Research Article: Integration of Leprosy Elimination into Primary Health Care in Orissa, India

Date Published: December 18, 2009

Publisher: Public Library of Science

Author(s): M. Ruby Siddiqui, Nageswara Rao Velidi, Surendra Pati, Nilambar Rath, Akshay K. Kanungo, Amiya K. Bhanjadeo, Bandaru Bhaskar Rao, Bijaya M. Ojha, Kodyur Krishna Moorthy, Douglas Soutar, John D. H. Porter, Pemmaraju V. Ranganadha Rao, Stefan Bereswill. http://doi.org/10.1371/journal.pone.0008351

Abstract: Leprosy was eliminated as a public health problem (<1 case per 10,000) in India by December 2005. With this target in sight the need for a separate vertical programme was diminished. The second phase of the National Leprosy Eradication Programme was therefore initiated: decentralisation of the vertical programme, integration of leprosy services into the primary health care (PHC) system and development of a surveillance system to monitor programme performance.

Partial Text: The National Leprosy Control Programme was launched in India in 1955, using surveys, education and dapsone monotherapy to detect and treat leprosy cases. The programme was re-launched as the National Leprosy Eradication Programme (NLEP) in 1983 with the goal of elimination of leprosy as a public health problem (<1 case per 10,000). Multi-drug therapy (MDT), including rifampicin, clofazimine and dapsone for multibacillary (MB) leprosy patients and rifampicin and dapsone for paucibacillary (PB) leprosy, replaced dapsone monotherapy and the first phase of this vertical programme focussed on detecting and treating all leprosy cases. This successfully reduced the national prevalence of leprosy from 57.6 per 10,000 in March 1981 to 2.44 per 10,000 in March 2004 [1]. Leprosy was eliminated nationally by December 2005 [1]. With this target in sight the need for a separate vertical programme was diminished. The Government of India (GOI) initiated the second phase of the NLEP programme: decentralisation of the vertical programme, integration of leprosy services into the general health system (GHS) and development of an adequate surveillance system to monitor programme performance. There was overwhelming support and approval for integration of the leprosy elimination programme into GHS. Patients could now obtain treatment and medical care easier and there was less stigma now that patient care was incorporated into the GHS. PHC staff felt they were now more knowledgeable about leprosy and able to serve their communities better. The two-stage strategies of functional and structural integration had built a strong knowledge-base and capacity within the PHC and provided a support network of leprosy experts. Source: http://doi.org/10.1371/journal.pone.0008351

 

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