Decentralisation of leprosy control activities in the municipality of Betim, Minas Gerais State, Brazil.

摘要

OBJECTIVES: The present study aims at evaluating the decentralisation of the leprosy control activities in the municipality of Betim, Minas Gerais, Brazil. DESIGN: A quantitative study was undertaken using data from SINAN (Sistema Nacional de Agravos de Notificacao) and patient records. The study included 435 new cases registered and living in Betim. The pre (1995-2000) and post (2001-2005) decentralisation periods were compared using the chi-square test. Besides this, units which already had leprosy control activities were compared to those which implemented them from 2001 on. RESULTS: There was a decrease in the percentage of cases diagnosed with deformities after decentralisation, as well as an increase in the number of cases detected through self-reporting. More patients were notified closer to home after decentralisation. The selected indicators did not show any difference between the quality of assistance regarding prevention of disabilities when comparing health units which already had leprosy activities to those which implemented them from 2001 onwards. Conclusions: Decentralisation, in Betim, did not lead to an increase in the number of cases, but led to earlier diagnosis and patients being treated closer to their homes. The study did not show evidence of decrease in the quality of care after decentralisation.