Dr' A' P' Kaswekar

1
National Leprosy Elimination Programme - Gujarat
11th Quarterly Review Meeting of State / Zonal
Coordinators (NLEP) NLEP Sustaining Intensive
Supervision and Programme Management 26th May
2005 at NIFHW, New Delhi
Dr. A. P. Kaswekar State DTST Coordinator Gujarat
/ Diu-Daman / Dadra NH
2
Present Epidemiological Status of the State
3

• At a Glance
• At National level, Gujarat has achieved the goal
  of Elimination of Leprosy in October-04 with PR
  0.96.
• 19 out of 25 Districts have achieved the goal of
  elimination of leprosy, At State level.
• Narmada, Baroda Surat being a high endemic
  districts, could also brought down their PR lt 1
  during 2004-05.
• 17 Blocks were having PR above 5 in the year
  Mar-04, which has reached to below 5 at Mar-05.
• 126 PHCs were having PR above 5 at Mar-04, at
  present only 17 PHCs have remained with PR gt 5.

4

• Major Activities carried out the year 04-05
• Case Validation Exercise carried out throughout
  State, which leads to reduction of PR
• Block Leprosy Awareness Campaign (BLAC) organized
  in 17 High Endemic Blocks covering intensive IEC
  Inter-Personal Communication activities under
  Leprosy Counseling Centres (LCCs)
• 25 Urban areas identified as per GOI Guidelines
  and prepare a State level Action Plan of Rs.
  27.00 lacs, which will be the major focus of next
  year.
• Around 200 MOs of PHCs, who was not trained for
  leprosy diagnosis and treatment, provided special
  2-Days training.

5
Status of Leprosy in Gujarat March-2004
3.45
2.60
1.87
4.51
1.56
2.23
6.03
4.79
6.13
6
Status of Leprosy in Gujarat March-2005
2.47
1.84
1.82
2.63
2.62
2.43
7
Status of Leprosy in Gujarat As on 31-March-05
8
(No Transcript)
9
(No Transcript)
10
(No Transcript)
11
(No Transcript)
12
(No Transcript)
13
(No Transcript)
14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
Epidemiological Status of Dadra NH UT
19
(No Transcript)
20
(No Transcript)
21
High Priority Districts Blocks
22
High Priority Districts (6)
23
(No Transcript)
24

• Criteria adopted for Identification of High
  Priority Blocks / PHCs
• Continues High Prevalence Rate of last Five Years
• Continues High NCDR of last five years
• Tribal / Hilly / Difficult Terrain
• Vacancy of GHS Staff for a long time.
• High Proportion of Migration

25
(No Transcript)
26
(No Transcript)
27
High Priority Blocks with PR gt 2 As On March-2005
28
Identified High Priority PHCs (March-2005)
29
Identified High Priority PHCs (March-2005)
30
Identified High Priority PHCs (March-2005)
31
Strategic Action Planned for the year 2005-06
in Identified Areas
32

• 22 Blocks with PR gt 2 90 PHCs with PR gt 3 have
  been identified as high priority areas for
  2005-06.
• Strategic Action Planned are
• To develop a Monitoring System
• Individual PHC will be allotted to DLO / DN MO /
  DTST MO as a Nodal Officer for overall monitoring
  of their respective PHC and he will be the solely
  responsible for all NLEP activities in his PHC
  Villages under PHC.
• They will be monitor all the indicators of NLEP
  regular monthly basis including IEC / IPC
  activities.
• A format for total activity wise monitoring has
  been designed and circulated to them as a
  check-list.

33

• 1. To develop a Monitoring System (conti)
• They have to ensure that no vacant post of any
  GHS staff should be in their PHC.
• They will monitor the activities done by whom
  supervised by whom.
• They will also have to give on job training to
  the GHS staff, especially MOs of PHC.
• They will be responsible for the implementation
  of Case Confirmation before Registration
  guidelines.
• They will confirm the cases within the month time
  of detection.
• Above Nodal Officer will have to make a
  presentation comprising of all the activities
  carried out during the month at State level on
  monthly basis in presence of SLO / State
  Coordinator / SSAU / DTSTs.

