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Lessons in integration--operations research in an Indian leprosy NGO.
J D H Porter1, J A Ogden, P V Ranganadha Rao
1Departments of Public Health and Policy and Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK. j.porter@lshtm.ac.uk
Leprosy Review
|August 24, 2002
Summary
Integrating leprosy and tuberculosis services into primary healthcare requires addressing physical access barriers and provider training gaps. Collaboration between NGOs and government is key for effective health system strengthening.
Area of Science:
- Public Health
- Health Systems Research
- Infectious Disease Control
Background:
- The Alma Ata Declaration (1978) advocated for integrating infectious disease control into primary healthcare.
- Over 20 years later, effective integration of services like leprosy and tuberculosis remains a challenge for many countries.
Purpose of the Study:
- To explore strategies for integrating tuberculosis (TB) services into existing leprosy control structures.
- To identify ways for non-governmental organizations (NGOs) to link with government healthcare systems.
- To assess community and provider perceptions of leprosy and TB services to inform integration efforts.
Main Methods:
- A qualitative operations research approach was employed.
- Perceptions of patients, communities, and healthcare providers were assessed.
- LEPRA India conducted a pilot project in Koraput district, Orissa (1996-2000).
Main Results:
- Physical access to treatment was a significant constraint for patients and communities.
- Local providers and family support facilitated healthcare access.
- Providers expressed willingness to collaborate but lacked training, support, and resources.
- Inadequate public information campaigns on diseases and treatment were identified.
Conclusions:
- LEPRA India can address system gaps by strengthening partnerships with government for training and service delivery.
- Developing collaborative relationships is crucial for successful service integration.
- Addressing provider needs and improving public awareness are essential for effective primary healthcare integration.