Background:

The National Leprosy Eradication Programme (NLEP) state action plan for the year 2008-09 has been prepared as per guideline issued by Central leprosy Division, New Delhi vide letter No. T 16011 / 6 / (38) / 2005 - 09 Lep (COORDN) dated 03.01.2008. The state action plan for the year 2008-09 is based on the same activity and expenditure norms of 2007-08 with slight modifications

Situation Analysis:

Assam has already reached the goal of Leprosy Elimination, i.e. PR below 1 per 10,000 populations at state level by 31st March 2001and at district level 18 districts (78%) out of total 23 districts also achieved elimination. By 2004 December all the 23 districts had attained the level of leprosy elimination. At present focused attention is kept on the high prevalent blocks and urban areas. The challenge to the state is not to eliminate but totally eradicate the disease and the profile of new case detection will be the main NLEP indicator for Assam along with deformity and child rate.

During the period from 01.04.2007 to 31.12.2007, 944 new leprosy cases were detected in Assam viz Kamrup, Dibrugarh, Sivsagar, Tinsukia, Sonitpur district contributes 523 new cases. These 5 districts with 28 % of state population contributes 55.48% of state's new case loads as on 31.12.2007. The PR/10000 population as on 31.03.2007 = 0.41/10000 population.

Strengths (NLEP):

Opportunities:

A.S.H.A., Village Health and Sanitation Committee, PHC management committee, Rogi Kalyan Samiti, District Health Societies, NGO, CBO, social worker may be involved for IEC activities for early case detection.

Infrastructure Development: -

Infrastructure : Contractual staff

State Leprosy Society (SLS) : The following contractual officers and staff are engaged in the State Leprosy Society Assam, which may be allowed to continue for the year 2008 - 2009.

Additional Requirement: -

State Level:

1 (one) Coordinator may be appointed on contractual basis in State Head Quarter for coordinating various Anti-Leprosy activities among the Community, Health Workers, etc.

District level :

12 Nos. driver on contractual basis were engaged the following districts, which may be allowed to continue: -
1. Kamrup 2. Nalbari. 3. Bongaigaon. 4. Dhubri. 5. Nagaon. 6. Morigaon. 7. Sonitpur. 8. Sivsagar. 9. Jorhat. 10. Dhemaji. 11. N.C. Hills. 12. Golaghat.

OBJECTIVE - STRATEGY & ACTIVITY

OBJECTIVE: The objective for the Annual Plan for the year has been drawn up based on the objective of PIP for the 11th plan (April 2007 to March 2012)

I. Further reduce the leprosy burden in the State.
II. Provision of high quality leprosy services for all persons affected by leprosy, through General Health Care System including referral services for complicated and chronic cases.
III. Enhanced Disability Prevention & Medical Rehabilitation (DPMR) services for deformity in leprosy affected persons.
IV. Enhanced advocacy in order to reduce stigma and stop discrimination against Leprosy affected persons and their families.
V. Capacity building among Health Service personal in integrated setting for rural and urban areas.
VI. Strengthen the monitoring and supervision component of the surveillance system.

STRATEGY: There are five basic components in the annual plan strategy for the year 2008-09.

1. Integrated Leprosy Services and Special initiatives: An integrated approach that uses primary health-care workers to deliver easily accessible leprosy services at a health facility near patients' homes will continue to be the key strategy. This will also ensure the sustainability of services in the future.

2. Disability Prevention and Medical Rehabilitation (DPMR): More emphasis will be given on Disability prevention among new leprosy cases and Reconstructive Surgery (RCS) services for leprosy deformed cases.

3. Community Education (IEC) and Advocacy Efforts : Guidelines and norms given by GOI during the year 2007-08 will be continued during the year 2008-09 is to be utilized for IEC campaign on the theme "Towards Leprosy Free India". The major head to be cover are: -

4. Coverage will have to move from high - risk centre to general community.

5. Intensive IEC with target groups will be given more emphasis for removal of social stigma.

6. Leprosy IEC will be integrated with IEC of other health programme under NRHM.


The messages to be given through IEC will be: -

Training & Capacity Building:- Training will be a continuous process during the year 2008-09 which will include :-
Training of private practitioners, Dermatologist and other Registered medical practitioners - 1 (one) day.

The above training will be conducted by ILEP

Disability Prevention and Medical Rehabilitation (DPMR): -

This is a major activity during the current year.

Silchar Medical College & Hospital, Silchar and Gauhati Medical College & Hospital, Guwahati, are identified for DPMR. It is suggested by the Head of Department of Plastic Surgery, Gauhati Medical College & Hospital, Guwahati, to appoint the following staff for smooth functioning, such as, reporting, management of post-operative patients: -

Urban Leprosy Control Programme :

Urban Leprosy Control Programme has been implemented in the following city / Towns:

Medium size city: - Guwahati.
Township: - Dibrugarh, Nagaon, Silchar.

The following new urban area is required for implement the urban leprosy control programme for the year 2008 - 2009 in addition of existing city / Town ship where the urban leprosy control programme is implemented.

Procurement Plan:-

The following have to procure during the year 2008 - 2009: -

1. Supportive Drugs
2. Laboratory reagent / equipment
3. Printing of forms / register etc.

Incentive for Accredited Social Health Activist (A.S.H.A.) :-

A provision for incentive @ Rs. 300/- for PB cases (6 doses) and @ Rs. 500/- for MB cases (12 doses) may be provided to A.S.H.A. subject to assisting the health centre in detection & completion of treatment by the leprosy affected persons.

Estimated case detection and completion of treatment for the year 2008-09 = 1200 nos. (MB = 900; PB = 300).

A.S.H.As assisting the Health Centres in detection of cases and completion of treatment of Leprosy affected persons = 600 nos. (MB = 450; PB = 150)

International Federation of Anti Leprosy Association (ILEP) :-

As per Memorandum of Understanding (MOU) signed between Govt. of India and ILEP on 24th October 2007. The MOU provides a framework for collaboration between Govt. of India and ILEP partner during the period April 2007 to 31st March 2012. ILEP support at state level will focus on strengthening of district nucleus, state leprosy unit and supervision & monitoring and DPMR

Accordingly the "Italian Leprosy Relief Association (Associations Italine Amica Di Raoul Follerean) - AIFO India will provide support to Assam as intimated by Deputy Director General (Lep) Nirman Bhawan, New Delhi vide letter No. M 12014 / 22 / 2002 - Lep (COORDN) dated 30.10.2007.

NLEP Monitoring & Evaluation :-

Regular maintaining and surveillance at state, district and block level will be continued to locate weak areas. So that needed plan corrective action can be taken in time. District Nucleus will be the basis structure of the district leprosy society and will supervise and monitor at the programme at the peripheral level.