Managing Urban Leprosy

Problem Statement

Incidence of leprosy in West Bengal is higher in urban areas than rural areas and it is estimated that over 2500 to 3000 new cases emerge every year in urban areas.

Programme Description

• Health infrastructure and field staff in urban areas is inadequate as compared to rural areas.
• Unlike in Rural areas where there is a streamlined referral mechanism from community to facility, in urban areas, patients report voluntarily to hospitals (tertiary level), get diagnosed there and are provided treatment i.e., MDT without any follow up.
• These gaps lead to late detection of leprosy cases with high disability and poor treatment compliance among patients, which also in turn adds to activetransmission at the community level.

Back Ground of the Initiative

Strengthening routine NLEP in urban areas involved the following steps:

• Incentivised Honorary Health Workers (HHWs) will screen the urban population in a phased manner which will include physical examination.
• Suspected cases will be referred to Urban PHCs where Medical Officers will confirm the diagnosis of the patients and initiate treatment.
• Complicated cases will be referred to Medical Colleges, District/Sub Divisional Hospitals.
• HHWs will also be responsible for follow up of the treatment.
• District Leprosy Officer (DLO) along with NUHM team will monitor the activity every month and will ensure supply of logistics.
• Designated person at UPHC will prepare a monthly report.

Programme Outcomes

Progress till date since June 2019

• Training initiated.
• Over 100 Urban MOs, 85 Epidemiologists and Programme Managers and a few thousand health workers have been trained.
• Funds have been allocated for IEC, logistics and mobility.
• In Durgapur Municipal Corporation 58 suspects have been referred by HHWs and 16 have been confirmed and initiated on treatment by MOs. No case of disability was reported.

Scalability

This initiative needs to be implemented for a fair length of time and then assessed.

Source : We Care Coffee Table Book - Good, Replicable and Innovative Practices 2019