WHO STEPS NCD Risk Factor Surveillance Training Course

Course overview

National and subnational NCD programmes need comparable evidence on tobacco use, alcohol consumption, diet, physical inactivity, obesity, raised blood pressure, blood glucose and blood lipids. Yet surveillance teams often face fragmented questionnaires, non-standard measurements, weak sampling documentation and datasets that cannot support defensible prevalence estimates. This WHO STEPS NCD Risk Factor Surveillance Training Course equips practitioners to plan and run a STEPS survey that produces reliable, policy-relevant results while protecting participants and meeting quality expectations.

Participants work through the WHO STEPwise approach to NCD risk factor surveillance, from defining survey objectives and selecting the appropriate STEPS modules to building a sampling plan and adapting the WHO STEPS Instrument without compromising comparability. The course develops practical capability in interviewer procedures, anthropometric and blood-pressure measurement, biochemical data collection pathways, field supervision, data cleaning, weighting, indicator calculation and interpretation of age-standardised estimates. Participants also learn how to identify common sources of bias, non-response and measurement error before results reach decision-makers.

Instructor-led technical sessions are paired with worked country survey scenarios, questionnaire review, measurement demonstrations and analysis exercises using a structured STEPS dataset. Teams make operational decisions on sample size, fieldwork controls and reporting priorities, then test their choices against realistic implementation constraints. Each participant leaves with a draft WHO STEPS survey implementation pack containing a survey protocol outline, adapted instrument plan, data-quality checklist, analysis table shell and action plan for applying the method in their setting.

The course is designed for public health professionals who contribute to NCD surveillance, population health surveys, epidemiology, health information systems or prevention planning. It is particularly valuable where an organisation is preparing a first STEPS survey, repeating a previous survey, or needs to strengthen the credibility and use of its NCD risk-factor data.

Course objectives

By the end of this course, participants will be able to:

• Define a WHO STEPS survey scope using core, expanded and optional modules aligned to national NCD priorities
• Adapt the WHO STEPS Instrument while preserving standard definitions, skip patterns and international comparability
• Construct a probability sampling design with target population, sampling frame, cluster selection and sample-size assumptions
• Apply standard WHO STEPS protocols for blood pressure, height, weight, waist circumference and biochemical measurement pathways
• Develop fieldwork procedures covering interviewer training, consent, pilot testing, supervision and non-response follow-up
• Assess STEPS data quality using range checks, completeness checks, duplicate review and fieldwork monitoring indicators
• Calculate and interpret weighted prevalence estimates, confidence intervals and age-standardised NCD risk-factor indicators
• Produce a survey implementation pack with protocol elements, data-analysis table shells and a stakeholder reporting plan

Benefits of attending

Target competencies

Who should attend

• NCD Surveillance Officers — who need to plan, coordinate or improve population-based risk-factor surveys
• Epidemiologists — who must produce valid prevalence estimates and interpret trends for NCD policy
• Public Health Programme Managers — who commission surveys and need evidence that can guide prevention investment
• Health Information System Managers — who integrate survey outputs with routine health and monitoring systems
• Survey and Fieldwork Coordinators — who manage interviewer teams, measurement procedures and quality controls
• Monitoring and Evaluation Specialists — who report population-level NCD indicators to ministries, funders or partners

Requirements and prerequisites

Participants should understand basic public health concepts, including prevalence, risk factors, target populations and ethical handling of health information. Familiarity with spreadsheets such as Microsoft Excel and simple descriptive statistics is expected; participants should be able to read tables, percentages and confidence intervals, although advanced statistical programming is not required. Prior experience of surveys, field data collection, NCD programmes or health information systems is helpful but not essential. This is an intermediate course: it does not assume previous WHO STEPS implementation, laboratory expertise, complex sampling software or proficiency in Epi Info.

Training methodology

The five-day programme combines instructor-led explanation of WHO STEPS standards with hands-on design and analysis work. Participants review a sample STEPS questionnaire, map indicators to policy questions, build sampling and fieldwork plans, and practise quality-control decisions using realistic survey records. Measurement demonstrations cover standard blood-pressure and anthropometric procedures; case studies examine common implementation failures such as non-response, missing data and inconsistent devices. Facilitated group workshops culminate in an individual application plan and a draft survey implementation pack for the participant’s organisation.

Course outline

Day 1: WHO STEPS framework and survey purpose

• WHO STEPwise approach to NCD risk factor surveillance
• Core, expanded and optional STEPS modules
• Behavioural, physical and biochemical measurement steps
• NCD indicators and policy-use questions
• Target population and survey geography definition
• Cross-survey comparability and trend measurement
• Ethical approval, informed consent and participant confidentiality

Workshop: Participants develop a STEPS survey purpose statement and indicator map for a realistic national or subnational NCD programme.

Day 2: Instrument design and sampling

• WHO STEPS Instrument structure and skip logic
• Questionnaire adaptation without changing indicator definitions
• Translation, back-translation and cognitive testing
• Sampling frames and eligible population listings
• Multistage cluster sampling procedures
• Sample-size assumptions, design effect and non-response inflation
• Household and respondent selection methods

Workshop: Participants adapt selected STEPS questionnaire sections and produce a sampling-design worksheet for a defined survey population.

Day 3: Field operations and measurement quality

• Interviewer recruitment, training and standardisation
• Fieldwork manual and team deployment planning
• Blood pressure measurement protocol and device checks
• Height, weight and waist circumference measurement procedures
• Biochemical measurement pathways and specimen governance
• Pilot survey procedures and instrument revision control
• Daily supervision, call-backs and non-response management

Workshop: Teams complete a fieldwork quality-control workshop and produce a supervisor checklist covering measurements, consent and daily returns.

Day 4: Data management and statistical analysis

• Data dictionaries, variable naming and codebooks
• Range checks, consistency checks and missing-data review
• Survey weights, selection probabilities and non-response adjustment
• Weighted prevalence estimates and confidence intervals
• Age standardisation using WHO reference populations
• STEPS risk-factor definitions and indicator derivation
• Epi Info and spreadsheet-based analysis workflows

Workshop: Participants clean a simulated STEPS dataset and calculate weighted, age-standardised indicators for a draft results table.

Day 5: Interpretation, reporting and implementation planning

• Interpreting prevalence patterns, inequalities and uncertainty
• Comparing STEPS findings across sex, age and geography
• Avoiding misleading trend and subgroup comparisons
• Results tables, charts and technical report structure
• Policy briefs for NCD prevention and service planning
• Data dissemination, access controls and documentation
• Survey implementation timelines, budgets and risk registers

Workshop: Participants present a concise NCD surveillance findings briefing and finalise a STEPS implementation pack for their own workplace context.

Tools & standards covered

WHO STEPwise approach to NCD Risk Factor Surveillance (STEPS), WHO STEPS Instrument, WHO STEPS Surveillance Manual, Epi Info

A typical training day

Live online deliveries follow the same structure in the East Africa Time zone, with shorter screen blocks and longer breaks.

What the fee includes

How you can take this course

Certification

Participants who complete the full five days receive the Skillset Development Certificate of Completion, stating the course title, course code, dates and delivery format — suitable for professional-development records and employer reimbursement.

Frequently asked questions