Integration of leprosy in general health system vis-à-vis leprosy endemicity, health situation and socioeconomic development: observations from Chhattisgarh & Kerala

摘要

This study looked at the integration of leprosy services in the GHS in context of healthand socioeconomic situations using predefined indicators. It also looked at clients'perception of MDT services. The Indian states of Chhattisgarh and Kerala, which are attwo extremes in leprosy endemicity, health situation and socioeconomic development,have been compared using predefined integration indicators related to the training ofhealth workers, availability of MDT services, maintenance of MDT stock andinvolvement of Sub-centres in leprosy care. Data was collected by surveys of healthfacilities, sub-centres and communities in the two states, during 2006– 2007.Information was collected by interviewing health personnel and clients, checking ofrecords and on the spot observations using specifically designed formats. Resultsshowed that integration is more inclusive in Chhattisgarh and has reached up toSub-centre level. Both the community and health systems are sensitive and responsiveto leprosy as it is perceived to be a major public health threat. But in Kerala, despiteintegration, it continues as a vertical programme with dependence on specialists anddistricts hospitals for diagnosis and treatment. MDT stock management is even poorer.Clients' perception towards MDT services are similar in both states.