Report Workshop4 Website+visit WBengalnlrindia.org/starnet/media/KIT/AnrikE/AE091116WS4Rep... · Web viewTable 1 Leprosy situation in Districts as on 31.03.2007 (source ) 10 Table

Report on Technical Assistance to

NLR supported projects in India

Fourth Website WorkshopDelhi

October 2009

Anrik CF EngelhardRoyal Tropical Institute Amsterdam, November 2009

Report Website Workshop 4 and Visit W-Bengal Oct09

List of AbbreviationsANCD Annual New Case DetectionBO Branch OfficeDPMRP Disability Prevention and Medical Rehabilitation ProgramCMS Content Management SystemDP District ProfileDN District NucleusGHC General Health CareGIS Geographical Information SystemGLRA German Leprosy and TB Relief AssociationHM Health Mapper, the GIS program of WHOHMIS Health Management Information SystemHQ Head QuartersHTD How To Do (HTD-lists are part of Helpdesk/manual) IECILEP International Federation of Leprosy AssociationsIT Information TechnologyKISS Keep It Short and SimpleLFA Logical Framework ApproachLPA Leprosy Program Adviser (employed by NLR, deployed at state/regional level)LPSH Leprosy Program StakeholderMB MultibacillaryMOU Memorandum of UnderstandingMOV Means of VerificationNCD New Case DetectionNCDR New Case Detection RateNLEP National Leprosy Eradication ProgramNLR Netherlands Leprosy ReliefNLRSH NLR StakeholderNMS Non Medical SupervisorOVI Objectively Verifiable IndicatorsPB PaucibacillaryPR Prevalence Rate RTFM Read The Fine ManualPSE Photoshop elements, the photo software used by NLR IndiaS@S SiteatSchool, the content management system used for the NLR India websiteSCG Self Care GroupSWOT Strengths Weaknesses Opportunities Threats (analysis)WHO World Health OrganizationWS Workshop

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Table of ContentsList of Abbreviations..................................................................................................................... iiTable of Contents........................................................................................................................ iiiList of Conclusions and Recommendations................................................................................. iv

Executive Summary..................................................................................................................1Part One Website Workshop4.................................................................................2

Introduction...............................................................................................................................2Participants...............................................................................................................................3Facilitators................................................................................................................................3Goal and Objectives..................................................................................................................3Methodology.............................................................................................................................3Previous workshops and reports...............................................................................................4Day by Day Program Workshop 4.............................................................................................5Results......................................................................................................................................6Conclusions...............................................................................................................................8Recommendations....................................................................................................................8After the workshop....................................................................................................................9

Part Two Visit West Bengal....................................................................................9Annex 1 Itinerary........................................................................................................................14Annex 2 Participants and other Contacts...................................................................................14Annex 3 Summary Workshop 3 Report......................................................................................15Annex 4 Program of the workshop-specified and explained......................................................16

Exercises and home work for participants as preparation for the workshop:.........................16Exercises Day 1.......................................................................................................................16Exercises Day 2.......................................................................................................................16Exercises Day 3.......................................................................................................................17Exercises Day 4.......................................................................................................................17Exercises Day 5.......................................................................................................................18

Annex 5 Still to do list: Branch Office.........................................................................................18Annex 6 Still to do list: All..........................................................................................................18Annex 7 Still to do list: States....................................................................................................18Annex 8 Still to do list: NLR Rep and KIT/NLR............................................................................19Annex 9 Still to do list: KIT/NLR..................................................................................................19Annex 10 Website Screenshots Public Area Sections.................................................................20Annex 11 Website Screenshots Intranet Sections......................................................................26Annex 12 Photoshop Elements...................................................................................................30Annex 13 Sources and References.............................................................................................30Annex 14 Leprosy Statistics West Bengal..................................................................................31Annex 15 Map of W Bengal........................................................................................................35Annex 16 Distribution list...........................................................................................................35

Figure 1 Website-Public Area Section Home..............................................................................19Figure 2 Website-Public Area Section About Us.........................................................................20Figure 3 Website-Public Area Section Activities.........................................................................21Figure 4 Website-Public Area Section Join Us.............................................................................21Figure 5 Website-Public Area Section Partners..........................................................................22Figure 6 Website-Public Area Section Library.............................................................................23Figure 7 Website-Public Area Section New & Events..................................................................24Figure 8 Intranet Section Branch Office (BO).............................................................................25Figure 9 Intranet Section Help...................................................................................................26Figure 10 Intranet Section Activities..........................................................................................26Figure 11 Intranet Section Archive.............................................................................................27Figure 12 Intranet Section Local pages......................................................................................27Figure 13 Intranet Section Fundraising......................................................................................28Figure 14 Intranet Section NLR International.............................................................................28Figure 15 Intranet Section Upload..............................................................................................28

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Table 1 Leprosy situation in Districts as on 31.03.2007 (source www.health.gov.in)...............................10Table 2 Year-wise Leprosy Status in West Bengal............................................................................30Table 3 Leprosy situation in Districts as on 31.03.2007......................................................................31Table 4 Leprosy Key Indicators as on 31.03.2007.............................................................................31Table 5 Trend of leprosy prevalence West Bengal 1994-2007...................................................32Table 6 Demographic Characteristics at a glance......................................................................33

List of Conclusions and RecommendationsConclusion 1 The Website Workshop4 was successful in relation to the objectives. The results can, however, not be considered sustainable yet. For sustainability, the Branch Office staff should achieve more capacity as web and content master. In other words, the website is not yet well established and embedded in the overall activities........................................................3Conclusion 2 At branch office staff is convinced about the usefulness of the website as tool to improve the quality and sustainability of NLR contributions to leprosy control...........................3Conclusion 3 Workshop 4 has not disclosed and explored all opportunities of Site at School yet......................................................................................................................................................3Conclusion 4 Large differences in program quality between East and West Medinapur, reportedly related to differences in program leadership and division of Medinapur in an eastern and western part..........................................................................................................................3Conclusion 5 Rapid development of IT infrastructure and hence opportunities for use of website (two way sharing of information through up and download; standard instructions; local printing of forms etc.)................................................................................................................................3Conclusion 6 IT infrastructure, also at district or block level is developing fast; absence of infrastructure should not be an argument not to work hard on a website for NLR India.............3Conclusion 7 Although the discussion on OVI and MOV could not be finalized due to time restrictions, it became sufficiently clear, however, that a vital link in the control process was not included in the LogFrame; the operational aspects of the health management information (HMIS) was for a large part overlooked........................................................................................3Conclusion 8 Apparently the assumption was made during the strategic planning workshop that sufficient MOV would be operational to monitor the OVI’s. This assumption was not entered in the Log Frame matrix and its absence could become a major constraint, if not a killer assumption, for the specific use and added value of the log frame approach of NLR.........3

Recommendation 1 To NLR: to plan a next website workshop as part of a technical assistance visit in the near future..................................................................................................................3Recommendation 2 Workshop5 to explore and exercise opportunities to connect with a few test districts.................................................................................................................................3Recommendation 3 Workshop 5 to explore and exercise on local production of short (2-5 minute) clinical instruction films for training through the website...............................................3Recommendation 4 The LPA and NLR Representative to further assess internet connectivity and computer literacy during routine field work..........................................................................3Recommendation 5 BO to upload to the district pages of the website, the leprosy figures from Kharagpur State Medical Unit (3 short reports shown during the visit).......................................3Recommendation 6 NLR to analyze and conclude on operational aspects of leprosy HMIS in relation to NLR support to leprosy control in India, with special emphasis on the strategic planning documents produced so far...........................................................................................3

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Executive SummaryObjectivesGoal of this fourth website workshop in Delhi (October 2009) was to improve knowledge management as an essential tool for NLR support in India. To contribute to this goal a few objectives were formulated:

As a team to elaborate and improve the communication processes of NLR activities by exploring website opportunities and by adding leprosy support related content to the website.

