1.5

1 . 5 ü¡ÙÛÉ Hhw ¢hfkÑu Ty¥¢L qÊÊ¡pLle 75 ¢j¢eV

1z A¢d−hn−el E−ŸnÉ (Session Objectives) :
A¢d−hn−el −n−o, AwnNËqeL¡l£l¡ ¢ejÀ¢m¢Ma ¢hou…¢m hÉ¡MÉ¡ Ll−a prj q−he -
¢hfkÑu Ty¥¢L qÊÊ¡pLle −r−œ ü¡ÙÛÉ f¢l−oh¡l j§m i¡N…¢m L£ L£ ?
¢hfkÑ−ul f§−hÑ, ¢hfkÑu Qm¡L¡m£e ab¡ ¢hfkÑ−ul f−l j¡e¤−ol Ap¤¤ÙÛa¡ (Morbidity) Hhw jªaÉl
¥
(Mortality) L¡lZ…¢m L£ L£ ?
pwœ²¡jL hÉ¡¢d Rs¡−e¡l L¡le L£ L£ ?
¢hfkÑ−ul pju Seü¡−ÙÛÉl Ty¥¢L…¢m−L ¢Li¡−h fË¢a−l¡d Ll¡ k¡u ?

2z A¢d−hn−el j§m ¢nr¡ (Key Learning Point) :
ü¡ÙÛÉ qm Hje HL¢V AhÙÛ¡ kMe j¡e¤o n¡¢ll£L, j¡e¢pL, p¡j¡¢SL ab¡ BdÉ¡¢aÈL i¡−h i¡−m¡
b¡−L z −l¡Nj¤š² b¡L¡V¡C ü¡ÙÛÉ eu z
ü¡ÙÛÉ f¢l−oh¡u ¢hfkÑu Ty¥¢L qÊÊ¡pLl−el Ef¡c¡e…¢m qm - ü¡ÙÛÉ hÉhÙÛ¡, ü¡ÙÛÉ hÉhÙÛ¡l NWe /
L¡W¡−j¡ ab¡ pwœ²¡jL Hhw Apwœ²¡jL hÉ¡¢d ¢eu¿»e z
f¢ÕQjh−‰l ü¡ÙÛÉ hÉhÙÛ¡ J a¡l NWe pÇf−LÑ S¡e¡ Sl¦l£ z
M¡cÉ J j−ml j¡dÉ−j ¢Li¡−h −l¡N Rs¡u Hhw ¢Li¡−h a¡ fË¢a−l¡d Ll¡ k¡u ; k¡−a Seü¡−ÙÛÉl
Ty¥¢L Lj−h z

3z −S−e l¡M¤e (Hand Out) x

ü¡ÙÛÉ L¡−L h−m ?
¢hnÄ ü¡ÙÛÉ pwÙÛ¡ (WHO) Ae¤p¡−l, ""ü¡ÙÛÉ qm n¡¢ll£L, j¡e¢pL, p¡j¡¢SL ab¡ BdÉ¡¢aÈL i¡−h i¡−m¡
b¡L¡ z −Lhmj¡œ −l¡Nj¤š² b¡L¡C ü¡ÙÛÉ eu''

