1. Staff Updating & Review meeting Netherlands Leprosy Relief, India Ramnagar (Uttrakhand ), 8 th & 9 th December 2010 Presented by Dr. H.C.Pandey ILEP State Coordinator, U.P. Lucknow 1

2. Field visits (supervision days) QuarterPlannedPerformed 1 st 39+ MOs,NLEP Staff & workers Trainings at Kannauj, Lucknow & K.Nagar. ( State Budget ) 03 days– ½ days Sensitization of ANMs at Uannao. 30 + Completed State Budget Training at Lko, K.nagar & Kannauj & 03 days– ½ day Sensitization of ANMs & ASHAs at Kannauj & Unnao. 2 nd 28+ 04 Days T.O.T. workshop. 11 Days– ½ Day Sensitization of ASHAs & ANMs. 03 Days-- NLR Review meeting ( 03 distts.) 01 Day NSS training at NIH & FW at New Delhi. 24+ All planned Trainings & workshops. 02 Days POD & Self Care in villages which was not planned earlier. 2

3. Field visits (supervision days) QuarterPlannedPerformed 3 rd 27+ 04 Review meetings at Dhanbad, Kalyanpur & Bilgram. 04 Days CHC Supdts. Training. 08 Days Situation Analysis 02 Days Validation of NSS. 24+ All planned Trainings & Workshops. 02 Days NSS Training at Unnao. 01 Day POD & Self Care in villages. 4 th 22 till 30 th November 2010. 04 Days DN workshop 02 Days Validation at Kanpur Nagar 06 Days Situation Analysis at 05 Distts. 02 Days CMS workshop. 18 + All activities planned except 06 Days Situation Analysis at 05 Distts. Total116 + Other Activities.96 + Other Activities. 3

4. New Changes in NLEP Situation (U.P.) 4  DPMR has been taken up & in progress. RCS centers identified & RCS Operations are being done.  2008-09 476 RCS Operations In U.P.  2009-10578 RCS Operations In U.P.  ANCDR is steadily falling from 51.70/ Lac in 2002-03 to 13.40 / Lac in 2009-10.  PR is also falling from 4.1/10,000 in 2002-03 to 0.81/10,000 in 2009-10.  U.P. achieved elimination level in 2006-07.  Child proportion is nearly stationary 5% to 6%.

5. New Changes in NLEP Situation ( U.P.) 5  Disability proportion is slightly increased from 1.5% in 2002-03 to 2.1 % in 2009-10.  Gr.I Disability is being recorded & reported by Districts.  New Case detection has declined from 48,000 in 2005 to 27,500 in 2009-10 in U.P.  No. of Districts having P.R. below 1.0/10,000 have increased from 39 in 2007-08 to 51 in 2009-10.  Districts having P.R. more than 01 are presently 20.  Only 01 district is having P.R. more than 02.  P.R. more than 05 no districts.

6. New Changes in NLEP Situation ( U.P.) 6  T.C.R. has increased above 95% in PB & MB both.  Nearly all District Nucleus Staff have been trained in U.P.  Most of GHC Staff has been sensitized in Leprosy & DPMR.  Adequate Supply of MDT has been ensured.  ASHAs have been trained & involved in Leprosy Programme for referring Leprosy Cases.  ST / VMT is done with adequate supply of Prednisolone.

7. New Changes in NLEP Situation ( U.P.) 7  Screening Camps for RCS are being organized in disability prone Districts. (01 to 02 Camps ) Money has been released.  Funds through society now NRHM is increased from 2.16 Cr. In 2005-06 to 6.00 Cr. In 2009-10.  ILEP Support is available in U.P. State in the field of Capacity building of different category Staff, Supervision, Monitoring & Validation, POD & Self Care Activities & other areas of Leprosy.  NLR support is being given for POD & Self Care Camps in villages & PALs home.  Children of the PALs in PALs home & Self Care in villages are being supported for their School fees, Uniforms & books etc.

8. Gaps/Needs Identified 8  SIS Guidelines are not implemented as per GoI Guidelines.  Gaps in integrated Services provided by GHC Staff.  Late Diagnosis.  MDT Services are not foolproof.  Instances of rerecording, wrong diagnosis & wrong type still exist.  Healthy Contact Examination, ST & VMT is not done regularly.

9. Gaps/Needs Identified 9  Absentee retrieval not done as per requirement.  Cases deleted otherwise are more which effects TCR.  Poor Supervision & Monitoring by DN.  Knowledge of DLO, NMS & NMA for filling DPMR forms is of below standard.  Few district yet not printed DPMR forms.  Referral Units are not constituted in quite many districts.

