A study on inclusion of leprosy in the curricula of pre-service health training institutions in Uganda.

OBJECTIVE: To establish the categories of pre-service health training institutions in Uganda that still maintain leprosy in their curricula and how leprosy training is organised. MATERIALS AND METHODS: A structured questionnaire was administered to the heads of 42 health training institutions including universities, paramedical and nurses' training schools. RESULTS: Leprosy was included in the curricula of 33 (78%) of the institutions studied but only 50% of them had organised leprosy training in the 2 years prior to the study. In 48% of cases the training was implemented by in-house trainers; the rest depended on external trainers and staff of a leprosy training centre. Course evaluation using a variety of methods was practiced by 80% of the institutions. CONCLUSIONS: Inclusion of leprosy in the curricula of pre-service health training institutions was not always followed by actual training. It is possible and acceptable to organise leprosy training within the confines of the institutions provided arrangements are made to include interaction with patients. Local leprosy control supervisors and dermatologists can be engaged to support pre-service training. In order to derive optimal benefit from this opportunity, the National Tuberculosis and Leprosy Control Programme should develop a national plan for leprosy training, organise training of trainers and assure access to appropriate teaching and learning materials. There is a need for more comprehensive evaluation of the ongoing leprosy training in pre-service institutions.

Potential role of dermatologists and dermatological services in developing and sustaining the leprosy control referral system in resource constrained settings.

General Health Services that pay due attention to the management of skin conditions are opportune for suspecting and diagnosing early leprosy. In many developing countries, patients with dermatological conditions can only access specialist services in the larger cities and university hospitals; unaffordable costs make the services even less accessible if they can only be provided in the private sector. The high profile of dermatologists in the health services, gives them the opportunity to facilitate the development and implementation of a referral system that includes leprosy. This potential benefit for leprosy control must be initiated by current National Leprosy Programme Managers through establishing formal relationships with the dermatologists and involving them and other partners in the re-designing of leprosy control strategies to keep them in tandem with changing epidemiological patterns, national policies and on -going health sector reforms. The same health service managers should avail of the opportunities from the dermatologists (both in public and private sectors) about the current knowledge on the management and control of leprosy.