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Establishment of Leprosy Referral Centre LRC in National Leprosy Eradication Programme. Maharashtra
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Subject Area="First Referral Units." Objective="Early assessment and provision of timely service to leprosy patients."
Details for Reform Option "Establishment of Leprosy Referral Centre LRC in National Leprosy Eradication Programme. Maharashtra"
Summary

During October 2006 to March 2008, 48 LRCs were established with the support from ALERT-INDIA and are functioning mainly at Rural Hospitals and in sub-district Hospitals. ALERT-INDIA played the role of facilitator, equipped the LRCs and provided hands on training to selected team. LRCs are manned by Medical Officer of RH(trained in leprosy), Physiotherapy technician (trained in leprosy), GHC workers(Leprosy / health workers – specially the staff nurse at some places). Following services are provided at these LRCs – • Assessment of high-risk patients identified and referred by PHC. • Treatment for neuritis and reaction patients. • Services like self-care, physiotherapy, ulcer dressing, muscle stimulation. • Providing protective aids like splints, Micro Cellular Rubber(MCR) footwear / goggles and ulcer kit to needy leprosy patients. • Back referral of cases to Primary Health Centre(PHC) for follow-up through out-reach programme. • Referral of cases from LRCs to specialised centres for Reconstructive Surgery (RCS), management of non-responding reaction, rehabilitation etc. • Counselling for confidence building and self-care. Following are the results achieved from October 2006 to March 2008 (LRCs were established at varied points of time) • 137 NLEP workers and staff nurse given hands-on training in providing quality services at LRCs activities. • 2954 GHC staff were sensitised on the services available at LRCs (Leprosy/health workers – specially the staff nurses); • 558 (21%) new cases were diagnosed among 2612 suspects referred to LRCs; • 326 cases with complications (Reactions/Neurities) managed successfully; • 160 cases provided ulcer care; and • 1340 cases provided with protective aids – MCR sandals and hand splints.

Cost Cost of establishment of LRC is as below: 1. Physiotherapy equipments: Rs.20,000/-; 2. Dressing instruments/Medicines/consumables: Rs.5,000/- 3. Stationary:Rs.5,000/- 4. Furniture & fixtures:Rs.20,000/- Total cost per center:Rs.50,000/-
Place Rural Hospital (CHCs) & Sub-District Hospital in Disrricts of Raigad, Mumbai, Thane, Nashik, Nandurbar, Gondia, Gadchiroli of Maharashtra
Time Frame Alert India has indicated technical & logistic support of these LRCs for initial five years; as capacity building continues LRC activities are being gradually taken over by General Health Care staff of the State Govt. This transfer is slow but has definite long term potential and benefit. The retention of technical staff alongwith GHC staff at these LRCs during this period is crucial to achieve the objective of enabling the GHC staff to provide appropriate services to leprosy affected persons.
Advantages

1. Early assessment and provision of timely services to all high-risk patients’ nerve damage will minimize the morbidity due to leprosy. 2. Improvement in disability status of cured leprosy patients. 3. Capacity building of GHC staff will enable them to gradually take over assuming the responsibility/ownership for managing LRCs. 4. Awareness creation in community at PHC level will promote appropriate referrals. 5. Counselling of patients & family members will improve compliance for self care measures. 6. No additional staff appointed – existing GHC personnel were trained and involved to provide quality care at LRCs.

Challanges

Full involvement of local Health authority (District Health Officers, Civil Surgeons etc.). Mobilization and motivation of leprosy patients to avail the specialized services at these LRCs.

Prerequisites

Good network of Govt. health institutes. Commitment of General Health Care staff, referrals from PHCs of needy leprosy patients. Information in the community about LRCs.

Who needs to be consulted

District level Health officials, Mid-level Programme Managers, NGOs engaged in leprosy control work and the community.

Risks

-

Sustainability

Today, LRCs supported by ALERT INDIA, in terms of helping the State to establish LRCs in health infrastructure of the Govt. is playing the role of facilitator. The support will be provided till five years. Thereafter the LRC activities will be totally taken over by General Health care System.

Chances of Replication

Experiences of LRC functioning has created enthusiasm among other District Leprosy Officers of the State and shown interest to start LRC in their Districts. The State has proposed this initiative in Annual National Leprosy Eradication Programme (NLEP) as a part of the plan to be supported by GOI as a routine activity. Some of these LRCs will be supported by ALERT-INDIA

Comments

Following are the results achieved from October 2006 to March 2008 (LRCs were established at varied points of time) • 137 NLEP workers and staff nurse given hands-on training in providing quality services at LRCs activities. • 2954 GHC staff were sensitised on the services available at LRCs (Leprosy/health workers – specially the staff nurses); • 558 (21%) new cases were diagnosed among 2612 suspects referred to LRCs; • 326 cases with complications (Reactions/Neurities) managed successfully; • 160 cases provided ulcer care; and • 1340 cases provided with protective aids – MCR sandals and hand splints.

Contact

Joint Director of Health Services(Leprosy & TB), Behind Pune Rly Station, Raja Bahadur Motilal Road, Pune-1. Tel : 020-26058308. E-mail : jtlepsa@rediffmail.com.

Submitted By

Sr. Regional Director (H&FW/GOI) and FSU / CBHI C/O ROHFW Bhopal, M.P.

Status Active
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