Netherlands Leprosy Relief

NLR Support to Adamawa State

NLR has been active in leprosy control activities in Nigeria for some 40 years. Over those years, NLR has worked successfully towards the integration of leprosy services into government health institutions and towards national staff taking over responsibilities and tasks from NLR technical staff.

Recently, the management structure of NLR Nigeria was revamped, and a core management teams has been set up to set priorities and identify funding initiatives in this area. In 2012NLR Nigeria focused strongly on the further improvement of its financial management system and procedures and on re-​designing its future policy. Positive feedback was received from major partners (the Global Fund and USAID) on these improvements.

Disease Control

For reasons of sustainability, NLR Nigeria developed a strategy to move away from integral support to government leprosy control and focus instead on capacity building and innovative approaches, like early leprosy case detection methods. Promising new effective and efficient methodologies were identified.

An example is the successful development of a simple treatment protocol for common skin diseases for peripheral health providers, inclusive of a referral system for leprosy and difficult skin diseases such as STDs. Research has shown that Traditional Healers (TH) and Patent Medicine Vendors (PMV) are often the ‘first-​point-​of-​call’ for persons who have a health/​skin problem. By training the TH and PMV in recognition and referral skills, early detection of leprosy cases will increase. Such approaches are offered to the government and donor programmes to help improve the programme at large.

In Nigeria, leprosy control activities are planned and implemented in a combined programme with tuberculosis control: NLR is implementing the Global Fund (GFATM) and TB CAREprogrammes to fight tuberculosis in the same area where it supports leprosy work. This contributes to the image of NLR as a well-​respected and influential organization in the Nigerian health system, on which any future programme extension (e.g. in the area of CBR) can further build.

Disability

In Nigeria, NLR is actively involved in the development of a Community Based Rehabilitation Programme in Plateau State. NLR is well positioned in this state, where it has its office and a well-​established network with State Government agencies and NGOs. A planning workshop in 2013 has outlined a CBR Set up and Action Plan with a variety of interventions and services.

NLR has also been actively involved in the establishment of a diploma course in CBR at the University of Jos, which is unique for West Africa. NLR funded a curriculum development workshop in 2011 and successfully applied for funds from NUFFIC, together with “Enablement” — a Dutch CBR training institute, to implement a Training of Trainers trajectory. The training course started March 2014, which means that early 2016 it will deliver a first batch of Community Based Rehabilitation field staff. It is expected that these two developments will be complementary and mutually reinforcing and a good reason for NLRNigeria to focus its attention in the area of CBR on Plateau State.

That is also true for the Primary Eye Care Programme, which NLR implements since 2011(funded by “Light for the World”). From 2014 onwards this programme will exclusively focus on Plateau State. As leprosy might lead to deteriorating vision, this programme is well-​placed in NLR and will seek ways to support other CBR developments in Plateau State and will, more than in the past, put more emphasis on the activities on secondary (referral) level in order to offer more services in the areas of actual eye rehabilitation, e.g. cataract and lagopthalmos eye lid surgery.