’t know 77
Other └─┴─┴─┴─┴─┴─┴─┘ D5other
CORE: Physical Activity

Next I am going to ask you about the time you spend doing different types of physical activity in a typical week. Please answer these questions
even if you do not consider yourself to be a physically active person.
Think first about the time you spend doing work. Think of work as the things that you have to do such as paid or unpaid work, study/training,
household chores, harvesting food/crops, fishing or hunting for food, seeking employment. [Insert other examples if needed]. In answering the
following questions 'vigorous-intensity activities' are activities that require hard physical effort and cause large increases in breathing or heart rate,
'moderate-intensity activities' are activities that require moderate physical effort and cause small increases in breathing or heart rate.
Activity at work
49 Kasi pa ntcito yinu iyo mukugwira mazuwa ghanandi:
yikuwapo ya kunyamula vinthu vizito, kujima, kupula, kuzenga Yes 1
zenga, kwambula kulekezga pa fupifupi 10 minutes kwambula
kulekezga?
P1
50 Pasabata yimoza, kasi mukuchita mazuwa ghalinga Number of days

masewero ghakulimbiska thupi (exercises)? └─┘ P2
51 Kasi mukutora nyengo yitali uli uko mukupanga masewero

└─┴─┘: └─┴─┘
P3
agha (#15)? Hours : minutes (a-b)
hrs mins
52 Does your work involve moderate-intensity activity that
causes small increases in breathing or heart rate such as Yes 1
brisk walking [or carrying light loads] for at least 10 minutes
continuously? Kasi ntchito yinu yikukhwaskana na kumovilani P4
kupanga ma exercise ghapakatikati mwakuti mukuthutila
muchanya? No 2 If No, go to P 7
[kulima, kunyamula katundu, kupula, kujimaa etc]
53 In a typical week, on how many days do you do moderate-
intensity activities as part of your work? Kasi ndi mazuwa P5
ghalinga agho mukuchita ma exercise ghapakatikati pa
Number of days └─┘
sabata yiliyose?
└─┴─┘: └─┴─┘
P6
activities at work on a typical day? Kasi nkhalinga kuntchito Hours : minutes
apo mukugwira ntchito yakulingana na exercise yapakatikati? (a-b)
hrs mins
Travel to and from places
The next questions exclude the physical activities at work that you have already mentioned.
Now I would like to ask you about the usual way you travel to and from places. For example to work, for shopping, to market, to place of worship.
[insert other examples if needed]
55 Do you walk or use a bicycle (pedal cycle) for at least 10 Yes 1

minutes continuously to get to and from places? P7
56 In a typical week, on how many days do you walk or bicycle P8
for at least 10 minutes continuously to get to and from places? Number of days └─┘
57 How much time do you spend walking or bicycling for travel
└─┴─┘: └─┴─┘
P9
on a typical day? Hours : minutes (a-b)
hrs mins
Recreational activities
The next questions exclude the work and transport activities that you have already mentioned.
Now I would like to ask you about sports, fitness and recreational activities (leisure), [insert relevant terms].
58 Do you do any vigorous-intensity sports, fitness or recreational
(leisure) activities that cause large increases in breathing or Yes 1
heart rate like [running or football,] for at least 10 minutes
continuously? / Kasi mukuchita masewero agho P10
ghakumovwirani kulimbiska thupi ngati: Kutchaya bola, No 2 If No, go to P 13
kuchimbila?
intensity sports, fitness or recreational (leisure) activities? P11
Pasabata yimoza, nimazuwa ghalinga agho mukupanga Number of days └─┘
masewero gheneko ghakulimbiska thupi?
60 How much time do you spend doing vigorous-intensity sports,
fitness or recreational activities on a typical day? Mukutora └─┴─┘: └─┴─┘
P12
nyengo yitali uli pa zuwa usange mwayamba kupanga ma Hours : minutes (a-b)
exercises? hrs mins
61 Do you do any moderate-intensity sports, fitness or

recreational (leisure) activities that causes a small Yes 1
increase in breathing or heart rate such as brisk
walking,(cycling, swimming, volleyball)for at least 10 P13
minutes continuously? Kasi mukuchita ma exercises
No 2 If No, go to P16
mwakulibikirako nga: volley ball, kuskamba, kwenda
waka kwakuyana na 10 minutes?
62 In a typical week, on how many days do you do Number of days
moderate-intensity sports, fitness or recreational (leisure) P14
activities? Mu sabata yimoza, ndimazuwa ghalinga agho
└─┘
mukuchita masewero ngati agho tazunula mu # 61?
Hours : minutes
sports, fitness or recreational (leisure) activities on a └─┴─┘: └─┴─┘ P15
typical day? Mukutola nyengo yitali uli pa masewero nga (a-b)
gha mu # 62? hrs mins
Sedentary behaviour
The following question is about sitting or reclining at work, at home, getting to and from places, or with friends including time spent [sitting at a desk,
sitting with friends, travelling in car, bus, train, reading, playing cards or watching television], but do not include time spent sleeping.
64 How much time do you usually spend sitting or reclining on a typical day? /
Hours : minutes
└─┴─┘: └─┴─┘
P16
Kasi ni nyengo yitali uli pazuwa iyo mukutola kukhala waka pani kuwonelela
waka ma cinema? (a-b)
hrs min s
EXPANDED: History of Raised Blood Pressure

65 When was your blood pressure last measured by a Within past 12 months 1
health professional? / Kasi ndopa zinu umo
zikuchimbirira (blood pressure) wakaziyezgapo pauli 1-5 years ago 2 H1
kaumaliro? Not within past 5 years 3
66 During the past 12 months have you been told by a Yes 1
doctor or other health worker that you have raised blood
pressure or hypertension? / Kasi pa myezi 12 yajumpha H2
iyi, wachipatala wamuphaliranipo kuti mukulwala ntheda No 2
ya blood pressure?
67 Are you currently receiving any of the following treatments for raised blood pressure prescribed by a doctor or other health worker as well as any
advice? / Kasi kufuma ku chipatal chilichose, ndi wovwiri uli wa nthenda ya blood pressure uwo mu ku pokera?
Drugs (medication) that you have taken in the last 2 Yes 1
weeks / Mankhwala gha BP ghakumwa agho
mwapokerpo sabata ziwiri zajumpha izo? H3a
No 2
Special prescribed diet / chakurya chakupatulika Yes 1

H3b
No 2
Advice or treatment to lose weight / Kumupemphani kuti Yes 1
muwandeko? H3c
No 2
Advice or treatment to stop smoking / Kumupemphani Yes 1
kuti muleka kukhwewa? H3d
No 2
Advice to start or do more exercise / Kumupemphani kuti Yes 1
muchitenge masowelo ghakulimbiska thupi (exercise)? H3e
No 2
68 Kasi mwalutapo kwa ng’anga chifukwa cha nthenda ya Yes 1
blood pressure mu myezi 12 yajumpha iyo? H4
No 2
69 Kasi mukumwapo maankhwala ghachikaya ghali ghose Yes 1
yakuti ghachizge nthenda ya blood pressure iyi? H5
No 2
EXPANDED: History of Diabetes

70 Mu myezi 12 yajumpha iyo, kasi wali Yes 1
kumuyezyanipo suga mu ndopa zinu? H6
No 2
71 During the past 12 months, have you ever been Yes 1
told by a doctor or other health worker that you
have diabetes? Mu myezi 12 yajumpha iyo, kasi H7
wachipatala wali kumuphaliranipo kuti muli na No 2
nthenda ya shuga?
Are you currently receiving any of the following treatments for diabetes prescribed by a doctor or other health worker as well as any advice?/
72
Kasi mukupokera ghamoza mwa mankhwala agha kufumila kuchipatala chilichose?
Insulin / munkhwala wamatenda gha shuga Yes 1
wakujigwaza. H8a
No 2
Oral drug (medication) that you have taken in the last 2 Yes 1
weeks / Mankhwala ghakumwa agho mwapokapo mu H8b
sabata ziwiri zajumpha izo. No 2
Special prescribed diet / muli pa chakurya cha kupatulika Yes 1
ich wachipatala wamulongozgani kuti mulyenge? H8c
No 2
Advice or treatment to lose weight / Kasi wachipatala Yes 1
wamulongozgani kuti muwandeko? H8d
No 2
Advice or treatment to stop smoking / Kasi wachipatala Yes 1
wamulongozgani kuti muleke kukhwewa? H8e
No 2
Advice to start or do more exercise / Kasi wachipatala Yes 1
wamulongozgani kuti muyambepo masewero H8f
ghakulibiska thupi (exercises)? No 2
healer for diabetes?Mu myezi 12 yajumpha iyo, kasi
H9
mwawonanapo na ng’anga chifukwa cha ulwali wa No 2
shuga?
for your diabetes? / Kasi mukumwa mankhwala H10
ghachikaya ghali ghose malinga na nthenda ya shuga? No 2
Step 2 Physical Measurements
CORE: Height and Weight Response Code

75 Interviewer ID
└─┴─┴─┘
M1
76 Device IDs for height and weight Height └─┴─┘ M2a
Weight └─┴─┘ M2b
77 Height in Centimetres (cm)
└─┴─┴─┘. └─┘
M3
78 Weight in Kilograms (kg)
If too large for scale, code 666.6 └─┴─┴─┘.└─┘
M4
79 For women: Are you pregnant? / Kasi munapathupi? Yes 1 If Yes, go to M 8
No 2
M5
CORE: Waist
80 Device ID for waist
└─┴─┘
M6
81 Waist circumference
in Centimetres (cm)
└─┴─┴─┘.└─┘
M7
CORE: Blood Pressure
82 Interviewer ID
└─┴─┴─┘ M8
83 Device ID for blood pressure
└─┴─┘
M9
84 Cuff size used Small 1
Medium 2 M10
Large 3
85 Reading 1
Systolic ( mmHg) └─┴─┴─┘ M11a

86 Reading 2 └─┴─┴─┘
Systolic ( mmHg) M12a
87 Reading 3 Systolic ( mmHg) └─┴─┴─┘ M13a
88 During the past two weeks, have you been treated for Yes 1
raised blood pressure with drugs (medication) prescribed
by a doctor or other health worker? / Kasi mulikupokerapo
wovvwili kufuma chipatala wakukhwaskana na matenda M14
No 2
gha Blood pressure?
(verify in the health passport)
EXPANDED: Hip Circumference and Heart Rate

89 └─┴─┴─┘.└─┘
Hip circumference / Usani wa mu chiuno in Centimetres (cm) M15
90 Heart Rate (Record if automatic blood pressure device is used) speed iyo mtima ukwendera
Reading 1 Beats per minute └─┴─┴─┘ M16a
Reading 2 Beats per minute └─┴─┴─┘ M16b
Reading 3 Beats per minute └─┴─┴─┘ M16c
Step 3 Biochemical Measurements
CORE: Blood Glucose Response Code

91 Mu ma ora 12 agho ghajumpa agho, kasi mwalyapo panji Yes 1
kumwapo chilichose kupatula maji? B1
No 2
92 Technician ID
└─┴─┴─┘ B2
93 Device ID
└─┴─┘ B3
94 Time of day blood specimen taken (24 hour clock)
Hours : minutes └─┴─┘: └─┴─┘ B4
hrs mins
95 Fasting blood glucose mmol/l
└─┴─┘. └─┴─┘
B5
CORE: Blood Lipids

96 Device ID
└─┴─┘
B6
97 Total cholesterol mmol/l
└─┴─┘. └─┴─┘
B7
EXPANDED: Triglycerides and HDL Cholesterol

98 Triglycerides mmol/l
└─┴─┘. └─┴─┘
B8
99 HDL Cholesterol B9
mmol/l
└─┘. └─┴─┘
WHO STEPS
Chronic Disease
Risk Factor Surveillance
DATA BOOK FOR

MALAWI, 2009
Part 6: Templates and Forms 6-3D-1

Section 3D: Data Book Template WHO STEPS Surveillance
Table of Contents
Demographic Information Results................................................................................... 3

Tobacco Use ................................................................................................................... 8
Alcohol Consumption ................................................................................................... 21
Fruit and Vegetable Consumption ................................................................................. 30
Physical Activity........................................................................................................... 35
Blood Pressure and Diabetes History ............................................................................ 45
Physical Measurements................................................................................................. 53
Biochemical Measurements .......................................................................................... 61
Summary of Combined Risk Factors............................................................................. 65

Demographic Information Results
Age Description: Summary information by age group and sex of the respondents.
group by
sex Instrument question:
• Sex
• What is your date of birth?
Age group and sex of respondents

Age Group Men Women Both Sexes
(years) n % n % n %
25-34 719 30.8 1616 69.2 2335 44.9
35-44 459 34.7 862 65.3 1321 25.4
45-54 296 32.8 604 67.1 902 17.3
55-64 216 33.2 434 66.8 650 12.5
25-64 1690 32.5 3516 67.5 5206 100.0
Education Description: Mean number of years of education among respondents.
Instrument question:
• In total, how many years have you spent at school or in full-time study (excluding
pre-school)?
Mean number of years of education

(years) n Mean n Mean n Mean
25-34 706 7.2 1576 5.4 2282 6.0
35-44 451 6.0 830 4.0 1281 4.7
45-54 286 5.7 572 2.9 858 3.9
55-64 209 4.7 401 2.3 610 3.1
25-64 1652 6.3 3379 4.3 5031 4.9

Highest Description: Highest level of education achieved by the survey respondents.
level of
education Instrument question:
• What is the highest level of education you have completed?
Highest level of education

Age Men
Group % Secondary and
(years) n % None % Standard 1-5 %Standard 6-8
above
25-34 719 9.7 28.5 30.3 31.4
35-44 459 16.3 34.6 32.0 17.0
45-54 295 14.6 36.3 38.6 10.5
55-64 216 22.7 40.3 27.8 9.3
25-64 1689 14.0 33.0 31.9 21.0

Age Women
above
25-34 1615 19.3 34.6 29.2 17.0
35-44 862 30.4 37.9 24.2 7.4
45-54 604 43.0 34.4 19.7 2.8
55-64 433 49.7 36.0 12.2 2.1
25-64 3514 29.8 35.5 24.2 10.4

Age Both sexes
above
25-34 2334 16.3 32.7 29.5 21.5
35-44 1321 25.5 36.8 26.9 10.7
45-54 899 33.7 35.0 25.9 5.3
55-64 649 40.7 37.4 17.4 4.5
25-64 5203 24.7 34.7 26.7 13.8
Ethnicity Description: Summary results for the ethnicity of the respondents.
Instrument Question:
• What is your ethnic background?
Ethnic group of respondents

Age Group Both Sexes
(years) n % Chewa % Tumbuka % Ngoni % Yao % Other
25-34 2332 34.9 12.7 8.8 12.5 31.1
35-44 1319 35.6 12.4 9.1 13.0 29.8
45-54 898 36.2 11.4 8.4 11.4 32.7
55-64 649 36.8 10.6 6.6 13.3 32.7
25-64 5198 35.6 12.1 8.5 12.5 31.3

Martial Description: Marital status of survey respondents.
status
• What is your marital status?
Marital status
Men
Age
Group %
% Never % % %
(years) n Currently % Divorced
married Separated Widowed Cohabiting
married
25-34 716 10.1 85.2 3.1 1.4 0.3 0.0
35-44 459 3.1 90.8 3.9 1.1 0.9 0.2
45-54 296 0.7 87.5 4.4 4.7 2.7 0.0
55-64 216 1.4 86.6 5.1 2.8 3.7 0.5
25-64 1687 5.4 87.3 3.8 2.1 1.3 0.1
Marital status
Women
Age
Group %
% Never % % %
married
25-34 1613 3.4 74.1 9.8 9.0 3.5 0.2
35-44 860 1.0 68.0 8.0 10.1 12.3 0.5
45-54 604 0.7 59.1 8.1 12.3 19.9 0.0
55-64 434 0.5 46.1 5.8 11.1 36.6 0.0
25-64 3511 2.0 66.6 8.6 10.1 12.6 0.2
Marital status
Both Sexes
Age
Group %
% Never % % %
married
25-34 2329 5.5 77.5 7.7 6.7 2.5 0.1
35-44 1319 1.7 76.0 6.6 7.0 8.3 0.4
45-54 900 0.7 68.4 6.9 9.8 14.2 0.0
55-64 650 0.8 59.5 5.5 8.3 25.7 0.2
25-64 5198 3.1 73.3 7.0 7.5 8.9 0.2

