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- {VZH$mo H$m¶©joÌ{^Ì OwZ ì¶{º$hê$gå‘ nw{JEH$mo N>Z¡ A{Z Omo {H$ZmarH¥$V N>Z² Ë¶ñVm ì¶{º$hê$gå‘ ñdmñÏ¶
godmhê$g{hV nw½Zw&
- ñdmñÏ¶ godmhê$ {b>>X± m{b>>X± ¡ d{#mV ÊH$mhê$bmB© {ZaÝVa ôQ>²Z OmZw, {VZrhê$~mao OmZH$mar OwQ>mCZw, godm J«hU JZ© ^Zr
{VZrhê$bmB© CËgm{hV Vwë¶mCZw a {VZrhê$bo godm {bBahoH$mo Hw$am gw{ZpíMV JZ©H$m bm{J ^«‘U J[aahZw&
2. J«m‘rU ñdmñÏ¶ Ed§ nmofU {Xdg (VHND)-‘m CnpñWV ahZw…
 ASHA -bo J««m‘rU ñdmñÏ¶ Ed§ nmofU {Xdg (VHND)-H$mo {‘{V a g‘¶~mao g‘wXm¶bmB© AmâZmo à^mdembr
Hw$amH$mZrH$mo H$bmÛmam OmZH$mar {XZo{N>Z²&
 AmâZmo {Z¶{‘V J¥h-n[a^«‘UH$mo ~obm {VZbo VHND -‘m CnbãY godmhê$~mao bm^mWuhê$bmB© OmZH$mar {XZo{N>Z² Vr
godmhê$ J«hU JZ© {VZrhê$bmB© àmoËgm{hV JZ}{N>Z²&
 {VZbo gwËHo$ar Am‘mhê$, Q>rH$mH$aU (Imon), n[adma {Z¶moOZ a AÝ¶ godmhê$H$mo {df¶‘m godm~mQ> d{#mV AWdm godm
{b>>X± m{b>>±X¡ Nw>Q>oH$mhê$bmB© {MpÝhV JZ}{N>Z² a VHND-H$mo {ZpåV {VZrhê$bmB© CËgm{hV Vwë¶mCZo{N>Z²&
6
 {VZr ñd¶§ AmâZmo joÌ‘m Am¶moOZ ^BahoH$mo VHND-‘m CnpñWV ahZo{N>Z² a Amdí¶H$ naoH$mo IÊS>‘m VHND-‘m
bm^mWuhê$bmB© gmW‘m {bEa OmZo{N>Z²&
 VHND-‘m {VZbo ANM a AWW-bmB© gh¶moJ JZ}{N>Z²&
 ‘mV¥ ñdmñÏ¶, {eew ñdmñÏ¶ a n[adma {Z¶moOZH$m {df¶hê$‘m {VZbo bm^mWuhê$bmB© gag„mh {XZo{N>Z²&
3. ñdmñÏ¶ ghþ{b¶VH$mo {ZpåV n[a^«‘Uhê$…

 ñdmñÏ¶ ghþ{b¶VH$mo {ZpåV ASHA J^©dVr ‘{hbmH$mo gmW‘m OmZo{N>Z² AWdm {VZH$mo gwajmH$mo {ZpåV {VZbmB©
Am’¡$bo ñdmñÏ¶ Ho$ÝÐ dm AñnVmb {bEa OmZo{N>Z²&
 Amdí¶H$ naoH$mo IÊS>‘m ñdmñÏ¶ ghþ{b¶VH$mo {ZpåV {~am‘r ZmZrH$mo gmW‘m {VZr Am’y$ n{Z OmZo{N>Z²&
 ASHA-bo à{ejU H$m¶©H«$‘‘m CnpñWV hþZH$m bm{J AWdm ~¡R>H$H$mo g‘rjmH$mo {ZpåV {ZaÝVa ñdmñÏ¶ Ho$ÝÐH$mo ^«‘U
JZ© g³Zo{N>Z²& Ho$hr ‘hrZm‘m ECQ>¡ ‘mÌ ^«‘U JZw©nZ}N>, Aê$ ‘hrZm Yoa¡ ^«‘Uhê$ hþZoN>Z²&
4. J«m‘rU ñVaH$m ~¡R>H$hê$ Am¶moOZ JZw©…

 ASHA-bo ñdmñÏ¶ gMoVZm ~‹T>mCZ a J«m‘rU ñdmñÏ¶ ¶moOZmhê$‘m gh¶moJ nwè¶mCZH$m bm{J {Z¶{‘V AmYma‘m
g‘wXm¶H$m gXñ¶hê$ a Aê$ g‘yhhê${gV ~¡R>H$hê$ Am¶moOZ JZ}{N>Z²&
 ASHA-bo àË¶oH$ ‘hrZm XþBdQ>m Kaobw ñVaH$m ~¡R>H$hê$ JZ}{N>Z²&
 Cº$ ~¡R>H$‘m {H$emoa-{H$emoarhê${gV {H$emoa ñdmñÏ¶~mao MMm©hê$bmB© gm‘ob J[aZoN>&
 ~¡R>H$H$mo {ZpåV ASHA-Ûmam V¶ma nm[aEH$m H$m¶©gyMrhê$H$m AmYma‘m ~¡R>H$hê$ Am¶moOZ J[aZoN>Z²&
 ~¡R>H$H$mo Vm[aI a g‘¶ ANM a AWW-hê${gV gag„mh Jaoa {ZpíMV J[aZoN>&
5. {ddaU-{Q>nmoQ>hê$H$mo aIaImC…
 ASHA-bo J«m‘rU ñdmñÏ¶ a{OñQ>a aIaImC a XþéñV am»Zo{N>Z² Og‘m {VZbo OÝ‘ a ‘¥Ë¶wH$mo nÄOrH$aU, ANC
bm^mWuhê$, Imon bJmBZwnZ} {eewhê$, gj‘ XånVrhê$~mao {ddaU boIoa am»Zo{N>Z²&
 ASHA-bo Am¡f{Y ^ÊS>maU a{OñQ>a (Am¡f{Yhê$H$mo ‘m{gH$ {ddaU bo{IZo a{OñQ>a)-H$mo aIaImC JZ}{N>Z², à‘wI
ñdmñÏ¶ {M{H$Ëgm A{YH$mar (CMOH)-bo Cn-Ho$ÝÐ‘m nR>mBZwnZ} a{OñQ>aH$mo ì¶dñWm JZ}N>Z²&
 ASHA-bo AmâZmo hmV‘m {bEH$mo H$m¶©H$mo {ZpåV H$m¶©H$m {Z¶‘hê$AZwgma Amdí¶H$ ~hr a H$mJO-nÌhê$H$mo
{Z¶{‘V aIaImC JZ}{N>Z²&
 ASHA-Ûmam J[aZo {H«$¶mH$bmnhê$H$m {dñV¥V {ddaU amÁ¶Ûmam ‘Revised Comprehensive Incentive Pakage of
ASHAs’ -‘m C„oI J[aEH$mo N>& ¶mo ‘mJ©-{ZX}{eH$mbmB© àË¶oH$ df© n[a‘m{O©V J[aÝN> A{Z amÁ¶ a ãbH$ ñVa‘m ECQ>m
{dÎmr¶ df©H$mo Ë¶ñV¡ ‘mJ©-{ZX}{eH$m CnbãY hþZoN>&
7
ASHA- H$m JwUhê$
Y¡¶©
ZoVË¥ d {XZw Ü¶mZ bJmEa

gwÝZw
gH$mamË‘H$ kmZ
ì¶dhma ASHA-‘m Ho$-Ho$
JwU hþZw Amdí¶H$
N>
n[al‘r ñdrH$m¶©Vm
H$m‘à{V Z‘«
bJZerbVm ì¶dhma
¶r JwUhê$ ‘hÎdnyU© {H$Z N>Z>²?>
 H$m¡ebg±Jg±J¡ kmZH$mo n{Z Amdí¶H$Vm nX©N> N> {H$Z^Zo ASHA-bo ‘mV¥ñdmñÏ¶ a {eewñdmñÏ¶H$m ajmË‘H$ a
CÝZ{V‘ybH$ (preventive and promotive) {Xemhê$ n{hë¶mEa amoJrH$mo {ZpåV à^mdH$mar ì¶dñWm AßZmCZ g³Zo{N>Z²
A{Z bm^mWubmB© Amdí¶H$ godm {XZ g³Zo{N>>Z²&
 Y¡¶© amIoa A{Z Ü¶mZ {XEa gwÝZw Amdí¶H$ N {H$Z^Zo ASHA-bo Y¡¶© amIoa Ü¶mZnyd©H$ ‘m{Zghê$H$mo Hw$am gw{ZZ² ^Zo
‘mÌ {VZbo {VZrhê$H$mo g‘ñ¶m am‘«ar ~wPoa {VZrhê$bmB© g„mh {XZ gp³N>Z²&
 {dZ‘« A{Z {‘ÌVmnyU© ì¶dhma Amdí¶H$ hþX± N> {H$Z^Zo ¶gbo ASHA-bmB© {VZH$mo JmC±{gV Agb gå~ÝYhê$ ñWm{nV
JZ© ‘XV nwè¶mC±N>&
 J«møVm Amdí¶H$ N>, {H$Z^Zo… g~¡ JwUhê$g±Jg±J¡ ¶{X ASHA g‘wXm¶g‘j ñdrH$m¶© ^BZ² AWm©V² g‘wXm¶bo {VZbmB©
ñdrH$ma Jè¶mo ^Zo {VZbo {dídmg AmO©Z JZ© g³Zo{N>Z² Ogbo {VZH$mo H$m¶©joÌ‘m gw{dYm nwè¶mCZoN>&
 ZoV¥Ëd {XZo Amdí¶H$Vm… ASHA-‘m ¶{X ZoV¥Ëd {XZo j‘Vm N> ^Zo {VZr g‘wXm¶H$m AÝ¶ gh^mJrhê$, OñV¡- ‘{hbm
Amamo½¶ g{‘{V, Am±JZdm‹S>r H$‘u, ANM à‘wIhê${gV Agb Vmb‘ob am»Z gj‘ hþZ{o N>Z²& ¶gbo {VZbmB© g‘wXm¶‘m
à^mdH$mar ^y{‘H$m nmbZ JZ©, OñV¡- g‘wXm¶‘m {‘{Q>L> JZo© dm g‘wXm¶bmB© g{H«$¶ am»Zo Am{X H$m¶©‘m ghm¶Vm
nwè¶mCZoN>&
 gH$mamË‘H$ ì¶dhma Amdí¶H$ N>, {H$Z^Zo… gH$mamË‘H$ ì¶dhmabo ASHA-bmB© Z¶m± H$m¡eb àmá JZ} joÌ‘m CËgm{hV
Vwë¶mC±XN>, ¶gmo hþ±Xm ASHA g{Ob¡{gV H${R>Z n[apñW{VH$mo gm‘Zm JZ© gj‘ hþZo{N>Z²&
8
 n[al‘r a H$m‘à{V bJZerbVm hþZw Amdí¶H$ N>, {H$Z^Zo… {d{^Þ joÌ‘m ASHA-bo {d{^Þ H${R>Z n[apñW{V‘m H$m‘
JZw©nZ} hþÝN>, ¶g¡H$maU {VZH$mo AmâZmo H$m‘à{V bJZerbVmbo g‘ñ¶m g‘mYmZ‘m ghm¶Vm nwè¶mC±XN>&
ASHA-H$m¶©H$« ‘H$m C„oIZr¶ n[aUm‘hê$…
‘mV¥ ñdmñÏ¶à{V ASHA-H$m {H«$¶mH$bmhê$H$m C„oIZr¶ n[aUm‘hê$-