ü¡ÙÛÉ f¢l−oh¡u ¢hfkÑu Ty¥¢L qÊÊ¡pLl−el Efc¡e x

1

f¢ÕQjh−‰ ü¡ÙÛÉ f¢l−oh¡l NWe / L¡W¡−j¡ x
pjam Hm¡L¡u fË¢a 5000 SepwMÉ¡ ¢fR¥ ab¡ f¡q¢s/B¢ch¡p£ Ad¤É¢oa Hm¡L¡u 3000 SepwMÉ¡ ¢fR¥
HL¢V Efü¡ÙÛÉ−L¾cÊ f¢l−oh¡ −c−h z fË¢a¢V −L−¾cÊ HLSe ANM B−R z HR¡s¡J hý −L−¾cÊ ÙÛ¡e£u
HLSe−L ¢àa£u ANM ¢qp¡−h l¡M¡ q−u−R z hý −L−¾cÊ HLSe f¤l¦o ü¡ÙÛÉ LjÑ£ B−Re z NË¡j f’¡−ua
Ù¹−l HLSe ü¡ÙÛÉ Ad£rL / (Health Supervisor) B−Re z HC pjNË cm¢V−L hÔL ü¡ÙÛÉ B¢dL¡¢lL
(BMOH) Hhw hÔL Seü¡ÙÛÉ −p¢hL¡ (BPHN) f¢lQ¡me¡ L−le z A−eL…¢m hÔ−L, hÔL ü¡ÙÛÉhdÑL fl£rL
(BSI) B−Re z

fË¡b¢jL ü¡ÙÛÉ −L¾cÊ : fË¡b¢jL ü¡ÙÛÉ −L−¾cÊ (PHC) fË¢a 30,000 Se pwMÉ¡ ¢fR¥ HL¢V L−l X¡š²¡l
B−R z HM¡−e HLSe X¡š²¡l J pq¡uL LjÑ£ c¡¢u−aÆ b¡−Le z p¡d¡lea HM¡−e −l¡N£ i¢šÑl hÉhÙÛ¡ b¡−L
e¡ (Non Beded) z

hÔL fË¡b¢jL ü¡ÙÛÉ −L¾cÊ (BPHC) x HC NË¡jÉ ü¡ÙÛÉ −L¾cÊ…¢m−a p¡d¡leax 16 −b−L 30 Se−L i¢šÑl
hÉhÙÛ¡ b¡−L z hÔL ü¡ÙÛÉ B¢dL¡¢lL R¡s¡J HM¡−e 2 −b−L 3 Se X¡š²¡l c¡¢u−aÆ b¡−Le z ph BPHC-
−aC NiÑha£ j¢qm¡−cl fËp−hl hÉhÙÛ¡ B−R z

fËbj Referral Unit (FRU) −a ¢h−no‘−cl b¡L¡l Lb¡ Hhw a¡l¡ A−Ù»¡f¡Q¡−ll j¡dÉ−j (Caesarean)
S¢Vm fËph…¢m Ll¡−a prj z
¢hfkÑu Ty¥¢L qÊÊ¡pLl−el fËb¢jL E−ŸnÉ…¢m qm -
1) A¢dL −l¡N Hhw jªaÉ¥ fË¢a−l¡d J qÊÊ¡p
2) ¢hfkÑ−ul fl ü¡i¡¢hL S£h−e ¢g−l Bp¡l SeÉ rja¡ue

¢hfkÑ−ul pju ü¡−ÙÛÉl Ty¥¢L pj§q

fËi¡h ¢j¢nËa c§−kÑ¡N i¨¢jLÇf Ts / a¥g¡e heÉ¡ qsL¡h¡e /
(heÉ¡ l¢qa) p¤e¡j£
¤
jªa¥É hý hý AÒf pwMÉL AÒf pwMÉL hý
L¢We/j¡l¡aÈL +/- hý jdÉj AÒf AÒf
BO¡a
pwœ²¡jL −l¡N −hn£ Lj Lj +/- Lj
h¡s¡l Ty¥¢L
M¡−cÉl Ai¡h p¡d¡le c¤mÑi/ ¢hlm c¤mÑi/ ¢hlm +/- p¡d¡le
hý j¡e¤−ol p¡d¡le c¤mÑi/ ¢hlm c¤mÑi/ ¢hlm p¡d¡le +/-
h¡pÙÛ¡e f¢lhaÑe (−hn£ r¢aNËÙ¹
nq−l O−V)

