ALERT-INDIA (Association for Leprosy Education, Rehabilitation and Treatment - India) is engaged in leprosy control efforts in urban and rural areas of Maharashtra since 1981.  ALERT-INDIA also works for other disease control programmes such as Tuberculosis (TB), HIV/AIDS as well as community health in close collaboration with national disease control programmes.

 

Development of a new strategy for leprosy control

Since its inception, ALERT-INDIA primarily focuses on leprosy control through community partnership strategies in line with government priorities under National Leprosy Eradication Programme (NLEP). Much progress has been made in the lives of several people affected by leprosy and their social and economic development. These achievements have prompted the Government of India to integrate leprosy services into the general health care system as a policy and announcement of achieving the goal of leprosy elimination at national level in December 2005 has created a setback and hardship to consolidate the gains made since 1991.

 

In response to this challenge,ALERT-INDIA developed and launched a “Leprosy Elimination Action Programme” (LEAP) as a new strategy to sustain the leprosy control and to strengthen the integration process in alliance with multiple stakeholders.  The overall objective of LEAP strategy is to “Promote right to health and social status of persons affected by leprosy with sustained leprosy control measures and improve accessibility for quality care in general health care system”. The strategy also demonstrates ALERT-INDIA’s commitment to promote rights to health of persons affected by leprosy. 

 

Strategic interventions of LEAP

LEAP interventions provide strategic directions and approaches to improve the health outcomes for persons affected by leprosy.  Specific districts in Maharashtra state of India were identified to implement LEAP where the disease burden is significantly higher than the national level and the public health services are weak. An operational plan for LEAP interventions is developed to ensure an effective coverage with reference to district to achieve measurable impact over a period of time.

 

The four specific interventions of LEAP are as follows:

 

1.        Selective Special Drives (SSD) to promote early case detection

 

Approach: ALERT-INDIA trained and involved community members and groups as volunteers to create awareness about leprosy among the community and school children through house-to-house campaigns using a variety of Information, Education and Communication (IEC) tools to promote self reporting of leprosy suspects for diagnosis at early stage that helps to reduce the disease transmission and morbidity thereby minimize the stigma and discrimination against leprosy.

Creating leprosy awareness by community volunteer to identify leprosy suspects during SSDs

 

Details of SSDs in community and schools in urban and rural areas of Maharashtra

Results of SSD

April 2015 to
March 2016

April 2016 to
March 2017

April 2017 to
March 2018

1

No. of districts covered for SSD

5

3

3

2

No. of PHCs / UHPs reached

50

13

23

3

No. of people reached in villages & slums

11,17,090

2,10,000

5,18,364

4

No. of Schools / Ashramshalas reached

-

123

201

5

No. of school children reached through IEC

-

26,195

42,498

6

No. of volunteers / teachers engaged

1,326

1,001

1,415

7

No. of leprosy suspects identified

4,418

163

932

 

No. of new leprosy cases diagnosed

301

27

158

 

 

2.        Leprosy Referral Centre (LRC) to ensure availability of quality leprosy services

 

Approach: ALERT-INDIA established and managed 123 LRCs at the premises of Rural Hospital and Sub-District Hospital in 15 districts of Maharashtra with increased availability of quality leprosy services to people affected by leprosy in collaboration with the GHC and NLEP staff that contributes to improved health status of the persons affected by leprosy. 

 

 



Nerve function and disability assessment of leprosy cases by the GHC staff at LRC

 

Details of quality leprosy services provided to persons affected by leprosy at LRCs

Results of LRCs

April 2015 to
March 2016

April 2016 to
March 2017

April 2017 to
March 2018

1

No. of leprosy suspects screened

15,695

13,627

21,787

2

No. of new leprosy cases diagnosed

3,122

3,180

4,011

3

No. of cases in lepra reaction treated

134

1,253

1,287

4

No. of cases risk for disability assessed

4,887

5,916

3,583

5

No. of cases taught self care practice

2,246

4,543

3,632

6

No. of cases given wax therapy

156

2,919

4,508

7

No. of cases done wound dressing

174

5,290

6,305

8

No. of cases given MCR footwear

16,674

15,895

17,267

9

No. of cases given dressing kits

3,298

4,458

4,069

10

No. of cases given pre-fabricated splints

3,998

1,225

1,236

 

 

3.        Continuing Medical Education (CMEs) to increase the skills of health personnel

 

Approach: ALERT-INDIA conducted task oriented training for general health care providers at all levels to build their capacity by improving their knowledge and skills that enabled them to deliver quality leprosy services to persons affected by leprosy at LRCs that guarantee prompt diagnosis and appropriate leprosy management within the GHC system.

 

 



Training of health workers to improve their skills and knowledge to provide quality services

 

Details of public health personnel trained in leprosy management

Results of CMEs

April 2015 to
March 2016

April 2016 to
March 2017

April 2017 to
March 2018

1

No. of doctors PHC / RH / SDH

1076

639

1866

2

No. of health staff / NLEP staff

156

869

2,214

3

No. of Private Medical practitioners

135

855

607

4

No. of Medical students / Nurses

103

3 batches

1389

5

No. of ASHA / Pada workers

1,219

1,115

1,773

 

4.        LEAP advocacy and promotion for a rights based policy formulation

 

Approach: ALERT-INDIA analyze the trends in new case detection and provide clear cues to the programme managers through epidemiological validation drives (EVD) through national / state level workshops and consultations to assist the government in formulating relevant polices and mechanisms and political commitment to ensure the rights of persons affected by leprosy. 

 



National workshops conducted and conferences participated

 

Details of public health personnel trained in leprosy management

Results of CMEs

April 2015 to
March 2016

April 2016 to
March 2017

April 2017 to
March 2018

1

No. of workshops / consultation meetings

1

3

1

2

No. of conferences participated

-

1

3

3

No. of Scientific studies presented

-

4

5

 

Our future plans to meet the challenge . . . .

It is important to ensure that the achievements made so far in controlling leprosy are sustained, that the burden of the disease is further reduced, and that affected people continue to receive quality leprosy services as long as they are needed. At the same time, efforts to increase community awareness are required to put an end to the prejudice and discrimination still faced by the people affected by leprosy and their families. Our challenge is to ensure that all persons affected by leprosy, wherever they live, have an equal opportunity to be diagnosed and treated by competent health workers, without unnecessary delays and at an affordable cost.

 

In the future, ALRT-INDIA intends to harmonize LEAP with the existing operational plans of the Government and connect these activities with the NLEP in focused areas or states in India. ALERT-INDIA has drawn a road map for future plans with national and state governments, as well as other key stakeholders that will result in significant health impacts thereby achieving a leprosy free status in India by 2030! 

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