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DIRECTORATE GENERAL OF HEALTH SERVICES

Ministry of Health & Family Welfare
Government of India

National Leprosy Eradication Programme

Introduction:

Since the inception of National Leprosy Eradication Programme (NLEP) in the year 1983 spectacular success have been made in reducing the burden of Leprosy. The country achieved the goal of leprosy elimination as a public health problem. i.e. prevalence rate (PR) of less than 1 case / 10,000 population at National level by December 2005, as set by National Health Policy 2002. Although prevalence has come down at national and state level, new cases are being continuously detected and these cases will have to be provided quality leprosy services through GHC system.

XII th Plan Objectives:

  1. Elimination of leprosy i.e. prevalence of less than 1 case per 10,000 population in all districts of the country.
  2. Strengthen Disability Prevention & Medical Rehabilitation of persons affected by leprosy.
  3. Reduction in the level of stigma associated with leprosy.

Background:

  • The National Leprosy Control Programme was launched by the Govt. of India in 1955. Multi Drug Therapy came into wide use from 1982 and the National Leprosy Eradication Programme was introduced in 1983. Since then, remarkable progress has been achieved in reducing the disease burden. India achieved the goal set by the National Health Policy, 2002 of elimination of leprosy as a public health problem, defined as less than 1 case per 10,000 population, at the National level in December 2005.
  • Following are the programme components :
    • Case Detection and Management
    • Disability Prevention and Medical Rehabilitation
    • Information, Education and Communication  (IEC) including Behaviour Change Communication (BCC)
    • Human Resource and Capacity building
    • Programme Management

Activities under NLEP:

  • Diagnosis and treatment of leprosy- Services for diagnosis and treatment (Multi drug therapy) are provided by all primary health centres and govt. dispensaries throughout the country free of cost. Difficult to diagnose and complicated cases and cases requiring reconstructive surgery are referred to district hospital for further management.
  • Training- Training of general health staff like medical officer, health workers, health supervisors, laboratory technicians and ASHAs are conducted every year to develop adequate skill in diagnosis and management of leprosy cases.                                     
  • Urban leprosy control- To address the complex problems in urban areas, the Urban Leprosy control activities are being implemented in  urban areas having population size of more than 1 lakh. These activities include MDT delivery services & follow up of patient for treatment completion, providing supportive medicines & dressing material and monitoring & supervision.
  • IEC- Intensive IEC activities are conducted for awareness generation and particularly reduction of stigma and discrimination against leprosy affected persons. These activities are carried through mass media, outdoor media, rural media and advocacy meetings. More focus is given on inter personnel communication.
  • NGO services under SET scheme- Presently, 43 NGOs are getting grants from Govt. of India under Survey, Education and Treatment (SET) scheme. The various activities undertaken by the NGOs are, IEC, Prevention of Impairments and Deformities, Case Detection and MDT Delivery. From financial year 2006 onwards, Grant-in-aid is being disbursed to NGO through State Health (Leprosy) Societies. 
  • Disability Prevention and Medical Rehabilitation –For prevention of disability among persons with insensitive hands and feet, they are given dressing material, supportive medicines and micro-cellular rubber (MCR) footwear. The patients are also empowered with self-care procedure for taking care of themselves. More emphasis is being given on correction of disability in leprosy affected persons through reconstructive surgery (RCS). To strengthen RCS services, GOI has recognized 112  institutions for conducting RCS based on the recommendations of the state government. Out of these, 60 are Govt. institutions and 52 are NGO institutions.
  • Special Activity in High Endemic Distt.- 209 Districts had reported ANCDR (Annual New Case Detection Rate) more than 10 per lakh population. Special activity for early detection and complete treatment, Capacity building and extensive IEC, Adequate availability of MDT, Strengthening of distt. nucleus, Regular monitoring & supervision and review, Regular follow up for neuritis and reaction, Self care practices, Supply of MCR footwear in adequate quantity and Improvement in RCS performance through camp approach are planned in the above districts to reduce the disease burden.
  • Supervision and Monitoring –Programme is being monitored at different level through analysis of monthly progress reports, through field visits by the supervisory officers and programme review meetings held at central, state and district level. For better epidemiological analysis of the disease situation, emphasis is given to assessment of New Case Detection and Treatment Completion Rate and proportion of grade II disability among new cases. Visit by Joint monitoring Teams with members from GOI, ILEP and WHO has been initiated from the year 2012-13 and to be continued annually.

Initiatives:

  1. Involvement of ASHA– A scheme to involve ASHAs was drawn up to bring out leprosy cases from their villages for diagnosis at PHC and follow up cases for treatment completion. To facilitate involvement, they are being paid an incentive as below:
    • On confirmed diagnosis of case brought by them – Rs. 250/-
    • On completion of full course of treatment of the case within specified time – Pauci bacillary (PB) leprosy case – Rs. 400/- and Multibacillary (MB) Leprosy case – Rs. 600/-.The scheme has been extended to involve any other person who brings in or reports a new case of leprosy.
    • An early case before onset of any visible deformity – Rs 250
    • A new case with visible deformity in hands, feet or eye – Rs 200
  2. E Newsletter- is a Quarterly publication from the house of CLD. NLEP Newsletter will share guidelines, feedback/best practices, experiences and activities undertaken in the programme in coordination with partner/ States/NGOs/Institutes/Medical Colleges & Associations etc. Newsletter will serve as one of the important tools for communication to keep inform, update and educate our stakeholders as well as target groups. This will be a platform for States/UTs/NGOs/A PAL to join their hands and share relevant articles which will be a source of inspiration for readers.
  1. In order to detect the hidden leprosy cases, Leprosy Case Detection Campaigns (LCDC), a unique initiative of its kind under NLEP, is being implemented in high endemic districts of the country, in line with Pulse polio Campaign by Central Leprosy Division. In this campaign each and every person in a house in the selected high endemic districts will be examined to detect all hidden cases in the community. This will interrupt the transmission of the disease in the community, and expedite achievement of elimination status at district and sub-district level. The important activities under LCDC are micro planning, selection of male volunteer for house to house search teams, training of field level staff and intensive IEC activities. All activities related to LCDC will be monitored by CLD and coordinated by States through various subcommittees formed at State and District level. The first LCDC is planned to be conducted in 50 selected high endemic districts of 7 States namely, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Maharashtra, Odisha and Uttar Pradesh, in March 2016.
  1. In order to strengthen planning, implementation and monitoring of activities in Central Leprosy Division , GIS Mapping has been initiated . GIS mapping was used in analysis of annual data received from states and UTs for the financial year 2014-15. Preparing GIS maps enabled visualization of district wise data pertaining to annual new case detection rate and prevalence of the disease spatially which was previously done manually. Pinpointing of high endemic districts in a color coded fashion helped us in micro planning for the special campaign in 50 high endemic districts across seven states.

 

 

Last Updated On 21/06/2017