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Goal-setting is indispensable for effective healthcare management. Yet, literature evidence suggests many organisations worldwide do not know how to formulate ‘SMART’ goals. Evidence of how existing theories work in practice is scarce, and the practices in low-income countries are unknown. Therefore, this research explored how leprosy project goals were formulated to describe the theoretical practice framework of The Leprosy Mission Nigeria (TLMN). Using a case-study design, ten managers were interviewed individually concerning their goal-setting knowledge, experience and perspective; and documented goals of six projects were reviewed. A five-step constructionist thematic data analysis generated eleven theoretical frameworks from the concepts of the emergent core themes of ‘stakeholders’, ‘strategies’ and ‘statements.’ Further theorisation reduced them to one general framework. This revealed TLMN’s goal-setting practice as a four-stage centre-led, top-down, beneficiary-focused and problem-based process. The stages were national preparation, baseline needs-survey, centralised goal formulation and nationalised planning. The outcome was the formulation of assigned, ‘non SMART’ objective statements, which are then used for planning projects. Other theoretical models constructed included a Goal Effects Cycle, ‘SMARTA’ goal attributes and hierarchical criteria for differentiating goal-types. A theory developed from TLMN goal-setting postulates that: ‘Assigned non SMART goal formulation directly results from centralised goal-setting practice and is the predictor of unrealistic project planning.’ Therefore, I propose that goal statements will be ‘SMARTA’ and plans, more realistic and relevant if goal setting is done collaboratively by all stakeholders at all stages of the process. Also, ‘Change-Beneficiary-Indicator-Target-Timeframe’ and ‘Change- Beneficiary-Location-Timeframe’ frameworks are recommended as templates for writing SMART objectives and aims respectively.

Before the consolidation of the germ theory of human diseases at the end of the nineteenth century, medical explanations about disease causation were dominated by the environmental notions of medical geography. This dissertation explores how nineteenth-century Colombian physicians transformed the medical geographical approach using the early concepts and technologies of the emerging Pasteurian germ theory. I follow this transformation in the cases of periodic fevers (yellow fever and malaria), continuous fevers (typhoid fever and typhus) and leprosy. The analysis reveals that by mid century physicians had incorporated neo-Hippocratic versions of disease causation and French medical geographical ideas in order to make sense of disease of the warm, temperate and cold lands. Their conceptual network revolved around the specific, predisposing and occasional causes in which climate and geography played a determinant role. Evidence indicates that this was the case of periodic fevers of the warm lands (yellow fever and malaria). I argue that the “parasitic” hypothesis of yellow fever was accepted during the controversy around the prophylactic inoculations inspired by Pasteurism that were applied in Colombia in 1887. However, doctors struggled to reconcile the medical geographical and the bacteriological perspective of both yellow fever and malaria. Continuous fevers, on the other hand, were also framed within the medical geography scheme of disease causation. I show how during the debates about typhoid fever and typhus happening in the Colombian highlands during the 70s, 80s and 90s, doctors used medical geographical notions and developed anti-pasteurian arguments, while the international scientific community had identified the specific bacilli for typhoid fever. Finally, I argue that the strong interest of Colombian doctors on leprosy –also understood in neo-Hippocratic terms- that foster the search for local treatments based on Pasteurism (antiseptics in the 1880s and serotherapy in the 1890s) also prompted the extension of the bacteriological model and techniques to other diseases in those decades.

