Disability Prevention and Rehabilitation

INFORMATION

Ministry of Health has designated Leprosy Control Division (LCD) as the disability focal unit related to health in 30th Chaitra 2071. Coordination among various organizations working in disability sector is necessary to mainstream the leprosy issues on disability movement.

After the Nepal Earthquake 2015, an Injury Rehab Sub-Cluster was formed under Health Emergency Operation Centre(HEOC), Ministry of Health(MoH). So far, LCD has conducted Injury Trauma Management Training in 14 Earthquake affected districts in district levels and community level for medical professionals, health workers and FCHVs in co-ordination with partners.

In between, the LCD and disability partners have extensively worked together to provide inputs on the health related National Policy for the Plan of Action on Disability (NPPAD) which is in the process of approval by Ministry of Women, Children and Social Welfare (MoWCSW). As NPPAD is in its approval process, MoH has approved Policy, Strategy and 10 Years Action Plan on Disability Management (Prevention, Treatment and Rehabilitation) on 30th Chaitra 2073.

Approach

Early case detection, management and disability prevention 

·         Prevention of disease transmission and disability through early case detection and treatment, post exposure prophylaxis;

·         Improve access to prompt and complete treatment including complication and reaction management;

·         Increase awareness about leprosy in the community; reduce stigma and discrimination due to leprosy;

·         Increase access leprosy services to unreached people/high risk populations.

·         Prevention, early detection and enhancing access to health related rehabilitation services for all kind of disabilities ;

·         Increase awareness about all types of disability through the community collaboration with existing service providers;

·         Reduce stigma and discrimination in collaboration with other ministries;

Community based rehabilitation

• Promote community activities focused on the health component of WHO CBR strategy, including health promotion, prevention, medical care, rehabilitation and assistive devices supply for people with disability including leprosy.
• Ensure the coordination with the other components of the CBR Strategy for sustainability and empowerment purposes based on the convention of the rights of people with disability.

REDUCE STIGMA AND DISCRIMINATION

• Advocacy, awareness and IEC/BCC; involve people with disabilities including leprosy in policies and plans;
• Collaboration with national and district stakeholders for public awareness activities.

MONITORING AND EVALUATION

• Case validation and data verification; follow-up the complications after release from treatment;
• Client satisfaction study; operational studies, Programme review and meetings.
• Ensure monitoring and evaluation of disability management and rehabilitation services at all levels.

CAPACITY BUILDING

• Training and continued medical education to various categories of service providers on health promotion
• Disability prevention, impairment detection, medical and community based rehabilitation services for people with disability including leprosy.

CONTACT

Focal Person: Mahesh Kumar Puri

Designation: TB Leprosy Officer

Contact: 01- 4248535

Mobile: 9848056407

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Leprosy Control

Leprosy is a least infectious, stigmatizing and potentially disabling disease caused by Mycobaterium leprae. It is also known as Hansen disease. The disease may lead to physical disability if not treated promptly and completely.

For ages, Leprosy was considered as one of the main public health problems in Nepal and existed here since time immemorial. Elimination and treatment of leprosy has always been a priority of the government’s plan and policy. Activities to control leprosy effectively started from 1960 onwards.According to a survey conducted in 1966, the estimated number of leprosy case was 1,00,000. Dapsone Monotherapy treatment was introduced as Pilot Project in the leprosy control programme and simultaneously the Multidrug Therapy (MDT) was also introduced in 1982/83 in few selected areas and hospital of the country which successfully reduced the leprosy cases to 21,537 with the registered prevalence rate of 21case per 10,000 population. Considering the seriousness of the disease, the vertical leprosy programme was an integrated with the general health services in 1987. MDT service was gradually expanded and by 1996, MDT coverage had extended to all 75 districts.

Following the continuous efforts from the government, Ministry of Health, Leprosy Control Division, WHO, district health/ public health office and concerned agencies, leprosy was eliminated at the national level in 2009 and declared so in 2010 with the registered prevalence rate of 0.77 case per 10,000 population. This rate is well below the cut-off point of below 1 per 10,000 population set by World Health Organization, to measure the elimination of leprosy as public health problem.

At present, the registered prevalence has remained under cut-off line so far because of continuous capacity building and training to health professionals, active case search and early case detection campaign, free distribution and availability of drugs and dedicated health professionals and organizations involved in leprosy control programme at national level (PR=0.89), 54 districts (PR<1) and 6 districts with PR=0.
Vision
To make a leprosy-free society where there is no new leprosy case and all the needs of existing leprosy affected persons having been fully met.

Mission
To provide accessible and acceptable cost effective quality leprosy services including rehabilitation and continue to provide such
services as long as and wherever needed.

Goal

Reduce further burden of leprosy and to break channel of
transmission of leprosy from person to person by providing quality service to all affected community.

Objectives

·         To eliminate leprosy (Prevalence Rate below 1 per 10,000 population) and further reduce disease burden at the district level.

·         To reduce disability due to leprosy.

·         To reduce stigma in the community against leprosy.

·         To provide high-quality service for all persons affected by leprosy.

·         To integrate leprosy in the integrated health care delivery set-up for the provision of quality services.

Strategies

The national strategy envisions delivering quality leprosy services through greater participation and meaningful involvement of people affected by leprosy and right based approaches in leprosy services as follows:

·         Early new case detection and their timely and complete management

·         Quality leprosy services in an integrated setup by qualified health workers

·         Prevention of impairment and disability associated with leprosy

·         Rehabilitation of people affected by leprosy, including medical and community-based rehabilitation

·         Reduce stigma and discrimination through advocacy, social mobilization, IEC activities and address gender equality and social inclusion

·         Strengthen referral centers for complications management

·         Meaningful involvement of people affected by leprosy in leprosy services and address human right issues

·         Promote and conduct operational researches/studies

·         Monitoring, supportive supervision including onsite coaching, surveillance and evaluation to ensure/strengthen quality leprosy services

·         Strengthen partnership, co-operation, coordination with local government, external development partners, civil society and community-based organizations.

Targets

·         Reduce New Case Detection Rate (NCDR) by 25 % at the national level by the end of 2015 in comparison to 2010

·         Reduce Prevalence Rate (PR) by 35 % at national level by the end of 2015 in comparison to 2010

·         Reduce by 35% Grade 2 disability (G2D) amongst newly detected cases per 100,000 population by the end of 2015 in comparison to 2010

·         Additional deformity during treatment <5% by eyes,hands and feet (EHF) score o 80% health workers are able to recognize and manage /refer reaction/complications o Promote prevention of disability in leprosy(POD)and Self-care

Suaahara