Exploring the acceptability of a blanket Post-Exposure Prophylaxis (PEP) approach for Leprosy prevention in Achham, Nepal

Popular Abstract

This thesis explores the implementation and acceptability of blanket (population-wide coverage of active case finding and prevention) Post-Exposure Prophylaxis (PEP) as a preventive measure for leprosy transmission in the Achham district of Sudurpaschim (Far-west) Province in Nepal. Leprosy remains a significant public health concern in Nepal, with persistent challenges in prevention and control efforts. The Nepal government has recognized the recommendation by the World Health Organization (WHO) to implement innovative approaches as preventive measures to eliminate leprosy and interrupt the transmission of leprosy (zero new autochthonous child leprosy cases for five consecutive years at the municipality level by 2030. The primary aim of this study is to investigate the acceptance of blanket PEP among community members, health workers, and key stakeholders, shedding light on the factors influencing its uptake and identifying barriers to its implementation.
Employing a qualitative approach, the study involved qualitative data collection methods, including interviews and focus group discussions (FGDs), to gather insights from diverse perspectives from key stakeholders within municipalities that while having unique characteristics also share similarities such as socio-cultural context, sparse population and mountainous terrains. The research questions focused on understanding the level of acceptance of blanket PEP, exploring the facilitators and barriers to its implementation, and elucidating recommendations for its effective adoption in the Nepalese context. Respondents were recruited from across all 10 municipalities of Achham, encompassing a range of demographic backgrounds and geographical locations. Data collection involved 26 structured interviews with key stakeholders including community members, health workers, and key informants, supplemented by 5 FGDs with community members and health workers to capture nuanced perspectives and experiences related to blanket PEP.
The findings of the study highlighted the extent to which the blanket PEP was perceived and accepted by the key stakeholders. Several facilitating factors emerged, including a non-disclosure approach, community engagement, effective communication strategies, and the integration of preventive measures into existing healthcare services. Notably, community members expressed a willingness to participate in blanket PEP campaigns, citing concerns about leprosy transmission and the desire for preventive measures.
However, the study also identified significant barriers to the implementation of blanket PEP. Logistical challenges, such as population mobility, inadequate training, and medication supply shortages, were reported, highlighting the need for robust infrastructure and resource allocation. Additionally, prevailing stigma and misconceptions about leprosy hindered the uptake of blanket PEP, emphasizing the importance of tailored educational interventions and awareness-raising campaigns with prioritization of policies regarding leprosy control initiatives and resource allocation.

• author: Regmi, Upasana
• supervisor: Jan Magnusson
• organization: Graduate School
• course: SIMZ31 20241
• year: 2024
• type: H2 - Master's Degree (Two Years)
• subject: Social Sciences
• keywords: Leprosy Prevention, Post-Exposure Prophylaxis, Blanket PEP, Mass Drug Administration, Leprosy Burden, Nepal, Acceptability of PEP
• publication/series: Exploring the acceptability of a blanket Post-Exposure Prophylaxis (PEP) approach for Leprosy prevention in Achham, Nepal
• language: English
• id: 9160314
• date added to LUP: 2024-06-26 12:32:14
• date last changed: 2024-06-26 12:32:14