This thesis examines the role of missionaries, the colonial government, and leprosy patients in the formation of leprosy settlements in Uganda, from the first inception of the settlements in 1927, until 1951 when the nature of leprosy control in Uganda changed, with the government appointment of a Protectorate leprologist and the creation of more treatment centres. It focuses on four leprosy settlements opened between 1930 and 1934 by the Anglican Church Missionary Society (CMS) and the British and Irish Catholic Franciscan Missionary Sisters for Africa (FMSA) and Mill Hill Mission (MHM). Firstly, this thesis explores the ways in which the differing goals, ideologies, and resources of the Protestant CMS and the Catholic FMSA and MHM shaped the formation of and social environment within leprosy settlements in a highly Christianised and denominationally divided Uganda. Secondly, it examines the relationship between the CMS and Franciscan leprosy missions and the government, exploring the cooperation and conflict that their spiritual and medical priorities had upon the social lives of patients within Uganda’s leprosy settlements. Thirdly, this thesis assesses the extent to which missionaries consciously endeavoured to engineer a social environment for leprosy patients within settlements that conformed to their ideal of Christianised, modern African communities, as well the roles that healthy and leprous Ugandans chose to play in response to these attempts at social engineering. Missionaries and Ugandan leprosy patients had different priorities, but far from being passive receptacles of the ‘civilising’ mission, most leprosy patients were active agents in pursuing their own medical, social, and economic priorities through life in the settlements.

A história da luta contra a hanseníase no Estado de São Paulo foi ímpar, assim como todo o movimento sanitário, incomum na história da saúde mundial, pela maneira como se desenvolveu e a rapidez com que foi implementado. Utilizar intensivamente a informação na gestão da saúde é o que confere o diferencial na qualificação do processo decisório. Esta constatação impõe a necessidade de implementação de estratégias políticas e técnicas que superem os limites ainda existentes na gestão da informação em saúde no Brasil. Esta pesquisa objetivou descrever a trajetória da informação sobre a hanseníase, a partir do começo do século XIX, em São Paulo, e sua conexão com a implantação e o desenvolvimento do conceito e das práticas de vigilância e controle desse agravo. O estudo foi de natureza exploratória. Foram utilizadas análises bibliográficas, documental, e também o banco de dados de notificação de hanseníase do Centro de Vigilância Epidemiológica “Prof. Alexandre Vranjac" da Secretaria de Estado da Saúde de São Paulo para a construção da linha temporal sobre a informação na hanseníase em âmbito mundial, nacional e estadual. Os ganhos em quantidade de armazenamento e velocidade de análise, possibilitados pelo uso de bancos de dados informatizados, enfatizam os problemas da coleta e inserção das informações nos sistemas. Todos os elos da cadeia de informações, da coleta à sua utilização, são responsáveis pela adequação, integridade, precisão, acurácia e confiabilidade de todo o processo. O volume de dados em saúde, em São Paulo, principalmente na hanseníase, é enorme, todavia, a imprecisão deles em determinados períodos inviabiliza sua utilização para análises consistentes e fidedignas. Os problemas da não-informação são pontuais, ou seja, há alguns municípios que sistematicamente são os responsáveis. O investimento de recursos deve ser dirigido ao treinamento dos responsáveis pela coleta e inclusão das informações no sistema, e também à criação de mecanismos para incentivar o comprometimento e aumentar a percepção da importância dessas funções. / The history of the fight against Hansen’s disease in the State of São Paulo was unique, as well as the whole sanitary movement, unusual in the world health history, due to the manner in which this fight was conducted and the quickness in which it was implemented. Intensive use of information in health management is what lends uniqueness to the decision making process. This statement brings forth the need to implement political strategies and techniques capable to overcome the limits that still stand in the management of health information in Brazil. This research was designed to describe the route of information regarding Hansen’s disease, up from the start of the XIX Century, in São Paulo and its connection with the implanting and the development of surveillance and control practices associated to this hazard. The study had exploratory venue, employing bibliographical and documental analysis as well as the databank of reports of Hansen’s disease of the Epidemiological Surveillance Center “Prof. Alexandre Vranjac", of the State Secretary of Health of São Paulo, in order to trace a time line of the information on Hansen’s disease comprising worldwide, nationwide and statewide levels. The profits in the amount of storage and quickness of analysis ensued by the use of cybernetic databanks stress the problems registered at data collection and also at the input of information in the system. All the links in the information chain, from collection to usage, are responsible for adequation, integrity, precision, accuracy and reliability of the whole process. Health data volume, in São Paulo, especially regarding Hansen’s disease, is enormous, however their imprecision, during some periods render these data useless for consistent and reliable analysis. Problems of no information are punctual, meaning some cities are systematically responsible for not registering their data. Resource investment must be directed to training programs of officers responsible for the collection and input of the information in the system, and must also be directed to the creation of mechanisms designed to increase commitment and further the perception of the importance of these tasks.

