FIDELITY OF IMPLEMENTATION OF HEALTHCARE PROVIDER-ORIENTED CARE AND SUPPORT TO PEOPLE WITH LEPROSY FOR DISABILITY PREVENTION AND MANAGEMENT IN RUPANDEHI DISTRICT, NEPAL: AN IMPLEMENTATION RESEARCH

Sudip Nepal, dr. Riris Andono Ahmad;Prof. Dr. Ari Natalia Probandari

2024 | Tesis | S2 Ilmu Kesehatan Masyarakat

Background: Leprosy is a chronic infectious disease likely transmitted by prolonged, close contact with untreated leprosy patients through nasal and oral droplets. Major events that may occur after completion of treatment include leprosy reaction, neuropathic pain and the relapse of disease. Healthcare providers should monitor the disease's progress, provide treatment for complications, and cross verification of prescribed medications.

 

Method: This  study used a qualitative approach and a multi-source, multi-method case study design to accomplish study objectives.Purposive and selective sampling techniques were used in this study. Interview questions and checklists were developed to facilitate FGDs, KIIs and observation. Thematic data analysis was done using Deedose.

 

Results: The study showed that people with leprosy appreciated healthcare providers' prompt care and support, accurate diagnoses, and counselling. However, the daily pill burden of MDT, drug side effects, and inadequate financial resources for managing the leprosy complications were the major issues. Healthcare providers adhere to the leprosy protocols, while the major challenges include the lack of skin smear test availability in the health facilities of Rupandehi district. The study identified major barriers to leprosy services such as financial hardship during referral, expensive treatment of complicated cases and institutional barriers. The facilitators of leprosy services such as adequate human resources, involvement of family members and female community health volunteers, effective communications, the role of external development partners and transportation incentives and support from local government enhance the leprosy services.

 

Conclusion: The healthcare provider of Rupandehi district adheres to the leprosy protocols so there is fidelity to leprosy services. Addressing the barriers of leprosy while leveraging facilitators of leprosy services is crucial for disability prevention and management.

Background: Leprosy is a chronic infectious disease likely transmitted by prolonged, close contact with untreated leprosy patients through nasal and oral droplets. Major events that may occur after completion of treatment include leprosy reaction, neuropathic pain and the relapse of disease. Healthcare providers should monitor the disease's progress, provide treatment for complications, and cross verification of prescribed medications.

 

Method: This  study used a qualitative approach and a multi-source, multi-method case study design to accomplish study objectives. Purposive and selective sampling techniques were used in this study. Interview questions and checklists were developed to facilitate FGDs, KIIs and observation. Thematic data analysis was done using Deedose.

 

Results: The study showed that people with leprosy appreciated healthcare providers' prompt care and support, accurate diagnoses, and counselling. However, the daily pill burden of MDT, drug side effects, and inadequate financial resources for managing the leprosy complications were the major issues. Healthcare providers adhere to the leprosy protocols, while the major challenges include the lack of skin smear test availability in the health facilities of Rupandehi district. The study identified major barriers to leprosy services such as financial hardship during referral, expensive treatment of complicated cases and institutional barriers. The facilitators of leprosy services such as adequate human resources, involvement of family members and female community health volunteers, effective communications, the role of external development partners and transportation incentives and support from local government enhance the leprosy services.

 

Conclusion: The healthcare provider of Rupandehi district adheres to the leprosy protocols so there is fidelity to leprosy services. Addressing the barriers of leprosy while leveraging facilitators of leprosy services is crucial for disability prevention and management.

Kata Kunci : Keywords: Care and support, Leprosy, Fidelity, Implementation Research, Nepal.