Employment Description: Proportion of respondents in paid employment and those who are
status unpaid. Unpaid includes persons who are non-paid, students, homemakers,
retired, and unemployed.
• Which of the following best describes your main work status over the past 12
months?
Employment status
Men
Age Group % % Non-
(years) % Self-
n Government government % Unpaid
employed
employee employee
25-34 719 3.2 9.0 54.1 33.7
35-44 459 5.7 6.1 54.9 33.3
45-54 296 5.4 5.4 45.6 43.6
55-64 216 2.8 5.1 47.2 44.9
25-64 1690 4.2 7.1 52.0 36.7
Employment status
Women
Age Group % % Non-
(years) % Self-
employed
employee employee
25-34 1611 1.1 1.2 35.8 61.8
35-44 860 3.4 0.7 35.7 60.2
45-54 604 1.0 1.0 33.6 64.4
55-64 433 0.7 0.5 33.5 65.4
25-64 3508 1.6 1.0 35.1 62.3
Employment status
Both Sexes
Age Group % % Non-
(years) % Self-
employed
employee employee
25-34 2330 1.8 3.6 41.5 53.1
35-44 1319 4.2 2.6 42.4 50.9
45-54 900 2.4 2.4 37.6 57.6
55-64 649 1.4 2.0 38.1 58.6
25-64 5198 2.4 3.0 40.6 54.0

Unpaid Description: Proportion of respondents in unpaid work.
work and
unemployed Instrument question:
• Which of the following best describes your main work status over the past 12
months?
Unpaid work and unemployed

Men
Age
Group Unemployed
% Non- % Home-
(years) n % Student % Retired % Able to % Not able
paid maker
work to work
25-34 242 18.6 2.1 36.8 0.8 37.6 4.1
35-44 153 14.4 0.0 39.2 0.7 40.5 5.2
45-54 129 15.5 0.0 36.4 5.4 33.3 9.3
55-64 97 11.3 0.0 28.9 10.3 37.1 12.4
25-64 621 15.8 0.8 36.1 3.2 37.4 6.8

Women
Age
Group Unemployed
% Non- % Home-
paid maker
work to work
25-34 996 11.7 1.3 60.2 0.4 25.1 1.2
35-44 518 7.9 0.0 66.8 0.4 23.9 1.0
45-54 389 8.7 0.0 64.8 0.8 25.2 0.5
55-64 283 8.8 0.0 66.8 2.8 19.1 2.5
25-64 2186 9.9 0.6 63.4 0.8 24.1 1.2

Both Sexes
Age
Group Unemployed
% Non- % Home-
paid maker
work to work
25-34 1238 13.1 1.5 55.7 0.5 27.5 1.8
35-44 671 9.4 0.0 60.5 0.4 27.7 1.9
45-54 518 10.4 0.0 57.7 1.9 27.2 2.7
55-64 380 9.5 0.0 57.1 4.7 23.7 5.0
25-64 2807 11.2 0.6 57.4 1.3 27.0 2.4
Per Description: Mean reported per capita annual income of respondents in local
capita currency.
annual
income Instrument question:
• How many people older than 18 years, including yourself, live in your household?
• Taking the past year, can you tell me what the average earning of the household
has been?
Mean annual per capita
income
n Mean
2818 48,379.33

Tobacco Use
Current Description: Current smokers among all respondents.

smoking
Instrument questions:
• Have you ever smoked any tobacco products in your life?
• Do you currently smoke any tobacco products, such as cigarettes, cigars, or pipes?
Percentage of current smokers

Men Women Both Sexes
Age Group % % %
(years) n Current 95% CI n Current 95% CI n Current 95% CI
smoker smoker smoker
25-34 719 21.7 17.9-25.5 1616 0.4 0.1-0.8 2335 11.2 9.2-13.2
35-44 459 28.2 24.0-32.5 862 2.3 1.2-3.4 1321 15.0 12.7-17.3
45-54 296 30.6 25.2-36.0 604 6.3 3.7-8.9 900 17.5 14.5-20.5
55-64 216 31.3 25.0-37.5 434 8.4 4.8-11.9 650 18.9 15.4-22.3
25-64 1690 25.9 23.3-28.5 3516 2.9 2.1-3.8 5206 14.1 12.7-15.6

Smoking Description: Smoking status of all respondents.
Status
• Do you currently smoke tobacco products daily?
Smoking status
Men
Age Group Current smoker
(years) % Does
n % Non- 95% CI
% Daily 95% CI 95% CI not smoke
daily
25-34 719 18.1 14.7-21.6 3.6 2.2-4.9 78.3 74.5-82.1
35-44 459 24.9 20.9-28.9 3.3 1.7-5.0 71.8 67.5-76.0
45-54 296 28.4 23.3-33.6 2.1 0.6-3.7 69.4 64.0-74.8
55-64 216 29.9 23.5-36.3 1.4 0.0-2.9 68.7 62.5-75.0
25-64 1690 22.8 20.5-25.2 3.0 2.2-3.9 74.1 71.5-76.7
Smoking status
Women
(years) % Does
n % Non- 95% CI
daily
25-34 1616 0.1 0.0-0.3 0.3 0.0-0.5 99.6 99.2-99.9
35-44 862 1.8 0.9-2.8 0.4 0.0-0.9 97.7 96.6-98.8
45-54 604 5.2 2.9-7.5 1.1 0.2-2.1 93.7 91.1-96.3
55-64 434 7.7 4.5-10.9 0.7 0.0-1.5 91.6 88.1-95.2
25-64 3516 2.4 1.7-3.2 0.5 0.3-0.8 97.1 96.2-97.9
Smoking status
Both Sexes
(years) % Does
n % Non- 95% CI
daily
25-34 2335 9.2 7.4-11.0 2.0 1.3-2.6 88.8 86.8-90.8
35-44 1321 13.1 10.9-15.3 1.8 1.0-2.7 85.0 82.7-87.3
45-54 900 15.9 13.0-18.7 1.6 0.7-2.5 82.5 79.5-85.5
55-64 650 17.9 14.4-21.3 1.0 0.2-1.8 81.1 77.7-84.6
25-64 5206 12.4 11.0-13.7 1.8 1.3-2.2 85.9 84.4-87.3

Smoking Description: Smoking status of all respondents.
Status
Smoking status
Men
Age Group Ever Smoked
(years) % Current % Never
n % Past 95% CI
smoker 95% CI 95% CI smoked
smoker
(daily + non daily)
25-34 719 21.7 17.9-25.5 9.4 7.4-11.4 68.9 65.0-72.7
35-44 459 28.2 24.0-32.5 9.3 6.2-12.4 62.5 57.7-67.2
45-54 296 30.6 25.2-36.0 14.7 11.0-18.4 54.8 48.8-60.7
55-64 216 31.3 25.0-37.5 21.1 15.7-26.5 47.7 40.5-54.9
25-64 1690 25.9 23.3-28.5 11.5 10.0-13.1 62.6 59.7-65.5
Smoking status
Women
n % Past 95% CI
smoker
(daily + non daily)
25-34 1616 0.4 0.1-0.8 1.0 0.4-1.6 98.6 97.9-99.2
35-44 862 2.3 1.2-3.4 3.1 1.9-4.3 94.6 92.9-96.3
45-54 604 6.3 3.7-8.9 7.8 5.5-10.2 85.9 82.5-89.3
55-64 434 8.4 4.8-11.9 14.7 10.9-18.5 76.9 72.2-81.6
25-64 3516 2.9 2.1-3.8 4.5 3.6-5.4 92.6 91.3-93.9
Smoking status
Both Sexes
n % Past 95% CI
smoker
(daily + non daily)
25-34 2335 11.2 9.2-13.2 5.3 4.1-6.4 83.6 81.4-85.7
35-44 1321 15.0 12.7-17.3 6.1 4.5-7.8 78.9 76.2-81.6
45-54 900 17.5 14.5-20.5 11.0 8.8-13.2 71.5 68.1-75.0
55-64 650 18.9 15.4-22.3 17.6 14.2-21.1 63.5 58.9-68.1
25-64 5206 14.1 12.7-15.6 7.9 7.0-8.9 77.9 76.2-79.7

Frequency Description: Percentage of current daily smokers among smokers.
of
smoking Instrument question:
• Do you currently smoke any tobacco products, such as cigarettes, cigars, or
pipes?
Current daily smokers among smokers
Age Group
(years) % Daily % Daily % Daily
n 95% CI n 95% CI n 95% CI
smokers smokers smokers
25-34 155 83.5 77.9-89.1 7 31.7 0.6-62.9 162 82.5 77.0-88.0
35-44 131 88.2 82.7-93.7 18 81.7 63.2-100.0 149 87.7 82.4-92.9
45-54 91 93.0 88.0-98.0 38 82.2 68.6-95.8 129 90.9 86.1-95.7
55-64 68 95.6 90.7-100.0 37 91.8 83.4-100.0 105 94.7 90.4-99.0
25-64 445 88.2 85.2-91.2 100 82.3 74.5-90.1 545 87.6 84.7-90.5
Initiation Description: Mean age of initiation and mean duration of smoking, in years, among
of daily smokers (no total age group for mean duration of smoking as age influences
smoking these values).
• How old were you when you first started smoking daily?
• Do you remember how long ago it was?
Mean age started smoking
Age Group
(years) Mean Mean Mean
n 95% CI n 95% CI n 95% CI
age age age
25-34 120 20.0 19.0-21.0 0 -- -- 120 20.0 19.0-21.0
35-44 104 22.2 20.9-23.5 13 24.6 19.8-29.4 117 22.4 21.1-23.6
45-54 74 24.1 22.0-26.1 23 26.5 20.5-32.4 97 24.4 22.6-26.3
55-64 50 23.8 20.6-27.0 24 22.6 18.2-27.1 74 23.6 20.9-26.2
25-64 348 21.9 21.2-22.7 60 24.6 21.5-27.7 408 22.1 21.4-22.9
Mean duration of smoking

Age Group
n 95% CI n 95% CI n 95% CI
duration duration duration
25-34 120 9.0 8.0-10.0 0 -- -- 120 9.0 8.0-10.0
35-44 104 16.7 15.4-18.1 13 16.9 12.0-21.8 117 16.7 15.4-18.0
45-54 74 24.9 22.8-26.9 23 23.8 17.8-29.7 97 24.7 22.9-26.5
55-64 50 35.7 32.8-38.7 24 37.2 32.5-42.0 74 36.1 33.5-38.6
25-64 348 17.7 16.5-19.0 60 27.4 23.5-31.2 408 18.5 17.3-19.8

Manufactured Description: Percentage of smokers who use manufactured cigarettes among
cigarette daily smokers.
smokers
• On average, how many of the following do you smoke each day?
Manufactured cigarette smokers among daily smokers

% % %
Age Group Manu- Manu- Manu-
(years) n factured 95% CI n factured 95% CI n factured 95% CI
cigarette cigarette cigarette
smoker smoker smoker
25-34 129 65.5 56.1-74.8 2 100.0 100.0-100.0 131 65.7 56.4-75.0
35-44 116 48.4 38.3-58.6 15 7.0 0.0-20.6 131 45.5 35.7-55.2
45-54 84 34.1 23.6-44.6 31 16.4 4.5-28.2 115 31.0 22.1-39.8
55-64 65 34.2 23.2-45.2 34 11.3 1.4-21.1 99 28.8 20.2-37.4
25-64 394 49.9 43.3-56.4 82 14.6 7.8-21.4 476 46.4 40.3-52.4

Amount Description: Mean amount of tobacco used by daily smokers per day, by type.
of
tobacco Instrument question:
used • On average, how many of the following do you smoke each day?
among
smokers
by type
Mean amount of tobacco used by daily smokers by type

Men
Age Mean # Mean # Mean #
Group Mean #of
of manu- 95% 95% of pipes 95% of other 95%
(years) n n hand- n n
factured CI CI of CI type of CI
rolled cig.
cig. tobacco tobacco
25-34 119 2.9 2.4-3.5 119 3.8 2.5-5.0 115 0.5 0.0-1.3 115 1.4 0.0-3.2
35-44 103 3.0 2.1-3.8 109 6.1 4.7-7.6 102 0.1 0.0-0.2 103 0.2 0.0-0.4
45-54 69 2.8 1.3-4.4 69 6.5 4.3-8.8 69 0.1 0.0-0.3 71 1.1 0.0-2.6
55-64 54 3.4 1.0-5.8 57 5.5 3.9-7.1 53 1.3 0.0-3.6 56 2.6 0.0-6.8
25-64 345 3.0 2.5-3.5 354 5.2 4.3-6.1 339 0.4 0.0-0.8 345 1.2 0.2-2.1

Women
Group Mean #of
rolled cig.
25-34 2 2.5 1.8-3.2 2 0.0 -- 2 0.0 -- 2 0.0 --
35-44 14 1.5 0.0-4.4 15 2.8 0.9-4.6 14 0.0 -- 14 1.7 0.0-3.7
45-54 24 0.9 0.0-1.8 26 4.6 0.9-8.3 23 0.0 0.0-0.1 26 3.4 0.0-8.1
55-64 27 2.1 0.0-5.4 28 2.5 1.6-3.5 28 1.7 0.0-4.9 28 3.7 0.0-7.7
25-64 67 1.5 0.1-3.0 71 3.3 1.7-5.0 67 0.7 0.0-2.0 70 3.0 0.0-6.3

Both Sexes
Group Mean #of
rolled cig.
25-34 121 2.9 2.4-3.4 121 3.7 2.5-5.0 117 0.5 0.0-1.3 117 1.4 0.0-3.1
35-44 117 2.9 2.0-3.7 124 5.9 4.5-7.3 116 0.1 0.0-0.2 117 0.3 0.1-0.5
45-54 93 2.5 1.2-3.8 95 6.2 4.2-8.1 92 0.1 0.0-0.3 97 1.5 0.0-3.0
55-64 81 3.1 1.1-5.1 85 4.8 3.5-6.1 81 1.4 0.0-3.3 84 2.8 0.0-6.2
25-64 412 2.8 2.4-3.3 425 5.0 4.2-5.8 406 0.4 0.0-0.9 415 1.3 0.4-2.3

Percentage Description: Percentage of ex-daily smokers among all respondents and the mean
of ex daily duration, in years, since ex-daily smokers quit smoking daily.
smokers in
the Instrument question:
population • In the past did you ever smoke daily?
• How old were you when you stopped smoking daily?
Ex-daily smokers among all respondents
Age Group % ex % ex % ex
(years) n daily 95% CI n daily 95% CI n daily 95% CI
smokers smokers smokers
25-34 719 4.9 3.2-6.6 1616 0.5 0.1-0.8 2335 2.7 1.8-3.6
35-44 459 6.7 4.6-8.9 862 0.9 0.3-1.5 1321 3.8 2.6-4.9
45-54 296 11.1 7.5-14.6 604 3.4 1.8-4.9 900 6.9 5.0-8.8
55-64 216 13.6 9.3-17.9 434 5.9 3.5-8.3 650 9.4 7.0-11.8
25-64 1690 7.3 6.1-8.5 3516 1.8 1.3-2.3 5206 4.5 3.8-5.2
Mean years since cessation

Age Group
n 95% CI n 95% CI n 95% CI
years years years
25-34 36 4.6 3.4-5.7 7 10.9 6.0-15.9 43 5.1 4.0-6.2
35-44 30 8.6 5.9-11.3 8 8.0 0.8-15.1 38 8.5 6.1-10.9
45-54 32 10.9 8.1-13.6 19 6.2 1.5-10.9 51 9.7 7.4-12.0
55-64 30 15.5 10.3-20.6 21 14.8 8.6-21.0 51 15.3 11.1-19.5
25-64 128 9.3 7.6-11.0 55 10.3 7.2-13.4 183 9.5 8.0-11.0

Current Description: Percentage of current users of smokeless tobacco among all
Users of respondents.
smokeless
• Do you currently use any smokeless tobacco such as snuff or chewing tobacco?
Current users of smokeless tobacco