A prevalência mundial da hanseníase vem demonstrando redução no número de casos, porém, no Brasil e em alguns países, ela ainda representa um grave problema de saúde pública, podendo levar a incapacidades funcionais graves como a cegueira. O objetivo do estudo foi avaliar a relação entre as alterações do piscar e a superfície ocular em hansenianos. Todos os pacientes estudados foram submetidos à mesma anamnese e avaliação oftalmológica: acuidade visual, ectoscopia, biomicroscopia, avaliação da superfície ocular, teste da graduação da força muscular do orbicular, sensibilidade corneana, distância da margem reflexa, medida da pressão intraocular e mensuração do piscar espontâneo palpebral por meio de um método de imagem por vídeo. Dos 56 pacientes examinados, 69,6% eram do sexo masculino, com média de idade de 55,96 ± 16,63 dp, 46,4% se declararam negros e 28,55% pardos, 71,4% apresentavam a forma multibacilar e 73,2% estavam fora do registro ativo da doença. Desses 56 pacientes, 43 apresentaram significativa simetria interocular no acometimento do nervo facial e do trigêmeo (p=0,11), o que foi corroborado pela alta correlação entre as medidas da amplitude do piscar entre os olhos (r=0,90). Apenas 12,5% apresentaram tempo de ruptura do filme lacrimal menor que 10 segundos e em um paciente este foi menor que 5. Evidenciou-se sofrimento da superfície ocular em cerca de 14% dos olhos. As alterações de sensibilidade foram mais prevalentes, pois 51,8% apresentaram algum grau de diminuição. A média geral da taxa do piscar foi de 17,0 ± 2,6 blink/min. De acordo com o exame de Lissamina, observou-se taxa média de 16,0 ± 2,8 (média±dp) para os pacientes com resultado negativo e 23,2 ± 6,8 para os com resultado positivo (t=0,961; p=0,3407); e em relação à sensibilidade corneana, as taxas médias foram 14,6 ± 3,8 e 19,2 ± 3,6 para os pacientes com resposta imediata e alterada, respectivamente (t=0,875; p=0,3857). De acordo com o tônus muscular, a média das taxas do piscar para os pacientes normais e alterados não foi significativa (t=0,539; p=0,592). Apesar do número e da amplitude dos movimentos serem diferentes, a main sequence demonstrou comportamento linear em todos os casos, sendo a média geral 20,25 ± 6,9 (0,94 ep). As médias da taxa, amplitude e efetividade do piscar em pacientes com função do músculo orbicular do olho normal e naqueles com função alterada não demonstraram diferença estatística, já a média da velocidade máxima do piscar com função normal foi de 115,5 ± 47,2 mm/s, enquanto que naqueles com lagoftalmo foi 67,7 ± 27 (t=2,08; p=0,04) e a média do deslocamento horizontal de 2,1 ± 0,7 mm e 0,9 ± 0,8 mm, respectivamente (t=1,99; p=0,05). Embora os pacientes hansenianos não apresentem taxa de piscar diferente do normal, demonstram tendência à diminuição da velocidade e do deslocamento horizontal quando apresentam alterações da função do músculo orbicular. A maioria dos pacientes apresentou alteração de sensibilidade corneana, porém, sem sinais de sofrimento da superfície ocular, principalmente com a cinemática palpebral preservada. / Global prevalence of leprosy has demonstrated a reduction in the number of cases, however, in Brazil and some countries, it still represents a serious public health problem, often leading to severe functional disabilities such as blindness for example. This study aimed to evaluate the relationship between blink and ocular surface in patients with leprosy. Leprosy patients underwent the same history and ophthalmologic evaluation: visual acuity, ectoscopy, slit lamp examination, evaluation of ocular surface, test the eyelid function and the degree of orbicularis function, corneal sensitivity, margin reflex distance, measured intraocular pressure and measuring eyelid spontaneous blinking through an image video system. 