To introduce and train new and improve existing website skills of NLR staff at BO and State level.

The workshop was of course based on the experiences of previous exercises. These are summarized in the report of the third workshop. One of the results of the team efforts is the existence of following hotlink to this report. ….report… It is stored on www.nlrindia.org .

Website WorkshopIn Part One of this report a rather extensive description is given on participants, methodology and the program of the workshop. The idea behind this is that later on experiences may be condensed in a manual for refreshing courses possibly in other locations. This justifies good documentation and room occupying screenshots.The follow up and results of previous workshops are briefly discussed. Finally a follow up program is of workshop 4, made by participants, is described.

Visit West Bengal and LogframePart Two of the report describes observations made during a technical assistance visit to West Bengal. The differences in the quality of leprosy control in East en West Medinapur are briefly discussed and observations on rapid increase in connectivity to internet are made. Finally the discussions in the State Leprosy Officers office are summarized. Main topic was the strategic planning 1010-102 and the logframe made during a workshop in august 2009. The main issue was in how far the indicators used in the logframe are in fact verifiable with the sources of information available. It was concluded that operational aspects of indicators constitute a major problem.

Main conclusions and recommendationsWebsite Workshop

Conclusion 1 The Website Workshop4 was successful in relation to the objectives. The results can, however, not be considered sustainable yet. For sustainability, the Branch Office staff should achieve more capacity as web and content master. In other words, the website is not yet well established and embedded in the overall activities.

Conclusion 2 At Branch Office staff is convinced about the usefulness of the website as tool to improve the quality and sustainability of NLR contributions to leprosy control.

Recommendation 1 To NLR: to plan a next website workshop as part of a technical assistance visit in the near future.

Recommendation 2 Workshop5 to explore and exercise opportunities to connect with a few test districts.

LogFrame Conclusion 7 Although the discussion (in the office of the SLO) on OVI and MOV could

not be finalized due to time limitations, it became sufficiently clear, however, that a vital link in the control process was not included in the LogFrame: the operational aspects of the health management information (HMIS) was for the larger part overlooked and not addressed.

Recommendation 6 NLR to analyze and conclude on operational aspects of leprosy HMIS in relation to NLR support to leprosy control in India, with special emphasis on the strategic planning documents produced so far.

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http://www.nlrindia.org/

http://www.nlrindia.org/starnet/media/KIT/AnrikE/AE090630ReportWS3WebsiteFINAL.doc


Part One Website Workshop4

Introduction

Background Why a websiteSustainability and cost effectiveness of leprosy control activities is influenced by a variety of factors. One of them is the health management information system that is needed to maintain the quality of knowledge, information, data their dissemination and other related work processes. In the HMIS one can distinguish institutional and individual aspects. Improving and maintenance of sustainability is a continuing process that is complicated by factors like a high staff attrition rate, decreasing interest in leprosy control, decreasing leprosy incidence and more.

To address the HMIS a few assumptions were made before embarking on the development of a website as tool for support to leprosy control.

-Corporate memory is an important parameter in the HMIS and influenced by several factors (including, but not necessarily complete)

Attrition rate of staff Competition for attention with other programs (TB, HIV/AIDS, polio) Training and supervision of staff as a complicated and not so straightforward process Accessibility of stored data and information Policy on building and maintenance of data systems: decentralized versus centralized

approach Involvement of beneficiaries and other stakeholders of leprosy control

-A well functioning corporate memory is of vital importance for (support of) leprosy control in times of increasing demand

for quick and consistent information transparency, accountability, cost effectiveness, result oriented planning, evidence based / research policies fundraising

How it started in NainitalIn the Branch Office of NLR in India logistical and personal preconditions were apparently in favour of a website pilot project that was conceived “spontaneously” in July 2007. As an informal and a bit provocative demonstration to prove its feasibility, an 80 Euro a year website was built, including the URL registration, host selection, installation of an open source content management system. The website was operational within 24 hours of the first hiccup to try it and was never down since then. This was all arranged through a connection from a hotel room in Nainital, North of India by the NLR representative and the KIT/NLR consultant.The first two more formal workshops (July and December 2008) were used for sensitization, to learn basic skills and to identify the outlines of the website. A third website workshop, carried out in May/June 2009, involved more peripheral NLR staff and was more content oriented.

Terms of reference To carry out a fourth workshop for further the development of a website for NLR India. To visit West Bengal with the country representative for field observations and

discussions on the state of affairs of the leprosy program and the Strategic Plan for NLEP of West Bengal for 2010-2012.

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AcknowledgementsAll accommodation, logistic, invitations and so on were organized perfectly by Branch Office staff, as usual I dare to say. The workshop took place in a brand new office with all its teething problems. This justifies an extra thank you! Welcome to all new BO staff including Ms Preeti Advani and Ms Shoryama Shrivastava.

Participants

DesignationA total of 11 participants were recruited from the Branch Office and NLR staff from the states. Considering the objectives this was a logic approach. Only one state could unfortunately not be represented. Most of the staff participated in the previous workshop as well. The professional backgrounds included doctors, non medical supervisors, administrative and financial staff. A list of participants is given in Annex 2.

Computer literacyThe variation in computer literacy was considerable. This did not constitute a problem for the workshop or for the functioning of the website as in daily practise under field circumstances different types of user can be distinguished, with each of them specific permissions and restrictions for managing the website and its content. It is the responsibility of the webmaster/ main facilitator to find a good balance and configure the system accordingly.

FacilitatorsThe main facilitator was Anrik Engelhard (KIT/NLR) with office staff members Ms Pooja Grover and Mr Vishal Singh practically acting as co-facilitator.Mr Peter Fokker and Mr Dirk Schouten acted as permanent IT stand by in the Netherlands.

Goal and Objectives

General goalTo improve knowledge management as an essential tool for NLR support in India.

Objectives of workshop4 As a team to elaborate and improve the communication processes of NLR activities by

exploring website opportunities and by adding leprosy support related content to the website.

To introduce and train new and improve existing website skills of NLR staff at BO and State level.

Methodology

FlexibleThe workshop was conducted in a semi structured, participative way with a group of 11 persons; work was carried out plenary wise, individually or in groups.

Everything at handMost activities were carried out in the conference room of the BO that was equipped with broadband wifi. All participants except one had their own laptop. The beamer was an indispensable tool for demonstration, exercising, planning and reporting. A flipover board was used for additional communication. A few books were on the table including Site at School Manual and Photoshop elements for Dummies. The catering from a local restaurant was excellent.

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SoftwareThe software used for this workshop was similar to the previous ones:

• Site at School (open source) as website content management system• Photoshop elements 7.0 (Adobe) as primary software for editing and organizing

pictures • IrfanView (open source) as secondary software for picture

A sandbox to play withSimilarly to previous workshops a test website was used for riskless experiments and general training of skills. The website is made permanently available by Site at School on http://siteatschool.org/index.php?section=9&page=4

PracticalEach day started at 09:30 with a recapitulation of the previous day program and introduction of the day program. After a plenary question and answer session (of sometimes more than 1 hour duration and energetic) the day program was addressed (introduction & practical work) The day concluded at 18:00 (except on Saturday, 16:00 hours) with a draft program for the following day.

HomeworkAs preparation participants were requested before the workshop to carry out a few assignments and bring some files (for instance Annual Reports and other key documents as content to upload (see Annex 4).

Evaluation & prospectsThe workshop did not close with a formal written evaluation but instead a closing-discussion was held on the achievements, issues to be solved, follow up and an orientation on for further steps in website development.

Previous workshops and reportsA summary of the previous workshop is given in Annex 3 and only the main conclusions and recommendations are quoted here. A full report of the third workshop is available through the website. ...full report…

Main conclusions and recommendations workshop 3 The choice to focus on epidemiology content was purposely made and further fields of

attention for more content were formulated (operational, financial, fundraising aspects).

The principle of “do once and use often” for content on a website is well understood by participants and translated into opportunities for more participation by LPAs and stakeholders.

