Integration of leprosy services with General Health Care System (GHS)
Leprosy Training of GHS functionaries
Early Diagnosis & Prompt MDT, Through routine and special efforts.
Inforamation Education and Communication (IEC) using Local & Mass Media for reduction of Stigma & Discrimination.
Prevention of Disability & Medical Rehabilitation.
Monitoring & Periodic Evaluation
Inter-sectoral collaboration.
Monitoring & Evaluation.
GOI has issued "New paradigms in NLEP for post elimination which are as follows –
To reduce the leprosy burden in the community.
To provide high quality leprosy services for all persons affected by leprosy, through General Health Care System including referral services for complications & chronic care.
Integration of NLEP in to General Health Care Services – Strengthening of integrated services.
Referral services & long term care.
Prevention & management of impairments and disabilities.
Improving community awareness & involvement.
Physical, Socio & Economical Rehabilitation of Leprosy patients.
Indicators for Monitoring & Evaluation –
No. of New Cases Detected in given area each year.
Treatment Completion / Cure rate.
Proportion of new cases presenting with Grade II disability / impairment at the time of diagnosis.
Proportion of child (0 to14 years of age) MB cases & Female cases among new cases.
Indicators for patient management & follow up -
Proportion of new cases verified as correctly diagnosed.
Proportion of treatment defaulters.
No. of relapses.
Proportion of patients who develop new / additional disability during Multi Drug Therapy.
Enhanced advocacy in order to reduce stigma and stop discrimination against leprosy affected persons and their families.
Capacity building among Health Service Personnel in integrated setting both for rural and urban areas.
Strengthen the monitoring and supervision components of the surveillance system.
Expected Outcome
The system of setting targets for leprosy case detection, case treatment and discharge of patients is not being followed in the National Leprosy Eradication Programme in India from the year 2003-04 onwards. These targets are no longer of much use after elimination of leprosy as a public health problem at the National level.
Main indicators to be used under the programme now to measure the progress and outcome expected are as below:-
Indicators Outcome expected by March 2012
PR < 1/10,000 in State - 100%
PR < 1/10,000 in Districts - 100%
ANCDR (National) - < 10/100,000
Cure rate MB - >95%
Cure rate PB - >97%
No. of Gr. II disabled cases 25% reduction
(Base – 2006-07)
Other additional indicators to assess the quality of services provided e.g. proportion of cases correctly diagnosed, Defaulter rates, Cases with disability after initial treatment, number of relapses, Proportion of new MB, Child, Female and Disability cases are to be used. However no target has to be fixed for the same.
Strategy for Programme Implementetion
No active searches except for high
Prevalence Rate (PR) pockets, Modified Leprosy Elimination
Campaign (MLEC), SAPEL/LEC
Full integration of anti-leprosy activities with
GHS in rural as well as urban area.
The Male MPW will include leprosy work in his
activities with emphasis on case finding, defaulter identification,
health education. The female MPW/ANM and the AWW will refer
suspected cases. Treatment follow up will be carried out by
the male MPW every month at village and sub centre level. He
will also advise new patient and provide POD services.
General hospitals, CHCs, PHCs, additional PHCs
and dispensary centres will offer leprosy diagnosis and treatment
facilities independently. One PME/NMS will be appointed in blocks
with high endemic pockets for guidance and support.
Promotion of voluntary reporting by creating enhanced
awareness among masses.