69.6% were male, with a mean age of 55.96 ± 16.63 SD. 46.4% declared themselves as black and brown were 28.55%, 71.4% were multibacillary and 73.2% were out of active disease registry. Between the 56 patients examined, 43 of those had significant interocular symmetry of the involvement of the facial and the trigeminal nerves (p=0.11), which was confirmed by the high correlation between the measurements of amplitude flashing of the eyes (r=0,90). Only 12.5% had TFRL was under 10 seconds and in one patient it was under 5 seconds. It was evidenced suffering from ocular surface in about 14% of the eyes. Sensitivity changes were more prevalent, 51.8% had some degree of impairment. Overall average blink rate was 17.0 ± 2.6 blinks/min. In the lissamine test, we observed an average rate of 16.0 ± 2.8 for patients with negative and 23.2 ± 6.8 for a positive result (t=0.961, p=0.3407). The mean values were 14.6 ± 3.8 (mean ± SD) and 19.2 ± 3.6 for for patients with immediate corneal sensitivity response and altered response, respectively (t=0.875, p=0.3857). According muscle tone, mean blink rates for normals and for injured patients, were not different (t=0.539, p=0.592). Although the number and range of motion are different, the main sequence had a linear behavior in all cases, with an overall mean 20.25 ± 6.9 (p 0.94). The mean blink rate, amplitude and effectiveness in patients with normal orbicularis function and those with altered function, showed no statistical diference, while the mean of maximum velocity blink was, with normal function, 115.5 ± 47.2 mm/s, while those with lagophthalmos was 27 ± 67.7 (t=2.08, p=0.04) and the mean horizontal displacement was 2.1 ± 0.7 mm and 0.9 ±0.8 mm respectively (t=1.99, p=0.05). Although leprosy patients do not have a different flash rate of the normal population, blinking characteristics show a tendency to decrease in speed and horizontal scrolling when they show important changes in orbicularis function. The vast majority of patients had corneal sensitivity changes, but without signs of ocular surface suffering, especially those with eyelid kinematics preserved.

Desde a antiguidade, as características epidemiológicas da hanseníase favoreceram sua propagação, principalmente diante de condições de adensamento populacional, deficiência de cuidados de higiene e baixa imunidade. As deformidades provocadas pela doença sempre degradaram a imagem do indivíduo, favorecendo a sua estigmatização. A intensificação do esforço em segregar os doentes com hanseníase no Brasil foi resultado de escolhas e formas de intervir na sociedade. A situação econômica do século XIX e XX, justificada pelo aumento dos casos de hanseníase e da necessidade de proteger a sociedade, levou as autoridades amazonenses, espelhadas nas condutas praticadas na Europa séculos atrás, a buscarem formas de criar locais para segregação e controle dos pacientes. Foi com este fim que surgiu o Leprosário Colônia Antonio Aleixo, no município de Manaus, em 1942. Nossa pesquisa tem como objetivo analisar a reprodução social (relação trabalho e vida) de moradores do bairro Colônia Antonio Aleixo em Manaus (AM), ex-colônia de hansenianos desde sua instalação até a atualidade, na transição de leprosário a bairro. Trata-se de uma pesquisa quali-quantitativa, de natureza transversal descritivo-analítico, com abordagem baseada na concepção materialista e dialética da história, tendo sido privilegiados levantamentos de campo, com entrevistas, aplicação de questionários, mapeamentos e séries fotográficas, bem como levantamentos em fontes secundárias, em órgãos governamentais e núcleos de pesquisa, além de revisão bibliográfica. Os resultados mostram a discriminação e as práticas excludentes que os portadores de hanseníase puderam experimentar, praticada pela sociedade, família, governo, equipe de saúde e pelos administradores da Colônia. As redes sociais presentes na Colônia mostraram-se muito importantes para o enfrentamento da doença, seja pela sua função objetiva (ajuda prática), seja pela sua função subjetiva (apoio e afeto). Analisando a forma de viver dos doentes segregados, percebemos como o tratamento negligenciado os levou a consequências físicas e