 àË¶oH$ J^©dVr ‘{hbm A{Z {VZH$mo n[admabo Amhma, Amam‘ OñVm Cn¶wº$ ñdmñÏ¶gå~ÝYr AmMaUhê$~mao àmoËgmhZH$mo
OmZH$mar A{Z àmá JX©N>Z² Ogbo J^m©dñWm, àgy{V, àgdnyd©H$mo hoaMmh A{Z n[adma {Z¶moOZ godmhê$‘m{W àH$me
nmX©N>&
 àË¶oH$ J^©dVr ‘{hbmbo Cn-ñdmñÏ¶ Ho$ÝÐ/VHND-‘m àgdn{N> a àgdnyd©H$m hoaMmh àmá JX©N>Z²&
 J^©dVr ‘{hbm ÊH$mo àË¶oH$ n[admabo ¶moOZm ~ZmEH$mo hþÝN A{Z> {eewH$mo OÝ‘H$mo {ZpåV V¶mar JaoH$mo hþÝN>&
 n[adma {Z¶moOZ JZ© MmhZo àË¶oH$ gj‘ XånVrbo Amdí¶H$ OmZH$mar a godmhê$ àmá JaoH$m hþÝN>Z²&
ZdOmV A{Z {eew ñdmñÏ¶à{V ASHA-H$m {H«$¶mH$bmnhê$H$m C„oIZr¶ n[aUm‘hê$-

 àm¶… Z¡ g‘ñ¶mhê$ XoIm naoH$m ~obm H$m¶©Vm{bH$mAZwgma àË¶oH$ Ka‘m ZdOmVbmB© hoZ© J¥h-n[a^«‘U J[aÝN> A{Z
AñdñW ZdOmVH$mo {ZpåV àË¶oH$ Kabo Amdí¶H$ Kaobw AmYm[aV A{Z Cn¶wº$ Amdí¶H$ hoaMmh àmá JX©N a
Amdí¶H$ nao ñdmñÏ¶ Ho$ÝÐ‘m nR>mBÝN>&
 àË¶oH$ n[admabo Imon godmhê$H$mo {ZpåV Amdí¶H$ godmhê$ àmá JX©N>&
 XþB df©^ÝXm H$åVr C‘oaH$m ZmZrhê$ ÊH$m g~¡ n[admahê$bmB© gag„mh {XBÝN> A{Z ‘bo[a¶m, nImbmo a OrU©
ídmggå~ÝYr gL²>H«$‘U OñVm {~‘mar A{Z aº$mënVm a Hw$nmofUH$mo amoH$Wm‘H$m bm{J ghm¶Vm àXmZ J[aÝN> a
Amdí¶H$ nao g‘¶‘¡ ñdmñÏ¶ Ho$ÝÐ‘m nR>mBÝN>&
 nm±M df©^ÝXm H$åVr C‘oaH$mo àË¶oH$ ZmZrbmB© nImbmo, Ádamo, OrU© ídmggå~ÝYr gL²>H«$‘U (ARI) A{Z noQ>‘m H¥${‘H$mo
g‘ñ¶m Ê CgbmB© PÅ>¡ ñdmñÏ¶ Ho$ÝÐ‘m b¡OmZwnZ} hmo dm hmoBZ ^Þo~mao gag„mh {XBÝN> AWdm ASHA-{gV ÊH$mo
Am¡f{Y a CnH$aUhê$Ûmam àW‘ CnMma‘ybH$ hoaMmh J[aÝN>&
amoJ-{Z¶ÝÌUà{V ASHA-H$m {H«$¶mH$bmnhê$H$m C„oIZr¶ n[aUm‘hê$-

 J¥h-n[a^«‘UH$mo ~obm Jm{‹S>EH$mo ImoH$s AWdm AÝYmonZ dm ËdMm‘m XmJhê$ Am{X ÊH$m ì¶{º$hê$ Xo{IE CZrhê$bmB©
Om±M a CnMmaH$mo {ZpåV Cn¶wº$ ñdmñÏ¶ Ho$ÝÐ‘m nR>mBÝN>&
 j¶amoJ AWdm Hw$ð>amoJ Am{XH$mo CnMmaH$mo {ZpåV bm‘mo g‘¶gå‘ Am¡f{Y {bBahoH$m {~am‘rhê$H$mo {ZaÝVa Om±M J[aÝN>
A{Z Amdí¶H$ Cnm¶hê$ AßZmBÝN>&
 Ádamo AmEH$m ì¶{º$hê$H$mo, OwZ Ádamo ‘bo[a¶m (AWdm H$mbmo Ádamo) n{Z hþZg³N>, {~‘mar IwQ>çmCZ aº$ Om±M
JamBÝN> A{Z Cn¶wº$ CnMma àXmZ J[aÝN> AWdm ñdmñÏ¶ Ho$ÝÐ‘m nR>mBÝN>&
9
ASHA-hê$H$mo {ZJamZr a XoIaoI
ñVahê$ XoIaoI a {ZJamZrH$mo {ZpåV {Oå‘odma ì¶{º$hê$
Cn-Ho$ÝÐ AmâZmo joÌ‘m H$m¶© J[aahoH$m 5-7 ASHA- hê$H$mo {ZJamZr a XoIaoI
ANM- bo JZ}N>Z²&
AmâZmo joÌ‘m H$m¶© J[aahoH$m 20-25 ASHA- hê$H$mo {ZJamZr a XoIaoI

J«m‘ n#mm¶V
J«m‘ n#mm¶V n¶©dojH$bo JZ}N>Z²&
J«m‘rU AñnVmbH$m gwna AWdm BPHC-H$m IÊS> ñdmñÏ¶ {M{H$Ëgm

IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ (BPHC)/J«m‘rU A{YH$ma (BMOH)-H$mo AYrZ‘m IÊS> OZñdmñÏ¶ n[aMm[aH$m (BPHN)-
AñnVmb (RH) bo ASHA-H$mo H$m¶©bmB© {VZH$mo joÌ‘m XoIaoI a {ZJamZr JZ}{N>Z²&
ãbH$ ASHA ’o${g{bQ>oQ>a (BAF), ãbH$ EH$mCÝQ> å¶mZoOa (BAM), S>mQ>m
EÝQ´>r AnaoQ>a (DEO) Am{Xbo {O„m ñVa‘m ASHA-hê$H$m H$m¶©hê$H$mo
XoIaoI a {ZJamZr JZ}N>Z²&
Cn ‘w»¶ ñdmñÏ¶ {M{H$Ëgm A{YH$mar (Dy. CMOH), {O„m OZñdmñÏ¶

n[aMm[aH$m A{YH$mar (DPHNO), {O„m ‘mV¥ Ed‘² {eew ñdmñÏ¶
A{YH$mar (DMCHO), {O„m H$m¶©H«$‘ g§¶moOH$ (DPC), {O„m ASHA
{Oëbm ñVa ghþ{b¶VH$Vm© (DAF) Am{X gm‘ob ahoH$mo A{Z CMOH-H$mo AYrZ‘m
ahoH$mo ECQ>m {ZJamZr àH$moð>bo {O„m ñVa‘m ASHA-hê$H$mo H$m¶©H$mo
XoIaoI a {ZJamZr JZ}N>&
am{ï´>¶ ñdmñÏ¶ {‘eZH$m {‘eZ {ZX}eH$H$mo AYrZ‘m ahoH$mo amÁ¶ ASHA

amÁ¶ ñVa àH$moð>bo amÁ¶ ñVa‘m ASHA-H$m {H«$¶mH$bmnhê$H$mo XoIaoI a {ZJamZr
JZ}N>&
10
^mJ-VrZ
H$m¶©H$Vm©H$m H$m¡ebhê$
H$m¶©H$Vm©‘m hþZnw Z} à‘wI H$m¡ebhê$ {ZåZ{b{IV hþZ-

²
 gånH©$ ñWmnZmH$m H$m¡ebhê$
 {ZU©¶ {bZo H$m¡ebhê$
 Hw$amH$mZr JZ} H$m¡ebhê$
 Vmb‘ob am»Zo H$m¡ebhê$
 AJwdmB JZ} H$m¡ebhê$
gånH©$ ñWmnZmH$m H$m¡ebhê$

gånH©$ ñWmnZm ^ZoH$mo Ho$ hmo?
gånH©$ ñWmnZm ^ZoH$mo {dMma a ^mdZmhê$H$mo A{^ì¶{º$H$mo à{H«$¶m AWdm ‘m{Zghê$bmB© OmZH$mar {XZo à{H«$¶m dm
{H«$¶mH$bmn hmo& AH$m}{Va, gånH©$ ñWmnZm JZ} H$m¶© ^ZoH$mo ~moboa, boIoa AWdm AÝ¶ Hw$Z¡ ‘mÜ¶‘ à¶moJ Jaoa OmZH$mar
~m±S²>Zw dm AmXmZ-àXmZ JZw© hmo&
àË¶oH$ gånH©$ ñWmnZm‘m (H$åVr‘m n{Z) EH$OZm àofH$, ECQ>m gÝXoe a EH$OZm àmnH$ dm J«hUH$Vm© gm‘ob ahoH$m hþÝN>Z²&
Hw$Z¡ ì¶{º$bo à^mdH$mar gånH©$ ñWmnZm JZ© ZgHo$H$mo IÊS>‘m ^«‘, H${R>ZmB A{Z ~wPmB~mao g‘ñ¶mhê$ CËnÞ hþÝN>Z²&
gånH©$ ñWmnZm EopÀN>H$ dm AZ¡pÀN>H$, nmaån[aH$ dm Anmaån[aH$, gL²>Ho$V‘m{W dm ^mfm‘m{W {Z^©a ahoH$mo hþZg³N>&
YoaOgmo ‘m{‘bmhê$‘m EH$V’}$ gånH©$ ñWmnZm nyU©ê$nbo à^mdH$mar hþ±X¡Z A{Z Yoa¡ pñW{Vhê$‘m Ë¶gbo ^yb ~wPm~wP a
H${R>ZmBhê$ CËnÞ JX©N>& ¶gH$maU à^mdH$mar gånH©$ ñWmnZm Xmohmoamo hþZwnN>©&
‘mÜ¶‘
àofH$ dm dº$m OmZH$mar dm J«hUH$Vm© dm lmoVm

Hw$amH$mZr
lmoVmH$mo
à{V{H«$¶m
11
à^mdH$mar gånH©$ ñWmnZm
à^mdH$mar gånH©$ ñWmnZm ^ZoH$mo Hw$Z¡ gÝXoe ¶ñVmo àH$mabo nR>mCZo à{H«$¶m hmo OgÛmam Ë¶mo gÝXoebo ^ÝZMmhoH$mo AW©
~wPmCZ g{H$¶mog²& ¶mo gånH©$ ñWmnZmH$mo Xmohmoamo à{H«$¶m hmo Og‘m-
 {dMma a ^mdZmhê$H$mo AmXmZ-àXmZ hþÝN>

 ¶moOZm a OmZH$marH$mo AmXmZ-àXmZ hþÝN>
à^mdH$mar gånH©$ ñWm{nV JZ} ì¶{º$ Adí¶¡ Agb lmoVm ~ÝZwnZ} hþÝN>& à^mdH$mar gånH©$ ñWmnZmH$mo ~obm g{Obmo,
gab ^mfm à¶moJ JZ}, Z‘«Vmnyd©H$ ~moëZo, Y¡¶© amIoa Aê$H$mo Hw$am gwÝZo, Hw$am gwÝZ CËgmh XoImCZo a àíZ JZ} BË¶m{X
{df¶hê$bmB© ‘Z‘m am»ZwnZ}N>&
gånH©$ ñWmnZm ‘m¡{IH$ AWdm A‘m¡{IH$ hþZg³N>-

