“Complete Guide to NLEP: Milestones, Strategies, and Achievements in Leprosy Eradication (2024)”

“Discover the comprehensive details of the National Leprosy Eradication Program (NLEP), including its historical milestones, current strategies, and achievements. Learn about the program’s objectives and how it’s combating leprosy in India.”

The National Leprosy Eradication Program (NLEP) has been a cornerstone in the fight against leprosy in India, aiming to eliminate the disease and reduce its associated stigma and disabilities.

National Leprosy Eradication Program (NLEP)

Overview:

• Public Health Concern: Leprosy poses significant disability risks and social stigma.
• Current Statistics: As of April 1, 2014, 86,000 cases in India; prevalence rate was 0.68 per 10,000 population.

Historical Milestones:

• 1848: Leper Act introduced in British India, later abolished.
• 1948: Hind Kusht Nivaran Sangh established.
• 1955: National Leprosy Control Program (NLCP) launched with case detection, Dapsone treatment, and community education.
• 1980: Introduction of Dapsone.
• 1982: Multidrug Therapy (MDT) introduced.
• 1983: NLEP launched, incorporating MDT.
• 1991: World Health Assembly resolution to eradicate leprosy by 2000.
• 1998-2004: Modified Leprosy Elimination Program.
• 2005: Prevalence rate at 0.95/10,000; government declared achievement of elimination target.
• 2005: NLEP integrated into National Rural Health Mission (NRHM).
• 2012: Special action plan for 209 high-endemic districts in 16 States/UTs.

Objectives (12th Five-Year Plan, 2012-2017):

• Eliminate leprosy: Achieve a prevalence rate of less than 1 case per 10,000 population in all districts.
• Disability Prevention and Rehabilitation: Strengthen services for affected individuals.
• Stigma Reduction: Decrease social stigma associated with leprosy.

Program Strategies:

• Integrated Services: Leprosy services provided through general health care systems.
• Early Detection and Treatment: Identify and treat new cases promptly.
• Household Surveys: Conduct surveys for early case detection.
• ASHA Involvement: Accredited Social Health Activists (ASHA) assist in case detection and treatment.
• Disability and Rehabilitation Services: Enhance disability prevention and medical rehabilitation services.
• IEC Activities: Promote community awareness to improve self-reporting and reduce stigma.
• Monitoring and Supervision: Intensify oversight at block primary health centers and community health centers.

Case Detection and Management in NLEP

Challenges:

• Social Stigma: Inhibits people from seeking diagnosis.
• Early Detection: Essential to reduce transmission and prevent disabilities.

Strategies for Case Detection:

• Improve Access: Enhance service accessibility.
• Involve Women: Include women and affected individuals in detection efforts.
• Organize Skin Camps: Detect leprosy cases while addressing other skin conditions.
• Contact Surveys: Identify sources of infection in the community.
• Increase Awareness: Educate through ANM, AWW, ASHA, and other health workers to motivate early reporting.

Urban Area Services:

• Higher Detection: More cases identified in urban areas due to better facilities and migration.
• Treatment Completion: Lower completion rates compared to rural areas.
• Additional Activities:
• Human Resources: Utilize government, NGOs, and private practitioners for detection and referrals.
• Capacity Building: Train and regularly examine household contacts.
• Referral Centers: Designate urban centers for diagnosis and management.
• Monitoring: District leprosy officers and referral center medical officers oversee the program.
• Mobile Clinics: Include leprosy services in general health mobile clinics.
• Record Keeping: Maintain accurate records and ensure regular MDT supply.
• Sensitization: Organize awareness activities to reduce stigma.

ASHA Involvement:

• Role: Facilitate diagnosis and follow-up.
• Incentives:
• Diagnosis Confirmation: ₹250
• Treatment Completion:
  • Pauci Bacillary (PB): Additional ₹400
  • Multi Bacillary (MB): Additional ₹600
• Activities:
• Case Search: Identify suspected cases early.
• Follow-Up: Ensure treatment completion and check for complications.
• Self-Care Advice: Guide disabled cases on proper care.
• Monitoring: ASHA involvement is overseen by PHC medical officers.

SET Scheme (NGOs):

• Responsibilities:
• Disability Prevention: Provide care and IEC activities.
• Referral & Surgery: Manage case referrals and reconstruction surgeries.
• Follow-Up: Essential for urban and hard-to-reach areas.

Disability Prevention and Medical Rehabilitation (DPMR):

• Services: Self-care, MCR footwear, aids, and appliances provided at medical institutes.

Role of Community Health Nurse:

• Education: Inform about leprosy causes, prevention, and management.
• Stigma Reduction: Address misconceptions and stigma.
• Early Detection: Emphasize the importance of early diagnosis to prevent deformities.
• Prevention: Teach prevention and correction of deformities.
• Regular Examination: Monitor skin surfaces for abnormalities.
• MDT Adherence: Ensure regular intake of medication.
• Safety Advice: Prevent injuries and infections due to lack of sensation.
• Education and Follow-Up: Conduct individual and mass education; provide home visits for treatment adherence and rehabilitation referrals.

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