sociais graves, atingindo sua autonomia e sua auto-estima. Embora o bairro hoje possua serviços básicos de infraestrutura (escolas, hospitais, energia elétrica, água potável, transporte, segurança, dentre outros), todos apresentam graves deficiências. Quanto à situação socioeconômica das famílias do bairro, percebemos que 77,8% delas apresentam deficientes formas de trabalhar e viver, ou seja, sua inserção social simultaneamente não lhes confere estabilidade no momento da produção e cuja inserção no momento da reprodução só lhes confere luta pela sobrevivência. O processo de reprodução social dos moradores deste bairro segue a tendência de todo o país, mas consegue ter distorções maiores e apresentar maior gravidade. A identificação das famílias do estrato inferior (formas de trabalhar e de viver instáveis), em particular, é socialmente e epidemiologicamente muito importante, pois, é aí que se insere o núcleo básico da pobreza e da miséria e a sua reprodução. / Since ancient times, the epidemiological characteristics of leprosy favored its spread, especially because of conditions of high populational density, deficient hygiene cares and low immunity. The deformities caused by the disease always degraded the image of the individual, favouring their stigmatization. The intensified effort to segregate leprosy patients in Brazil was the result of choices and ways to intervene in society. The economic situation of the 19th and 20th centuries, justified by the increase of cases of leprosy and the need to protect society, led the authorities of Amazon, mirrored in the behavior practiced in Europe centuries ago, to seek ways to create places for control and segregation of patients . It was with this purpose that the Leper Colony Antonio Aleixo was created, at the city of Manaus, in 1942. Our research aims to analyze the social reproduction (work and life relation) of the residents of Colony Antonio Aleixo, a neighborhood in Manaus (AM), former leper colony, since its establishment until today, in the transition from the leper colony into the present neighborhood. This is a qualitative/quantitative research, of cross sectional descriptive-analytic nature, which approach is based in materialist and dialectic conception of history, privileging field surveys, interviews, questionnaire applications, mappings and photographic series, as well as surveys in secondary sources, governmental agencies and research groups, besides bibliographic reviews. The results show the discrimination and exclusionary practices that leprosy patients experienced, practiced by society, family, government, health professionals and by administrators of the colony. Social networks present in the Colony were found very important to confront the disease, either by their objective function (practical assistance) or by their subjective function (support and affection). Analyzing the way of life of segregated patients, we realize how the neglected treatment led them to severe physical and social consequences, affecting their autonomy and self-esteem. Although the neighborhood today has basic infrastructure services (schools, hospitals, electricity, drinking water, transportation, security, among others), they are all defectives. Concerning the socioeconomic conditions of families in that neighborhood, we noticed that 77,8% of them presents deficient ways to work and live, which means that their social inclusion does not provide them with stability at the time of production and that their inclusion at the time of reproduction only provides them with the basic \'fight for survival\'. The process of social reproduction of the residents of this neighborhood is a trend across the country, but here it shows even higher distortion and presents greater severity. The identification of families in the lower layer (unstable ways of working and living), in particular, is socially and epidemiologically very important, because there you find the basic core of poverty and misery and its reproduction.