Age Group % % %
users users users
25-34 719 0.4 0.0-0.8 1616 0.8 0.3-1.3 2335 0.6 0.2-0.9
35-44 459 1.1 0.1-2.0 862 3.7 2.2-5.2 1321 2.4 1.5-3.3
45-54 296 4.5 2.4-6.7 604 9.9 7.1-12.7 900 7.4 5.4-9.5
55-64 216 6.7 3.2-10.1 434 15.4 12.0-18.8 650 11.4 8.8-14.0
25-64 1690 1.9 1.2-2.7 3516 5.0 4.0-6.0 5206 3.5 2.8-4.2

Smokeless Description: Status of using smokeless tobacco among all respondents.
tobacco
use Instrument questions:
• Do you currently use any smokeless tobacco such as snuff or chewing tobacco?
• Do you currently use smokeless tobacco products daily?
Smokeless tobacco use

Men
Age Group Current user % Does
(years) not use
n % Non- 95% CI
% Daily 95% CI 95% CI smokeless
daily
tobacco
25-34 719 0.0 0.0-0.0 0.4 0.0-0.8 99.6 99.2-100.0
35-44 459 0.4 0.0-1.0 0.7 0.0-1.4 98.9 98.0-99.9
45-54 296 3.2 1.3-5.1 1.3 0.0-2.6 95.5 93.3-97.6
55-64 216 6.2 2.9-9.5 0.5 0.0-1.4 93.3 89.9-96.8
25-64 1690 1.3 0.8-1.8 0.6 0.2-1.0 98.1 97.3-98.8

Women
(years) not use
n % Non- 95% CI
daily
tobacco
25-34 1616 0.6 0.2-1.0 0.2 0.0-0.4 99.2 98.7-99.8
35-44 862 2.6 1.3-3.8 1.1 0.4-1.8 96.3 94.8-97.8
45-54 604 8.4 5.9-10.9 1.5 0.5-2.5 90.1 87.3-92.9
55-64 434 14.7 11.3-18.0 0.7 0.0-1.6 84.6 81.2-88.0
25-64 3516 4.3 3.3-5.2 0.7 0.4-1.0 95.0 94.0-96.0

Both Sexes
(years) not use
n % Non- 95% CI
daily
tobacco
25-34 2335 0.3 0.1-0.5 0.3 0.0-0.6 99.4 99.1-99.8
35-44 1321 1.5 0.8-2.2 0.9 0.4-1.4 97.6 96.7-98.5
45-54 900 6.0 4.2-7.8 1.4 0.6-2.3 92.6 90.5-94.6
55-64 650 10.8 8.3-13.3 0.6 0.0-1.2 88.6 86.0-91.2
25-64 5206 2.8 2.2-3.4 0.7 0.4-0.9 96.5 95.8-97.2

Percentage Description: Percentage of ex-daily users of smokeless tobacco among all
of ex daily respondents.
users of
smokeless Instrument question:
tobacco in
• In the past, did you ever use smokeless tobacco such as snuff or chewing
the
population
tobacco?
Ex-daily smokeless tobacco users

Age Group % Ex % Ex % Ex
(years) n daily 95% CI n daily 95% CI n daily 95% CI
users users users
25-34 719 1.7 0.7-2.8 1616 0.4 0.0-0.7 2335 1.1 0.5-1.7
35-44 459 1.0 0.0-1.9 862 1.2 0.4-2.1 1321 1.1 0.5-1.8
45-54 296 2.5 0.6-4.3 604 2.5 1.3-3.8 900 2.5 1.4-3.6
55-64 216 2.3 0.3-4.3 434 3.3 1.6-4.9 650 2.8 1.6-4.1
25-64 1690 1.7 1.0-2.5 3516 1.3 0.9-1.8 5206 1.5 1.1-2.0

Frequency Description: Mean times per day smokeless tobacco used by smokeless tobacco
of users per day, by type.
smokeless
use among
• On average, how many times a day do you use…?
users by
type
Mean times per day smokeless tobacco used by daily smokeless tobacco users by type
Age Men
Group Snuff by Snuff by Chewing
(years) n 95% CI n 95% CI n 95% CI
mouth nose tobacco
25-34 0 -- -- 0 -- -- 0 -- --
35-44 2 3.0 -- 2 1.5 -- 2 0.0 --
45-54 10 0.7 -- 8 4.5 -- 10 0.0 --
55-64 13 0.3 -- 13 5.1 -- 13 0.0 --
25-64 25 0.7 -- 23 4.6 -- 25 0.0 --
Age Women
mouth nose tobacco
25-34 10 1.3 0.2-2.5 10 1.0 0.0-2.0 10 0.5 0.0-1.5
35-44 18 2.8 1.3-4.3 16 0.8 0.0-1.9 20 1.6 0.4-2.9
45-54 45 1.9 1.1-2.8 43 2.8 0.0-5.9 40 1.7 0.5-3.0
55-64 56 3.4 1.0-5.7 54 4.1 1.9-6.3 56 1.5 0.0-3.3
25-64 129 2.6 1.6-3.7 123 3.0 1.0-5.0 126 1.5 0.6-2.5
Age Both Sexes
mouth nose tobacco
25-34 10 1.3 0.2-2.4 10 1.0 0.0-2.0 10 0.5 0.0-1.5
35-44 20 2.8 1.4-4.2 18 0.9 0.0-1.9 22 1.4 0.3-2.5
45-54 55 1.6 0.8-2.3 51 3.2 0.9-5.6 50 1.2 0.3-2.2
55-64 69 2.5 0.8-4.3 67 4.4 2.7-6.1 69 1.1 0.0-2.4
25-64 154 2.1 1.3-3.0 146 3.3 1.8-4.9 151 1.2 0.5-1.9

Current Description: Percentage of daily and current (daily plus non-daily) tobacco users,
tobacco includes smoking and smokeless, among all respondents.
users
• Do you currently use smokeless tobacco products daily?
Daily tobacco users

Age Group % % %
(years) n Daily 95% CI n Daily 95% CI n Daily 95% CI
users users users
25-34 719 18.1 14.7-21.6 1616 0.7 0.3-1.2 2335 9.5 7.7-11.4
35-44 459 25.1 21.1-29.2 862 3.9 2.2-5.6 1321 14.3 12.0-16.5
45-54 296 30.7 25.4-36.1 604 11.4 8.1-14.6 900 20.3 17.1-23.5
55-64 216 34.7 28.5-41.0 434 18.9 14.9-22.9 650 26.2 22.5-29.8
25-64 1690 23.8 21.4-26.2 3516 5.7 4.5-6.9 5206 14.5 13.1-16.0
Current tobacco users

Age Group % % %
users users users
25-34 719 22.0 18.2-25.8 1616 1.2 0.6-1.8 2335 11.7 9.6-13.8
35-44 459 28.7 24.3-33.0 862 5.2 3.2-7.1 1321 16.7 14.3-19.1
45-54 296 33.2 27.7-38.8 604 13.8 10.3-17.3 900 22.8 19.4-26.2
55-64 216 36.6 30.4-42.8 434 19.8 15.8-23.8 650 27.5 23.8-31.2
25-64 1690 27.1 24.4-29.8 3516 6.8 5.5-8.1 5206 16.7 15.1-18.3

Exposure Description: Percentage of respondents exposed to environmental tobacco smoke in
to ETS in the home on one or more days in the past 7 days.
home in
past 7 days Instrument question:
• In the past 7 days, how many days did someone in the house smoke when you
were present?
Exposed to ETS in home on 1 or more of the past 7 days

Age Group
(years) % % %
n 95% CI n 95% CI n 95% CI
Exposed Exposed Exposed
25-34 598 20.2 16.7-23.7 1393 19.5 16.6-22.5 1991 19.9 17.3-22.5
35-44 399 24.7 20.2-29.2 755 23.1 19.4-26.7 1154 23.9 20.7-27.0
45-54 246 24.3 18.6-30.0 511 24.0 19.7-28.3 757 24.1 20.3-27.9
55-64 189 28.2 21.4-35.0 388 21.3 16.8-25.9 577 24.4 20.0-28.9
25-64 1432 23.0 20.1-25.9 3047 21.4 19.0-23.8 4479 22.2 19.9-24.4
Exposure Description: Percentage of respondents exposed to environmental tobacco smoke in

to ETS in the workplace on one or more days in the past 7 days.
the
workplace Instrument question:
in past 7
• In the past 7 days, how many days did someone smoke in closed areas in your
days
workplace (in the building, in a work area or a specific office) when you were
present?
Exposed to ETS in the workplace on 1 or more of the past 7 days

Age Group
(years) % % %
n 95% CI n 95% CI n 95% CI
Exposed Exposed Exposed
25-34 509 32.0 27.1-36.9 1154 15.4 12.2-18.7 1663 23.7 20.3-27.2
35-44 338 37.9 31.8-44.1 600 17.4 13.8-21.1 938 27.8 23.6-31.9
45-54 205 34.3 26.7-41.8 396 18.7 13.9-23.6 601 26.1 21.1-31.1
55-64 146 33.4 25.2-41.6 301 19.2 14.5-23.9 447 25.6 20.4-30.7
25-64 1198 34.1 30.0-38.1 2451 17.0 14.3-19.7 3649 25.4 22.4-28.3

Alcohol Consumption
Alcohol Description: Alcohol consumption status of all respondents.

consumption
status Instrument questions:
• Have you ever consumed an alcoholic drink such as …?
• Have you consumed an alcoholic drink in the past 12 months?
• Have you consumed an alcoholic drink in the past 30 days?
Alcohol consumption status

Men
Age Group % Current % Drank in % Past
%
(years) drinker past 12 12
n 95% CI 95% CI 95% CI Lifetime 95% CI
(past 30 months, months
abstainer
days) not current abstainer
25-34 719 27.4 23.8-30.9 8.8 6.5-11.0 15.1 12.1-18.2 48.7 44.6-52.9
35-44 459 34.5 29.0-40.0 5.8 3.7-7.8 12.3 9.5-15.2 47.4 41.7-53.1
45-54 296 33.7 28.0-39.4 5.5 2.8-8.2 16.9 12.5-21.3 43.9 37.3-50.6
55-64 216 27.0 20.7-33.3 6.4 3.1-9.7 19.8 14.5-25.2 46.8 39.8-53.7
25-64 1690 30.1 27.2-33.1 7.2 5.8-8.6 15.2 13.1-17.3 47.4 43.9-50.9

Women
%
abstainer
25-34 1616 2.2 1.4-3.1 1.8 1.1-2.4 4.4 3.3-5.6 91.6 90.1-93.0
35-44 862 4.4 2.7-6.0 1.9 1.0-2.8 4.6 3.2-6.1 89.1 86.7-91.5
45-54 604 6.4 4.3-8.6 1.8 0.7-2.8 8.1 5.8-10.3 83.7 80.3-87.2
55-64 434 7.6 5.0-10.1 3.3 1.7-4.9 11.1 7.4-14.8 78.0 73.0-83.1
25-64 3516 4.2 3.2-5.2 2.0 1.5-2.5 6.0 5.0-7.0 87.8 86.1-89.6

Both Sexes
%
abstainer
25-34 2335 14.9 13.0-16.8 5.3 4.1-6.5 9.9 8.1-11.6 69.9 67.5-72.3
35-44 1321 19.1 15.8-22.5 3.8 2.6-5.0 8.4 6.8-10.0 68.7 65.0-72.3
45-54 900 19.0 15.7-22.3 3.5 2.1-4.9 12.1 9.7-14.6 65.4 61.2-69.6
55-64 650 16.5 13.2-19.8 4.7 3.0-6.5 15.1 11.7-18.5 63.7 59.2-68.2
25-64 5206 16.9 15.1-18.7 4.5 3.8-5.3 10.5 9.3-11.7 68.1 65.8-70.4

Frequency Description: Frequency of alcohol consumption in the past 12 months among
of alcohol those respondents who have drank in the last 12 months.
consumption
• During the past 12 months, how frequently have you had at least one alcoholic
drink?
Frequency of alcohol consumption in the past 12 months

Men
Age
Group % 5-6 % 1-4 % 1-3 %
%
(years) n 95% CI days p. 95% CI days p. 95% CI days p. 95% CI < once a 95% CI
Daily
week week month month
25-34 256 3.8 1.5-6.0 5.7 2.6-8.7 30.8 25.1-36.6 34.6 28.2-41.0 25.1 19.1-31.1
35-44 186 15.1 9.8-20.3 5.0 1.4-8.5 45.2 37.5-53.0 22.5 16.0-29.0 12.2 7.8-16.7
45-54 114 12.9 6.5-19.2 1.8 0.0-4.3 35.7 27.6-43.9 27.3 19.4-35.3 22.3 14.8-29.7
55-64 72 14.9 5.9-23.8 7.8 1.6-14.1 34.0 21.1-46.9 17.7 6.9-28.4 25.6 13.7-37.6
25-64 628 9.5 6.9-12.2 5.0 3.0-7.0 35.9 32.0-39.9 28.4 24.2-32.5 21.2 17.6-24.7

Women
Age
Group % 5-6 % 1-4 % 1-3 %
%
Daily
25-34 65 5.0 0.0-10.2 3.1 0.0-7.1 23.3 11.6-35.1 25.8 12.3-39.4 42.8 29.1-56.5
35-44 52 10.0 0.6-19.4 6.1 0.0-12.8 23.2 11.7-34.6 30.9 19.1-42.7 29.9 16.0-43.7
45-54 48 17.8 4.5-31.1 0.0 0.0-0.0 24.8 10.4-39.3 30.7 15.1-46.3 26.7 12.8-40.6
55-64 47 6.6 0.0-15.6 6.1 0.0-12.8 23.9 11.5-36.3 31.3 17.1-45.4 32.2 19.3-45.0
25-64 212 9.7 3.2-16.1 3.8 1.1-6.4 23.8 16.6-30.9 29.5 22.9-36.1 33.3 26.1-40.5

Both Sexes
Age
Group % 5-6 % 1-4 % 1-3 %
%
Daily
25-34 321 3.9 1.8-6.0 5.4 2.6-8.2 30.1 24.9-35.3 33.8 27.8-39.7 26.8 21.2-32.4
35-44 238 14.4 9.4-19.3 5.1 1.9-8.3 42.2 35.5-48.9 23.7 17.6-29.7 14.7 10.2-19.1
45-54 162 13.8 7.5-20.2 1.5 0.0-3.5 33.6 26.5-40.8 28.0 20.9-35.0 23.1 16.4-29.8
55-64 119 12.6 5.1-20.0 7.3 2.1-12.5 31.2 21.5-40.9 21.5 12.9-30.0 27.5 18.4-36.5
25-64 840 9.6 6.7-12.4 4.8 3.1-6.6 34.1 30.6-37.6 28.5 24.7-32.4 22.9 19.7-26.2

Drinking Description: Mean number of occasions with at least one drink in the past 30 days
occasions among current (past 30 days) drinkers.
in the
past 30 Instrument question:
days
• During the past 30 days, on how many occasions did you have at least one
alcoholic drink?
Mean number of drinking occasions in the past 30 days among current (past 30 days) drinkers
(years) n Mean 95% CI n Mean 95% CI n Mean 95% CI
25-34 171 3.8 3.1-4.5 32 4.0 0.8-7.3 203 3.8 3.1-4.5
35-44 139 7.6 6.0-9.3 33 4.0 2.8-5.2 172 7.2 5.7-8.7
45-54 80 7.2 4.0-10.4 31 5.1 2.0-8.2 111 6.8 4.1-9.5
55-64 47 9.0 5.9-12.2 28 4.1 1.4-6.8 75 7.7 5.0-10.5
25-64 437 6.0 5.1-6.9 124 4.3 3.0-5.6 561 5.8 4.9-6.6
Standard Description: Mean number of standard drinks consumed on a drinking occasion

drinks among current (past 30 days) drinker.
per
drinking Instrument question:
day
• During the past 30 days, when you drank alcohol, on average, how many standard
alcoholic drinks did you have during one occasion?
Mean number of standard drinks per drinking occasion among current (past 30 days) drinkers
25-34 157 4.5 3.6-5.3 32 3.0 0.3-5.8 189 4.3 3.5-5.2
35-44 129 5.4 4.0-6.7 31 2.8 1.9-3.6 160 5.1 3.8-6.3
45-54 74 4.9 3.4-6.4 33 2.2 1.4-2.9 107 4.3 3.1-5.5
55-64 48 3.5 2.2-4.7 26 2.5 1.6-3.3 74 3.2 2.3-4.2
25-64 408 4.7 4.1-5.3 122 2.6 1.8-3.4 530 4.4 3.9-5.0

