Barriers to leprosy elimination in Bolivia: Exploring perspectives and experiences of medical professionals and leprosy patients-A phenomenological study.

BACKGROUND

Leprosy elimination has recently re-entered the global health sphere, with the World Health Organisation's (WHO) "Towards zero leprosy" strategy (2021-2030). Previously, its elimination had been defined as a prevalence of less than 1 case per 10,000, which was achieved on a global scale in 2000, leading to a large withdrawal of resources from leprosy control and to neglect on both global and national scales. Despite this, leprosy continued to spread and affect hundreds of thousands of people annually.

METHODS

The study explores the barriers to leprosy elimination in Bolivia, using a phenomenological approach, to discover the perceptions and experiences of leprosy patients and medical professionals regarding leprosy in Bolivia. It also explores the role of active case finding (ACF) for leprosy elimination in Bolivia. In-depth semi-structured interviews were conducted in Spanish, mainly at Jorochito Dermatological Hospital, the national referral centre for leprosy in Bolivia.

RESULTS

Barriers to leprosy elimination in Bolivia are present at provider, patient, governmental, societal and community levels. These include poor health financing, untrained workforce, poor treatment adherence, centralised organisation of leprosy diagnosis and treatment and health illiteracy.

CONCLUSION

The barriers to leprosy elimination in Bolivia are complex, interconnected and embedded in Bolivian society. Leprosy elimination must be given priority on global and national scales to increase funding and importance, to continue ACF activities, and to promote national solutions for sustainable leprosy control.