−l¡N Hhw jªa¥Él q¡l / j¡œ¡ ¢h¢iæ ¢hfkÑ−ul Efl ¢i¢š L−l f¢lhaÑen£m / f¢lhaÑe p¡−fr z p¤al¡w
¤
¢hfkÑ−ul fËL¡l Hhw f¢lj¡−el Efl ¢i¢š L−l Seü¡ÙÛÉ J ¢Q¢Lvp¡l fË−u¡Se f¢lh¢aÑa q−h z
ü¡ÙÛÉ f¢l−oh¡l ANË¡¢dLl−el SeÉ fËi¡¢ha Hm¡L¡ / pj¡−Sl ü¡i¡¢hL ü¡ÙÛÉ AhÙÛ¡, fË−u¡Se, ü¡−ÙÛl
Ty¥¢Lpj§q, pÇfc J rja¡l pjÉL ‘¡e b¡L¡ clL¡l z ¢hfkÑ−ul f§−hÑC pjÙ¹ fË−u¡Se£u abÉ Hhw p§Qe¡

2

pwNËq J ¢h−nÔoe L−l l¡M fË−u¡Se - k¡−a Seü¡ÙÛÉ ¢houL Sl¦l£ ¢eZÑu…¢m −eJu¡ −k−a f¡−l z
¢eu¢ja hý −rœ ¢h−nÔo−e (Multi Sectoral Assessment) Hm¡L¡l fË¢a¢e¢d−cl n¡¢jm qJu¡ fË−u¡Se£u z
HV¡ ¢c−u Seü¡ÙÛÉ fË−u¡Se…¢m ¢WL Ll−a, ÙÛ¡e£u pÇfc…¢m ¢Q¢q²a Ll−a, h¢ql¡Na p¡q¡−kÉl
fË−u¡Se£a¡ j§mÉ¡ue Ll−a Hhw Seü¡−ÙÛÉl Efl ¢hfkÑ−ul pñ¡hÉ fËi¡h…¢m Ae¤j¡e Ll−a - p¡q¡−kÉ
L−l z
f¢ÕQjh−‰l fË¡u 55 . 8 % Hm¡L¡ heÉ¡ fËhe z BCm¡u fË¡u 63 mr j¡e¤o Hhw 5 m¡M f¢lh¡l
fËi¡¢ha qu z
24 flNe¡l 13,50,000 −j¡V SepwMÉ¡l j−dÉ BCm¡u ü¡−ÙÛÉl Efl ¢ejÀ¢m¢Ma fËi¡h…¢m f−s x
• 53,840 S−el X¡C¢lu¡ qu Hhw a¡l j−dÉ 11 Se j¡l¡ k¡e z
• 61 Se−L p¡−f L¡js¡u Hhw a¡l j−dÉ 2 Se j¡l¡ k¡u z
• 6,17,000 j¡e¤o Bqa qu z
• 22,400 Se jÉ¡−m¢lu¡, −X¢‰ Hhw L−ml¡u Bœ²¡¿¹ qu z

f¢ÕQjh−‰ ü¡ÙÛÉ AhÙÛ¡l f¢lpwMÉ¡e x

f¢ÕQjh‰ hÔL / −Sm¡
¢nö jªa¥É q¡l 35 fË¢a 1000 (2008)
5 hR−ll e£−Ql ¢nö jªa¥É q¡l 59 .6 fË¢a 100 (NFHS J
2005-2006)
jªa¥É q¡l 6 .2 (2008)
jdÉj −nËe£l Af¤¢ø (MAM / 2u −nËe£) 27 . 6% MAM hu−pl Ae¤f¡−a JSe
EµQ −nËe£l Af¤¢ø (SAM / 3u Hhw 4bÑ 11 .1 (NFHS J
−nËe£) 2005 - 2006)

−R¡V −l¡NhÉ¡¢d - p¢cÑ, L¡¢n, SÆl, X¡C¢lu¡, L«¢j, L¡V¡ J hÉ¡bÉ¡, ra J BO¡a −Q¡M m¡m qJu¡ Hhw
AeÉ¡eÉ Hm¡¢SÑ ANM Hhw NË¡jÙ¹l£u ü¡ÙÛÉ LjÑ£ à¡l¡ ¢Q¢Lvp¡ qu z

