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NLEP – National Leprosy Eradication
Programme
• NLEP is a centrally sponsored public health programme of GOI

• evolved over a period of time with remarkable

changes from NLCP to NLEP

NLEP VISION: “Leprosy-Free India”

NLEP MISSION:“to provide quality leprosy services free of cost to all

sections of the population, with easy accessibility,
through the integrated healthcare system, including care
for disability after cure of the disease”
NLEP EMBLEM

LOTUS: symbolises beauty and purity

Leprosy can be cured and a leprosy patient

can be a useful member of society in the
form of a partially affected thumb;
a normal fore finger and shape of house

Symbol of hope and optimism in a rising sun

 Milestones of NLEP
1948 Hind Kusht Nivaran Sangh

1955 National Leprosy Control Programme

1970 Definite cure in form of MDT was identified

1982 WHO - study group recommended use of MDT

1983 National Leprosy Eradication Programme, MDT started

1993 World Bank supports the MDT programme phase NLEP1

1997 Midterm appraisal of NLEP

1998-2004 Modified Leprosy Elimination Campaign

2001-2004 NLEP Project Phase II

2005 Nationwide Evaluation of Project II

2005, Dec Prevalence Rate of leprosy dropped to 0.95 /10000 population, and
India achieved elimination status Nationally

2007 DPMR Guidelines introduced

2012 XII Five Year Plan adopted the Special Leprosy Action Plan for 209
High endemic districts in 16 States/UTs
 Programme Strategies
1.Decentralized integrated leprosy services through General Health Care
system.
2. Early detection & complete treatment of all new leprosy cases.
3. Carrying out house hold contact survey for early detection of cases
4. Capacity building of all general health services functionaries
5. Involvement of ASHAs in the detection & completion of treatment of leprosy
cases on time
6. Strengthening of Disability Prevention & Medical Rehabilitation (DPMR)
services.
7. IEC activities in the community to improve self reporting to PHC and
reduction of stigma.
8. Intensive monitoring and supervision at Health and Wellness centres and at
PHC/CHC.
Components
(1) Decentralized integrated leprosy services through general
health care system
(2) Capacity building of all general health services functionaries
(3) Intensified information, education and communication
(4) Prevention of disability and medical rehabilitation
(5) Intensified monitoring and supervision
Major initiatives
• More focus to new case detection than prevalence.
• Treatment completion rate has been taken as an important indicator, to be calculated by states at
yearly basis.
• More emphasis on providing disability prevention and medical rehabilitation (DPMR) services
to leprosy affected persons.
 Dressing materials, supportive medicines and ulcer kits are provided to leprosy affected
persons with ulcers and wounds.
 (b) Micro-cellular rubber footwear is provided for protection of insensitive feet
 (c) An amount of Rs. 8,000/- is provided as incentive to each leprosy affected person from BPL
family undergoing reconstructive surgery.
 (d) Support provided to government institutions/ PMR centres in the form of Rs 5,000/- per
reconstructive surgery conducted
• Intensive IEC campaign with a theme Towards Leprosy Free India has been
carried out.
(4) Involvement of ASHAs in bringing out suspected leprosy cases for
diagnosis and treatment at PHC and follow-up of confirmed cases for their
treatment completion.

incentive money to ASHA

a) On confirmed diagnosis of case brought by them Rs. 250
b) On completion of full course of treatment of the case within specified time
PB leprosy case Rs. 400/-, and MB leprosy case Rs. 600
c) An early case before onset of any visible deformity - Rs. 250
d) A new case with visible deformity in hands, feet or eye - Rs. 200/-.
Activities to be performed by ASHA
(a)Search for suspected cases of leprosy i.e. before any sign of disability
appears.
ASHA based surveillance for leprosy suspects (ABSULS) was
launched on 1st July 2019
(b) Follow-up all cases for completion of treatment in scheduled time.
(c)Advise and motivate self-care practices by disabled cases for proper
care of their hands and feet during the follow-up period.
(d) Spreading awareness.
Disability Prevention and Medical Rehabilitation (DPMR)
• Implementation of DPMR guidelines and reporting its outcome.
Eg: treatment of leprosy reaction ,ulcers , reconstructive surgery

• Integrating DPMR services

Like provision of services to persons with disability by various departments
under different ministries

• The patients are also empowered with trainings in self-care procedure for
preventing aggravating disability to the insensitive hands/feets

• To develop referral system to provide prevention of disability services to all

leprosy disabled persons in an integrated set up
DPMR activities carried out in 3 tier system

 Primary level care (First level)

PHC,CHC,sub divisional hospitals ,urban leprosy centres/dispensaries

 Secondary level (second level)

District head quarter hospitals and district nucleus units

 Tertiary level care (third level)

Central government institutes ( CLTRI Chingalpettu and RLTRI at Aska/Gauripur/Raipur)
ICMR institute Jalma , Agra
ILEP supported leprosy hospitals
All PMR institutes and departments of medical colleges
Other support units:
• Orthopaedics and plastic surgery departments of medical college
• Identified NGO programmes
• All National Institutes under Ministery of Social Justice and Empowerment
• Contractual surgeons skilled in RCS and Rehabilitation Programmes
Referral system in NLEP
 Recent strategies in NLEP
1. Three pronged strategy- LCDC, FLC, Hard to reach areas
2. ASHA based Surveillance for Leprosy Suspects (ABSULS)
3. ‘Sparsh Leprosy Awareness Campaign’(SLAC)
4. Post Exposure Prophylaxis - Single Dose Rifampicin (PEP-SDR)
5. Immunoprophylaxis - Mycobacterium indicus Pranii (MIP) vaccine
6. Implementation of online reporting system (‘Nikusth’) for improved
monitoring and supervision
7. Detailed investigation Grade II disability cases
8. Drug resistance surveillance
9. Modelling studies in leprosy
10. Active Case Detection & Regular Surveillance (ACD & RS)
11. District Award Scheme for achievements in NLEP
Services in the urban areas
• In rural areas there is non-availability of infrastructure like PHC and
manpower for providing services
• The services in urban areas are provided mainly through institutional
level.
• Multiple organizations provide health services in urban localities
without much of coordination amongst them.

