The study, titled the Rwanda National STEPs survey 2022, was unveiled on Friday 30th June 2023.

It aimed to assess the distribution of lifestyle factors, dietary practices, and various health measurements among adults aged 18-69 years. These findings offer valuable information that will assist in strengthening NCD prevention and control initiatives in the country.

Noncommunicable diseases (NCDs) have emerged as the leading causes of death worldwide. According to the WHO, these diseases account for a staggering 71% of global deaths, with a significant portion occurring in low- and middle-income countries (LMICs). Rwanda, like many LMICs, faces the challenge of addressing NCD risk factors to reduce the burden of these diseases on its population.

Methodology and objectives

The Rwanda National STEPs survey 2022 utilized the WHO STEPwise Approach (STEPS) to gather comprehensive information on NCD risk factors, injuries, and oral health. The study included a representative sample of 5,776 randomly selected participants across the country. Its specific objectives were to assess the distribution of lifestyle factors, identify dietary practices contributing to NCDs, determine the prevalence of various health conditions, and provide reliable information for planning and evaluating public health initiatives.

Behavioral risk factors

The survey revealed that 7% of Rwandans currently use tobacco products, with a higher prevalence among men (10.4%) compared to women (3.7%). Additionally, 48.1% of Rwandans consume alcohol, with higher rates among males (61.9%) than females (34.3%). A concerning statistic is that only 11.5% of women have ever been screened for cervical cancer.

Dietary practices

The study indicated that Rwandans consume fruits on average 1.8 days a week and vegetables on 4.2 days a week, falling significantly short of the WHO’s recommendation of at least five servings of fruits and vegetables per day. Additionally, a notable percentage (8.8%) of Rwandans regularly add salt to their food, and 2.8% consume processed foods high in salt.

Physical activity

Approximately 4.6% of Rwandans do not engage in the WHO-recommended amount of physical activity. Work-related activities constituted 61.5% of total physical activity, while transport-related and recreation-related activities accounted for 31.1% and 7.4%, respectively.

Health measurements

The study found that 18.6% of Rwandans are overweight or obese, with a higher prevalence among women (26%) than men (11.5%). Obesity was observed in 4.3% of respondents, with a higher prevalence among females (7.4%) compared to males (1.3%). Additionally, there were notable gaps in the detection and management of conditions such as high blood pressure, diabetes, and elevated cholesterol levels.

Combined NCD risk factors

Only 6% of Rwandans were found to have none of the major risk factors for NCDs. Among individuals aged 18-44 years, 5.4% had three or more risk factors, while among those aged 45-69 years, the percentage rose to 12.8%. Overall, 7.1% of individuals aged 18-69 years had three or more risk factors.

Ongoing efforts

Rwanda has made significant efforts to combat communicable diseases through public awareness campaigns and strategic planning. The country’s health sector has implemented campaigns to educate the public about non-communicable diseases (NCDs) like diabetes, heart disease, and cancer.

These initiatives aim to promote healthy lifestyles, early detection, and treatment of NCDs, thereby reducing the burden on the healthcare system.

Rwanda’s National Strategy and Costed Action Plan for the Prevention and Control of NCDs, covering the period from 2020 to 2025, emphasizes NCD prevention through health promotion and the reduction of risk factors.

This includes addressing unhealthy diets, physical inactivity, tobacco use, alcohol consumption, indoor pollution, occupational exposure to carcinogens, and infections leading to NCDs.

The strategy recognizes the importance of health literacy to enable individuals to make informed and healthy choices, as many of these risk factors can have an impact from childhood and even during the intrauterine period.

Speaking at the unveiling of the survey today, Dr. Theopista John Kabuteni, Health Systems and Policy Advisor at WHO Rwanda, emphasized the progress made compared to the previous survey in 2013. However, she stressed the importance of not becoming complacent and using this progress as an excuse to overlook the work that still needs to be done.

"We have observed significant progress compared to the previous survey in 2013. Nevertheless, there remains a considerable amount of work ahead, and it is crucial that we integrate these factors into our routine systems. We should not solely rely on large-scale surveys that require substantial resources and effort. Our primary focus should be on creating community awareness, establishing partnerships, and allocating resources to ensure the implementation of all recommendations," Dr. Kabuteni noted.

Mr. Marc Hagenimana, Director of the Cancer Unit at RBC, reaffirmed Rwanda’s commitment to enhancing cancer screening technology, raising awareness about non-communicable diseases (NCDs), and conducting impactful campaigns to reach a wider population.

"Our ultimate goal is to strengthen the human resources necessary for effective cancer management and achieve comprehensive cancer control," he stated.

Researchers indicate that eating and physical activity patterns, insufficient sleep are among several other factors influence excess weight gain.