INTEGRATION OF LEPROSY CONTROL INTO BASIC HEALTH-SERVICES - AN EXAMPLE FROM NEPAL

The need for integration of vertical projects into the Basic Health Se rvices (BHS) has been felt in Nepal since 1968. In 1987 it was decided to provide integrated BHS all over the country. The Nepal Leprosy Con trol Project (NLCP) was one of the vertical projects which had to be i ntegrated from that year. In order to prepare the BHS staff for this n ew task the NLCP developed a Comprehensive Leprosy Training course. Be sides adequate training, three other prerequisites for successful inte gration are: a) adequate supply of drugs and equipment; b) regular sup ervision and specialist referral facilities; and c) a well functioning BHS system in which to integrate. This article tries to assess to wha t extent these prerequisites have been met for leprosy control in Nepa l. To do this, some results of an evaluation of the training are used as well as existing Literature on the functioning of the BHS system. T he first three prerequisites are not fully met, but problems and obsta cles related to these are mainly due to problems in the last prerequis ite: a not so well functioning BHS system. It was, therefore, recommen ded to continue a (semi)vertical support system of leprosy control in those districts where the BHS is not so well developed.