During team discussions more opportunities for the site as a project tool were identified that would be worked out during the follow up or future workshops (specific recording/reporting routines; warehouse for project and leprosy information, photographs, clinical demonstrations; updating of existing information through e-questionnaires and more).

Evaluation of the new template with NLR HQ on branding qualities and further harmonization.

Planning of a workshop4 that will address operational aspects of support and possibly involvement of more stakeholders like ILEP partners, health facilities in the chain of referral of leprosy patients and institutions involved in rehabilitation.

Day by Day Program Workshop 4The main topics of the day by day program is given hereunder and in Annex 4 more details are presented.

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http://siteatschool.org/index.php?section=9&page=4



Day 1 - 091006• Welcome; introduction• Refresher of Site@School as content management system and • Refresher of website www.nlrindia.org• Group work on communication & content (see homework)• Draft outline for week program for LPA and BO based on suggested topics • Program for Day 2

Day 2 - 091007• Recap Day 1• “Contest” writing for Screen (all)• Exchange of NLR Content between BO and States (all)• Content of Library (all)• Format & Content of your intranet page (State NLR)• Discuss/ assess new NLR Stake Holders (NLRSH) for all NLR staff to be involved in the

website (all)• Discuss/ assess new Leprosy Program Stake Holders (LPSH) for some Districts/Facilities

to be involved in the website (all)• Preparing files for uploading (all)• Uploading files to file manager (by BO)• Uploading files with Upload to state upload page (State NLR)

Day 3 - 091008• Focus today on putting flesh (content) to the bones (site)!• Recap day 2• Uploading your key docs to State Upload Page• Library content: prepare & upload to file manager • Library structure: make basics including links to high priority documents• Catalogue of pictures: make plan, start tagging• Pictures for website: repair home page

The program was further customized for the BO group and the one from the states.

Day 4 - 091009• Recap day 3• Focus today on again putting more flesh to the bones!• Library content: prepare & upload to file manager • Library structure: make basics including links to high priority documents• Calendars install for all states• Catalog of pictures: finalize plan & tagging• Pictures for website: repair home page

Day 5 - 091010• Recap day 4• Uploading pictures for homepage news items• Resizing/cropping with Photo Shop Elements (PSE)• IrfanView, software for picture processing• Upload Self Care Group (SCG) content (report 2008-sept 2009 and other SC files)• Recap/review on File Manager and HTD• Uploading NLR India Ann Reps (done): BO website• KISS list; eml address for NLR staff; intro page fundraising as new content• Adding content to your personal page (MyPages) by all• Recap & Closure

Day 6 - 091012 (morning only)• Summary of the workshop and final plenary discussions with Dr Arif who just

returned from an assignment abroad.

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ResultsThe results were achieved by the team as a whole and by individual participants. The results can best be seen by visiting the website. Individual results would be reflected by use and contributions made to the website and-more difficult to measure- by quality improvement of NLR support.

Results on the Public Area (“the website”)HomepageThe Homepage of the public area was addressed on the quality of the pictures, text and opportunities for fundraising and payments.

Improved skills on systematic cataloging of pictures Cropping and resizing skills of BO staff improved A payment module can anytime be connected to the homepage when it is available in

India BO can add fundraising content to the right column of the homepage More ownership by BO staff on home page

Section Activities During the workshop a calendar module was installed and a start was made with data

entry on past activities Updating content was carried out as exercise

New Section Fundraising The section was designed and made by the recently appointed staff member for

fundraising At the end of the exercise she felt more empowered to carry out her fundraising

activities and add more content A draft plan for content was made including calendars for activities

Section Partners The need for updating content was identified and as exercise a modifications were

made Opportunities to offer pages to partners and other stakeholders were elaborated.

Related content can be found in the intranet section Local Pages (see screenshot below)

Section Library The new library section was made during the workshop; it will be the public resource

centre of the site. The basic structure was finalized by participants. Titles of documents with a very brief summary will be the content. Hotlinks will give access to (downloadable) documents that are stored in the File Manager of the site. Creating the hotlinks assigned as a post-workshop activity for the BO-staff.

Results on the Protected Area (“the intranet”)The systematic and amount of content on the intranet improved much. Though participants created their own pages and uploaded content from their laptops routine is, generally speaking, still lacking. The sections cover, for now, the following fields. One screenshot is given here and all others opening pages of the sections are given in Annex 11.

Please note that the look & feel (graphics) of the intranet is purposely different from the public area to prevent mistakes in handling confidential matter. However, some beautifying of the protected area will be planned.

Improved Sections Branch Office: more structure and content created Helpdesk for website skills for NLR staff: modest improvement only; no substantial

contributions from participants yet.

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State Activities (state pages; upload module; archive;): intensively used for exercising and experiments (“personal real live playground”).

Archive: a new section for practical, but more confidential documents, similar to the Library on the public area. The structure was created; the content and links are future steps.

Local Pages, a new section explaining and exploring the opportunities to involve other participants of leprosy control in the website. Local pages are for stakeholder and will be published through the public area. This is a main challenge for the near future. LPAs must be sufficiently skilled first however.

A new section for fundraising in India got its fundaments. NLR headquarters in the Netherlands: for content to be uploaded by and related to

NLR in the Netherlands and other supported programs else in the world.

Screenshot of intranet home page

Results of the follow up of the previous workshop3Five recommendations were formulated after Workshop 3. The result is written in bold italics

Evaluation of the new template with NLR HQ on branding qualities and further harmonization. The new template was received well by the content master of the website of NLR Netherlands.

Follow up of the Workshop3 through internet communication. The follow up was hampered by other activities from BO and KIT staff. A few essential gaps in skills became evident as well. All in all, follow up did not come to a standstill; it just should become more productive in future.

Planning of a workshop4 that will address operational aspects of support and possibly involvement of more stakeholders like ILEP partners, health facilities in the chain of referral of leprosy patients and institutions involved in rehabilitation. This recommendation has not been addressed yet.

The branch office to decide whether routine information (reports, pictures, maps) is suitable as content for the site. This content related task has been partially addressed before and partially during workshop4. .

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The BO to familiarize with the software that was introduced as a tool for content production: Health Mapper GIS and Photoshop Elements for management of illustrations should be exercised. Familiarization with both programs has not been done due to other priorities; For pictures, IrfanView was used, but the results were not yet up to standard due to width x height aspect ratio deformities of the pictures.

Overall judgment of resultsImportant achievements on technical and content related affairs are clearly visible in all participants. The routine demonstrated is, however, still modest. Familiarization with rather abstract issues would justify ongoing attention like

uploading, hotlinks, the IT principle of do it once-use often, the KISS principle (Keep it Short & Simple), the discipline on format systematics on file names, new conditions of writing style for screens and the confidence that you can do it (yourself) RTFM Read the Fine Manual!

All participants were enthusiast and actively participating in all exercises and feel ready for the next steps.

ConclusionsConclusion 1 The Website Workshop4 was successful in relation to the objectives. The results can, however, not be considered sustainable yet. For sustainability, the Branch Office staff should achieve more capacity as web and content master. In other words, the website is not yet well established and embedded in the overall activities.

Conclusion 2 At branch office staff is convinced about the usefulness of the website as tool to improve the quality and sustainability of NLR contributions to leprosy control.

Conclusion 3 Workshop 4 has not yet disclosed and explored all opportunities of Site at School.

RecommendationsMain opportunities that are open for piloting are here translated in recommendations. These recommendations are based on the above conclusions and field observations during the past years by NLR and NLR/KIT staff. The most recent observations were done in West Bengal. A review of this visit is given in Part Two of this report.

Recommendation 1 To NLR: to plan a next website workshop as part of a technical assistance visit in the near future.

Recommendation 2 Workshop5 to explore and exercise opportunities to connect with a few test districts.

Recommendation 3 Workshop 5 to explore and exercise on local production of short (2-5 minute) clinical instruction films for training through the website.

