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Household expenditure on leprosy outpatient services in the Indian health system: A comparative study.

TIWARI, Ajun
et al
January 2018

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The primary objective of this study is to estimate the expenditure in primary (outpatient) care incurred by leprosy patients in two different health system settings in India. The secondary objective is to compare the effect of the health systems on consumer behaviour and practices. 

The study followed a cross-sectional design, where a cohort from the Union Territory of DNH (an administrative division ruled directly by the federal government) was compared with a cohort from Umbergaon block of Valsad district, Gujarat, India. A block is the smallest administrative unit under a district. The cohorts were leprosy cases detected between April 2015 and March, 2016. A sample of 120 participants from each group was selected randomly. In the financial year of 2015–16, DNH reported 425 and Umbergaon reported 287 cases. 

A household survey was conducted between June and October, 2016 by means of a structured questionnaire collecting data on patient demographics, HH socioeconomic status, accessibility of health services, treatment seeking history and OPD expenditure. Respondents were asked to report on the last three OPD visits, either in a public or private facility, in the last 6 months. 

The costs were categorized as direct and indirect expenditure. The direct part included the expenditure on consultation, investigations and medicines & supplies. The indirect part constituted expenditure on transport, food, and days lost during illness of the patient and attendant

PLOS Neglected Tropical Diseases, January 4, 2018

https://doi.org/10.1371/journal.pntd.0006181

Caregivers' views on stigmatisation and discrimination of people affected by leprosy in Ghana

ASAMPONG, Emmanuel
DAKO-GYEKE, Mavis
ODURO, Razak
January 2018

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In Ghana, the social interpretation of leprosy regardless of the language, culture and tradition engenders stigmatisation and discrimination that leads to social rejection and exclusion of persons who have been cured of the disease. Often, these persons are cared for by relatives who happen to live with them in a confined place. From the views of these caregivers, this paper identifies areas of stigmatising and discriminatory tendencies against people affected by leprosy who reside in a Leprosarium in Accra. A qualitative interview with semi-structured interviews were conducted for twenty caregivers.

Best practices in the socio-economic rehabilitation of persons affected by leprosy and other marginalised people in their communities: findings from nine evaluations in Bangladesh, India and Africa

VELEEMA, Johan P
2008

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This paper presents an overview of findings from the formal evaluation of 9 socio-economic rehabilitation programmes (SER), in 4 countries in Africa, in Bangladesh and in India from 2002-2005. Bringing together the recommendations resulted in a description of best practices in the implementation of socio-economic rehabilitation programmes, derived from actual experiences in different contexts.

All the 9 programmes focused on supporting individual leprosy-affected beneficiaries or their families. Four projects also supported other marginalised clients. The usual interventions were micro-credit, housing and sponsoring of education for the children.

The recommendations touched upon each of the five steps in individual rehabilitation: Selection of clients, needs assessment, choosing an intervention, monitoring / follow--up of clients during rehabilitation, and separation at the end of the rehabilitation process. The evaluators also suggested ways in which participation of the client in their own rehabilitation might be boosted, made recommendations for the organisational structure of programmes, on maximising community involvement and emphasised the importance of information systems and of investing in the programme staff. A number of recommendations were specific to the types of interventions implemented i.e, housing, education or micro-credit.

Evidence of the impact of SER on the quality of life of clients is limited, but suggests increased self-esteem and increased respect/status in the family and community.

 

Asia Pacific Disability Rehabilitation Journal, vol.19, no.1, 2008

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