10. Gantt. Chart showing Annual Progress Report-2010 NLR Activities S. N. Activities1 st Quarter 2 nd Quarter 3 rd Quarter 4 th Quarter 1½ day ANMs Training workshop at Unnao Planned199155Nil Performed149129Nil 2½ day ASHAs Training workshop at Kannauj PlannedNil1,444Nil PerformedNil714Nil 3POD & Self Care in villages workshop at Kalyanpur Kanpur Nagar PlannedNil20 PALsNil PerformedNil25 PALsNil 4POD & Self Care in villages workshop at Bilgram -Hardoi PlannedNil20 PALsNil PerformedNil27 PALsNil 10

11. Gantt. Chart showing Annual Progress Report-2010 S. N. Activities1 st Quarter2 nd Quarter3 rd Quarter 4 th Quarter 1Review meetings at CHC Kalyanpur, K.nagar. Planned---010302 Performed---1 st Review meeting done. 03 Review meetings done. 02 Review meetings done. 2Review meetings at CHC Bilgram, Hardoi. Planned--- 03 Performed--- 0302 ( last due on 27 th Dec10.) 11

12. Half Day Sensitization of ANMs at CHC Bighapur Unnao on 05th April 2010

13. Half day Sensitization of ASHAs at CHC Chhibramau Kannauj on 04 th June 2010.

14. Activities Completion Report 2010 NLR Activities Result Based ActivitiesBatches PlanedBatches Done No. Planned No. Participated Result-1 GHC Staff performance improved ½ day Sensitization workshop of ANMs at District Unnao. 09 354278 Result-2 : Leprosy Services established under NRHM ½ day Sensitization workshop of ASHAs at District Kannauj. 07 1,444714 Result-3 : DPMR Services improved 02 days POD & Self Care in villages workshop at 1) CHC Kalyanpur K.Nagar 21 & 22/04/2010 01 2025 2) CHC Bilgram, Hardoi 29 & 30/06/2010 01 2027 14

15. Activities Completion contd… NLR Activities Result Based ActivitiesBatches PlanedBatches Done No. Planned (PALs) No. Participated ( PALs) 1 st Review meetings at CHC Bilgram on 30/07/2010 01 2722 2 nd Review meetings at CHC Bilgram on 27/08/2010 01 2721 3 rd Review meetings at CHC Bilgram on 30/09/2010 01 2714 4 th Review meetings at CHC Bilgram on 30/10/2010 01 2717 5 th Review meetings at CHC Bilgram on 29/11/2010 01 2719 6 th Review meetings at CHC Bilgram on 27/12/2010 Due on 27 th December 2010. 15

16. Activities Completion contd… NLR Activities Result Based ActivitiesBatches PlanedBatches Done No. Planned ( PALs) No. Participated (PALs) 1 st Review meetings at CHC Kalyanpur on 21/05/2010 01 2509 2 nd Review meetings at CHC Kalyanpur on 21/06/2010 01 2512 2 nd Review meetings at CHC Kalyanpur on 19/07/2010 01 2509 2 nd Review meetings at CHC Kalyanpur on 19/08/2010 01 2505+01( new) 2 nd Review meetings at CHC Kalyanpur on 29/09/2010 01 2516 2 nd Review meetings at CHC Kalyanpur on 26/10/2010 01 2514 16

17. Facilitations in State Trainings During 2010 DistrictsTrainingsCategory of Staff Dates of Facilitation Remark Lucknow 02 Days MOs Training MOs already working in fields. 26, 27 Feb.10 02 Days Training NLEP Staff & workers NLEP Staff + Health workers. 24, 25 Feb. 10 Kanpur Nagar 02 Days MOs Training Newly appointed MOs. 20, 21 Feb. 10 Kannauj02 Days MOs + workers Training MOs & workers already working in fields 17,18 Feb. 10 17

18. Facilitations in State Trainings During 2010 DistrictsTrainingsCategory of Staff Dates of FacilitationRemark Kannauj02 Days MOs + workers Training MOs & workers already working in fields 17 th,18 th Feb. 10 02 Days NLEP Staff & Health workers Training NLEP Staff & Health workers 8 th, 9 th Jan. 10 18

19. Activities not performed  All NLR & ILEP Planned activities performed except 01 Day Sensitization of Dermatologists, Eye Surgeons & Orthopedic Surgeons. The dates finalized as 12 th, 13 th & 29 th December 2010 respectively. Letters from D.G. Medical Health U.P. has been sent to participants.  01 Day Sensitization workshop of CMOs not done as SLO,U.P. refused for CMOs workshop & wants to Sensitize CMO FW.  Sensitization of CMO FW has been put in Budget of 2011. 19

