Monitoring and evaluation of the NAOS Strategy: minimum set of indicators

In 2007 the International Workshop ‘WHO Global Strategy on Diet, Physical Activity and Health: a framework to monitor and evaluate implementation’ was held in Madrid. This workshop was organised by WHO and AESAN with the purpose of reviewing and sharing evaluation experiences from different countries.

The recently enacted Spanish Law on Food Safety and Nutrition lays down that adequate indicators and tools must be set to carry out the monitoring and evaluation of the actions undertaken as part of the NAOS Strategy. It also establishes the creation of the Observatory for Nutrition and Obesity Study.

The main objective of this paper is to establish a minimum set of indicators related to healthy eating, physical activity and the prevention of overweight and obesity in the different areas of activity of the NAOS Strategy, which can be obtained by the Public Administrations and which reflect the evolution of the Strategy and the regional plans on the promotion of healthy eating and physical activity.

Within the joint working group of the Spanish Food Safety and Nutrition Agency (AESAN) and the Autonomous Communities (CC.AA.), a monitoring and evaluation subgroup was created with the participation of representatives from the municipalities, through the Network of Nutritional Observatories (RON) and the Spanish Government’s Sports Council (CSD). Various areas of information where to work were established in order to obtain indicators in each one of them:

• General framework: family and community environments. General indicators on the prevalence of overweight and obesity, and healthy habits in nutrition and physical activity.
• Schools: healthy eating and physical activity.
• Healthy eating and physical activity in the workplace.
• Healthcare.
• City planning and infrastructures for the practice of physical activity.
• Industry and food distribution.
• Hotels and restaurants.

The paper includes 60 indicators divided into the areas of information defined, including their purpose, definition and formulation, as well as the sources available or necessary for their measurement.

The sources of information used were: The National Health Survey of Spain (ENSE) conducted by the Spanish National Statistics Institute (INE) under the auspices of the Ministry of Health, Social Policy and Equality; the Health Barometer, conducted by the Spanish Centre for Sociological Research; the Survey on Sports Habits in Spain (population over 15 years), the Survey on sports habits among the school-age population, and the National Census of Sports Facilities, conducted by the Spanish Government’s Sports Council.

The gender perspective has been mainstreamed in the preparation, collection and analysis of the indicators to visualise the inequities between women and men, as well as the inequalities due to social, economic and educational factors as regards healthy eating, physical activity and overweight and obesity.

Evaluation and monitoring of the NAOS Strategy: minimum indicator set