Medical care delivery through leprosy clinics--consumer's perception, experiences and suggestions

Randomly selected 500 adult leprosy patients, registered for treatment with six Sectors of a Leprosy Control Unit in Chingleput District of Tamil Nadu (India) were interviewed to study their perception, and experiences with medical care being delivered to them through leprosy clinic(s), and their suggestions to improve the system. About 14% patients did not perceive their disease as leprosy. And 8% of the total patients were taking treatment outside their sector leprosy clinics. The services like physiotherapy, rehabilitation, health education etc. were known to only 3-8% patients, perhaps on account of their non-availability and or non-practice. On an average, a patient had to cover a distance of 2.1 +/- 2.5 KMs (one side) in 24 +/- 49 minutes to reach clinic spot, mostly by walk (83.2%), and spent 58.9 +/- 32.2 minutes at clinic, of which two third in waiting for service(s). Each patient had consulted 1.23 +/- 0.55 medical agencies for treatment of leprosy. The average man-day and wage losses to a patient, due to monthly clinic attendance, were estimated to be 0.48 +/- 0.49 days and Rs. 2.28 +/- 3.06, respectively. Only 10.6% of the 500 patients got admitted 1.55 +/- 0.89 times in leprosy hospital for a duration of 63 +/- 69.30 days and lost wages of Rs. 126.4 +/- 85.64 per month of stay in hospital. Availability and efficient delivery of comprehensive medical care through well organized and regularly conducted leprosy clinic, by considerate and sympathetic staff was much emphasised by patients. Various factors influencing medical care delivery and its utilization by patients, are discussed in this communication.