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After the workshopFollow up of Workshop4Follow up will be carried out through internet, including Skype, for site management. Branch Office, State LPAs and NLR/KIT could all take part by adding further content to the site and carry out other modifications. After reporting on the Website Workshop4 to NLR further concrete steps will probably be discussed.

The top 4 of the list of post workshop priorities is presented here and much more is listed in the Annexes 5 and 6 The follow up list was for the greater part formulated by participants and facilitator during final sessions of the workshop.

Low hanging fruits…• Upload all relevant files by/from states (LPAs)• Replace distorted pictures from site (BO) • Upload relevant files to File Manager (BO) • Enter links in Library and Archive (BO) • For more, see the Annexes 5-9

Part Two Visit West BengalSummaryMain ObservationsThe visiting team made an orientation tour in East and West Medinapur. West Medinapur has high leprosy figures and a well developed control program (ANCD >1600 and NCDR nearly 3/10,000 pop). East Medinapur in contrast had no functioning district nucleus and low leprosy figures (ANCD <200/yr and NCDR 0,3/10,000 pop). No in depth analysis was made but factors like the division into two districts of Medinapur and differences in leadership may have contributed.

From the perspective of the development of a website for NLR a quick assessment was carried out on local access to internet and computer literacy. At block level few examples of good connectivity to internet was found. Opportunities were discussed.

With the SLO and some stakeholders of the strategic workshop 2010-2012 (held in august 2009) a group discussion was held with the aim to assess the feasibility under field circumstances to apply the indicators and sources of verification of the logframe.

Main ConclusionsIT infrastructure, also at district or block level is developing fast; absence of local IT infrastructure should not be an argument not to invest on a website for NLR India.

During the strategic planning workshop, the operational aspects of the health management information (HMIS) were for a large part overlooked. Hence, a vital link in the control process was insufficiently included in the logframe.

BackgroundWest Bengal (WB) stretches from Himalayas in the north to the Bay of Bengal in the south, covering an area of more than 88,000 square kilometres. It shares border with Sikkim and Bhutan in the north, on the east with Assam and Bangladesh. On the south, it is bounded by the Bay of Bengal and on the west by Orissa, Bihar, Jharkand and Nepal. Northern part of West Bengal comprising the districts Darjeeling & Jalpaiguri falls in the Himalayan range, and rest of the area is plain. West Bengal has 19 districts, of which district Burdwan is the largest one. Burdwan is home to nearly 8 million people and it is spread over an area of about 7,000 sq km. NLR in W-Bengal has its office located at Burdwan.

NLR in West Bengal

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Netherlands Leprosy Relief – India started its support to NLEP in West Bengal, in the year 2001 by placing District Technical Support Teams (DTSTs) to strengthen the General Health Care (GHC) system so that they could provide leprosy services under an integrated set up. These DTSTs were withdrawn in March 2007, when MOU between GOI & ILEP agencies in India concluded. After integration to retain a supervisory structure at the district level, District Nucleus (DN) has been formed in every district of the country. This DN consists of one DLO, one MO, one NMS/PMW and one Health Educator/Physiotherapists in high endemic areas depending on the availability. NLR has placed one senior “Leprosy Programme Advisor (LPA)”, who is a medical doctor with training in leprosy and long experience of working in public health activities. This LPA is visiting all three NLR supported districts and transferring his skills, and providing guidance to DN; so that, DN is able to improve quality of leprosy services through supervisory activities and these are provided through GHC staff.

Logframe Workshop ILEP has been supporting NLEP of West Bengal since past many years. ILEP support as per Memorandum of Understanding (MoU) with Government of India (GOI) concluded on 31st March 2007. With signing of the new MOU, it was realized that there was a need to sit together and plan jointly as to how ILEP agencies & State Govt. of W.B. can best address the leprosy problem of the State. This was done by organizing a Strategic Planning Workshop based on Logical Framework Approach, at Kalimpong, West Bengal from 24th to 27th August 2008. This workshop was participatory in nature involving all stakeholders’ including state, district programme managers, NLR representatives, representatives of GLRA (an ILEP agency), representatives of local NGOs, non medical supervisors, Anganwadi workers, health assistants, patients, community leaders, private practitioner, and representative of medical college.

Purpose of VisitEast and West Medinapur District were visited during a two day tour with the purpose to get an impression on conditions in two districts with very different leprosy figures, performances and circumstances. In addition observations related to the possible application of the NLR website were envisaged. A third purpose was to discuss at the office of the State Leprosy Officer, the draft strategic plan for leprosy control 2010-2012 with a special focus on the indicators formulated and the feasibility of their practical application.

Findings field visitLeprosy Indicators for Strategic Planning After the division in 2002 into two districts a larger part of the government infrastructure and experienced staff remained available for West Medinapur while the Eastern part started with a considerable backlog. Differences in quality of leprosy control would, at least partially, indirectly be the result of this unequal division (personal communication dr Arif).

Table 1 Leprosy situation in Districts as on 31.03.2007 (source www.health.gov.in)

Name of the Districts

No. of new

cases (2006-

07) ANCDR/ 10000

Total Grade-II

deformed cases

(2006-07) Percentage

Grade -II

Registered cases

recorded 31.03.2007

PR/ 10000

Midnapore-East 174 0.34 4 2.3 132 0.26Midnapore-West 1623 2.94 37 2.28 1034 1.87

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The high caseloads and the differences between East and Wes Medinapur are striking.Figures including all other districts of W-Bengal are given in Annex 14.

East MedinapurA short visit was paid to the CMO and acting DLO in Tamluk, Dr Rabi Kinkarnayak. No district nucleus team was available and therefore no local leprosy audience to be addressed. Accompanied by a medical officer of the district Dr Subrata Sarkar one of the 25 blocks in the district a block primary health centre (BPHC) was visited in Kolaghat. A vivid discussion in Hindi developed between health staff, a local politician, Dr Arif, and Dr Ashok Kumar, Leprosy program Advisor for NLR in W Bengal.Meanwhile all kinds of statistics regarding health systems in the district were produced by the MO of the district on his laptop that was connected to internet through a mobile modem. The website was demonstrated and tested on the office computer, connected as well, at block level.

West MedinapurIn West Medinapur, Kharagpur State Medical Unit, the team met Dr Girish Chandra Bera, Dep Chief Medical Officer. During the previous 8 years Dr Girish Chandra was DLO and under his guidance the district leprosy control system became highly developed. This became obvious after quick reading three valuable and informative reports/presentations covering the past few years on an Annual Review Meeting; POID Initiatives and a NLEP statistics report. Unfortunately the reports could not be collected and due to time constraints no copy could be made. The file however would be forwarded soon to the BO for uploading to the website pages of this district. The number of newly detected cases was in 2007 1623 with a NCD rate of 2,9 per 10,000 pop. was high indeed.

Amba PHC was visited. No patients were seen but the registers and records were studied and discussed. The quality of entries was reasonable, though some extra guidelines on data entry we needed. Observations like this are quite usual in small facilities and underscore the importance of easy available and high quality guidelines on routine jobs. Maintenance and distribution of this kind of information is one of the practical features and applications of a website.

In Hyli Rural Hospital Kharagpur-1 Block a demonstration was given on the use of internet (dial in connection since 2008, but broadband applied for) and data entry at sub centre level. Extensive spreadsheets were developed at district level and introduced in all blocks. Patient data, even with personal information was also entered in the database. Some NLEP forms were downloaded and printed locally on demand.Qualified data entry staff was deployed by the facility. A short introduction of the website of NLR India was given and opportunities for future use of IT were discussed.

The IT available in the district clearly showed how fast IT infrastructure and local initiatives sometimes develop. With the data made accessible epidemiological analysis is more feasible.The LPA and BO would elaborate on this.

Conclusions and Recommendations District VisitConclusion 4 Large differences in program quality were noticed between East and West Medinapur, reportedly related to differences in program leadership and division of Medinapur in an eastern and western part.