QjÑ−l¡−N - Rœ¡L O¢Va pwœ²je, −M¡p-fy¡Qs¡ QjÑ−l¡N CaÉ¡¢c z

f¤−l¡−e¡ −l¡N / hÉ¡¢d
f¢ÕQjh‰ J i¡l−a f¤−l¡−e¡ −l¡NhÉ¡¢d (NFHS J 2005 - 2006)

fË¡c¤iÑ¡h f¢ÕQjh‰ i¡la
fË−jq (Diabetes) f¤l¦o 23 .23 /100 10 .51
fË−jq (j¢qm¡) 16 .41 8 .81
qy¡f¡¢e (Asthama) f¤l¦o 43 .65 /1000 16 .27
qy¡f¡¢e (j¢qm¡) 36 .04 16 .96
b¡Cl−uX (f¤l¦o) 6 .67 /1000 3 .83
b¡Cl−uX (j¢qm¡) 16 .26 9 .41

3

pwœ²¡jL hÉ¡¢dl ¢hÙ¹¡l / Rs¡−e¡ :
AfkÑ¡ç ab¡ ¢ejÀ j¡−el f¡e£u Sm, M¡l¡f ü¡ÙÛÉ hÉhÙÛ¡ Hhw Aü¡ÙÛÉLl / M¡l¡f AiÉ¡p −b−LC −l¡N
hÉ¡¢d Rs¡u z e£−Q −cJu¡ RL −b−L −h¡T¡ k¡−h −k, jm J M¡cÉ à¡l¡ ¢Li¡−h pwœ²je Rs¡u z H¢V−L
Cw−lS£−a F - Diagram h¡ f’ F - Diagram hm¡ qu z −k−qa¥ HM¡−e fËc¢nÑa pwœ²je Rs¡−e¡l
j¡dÉj…¢m phC Cwl¡¢S F Arl ¢c−u öl¦ - a¡C H¢V Hl©f e¡j z j¡dÉj…¢m qm kb¡ -
Finger - B‰¥m
Flies - j¡¢R
Field - j¡W / O¡V
Fluids - alm Hhw
Food - M¡h¡l

¢hfkÑ−ul f−l X¡C¢lu¡ L−ml¡ Hhw jÉ¡−m¢lu¡ fË−L¡f −cM¡ k¡u z ¢hfkÑ−ul fl jm J M¡cÉ à¡l¡
pwœ²¢ja X¡C¢lu¡ / L−ml¡ jq¡j¡l£l BL¡l d¡le Ll−a f¡−l z p¡d¡le AhÙÛ¡−aJ HC pwœ²¡jL
hÉ¡¢d…¢m F - Diagram h¢eÑa j¡dÉj à¡l¡C HLS−el −b−L AeÉS−el qu z
¢e−jÀ h¢eÑa 5¢V "F'Hl j−dÉ −k−L¡−e¡ HL¢Vl j¡dÉ−jC pwœ²je pñh z j−ml j−dÉ Ah¢ÙÛa −l¡N pª¢øL¡l£
S£h¡e,¤ −e¡wl¡ q¡a, j¡¢R, j¡W-O¡V (S¢j/j¡¢V), alm fc¡bÑ (Sm) Hhw M¡−cÉl j¡dÉ−j pl¡p¢l j¡e¤−ol
nl£−l fË−hn L−l z HC i¡−hC fË¡b¢jL pwœ²je O−V z R¡s¡J kMe −l¡Npª¢øL¡l£ S£h¡e¤ Sm −b−L M¡−cÉ
¢Lwh¡ −e¡wl¡ B‰¥−ml j¡dÉ−j M¡−cÉ −fy£R¡u - a¡−L h−m ¢àa£u Ù¹−ll pwœ²jZ z e£−Q −cJu¡ F -
Diagram H HCph Øføi¡−h −cM¡ k¡u -

