title: Lessons from the evolution of a CBR programme for people affected by leprosy in Northern Nigeria.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: School of Sociology & Social Policy, University of Leeds, Leeds LS2 9JT, UK. hss4bee@leeds.ac.uk
authors.forename: Bassey
authors.initials: B
authors.lastname: Ebenso
authors.forename: Michael
authors.initials: M
authors.lastname: Idah
authors.forename: Terver
authors.initials: T
authors.lastname: Anyor
authors.forename: Femi
authors.initials: F
authors.lastname: Opakunmi
mesh_terms: D003153:Community Health Services / Q000266:history / Q000458:organization & administration*; D003256:Community Participation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D006297:Health Services Accessibility; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007918:Leprosy / Q000534:rehabilitation*; D009549:Nigeria; D016730:Program Development; D015397:Program Evaluation; D011788:Quality of Life