Average Description: Percentage of respondents engaging in category II and category III
volume drinking.
drinking Category III is defined as drinking ≥60g of pure alcohol on average per day for
categories men and ≥40 g for women.
among all Category II is defined as drinking 40-59.9g of pure alcohol on average per day for
respondents
men and 20-39.9g for women.
A standard drink contains approximately 10g of pure alcohol.
alcoholic drink?
• During the past 30 days, when you drank alcohol, on average, how many
standard alcoholic drinks did you have during one occasion?
Category III drinking among all respondents

Age Group % % %
(years) n Category 95% CI n Category 95% CI n Category 95% CI
III III III
25-34 676 0.6 0.0-1.2 1612 0.1 0.0-0.2 2288 0.3 0.0-0.6
35-44 422 1.4 0.1-2.7 856 0.0 0.0-0.0 1278 0.7 0.1-1.3
45-54 268 1.2 0.0-2.6 596 0.1 0.0-0.4 864 0.6 0.0-1.3
55-64 202 1.4 0.0-2.9 426 0.2 0.0-0.5 628 0.7 0.0-1.5
25-64 1568 1.0 0.4-1.5 3490 0.1 0.0-0.2 5058 0.5 0.2-0.8
Category II drinking among all respondents

Age Group % % %
(years) n Category 95% CI n Category 95% CI n Category 95% CI
II II II
25-34 676 0.3 0.0-0.8 1612 0.0 0.0-0.0 2288 0.2 0.0-0.4
35-44 422 1.2 0.1-2.2 856 0.2 0.0-0.5 1278 0.6 0.1-1.2
45-54 268 0.8 0.0-2.0 596 0.3 0.0-0.8 864 0.5 0.0-1.1
55-64 202 1.1 0.0-2.6 426 0.0 0.0-0.0 628 0.5 0.0-1.2
25-64 1568 0.7 0.3-1.1 3490 0.1 0.0-0.2 5058 0.4 0.2-0.6

Average Description: Percentage of current (last 30 days) drinker engaging in category I,
volume category II and category III drinking.
drinking Category III is defined as drinking ≥60g of pure alcohol on average per day for men
categories and ≥40 g for women.
among Category II is defined as drinking 40-59.9g of pure alcohol on average per day for
current
men and 20-39.9g for women.
(past 30
days) Category I is defined as drinking <40g of pure alcohol on average per day for men
drinkers and <20 for women.
A standard drink contains approximately 10g of pure alcohol.
alcoholic drink?
• During the past 30 days, when you drank alcohol, on average, how many
standard alcoholic drinks did you have during one occasion?
Category I, II and III drinking among current (past 30 days) drinkers

Men
Age Group % % %
(years) n Category 95% CI Category 95% CI Category 95% CI
III II I
25-34 153 2.7 0.0-5.3 1.5 0.0-3.6 95.8 92.6-99.1
35-44 123 4.9 0.8-9.0 4.0 0.6-7.4 91.1 85.2-97.0
45-54 70 4.6 0.0-9.8 3.1 0.0-7.5 92.3 85.7-98.9
55-64 44 6.2 0.0-13.3 5.0 0.0-11.9 88.8 79.1-98.5
25-64 390 4.0 1.9-6.1 2.9 1.2-4.5 93.2 90.5-95.8

Women
Age Group % % %
III II I
25-34 32 3.3 0.0-10.1 0.0 0.0-0.0 96.7 89.9-100.0
35-44 31 0.0 0.0-0.0 5.2 0.0-12.6 94.8 87.4-100.0
45-54 30 2.8 0.0-8.3 6.2 0.0-14.3 91.0 78.7-100.0
55-64 25 3.1 0.0-9.3 0.0 0.0-0.0 96.9 90.7-100.0
25-64 118 2.3 0.0-4.9 3.0 0.2-5.9 94.7 90.4-99.0

Both Sexes
Age Group % % %
III II I
25-34 185 2.7 0.3-5.1 1.4 0.0-3.3 95.9 92.9-98.9
35-44 154 4.3 0.6-7.9 4.2 0.8-7.5 91.6 85.9-97.2
45-54 100 4.3 0.0-8.5 3.7 0.0-7.5 92.0 85.9-98.2
55-64 69 5.4 0.0-11.6 3.7 0.0-8.9 90.8 83.0-98.7
25-64 508 3.8 1.9-5.6 2.9 1.4-4.4 93.4 90.9-95.8

Largest Description: Largest number of drinks consumed during a single occasion in the past
number 30 days among current (past 30 days) drinker).
of drinks
in the Instrument question:
past 30
• During the past 30 days what was the largest number of standard alcoholic drinks
days
you had on a single occasion, counting all types of alcoholic drinks together?
Mean maximum number of drinks consumed on one occasion in the past 30 days
Age Group Mean Mean Mean
(years) n maximum 95% CI n maximum 95% CI n maximum 95% CI
number number number
25-34 156 5.3 4.5-6.1 32 3.4 0.6-6.2 188 5.1 4.4-5.9
35-44 132 5.8 4.5-7.1 30 2.8 1.9-3.7 162 5.4 4.3-6.6
45-54 72 6.8 4.9-8.6 33 2.2 1.6-2.8 105 5.8 4.4-7.2
55-64 47 3.7 3.0-4.4 25 3.1 2.0-4.3 72 3.5 2.9-4.1
25-64 407 5.5 4.9-6.2 120 2.8 2.0-3.7 527 5.2 4.6-5.7

Five/four Description: Percentage of men who had five or more/women who had four or more
or more drinks on any day in the past 30 days during a single occasion among the total
drinks on population.
a single
occasion Instrument question:
• During the past 30 days, how many times did you have
for men: five or more
for women: four or more
standard alcoholic drinks in a single drinking occasion?
Five/four or more drinks on a single occasion at least once during the past 30
days among total population
Men Women
Age Group
(years) % ≥ 5 % ≥4
n 95% CI n 95% CI
drinks drinks
25-34 719 16.7 13.7-19.8 1616 1.1 0.6-1.6
35-44 459 22.0 17.7-26.3 862 2.5 1.2-3.8
45-54 296 21.6 16.3-27.0 604 3.7 2.1-5.3
55-64 216 18.1 12.2-24.0 434 4.6 2.4-6.8
25-64 1690 19.0 16.5-21.5 3516 2.3 1.6-3.1
Five/four Description: Mean number of times in the past 30 days on which current (past 30
or more days) drinker drank five (for men)/four (for women) or more drinks during a single
drinks on occasion among current (past 30 days) drinkers.
a single
occasion Instrument question:
• During the past 30 days, how many times did you have
for men: five or more
for women: four or more
standard alcoholic drinks in a single drinking occasion?
Mean number of times with five/four or more drinks during a single occasion
in the past 30 days among current drinkers
Men Women
Age Group Mean Mean
(years) n number 95% CI n number 95% CI
of times of times
25-34 162 2.5 2.0-3.0 33 1.0 0.6-1.5
35-44 141 3.6 2.8-4.5 32 1.6 1.0-2.3
45-54 81 3.1 2.2-3.9 36 2.2 0.9-3.5
55-64 48 4.4 2.4-6.5 28 1.8 0.9-2.6
25-64 432 3.1 2.7-3.6 129 1.7 1.1-2.3

Drinking Description: Percentage of current (past 30 days) drinkers who usually, sometimes,
with rarely or never drink with meals.
meals
• During the past 30 days, when you consumed an alcoholic drink, how often was it
with meals? Please do not count snacks.
Drinking with meals among current drinker

Men
Age Group % % Rarely % Never
(years) % Usually
n 95% CI Sometimes 95% CI with 95% CI with 95% CI
with meals
with meals meals meals
25-34 196 62.0 55.2-68.7 21.5 15.8-27.2 5.4 1.7-9.2 11.1 6.1-16.0
35-44 160 60.7 53.3-68.0 24.2 18.5-29.9 8.4 4.2-12.7 6.7 2.4-11.0
45-54 98 56.0 45.0-67.0 23.6 14.6-32.6 8.6 3.0-14.1 11.9 5.6-18.2
55-64 58 62.4 50.7-74.2 25.3 14.9-35.8 3.5 0.0-8.3 8.7 1.2-16.2
25-64 512 60.5 56.1-65.0 23.0 19.5-26.6 6.7 4.3-9.1 9.7 6.8-12.7

Men
(years) % Usually
with meals
25-34 36 68.4 53.4-83.4 22.8 8.7-36.9 3.2 0.0-9.3 5.7 0.0-13.5
35-44 37 61.5 43.9-79.1 24.0 9.8-38.1 0.0 0.0-0.0 14.5 0.3-28.8
45-54 38 62.3 45.9-78.8 22.7 9.8-35.6 8.9 0.0-18.6 6.1 0.0-14.1
55-64 33 53.0 34.5-71.6 18.0 4.6-31.4 8.8 0.0-18.7 20.3 5.3-35.2
25-64 144 61.5 51.6-71.4 22.0 14.9-29.0 5.2 1.4-8.9 11.4 4.6-18.2

Men
(years) % Usually
with meals
25-34 232 62.4 56.0-68.9 21.6 16.1-27.2 5.3 1.8-8.8 10.7 5.9-15.4
35-44 197 60.8 53.9-67.7 24.1 19.0-29.3 7.5 3.7-11.2 7.6 3.2-12.1
45-54 136 57.1 47.8-66.5 23.4 15.7-31.1 8.6 4.0-13.3 10.8 5.4-16.3
55-64 91 60.1 49.6-70.6 23.5 14.9-32.1 4.8 0.4-9.2 11.6 4.6-18.6
25-64 656 60.7 56.3-65.0 22.9 19.6-26.2 6.5 4.3-8.7 9.9 6.9-12.9

Past 7 Description: Frequency and quantity of drinks consumed in the past 7 days by
days current (past 30 days) drinkers, grouped into three categories.
drinking
• During each of the past 7 days, how many standard drinks of any alcoholic drink
did you have each day?
Frequency and quantity of drinks consumed in the past 7 days

Men
Age Group % Drank % 5+ % 20+
(years) n on 4+ 95% CI drinks on 95% CI drinks in 7 95% CI
days any day days
25-34 187 16.9 11.1-22.6 24.0 16.6-31.3 7.6 3.5-11.7
35-44 151 31.1 22.5-39.8 27.7 20.6-34.8 12.3 6.9-17.6
45-54 88 15.2 8.0-22.4 19.0 10.8-27.2 3.7 0.0-7.8
55-64 54 33.9 21.3-46.5 25.4 13.5-37.4 11.8 3.0-20.6
25-64 480 22.4 18.0-26.8 24.3 19.5-29.2 8.7 5.9-11.5

Women
Age Group % Drank % 4+ % 15+
(years) n on 4+ 95% CI drinks on 95% CI drinks in 7 95% CI
days any day days
25-34 35 11.7 1.8-21.7 11.1 0.9-21.2 2.7 0.0-8.0
35-44 34 19.5 6.3-32.7 16.6 3.9-29.3 5.6 0.0-13.6
45-54 36 15.8 0.5-31.1 8.0 0.0-16.7 7.6 0.0-18.0
55-64 32 12.8 0.0-27.5 9.3 0.0-19.1 6.5 0.0-18.9
25-64 137 15.1 5.4-24.7 11.2 5.4-17.1 5.6 0.1-11.2

Both Sexes
Age Group
(years) % Drank on
n 95% CI
4+ days
25-34 222 16.5 11.0-21.9
35-44 185 29.8 21.5-38.1
45-54 124 15.3 8.4-22.1
55-64 86 28.5 18.3-38.7
25-64 617 21.5 17.0-25.9

Fruit and Vegetable Consumption
Mean Description: mean number of days fruit and vegetables consumed.

number of
days of fruit Instrument questions:
and • In a typical week, on how many days do you eat fruit?
vegetable
consumption
• In a typical week, on how many days do you eat vegetables?
Mean number of days fruit consumed in a typical week

(years) n number 95% CI n number 95% CI n number 95% CI
of days of days of days
25-34 631 2.2 2.0-2.4 1449 2.2 2.0-2.3 2080 2.2 2.0-2.3
35-44 403 1.8 1.6-2.1 766 2.0 1.8-2.2 1169 1.9 1.7-2.1
45-54 256 1.9 1.6-2.1 538 1.8 1.5-2.0 794 1.8 1.6-2.0
55-64 196 1.6 1.3-1.9 368 1.9 1.6-2.2 564 1.8 1.5-2.0
25-64 1486 2.0 1.8-2.1 3121 2.0 1.8-2.2 4607 2.0 1.8-2.1
Mean number of days vegetables consumed in a typical week

(years) n number 95% CI n number 95% CI n number 95% CI
of days of days of days
25-34 712 5.3 5.1-5.5 1608 5.7 5.5-5.8 2320 5.5 5.4-5.7
35-44 454 5.5 5.3-5.7 858 5.7 5.5-5.9 1312 5.6 5.4-5.8
45-54 294 5.6 5.3-5.8 602 5.9 5.7-6.1 896 5.8 5.6-5.9
55-64 216 5.9 5.6-6.2 430 5.7 5.5-6.0 646 5.8 5.6-6.0
25-64 1676 5.5 5.3-5.6 3498 5.7 5.6-5.9 5174 5.6 5.5-5.7

Mean Description: mean number of fruit, vegetable, and combined fruit and vegetable
number of servings on average per day.
servings of
fruit and Instrument questions:
vegetable
• In a typical week, on how many days do you eat fruit?
consumption
• How many servings of fruit do you eat on one of those days?
• How many servings of vegetables do you eat on one of those days?
Mean number of servings of fruit on average per day

(years) number number number
n 95% CI n 95% CI n 95% CI
of of of
servings servings servings
25-34 614 0.6 0.5-0.6 1399 0.5 0.5-0.6 2013 0.5 0.5-0.6
35-44 394 0.4 0.3-0.5 746 0.5 0.4-0.6 1140 0.4 0.4-0.5
45-54 245 0.5 0.4-0.6 510 0.4 0.3-0.6 755 0.5 0.4-0.6
55-64 187 0.4 0.3-0.5 351 0.5 0.4-0.7 538 0.4 0.3-0.5
25-64 1440 0.5 0.4-0.5 3006 0.5 0.4-0.6 4446 0.5 0.4-0.5
Mean number of servings of vegetables on average per day

n 95% CI n 95% CI n 95% CI
of of of
25-34 711 1.5 1.5-1.6 1607 1.6 1.6-1.7 2318 1.6 1.5-1.6
35-44 453 1.6 1.5-1.7 857 1.7 1.6-1.8 1310 1.6 1.6-1.7
45-54 293 1.6 1.5-1.7 599 1.7 1.6-1.8 892 1.7 1.6-1.8
55-64 216 1.7 1.6-1.8 429 1.8 1.6-2.0 645 1.7 1.6-1.9
25-64 1673 1.6 1.5-1.6 3492 1.7 1.6-1.8 5165 1.6 1.6-1.7
Mean number of servings of fruit and/or vegetables on average per day

n 95% CI n 95% CI n 95% CI
of of of
25-34 713 2.0 1.9-2.1 1611 2.1 2.0-2.2 2324 2.0 2.0-2.1
35-44 456 1.9 1.8-2.0 857 2.1 2.0-2.2 1313 2.0 1.9-2.1
45-54 294 2.0 1.9-2.2 599 2.1 2.0-2.3 893 2.1 1.9-2.2
55-64 216 2.0 1.8-2.2 431 2.2 1.9-2.5 647 2.1 1.9-2.3
25-64 1679 2.0 1.9-2.1 3498 2.1 2.0-2.2 5177 2.0 2.0-2.1

Fruit and Description: Frequency of fruit and/or vegetable consumption.
vegetable
consumption Instrument questions:
per day • In a typical week, on how many days do you eat fruit?
Number of servings of fruit and/or vegetables on average per day