4

F – Diagram H c¢nÑa Emð −lM¡…¢m pwœ²j−el f−bl h¡dL…¢m−L −cM¡−µR z HC h¡d¡…¢mC pwœ²je
Rs¡−e¡ fË¢a−l¡d L−l z Sm, ü¡ÙÛÉ¢hd¡e J ü¡ÙÛÉ ¢h¢d pðå£u ¢h−no fc−rf à¡l¡J pwœ²je fË¢a−l¡d
pñh z HC fc−rf…¢m−L fË¡b¢jL ab¡ ¢àa£u Ù¹−ll fË¢a−l¡dL hm¡ −k−a f¡−l z fË¡b¢jL fË¢a−l¡d−Ll
L¡S jm −b−L −l¡N pª¢øL¡l£ S£h¡e¤−L B‰¥m, j¡¢R, alm J M¡cÉ −b−L c§−l l¡M¡ z ¢àa£u Ù¹−ll
fË¢a−l¡dL qm −pC fc−rf…¢m k¡, ¢àa£u Ù¹−ll pwœ²je fË¢a−l¡d L−l z f¢l−n−o hm¡ −k−a f¡−l −k,
fË¡b¢jL fË¢a−l¡dL qm Sm J ü¡ÙÛÉ¢hd¡−el Eæu−el fc−rf…¢m z

−l¡N pwœ²j−el T¥y¢L qÊÊ¡pL¡l£ fy¡Q¢V fË¢a−l¡dL x
1) j¡a« J ¢nö ü¡ÙÛÉ x H¢V−L haÑj¡−e fËSee J ¢nö ü¡ÙÛÉJ hm¡ qu z NiÑ¡hÙÛ¡ L¡m£e p¤lr¡ J
¤
kaÀ (ANC) q¡pf¡a¡−m fËph J V£L¡Lle j¡a« J ¢nö ü¡−ÙÛÉl A¿¹NÑa z

2) Sm, ü¡ÙÛÉ¢hd¡e J ü¡ÙÛÉ¢h¢d (WASH) x ¢höÜ f¡e£u Sm (Sm f¢lú¡l J f¢l−o¡de), jmj§œ
aÉ¡−Nl SeÉ −n±Q¡N¡l J q¡a −d¡Ju¡ (M¡h¡l B−N J −n±−Q k¡Ju¡l fl) H¢Vl A¿¹ÑNa z p¡h¡−el
hÉhq¡l L−l i¡−m¡i¡−h q¡a −d¡Ju¡V¡ AaÉ¿¹ Sl¦l£ z

3) M¡cÉ x S−eÈl Bd O¾V¡l j−dÉ öl¦ L−l ¢nö−L 6 j¡p hup fkÑ¿¹ −Lhmj¡œ j¡−ul c¤d
M¡cÉ −cJu¡
AaÉ¡hnÉL z 6 j¡p hu−pl fl −b−L ¢nö−L j¡−ul c¤−dl f¡n¡f¡¢n AeÉ¡eÉ M¡h¡lJ ¢c−a q−h z a−h
j¡−ul c¤d 2 hRl fkÑ¿¹ Q¡m¤ b¡L−h z p−cÉ¡S¡a J ¢nö M¡cÉ hÉhq¡l (IYCF) Ae¤p¡−l 3 - 6 hR−ll
¢nö−cl (Pre - School Children) A¡‰eJu¡¢s −L−¾cÊ ab¡ 6 hR−ll E−ÜÑl ¢nö−cl ¢hcÉ¡m−u Af¤¢ø
¢eu¿»−el fc−rf z

