Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Alicante, Spain.
CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
PLoS Negl Trop Dis. 2022 Mar 28;16(3):e0010335. doi: 10.1371/journal.pntd.0010335. eCollection 2022 Mar.
Community participation and implementing interventions based on the community are key strategies to eliminate leprosy. Health professionals have an essential role as they are a necessary source of information because of their knowledge and experience, as well as their comprehensive perspective of contexts included in the programmes. This study has the aim of analysing the perceptions on the development of programmes with people affected by leprosy from the perspective of professionals that work at different organisations in endemic contexts.
A qualitative study was carried out with the written response to an open question questionnaire which was sent by email. The script content was related to positive aspects and difficulties in daily work, participation from the community in activities, contribution to gender equality and programme sustainability. 27 health professionals were interviewed, 14 women and 13 men, all of which belonged to 16 organisations in India and Brazil. Once the content of the interviews was analysed, two main topics emerged: barriers perceived by professionals and proposals to improve the sustainability of the programmes.
Professionals identify barriers related to social stigma, inequalities, gender inequalities, difficulty managing the disease, limited services, lack of resources and lack of community participation. Furthermore, some necessary recommendations were taken into account to improve programme development related to: Eliminating stigma, reaching gender equality, developing adequate and effective services, guaranteeing adequate and quality resources and achieving compassion among professionals.
Although introducing community programmes with people affected by leprosy has a long history in countries such as India and Brazil, there are still several barriers that can hinder their development. Based on the specific needs of the contexts, recommendations are suggested that, with the involvement of all parties and with sensitive approaches towards human rights and gender, they could help to guarantee universal health coverage and the sustainability of said programmes.
社区参与和基于社区的干预实施是消除麻风病的关键策略。由于他们的知识和经验，以及他们对方案所包含的各个方面的全面了解，卫生专业人员发挥着至关重要的作用，因为他们是信息的必要来源。本研究旨在从在流行地区工作的不同组织的专业人员的角度分析与麻风病患者一起开展方案的看法。
这是一项定性研究，通过电子邮件发送了书面回复开放式问题问卷。脚本内容涉及日常工作中的积极方面和困难、社区参与活动、对性别平等和方案可持续性的贡献。共采访了 27 名卫生专业人员，其中 14 名女性和 13 名男性，他们均来自印度和巴西的 16 个组织。在分析访谈内容后，出现了两个主要主题：专业人员认为的障碍和提高方案可持续性的建议。
专业人员确定了与社会耻辱、不平等、性别不平等、管理疾病困难、服务有限、资源匮乏和社区参与度低相关的障碍。此外，还考虑了一些必要的建议，以改善与消除耻辱、实现性别平等、发展适当和有效的服务、保证充足和优质资源以及培养专业人员同情心相关的方案发展。
尽管在印度和巴西等国家，引入与麻风病患者一起开展的社区方案已有很长的历史，但仍存在一些可能阻碍其发展的障碍。根据具体情况的需要，建议各方参与并采取对人权和性别敏感的方法，这有助于保障全民健康覆盖和这些方案的可持续性。