Apesar da Organização Mundial de Saúde (OMS) ter adotado medidas de controle, a hanseníase permanece como um problema social e de saúde pública em muitos países. O diagnóstico clínico e a baciloscopia permanecem como as principais ferramentas utilizadas para a classificação dos pacientes e definição da terapêutica a ser instituída. A identificação de novos antígenos de M. leprae, o desenvolvimento de novos métodos laboratoriais e melhorar o desempenho de testes sorológicos já existentes são prioridades para tentar atingir as metas da OMS programadas para o período de 2011-2015. Neste estudo avaliamos o desempenho diagnóstico dos antígenos glicolipídeo sintético ND-O-BSA para pesquisa de anticorpos totais e recombinante LID-1, para pesquisa anticorpos IgG por ELISA; e o perfil de reatividade de anticorpos IgG contra proteínas nativas de M. leprae por Western Blotting, em amostras de soros de pacientes de área endêmica com diferentes formas clínicas da doença. Nossos resultados mostraram que os testes ELISA ND-O-BSA e LID-1 auxiliaram na detecção de 70% dos pacientes multibacilares com baciloscopia negativa. O valor preditivo negativo foi de 94% para ambos os testes. A análise do Western Blotting mostrou que pacientes multibacilares possuem anticorpos IgG para a fração de 38kDa e região de 3,5kDa, esta reatividade não foi observada no grupo controle. Nosso estudo sugere a utilização do ELISA, com antígenos recombinante e sintético, na rotina diagnóstica; e que a fração de 38kDa e região de 3,5kDa, de antígeno nativo de M. leprae, são bons marcadores no diagnóstico de hanseníase e no prognóstico de pacientes com as formas borderline e indeterminada da doença. / Although several control measures have been adopted by the World Health Organization, (WHO) leprosy continues to be a social and public health problem in many countries. Clinical diagnosis and acid-fast bacilli skin smear are the main tools used to classify patients and define therapy. According to the WHO program for 2011-2015, the identification of new Mycobacterium leprae antigens, the development of new laboratory methods and improved serological tests are the priorities. In the present study, we evaluated the diagnostic performance of the synthetic glycolipid antigen, ND-O-BSA, to detect total antibodies and the recombinant antigen LID-1 to detect IgG antibodies by ELISA and the IgG reactivity profile against native M. leprae proteins by Western blot in serum samples from leprosy patients classified in the wide spectrum of the disease. Our results showed that ND-O-BSA and LID-1 ELISA are able to detect the disease in 70% of multibacillary patients with negative skin smears. The negative predictive values were 94% for both tests. The Western blot analysis revealed that most multibacillary patients had IgG antibodies against the 38 kDa and 3.5 kDa regions; this reactivity was not observed in the control group. Our study suggests the use of ELISA, with recombinant or synthetic antigens, in routine diagnosis and that the 38 kDa fraction and the 3.5 kDa region, from native M leprae antigen, are good markers for the diagnosis of leprosy and its prognosis as shown for the borderline and indeterminate forms of the disease.

A detecção de casos novos de hanseníase permanece elevada no mundo, no Brasil e em Alagoas. Trata-se de uma importante morbidade que leva a incapacidades físicas, preconceito e estigma. A ênfase dada à saúde reprodutiva de mulheres portadoras e ex-portadoras de hanseníase deve-se ao fato de a gestação induzir recidivas, exacerbar lesões pré-existentes e aumentar a evolução da forma indeterminada para outras formas clínicas, o que exige um acompanhamento para uma prática anticonceptiva segura. O objetivo geral foi conhecer a situação da saúde reprodutiva das mulheres portadoras e ex-portadoras de hanseníase na rede de atenção básica do município de Maceió. Trata-se de um estudo descritivo de corte transversal com abordagem quantitativa. O estudo foi realizado em 14 Unidades Básicas de Saúde (UBS) dos 07 Distritos Sanitários do município de Maceió/Alagoas. A população foi constituída por 60 mulheres. Os dados nos revelam que a maioria das mulheres se encontrava na faixa etária de 30 a 49 anos (75%), tinham companheiro (70%), eram analfabetas ou com o ensino fundamental incompleto (53,3%). Em relação à ocupação, 45% eram do lar e 55% desempenhavam outras ocupações remuneradas. Essas mulheres coabitavam com uma a três pessoas (36,7%) ou com seis a quatorze pessoas (28,3%). Quanto à religião, 61,7% eram católicas. A maioria buscou detecção por demanda espontânea (30,0%). Quanto à forma clínica, 30,0% era Dimorfa, 20% Tuberculóide, 15% Indeterminada, 10% Virchowiana e 25,0% formas clínicas não classificadas. Eram multibacilares 56,7%. Quanto às reações hansênicas, 