Men
Age
Group % no fruit
% 1-2 % 3-4 % ≥5
(years) n and/or 95% CI 95% CI 95% CI 95% CI
vegetables
25-34 713 13.9 11.1-16.8 74.6 70.9-78.3 9.1 6.7-11.5 2.4 1.2-3.5
35-44 456 17.5 13.4-21.6 73.4 69.0-77.9 8.1 5.6-10.6 1.0 0.0-1.9
45-54 294 16.0 11.5-20.4 74.7 69.6-79.7 6.5 3.4-9.7 2.8 0.8-4.8
55-64 216 11.9 6.7-17.1 79.0 73.5-84.6 7.1 3.9-10.3 2.0 0.0-4.1
25-64 1679 14.9 12.5-17.4 74.8 72.1-77.5 8.2 6.6-9.8 2.0 1.3-2.8

Women
Age
Group % no fruit
% 1-2 % 3-4 % ≥5
vegetables
25-34 1611 12.0 9.8-14.2 75.9 73.3-78.4 9.7 8.1-11.3 2.4 1.6-3.3
35-44 857 12.8 10.0-15.6 74.3 71.0-77.7 9.9 7.5-12.3 3.0 1.7-4.3
45-54 599 11.6 8.7-14.5 78.4 75.0-81.7 7.0 4.9-9.1 3.1 1.6-4.6
55-64 431 15.5 11.2-19.8 72.6 67.7-77.5 8.0 5.3-10.7 4.0 1.9-6.1
25-64 3498 12.5 10.7-14.4 75.5 73.5-77.5 9.0 7.7-10.4 2.9 2.0-3.8

Both Sexes
Age
Group % no fruit
% 1-2 % 3-4 % ≥5
vegetables
25-34 2324 13.0 11.0-14.9 75.2 72.8-77.7 9.4 7.8-11.0 2.4 1.6-3.2
35-44 1313 15.1 12.2-18.0 73.9 70.8-77.0 9.0 7.2-10.8 2.0 1.0-3.0
45-54 893 13.6 10.8-16.4 76.7 73.6-79.7 6.8 4.9-8.7 3.0 1.6-4.3
55-64 647 13.8 10.1-17.6 75.6 71.7-79.4 7.6 5.3-9.8 3.0 1.5-4.6
25-64 5177 13.7 11.8-15.6 75.2 73.3-77.1 8.6 7.4-9.8 2.5 1.8-3.2

Fruit and Description: Percentage of those eating less than five servings of fruit and/or
vegetable vegetables on average per day.
consumption
per day Instrument questions:
• In a typical week, on how many days do you eat fruit?
Less than five servings of fruit and/or vegetables on average per day
Age Group % < five % < five % < five
(years) n servings 95% CI n servings 95% CI n servings 95% CI
per day per day per day
25-34 713 97.6 96.5-98.8 1611 97.6 96.7-98.4 2324 97.6 96.8-98.4
35-44 456 99.0 98.1-100.0 857 97.0 95.7-98.3 1313 98.0 97.0-99.0
45-54 294 97.2 95.2-99.2 599 96.9 95.4-98.4 893 97.0 95.7-98.4
55-64 216 98.0 95.9-100.0 431 96.0 93.9-98.1 647 97.0 95.4-98.5
25-64 1679 98.0 97.2-98.7 3498 97.1 96.2-98.0 5177 97.5 96.8-98.2

Type of Description: Type of oil or fat most often used for meal preparation in households
oil used (presented only for both sexes because results are for the household not
most individuals).
frequently
• What type of oil or fat is most often used for meal preparation in your
household?
Type of oil or fat most often used for meal preparation in household
n
% Vegetable % Animal
(house 95% CI 95% CI % Butter 95% CI % Margarine 95% CI
oil Fat
-holds)
5180 79.4 77.2-81.5 0.8 0.5-1.1 1.9 1.1-2.8 0.0 0.0-0.1
Type of oil or fat most often used for meal preparation in household
n
% None
(house % none in particular 95% CI 95% CI % Other 95% CI
used
-holds)
5180 4.1 2.7-5.4 13.0 11.2-14.9 0.8 0.1-1.4
Eating Description: Mean number of meals per week eaten outside a home.
outside
home Instrument question:
• On average, how many meals per week do you eat that were not prepared at a
home? By meal, I mean breakfast, lunch and dinner.
Mean number of meals eaten outside a home

(years) n mean 95% CI n mean 95% CI n mean 95% CI
25-34 663 1.1 0.8-1.4 1497 0.7 0.5-0.9 2160 0.9 0.7-1.1
35-44 424 1.0 0.7-1.2 781 0.5 0.4-0.6 1205 0.7 0.6-0.9
45-54 265 0.8 0.5-1.2 540 0.8 0.4-1.1 805 0.8 0.5-1.1
55-64 198 1.1 0.6-1.7 405 0.7 0.4-1.1 603 0.9 0.6-1.2
25-64 1550 1.0 0.8-1.3 3223 0.7 0.5-0.8 4773 0.8 0.7-1.0

Physical Activity
Introduction A population's physical activity (or inactivity) can be described in different ways.
The two most common ways are
(1) to estimate a population's mean or median physical activity using a continuous
indicator such as MET-minutes per week or time spent in physical activity, and
(2) to classify a certain percentage of a population as 'inactive' by setting up a cut-
point for a specific amount of physical activity.
When analyzing GPAQ data, both continuous as well as categorical indicators are
used.
Metabolic METs (Metabolic Equivalents) are commonly used to express the intensity of
Equivalent physical activities, and are also used for the analysis of GPAQ data.
(MET)
Applying MET values to activity levels allows us to calculate total physical
activity. MET is the ratio of a person's working metabolic rate relative to the
resting metabolic rate. One MET is defined as the energy cost of sitting quietly,
and is equivalent to a caloric consumption of 1 kcal/kg/hour. For the analysis of
GPAQ data, existing guidelines have been adopted: It is estimated that, compared
to sitting quietly, a person's caloric consumption is four times as high when being
moderately active, and eight times as high when being vigorously active.
Therefore, for the calculation of a person's total physical activity using GPAQ data,
the following MET values are used:
Domain MET value

Work • Moderate MET value = 4.0
• Vigorous MET value = 8.0
Transport Cycling and walking MET value = 4.0
Recreation • Moderate MET value = 4.0
• Vigorous MET value = 8.0
Categorical For the calculation of a categorical indicator, the total time spent in physical
indicator activity during a typical week, the number of days as well as the intensity of the
physical activity are taken into account.
The three levels of physical activity suggested for classifying populations are low,
moderate, and high. The criteria for these levels are shown below.
• High
A person reaching any of the following criteria is classified in this category:
- Vigorous-intensity activity on at least 3 days achieving a minimum of at least
1,500 MET-minutes/week OR
- 7 or more days of any combination of walking, moderate- or vigorous-
intensity activities achieving a minimum of at least 3,000 MET-minutes per
week.
• Moderate
A person not meeting the criteria for the "high" category, but meeting any of
the following criteria is classified in this category:
- 3 or more days of vigorous-intensity activity of at least 20 minutes per day
OR
- 5 or more days of moderate-intensity activity or walking of at least 30
minutes per day OR
- 5 or more days of any combination of walking, moderate- or vigorous-
intensity activities achieving a minimum of at least 600 MET-minutes per
week.
• Low
A person not meeting any of the above mentioned criteria falls in this category.

Levels of Description: Percentage of respondents classified into three categories of total
total physical activity.
physical
activity Instrument questions:
• activity at work
• travel to and from places
• recreational activities
Level of total physical activity

Men
Age Group
(years) %
n % Low 95% CI 95% CI % High 95% CI
Moderate
25-34 579 5.6 3.4-7.8 4.8 2.8-6.9 89.5 86.6-92.4
35-44 361 5.4 3.2-7.7 7.6 4.6-10.5 87.0 83.2-90.8
45-54 243 8.8 5.1-12.4 6.4 2.5-10.3 84.9 80.1-89.6
55-64 172 7.6 3.3-11.9 4.0 1.2-6.8 88.4 83.5-93.3
25-64 1355 6.3 4.8-7.8 5.7 4.3-7.1 88.0 85.8-90.2

Women
Age Group
(years) %
Moderate
25-34 1247 12.7 10.2-15.2 9.7 7.5-11.9 77.6 74.3-81.0
35-44 660 11.6 8.3-14.9 6.5 4.5-8.4 81.9 77.8-86.1
45-54 471 11.8 8.7-14.9 6.0 3.6-8.3 82.2 78.5-86.0
55-64 324 15.8 11.3-20.2 7.7 4.9-10.5 76.5 71.2-81.8
25-64 2702 12.6 10.6-14.7 8.0 6.5-9.4 79.4 76.6-82.2

Both Sexes
Age Group
(years) %
Moderate
25-34 1826 9.1 7.2-10.9 7.2 5.6-8.8 83.8 81.3-86.2
35-44 1021 8.5 6.3-10.7 7.0 5.2-8.8 84.4 81.4-87.5
45-54 714 10.4 7.9-12.8 6.2 3.9-8.5 83.5 80.2-86.8
55-64 496 11.9 8.4-15.4 5.9 3.9-8.0 82.2 78.2-86.2
25-64 4057 9.5 8.0-10.9 6.8 5.7-8.0 83.7 81.5-85.9

Total Description: Mean minutes of total physical activity on average per day.
physical
activity- Instrument questions
mean • activity at work
Mean minutes of total physical activity on average per day

Age Group
n 95% CI n 95% CI n 95% CI
minutes minutes minutes
25-34 579 333.0 313.8-352.2 1247 238.0 224.4-251.7 1826 286.9 273.6-300.2
35-44 361 330.6 305.8-355.4 660 255.1 238.6-271.6 1021 292.6 275.9-309.4
45-54 243 311.4 284.0-338.9 471 261.3 243.0-279.6 714 285.1 267.7-302.4
55-64 172 301.9 273.2-330.5 324 228.3 207.8-248.9 496 263.3 244.4-282.1
25-64 1355 325.4 310.9-339.9 2702 245.4 234.4-256.4 4057 285.2 274.3-296.2
Total Description: Median minutes of total physical activity on average per day.
physical
activity- Instrument questions
median • activity at work
Median minutes of total physical activity on average per day

Age Group Inter- Inter- Inter-
(years) Median quartile Median quartile Median quartile
n n n
minutes range minutes range minutes range
(P25-P75) (P25-P75) (P25-P75)
25-34 579 302.1 199.3-426.4 1247 218.6 108.6-325.7 1826 257.1 150.0-385.7
35-44 361 308.6 175.7-454.3 660 244.3 128.6-360.0 1021 274.3 150.0-400.0
45-54 243 282.9 157.1-436.9 471 248.6 145.7-357.1 714 265.7 154.3-381.4
55-64 172 295.7 180.0-368.6 324 214.3 90.0-334.3 496 257.1 138.6-355.7
25-64 1355 300.0 188.6-428.6 2702 231.4 120.0-342.9 4057 261.4 150.0-385.7

Domain- Description: Mean minutes spent in work-, transport- and recreation-related physical
specific activity on average per day.
physical
activity- Instrument questions:
mean
Mean minutes of work-related physical activity on average per day

Age Men Women Both Sexes
Group Mean Mean Mean
25-34 579 238.7 225.1-252.3 1247 187.8 176.8-198.7 1826 214.0 204.5-223.4
35-44 361 255.7 234.8-276.6 660 208.3 193.6-223.0 1021 231.8 218.0-245.6
45-54 243 250.3 228.0-272.7 471 217.6 202.1-233.1 714 233.1 219.2-247.1
55-64 172 233.4 207.1-259.7 324 188.4 171.0-205.9 496 209.8 193.1-226.5
25-64 1355 244.3 233.2-255.3 2702 198.5 189.5-207.4 4057 221.3 213.0-229.6
Mean minutes of transport-related physical activity on average per day

25-34 579 63.6 54.8-72.4 1247 38.4 34.4-42.5 1826 51.4 46.2-56.6
35-44 361 54.0 45.9-62.0 660 37.5 33.3-41.8 1021 45.7 40.9-50.5
45-54 243 47.4 37.7-57.1 471 37.4 31.9-42.8 714 42.1 36.5-47.8
55-64 172 52.8 43.6-62.0 324 32.4 27.5-37.4 496 42.1 36.9-47.3
25-64 1355 57.3 51.6-63.0 2702 37.3 34.3-40.2 4057 47.3 43.7-50.8
Mean minutes of recreation-related physical activity on average per day

25-34 579 30.7 23.9-37.6 1247 11.8 8.4-15.2 1826 21.5 17.4-25.7
35-44 361 21.0 16.3-25.7 660 9.3 6.4-12.1 1021 15.1 12.1-18.1
45-54 243 13.7 8.2-19.2 471 6.3 3.0-9.6 714 9.8 6.3-13.4
55-64 172 15.7 8.3-23.1 324 7.5 3.7-11.2 496 11.4 7.3-15.5
25-64 1355 23.8 19.4-28.2 2702 9.6 7.3-12.0 4057 16.7 13.7-19.7

Domain- Description: Median minutes spent on average per day in work-, transport- and
specific recreation-related physical activity.
physical
activity - Instrument questions:
median
Median minutes of work-related physical activity on average per day

Age
Group Interquartile Interquartile Interquartile
Median Median Median
(years) n range n range n range
(P25-P75) (P25-P75) (P25-P75)
25-34 579 214.3 128.6-325.7 1247 171.4 68.6-267.1 1826 205.7 94.3-308.6
35-44 361 240.0 128.6-360.0 660 197.1 90.0-308.6 1021 214.3 102.9-325.7
45-54 243 240.0 128.6-360.0 471 205.7 111.4-300.0 714 222.9 120.0-317.1
55-64 172 214.3 128.6-308.6 324 180.0 61.4-300.0 496 201.4 94.3-308.6
25-64 1355 222.9 128.6-334.3 2702 184.3 81.4-291.4 4057 205.7 102.9-308.6
Median minutes of transport-related physical activity on average per day

Age
(P25-P75) (P25-P75) (P25-P75)
25-34 579 34.3 12.9-85.7 1247 20.0 8.6-51.4 1826 25.7 8.6-60.0
35-44 361 30.0 14.3-68.6 660 25.7 4.3-51.4 1021 25.7 8.6-51.4
45-54 243 25.7 8.6-60.0 471 20.0 4.3-51.4 714 25.7 6.4-51.4
55-64 172 26.6 12.9-64.3 324 17.1 0.0-42.9 496 25.0 8.6-51.4
25-64 1355 30.0 12.9-75.0 2702 20.0 5.1-51.4 4057 25.7 8.6-60.0
Median minutes of recreation-related physical activity on average per day

Age
(P25-P75) (P25-P75) (P25-P75)
25-34 579 0.0 0.0-38.6 1247 0.0 0.0-7.1 1826 0.0 0.0-25.7
35-44 361 0.0 0.0-25.7 660 0.0 0.0-0.0 1021 0.0 0.0-12.9
45-54 243 0.0 0.0-1.4 471 0.0 0.0-0.0 714 0.0 0.0-0.0
55-64 172 0.0 0.0-0.0 324 0.0 0.0-0.0 496 0.0 0.0-0.0
25-64 1355 0.0 0.0-25.7 2702 0.0 0.0-0.0 4057 0.0 0.0-12.9

No Description: Percentage of respondents classified as doing no work-, transport- or
physical recreational-related physical activity.
activity
by Instrument questions:
domain
No work-related physical activity

Age Group % no % no % no
(years) n activity 95% CI n activity 95% CI n activity 95% CI
at work at work at work
25-34 579 8.0 5.1-11.0 1247 10.1 8.1-12.1 1826 9.1 7.1-11.0
35-44 361 8.2 5.0-11.4 660 10.0 7.1-12.9 1021 9.1 6.8-11.4
45-54 243 8.9 5.2-12.5 471 7.9 5.1-10.6 714 8.3 5.9-10.8
55-64 172 11.6 6.6-16.6 324 13.7 9.6-17.8 496 12.7 9.2-16.2
25-64 1355 8.6 6.5-10.8 2702 10.1 8.3-12.0 4057 9.4 7.7-11.0
No transport-related physical activity

