Objective: This paper reviews the 13-year evolution of the social economic activities
in Northern Nigeria from a welfare-oriented to a community-centred programme for
people affected by leprosy.
Design: The review relied on the analysis of policy and strategy documents,
programme guidelines and statistical and evaluation reports.
Results: Findings revealed that the transformation among other things, demanded
formulation of new programme policies and guidelines; and staff training in CBR
principles and practice. Findings also showed that adopting CBR principles and
community development projects can stimulate improvements in living conditions,
self-esteem and acceptance of people affected by leprosy into the community.
Regardless of becoming a more inclusive and participatory programme wherein
people affected by leprosy contribute to programme implementation and evaluation;
groups affected by leprosy remain economically dependent on the programme and
partnership mobilisation is weak. This explains why the priorities for sustaining the
processes and impacts generated through CBR in northern Nigeria include: i)
empowering groups to access mainline services; ii) working through partners to
implement CBR and attract extra funding/ownership of interventions, and iii)
promoting human rights of people affected by leprosy and working for a barrier free
environment.
Conclusions: In the absence of an agreeable understanding and method of assessing
sustainability in CBR, we recommend the field-testing of a proposal for evaluating
sustainability, to determine its utility in different contexts. Such field-tests have the
potential of influencing policy and practice in the future.