20. Budget Utilization 2010 ( NLR Activities ) Planned ActivitiesBudgetBudget UtilizedReasons for non Utilization ½ day Sensitization workshop of ANMs at District Unnao. 96,132=0018,109=00Budget asked was Rs. 120 per head & Spent Rs. 60-65 per head. 278 ANMs participated out 354. ½ day Sensitization workshop of ASHAs at District Kannauj. 50,000=0042,840=00 20

21. Budget Utilization 2010 ( NLR Activities ) Planned ActivitiesBudgetBudget UtilizedReasons for non Utilization 02 days POD & Self Care in villages workshop at CHC Kalyanpur, K.Nagar 32,320=0017,218=00Review meetings are going on. 02 days POD & Self Care in villages workshop at CHC Bilgram, Hardoi 32,320=0014,214=00Review meetings are going on. 05 Review meetings at CHC Bilgram, Hardoi. 32,320=0012,648=0005 Review meetings completed. 06 Review meetings at CHC Kalyanpur, Kanpur Nagar. 32,320=008,383=0006 Review meetings completed. 21

22. Budget Utilization 2010 ( ILEP Activities ) Planned ActivitiesBudgetBudget UtilizedReasons for non Utilization Training of Trainers ( T.O.T.) 1,50,000=001,45,217=00 01 Day Sensitization of Supdts. CHCs at lko & Kanpur. 1,20,000=001,15,338=00 Decentralized Planning for DPMU & DN Staff at lko. 1,00,000=0095,344=00 01 Day Sensitization of CMS ( Male ) 1,25,000=0090,285=00 Training of DLOs / Dy. DLOs at TLM Naini, Allahabad. Bill has not been received form TLM Naini, Allahabad. 01 Day Sensitization of Eye, Ortho. Surgeons & Dermatologists. To be organized from 13 th to 29 th Dec.2010. 22

23. Major Challenges  Quite many districts have offg. DLOs / Part time DLOs / No DLOs.  Leprosy programme is given lowest priority at higher levels.  IEC is poor which effects voluntary reporting of Leprosy Cases.  Provision to measure disability status before the treatment & at RFT not included in present SIS.  IEC of Pts. Relation & community is at very low level.  Supervision, Validation & Monitoring by DN Staff is still weak.  Referral unit is not constituted in all districts of U.P. where complicated cases can be treated at district HQ. 23

24. Major Challenges  Supply of MCR Chappals is poor.  DPMR forms are not used by HCFs.  Poor knowledge of NLEP Staff for filling of DPMR forms.  HC, ST, VMT & Absentee retrieval is not done as regular feature.  Involvement of ASHAs is still wanting.  POD & Self Care Practices are poor in HCFs.  Availability of Prednisolone is not ensured. 24

25. GANTT Chart for the year 2011 Quarterly ( NLR activities ) Activity as planned1 st Quarter 2 nd Quarter 3 rd Quarter POD & Self care in villages camps at CHC Safipur, Unnao.  POD & Self care in villages camps at CHC Sandila, Hardoi.  25

26. GANTT Chart for the year 2011 Quarterly ( ILEP activities ) Activity as planned1 st Quarter 2 nd Quarter 3 rd Quarter 4 th Quarter Result 1: Program Management ensured 2 days Decentralized planning & management workshop for D.N  Workshop of DPMU officers on decentralized planning  Training of newly recruited / posted D.N staff  At TLM Naini Allahabad ) Sensitization of District Program Officers (CMO FW) - NRHM  DLOs regional review meeting, 2 in no. (2 will be supported by state)  Sensitization of CMS Male of district hospitals  26

27. GANTT Chart for the year 2011 Quarterly ( ILEP activities ) Activity as planned1 st Quarter 2 nd Quarter 3 rd Quarter 4 th Quarter Result 2: Increased attention to leprosy by decision makers Stake holders advocacy meeting at state level for stigma reduction & micro/macro financing from banks  Result 3: Operational Research Pilot Project for improving urban leprosy program  Result 4: Increased awareness about disease & treatment Orientation of final year students of 2 Medical Colleges  27

28. GANTT Chart for the year 2011 Quarterly ( NLR +ILEP activities ) Activity as planned1 st Quarter 2 nd Quarter 3 rd Quarter 4 th Quarter Result 5: DPMR services improved One day orientation of orthopedic surgeons  One day orientation of Dermatologist/Physicians  One day orientation of ophthalmologists  Self care in villages in 2 new blocks  Follow up of self care in villages in existing 2 blocks  Follow up of self care groups in 11 leprosy colonies  Result 6: All children of persons affected are educated Education support to the children (108) of 11 leprosy colonies  28

29. THANKS SCP 29