Conclusion 5 Rapid development of IT infrastructure and hence opportunities for use of website (two way sharing of information through up and download; standard instructions; local printing of forms etc.)

Conclusion 6 IT infrastructure, also at district or block level is developing fast; absence of infrastructure should not be an argument not to work hard on a website for NLR India

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Recommendation 4 The LPA and NLR Representative to further assess internet connectivity and computer literacy during routine field work

Recommendation 5 BO to upload to the district pages of the website, the leprosy figures from Kharagpur State Medical Unit (3 short reports shown during the visit)

Findings Office of the State Leprosy Officer, KolkataA few hours were spent in the SLO office of Dr KL Sinha, Joint Director of Health Services(Leprosy) & State Leprosy Officer, together with the National Technical Coordinator GLRA, Dr P Mitra; Mr Kartik Chandra Daschowduri, Former Budget officer.

After debriefing on the visit to the districts, the strategic plan and more specifically the indicators and their sources of verification were studied. The challenge on the table was to see whether information about the objectively verifiable indicators (OVI) was actually available and practically retrievable in the means of verification (MOV) mentioned in the log frame.

To apply the supposedly available information during monitoring and evaluation, is in fact a crucial operational finishing touch of the log frame. If not carried out as part of common periodical leprosy control management, the log frame is not fully utilized.

Findings on OVI and MOV

Most time was spent on the result areas 1 Case Management, 2 Services for Disabled Patients and 5 Supervision.Virtually all means of verification rely on routine recording and reporting, and this is a well known weakness of the program (SWOT analysis LFA workshop and daily experience).In addition, the supervision checklists were not yet available although the supervision reports are mentioned as crucial MOV

The workload and required skills to comply with all new forms seems high. The challenge to create such a MOV is huge (maybe even justifying a result area on its own if DPMR goals are maintained). Improvement of recordkeeping & reporting system is, however, only mentioned as indicator for result area 4 on Urban leprosy services effectively functioning with MOV the monthly progress report (MPR).

The targets formulated for recording and reporting were in view of the great challenges involved, only set for 2011. This was apparently purposely done to create room for upgrading. Hence, in the mean time availability of the MOV will be limited.

Weaknesses in recording and reporting that would be addressed include recordings on Disability Prevention and Medical Rehabilitation (DPMR). Guidelines were produced by NLEP in the recent past and include numerous and extensive forms that are meant as MOV in this strategic plan. From the data supply point of view this is a positive development although it is much in contrast to the previous patient record card (simplified information system, SIS) that showed an absolute minimum on data fields (to increase operational feasibility). The extra skills and time involved may constitute constraints for systematic use by often overloaded peripheral staff.

Diagnosis Verification and the Case Validation ReportIt was noticed and discussed that one of the OVI indicators of improved case management was “Wrong diagnosis below 5% by 2012”, with the Case Validation Report as MOV.

The issue discussed, was why this indicator would be lowered. The diagnostic process at the periphery was considered a screening procedure to select leprosy suspects. Before start of treatment confirmation (by DN or higher staff) would be required.If this is true than the screening should remain sensitive enough to select all suspects and therefore the percentage of “wrong” diagnosis should not be lowered to much. Similar screening is done for TB. A percentage of 10 % negative sputum smears is often used as target, not lower.

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Before elaborating on this OVI and MOV and possibly adapting the log frame, it should be verified whether this validation of diagnosis is made before or after the beginning of the MDT or in other words, whether we talk about screening suspects or validating patients already on treatment for a while, or after completion of treatment. During the discussions we focused on the screening of suspects.

Conclusions and Recommendations Strategic PlanningConclusion 7 Although the discussion on OVI and MOV could not be finalized due to time limitations, it became sufficiently clear, however, that a vital link in the control process was not included in the Logframe: the operational aspects of the health management information (HMIS) was for the larger part overlooked and not addressed.

Conclusion 8 Apparently the assumption was made during the strategic planning workshop, that sufficient MOV would be operational to monitor the OVI’s. This assumption was not entered in the Log Frame matrix and its absence could become a major constraint - if not a killer assumption - for the specific application on monitoring and evaluation and added value of the log frame approach by NLR.

Recommendation 6 NLR to analyze and conclude on operational aspects of leprosy HMIS in relation to NLR support to leprosy control in India, with special emphasis on the strategic planning documents produced so far.

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Annex 1 Itinerary05/10/09 Arrival in Delhi from Bangkok (LF workshop)6-10/10Website Workshop4 11/10 Website content & structure; Report writing 12/10 Team discussions at BO; Travel Delhi-Kolkata13/10 Visit to East Medinapur ; Tamluk District; 13/10 Visit to West Medinapur District: Block PHC Kolaghat; Purba14/10 Visit to West Medinapur and return to Kolkata15/10 Debriefing and Log Frame meeting at office of SLOs office; Courtesy call to the

State director of Health Services; return to Delhi; Departure to Amsterdam16/10 Arrival in Amsterdam

Annex 2 Participants and other ContactsParticipants Website Workshop

Branch OfficeDr Satish Chandra Pandey Coordinator Projects NLR in IndiaDr Jang Bahadur Singh NLR Technical Adviser Delhi, Zone 2Ms Pooja Grover Office ExecutiveMr Vishal Singh Accounts OfficerDr Virendra Gautam Technical staff BO (only day 1)Ms Preeti Advani Fundraising OfficerMs Shoryamaa Shrivastava Admin Staff member

NLR staff in statesMr NK Chakraborty NMS Uttar PradeshDr SN Mishra LPA UttarakhandRK Prajapati Computer technician JharkhandDr VS Pal LPA Uttarakhand

Other staff members of Branch Office, BO (not participating in Workshop)

Dr M A Arif NLR Representative IndiaMr Ghanshyam Dikshit NLR Coordinator Self Care GroupsMr Ashok Kumar Manager Accounts & AdministrationMr Rustam Mansoor DriverMr. Ali Ahmed DriverMr Ramesh DriverMr Joginder Prasad Peon

West BengalDr Ashok Som LPA Burdwan Zone, NLR

East Medinapur (Midnapur)Dr Rabi Kinkarnayak CMO and acting DLO; Purba Medinapur DistrictDr Subrata Sarkar MO DN Purba District; [email protected]

West Medinapur (Midnapur)Block PHC Kolaghat

Mr Sandip Maiti Block accounts managerMs Sadhana Chattopadhyay PHNMs Suravi Das GNM for Anwesha ClinicMs Dipali Samanta Block data Entry OperatorMr Prasant Manna Block data Entry OperatorDr Subrata Samanta MOMr Dipak Das Pharmacist

Kharagpur State Medical unit

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Dr Suravi Mandi Senior Medical officerDr Girish Chandra Bera Dep Chief Medical OfficerDr Biswanath Halder Amba PHC under Hisli RHMrs Sibani DE pharmacist Amba RHCMrs Kalpan gosh ANMMr M Ali GDA Dr Madhumita Das MO Hyeli Rural HospitalMitali Das PHN Hyeli Rural HospitalDr Pampa Ray BMOH Hyeli Rural HospitalMs Shrabanti SamanataDEO Hyeli Rural HospitalMs Sumita Das DEO Hyeli Rural HospitalMs Sabita Bera BPHN Hyeli Rural Hospital

West Bengal StateDr KL Sinha Joint Director of Health Services (Leprosy) & State Leprosy

OfficerDr P Mitra National Technical Coordinator GLRAMr Kartik Chandra Daschowduri Former Budget officerDr Anniruddha Kar Director of Health Services West Bengal

Annex 3 Summary Workshop 3 ReportNetherlands Leprosy Relief (NLR) provides support to National Leprosy Eradication Programme (NLEP) of India for strengthening the sustainable Leprosy services. A third website workshop carried out in May/June 2009 in the Branch Office of NLR India. The aim of a project website was formulated as to improve knowledge management as an essential tool for NLR support in India. The previous two workshops (July and December 2008) were used for sensitization, to learn basic skills and to identify the outlines of the site.

