Countrywide “best buy” interventions for noncommunicable diseases prevention and control in countries with different level of socioeconomic development

Abstract

Background: Noncommunicable diseases (NCDs) place a heavy burden on populations globally and in particular, on lower-income countries (LIC). WHO identified a package of 16 “best buy” lifestyle and management interventions that are cost-effective and applicable in all settings. The purpose of this study was to evaluate and compare NCD risk factors in all WHO countries and make preliminary assessment of “best buy” interventions. Methods: Risk factors estimation was made in 188 countries. NCD attributable “best buys” concern tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. Management issues are based on the availability of the national NCD guidelines and provision of drug therapy. Results: Every fourth adult in high-income countries (HIC) has raised blood pressure (RBP). Prevalence of RBP in lower-middle-income countries (LMIC) and LIC is 22%–23% (HIC/LMIC: t = 3.12, p < 0.01). Prevalence of diabetes in LIC is less than half of that in HIC and upper-middle-income countries (UMIC) UMIC/LIC: t = 8.37, p < 0.001. Obesity prevalence is gradually decreasing from HIC to LIC (HIC/LIC: t = 11.48, p < 0.001). Highest level of physical inactivity is seen in HIC, which then gradually declines to LIC (17%). Tobacco prevalence in LIC is almost less than half of that in HIC and UMIC (HIC/LIC: t = 7.2, p < 0.0001). There is a gradual decline in the implementation of “best buys” from HIC to LIC. Conclusion: Wealthier countries have better implementation of the WHO NCD prevention strategy.