Behavioural Risk Factors of Noncommunicable Diseases among Nepalese Urban Poor: A Descriptive Study from a Slum Area of Kathmandu

There has been a rapid rise in the burden of noncommunicable diseases in low-income countries like Nepal. Political and economical instability leading to internal migration give rise to haphazard urbanization in Nepal. This, coupled with negative effects of globalization, is largely responsible for changing lifestyle and developing risky behaviour among the urban poor that put them at high risk of developing noncommunicable diseases. A descriptive cross-sectional quantitative study was conducted from September to December 2012 in an urban slum of Kathmandu to explore the prevalence of four major behaviour risk factors namely physical inactivity, low fruit and vegetable consumption, and tobacco and alcohol use and to measure the burden of obesity and hypertension in the population. We used WHO NCDs Risk Factor steps 1 and 2 questionnaires in all the 689 households of the slum. The major behavioral risk factors for noncommunicable diseases were very common with at least a quarter of the population having the major risk factors. The results may serve to form a framework to future planning, policy-making, implementation, and evaluation of any measures undertaken to reduce these risk factors, especially as the government is planning to unveil the National Urban Health Policy soon. 1. Introduction It is well established that noncommunicable diseases (NCDs) are the leading cause of adult mortality and morbidity worldwide including the Southeast Asia region (SEAR) [1]. Four main NCDs, namely cardiovascular diseases (CVDs), diabetes, cancers, and chronic respiratory diseases, are mainly responsible for this high mortality and morbidity. Of the estimated 14.5 million total deaths in 2008 in SEAR, more than half (55%) of them were due to NCDs, mainly cardiovascular disease (25%) [1]. From the beginning, NCDs and particularly CVDs were termed diseases of the rich in the developed countries [2]. However, over the past two decades, CVD deaths have been declining in the high-income countries but increasing significantly in the low- and middle-income countries (LMICs) [3]. One of the reasons for this increase is the rising life expectancy like the one being seen in South Asia region which leads to shifting disease burden towards NCDs [4]. Moreover, at the same time, the trend of urbanization is drastically increasing in this region causing changes in lifestyle of the people. For example, shifting lifestyle towards low physical activity and unhealthy diet leads to a rise in prevalence of obesity and NCDs among urban population [5]. For this reason, NCDs have also been