Implementation of the WHO STEPS Approach for NCD Risk Factor Surveillance in Rural Communities: Challenges, Adaptations, and Outcomes

Background and Objective: Non-Communicable Diseases (NCDs) such as cardiovascular diseases, diabetes, and cancer present a growing global health challenge, particularly in low- and middle-income countries. This study aims to evaluate the implementation, challenges, and contributions of the WHO STEPS framework in facilitating national NCD surveillance and informing public health strategies. Materials and Methods: This descriptive study reviewed the implementation of the WHO STEPS surveys across more than 129 countries over the past decade. Emphasis was placed on the integration of mHealth technologies and the involvement of Community Health Workers (CHWs) to overcome infrastructural and cultural barriers. Data sources included national STEPS reports and WHO documentation. Thematic analysis was used to assess patterns in data usage, implementation challenges, and policy outcomes. Results: The STEPS framework successfully generated standardized, country-specific data critical for NCD monitoring and control. Participation included over 129 countries, with improvements in data quality and accessibility observed through the incorporation of mHealth tools and CHW training. These efforts enhanced survey reach, especially in rural and resource-constrained settings. The data informed national action plans and guided targeted interventions. Despite persistent challenges in healthcare infrastructure and logistics, the methodology proved adaptable and scalable across diverse contexts. Conclusion: The WHO STEPS framework has significantly contributed to global NCD surveillance, enabling countries to formulate evidence-based health policies. While challenges remain, particularly in under-resourced areas, the incorporation of digital tools and community-based approaches has enhanced its effectiveness. Future success will depend on continued international support, inter-country data-sharing, and adaptive strategies to sustain and expand NCD prevention efforts globally.