‘m¡{IH$ gånH©$ ñWmnZm - YoaOgmo ‘m{‘bmhê$‘m ‘m{Zghê$bo AmâZm {dMmahê$ eãX a ^mfmÛmam ì¶º$ JX©N>Z²& ‘m¡{IH$
gånH©$ ñWmnZm JXm© eãXhê$ à¶moJ ^BahoH$m N>Z² ^ÝZo Hw$am{gV AdJV hþZwnX©N>&
‘m¡{IH$ gånH©$ ñWmnZmH$mo ~obm ¶mX am»ZwnZ} Hw$amhê$…

 gånH©$ ñWmnZm ewé JZ©H$m bm{J ì¶{º$bmB© A{^dmXZ JZw© a AmâZmo n[aM¶ {XZw A{Z Am’y$ Ë¶hm± AmCZwH$mo CÔoí¶
~VmCZw Amdí¶H$ N>&
 H$g¡g±J gånH©$ ñWmnZm JXm© AH$m} ì¶{º$H$m Am±Im‘m hoaoa Hw$amH$mZr JZw© Amdí¶H$ N>&
 ñnï> a gwÝZ g{H$Zo Jar Z‘« ñda‘m ~moëZwnX©N>, gmW¡ AmXaH$mo n{Z I¶mb am»ZwnX©N>&
 H$g¡g±J gånH©$ ñWm{nV dm Hw$amH$mZr JXm© AmâZmo Hw$ambmB© ghr {dam‘ {MÝh à¶moJ JX£ gab ^mfm‘m Ymamàdmh àñVwV
JZw©nX©N>&
 gånH©$ ñWmnZm JXm© AmâZmo {dMmabmB© Iw„m am»ZwnX©N> A{Z AH$m} ì¶{º$H$mo {dMmaà{V AmXa Xem©CZwnX©N>&
 gånH©$ ñWmnZm J[aahoH$mo ~obm lmoVmbo Hw$Z¡ àíZ JZ© AWdm Hw$Z¡ Hw$am OmÝZ MmhoH$mo IÊS>‘m Ë¶gH$mo CÎma {XZwnX©N>
AWdm Ë¶gbmB© ñnï> nmZw©nX©N>& ¶gmo JXm© dº$m a lmoVm‘mP Agb ~wPm~wP g¥OZm hþÝN>&
 Hw$amH$mZr J[aahoH$mo ~obm dº$m a lmoVm Xþd¡bo {deof a àË¶j gånH©$ ñWm{nV JaoH$mo hþZwnN>©&
 à^mdH$mar ‘m¡{IH$ gånH©$ ñWmnZm‘m ~mo{bZo Hw$am gQ>rH$, àï> a N>mQo >mo hþZwnN>©&
A‘m¡{IH$ gånH©$ ñWmnZm…

A‘m¡{IH$ gånH©$ ñWmnZm ^ZoH$mo A‘m¡{IH$ ‘mÜ¶‘, OñV¡- Am±ImH$mo B©emam, AZwhmaH$mo A{^ì¶{º$, gL²>Ho$V, ‘wÐm A{Z
XþB ì¶{º$~rMH$mo XÿarÛmam gÝXoe AWdm gL²>Ho$Vhê$H$mo g#mma hmo& ¶ñVmo pñW{V‘m, gQ>rH$ a AW©nyU© V[aH$mbo EH$AH$m©{gV
gånH©$ ñWm{nV JZw© ‘hÎdnyU© Hw$am hþ±XN>&
A‘m¡{IH$ gånH©$ ñWmnZmH$mo ~obm ¶mX am»ZwnZ} Hw$amhê$…

 Am±Im‘m hoZw©… ¶ñVmo gånH©$ ñWmnZm JXm© Am±Im‘m hoZw© AË¶mdí¶H$ hþÝN>& ¶gbo dº$mH$mo AmË‘{dídmg a gË¶Vm
Xem©C±N>&
12
 emar[aH$ hmd^md… Hw$Z¡ ‘m{Zgg±J gånH©$ ñWm{nV JXm© CgH$mo gm‘wÝZo C{^Zw AWdm ~ñZw, hm±ñZw Am{Xbo ^ZmBbmB©
gQ>rH$ ê$n‘m ì¶º$ JZ© ghm¶Vm JX©N>&
 AZwhmaH$m A{^ì¶{º$hê$… A‘m¡{IH$ gånH©$ ñWmnZmbmB© à^mdH$mar ~ZmCZw hmo ^Zo AZwhmaH$mo dmñV{dH$ ^md ì¶º$
JZw© Amdí¶H$ hþ±XN>& gånH©$ ñWmnZmH$mo ~obm AZwhmaH$m hmd^mdbo Yoa¡ Hw$amhê$ ì¶º$ JX©N>Z²& Va ECQ>m Hw$am ‘Z‘m
am»Zw Amdí¶H$ N>, Ë¶gmo JXm© lmoVmg‘j Hw$Z¡ ZH$mamË‘H$ gÝXoe ZnwJmog²& AZwhmaH$mo gH$mamË‘H$ a ¶WmW© hmd^mdbo
gånH©$ ñWmnZmH$mo joÌ‘m Yoa¡ à^md nmX©N>&
 gL²>Ho$V… Hw$Z¡ {df¶bmB© ^ZmBg±Jg±J¡ B©emam Jaoa ì¶º$ Jao Ë¶gH$mo ‘hÎd AP ~‹T>oa OmÝN> Va Ë¶gbo Hw$Z¡ {MÝVm dm
CÎmoOZm Xem©EH$mo hþZw hþ±X¡Z&
ASHA A{Z gånH©$ ñWmnZmH$mo ‘hÎd…

g~¡ J¥h-n[a^«‘Uhê$H$mo ~obm ASHA-bo {ZåZ{b{IV Hw$amhê$ nmbZ JZw©nX©N>…
 ‘{hbm/bm^mWubmB© A{^dmXZ JZw©nN>©&
 n[a^«‘UH$mo H$maU ~VmCZwnN>©&
 ¶ñVmo ì¶dhma JZw©nN>© Og‘m ‘{hbm a n[admaH$m gXñ¶hê$bo {VZr‘m{W âmogm JZ©gHy$Z²&
 ¶ñVmo àH$mabo ~moëZwnN>© Vm{H$ ‘{hbm a CgH$mo n[admabo {VZr‘m{W {dídmg JZ©g³Zo AZw^d Jê$Z²&
 Za‘ ñda‘m ~moëZwnN>©&
 ñWmZr¶ ^mfm‘m gab eãXhê$ à¶moJ JZw©nX©N>&
 AmXa Xem©CZwnN>©&
 ‘{hbmbo Hw$Z¡ Agb Hw$am Jao CZH$mo gamhZm JZw©nN>© Vm{H$ CZbo AmâZm Hw$amhê$ {ZaÝVa am»X¡ OmD$Z²&
 Ë¶mo n[admabo ñdmñÏ¶dÕ©H$ ImZnmZH$mo ~mZr {H$Z ~gmboH$mo N>¡Z ^ÝZo~mao ~wÂZo à¶mg JZw©nN>© Va VH©$ JZw© dm Hw$Z¡
Hw$ambmB© Zam‘«mo R>hè¶mCZw hþ±X¡Z&
 Am’y$ ‘mÌ ~moëZw hþ±X¡Z, Aê$H$mo Hw$am gwÝZw n{Z nN>©&
 ‘{hbm/bm^mWubo Hw$Z¡ àíZ JZ©Mmho àíZ gwZoa Ë¶gH$mo CÎma {XZo à¶mg JZw©nN>©&
 eL²>H$m-CneL²>H$mhê$bmB© gab ^mfm‘m {Z‘y©b nmZw©nX©N>&
 J¥h-n[a^«‘Uhê$ g{H$En{N> ’${H©$ZwA{K ‘{hbm/bm^mWubmB© YÝ¶dmX {XEa AH$m} n[a^«‘UH$mo {‘{V OZmB{XZwnN>©&
{ZU©¶ {bZo XjVmhê$

