Kala-azar treatment without bias in Bihar, India

Wednesday, 17 May, 2017

Two cases illutsrating the success of the incentive scheme unrolled in Bihar.  This Governmental effort with the support from KalaCORE has helped bring AmBisome treatment closer to patients places of residence, and fairly, wihtout bias.

Case 1

13-year-old girl belonging to scheduled castes (Chamar community) received Kala-azar treatment within 48 hours of diagnosis at a government facility. Rani (name changed) lives in abject poverty as her father died four years ago with no own land and her mother works as daily labourer to earn a living. Her mother’s income is not sufficient to feed a family of six members. The family’s caste is deprived of basic services and faces bias in receiving government schemes to improve their social status. In this case, however, Rani was able to report a positive experience and was able to access health services without any hurdles. She did not face any unfriendly behaviour or bad treatment at the government facility.

The IEC/ BCC activities carried out in this village by KalaCORE played a key role in identification, treatment and receiving incentive from the government. During group communication sessions, using customized video, facilitators share information on the cause, symptoms, treatment and nearest centers for availing Kala-azar services with villagers.

As a result of these sessions, a family member of Rani recognised her symptoms as Kala-azar. Before that point, she had been treated by local doctors using indigenous medicines. The family members approached the village ASHA, who had been sensitized through inter-personal communication (IPC) by KalaCORE. On seeing her symptoms, the ASHA connected the dots and advised Rani’s mother to visit the government health facility. The ASHA accompanied them to the nearest primary health centre in Patepur where Rani tested positive for Kala-azar.

The ASHA also accompanied Rani when she returned two days later to start treatment. The Government of Bihar provides an incentive of INR 6,600 for availing treatment at government facilities, which is attracting more uptake than foreseen. After receiving treatment, the family opened a bank account in the name of the girl to receive the incentive. The government is also rewarding ASHAs with a payment of INR 400 for each patient tested positive and receiving treatment at government health facilities.

Case 2

A 15-year old boy from a scheduled caste in a neighbouring village, Padmaul, also received quality care at Patepur PHC after suffering from fever for more than one month. He was examined by a local doctor in the village but was not cured. The same doctor asked the family to visit the government health centre. The boy was taken by his father on a bicycle to Patepur PHC, where he tested positive for Kala-azar. His treatment started the following day when the doctor returned from holiday. The treatment went well and the boy faced no bias at the government health facility and has now recovered fully. The boy did not receive an incentive payment as he was treated before the announcement of the incentive for Kala-azar patients by the government.