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SUSTAINING LEPROSY CONTROL MEASURES IN THE PUBLIC HEALTH SYSTEM TO ENSURE QUALITY CARE Supported by ANESVAD Foundation,

SUSTAINING LEPROSY CONTROL MEASURES IN THE PUBLIC HEALTH SYSTEM TO ENSURE QUALITY CARE Supported by ANESVAD Foundation, Spain implemented by ALERT INDIA, Mumbai, India. INDEX. ANESVAD MISSION AND ITS PRIORITIES 2. ANESVAD INTERVENTIONS IN THE FIELD OF LEPROSY

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SUSTAINING LEPROSY CONTROL MEASURES IN THE PUBLIC HEALTH SYSTEM TO ENSURE QUALITY CARE Supported by ANESVAD Foundation,

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  1. SUSTAINING LEPROSY CONTROL MEASURES IN THE PUBLIC HEALTH SYSTEM TO ENSURE QUALITY CARE Supported by ANESVAD Foundation, Spain implemented by ALERT INDIA, Mumbai, India

  2. INDEX ANESVAD MISSION AND ITS PRIORITIES 2. ANESVAD INTERVENTIONS IN THE FIELD OF LEPROSY 3. LEPROSY - BASIC CONCEPTS 4. LEPROSY - WORLDWIDE 5. WHY A LEPROSY ELIMINATION ACTION PROGRAMME (LEAP)? 6. LEAP AND ITS COMPONENTS 7. INNOVATIVE APPROACH

  3. ANESVAD’s MISSION • To contribute to the PROMOTION AND PROTECTION OF • HEALTH understood as a fundamental human right: • - Defending health as complete physical, mental and social well-being. • - Intervening politically, socially, economically and culturally. • - Developing alliances with the different actors involved. ANESVAD Foundation established in 1968 is an independent, non religious and non-governmental organisation for development (NGOD) with the following objective:

  4. ANESVAD’sPRIORITIES NEGLECTED TROPICAL DISEASES (NTDs) Leprosy, Buruli Ulcer, Chagas Disease, Dengue Fever and Leishmaniasis COMMUNITY HEALTH MOTHER - CHILD HEALTH AND SEXUAL & REPRODUCTIVE HEALTH HUMAN TRAFFICKING

  5. ANESVAD AND ITS INTERVENTION IN THE FIELD OF LEPROSY • 40 years of experience. • 1st experience in Culion Island (Philippines) with 36 years of intervention. In 1997 leprosy was eliminated. • More than 500 projects to combat leprosy in Asia, America and Africa have been developed. • Special focus in Asia, particularly in India supporting leprosy control programmes. Culion Island, Philippines was a former leprosy colony. Now leprosy free island and a famous tourist destination.

  6. Is caused by bacillus called Mycobacterium leprae (Hansen, 1874) that causes nerve damage leading to disabilities and deformities. Least infectious of all communicable diseases. Completely curable and treatment provided in the early stages averts permanent disability. Since early 80’s there is a treatment for leprosy MDT (3 drugs) free of charge since 1995. With minimal training, leprosy can be easily diagnosed based on clinical signs. Between 1985 and 2008, close to 15 million people were diagnosed and cured with MDT LEPROSY BASIC CONCEPTS M.Leprae, a germ causing leprosy Multidrug therapy (MDT) cures leprosy

  7. LEPROSY WORLDWIDE 17 countries represent 94% of the new leprosy cases detected (NCD) worldwide. The total of NCD in 2002 was 620.638 while in 2007 were 254.525 cases detected. Although global leprosy prevalence is declining between 2006-2007, in 10 countries NCD has increased. The NCD in India represented 54% of the global total leprosy burden in 2007. Table 1. 17 countries reporting >1000 new cases during 2007 Source: Weekly Epidemiological Record, WHO 2008, 83

  8. WHY A LEPROSY ELIMINATION ACTION PROGRAMME (LEAP)? • WHO global strategy for leprosy states that the efforts must focus on integrating leprosy in the general health caresystem and ensure providing quality care and services. • Inadequate leprosy care services in the general health care due to absence of an effective referral system. • New leprosy cases continue to emerge and a significant number are detected with early disabilities and deformities results in social ostracisms. • Leprosy is a chronic disease that requires long-term planning and control measures. • The challenge is to deliver a sustainable care and services for leprosy affected persons (new & old cases).

