Table 1 Key components of the IMPACT intervention

Group membership

Up to 25 participants, equal numbers of sexes, approximately half of participants affected by leprosy.

Meeting frequency

Sessions lasting approximately 2 h will be held fortnightly for three months and then monthly thereafter.

Facilitation

Three trained facilitators will establish 36 self-help groups. Facilitators will move between groups to provide training in their own speciality area, e.g. budgeting, bookkeeping, wound care. Key tasks include recruitment, encouraging attendance, maintaining registers of group members and activities, monitoring loan repayment, problem solving, engaging in advocacy with influential people in the community.

Peer leadership

The groups will elect four leaders (chairperson, vice-chairperson, secretary and treasurer), half of whom must be women. Leaders can be changed after 2 y if necessary. Leaders will be trained in basic accounting and each group will be given assistance to open a bank account.

Mutual support

Members will be encouraged to share their experiences, support each other and learn from each other.

Encouraging self-care* practices

Facilitators will ensure that group members have appropriate tools and equipment; observe self-care activities and encourage diligence; and encourage early referral to health facilities where necessary.

Tool provision*

Simple tools and equipment will be provided (e.g. mirrors to inspect the plantar surface of the foot, basins for soaking limbs in tap water, crutches, etc.)

Shaping knowledge

Group discussions to include: provision of disability cards, gender violence, civil rights, disaster preparedness. Members will be provided with information and encouraged to adopt healthy behaviours including Water, Sanitation and Hygiene (WASH).

Economic empowerment

Saving credit schemes will be facilitated. Seed money will be provided to establish enterprises. Business awards may be granted after skills training. Groups will be facilitated to become co-operatives that qualify to join the broader co-operative infra-structure in Nepal. Membership of this national, official, collaborative structure confers certain opportunities, such as advice, support and networking opportunities.

Livelihood and skill training

Training will be provided including organic farming, animal husbandry, basic accountancy, sewing, hairdressing.

Advocacy

The facilitators make contact with elected village chiefs, traditional healers, religious leaders and female community health volunteers to advocate for group members.

Ownership

Groups will be autonomous and able to direct and modify their training needs and activities. They will be encouraged to innovate. Past examples include use of games that have been designed for differently abled people and ‘street drama’.