NRHM SECOND COMMON REVIEW MISSION NATIONAL LEPROSY ERADICATION PROGRAMME

1. NRHM SECOND COMMON REVIEW MISSION NATIONAL LEPROSY ERADICATION PROGRAMME

2. Special Features of Leprosy Long incubation period Lack of early warning of symptoms to affected person Lepra reaction at any time even after MDT Involvement of peripheral nerves Disability of various grades Deep rooted stigma

3. Trend of Leprosy Prevalence & Annual New Case Detection (ANCDR) Rates

4. State wise Contribution Of New Leprosy Cases During Year 2007-08 Figures in brackets indicate proportion of state population to total population

5. EPIDEMIOLOGICAL STATUS • 29 States/UTs achieved the level of elimination of leprosy • 6 States/UTs viz. Bihar, Chhattisgarh, Jharkhand, WB, Chandigarh and D & N Haveli are yet to achieve elimination. • 78.5% of districts have PR of < 1/10,000 • 1.38 lakh new cases detected during 2007-08 with ANCDR of 1.17/10,000 • Proportion: MB – 47.2, Female – 34.5, Child – 9.4 and visible deformity – 2.5

6. EPIDEMIOLOGICAL STATUS • 0.87 lakh cases on record as on 31st March’08 with PR of 0.74/10000 • 1.41 lakh cases discharged of which 1.27 lakh (90%) were cured • During April to Sept. 2008, 76554 new leprosy cases detected as compared to 75207 cases detected during corresponding period of previous year

7. ProgrammeStrategies • Infrastructure support where needed • Further strengthening of integrated services with backup Referral support system • Free supply of Multi Drug Therapy (MDT) • Higher emphasis on Disability Prevention & Medical Rehabilitation (DPMR) services • Increase IEC coverage with emphasis on inter-personal communication to reduce stigma and discrimination • Orientation training/capacity building of GHC staff for ensuring sustainable leprosy services • Monitoring & Supervision

8. Monitoring at State level • State leprosy cell with trained state leprosy officer looking after one-two programmes • Supported by SMO/MO, BFO & DEO • Additional support from WHO & ILEP coordinator • Computer & other office equipments available and in use • Coordination with NRHM- Programme Management Units, Finance Management Units & Statistical Units • Co-ordination with social welfare Deptt. for socio-economic rehabilitation

9. Monitoring at State level • Discussing leprosy in State Health Society meeting • Release of fund to districts as per annual action plan • Support from local NGOs for disability prevention and medical rehabilitation • Trend of New Case Detection in last 5 years • Treatment Completion Rate for rural & urban areas

10. Monitoring at District level • Adequacy of trained staff at District Nucleus – DLO, MO, 2 NMS/NMA , Physiotherapy Technician, Health educator • Mobility – Provision for 2 vehicles • Coordination with Districts Planning & Management Unit/Finance Management Unit (NRHM) • Quarterly assessment of New Case Detection Rate • Treatment Completion Rate for urban & rural areas

11. Monitoring at District level • Implementation of DPMR- -Procurement & distribution of MCR footwear -Coordination with tertiary level institute for management of complicated cases & RCS services -Distribution of dressing material & supportive drugs for ulcer care -Reconstructive Surgeries conducted • IEC plan in coordination with NRHM • Drug stock management – availability of 2 months stock for each category against under treatment cases • Co-ordination with District Disability & Rehabilitation Centre (DDRCs)/ Social Welfare Department • No. of leprosy homes/leprosy colonies & provision of civic amenities & health care services • Timely submission of reports to state

12. Monitoring at District Hospital • Availability of a trained dermatologist/medical • specialist • Any vertical staff attached for leprosy work • Leprosy services provided on daily basis or on fixed • clinic days • Adequate MDT stock available • Working as a referral centre for complicated leprosy • cases referred from PHC • Co-ordination with other tertiary care institutes for • referring patient for management and Reconstructive • surgery • Timely submission of reports to district

13. Monitoring at PHC Medical officers trained & involved in case diagnosis and treatment Maintenance of DPMR register Involvement of Health Workers for leprosy work Maintenance of a master treatment register & individual patient cards and its regular updation Drug stock management-availability of 2 months stock of each category against under treatment cases

14. Monitoring at PHC Involvement of NRHM- Rogi Kalyan Samities, PRIs IEC activities during Village Health & Nutrition Day & Health Melas Inclusion of leprosy in school health programme Timely submission of reports to district

15. Monitoring at Subcentre • ANM/MPW (male) trained in leprosy, suspects and refers patients to PHC • Involved in distributing MDT to patient under treatment & maintains treatment card • Does IPC for leprosy during house visit • Follow up cases under treatment and retrieve absentees in time • Coordination with Village health & Sanitation Committee

16. Monitoring at Village • ASHA (if available) trained & involved in suspecting leprosy • IEC material displayed in the village • Feed back from villagers on past IEC work • Level of stigma felt

17. Thanks