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Initiatives in
the National Leprosy Eradication Program of India
Modified MDT Management
The Government of India has initiated procedures
for modifying the MDT management based on requisition as per the
number of patients detected in each PHC. This had been suggested by WHO. The new MDT management plan
had been started experimentally in Orissa and
Kerala. Soon it is to be started in
Andhra Pradesh and West Bengal.
Deformity Management and Medical Rehabilitation
The Central Leprosy Division of the Ministry of
Health and Family Welfare has recently launched a Deformity Management and
Medical Rehabilitation Program (DPMR) within the National Leprosy
Eradication Program (NLEP). This is meant to prevent, reverse or manage the
deformities caused by leprosy as this is the public face of the disease and
the root of social stigma. This program aims to initiate and provide
deformity management services in every part of the country. It would include Prednisolone therapy for lepra reactions, self care training, rehab aids,
assisted care and physiotherapy and Reconstructive surgery. Health Units both
in the Government and NGO sector are expected to work together in this.
Depending on the need, services would be available in primary secondary and
tertiary levels of health country throughout the country.
2007-08
In the last year the reporting formats had been
modified to include Grade-I deformity as well and 7483 new Grade I deformity
cases have been reported from all over the country. Sixty Government and forty nine private
institutions are providing Reconstructive Surgery services and 1004 and 2435
operations have been performed respectively
Sustained Action Plan
Focused attention on the endemic districts
and blocks has remained a major strategy in NLEP and much of the
recent success of the program is attributed to this. In 2004, 174 districts
and 836 blocks were identified as high endemic (PR over 5) and Block Level
Awareness Campaign (BLAC) was organized. By 2005 the number of blocks with PR
greater than 5 had dropped to 150, so the threshold of high endemicity was lowered to PR
above 3. Forty six districts and 552 blocks were identified and BLAC was
held. In 2006 only 30 blocks remained that had a PR more than 5 and 140
blocks remained with PR over 3. Hence the threshold was lowered further to a
PR of over 2. In this way 29 districts and 433 blocks had been
identified where focused attention was given. The priority blocks are spread
out in 14 states and the priority districts in 7 states. A special series of
IEC programs and intensified attention on program management was executed in
these blocks in September 2006. This month was designated Intensive
Supervision Month.
2007-08
After detailed
scrutiny two hundred seventy five blocks in nineteen districts were
identified as high priority areas in which the Sustained Activity Plan (SAP
2007) was carried out in 2007-08. this consisted of
intensified Inter Personal Communication and additional arrangements for case
management. Similarly Urban Leprosy Sensitization and Awareness Campaigns was carried out in forty nine urban locations.
The other activities to improve the quality of
diagnosis, treatment and record keeping at the peripheral level by means of
continuous training and monitoring continue.
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