During the workshops more future gains of a website were discovered by the participants:A website of this kind could be a stimulating example for other stakeholders to interact and to participate. It was a challenge to realize that stakeholders could vary from (inter) national institutions, other leprosy projects or initiatives, to health institutions (facilities in the referral chain); people affected by leprosy and the general public.

The workshop had a few objectives, namely To add content to the (public) website with main focus on district profiles. To add content to the (protected) intranet Harmonization of brands between the website of NLR and NLR India To address technical and content matters that come up Technical training of BO staff on content management To exchange information on curriculum development for health workers on leprosy

between MoH and NLR India

The results are listed up hereafter and explained in the main text. However, they can of course better be seen and experienced than described! …see more…

Improved teamwork in processing of data, information, content Improved systematic on writing content and handling of files in general Improved use of already available data/information Identification of data/info gaps New template for NLR branding purposes

The main conclusions and recommendations are as follows The choice to focus on epidemiology content was purposely made and further fields of

attention for more content were formulated (operational, financial, fundraising aspects).

The principle of “do once and use often” for content on a website is well understood and translated into opportunities for more participation by LPAs and stakeholders.

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http://www.nlrindia.org/index.php?section=12&category=10%20Branch%20Office&page=142


During team discussions many further opportunities were recognized and could be worked out during the follow up or future workshops.

Evaluation of the new template with NLR HQ on branding qualities and further harmonization.

Planning of a workshop4 that will address operational aspects of support and possibly involvement of more stakeholders like ILEP partners, health facilities in the chain of referral of leprosy patients and institutions involved in rehabilitation.

Annex 4 Program of the workshop-specified and explained

Exercises and home work for participants as preparation for the workshop:

1. Proposals by all LPAs for the submission of content (relevant; feasible) to BO and access for LPAs to content produced by BO

2. Proposals by BO for content to be received from State level3. Ideas about content related to Districts and the LPAs4. Ideas about content related to NLR NL including archive, reporting and fundraising5. What files will LPAs send to BO?6. What files (content) do LPAs want from BO?7. What content does BO want from LPAs?8. What content is needed from NLR NL for the website in India?

Exercises Day 1LPAs put content on their state pages

• Make your own (state/LPA) pages for intranet• Prepare your files for uploading• Upload your files to file manager• Design a format of your state homepage (a kind of table of contents with an

introduction and links)• Install calendar for your fieldwork

Challenges for Branch Office• Co-facilitating the workshop• Library-selection & uploading reports etc• Processing of pictures: fresh up • Home>home page; Right column; Title Bar• Newsletters & other PR communication• Calendar on NLR support (incl. past & future)• Forms Builder, Album, Links: implement basics• Own pages for NLR-stakeholders (NLRSH) & NLEP-stakeholders (LPSH)-exploration• Build Helpdesk (HTD’s, How To Do s)

Exercises Day 2How to handle the File Manager for the states

• Where to store content??Let’s have a look• Folder tree• State level = 1 folder per state

– Subfolders grouped by year(s)• District level= 1 folder per district

– All district profiles• SCG

Make your own Personal page on intranet (MyPage)

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• Exercise access to intranet• Make page on section of your state• Decide on content: see next slide• Put content on your page

Create content for your personal page• Who, what, where, when, how• Who are you?• What do you do: general terms and then main activities this year.• Where do you live and work• Since when• With whom, in which team do you work

Exercises Day 3For State StaffUpload content to State Upload Page

• Select relevant files• Prepare for uploading: final version? file name? Some info in properties?• Upload as much as possible• Make list of missing documents for search when back in office and send list by eml to

yourself and BO as reminderMore exercises

• Explore manual on page manager• More on MyPage incl your website ideas• Update MyPage (exercise) by• Adding a few logbook notes about what we did on day 1 and 2 (Your most important

things, and, keep it KISS!)

For BO Staff• Is File Manager (FM) prepared for upload? (Check with BO the list of requests for

content from States!)• Upload key docs from BO to FM; link with Library (later)• Upload Pictures (after processing like proper identification, cropping, resizing)• Fundraising add content (if only intro!)

Exercises Day 4For BO Staff

• Catalog of pictures: finalize plan & tagging• Pictures for website: repair home page• “KISS list” with common abbreviations for folder & filenames• Guidelines on uploading docs by State by Vishal & Pandey “How To Do” (HTD)• List of NLR Staff upload to FM; link to intranet BO>General; by Vishal

For all• Content on SCG (Dr Pandey and Mr Dikshit)• IEC materials for library (BO)• Who is connected to internet? (all)• Follow up workshop? (BO and States)

• List missing key documents for upload• Share website with other NLR staff (all)

• Library structure: make basics incl links to high priority documents (that are stored in File Manager (BO)

Exercises Day 5• Uploading pictures for homepage news items• Get routine in resizing/cropping with Photo Shop Elements• Explore IrfanView, software for picture processing• Upload SCG content (report 2008-sept 2009 and other SC files)

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• Recap/review on File Manager and How To Do lists (HTD)• Uploading NLR India Annual Reports; BO website• KISS list; e-maill address for NLR staff; intro page fundraising as new content• Adding content to MyPages by all

Annex 5 Still to do list: Branch Office• Introduction specially made for virgin newcomers (“dummies”) on intranet/websites for

first aid in the “ labyrinth-jungle”• Repair all deformed pictures on the site• See if promised reports arrive by e-maill from W-Bengal/Medinapur

Annex 6 Still to do list: All• Large presentations (power point+pictures) better upload in .pdf format• Add and update content; repair dead links (All)• Upload all relevant files by/from states including

• NLR Annual report• ILEP Annual report• Workshop Reports• Compilations+ conclusions of Monthly Progress Reports• Success stories• Pictures (submit per CD or email); resizing by BO before upload• Newspapers on leprosy (media); hard or soft copy (scan)

Maintenance of content• Ongoing updating of District Profiles by using info from MPR; scanning/using maps;• Asking ILEP partners for content on districts supported by them• Requesting feedback on District content by DN and LPAs (eventually pages would be

updated at state/district level)• Periodic sanitation of State down load pages including decions on relevance by content

master

Annex 7 Still to do list: States• Adding content to MyPages : what you like to share with collegues• For uploading files-use this checklist

• Name of file• Footer; properties• KISS? Headers etc• Upload to File Manager (for advise Pooja or Vishal)• Make links to some pages that make sense• Corporate header? • NLR India www.nlrindia.org (Small, underscored)

Annex 8 Still to do list: NLR Rep and KIT/NLRBy BO and AE

• Preferably use .pdf format for files on the site meant for downloading; find free software (BO&AE)

• Explore/advise on e-mail addresses ***@nlrindia.* format (BO&AE)• BO to send info on airtelmail number of available mailboxes etc

By Dr Arif and AE• Explore/advise on short movies/clips on clinical leprosy for teaching and awareness

(MA&AE)

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• Think about Workshop 5: at State level? More focus on Intranet • Proposals for local pages for Leprosy Program Stake Holders (LPSH); this gives insight

in referral facilities for instance and could be published on public website

Annex 9 Still to do list: KIT/NLRBy AE

• Technical evaluation of workshop ups & downs with Peter Fokker (AE)• Presentation for NLR NL on www.nlrindia.org and workshop4 (AE)

Topics for discussions by AE with IT webmaster Peter Fokker• E-mail addresses **@nlrindia.*• Calendar: font size; hotlinks in entries? Html? Pictures?• Statistics of website visits• Home page: Extra text on empty room above 4 news items possible?• Pictures in landscape format possible?• Column-3-at-the-bottom problem• Export facility for forms builder module installed?• Folders with uploaded files (see intranet) are identified in File Manager by codes only;

this hampers safe sanitation• Other (standard) template for intranet (more room for section titles) risky?• Advise on user permissions (low/medium/high) Access rights & installed modules• Navigation for only users (intranet to public area and vv)• Advise on use of server at school • Suggestions on the use of software “snag it”? (this is software for distance demo’s)

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mailto:**@nlrindia.*



Annex 10 Website Screenshots Public Area Sections

Figure 1 Website-Public Area Section Home

The home page template was given the same look and feel as the homepage of NLR Netherlands (www.leprastichting.nl). Four news items with a picture can be renewed at any time by the content master. Links give access to a full story.