(years) activity activity activity
n 95% CI n 95% CI n 95% CI
for for for
transport transport transport
25-34 579 11.2 8.4-14.1 1247 17.6 15.0-20.2 1826 14.3 12.2-16.5
35-44 361 13.0 9.0-17.0 660 21.2 17.6-24.7 1021 17.1 14.3-20.0
45-54 243 13.7 9.2-18.1 471 22.1 17.4-26.8 714 18.1 14.8-21.4
55-64 172 5.3 2.2-8.5 324 26.2 20.6-31.8 496 16.3 13.0-19.6
25-64 1355 11.4 9.4-13.5 2702 20.4 18.1-22.7 4057 15.9 14.1-17.7
No recreation-related physical activity

(years) n activity at 95% CI n activity at 95% CI n activity at 95% CI
recreation recreation recreation
25-34 579 50.3 45.4-55.3 1247 71.0 67.3-74.8 1826 60.4 56.7-64.1
35-44 361 58.9 53.4-64.4 660 77.9 73.5-82.2 1021 68.4 64.4-72.5
45-54 243 74.9 69.2-80.5 471 84.2 79.9-88.5 714 79.8 76.0-83.6
55-64 172 78.0 71.6-84.4 324 82.7 77.9-87.6 496 80.5 76.3-84.7
25-64 1355 59.6 56.0-63.2 2702 76.6 73.3-79.8 4057 68.1 65.1-71.2

Composition Description: Percentage of work, transport and recreational activity contributing
of total to total activity.
physical
activity Instrument questions:
Composition of total physical activity

Men
Age Group % Activity
% Activity
(years) % Activity during
n 95% CI for 95% CI 95% CI
from work leisure
transport
time
25-34 569 68.6 65.8-71.4 21.5 19.4-23.6 9.9 8.2-11.6
35-44 358 72.2 69.1-75.4 20.8 18.0-23.6 6.9 5.2-8.7
45-54 235 77.3 73.8-80.8 19.0 15.6-22.4 3.7 2.4-5.0
55-64 171 70.3 65.1-75.5 24.5 19.8-29.3 5.2 3.2-7.3
25-64 1333 71.1 69.1-73.2 21.2 19.6-22.9 7.6 6.5-8.8

Women
% Activity
n 95% CI for 95% CI 95% CI
from work leisure
transport
time
25-34 1196 74.2 72.4-76.1 20.3 18.6-22.0 5.5 4.3-6.7
35-44 632 76.7 74.3-79.1 19.6 17.3-21.9 3.7 2.7-4.7
45-54 453 80.5 78.1-82.9 17.0 14.8-19.2 2.6 1.4-3.7
55-64 301 77.1 73.5-80.7 19.5 16.1-22.9 3.4 1.9-4.9
25-64 2582 76.3 74.7-77.9 19.4 17.9-20.9 4.3 3.4-5.1

Both Sexes
% Activity
n 95% CI for 95% CI 95% CI
from work leisure
transport
time
25-34 1765 71.3 69.4-73.2 20.9 19.4-22.4 7.8 6.7-8.9
35-44 990 74.4 72.3-76.6 20.2 18.2-22.2 5.3 4.3-6.4
45-54 688 79.0 76.7-81.2 17.9 15.8-20.1 3.1 2.1-4.1
55-64 472 73.7 70.5-77.0 22.0 19.0-24.9 4.3 3.0-5.6
25-64 3915 73.7 72.2-75.2 20.3 19.0-21.6 6.0 5.1-6.8

No Description: Percentage of respondents not engaging in vigorous physical activity.
vigorous
physical Instrument questions:
activity • activity at work
No vigorous physical activity

(years) n vigorous 95% CI n vigorous 95% CI n vigorous 95% CI
activity activity activity
25-34 579 11.2 8.5-13.8 1247 25.4 21.6-29.2 1826 18.1 15.4-20.7
35-44 361 14.0 9.9-18.0 660 20.0 16.1-24.0 1021 17.0 14.0-20.1
45-54 243 15.4 10.3-20.5 471 16.5 12.8-20.2 714 16.0 12.6-19.4
55-64 172 16.9 11.0-22.9 324 24.4 18.7-30.1 496 20.9 16.3-25.4
25-64 1355 13.2 10.9-15.5 2702 22.3 19.3-25.3 4057 17.8 15.5-20.1

Sedentary Description: Minutes spent in sedentary activities on a typical day.
• sedentary behaviour
Minutes spent in sedentary activities on average per day

Men
Age Group Interquartile
(years) Mean Median
n 95% CI range
minutes minutes
(P25-P75)
25-34 719 164.7 150.4-179.0 120.0 60.0-240.0
35-44 459 166.8 150.8-182.7 120.0 60.0-240.0
45-54 296 169.3 152.0-186.6 120.0 60.0-240.0
55-64 216 170.8 151.8-189.8 120.0 60.0-240.0
25-64 1690 166.6 156.6-176.7 120.0 60.0-240.0

Women
(years) Mean Median
n 95% CI range
minutes minutes
(P25-P75)
25-34 1614 147.5 136.6-158.4 120.0 30.0-240.0
35-44 862 143.6 132.6-154.6 120.0 30.0-180.0
45-54 604 141.1 128.6-153.6 120.0 30.0-210.0
55-64 434 159.6 139.8-179.4 120.0 0.0-240.0
25-64 3514 146.9 138.0-155.8 120.0 30.0-240.0

Both Sexes
(years) Mean Median
n 95% CI range
minutes minutes
(P25-P75)
25-34 2333 156.2 145.8-166.6 120.0 60.0-240.0
35-44 1321 154.9 143.9-166.0 120.0 60.0-240.0
45-54 900 154.1 143.3-164.9 120.0 45.0-240.0
55-64 650 164.7 149.9-179.5 120.0 30.0-240.0
25-64 5204 156.5 148.2-164.9 120.0 60.0-240.0

Blood Pressure and Diabetes History
Blood Description: Blood pressure measurement and diagnosis among all respondents.
pressure
measurement Instrument questions:
and • Have you ever had your blood pressure measured by a doctor or other health
diagnosis worker?
• Have you ever been told by a doctor or other health worker that you have
raised blood pressure or hypertension?
• Have you been told in the past 12 months?
Blood pressure measurement and diagnosis
Men
Age %
% %
Group diagnosed,
% Never measured, diagnosed
(years) n 95% CI 95% CI but not 95% CI 95% CI
measured not within past
within past
diagnosed 12 months
12 months
25-34 719 93.7 92.0-95.4 5.1 3.6-6.6 1.1 0.3-1.8 0.1 0.0-0.4
35-44 459 87.4 84.1-90.8 9.9 6.9-12.9 1.5 0.2-2.8 1.2 0.1-2.2
45-54 296 87.7 83.8-91.7 6.3 3.4-9.2 3.1 1.2-5.0 2.9 1.0-4.7
55-64 216 85.6 81.2-90.1 8.7 4.9-12.5 2.3 0.3-4.3 3.5 1.1-5.8
25-64 1690 90.3 88.8-91.8 6.9 5.6-8.2 1.7 1.1-2.3 1.2 0.7-1.7

Women
Age %
% %
Group diagnosed,
within past
diagnosed 12 months
12 months
25-34 1614 55.4 52.0-58.8 38.2 35.1-41.4 4.1 3.1-5.1 2.3 1.5-3.1
35-44 862 61.2 57.7-64.7 30.4 27.1-33.6 5.7 4.0-7.3 2.8 1.6-3.9
45-54 604 64.8 60.4-69.3 21.3 17.6-25.0 6.9 4.5-9.2 7.0 4.8-9.2
55-64 434 65.8 60.9-70.6 19.2 15.3-23.2 7.6 4.7-10.4 7.4 4.7-10.1
25-64 3514 59.9 57.3-62.4 30.8 28.6-33.0 5.4 4.5-6.3 3.9 3.1-4.7

Both sexes
Age %
% %
Group diagnosed,
within past
diagnosed 12 months
12 months
25-34 2333 74.8 72.7-76.8 21.5 19.6-23.3 2.6 1.9-3.2 1.2 0.8-1.6
35-44 1321 74.0 71.5-76.6 20.3 18.0-22.7 3.6 2.6-4.6 2.0 1.1-2.8
45-54 900 75.4 72.3-78.5 14.4 11.9-16.8 5.1 3.6-6.7 5.1 3.6-6.6
55-64 650 74.9 71.2-78.5 14.4 11.5-17.3 5.1 3.3-7.0 5.6 3.7-7.5
25-64 5204 74.7 73.0-76.4 19.1 17.7-20.5 3.6 3.0-4.2 2.6 2.1-3.1

Blood Description: raised blood pressure treatment among those previously diagnosed with
pressure raised blood pressure.
treatment
among Instrument questions:
those
• Have you ever been told by a doctor or other health worker that you have raised
diagnosed
blood pressure or hypertension?
• Are you currently receiving any of the following treatments/advice for high blood
pressure prescribed by a doctor or other health worker?
• Drugs (medication) that you have taken in the last 2 weeks?
Currently taking blood pressure drugs prescribed by doctor or health worker among those diagnosed
Age Group
(years) % taking % taking % taking
n 95% CI n 95% CI n 95% CI
meds meds meds
25-34 9 23.5 0.0-53.0 104 12.7 6.1-19.2 113 14.5 7.2-21.7
35-44 12 32.2 3.3-61.0 73 21.3 12.2-30.4 85 23.8 13.8-33.9
45-54 18 21.6 4.2-39.0 83 27.3 15.3-39.4 101 25.8 15.8-35.8
55-64 13 23.7 0.0-48.9 64 39.6 27.1-52.0 77 35.7 24.5-46.9
25-64 52 25.0 13.0-36.9 324 24.0 18.4-29.6 376 24.2 19.3-29.1

Blood Description: Percentage of respondents who received lifestyle advice from a doctor
pressure or health worker to treat raised blood pressure among those previously diagnosed
lifestyle with raised blood pressure.
advice
• When was your blood pressure last measured by a health professional?
• Are you currently receiving any of the following treatments/advice for high blood
pressure prescribed by a doctor or other health worker?
Advised by doctor or health worker to reduce salt intake among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 9 24.2 0.0-54.4 104 43.1 33.7-52.5 113 40.0 30.5-49.5
35-44 12 49.8 17.4-82.2 73 59.2 47.7-70.6 85 57.0 45.4-68.5
45-54 18 55.4 32.7-78.0 83 47.4 35.7-59.2 101 49.6 39.3-59.8
55-64 13 46.2 18.1-74.2 64 53.7 41.6-65.8 77 51.8 40.6-63.1
25-64 52 45.7 31.9-59.5 324 50.0 43.9-56.2 376 49.0 43.3-54.8
Advised by doctor or health worker to lose weight among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 9 0.0 0.0-0.0 104 15.5 9.0-22.0 113 12.9 7.5-18.4
35-44 12 33.2 3.9-62.5 73 32.3 21.0-43.6 85 32.5 21.2-43.8
45-54 18 33.2 11.3-55.1 83 23.3 14.3-32.3 101 26.0 17.2-34.8
55-64 13 15.5 0.0-36.8 64 26.4 16.4-36.4 77 23.8 14.1-33.4
25-64 52 22.5 11.3-33.7 324 23.6 19.2-28.0 376 23.4 19.0-27.7
Advised by doctor or health worker to stop smoking among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 9 10.7 0.0-31.6 104 10.0 3.9-16.1 113 10.1 4.3-16.0
35-44 12 23.1 0.0-48.2 73 18.5 9.2-27.8 85 19.6 10.6-28.5
45-54 18 54.4 29.0-79.8 83 22.0 12.2-31.8 101 30.7 20.6-40.8
55-64 13 14.4 0.0-34.4 64 28.6 16.8-40.5 77 25.2 14.4-35.9
25-64 52 29.2 15.9-42.6 324 18.9 14.1-23.7 376 21.2 16.6-25.9
Advised by doctor or health worker to start or do more exercise among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 9 20.8 0.0-48.0 104 23.5 14.7-32.3 113 23.1 14.5-31.6
35-44 12 22.8 0.0-47.8 73 34.0 22.8-45.2 85 31.4 21.3-41.5
45-54 18 26.8 6.5-47.1 83 27.1 17.0-37.2 101 27.0 18.0-36.0
55-64 13 8.0 0.0-23.5 64 23.7 14.7-32.8 77 19.9 11.2-28.6
25-64 52 20.5 9.8-31.2 324 26.9 22.3-31.5 376 25.5 21.2-29.7

Blood Description: Percentage of respondents who have sought advice or received
pressure treatment from traditional healers for raised blood pressure among those previously
advice by diagnosed with raised blood pressure.
a
traditional Instrument questions:
healer
• When was your blood pressure last measured by a health professional?
• Have you ever seen a traditional healer for raised blood pressure?
• Are you currently taking any herbal or traditional remedy for your high blood
pressure?
Seen a traditional healer among those previously diagnosed

(years) n % 95% CI n % 95% CI n % 95% CI
25-34 9 0.0 0.0-0.0 104 5.7 1.3-10.2 113 4.8 1.0-8.6
35-44 12 0.0 0.0-0.0 73 10.0 3.0-17.1 85 7.7 2.2-13.2
45-54 18 5.6 0.0-16.7 83 18.2 9.2-27.2 101 14.8 7.5-22.2
55-64 13 7.6 0.0-22.3 64 15.9 6.2-25.6 77 13.9 5.7-22.1
25-64 52 3.6 0.0-8.6 324 12.1 8.5-15.8 376 10.2 7.3-13.1
Currently taking herbal or traditional remedy for high blood pressure among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 9 10.7 0.0-31.6 104 2.2 0.0-5.2 113 3.6 0.0-7.8
35-44 12 0.0 0.0-0.0 73 4.6 0.0-9.6 85 3.5 0.0-7.3
45-54 18 10.8 0.0-24.8 83 1.4 0.0-4.3 101 3.9 0.0-8.4
55-64 13 7.6 0.0-22.3 64 6.5 0.5-12.5 77 6.8 1.0-12.5
25-64 52 7.5 0.0-16.6 324 3.4 1.2-5.6 376 4.3 1.7-6.9

Diabetes Description: Diabetes measurement and diagnosis among all respondents.
measurement
and Instrument questions:
diagnosis • Have you ever had your blood sugar measured by a doctor or other health
worker?
• Have you ever been told by a doctor or other health worker that you have
raised blood sugar or diabetes?
• Have you been told in the past 12 months?
Blood sugar measurement and diagnosis
Men
Age %
% %
Group diagnosed,
within past
diagnosed 12 months
12 months
25-34 719 99.3 98.8-99.9 0.5 0.0-1.1 0.1 0.0-0.3 0.0 0.0-0.0
35-44 459 97.9 96.7-99.2 1.7 0.6-2.8 0.2 0.0-0.5 0.2 0.0-0.6
45-54 296 97.0 95.2-98.9 1.9 0.4-3.5 0.7 0.0-1.7 0.3 0.0-0.9
55-64 216 99.6 98.9-100.0 0.0 0.0-0.0 0.4 0.0-1.1 0.0 0.0-0.0
25-64 1690 98.6 98.1-99.2 1.0 0.5-1.5 0.3 0.0-0.5 0.1 0.0-0.2

Women
Age %
% %
Group diagnosed,
within past
diagnosed 12 months
12 months
25-34 1614 97.2 96.3-98.0 2.7 1.9-3.6 0.1 0.0-0.2 0.1 0.0-0.2
35-44 862 98.5 97.7-99.3 1.4 0.6-2.2 0.1 0.0-0.4 0.0 0.0-0.0
45-54 604 98.6 97.6-99.5 1.3 0.4-2.1 0.0 0.0-0.0 0.2 0.0-0.5
55-64 434 96.3 94.2-98.4 2.0 0.8-3.3 0.5 0.0-1.2 1.2 0.1-2.2
25-64 3514 97.6 97.1-98.2 2.0 1.5-2.6 0.1 0.0-0.2 0.2 0.1-0.4

