DEFINITION

1
ACHIEVEMENTS IN LEPROSY ELIMINATION AND FUTURE
LEPROSY PROGRAMMEDr. D.M.THORATCentral
Leprosy Division Directorate
General of Health Services
2
MILESTONES IN NLEP IN INDIA

• Launched National Leprosy Control
• Programme
  
• Launched National Leprosy
  Eradication Programme and introduced MDT
• 1991 WHO declaration to eliminate
  leprosy at global level by 2000.
• 1993 World Bank supported
  NLEP I
• 2001 World Bank supported
  NLEP II
• Integration of Leprosy services with General
  Health Care System
• 2002 - National Health Policy
  Statement Elimination of Leprosy by 2005
• Dec.2005 Elimination of leprosy as public
  health problem at National level.
• Since 2005 Programme continues with GOI
  support since January 2005.

3
Trend of Leprosy Prevalence Annual New
Case Detection (ANCDR) Rates
4
STATEWISE PREVALENCE
As on 1981 PR 57.60/10,000
As on Mar.2001 PR 3.74/10,000
As on Mar.2007 PR 0.72/10,000
Elimination achieved in 28 out of 35 States/Union
Territories
5
STATEWISE CONTRIBUTION OF NEW LEPROSY CASES
DURING YEAR 2006-07
Figures in brackets indicate proportion of state
population to total population
6
EPIDEMIOLOGICAL SITUATION

• India achieved goal of leprosy elimination in
  December 2005.
• 30 states/UTs achieved elimination.
• 6 states / UTs yet to achieve elimination are
  Bihar, UP, Jharkhand, West Bengal, Chattisgarh
  and D N Haveli.
• 80 of districts, 75 blocks and 70 of urban
  localities have PR lt 1.
• 19 districts, 275 blocks and 49 urban areas have
  PR gt 2.

7
EPIDEMIOLOGICAL SITUATION (contd..)

• Indicators March 2007
  December 2007
• PR/10,000 - 0.72 (82,801) 0.83
  (95,212)
• ANCDR/1,00,000 - 12.07 (1,39,252) 11.7
  (135,277)
• MB - 45.0
  46.7
• Child - 10.1 9.5
• Female - 34.2
  34.2
• Gr. I deformity - -
  5.8 (6,022)
• Gr. II deformity - 2.2 (3,130)
  2.3 (2,485)
• Cure rate - 90.6
  91.2
• 
  (151601/137340) (96530/88076)

8

EPIDEMIOLOGICAL SITUATION (contd..)

• During 2007-08 (upto Dec.07), 106182 new cases
  were detected compared to 110157 cases detected
  in corresponding period of previous year.
• 64 of recorded cases as in Dec.07 and 65 of new
  cases detected during April Dec.07 are
  contributed by Bihar , Jharkhand , Maharashtra,
  Uttar Pradesh, Chhattisgarh and West Bengal.
  However these 6 states contributed to 46.6 of
  countrys population.

9
YEAR-WISE ENDEMICITY STATUS OF STATES
10
YEAR-WISE ENDEMICITY STATUS OF
DISTRICTS
124 districts yet to achieve elimination.
11
LEPROSY ELIMINATION STRATEGY

• Decentralization of NLEP services
• Integration of NLEP with General Health
  Care System
• Capacity building of GHS functionaries
• Timely diagnosis prompt MDT
• Intensified IEC using Local and Mass Media
• Prevention of Disability Medical
  Rehabilitation
• Monitoring Evaluation
• M.I.S.
• Independent Evaluation
• Leprosy Elimination Monitoring (LEM)

12
FACTORS HELPED IN REACHING ELIMINATION

• Strong political commitment.
• Availability of adequate resources.
• Support from partners in NLEP like WHO, World
  Bank, ILEP, The Nippon Foundation, Novartis, and
  NGOs.
• Strategic planning and timely implementation of
  the activities.
• Special campaigns in vulnerable areas
  MLEC/BLAC/ULSAC

13
Aims Objectives of 11th Five Year Plan

• Further reduce leprosy burden in the country
• Provide quality leprosy services through GHC
  system
• Enhance Disability Prevention and Medical
  Rehabilitation services
• Enhance advocacy to reduce stigma and
  discrimination
• Capacity building of GHC staff
• Strengthening monitoring supervision

14
NEW PARADIGMS CHANGES

• New paradigms are in conformity with WHO
  Operational Guidelines 2006-2010
• Providing quality services
• Sustainable Leprosy services through the PHC
  System .
• Referral services and long term care

15
Contd ..

• Prevention and management of impairment
  disabilities
• Measurement of persons with disabilities
• Comprehensive approach to rehabilitation in
  co-ordination with MOSJE
• Community based rehabilitation
• Expanding facilities for reconstructive surgery

16
Contd ..

• - Increased access to DPMR services at first,
  second and third level Institutions.
• - Payment of Rs. 5000/- to poor patients for
  each major RCS to compensate for wage loss.
• - Reimburse funds upto Rs. 5000/- for each
  surgery to Govt. Hospitals to facilitate RCS
  operations.

17
Programme Monitoring

• Primary indicator
• Annual New Case Detection Rate
• Treatment Completion Rate (cohort analysis)

18
Programme Monitoring (contd)

• Indicators for case detection
• Proportion of new cases with Gr II disability
• Proportion of child cases among new cases
• Proportion of MB cases among new cases
• Proportion of Female cases among new cases

19
Programme Monitoring (contd)

• Indicators for quality of service
• Proportion of new cases correctly diagnosed.
• Proportion of defaulters.
• Number of relapses during a year.
• Proportion of cases with new disabilities.

20
TOWARDS ACHIEVING LEPROSY FREE INDIA

• Campaign theme Leprosy Free India
• Reduction in stigma and discrimination.
• Early detection and complete treatment
• Prevention of disabilities by early reporting,
  protection and self care.
• Correction of disabilities by RCS.

21
(No Transcript)
22
Thanks