16,7% informaram tê-las antes do diagnóstico, 28,3% durante o tratamento e 21,7% no pós-tratamento; 8,3% das reações eram do tipo I e 66,7%, do tipo II. Das mulheres, 5% estavam grávidas no diagnóstico, 1,7% no período puerperal e 1,7% amamentando. Em relação à história reprodutiva, 63,3% engravidou de uma a três vezes e 26,6% de quatro a dez vezes e 75% tiveram de um a três partos. Três mulheres estavam grávidas no momento do diagnóstico. Conheciam métodos contraceptivos, como condom masculino (98,3%), pílula (88,3%), laqueadura tubária (86,7%) e outros; os utilizavam, em maior índice, pílula (73,3%), condom masculino (70,0%), laqueadura tubária (53,3%) e outros. Quanto ao conhecimento dos métodos anticoncepcionais e características sociodemográficas, os maiores percentuais foram: condom masculino (100%), pílula (87,8%), laqueadura tubária (85,7%), injeção (75,6%), tabela (71,4%), DIU (64,3%). Realizando uma análise inferencial os dados denotam relação significativa com associação entre temperatura e ocupação, aleitamento materno e número de pessoas na família, pílula e número de pessoas, injeção e escolaridade, injeção e ocupação, diafragma e número de pessoas, espermicida e número de pessoas, vasectomia e se estudava, com p>0,05. Médicos e enfermeiros contribuíram mais na oferta de informações sobre contraceptivos, meios midiáticos exerceram grande influência. O principal local de recebimento dos contraceptivos foi a UBS. Concluímos que as mulheres em idade fértil portadoras e ex-portadoras de hanseníase estão sendo pouco aconselhadas para a anticoncepção, tornando-se susceptíveis ao risco de uma gravidez indesejável, levando-as a apresentar reações imunológicas graves / The detection of new leprosy cases in the world remains high in Brazil and Alagoas. This is an important morbidity that leads to physical disability, prejudice and stigma. The emphasis on reproductive health of women suffering and former carriers of leprosy is due to the fact pregnancy induce relapses, exacerbate pre-existing injuries and increase the evolution of indeterminate form for other clinical forms, which requires monitoring for a safe contraceptive practice. The overall objective was to know the situation of reproductive health of women suffering and former carriers of leprosy in primary health care in the city of Maceió network. This is a descriptive cross-sectional study with a quantitative approach. The study was conducted in 14 Basic Health Units (BHU) of the 07 health districts of the city of Maceió / Alagoas. The study population consisted of 60 women. The data reveal that a majority of women in the age group 30-49 years (75%) had a partner (70%) were illiterate or with incomplete primary education (53.3%). In terms of occupation, 45% were housewives and 55% played other paid occupations. These women lived with one to three people (36.7%) or six to fourteen people (28.3%). As for religion, 61.7% were Catholic. Most searched detection by spontaneous demand (30.0%). Clinical forms, 30.0% were borderline, 20% Tuberculoid, Indefinite 15%, 10% and 25.0% Lepromatous clinical forms not classified. 56.7% were multibacillary. As for leprosy reactions, 16.7% reported having them before diagnosis, during treatment 28.3% and 21.7% after treatment; 8.3% of the reactions were of type I and 66.7% type II. Among women, 5% were pregnant at diagnosis, 1.7% in the postpartum period and 1.7% breastfeeding. Regarding reproductive history, 63.3% of pregnant once to three times, and 26.6% for four to ten times, and 75% had one to three deliveries. Three women were pregnant at the time of diagnosis. Knew contraception, and male condom (98.3%), pill (88.3%), female sterilization (86.7%) and others; used them in highest pill (73.3%), male condom (70.0%), female sterilization (53.3%) and others. Regarding knowledge of contraceptive methods and sociodemographic characteristics, the highest percentages were male condom (100%), pill (87.8%), female sterilization (85.7%), injection (75.6%), table (71 , 4%), IUD (64.3%). Performing an inferential data analysis showed a significant relationship with association between temperature and occupation, breastfeeding and number of family members, and number of people pill, injection and education, and occupation injection, diaphragm and number of people, number of people and spermicide, vasectomy and studied with p> 0.05. Doctors and nurses have contributed more to offer information about contraceptives, exerted great influence from the media. The principal place of receipt of contraceptives was BHU. We conclude that women of childbearing age bearers and former carriers of leprosy are being advised to little contraception, making it susceptible to the risk of an unwanted pregnancy, leading them to develop severe immune reactions