Both sexes
Age %
% %
Group diagnosed,
within past
diagnosed 12 months
12 months
25-34 2333 98.3 97.7-98.8 1.6 1.1-2.2 0.1 0.0-0.2 0.0 0.0-0.1
35-44 1321 98.2 97.5-98.9 1.6 0.9-2.2 0.2 0.0-0.4 0.1 0.0-0.3
45-54 900 97.9 96.9-98.9 1.6 0.7-2.4 0.3 0.0-0.8 0.2 0.0-0.6
55-64 650 97.8 96.6-99.0 1.1 0.4-1.8 0.4 0.0-1.0 0.6 0.1-1.2
25-64 5204 98.1 97.7-98.6 1.5 1.1-1.9 0.2 0.0-0.3 0.2 0.0-0.3

Diabetes Description: Diabetes treatment results among those previously diagnosed with
treatment raised blood sugar or diabetes.
among
those Instrument questions:
diagnosed
• Have you ever had your blood sugar measured by a doctor or other health
worker?
blood sugar or diabetes?
• Are you currently receiving any of the following treatments/advice for diabetes
prescribed by a doctor or other health worker?
Currently taking insulin prescribed for diabetes among those previously diagnosed
Age Group
n 95% CI n 95% CI n 95% CI
insulin insulin insulin
25-34 1 0.0 -- 2 0.0 0.0-0.0 3 0.0 0.0-0.0
35-44 2 0.0 -- 1 0.0 0.0-0.0 3 0.0 0.0-0.0
45-54 3 0.0 -- 1 0.0 0.0-0.0 4 0.0 0.0-0.0
55-64 1 0.0 -- 7 30.1 0.0-85.3 8 25.4 0.0-68.6
25-64 7 0.0 -- 11 19.2 0.0-53.7 18 9.5 0.0-23.7
Currently taking oral drugs prescribed for diabetes among those previously diagnosed
Age Group
n 95% CI n 95% CI n 95% CI
meds meds meds
25-34 1 0.0 0.0-0.0 2 52.6 0.0-100.0 3 27.3 0.0-82.9
35-44 2 0.0 0.0-0.0 1 0.0 0.0-0.0 3 0.0 0.0-0.0
45-54 3 28.9 0.0-91.6 1 100.0 100.0-100.0 4 41.4 0.0-95.2
55-64 1 0.0 0.0-0.0 7 29.9 0.0-68.8 8 25.3 0.0-57.6
25-64 7 13.5 0.0-48.4 11 38.0 4.4-71.6 18 25.6 1.1-50.1

Diabetes Description: Percentage of respondents who received diabetes lifestyle advice from a
lifestyle doctor or health worker among those previously diagnosed with diabetes.
advice
• Have you ever had your blood sugar measured by a doctor or other health worker?
• Are you currently receiving any of the following treatments/advice for diabetes
Advised by doctor or health worker to have special prescribed diet among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 1 0.0 0.0-0.0 2 47.4 0.0-100.0 3 24.6 0.0-76.3
35-44 2 0.0 0.0-0.0 1 0.0 0.0-0.0 3 0.0 0.0-0.0
45-54 3 62.3 24.0-100.0 1 0.0 0.0-0.0 4 51.3 0.0-100.0
55-64 1 100.0 100.0-100.0 7 57.1 24.2-89.9 8 63.7 37.3-90.2
25-64 7 40.7 0.0-88.2 11 44.2 11.0-77.4 18 42.4 16.1-68.7
Advised by doctor or health worker to lose weight among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 1 0.0 0.0-0.0 2 0.0 0.0-0.0 3 0.0 0.0-0.0
35-44 2 0.0 0.0-0.0 1 0.0 0.0-0.0 3 0.0 0.0-0.0
45-54 3 28.9 0.0-91.6 1 0.0 0.0-0.0 4 23.8 0.0-70.8
55-64 1 0.0 0.0-0.0 7 27.7 0.0-64.9 8 23.4 0.0-54.2
25-64 7 13.5 0.0-48.4 11 17.7 0.0-43.9 18 15.6 0.0-34.9
Advised by doctor or health worker to stop smoking among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 1 0.0 0.0-0.0 2 0.0 0.0-0.0 3 0.0 0.0-0.0
35-44 2 0.0 0.0-0.0 1 0.0 0.0-0.0 3 0.0 0.0-0.0
45-54 3 62.3 24.0-100.0 1 100.0 100.0-100.0 4 69.0 16.4-100.0
55-64 1 100.0 100.0-100.0 7 12.1 0.0-39.2 8 25.8 0.0-59.2
25-64 7 40.7 0.0-88.2 11 18.0 0.0-45.6 18 29.4 6.9-52.0
Advised by doctor or health worker to start or do more exercise among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 1 0.0 0.0-0.0 2 0.0 0.0-0.0 3 0.0 0.0-0.0
35-44 2 0.0 0.0-0.0 1 0.0 0.0-0.0 3 0.0 0.0-0.0
45-54 3 28.9 0.0-91.6 1 100.0 100.0-100.0 4 41.4 0.0-95.2
55-64 1 0.0 0.0-0.0 7 42.0 2.9-81.1 8 35.5 1.2-69.8
25-64 7 13.5 0.0-48.4 11 37.1 3.7-70.4 18 25.2 2.3-48.0

Diabetes Description: Percentage of respondents who are have sought advice or treatment
advice by from traditional healers for diabetes among those previously diagnosed.
traditional
healer Instrument questions:
• Have you ever had your blood sugar measured by a doctor or other health
worker?
• Have you ever seen a traditional healer for diabetes or raised blood sugar?
• Are you currently taking any herbal or traditional remedy for your diabetes?
Seen a traditional healer for diabetes among those previously diagnosed

(years) n % 95% CI n % 95% CI n % 95% CI
25-34 1 0.0 0.0-0.0 2 0.0 0.0-0.0 3 0.0 0.0-0.0
35-44 2 100.0 100.0-100.0 1 0.0 0.0-0.0 3 74.3 21.8-100.0
45-54 3 0.0 0.0-0.0 1 0.0 0.0-0.0 4 0.0 0.0-0.0
55-64 1 0.0 0.0-0.0 7 0.0 0.0-0.0 8 0.0 0.0-0.0
25-64 7 26.8 0.0-71.0 11 0.0 0.0-0.0 18 13.6 0.0-32.2
Currently taking herbal or traditional treatment for diabetes among those previously diagnosed
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 1 0.0 0.0-0.0 2 0.0 0.0-0.0 3 0.0 0.0-0.0
35-44 2 0.0 0.0-0.0 1 0.0 0.0-0.0 3 0.0 0.0-0.0
45-54 3 0.0 0.0-0.0 1 0.0 0.0-0.0 4 0.0 0.0-0.0
55-64 1 0.0 0.0-0.0 7 0.0 0.0-0.0 8 0.0 0.0-0.0
25-64 7 0.0 0.0-0.0 11 0.0 0.0-0.0 18 0.0 0.0-0.0

Physical Measurements
Height, Description: Mean height, weight, and body mass index among all respondents
weight (excluding pregnant women for weight and BMI).
and BMI
• Height
• Weight
Mean height (cm)

Age Group Men Women
(years) n Mean 95% CI n Mean 95% CI
25-34 713 164.2 163.5-164.8 1584 155.4 154.9-155.9
35-44 453 164.3 163.5-165.2 853 155.9 155.4-156.5
45-54 291 164.7 163.8-165.6 596 155.5 154.9-156.1
55-64 212 163.9 162.9-164.9 421 154.3 153.5-155.1
25-64 1669 164.3 163.8-164.8 3454 155.4 155.1-155.7
Mean weight (kg)

Age Group Men Women
25-34 714 60.5 59.9-61.1 1387 56.5 55.9-57.2
35-44 453 61.3 60.3-62.2 796 57.9 57.1-58.8
45-54 291 61.4 58.8-64.0 591 56.9 55.9-57.9
55-64 215 59.0 57.9-60.1 423 55.3 54.0-56.6
25-64 1673 60.7 60.0-61.3 3197 56.8 56.2-57.4
Mean BMI (kg/m2)

25-34 713 22.5 22.3-22.7 1381 23.4 23.2-23.6 2094 22.9 22.8-23.1
35-44 450 22.6 22.3-22.9 794 23.9 23.5-24.3 1244 23.2 23.0-23.5
45-54 289 22.3 21.8-22.7 590 23.5 23.1-23.9 879 22.9 22.6-23.2
55-64 212 22.0 21.6-22.3 416 23.2 22.7-23.7 628 22.7 22.3-23.0
25-64 1664 22.4 22.3-22.6 3181 23.5 23.3-23.7 4845 23.0 22.8-23.1

BMI Description: Percentage of respondents (excluding pregnant women) in each BMI
categories category.
• Height
• Weight
BMI classifications
Men
Age
Group % Under- % Normal
% BMI % Obese
(years) n weight 95% CI weight 95% CI 95% CI 95% CI
25.0-29.9 ≥30.0
<18.5 18.5-24.9
25-34 713 5.6 3.8-7.4 78.8 75.9-81.7 14.1 11.5-16.6 1.5 0.7-2.4
35-44 450 5.2 3.0-7.4 77.3 73.3-81.2 14.7 11.5-18.0 2.8 1.4-4.2
45-54 289 8.5 5.0-12.0 75.7 70.7-80.6 13.5 9.7-17.2 2.4 0.4-4.4
55-64 212 7.6 3.7-11.5 77.4 70.7-84.1 13.7 9.1-18.4 1.3 0.0-2.8
25-64 1664 6.2 4.9-7.5 77.8 75.6-79.9 14.1 12.3-15.9 2.0 1.3-2.6
BMI classifications
Women
Age
% BMI % Obese
25.0-29.9 ≥30.0
<18.5 18.5-24.9
25-34 1381 5.4 4.2-6.6 69.0 66.6-71.3 19.8 17.8-21.8 5.8 4.5-7.1
35-44 794 5.1 3.6-6.5 63.6 59.8-67.4 23.4 19.9-26.8 8.0 6.0-10.0
45-54 590 8.0 5.7-10.2 63.4 59.1-67.8 20.3 16.9-23.8 8.3 6.1-10.5
55-64 416 13.4 9.8-17.0 57.9 52.8-63.1 18.8 14.7-22.9 9.9 7.1-12.6
25-64 3181 6.9 6.0-7.8 65.1 63.0-67.1 20.7 19.0-22.4 7.4 6.3-8.4
BMI classifications
Both Sexes
Age
% BMI % Obese
25.0-29.9 ≥30.0
<18.5 18.5-24.9
25-34 2094 5.5 4.4-6.6 74.3 72.4-76.2 16.7 15.0-18.4 3.5 2.7-4.3
35-44 1244 5.1 3.8-6.5 70.5 67.8-73.2 19.0 16.6-21.4 5.4 4.1-6.6
45-54 879 8.2 6.3-10.1 69.1 65.7-72.5 17.2 14.4-19.9 5.6 4.1-7.1
55-64 628 10.7 8.0-13.4 67.0 62.5-71.4 16.4 13.1-19.8 5.9 4.3-7.5
25-64 4845 6.5 5.7-7.3 71.5 70.0-73.1 17.3 16.0-18.6 4.6 4.0-5.3

BMI ≥25 Description: Percentage of respondents being classified as overweight (BMI≥25)
• Height
• Weight
BMI≥25
Age Group
(years) % % %
n 95% CI n 95% CI n 95% CI
BMI≥25 BMI≥25 BMI≥25
25-34 713 15.6 13.0-18.2 1381 25.6 23.4-27.8 2094 20.2 18.5-21.9
35-44 450 17.5 14.1-20.9 794 31.3 27.4-35.3 1244 24.4 21.6-27.1
45-54 289 15.8 11.7-20.0 590 28.6 24.5-32.8 879 22.7 19.6-25.8
55-64 212 15.0 10.0-19.9 416 28.6 23.6-33.7 628 22.3 18.5-26.1
25-64 1664 16.1 14.1-18.0 3181 28.1 25.9-30.2 4845 21.9 20.4-23.5

Waist Description: Mean waist circumference among all respondents (excluding
circumference pregnant women).
• Waist circumference measurement
Waist circumference (cm)

Age Group Men Women
25-34 704 76.1 75.2-76.9 1346 77.5 76.7-78.3
35-44 442 77.7 76.9-78.6 773 78.6 77.5-79.6
45-54 289 79.4 77.4-81.4 578 80.8 79.5-82.1
55-64 210 78.3 76.9-79.8 412 78.9 77.2-80.5
25-64 1645 77.3 76.6-78.0 3109 78.6 77.8-79.4
Hip Description: Mean hip circumference among all respondents (excluding

circumference pregnant women).
• Hip circumference measurement
Hip circumference (cm)

Age Group Men Women
25-34 703 89.4 88.5-90.3 1346 91.5 90.5-92.5
35-44 442 90.3 89.3-91.4 773 92.4 91.0-93.8
45-54 289 91.5 88.9-94.1 578 93.9 92.4-95.3
55-64 210 89.4 87.5-91.2 412 91.7 89.7-93.7
25-64 1644 90.0 89.2-90.7 3109 92.2 91.2-93.2
Waist / Description: Mean waist-to-hip ratio among all respondents (excluding pregnant
hip ratio women).
• Waist and hip circumference measurement
Mean waist / hip ratio

Age Group Men Women
25-34 703 0.9 0.8-0.9 1346 0.8 0.8-0.9
35-44 442 0.9 0.9-0.9 773 0.9 0.8-0.9
45-54 289 0.9 0.9-0.9 578 0.9 0.9-0.9
55-64 210 0.9 0.9-0.9 412 0.9 0.9-0.9
25-64 1644 0.9 0.9-0.9 3109 0.9 0.9-0.9

Blood Description: Mean blood pressure among all respondents, including those
pressure currently on medication for raised blood pressure.
• Reading 1-3 systolic and diastolic blood pressure
Mean systolic blood pressure (mmHg)

25-34 460 132.7 131.1-134.4 1172 121.4 120.3-122.5 1632 126.7 125.6-127.9
35-44 326 134.3 132.2-136.3 686 128.8 127.1-130.5 1012 131.3 130.0-132.7
45-54 221 138.7 135.5-141.8 499 138.3 135.7-141.0 720 138.5 136.3-140.7
55-64 176 145.3 141.2-149.3 370 148.8 145.8-151.7 546 147.2 144.6-149.8
25-64 1183 135.8 134.4-137.2 2727 130.3 129.2-131.4 3910 132.8 131.8-133.8
Mean diastolic blood pressure (mmHg)

25-34 460 77.0 75.9-78.2 1172 75.6 74.8-76.3 1632 76.3 75.5-77.0
35-44 326 80.3 79.0-81.7 686 79.4 78.4-80.4 1012 79.8 78.9-80.7
45-54 221 80.5 79.0-82.1 499 82.4 81.1-83.7 720 81.6 80.5-82.7
55-64 176 81.7 79.8-83.7 370 84.9 83.4-86.5 546 83.5 82.2-84.8
25-64 1183 79.1 78.3-80.0 2727 79.1 78.4-79.8 3910 79.1 78.5-79.8

