Applications of HP & E Theories and Principles in TB and Leprosy

1. Applications of HP & E Theories
and Principles in TB and Leprosy
Prepared by- Surakshya Poudel
Bph 2nd batch (3rd year)
Universal college of Medical
Sciences (UCMS),Bhairahawa
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2. Tuberculosis
Introduction
Tuberculosis, also known
as TB , is a contagious bacterial
infection that can be found
nearly anywhere in the body,
but is found most commonly in
the lungs.
• Tuberculosis (TB) is caused by
bacteria Mycobacterium
tuberculosis that most often
affect the lungs.
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3. • Tuberculosis is curable and preventable.
• TB is spread from person to person through the air.
When people with lung TB cough, sneeze or spit, they
propel the TB germs into the air. A person needs to
inhale only a few of these germs to become infected.
• TB is a leading killer of HIV-positive people.
• Ending the TB epidemic by 2030 is among the health
targets of the Sustainable Development Goals.
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4. Scenario of TB
GLOBAL
• Tuberculosis (TB) is one of
the top 10 causes of death
worldwide.
• In 2017, 10 million people
fell ill with TB, and 1.6
million died from the
disease (including 0.3
million among people with
HIV).(Source:WHO factsheet
2018)
NEPAL
• It is ranked as the sixth leading
cause of death in the country.
• During the reporting year, NTP
registered 31764 all forms of
TB cases. Out of total
registered cases in NTP, 11400
(36%) were female and 20364
(64%) were male with the
male/female ratio of 1.8:1.
(Source:DOHS annual report
2073/74)
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5. Leprosy
Introduction
Leprosy is a chronic infectious
disease caused by
Mycobacterium leprae, an acid-
fast, rod-shaped bacillus.
• The disease mainly affects the
skin, the peripheral nerves,
mucosa of the upper respiratory
tract, and the eyes.
• Leprosy is curable and
treatment in the early stages can
prevent disability.
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6. Scenario of Leprosy
GLOBAL
• There were 216 108 new
leprosy cases registered
globally in 2016, according
to official figures from 145
countries from the 6 WHO
Regions.
• Based on 173 358 cases at
the end of 2016, prevalence
rate corresponds to
0.29/10,000.
(Source:WHO factsheet 2018)
NEPAL
• In 2073/74, 3215 new
leprosy patients were
detected and put under
multi-drug therapy out of
whom 2,626 cases were
under treatment at the end
of the fiscal year.
(Source:DOHS annual report
2073/74)
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7. • Tuberculosis (TB) is a public health problem in Nepal,
as it is responsible for ill health among thousands of
people each year. TB is the sixth leading cause of death
in our country.
• TB mortality is unacceptably high given that most
deaths are preventable if people can access
tuberculosis care for diagnosis and the correct
treatment is provided.
• Nepal has achieved the elimination of leprosy as a
public health problem in December 2009 and declared
elimination in 2010.
• Disability Prevention and Rehabilitation Focal Unit
(DRFU) is established at the leprosy control division
under Ministry of Health and Population. Coordination
among disability organization is necessary to
mainstream the leprosy issues on disability movement.
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8. Different settings on TB and Leprosy
control
• National Tuberculosis centre(NTC)
• Leprosy Control Division
• Regional TB centre
• DOTS clinic at Health post
• PHC centers
• District hospital
• Zonal hospital
• NGOs/INGOs
• Private hospital

9. Responsible people for health
promotion in those settings
• Health Professionals at National Level
• Health post staff
• District hospital staff
• Local leaders
• Teachers
• Participation of community people

10. Importances of HP & E in this
setting
• Services providers.
• Planners, implementers and evaluaters.
• People rely on those organizations who are
working on TB and leprosy control.
• To develop a health promoting organizational
structure and culture.
• For better dissemination of plan and action for
controlling and preventionof TB and leprosy.

11. Application of health promotion and
health education theories in controlling
of TB and Leprosy
• BCC Strategy framework is the best example of
application of health promotion and health
education theories and its principle in controlling
of TB and leprosy in the present context.
• This strategy can be used by organization which
are working for the control and prevention of TB
and leprosy.

12. 5 steps of developing BCC about TB
and leprosy control
• Step 1: Analysis
• Step 2: strategic design
• Step3: development & testing
• Step 4: implementing & monitoring
• Step 5: evaluation & Replanning

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14. Other strategies such as
For TB control
1.TB basic training to newly recruited health personnel.
2. Operate mobile screening camps.
3. Strengthen the public private mix approach.
4. Update supervision checklists and prepare data based
entry system for effective feedback.
5. Expand the community-based DOTs programme.
6. Plan operational research on TB.
7. Develop and distribute patient-centred TB IEC
materials.
8. Strengthen the Community Support System program.
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15. For leprosy control
1. Expand and Enhance early case detection
through selected diverse approaches (ISDT).
2. Strive to achieve the surveillance
performance indicator .
3. Modernize and intensify the service delivery
pathways for ensuring quality services.
4. Heighten the collaboration and partnership
for Leprosy-Free Nepal.
5. Enhance support mechanism for people
infected and affected by leprosy. 15

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17. Different HP & E THEORIES For TB and
leprosy prevention and control
• Behavioural Learning Theory
• Protection Motivation Theory
• Social Cognitive Theory
• Theory of Reasoned Action
• Theory of Planned Behaviour
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