"{ZU©¶ {bZw'-H$mo n[a^mfm…
haoH$ {ZU©¶H$mo {ZaÝVaVm hþÝN, ¶gH$maU Hw$Z¡ n{Z {ZU©¶‘m ì¶{º$H$mo OrdZ n[adV©Z JZ} gm‘Ï¶© ahoH$mo hþÝN>& g‘yh‘m ahoH$m
‘m{Zghê${gV gag„mh Jaoa gm‘y{hH$ {ZU©¶ {bZwnX©N> {H$Z^Zo ¶ñVmo {ZU©¶~mQ> g‘yh‘m ahoH$m ì¶{º$hê$bmB© bm^ hþZoN>&
{ZU©¶ J«hUH$m MaUhê$
{ZU©¶ J«hUH$m ~w{Z¶mXr MaUhê$ hþÝN>Z² Omo {ZåZ{b{IV hþZ²…
MaU 1… {ZU©¶H$mo CÔoí¶ {MpÝhV JZw©
n{hbmo MaU‘m g‘ñ¶mH$mo {díbofU JZw©nN>© A{Z Ë¶mo {ZU©¶ {H$Z {b>B±X¡N> ^Þo Hw$am ~wÂZwnN>&© {ZU©¶ {bBZwH$m H$maUhê$bmB©
Ho$hr àíZhê$ Jaoa ~wÂZ g{H$ÝN>, OñV¡-
13
 g‘ñ¶m Ho$ hmo?
 Ë¶mo g‘ñ¶m g‘mYmZ J[aZw {H$Z Amdí¶H$ N>?
 Ë¶mo g‘ñ¶mÛmam H$mo à^m{dV ^BahoH$mo N>?
 Ë¶mo g‘ñ¶m g‘mYmZH$mo Hw$Z¡ g‘¶-gr‘m~ÕVm N>?
MaU 2 … OmZH$mar OwQ>mCZw
{ZU©¶ {bZo ì¶{º$bo ghr {ZU©¶ {bZH$m bm{J Ho$hr Amdí¶H$ OmZH$marhê$ OwQ>mCZwnZ} hþÝN>& ¶{X A{K~mQ>¡ OmZH$mar
OwQ>mBg{H$EH$mo N> ^Zo {ZU©¶ {bZo ì¶{º$bo Ë¶mo OmZH$mar nT²>Zo a ~wÂZoN>& ¶{X Hw$Z¡ gmÝX{^©H$ OmZH$mar CnbãY N>¡Z AWdm
OwZ OmZH$mar CnbãY N> Ë¶mo n¶m©á N>Z¡ ^Zo CnbãY OmZH$marH¡$ AmYma‘m {ZU©¶ {bZo à{H«$¶mbmB© Omar am»ZwnX©N>& Va,
O{V ~‹T>r OmZH$marhê$ CnbãY hþÝN>Z², {ZU©¶ Ë¶{V Z¡ Agb hþZoN>&
MaU 3… CnbãY {dH$ënhê$bmB© {MpÝhV JZw©
¶g MaU‘m CnbãY {dH$ënhê$‘m{W Hw$Z Ñ{ï>H$moU~mQ> {dMma JZ© g{H$ÝN> ^Þo~mao {ZU©¶ {bZo ì¶{º$bo ’$gobm JZw©nZ}N>&
{dH$ënhê$bmB© {d{^ÝZ H$moUhê$~mQ> hoXm© bú¶ àmá JZ©H$m bm{J {VZrhê$ ({dH$ënhê$) H${V g‘W© N>Z² AWdm dV©‘mZ
n[apñW{V‘m {VZrhê$ H${V ¶WmW© N>Z² ^Þo Hw$ambmB© hoZw©nX©N>&
MaU 4 … {d{^Þ {dH$ënhê$~mao gmoÀZw a {díbofU JZw©
g‘mYmZhê$ {MpÝhV JZ©o Amdí¶H$Vm AmBnaoH$mo IÊS>‘m ASHA-bo ñWmZr¶ g‘wXm¶H$m gXñ¶hê${gV H$m‘ JZw©nZ}N>& ¶g
MaU‘m Yoa¡ g‘mYmZhê$ ~VmBZoN>Z²& g‘ñ¶mH$m H$maUhê$H$mo gQ>rH$ {M{hÝVH$aUn{N> g~¡ gå^m{dV g‘mYmZhê$H$mo gyMr
~ZmCZwnZ}N> a CnbãY H$maUhê$bmB© àmW{‘H$Vm {XZwnZ}N>&
MaU 5 … CnbãY {dH$ënhê$H$mo ‘yë¶mL²>H$Z JZw©
g~¡ CnbãY {dH$ënhê$H$mo gmdYmZrnyd©H$ ‘yë¶mL²>H$Z JZw© Amdí¶H$ N>& ¶g MaU‘m AZw^dhê$ a {ZU©¶H$m {gÕmÝVhê$bo
Yoa¡ ‘XV JX©N>Z²& Hw$Z¡ n{Z {ZU©¶ {bZw^ÝXm A{K ghr a ì¶mdhm[aH$ g‘mYmZH$mo {ZpåV g~¡ gå^m{dV {dH$ënhê$H$m gw{dYm
a Agw{dYmhê$H$mo ‘yë¶mL²>H$Z JZw© Amdí¶H$ N>&
MaU 6 … g~¡^ÝXm gmÝX{^©H$ g‘mYmZbmB© amoÁZw
MaU 1-5 bmB© AZwgaU J[agHo$n{N> ‘mÌ ¶g MaUbmB© n{hë¶mCZw g{Obmo hþZoN>& ‘m{WH$m MaUhê$Ûmam d¡H$pënH$
g‘mYmZhê$bmB© N>mo{‹S>EH$mo a g~¡^ÝXm gmÝX{^©H$ {dH$ën‘m{W {ZU©¶ {bBEH$mo Hw$am ~wÂZ g{H$ÝN>&
MaU 7 … {ZU©¶bmB© H$m¶m©Ýd¶Z JZw©
{bBEH$mo {ZU©¶bmB© ¶moOZmÛmam H$m¶©ê$n‘m n[aUV JZw© a Ë¶gbmB© gånÝZ JZw© {ZU©¶ {bZo H$m¶©H$mo ECQ>m ‘hÎdnyU© MaU hmo&
Hw$Z¡ n{Z {ZU©¶bmB© à^mdH$mar ê$n‘m H$m¶m©Ýd¶Z JZ© g~¡ ^mJrXmahê$H$mo g{H«$¶ gh^m{JVmH$mo Im±Mmo nX©N>&
MaU 8 … n[aUm‘H$mo ‘yë¶mL²>H$Z
{ZU©¶-J«hU à{H«$¶mH$mo g~¡^ÝXm ApÝV‘ MaU hmo n[aUm‘H$mo ‘yë¶mL²>H$Z JZw©& ‘yë¶mL²>H$Zbo AÝVambhê$bmB© ~wÂZ a
n{hboH$m {ZU©¶hê$~mQ> {g³Z ‘XV JX©N> OgbmB© ^{dî¶‘m Aê$ {ZU©¶hê$ {b±Xm Ü¶mZ‘m am»Z g{H$ZoN>&
14
à^mdH$mar {ZU©¶ {bZw ^ZoH$mo Ho$ hmo?
 ~¡R>H$ gånÝZ Ên{N> à^mdH$mar {ZU©¶bo g‘yhH$m gXñ¶hê$~rM Hw$Z¡ AgÝVmofOZH$ ^mdZm N>mo‹S>oH$mo hþZw hþ±X¡Z&
 à^mdH$mar {ZU©¶ Ë¶mo hmo OgbmB© H$m¶m©Ýd¶Z JZ© g{H$ÝN>& ¶gH$maU H$m¶m©Ýd¶Z Yoa¡ ‘hÎdnyU© Hw$am hmo&
 à^mdH$mar {ZU©¶-J«hU ghO a ñdm^m{dH$ hþZwnX©N>& Ë¶gbo g‘wXm¶H$m gXñ¶hê$~rM PJ‹S>m CËnÞ JamCZo AWdm
gXñ¶hê$bmB© Xþ~b © Vwë¶mCZo ^mdZm CËnÝZ JaoH$mo hþZw hþ±X¡Z&
 à^mdH$mar {ZU©¶-J«hUbo g‘wXm¶H$m gXñ¶hê$bmB© gh^m{JVmH$mo Adga àXmZ JZ}N> a {VZrhê$bo AÝË¶‘m
Ë¶mo {ZU©¶bmB© H$m¶m©Ýd¶Z JZ© g³ZoN>Z²&
ASHA A{Z {ZU©¶-J«hU
g‘wXm¶‘m H$m¶© JXm© Yoa¡ joÌ‘m Z¡ ASHA-bo à^mdH$mar {ZU©¶ {bZwnZ} hþÝN>>& ‘hÎdnyU© {ZU©¶ {bZo {df¶‘m ASHA- bo
{ZåZ{b{IV Hw$amhê$ ‘Z‘m am»ZwnZ}N>&
 {ZU©¶-J«hUH$mo {ZpåV dmñV{dH$ g‘ñ¶mbmB© {MpÝhV JZw©nZ}N>&
 {ZU©¶-J«hUH$m g~¡ MaU‘m ^mJrXmahê$H$mo gh^m{JVm Adí¶¡ gw{ZpíMV JZw©nZ}N>&
 gQ>rH$ {ZU©¶ {bZH$m bm{J ‘m{W C„oI J[aEH$m g~¡ MaUhê$bmB© A{Zdm¶© ê$n‘m n{hë¶mCZwnZ}N>&
 OwZ {ZU©¶ {bBEH$mo N> Ë¶gH$mo ‘yë¶mL²>H$Z a g‘rjm J[aEH$mo hþZwnN>©& Ë¶g‘m g§emoYZH$mo Amdí¶H$Vm XoIm nao
g§emoYZ JZw©nZ}N>& {ZU©¶-J«hUH$m H$m¡ebhê$bmB© AZw^d a Aä¶mgÛmam {VIm[aÝN>& Va {ZU©¶ Ag’$b ÊH$mo
IÊS>‘m Ë¶gH$mo {Oå‘mdmar {bZ ASHA AmË‘{dídmgr a V¶ma ahoH$mo hþZnw N>©&
Hw$amH$mZr a gåPm¡VmH$m H$m¡ebhê$

Hw$amH$mZr a gåPm¡Vm JZw© ^ZoH$mo Ë¶mo à{H«$¶m hmo OgÛmam ~o½bm~o½b¡ Amdí¶H$Vm a bú¶hê$ ÊH$m XþB AWdm Ë¶mo^ÝXm Yoa¡
‘m{Zg/njhê$bo Hw$Z¡ {df¶‘m Amng‘m ñdrH$ma JZ©g{H$Zo g‘mYmZ ImoÁZ {‘boa H$m¶© JX©N>Z²& ASHA-bo {d{^ÝZ
g‘ñ¶mhê$bmB© g‘mYmZ JZw©nZ} hþÝN>& {VZbo J«m‘rU ñdmñÏ¶ H$m¶©H«$‘hê$H$m AP Ry>bm bú¶hê$bmB© àmá JZ©H$m bm{J ¶r
{d{^ÝZ g‘ñ¶mhê$bmB© g‘mYmZ JZw©nZ} hþÝN>& AmâZmo {Oå‘odmar nyam JZ© g‘W© hþZH$m bm{J {VZbo {d{^ÝZ ‘m{Zghê$g±J
a {d{^ÝZ n[apñW{Vhê$‘m {ZaÝVa Hw$amH$mZr JZw©nZ} hþÝN>& A{YH$maàmá ‘m{Zghê${gV Hw$amH$mZr JZw© ECQ>m MwZm¡VrH$mo H$m‘
hmo ^ÝZo Hw$am ~wÂZw ‘hÎdnyU© hþ±XN> Va Hw$amH$mZrH$mo Amdí¶H$Vm naoH$mo Hw$Z¡ n{Z n[apñW{V‘m H$g¡bo n{Z n¶m©á V¶mar a
Aä¶mgÛmam à^mdH$mar T>L²>J‘m H$m¶© JZ©g³ZoN>&
à^mdH$mar Hw$amH$mZrH$m CnmXmZhê$…
 n[aUm‘H$mo {ZpåV VËna ahZwhmog-
² Hw$amH$mZr JZwA
© {K, Hw$Z Hw$Z {df¶hê$bmB© {ZYm©[aV JZw© N> A{Z Hw$Z {df¶hê$bmB©
b{Mbmo am»Zw N> ^ÝZo Hw$am VnmBªbo n{hë¶¡ ~w{Pam»ZwnZ}N>&
 Am’y$bmB© V¶ma nmZw©hmog²- Hw$amH$mZr JZ} ì¶{º$bo ^mdZm^ÝXm ~‹T>r H$maU‘m{W Ü¶mZ Ho$pÝÐV JZw©nZ}N>&
 Amdí¶H$ JwU a aUZr{Vhê$- g’$b Hw$amH$mZrH$mo {ZpåV Hw$am JZ} ì¶{º$‘m N>mQo >mo g‘¶‘¡ AÝ¶ ‘m{Zghê${gV {‘ÌVm
Jm±ñZg³Zo, Agb H$m¶©H$mo gå~ÝY ñWm{nV JZ}, Aê$hê$‘m{W à^md nmZ}, {dídmg àmá JZ} Am{X OñVm ¶mo½¶Vmhê$
hþZnw X©N>&
15
 Hw$amH$mZrH$mo V[aH$m- H$gar Hw$amH$mZr JZw©nZ} hmo ^Þo~mao VnmBªbo n{hë¶¡ gmoM{dMma J[aam»ZwnX©N>& Hw$Z gÝX^©‘m MMm©
JZw©nZ} hmo ^Þo~mao n{Z n{hë¶¡ gmoM{dMma a {ZU©¶ JZw©nX©N>& ¶g ‘m{‘bm‘m Hw$Z¡ {deof eãX‘m AH$m} njbo H$ñVmo
à{V{H«$¶m OZmCZg³N> A{Z Ho$ H$ñVm n[aUmUhê$ XoIm nZ©g³N>Z² ^Þo~mao n{Z Hw$amH$mZr JZ} ì¶{º$bo n{hë¶¡
gmoÀZwnX©N>& Vr g~¡ gå^m{dV n[apñW{Vhê$~mao n{hë¶¡ gmo{M{dMma J[aam»ZwnX©N>&
 AH$m} MaU- Hw$amH$mZr g‘má Ên{N> {df¶bmB© ¶ñVmo àH$mabo ì¶dpñWV Vwë¶mCZwhmog² Ogbo Xþd¡ njbmB© ’$mBXm
nwè¶mAmog²& Yoa¡ pñW{Vhê$‘m Hw$amH$mZr hR>mV² JZ} J[aÝN>&
g’$b Hw$amH$mZrH$m MaUhê$

