RESUMO
Introduction: The COVID-19 pandemic imposed new challenge to the implementation of the National Leprosy Eradication Programme. According to national data, after lockdown due to COVID-19, there was a 29% reduction in total leprosy cases reported in the first quarter (April-June) of 2020 in comparison to 2019. Objectives: To explore the difficulties faced by different stakeholders of the National Leprosy Eradication Programme like policy makers, doctors, grass root level health workers as well as leprosy patients during COVID-19 pandemic with respect to programme implementation and access to leprosy care. Materials and Methods: Qualitative research was undertaken including two focus-group-discussions held among six leprosy patients diagnosed after lockdown and nine ASHA workers as well as six in-depth interviews of doctors, leprologists, and programme managers. Ethics committee approval was sought and informed consent was obtained from all participants. All focus-group-discussions were electronically recorded and the in-depth interviews telephonically recorded, transcribed and translated from Bengali-to-English. Transcripts were separately coded by researchers and thematically analysed with the help of Visual-Anthropac software version 1.0. Results: Solitary focus on COVID-19 control, capacity building and information, education and communication, leprosy case search & surveillance, co-infection among health workers, transportation issues were the themes explored from focus-group-discussions of health workers and ASHA workers. Similarly, the present study identified six themes from in-depth interviews of programme manager, leprologists, programme manager as diagnostic difficulty, operational issues, rehabilitation issues, capacity building & information education and communication activities and way forward. Limitations: The research reveals the perceptions of rural population of Eastern India with high leprosy prevalence, which might not be applicable for urban areas or low prevalent districts Conclusion: The solitary focus of the administration towards COVID and shifting the infrastructure and human resource only towards the management of COVID can lead to resurgence of the leprosy. Having an organised framework of operations, catering to the need of the front-line workers in rendering services, utilizing the digital platform and social media, and focusing on rehabilitation would be needed to overcome the crisis
RESUMO
Introduction: Safe immunization is one of the prerequisites for successful routine immunization program. Awareness on various components of immunization safety among frontline health workers determines their practice. Objectives: This study was conducted to assess knowledge of Auxiliary Nurse Midwives (ANM) regarding various components of immunization safety and to determine association of their knowledge with some background characteristics (if any). Method: This cross-sectional study was conducted at four community development blocks of Sadar North sub-division of Purba Bardhaman district of West Bengal between June - September, 2017. All the 189 ANMs working in 107 sub-centres of these four blocks were interviewed for knowledge on various components of immunization safety with a pre- designed, structured, self-administered questionnaire. Results: Only 68 (36%) ANMs had adequate knowledge (score ≥ 33) combining all components on immunization safety. Chi-square test revealed that knowledge of ANM had statistically significant association with education level (p = 0.00) and last training status (p = 0.00). Education and last training status remained significant in binary logistic regression. Conclusion: Despite being trained, knowledge among ANMs regarding various components of immunization safety in the study area was still not satisfactory. Further emphasis on training and supportive supervision by local and district health authority is the need of the hour.