4) Qa¥bÑ fË¢a−l¡dL qm Apwœ²¢ja −l¡N - hÉ¡¢dl SeÉ
S¥m¡C Hhw BNø j¡−p p¡−f L¡V¡ −l¡N£−cl fË¡Z lr¡l SeÉ pjÙ¹ fË¡b¢jL ü¡ÙÛÉ−L−¾cÊ p¡−fl ¢ho
eøL¡l£ Kod (AVS) l¡M¡−a q−h z
i¡−m¡ m¡Cg SÉ¡−LV °al£ L−l ¢hale Ll−m S−m −X¡h¡l Ty¥¢L qÊÊ¡p Ll¡ k¡−h z
Ts J ¢hcÉ¥v −b−L p¤¤l¢ra h¡¢s °al£ Ll−m jªaÉ¥ / S£he q¡e£l Ty¥¢L Lj¡−e¡ k¡−h z p¤¤l¢ra
h¡¢s e¡ b¡L¡u 2010 p¡−ml V−eÑ−X¡−a Ešl ¢ce¡Sf¤−l hý j¡e¤o j¡l¡ k¡u z

5z f’j fË¢a−l¡dL qm f¤−l¡−e¡ −l¡N /hÉ¡¢dl SeÉ x Efü¡ÙÛÉ −L−¾cÊ fl£r¡l j¡dÉ−j fË−jq (Diabetes),
EµQ lš²Q¡f (High Blood Pressure) Hhw AeÉ¡eÉ f¤−l¡−e¡ hÉ¡¢d ¢Q¢q²a Ll−a p¡q¡kÉ L−l z
f¢ÕQjh−‰l 53 % NË¡j heÉ¡ fËhe, HCph Hm¡L¡u f¤el¦Ü¡l pq f¤ehÑ¡pe J f¤e¢eÑj¡e M¤hC L¢We z
HCph ¢hfkÑu −j¡L¡¢hm¡ Ll¡l SeÉ plL¡l£ Hhw −h-plL¡l£ pwÙÛ¡l HLp−‰ L¡S Ll¡ E¢Qv z p¢ð−al
fl¡jnÑ Ae¤k¡u£, fË¢a¢V hÔ−L plL¡l£ B¢dL¡¢lL J X¡š²¡l−cl HL¢V cm NWe Ll¡ fË−u¡Se z HC c−ml
fË¢a¢V hÉ¢š²l −k¡N¡−k¡−Nl eðl hÔ−L pL−ml L¡−R b¡L¡ fË−u¡Se z ¢hfkÑ−ul f§−hÑl ab¡ ¢hfkÑ−ul f−ll
LjÑp§Q£…¢mlJ f¢lLÒfe¡ L−l l¡M−a q−h z

5

4z A¢d−hne f¢lLÒfe¡ (Session Plan):

pju A¢d−hnel
A¢d−hnel L¡kÑ ¢hhle£
fËbj 5 ¢j¢eV fË¢nrL A¢d−hnel E−ŸnÉ Hhw f¤−l¡ fË¢nr−Z Hl a¡vfkÑ ¢L a¡ heÑe¡ L−l
öl¦ Ll−he z
â¥a ¢Q¿¹−el j¡dÉ−j H¢V Ll−a 2 ¢j¢eV pju m¡N−h z fË¢nrL fËnÀ Ll−he -
""ü¡ÙÛÉ ¢L ?'' Hhw ¢nr¡bÑ£−cl p¡q¡kÉ Ll−he Ešl ¢c−a z k¡ ü¡−ÙÛÉl d¡le¡
¢c−a p¡q¡kÉ Ll−h z ¢nr¡bÑ£−cl −cJu¡ Ešl…¢m −h¡−XÑ ¢m−M l¡M−a q−h z
−n−o ¢e−jÀl abÉ…¢ml Efl −S¡l −cJu¡ clL¡l z

öd¤ j¡œ −l¡N ¢hq£e q−mC ü¡ÙÛÉ i¡−m¡ qu e¡ z
Ef¡c¡e …¢m ¢e¢cÑø Ec¡qle ¢c−u heÑe¡ Ll−a q−h, kb¡ -
°c¢qL - L¡S Ll−a Hhw Ef¡SÑe Ll−a prj z
j¡e¢pL - ¢Q¿¹¡ j¤š² q−a q−h z
p¡j¡¢SL - ü¡d£ei¡−h ¢e−Sl ja fËL¡n Ll−a f¡l−h z