 à{V{H«$¶mbmB© {Z¶ÝÌU‘m am»Zw- g’$b Hw$amH$mZrH$mo n{hbmo MaU VnmBªH$m ^mdZmhê$bmB© {Z¶ÝÌU‘m am»Zw hmo&
[agmCZo, {~pÀH$Zo, AmH«$‘U JZ}, XÊS> {XZo AWdm à{VemoY {bZo OñVm Hw$amhê$~mQ> Omo{JZwnX©N>&
 AH$m} ì¶{º$H$mo Ñ{ï>H$moU‘m{W {dMma JZw©- MMm©bmB© Omar am»ZH$m bm{J AH$m} ì¶{º$ AWdm njà{V [ag, AmKmV,
eÌwVm Am{XbmB© Q>mT‹ >m amIoa gH$mamË‘H$ a ghO dmVmdaU g¥OZm J[aEH$mo hþZwnX©N>& AmH«$‘U ZJar dm {damoYH$mo
à¶mg ZJar Ohm± gå^d hþÝN> Ë¶hm± gh‘V Êa Hw$amH$mZrbmB© Qw>L²>Jmo‘m nwè¶mCZwnX©N>&
 gm‘mÝ¶ a gmZm g‘ñ¶mhê$bmB© g‘mYmZ JZw©- gm‘mÝ¶ {df¶hê$, Omo Ë¶{V ‘hÎdnyU© N>Z¡ Z², {VZrhê$bmB© ~wPoa
g‘mYmZ JZ© g{H$ÝN>&
 H$‹S>r- Hw$amH$mZrÛmam Hw$Z¡ n{Z nj AgÝVwï> ZhþZo a H$g¡bo gOm¶ ZnmCZo A{Z g~¡ njbo à{H«$¶m‘m g{H«$¶ gh^m{JVm
OZmCZo Hw$am {VZrhê$~rMH$mo H$‹S>r ~Zoa gw{ZpíMV JZw©hmog²&
 dmñV{dH$VmbmB© àñVwV JZw©- Hw$amH$mZrH$mo ~obm ¶{X Hw$Z¡ ì¶{º$/nj AmâZm {hV dm {dídmg‘m AQ>b ah²¶mo A{Z
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Vmb‘obH$m H$m¡ebhê$
Vmb‘ob ^ZoH$mo Ho$ hmo?
 Vmb‘ob ^ZoH$mo Vr g~¡ gh^mJrhê${gV gå~ÝY ~‹T>mEa b¡OmZw hmo Ogbo g‘yhH$mo {dH$mgH$mo {ZpåV ‘hÎdnyU© ^y{‘H$m
IoëXN>Z²&
 ASHA -bo ñdmñÏ¶ godmhê$ a g‘wXm¶~rM H$‹S>rH$mo ê$n‘m H$m‘ JZ} hþZmbo g‘yhH$m {d{^Þ ‘m{Zghê$ a ^mJrXmahê${gV
{Z¶{‘Vê$n‘m Vmb‘ob amIoH$mo hþZnw N>©&
 Vmb‘obH$m {d{^Þ V[aH$mhê${gV ASHA AdJV ahoH$mo hþZwnN>© A{Z AmâZmo H$m‘ JXm© Ë¶mo Vmb‘ob ahoH$mo {VZbo
gw{ZpíMV JZw©nX©N>&
16
ASHA-bo AmâZmo H$m¶© JXm© {ZåZ{b{IV ^mJrXmahê${gV Vmb‘ob am»Zo{N>Z²…
Am±JZdm‹S>r
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17
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18
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19
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20
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22
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23
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24
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AWdm CZrhê$ ¶m¡Z dm{hV amoJhê$bo AmH«$mÝV hþZo JX©N>Z²&
 {díd^[a 15-24 df©H$m bJ^J 10 H$amo‹S> Ho$Q>m a Ho$Q>rhê$ EMAmB©^r/ES²>gbo J«ñV N>Z²&
 ¶g Ad{Y àOZZ ñdmñÏ¶gå~ÝYr {~‘marhê$‘m Ho$Q>mhê$H$mo VwbZm‘m Ho$Q>rhê$ gm‘m{OH$ a emar[aH$ ê$nbo ~‹T>r
gL²>H«${‘V hþZo JX©N>Z²& àOZZ-ñdmñÏ¶H$mo gå~ÝY‘m {H$emoa a {H$emoarhê$H$mo {ZpåV OmZH$marH$m {ZaÝVa òmoV
d¶ñH$hê$bmB© ‘m{ZÝN>& Vr d¶ñH$hê$ {dÚ‘mZ n[aÑí¶{gV gwn[a{MV ZÊH$mo IÊS>‘m Vr {H$emoa-{H$emoarhê$bmB©
ghr OmZH$mar {XZ Ag‘W© hþÝN>Z²& Cnamoº$ H$maUbo JXm© {H$emoa-{H$emoarhê$bo g‘ñ¶mhê$H$mo gm‘Zm JZw©nZ} hþÝN>
OgH$mo {deofê$n‘m »¶mb am»Zw Amdí¶H$ N>&
 {H$emoa-{H$emoarhê$bo ghr OmZH$mar nmE ^Zo CZrhê$bo Am’y$bmB© Hw$Z¡ n{Z Omo{I‘~mQ> OmoJmCZ g³N>Z² A{Z emar[aH$
a ‘mZ{gH$ Xþd¡ ê$n‘m ñdñW ahZg³N>Z²&
{H$emoa AdñWm‘m hþZo emar[aH$ a ‘mZ{gH$ n[adV©Zhê$…
{H$emoamdñWm‘m Ho$Q>m a Ho$Q>r Xþd¡‘m hþZo ‘mZ{gH$ n[adV©Zhê$ {ZåZ{b{IV hþZ²…
 ^mdwH$ hþZo  {dnarV {b“rà{V AmH${f©V hþZo
 ~ogr {Okmgw hþZo  AmâZmo earaà{V gMoV hþZo
 H$ënZm JZ© ‘Z namCZo  n{haZhê$ a Ü¶mZ AmH$f©U JZ© ‘Z namCZo
 AmâZmo n[aM¶ ñWm{nV JZ© a  bmO ‘mÝZo
ñdVÝÌ {dMma am»Z ‘Z namCZo
 Z³H$b JZ© ‘Z namCZo  gmoM{dMma¡ ZJar {ZU©¶ {bZo/ApñWa {ZU©¶ {bZo
 EH¡${N>Z‘m ‘ZmopñWV ~X²{bZo  AdgmXJ«ñV ({Zame) hþZo
 ‘mVm{nVmbmB© ^ÝXm gmWrg“rhê$bmB©  hmoS‹ >H$mo ^mdZm am»Zo
àmW{‘H$Vm {XZo
‘pñVîH$H$mo n{N>pëVa ECQ>m gmZmo W¡brOñVmo g§aMZm hþÝN> OgbmB© {nQ>çwQ>ar J«pÝW ^{ZÝN> Ogbo EH$ àH$maH$mo h‘m}Z
òm{dV JX©N>& ¶r ‘mZ{gH$ n[adV©Zhê$ hm‘«mo eara‘m ÊH$m amgm¶{ZH$ nXmW©hê$H$mo à^mdbo hþZo JX©N>Z² OgbmB© h‘m}Ýg
^{ZÝN>& ¶g Ad{Y‘m hþZo ¶r {dH$mg‘ybH$ n[adV©Zhê$ ñdm^m{dH$ Z¡ hþÝN>Z² Va ¶r n[adV©Zhê$~mao Ho$Q>m a Ho$Q>rhê$ AdJV
hþZw Amdí¶H$ N>&
27
Ho$Q>rhê$‘m {ZåZ{b{IV emar[aH$ n[adV©Zhê$ hþÝN>Z…²
 ‘m{gH$ Y‘© (F$Vw MH«$) ewé hþZw  CMmB a AmoOZ ~T²>Zw
 ñVZhê$ ~T²>Zw  ñda ~X²{bZw
 {ZVå~hê$ ~T²>Zw  S>ÝS>r’$moa {ZpñH$Zw
 H$mIr a ¶m¡ZmL²>J‘m am¢ C{‘«Zw
Ho$Q>mhê$‘m {ZåZ{b{IV emar[aH$ n[adV©Zhê$ hþÝN>Z…²
 OwJ± m-Xmõr C{‘«Zw  ‘m§gnoerhê$ ~{ZZw
 ñda KmobZ© o hþZw  H$mIr a ¶m¡ZmL²>J‘m am¢ C{‘«Zw
 CMmB a AmoOZ ~T²>Zw  {b“ a AÊS>H$moe Ry>bmo hþZw
 H$ÊR> (Km±Q>r)-H$mo hÈ>r Xo{IZw  dr¶©nmV hþZw
 S>ÝS>r’$moa {ZpñH$Zw
{nQ>çyQ>ar J«pÝW~mQ> òm{dV hþZo agm¶Zhê$bmB© h‘m}Z ^{ZÝN> Ogbo àOZZ AL²>Jhê$bmB© {H«$¶merb ~ZmC±N>Z&² àOZZ J«pÝW~mQ>
òm{dV hþZo h‘m}ZbmB© àOZZ h‘m}Z ^{ZÝN> A{Z {¶Z¡ h‘m}Zhê$H$mo òmdH$mo H$maUbo Ho$Q>m/Ho$Q>rhê$‘m n[adV©Zhê$ AmCZo JX©N>Z²&
 Ho$Q>mhê$‘m 10-14 df© A{Z Ho$Q>rhê$‘m 12-16 df©~rM VéUmdñWm ewé hþÝN>&
 Ho$Q>mhê$H$mo VwbZm‘m Ho$Q>rhê$‘m 1-2 df©A{KZ¡ {H$emoamdñWmH$m n[adV©Zhê$ ewé hþÝN>Z²& n[adV©ZH$mo g‘¶md{Y
a n[adV©Zhê$ Ho$Q>m a Ho$Q>r‘m {^ÝXm{^ÝX¡ hþÝN>Z²& EH$gmW ~T²>X¡ JBahoH$m gmWr-g“rhê$H$mo g‘yh‘m ¶ñVm ~o½b¡
n[adV©Zhê$bo àm¶… Z¡ "‘ gm‘mÝ¶ Z¡ Nw> V?' ^ÝZo Hw$amH$mo {MÝVm CËnÝZ JX©N>& ¶g¡H$maU ¶r n[adV©Zhê$
Añdm^m{dH$ hmoBZZ² ^Zr {VZrhê$bmB© gåPmCZw Amdí¶H$ hþ±XN>&
 Hw$Z¡ {H$emoar 16 df© nwJno {N> n{Z CgH$mo ‘m{gH$ Y‘© ewé ZhþZw g‘ñ¶mH$mo bjU hmo a Ë¶ñVmo pñW{V‘m S>m³Q>aH$mo g„mh {bZw Oê$ar hþÝN>&
‘m{gH$ Y‘©
‘m{gH$ Y‘©H$mo à{H«$¶m {ZåZ{b{IV àH$maH$mo hþX± N>-
 ECQ>r Ho$Q>r VéUr AdñWm nwJon{N> CgH$m {S>å~me¶hê$~mQ> àË¶oH$ ‘hrZm ECQ>m n[an³d {S>å~ (AÊS>m) {ZñHo$a ‘wpÝVa
ahoH$mo ’o$bmo{n¶Z Q>ç~y V{Va OmÝN> Ohm± ewH$« mUw H$mo{eH$mÛmam Ë¶gH$mo {ZfoMZ hþZg³N>& ¶gbmB© AÊS>mËo H$f© (Ovulation)
^{ZÝN>& Ë¶mo {S>å~ ’o$bmo{n¶Z Q>çy~ Êa A{K ~T²>Xm J^m©e¶{^Ì ECQ>m aJVH$mo Za‘ a b{Mbmo À¶mXa OñVmo nÌ
(Vh) V¶ma hþÝN>>& Ë¶mo Vh aJV a íbo‘ (Mucus)-bo ~{ZEH$mo hþÝN>& ¶{X Ë¶mo {S>å~ ewH«$mUw H$mo{eH$mÛmam {Zfo{MV
^¶mo ^Zo Ë¶mo J^m©e¶H$mo {^Îmm{gV Q>m±{gÝN> Ohm± g‘¶ nwJon{N> ECQ>m {eew‘m {dH${gV hþÝN>& Ë¶mo {S>å~ {Zfo{MV ÊZ
^Zo J^m©e¶‘m ~{ZEH$mo Ë¶mo À¶mXa OñVmo Vh ’$mQ²>N> a aº$òmd hþÝN>& Ë¶mo J^m©e¶H$mo ’$mQ>oH$mo Vhg{hV {Zfo{MV
ZÊH$mo {S>å~bo aJV a íbo‘{gV¡ ¶mo{Z‘mJ© a J^m©e¶H$mo Zbr~mQ> Êa ‘m{gH$ Y‘©H$mo òmd ~ZmC±XN> A{Z Ë¶mo òmd
¶mo{Z‘mJ©~mQ> earabmB© N>mo‹S>ao {ZpñH$ÝN> OgbmB© ‘m{gH$ òmd ^{ZÝN>& ¶gH$mo gånyU© MH«$bmB© ‘m{gH$ Y‘© dm F$Vw
MH«$ ^{ZÝN>&
 gm‘mÝ¶V¶m ‘m{gH$ Y‘© 10-13 df©H$mo C‘oa{^Ì ewé hþÝN>&
 gm‘mÝ¶V¶m n{hbmo F$Vw MH«$H$mo 25-35 {XZn{N> AH$m} F$Vw MH«$ ewé hþÝN>&
 F$Vw MH«$H$mo g‘¶md{Y gm‘mÝ¶V¶m 3-5 {XZH$mo hþÝN>&
28
{H$emoar A{Z CgH$s Am‘mbmB© {ZåZ{b{IV VÏ¶hê$~mao ~VmCZw Amdí¶H$ N>…
· ‘m{gH$ Y‘© ECQ>m ñdm^m{dH$ KQ>Zm hmo A{Z ¶mo ZmarH$mo OrdZ MH«$H$mo A§e hmo& ¶gH$maU ¶g‘m ^¶^rV hþZw
dm bmO ‘mÝZwnX£Z&
· ‘m{gH$ Y‘© M{bahoH$mo ~obm {Z¶{‘V H$m‘H$mOhê$ ~ÝX JZ} Amdí¶H$Vm N>Z¡ & H$hm±gå‘ ^Zo ñHy$b OmZXo{I n{Z Hw$Z¡ amoH$Q>mHo $ N>Z¡ &
· ‘m{gH$H$mo aJV AewÕ dm ‘¡bmo hþX± Z¡ &
· ‘m{gH$ Y‘©H$mo ~obm A{‘bm ’$bhê$H$mo godZbo AË¶{YH$ aº$òmd JamC±XZ¡ &
· ¶g Ad{Y g~¡ àH$maH$m ImZmhê$ A{Z {Mgmo àH¥${VH$m ImZoH$w amhê$ n{Z ImZ g{H$ÝN>&
‘m{gH$ Y‘©H$mo ~obm hþZo H${R>ZmBhê$…