34

• 1. To develop a Monitoring System (conti)
• State has created infrastructure of Block Health
  Officers (BHO) in all the Blocks of the State and
  10-12 years experienced senior Medical Officers
  have been appointed as a BHO to look after all
  the health services in their Block.
• BHOs will be involved for monitoring of leprosy
  programme in their blocks and review the
  activities in monthly meetings of PHC MO,
  regularly, and report to the DLO/CDHO.
• A State Task Force comprising of SLO / State DTST
  Coordinator / MO / Supervisor will be created and
  they will do surprise checking of all high
  priority Blocks / PHCs on fortnightly basis for
  evaluation of work done by DLO / DN MO / DTST MO
  CDHO/BHOs.

35

• 1. To develop a Monitoring System (conti)
• Sr. MO of District Training Team will do
  independent evaluation of IEC IPC Training
  activities carried out in PHCs Villages.
• Block Health IEC Officer (BIECO) and Block Health
  Supervisor will supervise and monitor IEC IPC
  activities carried out in PHCs Villages.
• Associate Professor of Divisional Training Centre
  MO will be involved for evaluation of training
  given to GHS staff.
• There are Mahila Swasthya Sangh in many villages.
  The members of this Sangh will be oriented for
  leprosy and they will manage for checking of
  females in high endemic villages. FHWs, AWWs and
  Female Teachers will identify the suspects.

36

• 1. To develop a Monitoring System (conti)
• Intensive IEC activities will be carried out in
  Primary / Secondary Ashram Schools and create
  awareness in children so hidden cases can be
  found.
• Block Health Supervisor of BHO will make combined
  tour programme with PHC supervisor in villages
  and monitor activity at village level. This will
  be monitor by BHO DN MO / DTST MO.
• Quarterly meeting of CDHO / DLO / CDMO / CHC
  Suptd. BHO will be conducted by RDD SLO for
  review.
• IEC check list, given by GOI will be strictly
  monitored regularly.

37
Model for Supervision Monitoring of SCs /
Village Level Activities
Block Nodal Officer (DLO / DN MO / DTST MO)
Block Level Monitoring by BHO / BIECO / BPHN /
Sr. HV / BHS
PHC Level Monitoring by MO / MPHS / FHS
Activities Carried out At Sub-Centre Level By
MPHW / FHW
IEC / IPC
POID Care Self Care
Pts. Follow up Counseling
38
Format of NLEP Activities Monitoring Check-List
39
Format of NLEP Activities Monitoring Check-List
(Conti)
40
Format of NLEP Activities Monitoring Check-List
(Conti)
41

• 2. Other Activities
• Block Leprosy Awareness Campaign (BLAC) in
  22-identified high endemic blocks will be
  organized covering Blocks / PHCs / SCs Villages
  with intensive IEC IPC activities.
• Training to 69-Untrained MOs of PHCs of high
  endemic blocks will be organized in the
  first/second week of June-05.
• On the job training of GHS staff will be also
  strengthened in the identified areas.
• POID activities will be intensified and all the
  grassroot level health workers including AWWs
  will be trained for POID care.
• Selected Urban areas where the leprosy prevalence
  is high as well as there is no infrastructure of
  leprosy, will be given priority for
  implementation of Urban Leprosy Plan.

42

• 2. Other Activities
• There are comprehensive upgraded CHCs in
  districts where 4-Specialists (Physician, Gynac.,
  Peadi., Anesthe.) are there. These Centres will
  be developed for Management of Reaction
  Complicated Cases of leprosy as a Referral
  Centre.
• Dist. Hospitals and Medical College Hospitals
  will be developed as a Referral Centre as well as
  RCS Centre.
• Comprehensive training will be given to the
  concern Medical Para-Medical Staff.

43
Feedback on GOI guideline on Case Confirmation
before Registration
44

• Govt. of Indias guideline for Case Confirmation
  before Registration has been circulated
  throughout the State.
• During Annual Review Meeting of DLOs, this point
  was discussed in length and necessary guidance
  were given.
• During the field visit cross checking for
  implementation of this guideline have been
  verified.
• DLO / Dist. Nucleus MO DTST MOs during their
  regular field visit confirm the case on regular
  basis.
• Regular updating of Treatment Register at PHC
  level will be intensified.
• The Registration of cases after confirmation by
  DLO / Dist Nucleus MO DTST MOs have started as
  a regular phenomena.

45
Any Other Issue
46

• Funds for IEC / IPC BLAC may be continued
  during 2005-06 at least as sanctioned in previous
  year.
• POD training of GHS Staff and updating of Self
  Care for patient should be continued for the year
  2005-06.

47
Thank You
Leprosy work is not merely medical relief
It is transforming frustration of life into joy
of dedication personal ambition into selfless
services. - Mahatma Gandhi