Assessment of interventions becomes particularly important when considering the leprosy elimination goal. The purpose of monitoring is to assist decision makers and programme managers to assess the progress towards leprosy elimination, to make a plan of action, to implement it and to measure its impact. Monitoring a minimum set of indicators that describes the MDT services will serve the purpose.
The selection of indicators to be monitored needs to be made carefully, in the light of the epidemiological characteristics of leprosy and the large number of grey areas in our understanding of the disease. Incidence is the most relevant but probably the most difficult indicator. Prevalence varies not only with the level of disease burden but also with the operational component of intervention. The uneven distribution of leprosy, as well as the role of various local factors, calls for caution when extrapolating the results from one place to another.
Monitoring methods should be quick and cost-effective. Routine information system is the principal and essential component in monitoring leprosy situation. It needs to be programme oriented, simple and speedy. Too many indicators to be put on the information flow of routine systems will cause paralysis, and therefore some of the indicators among ‘a set of minimum indicators’ cannot be collected from routine systems. A monitoring exercise that complements routine information systems is needed to measure specific aspects of leprosy elimination programmes and methods for reviewing elimination programmes. |