‘m{gH$ Y‘©H$mo ~obm {ZåZ{b{IV (Hw$Z¡ n{Z) H${R>ZmBhê$ Xo{IE VËH$mb¡ ñdmñÏ¶ Ho$ÝÐ‘m nR>mCZw Amdí¶H$ N>…
 6 {XZ^ÝXm ~‹T>r aº$òmd
 AË¶{YH$ aº$òmd (24 KÊQ>m‘m 5 dQ>m^ÝXm ~ogr ß¶mS> nya¡ {^ÁZo Jar AWm©V² gå^dV 500 {‘. br. aº$òmd) A{Z
{deofJar aJVH$m ’$mëgmhê$¶wº$ òmd
 A{Z¶{‘V òmd, CXmhaUH$mo {ZpåV- XþB ‘m{gH$ MH«$H$mo ~rMH$mo AÝVamb‘¡ aº$òmd hþZw AWdm ‘m{gH$ Y‘© {T>bmo ewé hþZw
 16 df©H$mo C‘oa nwJoa n{Z ‘m{gH$ Y‘© ewé ZhþZw&
 ‘m{gH$ Y‘©H$mo ~obm noQ> Xþ»Zw&
 ‘m{gH$ Y‘©H$mo ~obm A{YH$m§e Ho$Q>rhê$bmB© Z¡ noQ>-ì¶WmH$mo g‘ñ¶m, {deofJar V„mo noQ>‘m nr‹S>m hþZo JX©N>& ¶mo nr‹S>m
{nR>çy±H$mo V„mo ^mJ a IwÅ>m‘m n{Z hþZg³N>& ¶gH$m gmW¡ dmH²$dmH$s bm½Zo, Q>mCH$mo Xþ»Zo a WH$mZH$mo g‘ñ¶m n{Z
hþZg³N>& ¶ñVm g‘ñ¶mhê$ Ê S>amCZwnZ} Hw$Z¡ H$maU N>Z¡ &
 Va ¶{X Ë¶ñVmo nr‹S>m AË¶{YH$ AWdm Yoa¡ g‘¶gå‘ ^Baho IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ (BPHC)/J«m‘rU AñnVmb
(RH)/gXa AñnVmb (SDH)/{O„m AñnVmb (DH)-H$m S>m³Q>a{gV g„mh {bZg{H$ÝN>&
 XþB ‘hrZm^ÝXm ~‹T>r g‘¶gå‘ ‘m{gH$ Y‘© amo{H$EH$mo IÊS>‘m n{Z S>m³Q>aH$mo g„mh {bZw Amdí¶H$ N>&
‘m{gH$ Y‘©H$mo ~obm AßZmBZwnZ} gag’$mB©gå~ÝYr ‘hÎdnyU© Hw$amhê$…

 ‘m{gH$ Y‘©H$mo ~obm AßZmBZwnZ} ñdmñÏ¶gå~ÝYr {Z¶‘hê$-
- {Z¶{‘V ê$n‘m Adí¶ ZwhmCZwnX©N>&
- nmoIar AWdm ZXr‘m ZwhmCZw hþ±X¡Z&
- ‘m{gH$ Y‘© M{bahoH$mo ~obm em¡M Jaoa AmEn{N> AWdm Ý¶mpßH$Z ’o$Zw©A{K JwámL²>Jhê$ g’$m nmZrbo am‘«ar YwZwnN>,© A{Z
JwwámL²>Jhê$H$mo ~m{har ^mJbmB© n{Z g‘¶-g‘¶‘m YwZwnN>© Vm{H$ Ë¶hm± Hw$Z¡ aJV bmJoH$mo Zhmog²&
- ‘m{gH$ Y‘©H$mo ~obm gw³Im gwVrH$mo noÝQ>r bJmCZwnN>©& noÝQ>rbmB© {Z¶{‘V ê$n‘m YmoEa Km‘‘m gwH$mCZwnN>©&
- go{ZQ>oar Ý¶mpßH$Z AWdm ß¶mS> à¶moJ JZw©nN>©&
- go{ZQ>oar Ý¶mpßH$Z/ß¶mS> CnbãY ZÊ Ka‘m ~ZmBEH$mo go{ZQ>oar Ý¶mpßH$Z {ZåZ{b{IV àH$mabo à¶moJ JZ©g{H$ÝN>-
 g’$m, gw³Im, Za‘ gwVrH$mo bwJm à¶moJ JZ© g{H$ÝN>&
 Ka‘m ~ZmBEH$mo go{ZQ>oar Ý¶mpßH$Z à¶moJ Jaon{N> Ë¶gbmB© g’$m gm~wZ-nmZrbo YmoEa Km‘‘m gwH$mCZwnN>© a gwHo$n{N>
gw³Im a g’$m R>mC±‘m am»ZwnN>©&
 Ka‘m ~ZmBEH$m go{ZQ>oar Ý¶mpßH$Zhê$ ECQ>m ‘m{gH$ MH«$^ÝXm ~‹T>r g‘¶ à¶moJ JZ© g{H>>$± X¡Z&
29
 àË¶oH$ ‘hrZm ‘m{gH$ Y‘© ÊH$mo Vm[aI Am’y$bo ¶mX am»Zg{H$ÝN>, Ë¶gmo JXm© {VZrhê$bo AH$m}nëQ> aº$òmd hþZo
pñW{VH$mo {ZpåV Am’y$bmB© V¶ma am»Z g³N>Z²& ¶{X {VZrhê$ ñHy$bo {dÚmWu hþZ² AWdm bm‘mo g‘¶H$mo {ZpåV ~m{ha
OmZo ¶moOZm‘m N>Z² ^Zo {VZrhê$bo Am’y$g±J ’o$Z} go{ZQ>oar Ý¶mpßH$Z ~mo³ZwnX©N>&
‘m{gH$ Y‘©H$mo ~obm AßZmBZwnZ} ì¶{º$JV gag’$mB©gå~ÝYr ‘hÎdnyU© VÏ¶hê$…
 ZL>hê$ {Z¶{‘Vê$n‘m H$mQ²>Zw a g’$m am»ZwnX©N>&
 Hw$Z¡ n{Z ImZoHw$am ImZwA{K hmVhê$ am‘«ar YwZwnX©N>&
 gag’$mB© H$m¶‘ am»ZH$m bm{J em¡Mn{N> hmVhê$ gm~wZ-nmZrbo am‘«ar YwZwnX©N>&
 em¡M Jaon{N> JwámL²>Jhê$ am‘«ar YwZwnX©N> A{Z hmVhê$ gm~wZ-nmZrbo YwZwnN>©&
 Im{bIwÅ>m {h>>±S²>ZwH$mo gÅ>m, Mßnb/OwÎmm bJmCZwnX©N>&
 ‘m{gH$ Y‘©H$mo ~obm gw³Im gwVrH$m ß¶mÝQ>rhê$ bJmCZwnN>©& Ë¶gbmB© {Z¶{‘V ê$n‘m YmoEa Km‘‘m gwH$mCZwnN>©&
 ‘m{gH$ Y‘©gå~ÝYr a ì¶{º$JV gag’$mB© H$m¶‘ ZamIo àOZZ àUmbr‘m gL²>H«$‘U AWdm ¶m¡Z dm{hV gL²>H«$‘Uhê$
hþZg³N>Z²&
 {H$emoarhê${gV ~¡R>H$ JXm© "‘m{gH$ Y‘©gå~ÝYr gag’$mB© a ì¶{º$JV gag’$mB©'-‘m{W ‘hÎd {XBZwnX©N>&
‘m{gH$ Y‘©gå~ÝYr JbV YmaUm…

 ‘m{gH$ Y‘© àË¶oH$ ‘{hbmH$mo OrdZH$mo ECQ>m A§e hmo A{Z ¶gbmB© {bEa Hw$Z¡ {H${g‘H$mo bmO dm AßR>çmamo ‘mÞw
hþ±X¡Z& ¶gbmB© X¡{ZH$ {H«$¶mH$bmnhê$à{V ~mYmH$mo ê$n‘m hoZw© hþ±X¡Z&
 ‘m{gH$ Y‘©{gV Hw$Z¡ àH$maH$mo AewÕVm dm àXÿfU Omo{‹S>EH$mo hþ±X¡Z& ‘m{gH$H$mo ~obm EH$mH$snZ AWdm ñHy$b ZOmZo
MbZhê$ ~ÝX J[aZwnN>©& àOZZ h‘m}Z/Vab òmdH$mo H$maUbo ‘m{gH$ Y‘© hþZo hþZmbo hm‘rbo ImZo ImZmhê${gV
¶gH$mo Hw$Z¡ gå~ÝY ahoH$mo hþ±X¡Z& ‘m{gH$ Y‘©H$mo ~obm A{‘bmo ImZoHw$amhê$ Im±Xm Ë¶gbo AË¶{YH$ aº$òmd hþ±X¡Z&
{Mgmo àH¥${VH$m bJm¶V g~¡ {H${g‘H$m ImZoHw$amhê$ ImZg{H$ÝN>&
J^© H$gar ~ñN>?