6 - 10 ¢j¢eV ¢hfkÑu pñ¡he¡ qÊÊ¡pLl−e ü¡ÙÛÉ f¢l−oh¡ pÇf−LÑ −h¡T¡−e¡l SeÉ ¢ejÀ¢m¢Ma
cªnÉ…¢m hÉhq¡l Ll¡ q−h z

cªnÉ 1 x ü¡ÙÛÉ f¢l−oh¡ Hhw NWe

ü¡ÙÛÉ f¢l−oh¡l ¢ae¢V Ef¡c¡e pÇf−LÑ heÑe¡ x Ec¡qle - Efü¡ÙÛÉ
−L¾cÊ
pj¡−Sl pwœ²¡jL −l¡N…¢m ¢eu¿»e x −kje - kr¡ ¢eu¿»e Abh¡
jq¡j¡¢ll ¢Q¢Lvp¡, Apwœ²¡jL −l¡N ¢e¿»ue x −kje - EµQ lš² Q¡f/
ra / fËSee J ¢nö ü¡ÙÛÉ z
11 - 15 ¢j¢eV f¢ÕQjh−‰l ¢h¢iæ ü¡ÙÛÉ f¢l−oh¡l NW−el Efl fË¢nrLl¡ −S¡l −c−he z
HM¡−e ü¡−ÙÛÉl p¡−b k¤š² ¢h¢iæ pwÙÛ¡l Efl −S¡l −cJu¡ q−h, kb¡ - ANM,
ASHA Hhw AWW z fË¡b¢jL ü¡ÙÛÉ−L¾cÊ, Efü¡ÙÛÉ −L¾cÊ CaÉ¡¢cl NWeJ
heÑe¡ L−l ¢c−a q−h z

6

16 - 30 ¢j¢eV cªnÉ x 2

cª−nÉl heÑe¡ :
- hÉ¡e¡l H ¢fË¾V q−u b¡L¡ 2ew
¢Qœ¢V −cM¡−e¡ q−h z
¢hfkÑ−ul pju −k ph p¡d¡le −l¡N
−cM¡ k¡u a¡l heÑe¡ HM¡−e B−R z
kb¡ - ra, S−m −X¡h¡, X¡C¢lu¡,
jÉ¡−m¢lu¡, q¡j, ¢eE−j¡¢eu¡ pcÉS¡a
¢nöl jªaÉ¥ Ca¡¢c z
fË¢nrL 2 ew ¢Qœ¢V AwnNËqeL¡l£−cl −cM¡−he Hhw −l¡N…¢ml pÇf−LÑ
pw¢rç d¡le¡ −c−he z
31 - 45 ¢j¢eV f¢ÕQjh−‰ ¢h¢iæ −l¡−Nl f¢lpwMÉ¡e x
Q¡VÑ −cM¡−a q−h (a¡¢mL¡ 1 Hhw 2) k¡−a f¢ÕQjh−‰ p¡d¡le −l¡N…¢m ¢Qq²a
Ll¡ b¡L−h z
jªa¥É / jªa¥Él q¡l - l¡−SÉl j¡e¤−ol jªa¥Él q¡l−L ÙÛ¡e£u IMR USMR Hl
p¡−b a¥me¡ Ll−a q−h z BPOH h¡ hÔL ü¡ÙÛÉ B¢dL¡¢l−Ll −b−L ÙÛ¡e£u jªa¥É
q¡l −S−e ¢e−a q−h z
f¤¢ø - (hª¢Ü fkÑ−hre) - CDPO h¡ DPO - l −b−L ÙÛ¡e£u f¤¢ø pwœ²¡¿¹ abÉ
¢e−u ÙÛ¡e£u AhÙÛ¡ l¡−SÉl p¡−b a¥me¡ Ll−a q−h z
46 - 60 ¢j¢eV

