Posted on 8 Oct, 2021 by Dr. Juma Khudonazarov and Heiko Königstein

On the 28th of September 2021, Ukraine began with the implementation of a Childhood Obesity Surveillance Initiative (COSI) survey. This historic moment joined the partners: WHO (World Health Organisation), SDC (Swiss Agency for Development and Corporation), MoH (Ministry of Health), UPHC (Ukraine Public Health Centre), and GFA Consulting Group led project, Act4Health, in support of the implementation of the survey. This marks the beginning of an accurate compilation of useful data on childhood obesity as well as for other overweight issues within the country in order to create an informative baseline from which to tackle the non-communicable diseases (NCDs), in Ukraine that are responsible for 91% of overall mortality. The COSI will bring benefits in terms of reliable data concerning the physical anthropometric of schoolchildren along with the associated information within school environments. Furthermore, the findings on the established habits surrounding diet and physical activity shall inform policy development for combating the emerging obesity epidemic. 

“The way to combat the emerging obesity epidemic is via reliable data that the COSI survey can provide. For us, this unique moment marks a start of the largest and longest project to reduce risk factors for non-communicable diseases in Ukraine. The Government of Switzerland supports the project through SDC. Within the framework of our project, we will support the COSI survey as we have a long term interest on how to tackle obesity and overweight issues among school children as part of the NCD prevention strategy,” said Dr. Juma Khudonazarov, head of Act4Health project, Ukraine.

Each country is responsible for national data collection and analysis through previously identified institutions in charge of the overall national coordination and management. The data management process will be completed via releasing information through reports and/or scientific publications. The Act4health project will support the Ukraine Public Health Centre via leading the implementation of the COSI survey in Ukraine. The WHO will provide the necessary technical support.

To date there remains no qualitative or quantitative data related to obesity and overweight issues amongst schoolchildren in Ukraine. This is therefore a unique opportunity to produce the initial benchmark set of accurate, representative and reliable data. This will support policymakers in tailoring the mainstream food regulation in order to prevent NCDs while also promoting the change to healthier lifestyle activities.
Childhood obesity is strongly associated with risk factors for cardiovascular diseases, diabetes, orthopedic problems and mental disorders. Moreover, childhood obesity is linked to underachievement at school and lowered self-esteem. Over 60% of children who are overweight by puberty will be overweight in early adulthood, which reduces the average age at which non-communicable diseases emerge to greatly increase the burden on health services.
COSI is a survey based on nationally representative samples that takes standardized weight and height measurements while collecting information amongst school environments that include the dietary and physical activity habits. 2,800 primary school children, seven years of age, will be measured in more than 200 schools across the country with an included over-sampling to be made within five priority regions of Ukraine (Dnipropetrovsk, Kherson, Rivne, Lviv, and Poltava). The child form includes the mandatory variable measurements: weight, height, date of birth (or age), gender; along with optional questions. The anthropometric measurements will be taken by trained and standardized examiners working according to a common protocol. Similar to the child form, the school records form includes a few mandatory characteristics concerning the school environment, such as the frequency of physical education, the availability of school playgrounds, the possibility of purchasing a number of listed food and beverage items within the school premises; along with the information about any current school initiatives that promote a healthy lifestyle. The voluntary family record form is to be completed by parents or caregivers and can provide data on the  dietary intake, physical activity, and inactivity patterns of the children; along with the socioeconomic characteristics and co morbidity conditions of the family that are associated with obesity. Data is collected once in a given school year and rounds will be conducted every two or three years. With a widespread availability of cheap, processed and fast-food, the rate of obesity and overweight issues is becoming a global threat to the wellbeing of future generations and Ukraine is no exception. The only way to positively convince the hearts and minds of policy makers is to provide them with evidence-based data and the COSI survey is the effective tool.

International ethical guidelines will be followed when implementing the COSI survey in Ukraine. Parents are fully informed about all the study procedures, and their subsequent consent for the measurements and data treatment is voluntary prior to any child’s enrolment into the system. The child’s consent is also obtained before the measurements. Information is collected on two mandatory forms (child and school), and one optional form (family).

Project in brief

Photo: Representatives from WHO Ukraine, EURO WHO, MoH, and SDC sponsored project, UPHC, COSI team Latvia and Kazakhstan

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