 J^©YmZH$mo à{H«$¶m {ZåZ{b{IV àH$maH$mo hþÝN>…
 Ho$Q>rH$mo eara{^Ì àË¶oH$ ‘hrZm AZJÝVr {S>å~hê$‘Ü¶o ECQ>m n[an³d {S>å~ Hw$Z¡ ECQ>m {S>å~me¶~mQ> ‘wº$ hþÝN>, OwZ
A{K ~‹T>oa ‘wpÝVa ’o$bmo{n¶Z Q>çy~{Va OmÝN>&
 ¶m¡Z gånH©$H$mo ’$bñdê$n dr¶©~mQ> AZJÝVr ewH«$mUwhê$ Ho$Q>rH$mo eara{^Ì àdoe JX©N>Z² a ’o$bmo{n¶Z Q>çy~‘m nw½N>Z²&
 ewH«$mUw H$mo{eH$mbo n[an³d {S>å~bmB© {Zfo{MV Jaon{N> ‘mÌ J^© ~ñXN>&
 Ë¶mo n[an³H$ {S>å~ (ewH«$mUwÛmam {Zfo{MV Ên{N>) J^m©e¶‘m nw½N> A{Z ^«yUH$mo ê$n‘m ~T²>ZWmëN>& J^m©e¶H$mo Vhbo
{eewbmB© nmofU àXmZ JX©N>&
 ¶m¡Z gånH©$H$mo ’$bñdê$n Ho$Q>r AWdm ‘{hbm, ¶{X CZrhê$bo n{hbmoMmo{Q> ¶m¡Z gånH©$ JaoH$m hþZ² ^Zo n{Z, J^©dVr
hþZgp³N>Z²&
30
H$åVr C‘oa‘m {~ho A{Z J^©YmZ‘m hþZo H${R>ZmBhê$…
 nwéfH$mo C‘oa 21 df© A{Z ‘{hbmH$mo C‘oa 18 df© ZnwJr {~ho JZw© H$mZwZrê$n‘m XÊS>Zr¶ AnamY hmo {H$Z^Zo Ë¶mo
C‘oaA{K {H$emoa a {H$emoar Xþd¡ d¡dm{hH$ OrdZ {OCZ emar[aH$ a ‘mZ{gH$ê$nbo V¶ma ÊH$m hþ±X¡ZZ²&
 ¶g g‘¶ {H$emoarH$mo eara ZmZr OÝ‘mCZH$m bm{J R>rH$g±J JR>Z ^BgHo$H$mo hþ±X¡Z&
 Ho$Q>rbo 20 df©H$mo C‘oa^ÝXm A{K J^©YmZ JZw© hþ±X¡Z& ¶mo C‘oaA{K Z¡ Hw$Z¡ Ho$Q>r J^©dVr Ê Hw$nmo{fV a H$åVr OÝ‘-
AmoOZH$mo {eew OpÝ‘Zg³N>, AË¶{YH$ aº$òmd hþZg³N>, àgdH$mo ~obm H${R>ZmBhê$ CËnÞ hþZg³N>Z², Am‘m dm
{eewH$mo ‘¥Ë¶w n{Z hþZg³N>&
{b“ {ZYm©aU…
ZmZrH$mo {b“ JwUgyÌ (chromosome)-H$mo narjUÛmam {ZYm©aU JZ©g{H$ÝN> {H$Z{H$ ZmZrbo CgH$m ‘mVm{nVmH$m {deofVm
dm JwUhê$ ~moHo$H$mo hþÝN>& {S>å~‘m ‘X’ JwUgyÌ A{Z ewH«$mUw‘m ‘X’ a ‘Y’ JwUgyÌhê$ hþÝN>Z²& ¶{X {S>å~H$mo ‘X’ JwUgyÌ
ewH«$mUwH$mo ‘X’ JwUgyÌ{gV {‘{g¶mo ^Zo Ë¶mo ‘{hbm ^«yU (XX chromosome) hþÝN>& ¶{X {S>å~H$mo ‘X’ JwUgyÌ ewH«$mUwH$mo ‘Y’
JwUgyÌ{gV {‘{g¶mo ^Zo Ë¶mo nwéf ^«yU (XY chromosome) hþÝN&
¶gH$maU N>moar dm N>moam OpÝ‘Zw‘m Z V Am‘m Z ~mC {Oå‘odma hþÝN>Z²& N>moam dm N>moar hþZw V JwUgyÌhê$H$mo g§¶moOZ‘m{W
â nX©N> OwZ g§¶moOZ ‘{hbmH$mo eara{^Ì hþZo JX©N>& ¶gH$maU N>moam ZOpÝ‘>>±Xm ‘{hbmhê$bmB© Xmof bJmCZw hþ±X¡Z, OwZ Xmof
àm¶…Z¡ bJmCZo J[aÝN>&
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 hñV‘¡WwZ ECQ>m à{H«$¶m hmo OgÛmam ¶m¡Z gånH©$ Z¡ ZJar AmZÝXH$mo {ZpåV Ho$Q>m/Ho$Q>rbo
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 gw³Im gwVrH$mo AYmodñÌ bJmCZwnX©N> a Ë¶gbmB© {Z¶{‘Vê$n‘m YmoEa Km‘‘m gwH$mCZwnN>©&
 {H$emoahê$g±J ~¡R>H$ JXm© "¶m¡Zm“gå~ÝYr gag’$mB©'-‘m{W ‘hÎd {XBZwnX©N>&
nmofUH$m Amdí¶H$Vm, ’$bm‘H$mo H$‘rbo hþZo aº$mënVm A{Z ¶gH$mo à~ÝYZ…

 {H$emoamdñWm‘m emar[aH$ n[adV©Z a d¥{ÕH$mo H$maUbo nmofUH$mo ‘mJ ~‹T>ao OmÝN>&
¶gH$maU ¶g Ad{Y Mm{hZo ImZoHw$amhê$~mao {H$emoa-{H$emoarhê$bmB© AdJV
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 àmo{Q>ZH$mo ‘mJ nyam JZ©H$m bm{J Xmbhê$, MZm, ‘Q>a, gmo¶m{~Z, Jo‹S>mJw‹S>rhê$ A{Z gå^d
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31
 ’$bm‘H$mo ‘mJ nyam JZ© h[a¶mo nÎmm¶wº$ gmJgãOrhê$, OñV¡- amVmo a h[a¶mo bmbrgmJ, Y{Z¶m± nÎmm, gOZmH$mo gmJ,
Hw$boIm‹S>m gmJ, H$b‘m gmJ, ImÚmÞ, Vm‹S> {‘R>mB©, Ia~wOm, IOya, Jw‹S>, ‘mgw, H$boOmo, ‘mN>m a AL²>Hw$[aV MZm
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 Am¶mo{S>Z¶wº$ ZyZ godZ JZw©nX©N>&
 ImZm‘m Vob gm‘ob J[aEH$mo hþZwnN>©&
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{H$emoa AdñWmH$mo ~obm eara‘m ’$bm‘H$mo ‘mJ ~‹T²>XN>& ’$bm‘¶wº$ ImZm n¶m©á ‘mÌm‘m godZ ZJ[aE aº$mënVmH$mo
gå^mdZm ~‹T>oa OmÝN>& A{YH$m§eV… aJV‘m n¶m©á ‘mÌm‘m ’$bm‘ Zhþ±Xm aº$mënVm hþZo JX©N>&
 {H$emoa AdñWm‘m hþZo aº$mënVmH$m H$maUhê$ {ZåZ{b{IV hþZ²…
- ‘m{gH$ Y‘©H$mo ~obm aº$òmd
- ’$bm‘¶wº$ ImZmhê$H$mo godZ‘m H$‘r
- godZ J[aEH$mo ImZm~mQ> n¶m©á ’$bm‘ eara‘m Zgmo{gZw&
 aº$mënVmH$m gmYmaU bjUhê$…
- {O~«mo {’$H$m dm nh|bmo/Yoa¡ nh|bmo hþZw
- H$‘Omoar
- eara gw{ÞZw
- WH$mZ
- WH$mZH$mo H$maUbo Hw$Z¡ H$m‘ JZ} Om±Ja ZMëZw
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- Am±ImH$mo nQ>bH$mo {^Ìn{Å>, ZL>hê$, hËHo$bm a ËdMm nh|bmo hþZw
- ImZm ImZo BÀN>m ZhþZw
- ¶{X Cnamoº$ bjUhê$ XoIm nao ANM/S>m³Q>a{gV g„mh {bZwnX©N>&
 ’$bm‘H$mo ‘mJ nyam JZ© h[a¶monÎmm¶wº$ gmJgãOrhê$, OñV¡- amVmo a h[a¶mo bmbrgmJ, Y{Z¶m± nÎmm, gOZmH$mo gmJ,
Hw$boIm‹S>m gmJ, H$b‘m gmJ, ImÚmÞ, Vm‹S> {‘R>mB©, Ia~wOm, IOya, Jw‹S>, ‘mgw, H$boOmo, ‘mN>m a AL²>Hw$[aV MZm {Z¶{‘V
ê$n‘m godZ JZw©nX©N>& {Zå~w, Aå~H$, A‘bm‘m n¶m©á {^Q>m{‘Z-gr nmBZo hþZmbo {¶Zrhê$H$mo godZ JZw©nX©N>&
· gmám{hH$ ’$bm‘ Ed‘² ’$mo{bH$ E{gS> n[anyaU (WIFS) H$m¶©H$« ‘ {H$emoamdñWm‘m nmofUgå~ÝYr aº$mënVmbmB©
Xÿa JZ© gaH$maÛmam g#mm{bV ECQ>m H$m¶©H$« ‘ hmo&
· WIFS H$m¶©H$« ‘AÝVJ©V IFA Q>çmãboQ> gmVmH$mo Hw$Z¡ EH$ {XZ AWC/ñHy$b~mQ> {dVaU J[aÝN> a Vr Q>çmãboQ>² g
Cn¶wº$ V[aH$mbo godZ JZwn© X©N>&
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Ë¶mo Q>çmãboQ>²g AWC -~mQ> nmCZg³N>Z&²
32
· ñHy$b OmZo {H$emoa-{H$emoarhê$bmB© ñHy$b~mQ> df©‘m XþBnëQ> H¥${‘ZmeH$ Q>çmãboQ>²g {dVaU J[aÝN> ^Zo ñHy$b
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- dmH²$dmH$s bm½Zw
- H$pãO¶V/nmVbmo {Xem (nImbmo hmoBZ/H$mbmo {Xem)
 nmíd© à^mdhê$ Ê n{Z IFA Q>çmãboQ²>g godZ JZ£nN>©&
 H$pãO¶V ÊH$mo IÊS>‘m ‘{hbmbo AP ~‹T>r nmZr {nCZwnN>© A{Z AmâZmo Amhma‘m n¶m©á h[a¶mo gmJgãOr gm‘ob JZwn© N>&©
 ’$bm‘¶wº$ ImZoHw$am AWdm IFA Q>çmãboQ²>g godZH$mo EH$ KÊQ>mA{K a EH$ KÊQ>mn{N>gå‘ {M¶m, H$’$s, ³¶mpëg¶‘
Q>çmãboQ²>g AWdm XÿY godZ JZw© hþ±X¡Z&
H¥${‘ Zme JZw…©