The title bar shows a collection of pictures that that is automatically changing in time. Pictures can be uploaded after cropping and resizing. They should preferably be taken by NLR staff for copy right reasons and privacy arrangements; Training of the necessary steps and skills was part of the workshop. Better techniques are not yet applied to all pictures currently published on the site; however, dependency on external expertise is decreasing step by step.

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http://www.leprastichting.nl/


Figure 2 Website-Public Area Section About Us Some background information is presented here. In future content may be prepared by, or in cooperation with, for instance by NLR Netherlands as well.

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Figure 3 Website-Public Area Section ActivitiesThis home page look empty, but this section actually contains most of the current content of the site. Large amounts of district level information on leprosy control is easily accessible here. The content was collected from routine reports and recent, specific surveys. Before publishing it on this website all information was stored in box files and hardly accessible, hence hardly ever used.

Figure 4 Website-Public Area Section Join Us

The section Join Us is dedicated to fundraising activities of NLR in India. This initiative has started in September 2009. The focus person fundraising participated for the first time to a website workshop and feel greatly empowered now to develop her activities.

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Figure 5 Website-Public Area Section Partners

For better teamwork the network of cooperating partners is disclosed through this section. Each others websites can hence become a wide source of inspiration and a practical line for communication. Partners could be invited to contribute up to date content, either through links or by content.

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Figure 6 Website-Public Area Section Library

The library is a powerful instrument to serve visitors looking for information. The library could become an important reason to visit the site of NLR India. The virtual shelves of this library are created in the File Manager. This the beating heart of the website. Much and careful attention has been given to the design of the structure (folders, subfolders). This was a major exercise during workshop3 and could only be accomplished with expertise of the NLR team in India.

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Figure 7 Website-Public Area Section New & EventsThis section will harbour news letters for the public and other stakeholders. An archive of letters is created as well. Giving access to historical developments of NLR India is part of sustainable support and another example of how a website can be a tool to increase and maintain sustainability.

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Annex 11 Website Screenshots Intranet SectionsThis part of the site is primarily focusing on the practical aspects of support to leprosy control.The intranet is only accessible for authorized persons supplied with a login name and password. Currently only NLR staff is given access. The content is related to the implementation of NLR India activities. Tools are installed for collection and dissemination of content by Branch Office and NLR Leprosy Program Advisors (LPA’s). In future also other stakeholders will be offered the opportunity to manage their own pages on the site. These pages will be accessible through the public area of the site.

Figure 8 Intranet Section Branch Office (BO)The template used for the intranet is only temporary and shows room for improvement. Please notice the pages in the left column. A variety of topics is visible. Behind these titles Branch Office builds on content to support field staff during their daily and specific activities. This part is heavily under development. The power of the workshops so far has been the empowerment of administrative staff to produce content independent from expensive external companies. And professionals from BO can concentrate on their specific job description and easily delegate/cooperate with administrative staff.

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Figure 9 Intranet Section HelpThe section Help is meant to empower users to solve their own problems and to encourage and train them how to search and get access to knowledge. In the same way users are invited and given skills to share their own experiences to improve the databank of the FAQ (frequently asked questions). The Help section also strives to convince people that it is not necessary to know everything and always. Finding your way is more important. The site as a whole is aiming to contribute to this principle and thus presents itself again as a tool for sustainability.

Figure 10 Intranet Section ActivitiesActivities carried out by states are accessible here; content is made in cooperation between BO and State LPA’s. The structure of the section is not yet fully developed and only few content is uploaded. Mutual expectations between BO and States on content have been formulated during workshop4. All participants have been exercising uploading. Much follow up is needed still.

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Figure 11 Intranet Section ArchiveThe Archive is the non-public library and meant for NLR users only. For instance training courses, presentations, guidelines, empty forms, etc. will be available for downloading, printing and use by the periphery. It is also meant for reports that can only be published for the public website after further clearance of adaptation. Really confidential matter will not be published here.

Figure 12 Intranet Section Local pagesThe opportunity of Local Pages is still virtually undisclosed. The challenge will be to get other stakeholders on board so that they can give practical information of their activities (for instance for referral, rehabilitation etc). Groups of persons, including for example Leprosy Settlement will be given opportunity to show themselves to the world. The appliance of local pages for fundraising activities may be substantial.

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Figure 13 Intranet Section FundraisingThis section is created during the workshop 4 to serve all NLR related content to NLR India Fundraising. No content has been added yet.

Figure 14 Intranet Section NLR InternationalThe purpose of this section is to give acces to content related to NLR headquarters in Amsterdam and support given by NLR in other countries. Content will be added mainly by NLR Amsterdam. Only Nigeria and Brazil developed initiatives on internet.

Figure 15 Intranet Section UploadThe upload section is made for fieldworkers to place their documents on the site. During uploading a choice from a roll down menu must made where to publish the content on the intranet. Every state has a download page where uploaded content can be published for downloading. If desired, hotlinks can easily be made to related text on the intranet. All

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participants did individual upload exercises. The homepage shows a checklist and instructions for uploading.

Annex 12 Photoshop ElementsNearly drowned in loads of picturesPhotoshop Elements (PSE) (http://www.adobe.com/products/photoshopelwin/) is purchased for handling the quickly increasing number of pictures stored by NLR India.

Easy retrieval of picturesStrengths of PSE that contributes to the choice are in the first place its powerful database, called the Organizer. Pictures and other media files are easily selected when using so called tags. Tags are made on a flexible way according to ones own choice and attached to individual or groups of files There are many search strategies available.

Processing for upload and emailFor the website and other sharing of pictures simple cropping and resizing is essential. In addition slide series in .pdf format are made in a few steps. The result can be applied in presentations and emails that remain surprisingly low in their kilobyte weight.

Summary of PSE Acquire images from your camera or scanner Organize your files and photos you so can quickly find what you’re looking for Crop and straighten pictures, fix exposure, and clean up dust and scratches Create sharp and colorful images for printing Correct color, contrast, and clarity Combine multiple images into creative collages Use filters to create different effects Turn your photos into slide shows, movie files, or Web-hosted images

The features of the organizer are stronger than many other popular software like for instance Picasa.All other editing features are available and if professional editing would be needed the step to Photoshop is relatively modest. Photoshop however does not have a powerful organizer like Photoshop Elements.

Annex 13 Sources and ReferencesSources and References for this workshop include:

www.nlrindia.org

Site at School, the content management system used for the website www.nlrindia.org

Server at School, is an open source server designed for primary schools with all facilities and features needed for schools. Site at School is part of Server at School. Its design, capacity security and robustness result in a server that would probably justify research on fitness for application in NLR India.