Raised blood Description: Percentage of respondents with raised blood pressure.
pressure
• During the past two weeks, have you been treated for raised blood pressure
with drugs (medication) prescribed by a doctor or other health worker?
SBP ≥140 and/or DBP ≥ 90 mmHg, excluding those on medication for raised blood pressure
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 456 29.9 24.8-35.0 1160 11.9 10.0-13.9 1616 20.4 17.5-23.4
35-44 319 33.8 28.0-39.5 674 26.8 23.2-30.5 993 30.0 26.6-33.4
45-54 216 41.9 34.6-49.1 487 41.4 36.5-46.2 703 41.6 37.2-46.0
55-64 175 55.9 46.8-65.0 352 60.0 54.4-65.6 527 58.1 52.7-63.6
25-64 1166 36.4 32.7-40.0 2673 27.8 25.7-29.8 3839 31.7 29.5-34.0
SBP ≥140 and/or DBP ≥ 90 mmHg or currently on medication for raised blood pressure
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 460 30.4 25.3-35.5 1172 12.8 10.8-14.7 1632 21.1 18.1-24.1
35-44 326 35.2 29.7-40.7 686 28.2 24.5-31.9 1012 31.4 28.1-34.7
45-54 221 43.2 36.1-50.3 499 42.7 37.9-47.6 720 42.9 38.6-47.3
55-64 176 56.2 47.0-65.3 370 61.9 56.4-67.5 546 59.3 53.9-64.8
25-64 1183 37.2 33.6-40.8 2727 29.2 27.1-31.3 3910 32.9 30.6-35.2
SBP ≥160 and/or DBP ≥ 100 mmHg, excluding those on medication for raised blood pressure
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 456 5.6 3.4-7.8 1160 1.8 1.1-2.6 1616 3.6 2.5-4.7
35-44 319 8.6 5.5-11.6 674 6.9 4.7-9.1 993 7.7 5.8-9.6
45-54 216 15.4 10.1-20.8 487 16.5 12.9-20.1 703 16.0 12.9-19.2
55-64 175 24.7 17.6-31.7 352 27.7 23.2-32.2 527 26.3 22.2-30.4
25-64 1166 10.6 8.7-12.5 2673 9.4 8.1-10.7 3839 9.9 8.8-11.0
SBP ≥160 and/or DBP ≥ 100 mmHg or currently on medication for raised blood pressure
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 460 6.3 4.0-8.7 1172 2.8 1.9-3.6 1632 4.4 3.2-5.7
35-44 326 10.5 7.4-13.6 686 8.6 6.2-11.0 1012 9.5 7.5-11.5
45-54 221 17.3 11.8-22.9 499 18.4 14.7-22.2 720 17.9 14.6-21.3
55-64 176 25.1 18.0-32.2 370 31.2 26.4-35.9 546 28.5 24.1-32.8
25-64 1183 11.8 9.9-13.7 2727 11.2 9.7-12.6 3910 11.4 10.2-12.6

Treatment Description: Percentage of respondents with treated and/or controlled of raised
and control of blood pressure among those with raised blood pressure (SBP ≥140 and/or DBP ≥
raised blood 90 mmHg) or currently on medication for raised blood pressure.
pressure
• During the past two weeks, have you been treated for raised blood pressure
with drugs (medication) prescribed by a doctor or other health worker?
Respondents with treated and/or controlled raised blood pressure
Men
% On
Age Group medication % On % Not on
(years) and medication medication
n 95% CI 95% CI 95% CI
SBP<140 and SBP≥140 and SBP≥140
and and/orDBP≥90 and/orDBP≥90
DBP<90
25-34 140 1.2 0.0-2.8 1.3 0.0-3.2 97.5 95.1-100.0
35-44 115 1.6 0.0-4.0 4.4 0.6-8.3 93.9 89.5-98.4
45-54 96 0.0 0.0-0.0 5.1 0.6-9.6 94.9 90.4-99.4
55-64 100 0.0 0.0-0.0 1.1 0.0-3.1 98.9 96.9-100.0
25-64 451 0.8 0.0-1.6 2.8 1.2-4.4 96.4 94.7-98.1

Women
% On
n 95% CI 95% CI 95% CI
DBP<90
25-34 148 5.1 1.6-8.6 2.2 0.0-4.4 92.6 88.5-96.8
35-44 191 3.1 0.6-5.7 3.3 0.7-5.9 93.5 90.0-97.1
45-54 213 1.0 0.0-2.3 4.5 1.6-7.4 94.5 91.4-97.7
55-64 229 0.9 0.0-2.2 6.8 3.0-10.7 92.3 88.3-96.2
25-64 781 2.2 1.2-3.2 4.5 2.6-6.4 93.3 91.1-95.5

Both Sexes
% On
n 95% CI 95% CI 95% CI
DBP<90
25-34 288 2.4 0.9-4.0 1.6 0.2-3.0 96.0 93.9-98.0
35-44 306 2.4 0.7-4.1 3.9 1.6-6.2 93.8 91.0-96.5
45-54 309 0.5 0.0-1.3 4.8 2.0-7.5 94.7 91.7-97.7
55-64 329 0.5 0.0-1.2 4.4 2.1-6.7 95.1 92.7-97.5
25-64 1232 1.5 0.9-2.1 3.6 2.3-4.9 94.9 93.5-96.3

Mean heart Description: Mean heart rate (beats per minute).
rate
• Reading 1-3 heart rate
Mean heart rate (beats per minute)

(years) n mean 95% CI n mean 95% CI n mean 95% CI
25-34 460 69.6 68.1-71.0 1172 82.9 81.8-84.1 1632 76.6 75.4-77.8
35-44 326 72.1 70.5-73.7 686 81.8 80.4-83.2 1012 77.3 76.2-78.5
45-54 221 72.5 70.5-74.6 499 79.9 78.7-81.0 720 76.7 75.5-77.8
55-64 176 71.7 69.5-73.8 370 79.7 78.2-81.2 546 76.1 74.6-77.6
25-64 1183 71.0 69.9-72.1 2727 81.6 80.7-82.5 3910 76.7 75.8-77.6

Biochemical Measurements
Mean Description: mean fasting blood glucose results including those currently on
fasting medication for diabetes (non-fasting recipients excluded).
blood
glucose Instrument questions:
• During the last 12 hours have you had anything to eat or drink, other than
water?
• Blood glucose measurement
Mean fasting blood glucose (mmol/L)

25-34 349 4.3 4.1-4.5 897 4.2 4.1-4.3 1246 4.2 4.1-4.4
35-44 257 4.4 4.2-4.7 544 4.2 4.0-4.4 801 4.3 4.1-4.5
45-54 169 4.1 3.9-4.3 400 4.3 4.1-4.4 569 4.2 4.0-4.4
55-64 134 4.6 4.1-5.0 303 4.4 4.2-4.5 437 4.4 4.2-4.7
25-64 909 4.3 4.2-4.5 2144 4.2 4.1-4.3 3053 4.3 4.1-4.4
Mean fasting blood glucose (mg/dl)

25-34 349 77.4 74.1-80.7 897 75.1 73.2-77.1 1246 76.3 73.9-78.7
35-44 257 79.6 75.3-83.9 544 75.8 72.7-78.9 801 77.7 74.6-80.7
45-54 169 73.7 69.7-77.8 400 76.8 73.7-79.8 569 75.4 72.3-78.4
55-64 134 82.0 74.3-89.8 303 78.4 75.6-81.2 437 80.0 76.0-84.1
25-64 909 77.9 75.0-80.7 2144 76.0 74.0-78.0 3053 76.9 74.6-79.2

Raised blood Description: Categorization of respondents into blood glucose level categories
glucose and percentage of respondents currently on medication for raised blood glucose
(non-fasting recipients excluded).
• Are you currently receiving any of the following treatments for diabetes
prescribed by a doctor or other health worker? Insulin? Oral drugs
(medication) that you have taken in the last 2 weeks?
• During the last 12 hours have you had anything to eat or drink, other than
water?
• Blood glucose measurement
• Today, have you taken insulin or other drugs (medication) that have been
Impaired Fasting Glycaemia*

(years) n % 95% CI n % 95% CI n % 95% CI
25-34 351 5.4 2.8-8.0 898 2.0 0.9-3.0 1249 3.7 2.1-5.3
35-44 257 6.1 3.2-8.9 544 1.8 0.4-3.3 801 3.9 2.3-5.5
45-54 169 5.3 2.0-8.7 400 4.1 1.9-6.3 569 4.7 2.7-6.6
55-64 134 6.7 2.4-11.0 303 5.4 2.6-8.2 437 6.0 3.2-8.7
25-64 911 5.7 3.9-7.5 2145 2.7 1.6-3.8 3056 4.2 3.0-5.4
Raised blood glucose or currently on medication for diabetes **

(years) n % 95% CI n % 95% CI n % 95% CI
25-34 351 6.2 1.5-10.9 898 3.6 1.8-5.4 1249 4.9 1.8-8.0
35-44 257 7.8 2.8-12.7 544 4.7 1.6-7.8 801 6.2 2.4-10.0
45-54 169 4.7 0.9-8.4 400 6.4 2.2-10.6 569 5.6 2.0-9.2
55-64 134 7.6 2.7-12.5 303 6.1 3.3-8.9 437 6.8 3.8-9.8
25-64 911 6.5 2.6-10.3 2145 4.7 2.4-7.0 3056 5.6 2.6-8.5
Currently on medication for diabetes

(years) n % 95% CI n % 95% CI n % 95% CI
25-34 719 0.3 0.0-0.8 1616 0.1 0.0-0.3 2335 0.2 0.0-0.5
35-44 459 0.0 0.0-0.0 862 0.1 0.0-0.3 1321 0.1 0.0-0.1
45-54 296 0.6 0.0-1.4 606 0.4 0.0-1.0 902 0.5 0.0-1.0
55-64 216 0.0 0.0-0.0 434 1.2 0.2-2.3 650 0.6 0.1-1.2
25-64 1690 0.3 0.0-0.5 3518 0.3 0.1-0.5 5208 0.3 0.1-0.4
* Impaired fasting glycaemia is defined as either
• plasma venous value: ≥6.1mmol/L (110mg/dl) and <7.0mmol/L (126mg/dl)
• capillary whole blood value: ≥5.6mmol/L (100mg/dl) and <6.1mmol/L (110mg/dl)
** Raised blood glucose is defined as either
• plasma venous value: ≥ 7.0 mmol/L (126 mg/dl)
• capillary whole blood value: ≥ 6.1 mmol/L (110 mg/dl)

Total Description: Mean total cholesterol among all respondents including those
cholesterol currently on medication for raised cholesterol.
• Total cholesterol measurement
Mean total cholesterol (mmol/L)

25-34 297 4.3 4.2-4.3 727 4.3 4.3-4.4 1024 4.3 4.2-4.3
35-44 224 4.4 4.3-4.4 458 4.4 4.3-4.5 682 4.4 4.3-4.4
45-54 150 4.3 4.3-4.4 354 4.4 4.3-4.5 504 4.4 4.3-4.4
55-64 104 4.4 4.3-4.6 273 4.6 4.5-4.7 377 4.5 4.5-4.6
25-64 775 4.3 4.3-4.4 1812 4.4 4.4-4.4 2587 4.4 4.3-4.4
Mean total cholesterol (mg/dl)

25-34 297 164.5 161.8-167.1 727 167.9 165.9-169.9 1024 166.1 164.1-168.2
35-44 224 168.7 165.8-171.7 458 170.4 167.9-172.9 682 169.6 167.4-171.7
45-54 150 167.8 164.7-170.8 354 170.5 168.2-172.9 504 169.3 167.2-171.3
55-64 104 171.9 167.8-176.0 273 177.3 173.8-180.8 377 175.0 172.3-177.7
25-64 775 166.9 164.9-168.9 1812 170.3 168.7-171.9 2587 168.6 167.0-170.3

Raised Description: Percentage of respondents with raised total cholesterol and percentage
total of respondents currently on medication for raised cholesterol.
cholesterol
• Total cholesterol measurement
• During the past two weeks, have you been treated for raised cholesterol with
drugs (medication) prescribed by a doctor or other health worker?
Total cholesterol ≥ 5.0 mmol/L or ≥ 190 mg/dl or currently on medication for raised cholesterol
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 297 2.9 0.9-4.9 727 8.2 6.2-10.2 1024 5.5 4.0-6.9
35-44 224 8.1 4.8-11.5 458 9.8 6.7-13.0 682 9.0 6.5-11.5
45-54 150 8.1 3.7-12.5 354 11.0 7.4-14.6 504 9.7 6.8-12.6
55-64 104 14.5 7.9-21.1 273 22.2 17.1-27.3 377 18.9 14.9-23.0
25-64 775 6.3 4.6-8.1 1812 11.0 9.4-12.6 2587 8.7 7.4-10.0
Total cholesterol ≥ 6.2 mmol/L or ≥ 240 mg/dl or currently on medication for raised cholesterol
(years) n % 95% CI n % 95% CI n % 95% CI
25-34 297 0.3 0.0-1.0 727 0.5 0.0-1.1 1024 0.4 0.0-1.0
35-44 224 0.9 0.0-2.0 458 1.1 0.1-2.1 682 1.0 0.2-1.7
45-54 150 0.0 0.0-0.0 354 0.5 0.0-1.3 504 0.3 0.0-0.7
55-64 104 1.0 0.0-2.9 273 4.8 2.4-7.1 377 3.2 1.6-4.8
25-64 775 0.5 0.0-1.1 1812 1.2 0.7-1.8 2587 0.9 0.4-1.3

Summary of Combined Risk Factors
Summary Description: Percentage of respondents with 0, 1-2, or 3-5 of the following risk
of factors:
Combined
Risk • current daily smoker
Factors
• less than 5 servings of fruits & vegetables per day
• low level of activity (<600 MET -minutes)
• overweight or obese (BMI ≥ 25 kg/m2)
• raised BP (SBP ≥ 140 and/or DBP ≥ 90 mmHg or currently on medication
for raised BP).
Instrument questions: combined from Step 1 and Step 2

Men
Age Group % with 0 % with 1-2 % with 3-5
(years) n risk 95% CI risk 95% CI risk 95% CI
factors factors factors
25-44 617 0.3 0.0-0.7 84.4 81.3-87.5 15.3 12.2-18.4
45-64 323 0.3 0.0-0.9 77.1 72.2-82.1 22.6 17.6-27.5
25-64 940 0.3 0.0-0.7 82.1 79.3-84.9 17.6 14.8-20.4

Women
25-44 1264 1.7 1.0-2.5 87.6 85.5-89.7 10.7 8.6-12.7
45-64 638 1.5 0.5-2.5 73.8 69.6-77.9 24.7 20.6-28.9
25-64 1902 1.6 1.0-2.3 82.8 80.6-85.0 15.5 13.5-17.6

Both Sexes
25-44 1881 1.0 0.6-1.5 86.0 84.1-87.9 13.0 11.1-14.9
45-64 961 0.9 0.3-1.5 75.3 72.2-78.5 23.7 20.6-26.9
25-64 2842 1.0 0.6-1.4 82.5 80.6-84.3 16.5 14.7-18.4


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Malawi National STEPS Survey for

Chronic Non-Communicable Diseases and

Ministry of Health ADL House

Introduction and literature review……………………………………………………….6-12

Attachment: Malawi NCD STEPS Survey Data Book

Introduction/background: With changes in life styles, chronic non-communicable

Objectives/rationale: The Specific objectives of the survey were to determine the

1.1: Global perspective

The global burden of disease is shifting from infectious to non-communicable diseases.

1.2 Developing countries

1.3 Sub-Saharan Africa

Tobacco 18.9 12.8 14.4 8 4 20 18.7 9.5 12.1 19.5 4.6

Alcohol - 5.1 62.5 39.6 11 42.5 77.2 71 74.7 27.4 61.6

Source: WHO 2004

1.4.1: Geographic location

Table two: Health facilities by type and ownership

Ownership Primary Secondary Tertiary Others Total

Total 901 100 6 52 1059

Government 493 53 5 24 575

Private for profit 196 4 0 0 200

Source: MoH 2008. Malawi Health Sector Employee Census Report

CENTRAL WESTERN ZONE Ntchisi

SOUTH WESTERN ZONE Thyolo

Zonal Grouping of Districts of Malawi (January 2007)

Figure three: Malawi estimated total DALYs by cause

Source: WHO 2004

In most developing countries including Malawi diabetes and cardiovascular diseases in

2.0: OBJECTIVES OF THE STUDY

2.1: GENERAL OBJECTIVE

To determine the magnitude of non-communicable diseases and their risk factors in

2.2: SPECIFIC OBJECTIVES

3.0: MATERIALS AND METHODS

3.1: Survey design

3.2: STEPwise (STEPS) Approach

3.3: Adaptation of survey methods and tools

3.4 Survey participants

3.5 Sample size

3.6: Sample design

Number of enumeration areas selected:

Sampling method for EA selection:

Stage 2: Selection of households

Stage 3: Selection of eligible participants at household level

3.7: Conduct of the survey

3.7.1: National Team

3.7.2: Field Team

3.7.3: Adaptation of survey tools and training manuals

3.7.4: Training of Interviewers

3.7.6: Field Activities

3.7.7: Survey period

3.7.8: Ethical clearance

3.7.9: Survey flow

Obtaining informed written consent

Step1: Questionnaire-based assessment:

Step 2: Physical measurements

Step 3: Biochemical assessment

3.8.1: Overweight and Obesity

3.8.2: Central Obesity

Table 3.2: Definition of hypertension

Normal <130 <85