Validating the self-reported annual monitoring grid for the 2007 Caribbean Community Declaration of Port-of-Spain on noncommunicable diseases

Objectives. In 2007, the Caribbean Community (CARICOM) convened the world’s
first-ever heads of government summit on noncommunicable diseases (NCDs) and issued the
landmark Declaration of Port-of-Spain: Uniting to Stop the Epidemic of Chronic NCDs. Since
then, ministry of health (MoH) focal points in each country have self-reported annually on
their NCD efforts, using a 26-indicator grid created to assess implementation of the Declaration.
Our objective was to assess the validity of those grid responses, as compared to information
from in-depth interviews and document reviews.
Methods. Seven national case studies on policy responses to the Declaration were undertaken
in 2015. In-depth, semistructured interviews were conducted with stakeholders from
multiple sectors, including the MoH. Policy documents were also identified and reviewed. The
results from the 2015 case studies were compared to the 2014 MoH focal point grid responses.
Kappa statistics evaluated chance agreement.
Results. The information from the grid and from the case studies agreed closely. Out of a
total of 182 indicators (26 each for seven countries), there was a lack of agreement on just 9
(4.9%). All the differences were between policy statements and implementation. Except for
physical activity, kappa statistics indicated that agreement was good to excellent for all the
clusters of the grid and for the grid as a whole, but with wide confidence intervals.
Conclusions. In general, the monitoring grid accurately assessed the national situation, but
with a possible tendency to overstate performance in some areas. These findings contributed to
the design of a new, 50-indicator monitoring grid in 2016. Alongside these improvements,
CARICOM countries face a substantial burden from having to complete many other required
NCD reports, mainly for the Pan American Health Organization and the World Health
Organization.