• More number of cases are detected in urban localities due to migration

of people, availability of good quality institutions with easy accessibility,
but treatment completion rate is less as compared to rural areas .
• Under the plan, about 524 urban localities identified out
of 4,388 urban areas (census 2011) (with population more
than 100,000)
• Remaining areas will be covered by PHC services as in
rural areas
These urban areas are divided into 4 categories:
(a) Town and city (population 1 lac to 5 lacs) 432 areas;
(b) Medium city (population >5 lac to 1 million) 53 areas;
(c) Mega city (population 1 million to 4.5 million) 34 areas;
and
(d) Areas with >4.5 million population - 5 areas.
Programme Implementation Plan for 12th Plan period
(2012-13 to 2016-17)
As the disease is still prevalent with moderate endemicity in about 15 per cent
of the country, the plan objectives are set as follows

a. Elimination of leprosy i.e. prevalence of less than 1 case per 10,000

population in all districts of the country.

b. Strengthen disability prevention and medical rehabilitation of persons

affected by leprosy.

c. Reduction in the level of stigma associated with leprosy

Case detection and management
Detection of the new cases at the early stage is the only solution to cut down the transmission
potential in the community, and also to provide relief to the leprosy affected persons by
preventing disabilities. innovative plans are made :

(i) To improve access to services.

(ii) To involve women including leprosy affected persons in case detection.

(iii) To organize skin camps for detecting leprosy patients while providing services for other
skin conditions.

(iv) To undertake contact survey to identify the source in the neighbourhood of each child or
multibacillary case.

(v) To increase awareness through the ANM, AWW, ASHA and other health workers to
motivate leprosy affected persons for early reporting to the medical officer.
Integrated leprosy services through all the primary health care facilities will
continue to be provided in the rural areas.

"District Leprosy Cell“

 a team of medical officer and para-medical workers at district level
 For providing technical support to the primary health care system
 to strengthen the quality of services being provided
Three pronged strategy was introduced in the National
Leprosy Eradication Programme from 2016-2017.
Components:

1. Leprosy Case Detection Campaign (LCDC);

163 districts of 20 states ; early detection and timely
treatment
2. Focused Leprosy Campaign
House by house survey in village/urban areas ; grade II
disability

3. Special plan for hard to reach areas

To find cases in difficult terrains , Naxalite affected
areas etc
Capacity building
Training of general health staff like Medical Officer, health workers,
health supervisors, laboratory technicians and ASHAs are conducted
every year to develop adequate skills for diagnosis and management
of leprosy cases.

NGO services under SET scheme

NGOs are getting grants from Govt. of India under Survey,
Education and Treatment (SET) scheme.

Various activities undertaken by the NGOs are IEC, Prevention of

Impairments and Deformities, Case Detection and MDT Delivery .
Sparsh leprosy awareness campaign

• launched 2017 through Gram Sabhas

• carried out with the help of Panchayat and Village
Health and Sanitation Community.

• aim :to generate awareness, reduce stigma and

improve self-reporting of the cases.

• The campaign activity was carried out in 60 per cent

of the total villages across India .

Theme for 2024 : ENDING STIGMA,

EMBRACING DIGNITY
Survey education and treatment (SET)
scheme

Under the scheme, the NGOs are presently involved in

disability prevention and ulcer care, IEC, referral of suspected
cases, referral for reconstruction surgery (RCS), research and
rehabilitation.

NGO support is mainly required for follow-up of under

treatment cases in urban locations and difficult to reach areas.
 Incentive to patient
An incentive of Rs. 8000/- will be paid to all patients
affected by leprosy undergoing major reconstructive
surgery irrespective of their financial status

Information, education and communication

(IEC/BCC)

• focus on communication for behavioural changes in general public

against the stigma and discrimination against the leprosy affected
persons.
• These activities are carried through mass media, outdoor media, rural
media and advocacy meetings.
• Major focus is also given on inter personnel communication.
Achievements during 2020:

• Percentage of Grade II Disability (G2D)/visible

deformity among new cases decreased from 3.05% in
2018-19 to 2.39% (2019-20).

• The G2D amongst new cases/ million population

decreased from 2.65/million population as on 31st
March, 2019 to 1.94/million population as on 31st
March 2020.

• Child cases percentage has reduced from 7.67%

as on 31st March 2019 to 6.86 % as on 31st March
2020.
‘Sapna’ is a concept designed and developed using
a common girl living in community, who will help
spread awareness in the community, through key
IEC messages.

Sapna can be local school going girl who is willing

to be ‘Sapna’ .There can be any number of
Sapnas in a village.
January 30

THEME FOR 2024:

BEAT LEPROSY
thankyou