Report Website Workshop 3

Photoshop Elements

Photoshop Elements for dummies

Sources and References West Bengal

http://www.wbhealth.gov.in/

Leprosy Statistics MiH W Bengal

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http://books.google.nl/books?id=HlbuqPYG5QUC&dq=Photoshop+Elements+for+Dummies&printsec=frontcover&source=bl&ots=8JP5rC30aY&sig=dXZbA9wPoodyDOKAr2EQnARHErs&hl=nl&ei=MU7wSsLiIpLS-Qbw-L30Bw&sa=X&oi=book_result&ct=result&resnum=6&ved=0CCAQ6AEwBQ#v=onepage&q=&

http://www.adobe.com/products/photoshopelwin/


http://serveropschool.nl/




http://www.adobe.com/products/photoshopelwin/


Annex 14 Leprosy Statistics West Bengal

Year wise Balance Regd. Cases beginning of year

New cases detected

Cases Discharged Balance Regd. Cases end of year

Per 10,000 Population

PD Ratio

CURED (RFT)

O.D PR NCDR

94-95 1,49,427 48,465 1,02,290 95,602 12.76 6.47 1.9795-96 95,602 41,379 66,044 70,937 9.26 5.40 1.7196-97 70,937 42,092 36,137 25,226 51,666 6.63 5.40 1.2397-98 51,666 38,134 44,654 8,197 37,422 4.72 4.80 0.9898-99 37,422 71,728 44,528 12,61 54,116 6.64 8.88 0.7599-00 54,116 54,361 55,25 11,747 42,466 5.25 6.73 0.782000-01 42,466 35,666 46,558 9,843 22,396 2.72 4.33 0.632001-02 22,396 46,620 33,175 2,970 32,871 4.03 5.72 0.702002-03 32,871 32,374 40,578 2,772 21,895 2.69 3.97 0.682003-04 21,895 25,050 18,765 2,423 25,757 3.11 3.02 1.032004-05 25,757 20,908 19,779 8,565 18,321 2.14 2.44 0.862005-06 18,321 15,755 18,115 5,167 10,794 1.24 1.81 0.692006-07 10,794 13,620 13,105 2,588 8,721 0.99 1.54 0.64

Table 2 Year-wise Leprosy Status in West BengalSource: MoH www.wbhealth.gov.in leprosy statistics & demography, consulted on 091104

Sl. Name of the Districts

No. of new

cases (2006-

07) ANCDR/ 10000

Total Grade-II

deformed cases

(2006-07) Percentage

Grade -II

Registered cases

recorded 31.03.2007

PR/ 10000

no.

1 Bankura 1372 3.9 34 2.48 865 2.462 Birbhum 732 2.2 25 3.42 548 1.653 Burdwan 1587 2.08 29 1.83 989 1.34 Kolkata 761 1.51 46 6.04 513 1.025 Cooch Behar 285 1.04 0 0 231 0.856 Darjeeling 233 1.32 4 1.72 124 0.77 Dinajpur-N 975 3.62 56 5.74 561 2.088 Dinajpur-S 478 2.89 21 4.39 316 1.919 Hooghly 586 1.05 18 3.07 364 0.66

10 Howrah 269 0.57 15 5.58 194 0.4111 Jalpaiguri 510 1.36 42 8.24 363 0.9712 Malda 449 1.24 27 6.01 371 1.02

13Midnapore-East 174 0.34 4 2.3 132 0.26

14Midnapore-West 1623 2.94 37 2.28 1034 1.87

15 Murshidabad 505 0.78 9 1.78 370 0.57

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16 Nadia 359 0.71 20 5.57 269 0.5317 Purulia 1863 6.67 38 2.04 876 3.13

1824 Parganas-N 565 0.57 15 2.65 363 0.37

1924 Parganas-S 294 0.39 2 0.68 238 0.31

West Bengal 13620 1.54 442 3.25 8721 0.99

Table 3 Leprosy situation in Districts as on 31.03.2007

Sl.Districts

PR/ 10,000

NCDR/ 10,000

Proportion of Female

among new

cases

Proportion of Child among

new cases

Proportion of Visible Deformity grade-II

among new cases MB% SC% ST%no.

1Medinipore-East 0.26 0.34 27.59 4.02 2.30 67.24 6.90 4.60

2 24 Parganas-S 0.31 0.39 36.39 6.12 0.68 68.71 17.01 2.043 24 Parganas-N 0.37 0.57 29.56 10.44 2.65 58.05 12.57 6.374 Howrah 0.41 0.57 14.87 6.32 5.58 62.45 2.23 0.005 Nadia 0.53 0.71 39.00 6.41 5.57 52.37 27.30 11.426 Murshidabad 0.57 0.78 30.50 9.50 1.78 59.60 11.68 5.357 Hooghly 0.66 1.05 31.91 8.02 3.07 55.29 24.06 13.998 Darjeeling 0.70 1.32 35.62 12.45 1.72 51.93 19.74 14.599 Coochbehar 0.85 1.04 26.67 4.56 0.00 60.00 42.11 2.46

10 Jalpaiguri 0.97 1.36 27.84 3.73 8.24 64.12 34.71 25.6911 Kolkata 1.02 1.51 22.08 5.26 6.04 56.77 2.50 0.1312 Malda 1.02 1.24 37.19 6.68 6.01 63.03 16.04 24.9413 Burdwan 1.30 2.08 35.41 12.92 1.83 44.55 35.85 19.4114 Birbhum 1.65 2.20 28.14 10.25 3.42 57.24 28.69 16.26

15Midnapore-West 1.87 2.94 36.60 10.54 2.28 51.08 22.61 29.45

16 Dinajpur-South 1.91 2.89 36.82 7.32 4.39 50.21 20.29 50.8417 Dinajpur-North 2.08 3.62 42.26 10.77 5.74 50.15 25.23 13.0318 Bankura 2.46 3.90 38.78 11.22 2.48 46.57 43.88 16.9819 Purulia 3.13 6.67 41.65 14.92 2.04 34.73 23.13 22.11 West Bengal 0.99 1.54 34.78 10.08 3.25 50.90 24.91 17.66

Table 4 Leprosy Key Indicators as on 31.03.2007

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Table 5 Trend of leprosy prevalence West Bengal 1994-2007

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Year West Bengal India1 Area ( in square kilometres ) 2001 88.752 30,65,0272 Number of villages 2001 40.782 6,38,5883 Number of towns 2001 375 5.1614 Census population 2001 8,01,76,197 1,02,86,10,328*

1991 6,80,77,965 84,63,02,6885 Sex ratio ( females per 1000 males ) 2001 934 933

1991 917 9276 Decennial population growth ( percentage) 1991 -

200117,77 21,54

1981 - 1991

24,73 23,85

7 Density of population 2001 903 3361991 767 274

8 Crude birth rate ( SRS ) 2007 17,9 23,19 Crude death rate ( SRS) 2007 6,3 7,410 Infant mortality rate ( SRS) 2007 37 5511 Expectation of life at birth ( projected ) 2006 -

2010

Male 68,2 65,8Female 70,9 68,1

12 Total Fertility Rate 2006 2,0 2,813 Mean age at effective marriage for females 2006 19,8 20,514 Percentage of urban population to total

population2001 27,97 27,821991 27,48 25,73

15 Literacy Rate << 2001 68,6 64,81991 57,70 52,20

16 Percentage of population by religion (2001) Hindu 72,47 80,46Muslim 25,25 13,43Others 2,28 6,11

17 Percentage of Scheduled Caste population to total population

2001 23.02 16.201991 23.62 16.33

18 Percentage of Scheduled Tribe population to total population

2001 5.50 8.201991 5.59 8.01

<< The literacy rates refer to the percentage of Literate to estimated population aged 7 (seven) years and above

* Excluding the population of Mao-Maram, Paomata and Purul Sub-divisions of Senapati district of Manipur.

Table 6 Demographic Characteristics at a glance.

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Annex 15 Map of W Bengal

Annex 16 Distribution listHard copies (printed) to

NLR Archive 2KIT Leprosy Unit 4

Softcopies (e-mail)

NLR AmsterdamProject Department Mr Rens Verstappen; Mr Jan Willem Dogger; Mr Daan Ponsteen;

Ms Nicole DinessenFundraising Department Mr Raymond van Haaften

NLR IndiaRepresentative NLR Dr M.A. Arif

KIT secretariat

Site at School Team Mr Dirk Schouten [email protected] Peter Fokker [email protected]

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mailto:[email protected]

mailto:[email protected]

Report Workshop4 Website+visit WBengalnlrindia.org/starnet/media/KIT/AnrikE/AE091116WS4Rep... · Web viewTable 1 Leprosy situation in Districts as on 31.03.2007 (source ) 10 Table

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