Leprosy control activities in India: integration into general health system

Area of Science:

• Public Health
• Infectious Disease Control
• Health Systems Strengthening

Background:

• Leprosy elimination strategies necessitate integrating specialized control programs into general healthcare systems.
• India's phased integration approach, supported by the World Bank, targeted low/moderately endemic provinces in its first phase (2001-2002).

Purpose of the Study:

• To evaluate the progress of leprosy control integration within India's general health system.
• To assess structural integration, staff training, Multi-Drug Therapy (MDT) availability, and case reporting.

Main Methods:

• A multistage stratified random sampling technique was used to select provinces, districts, health facilities, and sub-centres.
• Data collection involved interviews with healthcare staff, record scrutiny, and MDT stock checks by health officers.

Main Results:

• District leprosy nuclei were established in 16/18 districts, with 56% of facilities redeploying vertical staff for general care.
• Training in leprosy was received by 45% of medical officers, 71% of health supervisors, and 75% of multipurpose workers.
• While MDT was available in over 80% of facilities, only 2% maintained a 3-month stock; 44% of sub-centres administered subsequent MDT doses.

Conclusions:

• The study highlights the need for reorientation training for medical officers to improve leprosy management.
• Enhanced MDT stock management and decentralized case management up to the sub-centre level are crucial for effective integration.