Integration of leprosy control into basic health services; an example from Nepal

Area of Science:

• Public Health
• Health Services Management
• Infectious Disease Control

Background:

• Nepal aimed to integrate vertical health projects into Basic Health Services (BHS) nationwide starting in 1987.
• The Nepal Leprosy Control Project (NLCP) was one such vertical project requiring integration.
• Successful integration necessitates trained staff, adequate supplies, supervision, and a functional BHS system.

Purpose of the Study:

• To assess the fulfillment of prerequisites for leprosy control integration into Nepal's BHS.
• To evaluate the effectiveness of the Comprehensive Leprosy Training course.
• To identify obstacles hindering the integration of leprosy control.

Main Methods:

• Utilized results from an evaluation of the Comprehensive Leprosy Training course.
• Reviewed existing literature on the functionality of the Basic Health Services (BHS) system in Nepal.
• Assessed the availability of drugs, equipment, supervision, and referral facilities.

Main Results:

• The Comprehensive Leprosy Training course was developed to prepare BHS staff.
• Adequate training, drug supply, and supervision were not fully met.
• Underlying issues in the Basic Health Services (BHS) system significantly impacted integration success.

Conclusions:

• The Basic Health Services (BHS) system's suboptimal functioning is the primary barrier to leprosy control integration.
• Continued (semi)vertical support for leprosy control is recommended in districts with underdeveloped BHS.
• Addressing BHS system weaknesses is crucial for effective long-term integration of health programs.