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Leaving no one behind. A qualitative study about the accessibility of leprosy healthcare services


In 2015, the United Nations (UN) developed the Sustainable Development Goals (SDGs) to obtain a better and more sustainable future for all (Hák et al., 2016). ‘Leave no one behind’ is the central promise of these goals. One of the SDGs describes equal accessibility to quality health services which should be met for all people and countries (Stuart & Woodroffe, 2016). However, little research about leaving no one behind has been conducted in the field of NTDs, even though they have been defined by their burden on the poorest and most marginalized populations (Fitzpatrick & Engels, 2016).

Aim & research question
The current study aims to capture who has a limited access to leprosy healthcare services and to examine why these people are facing difficulties accessing these services. This has led to the following research question: Which persons are left behind in the accessibility of leprosy healthcare services worldwide, why is this the case and what can be done to leave no one behind according to leprosy experts?

A qualitative research design was used in this study. Twelve in-depth interviews were conducted with experts in the field of leprosy. Experts that are active as a health professional or researcher with a minimum of five years of experience within the field of leprosy were eligible. Additionally, a focus  group was organized to discuss the results and focused on the question what can and needs to be done to increase the access to leprosy health services. Afterwards, all interviews and the focus group were transcribed. Finally, thematic analysis of all transcripts was performed.

Experts identified geographical locations, demographic characteristics, financial resources, and the physical condition of the patients as factors that influence the access to health services. Existing social factors such as stigma, values and beliefs in communities can also complicate access to leprosy health services according to the experts. Furthermore, the experts explained that health system characteristics such as the health center coverage, the attitude, and the knowledge of health staff also affect the access to leprosy health services. In addition, the experts indicated that governments are
not prioritizing leprosy within policies and programmes, and policies regarding accessing health services and quality of living are currently lacking. Leprosy experts agreed that policymakers should give first priority to providing training and education to health care providers to increase their

The current study showed that access to leprosy healthcare services remains a problem worldwide. Patient characteristics, healthcare system characteristics, and policies within the field of leprosy all affect the access to leprosy. Research and programmes around these groups should be prioritized
more among donors and governments, which may eventually facilitate an increase in access to these services.

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