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Role of GIS in planning and evaluation of leprosy elimination programme
Br. Suresh
Management Information Systems Coordinator,
DANLEP, Tamil Nadu
danlep@vsnl.com
Leprosy control in India
The Government of India started the National Leprosy Control Programme in 1955 with the objective of controlling Leprosy with help of Dapsone. It was redesignated as National Leprosy Eradication Programme (NLEP) in 1983 as a centrally sponsored scheme, after Multi-Drug Therapy MDT became available for effective treatment of Leprosy. In 1991, WHO and its member States committed themselves to eliminate Leprosy as a public health problem by the year 2000. This commitment vowed to bring down the Leprosy cases below one case per 10,000 population. Government of India's fight against Leprosy is now being supported by organizations such as WHO, World Bank, DANIDA and many other international Non Government Organisations (NGO). In India itself, NGOs have played a key role in leprosy control. For example, there are now about 285 NGOs actively involved in running several leprosy related services through the length and breadth of the country. Impact of the programmes of the governmental and non-governmental agencies has indeed been remarkable and the second section which discusses the trends in leprosy prevalence bears testimony to this assertion.
Trends and Differences in Leprosy Prevalence in India
When leprosy control programme in India was redesignated as National Leprosy Eradication Programme in 1983, the prevalence rate for India stood around 57 per 10,000 population working out to a total patient load of about 4 million cases. The national prevalence rate has come down to 5.2 per 10,000 population by March 1999 and patient workload was slashed to a total of approximately less than a million leprosy affected individuals (LAIs). However, statistics on leprosy prevalence rates are not accurate and the estimates of prevalence vary. In spite of the impressive decline observed in India, one disturbing fact is that these constitute a whopping 60 per cent of the total number of LAIs globally recorded. Out of the 0.5 million total
LAIs in India, 70 per cent of the LAIs are concentrated in the states of Bihar, Uttar Pradesh, West Bengal and Orissa and Madhya Pradesh alone. Bihar alone has the dubious distinction of having about 32 per cent of recorded LAIs in India. The state of Punjab, Nagaland and Haryana have been able to reach the national target of reducing prevalence rate to 1 per 10,000 population.
In April 1986, by a bilateral agreement between Govt. of India and Govt. of Denmark, Danish International Development Assistance (DANIDA) working together with the National Leprosy Eradication Programme (NLEP) in India, called DANLEP with a multi-pronged approach to leprosy eradication. The major strategy followed by DANLEP has been to implement activities that were strongly rooted in the community and which involved the LAIs, their families, leprosy and general health staff and the community at large. DANLEP supported at State/district level in India: at district level, eight pilot districts viz. Gwalior, Durg, Rajnandgaon, Cuttack, Sambalpur, South Arcot, Salem and Madras; at the state level, Madhya Pradesh, Orissa, and Tamil Nadu;. Danida extended material and financial support for the programme including the training of leprosy programme personnel, monitoring and evaluation of the programme as well as the necessary logistical support. In the meantime, the collection, storage and manipulation of geographic information have undergone a revolution with the development and widespread availability of GIS software. Realizing the vast potential of the GIS technology and in order to take advantage of it for its programme planning, monitoring and evaluation needs, Danida decided to train its Management Information Systems Officer in this new technology. The present paper is an effort to provide a brief review of DANIDA's use of GIS in the planning, monitoring and evaluation of the National Programme for Eradication of Leprosy in India. As the purpose here is to demonstrate its usefulness as a tool in policy formation, decision making and resource allocation, we have restricted our presentation to only one state in which DANIDA has been working viz., Tamil Nadu.
Geographical Information Systems and Leprosy Programme
Application of GIS for managing the leprosy programme's service statistics became possible as a result of several developments:
- Availability of a reliable and regular system of data generation made possible by years of systematic and careful work in designing the system by DANIDA and the sincere and dedicated work of the field staff of the NLEP who meticulously maintained the records of the services provided by them with a detailed data on case load, deformities, age and sex profile and type of leprosy.
- Availability of survey of India maps for various political units up to the village level.
- Generous funding by DANIDA for acquisition of digitizing equipment, plotters and other infrastructure for the use of GIS.
- Inexpensive availability of software for application of GIS technology and its user friendliness and versatility for use in a wide range of software and hardware platforms.
- Service Statistics and GIS technology
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