  9. LEPROSY ELIMINATION ACTION PROGRAMME (LEAP) WHAT’S LEAP: LEAP is a strategic programme with defined intervention to ensure the rights of people affected by leprosy through sustained leprosy controlmeasures and enhanced quality care within public health care system. WHERE IS LEAP IMPLEMENTED: States of Maharashtra and Chhattisgarh HOW: ALERT INDIA + 35 partners with the involvement of the national health care system and the local communities SUPPORT: 8 years (2005 -2013) 2.262.150 euros (2005-2009)

  10. LEAP COMPONENTS Component 1: SPECIAL SELECTIVE DRIVES Component 2: LEPROSY REFERAL CENTERS Component 3: CONTINUING MEDICAL EDUCATION Component 4: EPIDEMIOLOGICAL MONITORING AND EVALUATION (EME) 10

  11. LEAP COMPONENT 1 SELECTIVE SPECIAL DRIVES (SSD) Train local community members for creating mass awareness. Objective Enablelocal community to promote voluntaryreporting of new cases and to refer them to the adequate services Main Achievements 5.309.391 people reached through awareness programmes - 3.829 villages / slum pockets 4.847 new leprosy cases detected

  12. LEAP COMPONENTS Component 1: SPECIAL SELECTIVE DRIVES Component 2: LEPROSY REFERAL CENTERS Component 3: CONTINUING MEDICAL EDUCATION Component 4: EPIDEMIOLOGICAL MONITORING AND EVALUATION (EME) 12

  13. LEAP COMPONENT 2 LEPROSY REFERAL CENTRES (LRC) Train and equip the health care providersat the primary and intermediate level with the necessary skills and tools. Objective Improveaccess to quality servicesin the public health system increasing the self-reliance of the health care providers. Main Achievements 62 LRCs supported - 3385 patients receive disability care and prevention services State government of Maharashtra has recommended the LRC’s as a “best practice” under health system reforms.

  14. LEAP COMPONENTS • Component 1: SPECIAL SELECTIVE DRIVES • Component 2: LEPROSY REFERAL CENTERS Component 3: CONTINUING MEDICAL EDUCATION Component 4: EPIDEMIOLOGICAL MONITORING AND EVALUATION (EME) 14

  15. LEAP COMPONENT 3 CONTINUING MEDICAL EDUCATION (CME) Updating the technical knowledge and transferring practical skills to the public and private health care providers using information and communication technology (ICT) tools. Objective Add clinical acumen to identify, treat and manage leprosy by health providers and develop links with other health programmes. Main Achievements 8403 medical and paramedical personnel / students given orientation on leprosy 1.135 private medicine / general practitioners trained in diagnosis and treatment Diagnostic, treatment and deformity control guides for public health doctors recognised by the Leprosy Division (G.I) and used nationally

  16. LEAP COMPONENTS Component 4: EPIDEMIOLOGICAL MONITORING AND EVALUATION (EME) • Component 1: SPECIAL SELECTIVE DRIVES • Component 2: LEPROSY REFERAL CENTERS • Component 3: CONTINUING MEDICAL EDUCATION 16

  17. LEAP COMPONENT 4 EPIDEMIOLOGICAL MONITORING AND EVALUATION (EME) Disease surveillanceand monitoring through operational research programmes and validating trend and magnitude of leprosy burden In Mumbai Objective Obtain update leprosy related data and trends Main Achievements Mumbai leprosy statistics system established Provide inputs for publications and advocacy for policy change Involvement of different actors in data collection

  18. LEAP has anintegral approach tosustainleprosy control andensurerights of leprosy affected persons by . . . INNOVATIVE APPROACH facilitating the process of integration of basic leprosy services and specialized referral services within the public health system promotingan IEC strategy that involves and trains volunteers as spokesperson for leprosy in local communities who suspect and refer new cases of leprosy at an early stage

  19. INNOVATIVE APPROACH advocatinga decentralized, guaranteed access to quality care for the leprosy affected persons at the primary and intermediary levels in the public health delivery system and thus aims to secure a right place in health resource planning developingtrainers and faculty at different levels of Health System for Continuing Medical Education involvinghealth and development NGOs as partners in leprosy control by imparting the skill and expertise required for under a common strategy for leprosy detection and referral services

  20. THANK YOU VERY MUCH FOR YOUR ATTENTION ENSURING RIGHTS OF THE LEPROSY AFFECTED TODAY 20

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