Fig: F diagram
−Lje i¡−h −l¡−Nl fË¡c¤Ñi¡h O−V ?
fË¢nrLl¡ HC fËnÀ ¢c−uC B−m¡Qe¡ öl¦ Ll−he z Hlfl iy¡S Ll¡ hÉ¡e¡−ll
R¢h¢V AwnNËqeL¡l£−cl −cM¡−a q−h Hhw −l¡−Nl e¡j …¢m J −Le −p…¢m
O−V a¡ ¢Q¢q²a Ll−a hm−a q−h z ¢Qœ¢V AwnNËqeL¡l£−cl L¡−R heÑe¡ L−l
¢c−a q−h Hhw fË¢a¢V Ef¡c¡e −k HL¢V Afl¢Vl p¡−b k¤š² - a¡ −h¡T¡−a
q−h z hÉ¡e¡−ll ¢Qœ −c¢M−u −h¡T¡−a q−h −k −Ljei¡−h jm −b−L −l¡N£l
B‰¥m, M¡cÉ, j¡W-O¡V, alm Hhw j¡¢R −b−L ¢Li¡−h −l¡N R¡s¡u z

7

61 - 75 ¢j¢eV AwnNËqej§mL B−m¡Qe¡ x −l¡N pwœ²j−el fË¢a−l¡dL…¢m heÑe¡ Ll−a q−h z
AwnNËqeL¡l£−cl ¢S‘¡p¡ Ll−a q−h −k, ¢Li¡−h −l¡Nj¤š² q−a f¡¢l ? a¡−cl
ja¡ja…¢m−L ü¡Na S¡¢e−u −p…¢m−L heÑe¡ Ll−a hm−a q−h z Hh¡l ¢Qœ
−c¢M−u −l¡−Nl Ty¥¢L qÊÊ¡pLl−el fË¢a−l¡dL…¢m hÉ¡MÉ¡ L−l ¢c−a q−h z
1 . j¡a« Hhw ¢nö ü¡ÙÛÉ;
2 . Sm, ü¡ÙÛÉ¢hd¡e Hhw ü¡ÙÛÉ ¢h¢d (WASH)
3 . M¡cÉ
4 . Apwœ²¡jL −l¡NhÉ¡¢d fË¢a−l¡d, p¡−fl ¢ho eøL¡l£ Kod, S−m −X¡h¡l
−b−L hy¡Q¡l SeÉ m¡Cg SÉ¡−LV, p¤¤l¢ra h¡¢s °al£ CaÉ¡¢c z
5 . f¤−l¡−e¡ −l¡N ¢Q¢q²aLl−el SeÉ fl£r¡ : AwnNËqeL¡l£−cl Seü¡ÙÛÉ J
Ty¥¢L pð−å kb¡ pñh ¢hÙ¹«a heÑe¡ ¢c−u A¢d−hn−el pj¡¢ç −O¡oe¡ Ll¡ q−h z

5z fË¢nre fÜ¢a (Training Method) x

A¢d−hn−el Awn fÜ¢a

A¢d−hnel E−ŸnÉ, fË¢nr−Z Hl a¡vfkÑ â¥a ¢Q¿¹e

¢hfkÑu pñhe¡ qÊÊ¡pLl−e ü¡ÙÛÉ f¢l−oh¡, cª−nÉl hÉhq¡l
¢hfkÑ−ul pju - p¡d¡le −l¡N

−l¡−Nl fË¡c¤Ñi¡h F- Diagram cª−nÉl hÉhq¡l

ü¡−ÙÛÉl eÉ§eaj j¡e Hhw 5¢V fË¢a−l¡dL fËnÀ Eš−ll j¡dÉ−j , AwnNËqej§mL
B−m¡Qe¡

6z fË−u¡Se£u EfLle (Material Required) x
• −h¡XÑ
• j¡LÑ¡l −fe
• ¢gÓÓf Q¡VÑ (Flip Chart)
• f§−hÑl ByL¡ cªnÉ - −f¡ø¡l, jn¡l R¢h, −e¡wl¡ Sm, j¡¢R
• hÉ¡e¡l
• IMR Hl USMR
• f¤¢øl ÙÛ¡e£u abÉ

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