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gag’$mB©hê$ H$m¶‘ am»ZwnX©N>…
 ZL>hê$ {Z¶{‘Vê$n‘m H$mQ²>Zw a g’$m am»ZwnX©N>&
 Hw$Z¡ n{Z ImZoHw$am ImZwA{K hmVhê$ am‘«ar YwZwnX©N>&
 gag’$mB© H$m¶‘ am»ZH$m bm{J em¡Mn{N> hmVhê$ gm~wZ-nmZrbo am‘«ar YwZwnX©N>& em¡M Jaon{N> JwámL²>Jhê$ am‘«ar
YwZwnX©N> A{Z hmVhê$ gm~wZ-nmZrbo YwZwnN>©&
 Im{bIwÅ>m {h>>±S²>ZwH$mo gÅ>m, Mßnb/OwÎmm bJmCZwnX©N>&
{H$emoa-{H$emoarhê$bmB© H¥${‘ZmeH$ Q>çmãboQ²>g AWC/ñHy$b~mQ> àXmZ J[aÝN> OwZ {Z¶‘AZwgma (6 ‘{hZmH$mo AÝVamb‘m)
godZ JZw©nX©N>&
{H$emoa-{H$emoarhê$H$m bm{J gaH$mar godmhê$…

 AÝdofm p³bZrH$/{H$emoa-{H$emoar ñdmñÏ¶ ghm¶H$ p³bZrH$ (Adolescent Health Friendly Clinic)-bo {H$emoa-
{H$emoarhê$bmB© emar[aH$ a ‘mZ{gH$ ñdmñÏ¶~mao nam‘e©H$mo ghþ{b¶V àXmZ JX©N> A{Z Amdí¶H$ nao CnMma n{Z
J[aÝN>& Cnamoº$ Hw$amhê${gV A{^^mdH$hê$ n{Z AdJV ahoH$mo hþZwnN>©&
 ¶r godmhê$ gånyU©ê$n‘m {Z…ewëH$ àXmZ J[aÝN> A{Z g~¡ Hw$am Jmoß¶ am{IÝN>&
{H$emoa-{H$emoarhê$bo ghr OmZH$mar nmE ^Zo {VZrhê$bo Am’y$bmB© Hw$Z¡ n{Z Omo{I‘~mQ> gwa{jV am»Z g³N>Z² A{Z
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hþZg³Zo AZmdí¶H$ J^©YmZ, gL²>H$« m‘H$ amoJhê$ A{Z EMAmB©^r/ES²>g OñVm {~‘marhê$~mQ> ~MmCZ g{H>>$± X¡Z&
33
ASHA-H$mo ^y{‘H$m
 ASHA-bo {H$emoa-{H$emoarhê${gV ~¡R>H$ Jaoa {ZåZ{b{IV H$m¶©hê$ JZ}{N>Z²…
- {VZrhê$bmB© emar[aH$ a ‘mZ{gH$ n[adV©Zhê$~mao OmZH$mar {XZo{N>Z²&
- nwéf a ‘{hbm àOZZ AL²>Jhê$, ‘m{gH$ Y‘©, ‘m{gH$ Y‘©gå~ÝYr gag’$mB© a H${R>ZmBhê$ A{Z ¶gH$mo à~ÝYZ~mao
OmZH$mar àXmZ JZ}{N>Z²&
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- {H$emoamdñWm a ‘mV¥ ñdmñÏ¶~rM gå~ÝY, H$åVr C‘oa‘m {~ho A{Z H$åVr C‘oaH$mo J^©YmZH$m H${R>ZmBhê$~mao
gMoVZm ’¡$bmCZo{N>Z²&
- nmofUH$mo Amdí¶H$Vm, ’$bm‘H$mo H$‘rbo hþZo aº$mënVm a ¶gH$mo à~ÝYZH$mo gå~ÝY‘m {H$emoa-{H$emoarhê$bmB©
nam‘e© {XZo{N>Z²&
- nmofUgå~ÝYr aº$mënVm a ¶gH$mo à~ÝYZ~mao {H$emoa-{H$emoarhê$bmB© ga-g„mh {XZo{N>Z²&
- {H$emoa-{H$emoar ñdmñÏ¶ ghm¶H$ godmhê$~mao OmJê$H$Vm ’¡$bmCZo{N>Z² A{Z ¶r Ho$ÝÐhê$‘m nam‘e©XmVmhê$ hþÝN>Z²
Ogbo gL²>H$Q> AWdm Amdí¶H$Vm naoH$mo IÊS>‘m {H$emoa-{H$emoarhê$g±J Hw$amH$mZr JZ}N>Z² a g‘ñ¶m~mao OmZH$mar
{bEa CZrhê$bmB© ‘XV JZ}N>Z² ^ÝZo Hw$am A{^^mdH$hê$bmB© CZbo ~VmCZo{N>Z²&
- ¶r n[adV©Zhê$à{V g§doXZerb ~Þ A{Z ¶ñVm {df¶hê$H$mo {ZJamZr JZ© ^Zr A{^^mdH$hê$bmB© gag„mh
{XZo{NZ²& AmâZm ZmZrhê$H$m ‘Z‘m Hw$Z¡ {MÝVm nmo N> {H$ ^Zr Ë¶gH$m bjUhê$bmB© ~wÂZw a Vr {MÝVmhê$ Xÿa
JZw© Amdí¶H$ N> ^Zr Vr A{^^mdH$hê$bmB© g„mh {XZo{N>Z²&
34
^mJ - nm±M
àgdnydH© $mo hoaMmh
‘mV¥ ñdmñÏ¶H$mo n[a^mfm…

{díd ñdmñÏ¶ g“R>Z (WHO)-AZwgma ‘mV¥ ñdmñÏ¶ ^Þmbo J^©YmaUH$mo Ad{Y/àgdnyd©H$mo g‘¶, ZmZrH$mo OÝ‘md{Y/
àgH$mbrZ g‘¶ A{Z ZmZr OÝ‘on{N> dm àgdn{N> ‘{hbmH$mo ñdmñÏ¶ ^Þo ~w{PÝN>&
J^m©dñWm Hw$Z¡ n{Z ‘{hbmH$mo {ZpåV AmZÝXXm¶H$ AZw^d Ê Vmn{Z H${hboH$m{h>>± ‘¥Ë¶w, AñdñWVm, J^©nVZ A{Z
àgdgå~ÝYr H${R>ZmBhê$H$mo H$maUbo Ë¶mo nr‹S>mXm¶H$ ~{Z{XÝN>&
dV©‘mZ n[aÑí¶…
gyMH$$ ^maV npíM‘ ~“mb gdm}Îm‘ H$m‘ J[aahoH$mo amÁ¶
IMR 32* 22* 7* (Ho$abm)
MMR 113** 98** 43** (Ho$abm)
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* Z‘yZm nÄOrH$aU àUmbr (SRS) ~wbo{Q>Z, gÝX^© df© - 2018
** ^maV‘m ‘mV¥ ‘¥Ë¶w‘m{W {deof ~wbo{Q>Z, (SRS) - 2016-2018
‘mV¥ ñdmñÏ¶bmB© VrZ ^mJ‘m ~m±{‹S>EH$mo N>, Vr hþZ²-

‘mV¥ ñdmñÏ¶
àgdnydH© $mo MaU àgdH$mbrZ MaU àgdn{N>H$mo MaU
J^©YmaUXo{I {bEa àgd (àgd nr‹S>mhê$Xo{I {bEa (J^©’y$b {ZñHo$H$mo g‘¶Xo{I

nr‹S>mhê$gå‘ J^©’y$b {ZñHo$H$mo EH$ {bEa 42 {XZgå‘)
9 ‘hrZm 7 {XZ KÊQ>mn{N>gå‘)
J^©YmaU ¶gar IwQ>çmBÝN>…

àOZZ C‘oa (15 Xo{I 49 df©)-‘m ‘{hbmH$mo EH$ ‘hrZm AWdm Ë¶mo^ÝXm Yoa g‘¶gå‘ ‘m{gH$ Y‘©/
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g‘¶‘¡ JwUñVar¶ àgdnyd©H$m godmhê$ àmá JZ} gå^mdZm ~‹T>oa OmÝN>&
35
J^©YmaU IwQ>² çmCZo XþB MaU…
 EH$ ‘hrZmgå‘ AWdm EH$ ‘hrZm^ÝXm ~‹T>r g‘¶gå‘ ‘m{gH$ Y‘© ZhþZw
 {ZíM¶ ào½ZoÝgr Q>oñQ> H$sQ à¶moJ> Jaoa J^©YmaU IwQ>çmCZw
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{ZíM¶ ào½ZoÝgr Q>oñQ> H$sQ‘m {ZåZ{b{IV Hw$amhê$ hþÝN>Z²…
· ECQ>m Q>oñQ> H$mS>©

· à¶moJn{N> â¶m±{H$Zo ECQ>m S´>na
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à¶moJA{K…
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H$gar à¶moJ JZ}…
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‘yÌH$mo ‘Ü¶àdmhH$mo A§e {bZwnX©N> (J^©dVr ‘{hbmÛmam)
36
XþB Wmonm ‘yÌ
"ñ¶månb dob'-‘m XþB Wmonm ‘yÌ am»Zwhmog²& nm±M
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¶{X Om±M joÌ (T)-‘m ECQ>m ‘mÌ aL²>JrZ aoIm XoIm

VnmBª J^©dVr
hþZwhþÝZ> nao ‘{hbm J^©dVr N>Z¡ Z²&
Om±M joÌ (T)-‘m Hw$Z¡ n{Z aoIm XoIm Znao narjU

Om±M à{H«$¶m‘m Adí¶¡ Hw$Z¡ Ìw{Q> ahoH$mo hþZnw N>&© AH$m} {~hmZ
Xmohmoè¶mCZwhmog²
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37
¶{X Om±Mn{N> Om±M joÌ (T)-‘m ECQ>m ~¡JwZo aL²>JH$mo aoIm XoIm nao-
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n{N>„mo ApÝV‘ ‘m{gH$ MH«$ A{Z àgdH$mo Ano{jV {‘{V
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 n{N>„mo ApÝV‘ ‘m{gH$ MH«$H$mo nw{ï>H$mo {ZpåV ASHA-bo Vr ‘{hbmbmB© Ë¶mo CZH$mo ‘m{gH$ MH«$H$mo ApÝV‘ {‘{V {W¶mo
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 n{N>„mo ApÝV‘ ‘m{gH$ MH«$H$mo {‘{V nw{ï> Ên{N> Am¢br‘m Zm¡ ‘hrZm JÝVr Jaoa Ano{jV àgdH$mo ‘hrZm JUZm JZw©hmog²&
 Ano{jV àgd {‘{V (EDD)) JUZm JZ©H$m bm{J Ë¶mo {‘{V‘m gmV {XZ OmoS²>Zwhmog²&
 ASHA-bo J^©dVr ‘{hbmH$mo Ano{jV àgd {‘{V (EDD) JUZm JZ}{N>Z² A{Z Ë¶g~mao J^©dVr ‘{hbm a {VZH$mo
n[admaH$m gXñ¶hê$bmB© ~VmCZo{N>Z² a AmâZmo S>m¶ar‘m n{Z boIoa am»Zo{N>Z²&
ECQ>m Z‘yZm JUZm
‘{hbmH$mo n{N>„mo ApÝV‘ ‘m{gH$ MH«$H$mo n{hbmo {XZ hmo 16.06.2012
LMP-H$mo n{hbmo {XZ‘m Zm¡ ‘hrZm OmoS²>Xm, {‘{V a ‘hrZm hþÝN> 16.03.2013
AZw‘m{ZV {‘{V nmCZH$m bm{J Ë¶mo {‘{V‘m AH$m} gmV {XZ OmoS²>Zwhmog² OwZ {‘{V hþÝN> 23.03.2013
¶gH$maU Ano{jV àgd {‘{V (EDD) hmo… 23.03.2013
¶g {d{Ybo Ho$db àgdH$mo AZw‘m{ZV {‘{V {XÝN> Va Ano{jV àgd {‘{V (EDD)-H$mo 15 {XZA{K dm n{N> {eew
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38
àgdnyd© hoaMmhH$m CnmXmZhê$…
PÅ>¡ nÄOrH$aU
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 bm^mWubo Ë¶mo (MCP) H$mS>© gwa{jV R>mC±‘m am»ZwnZ}N>&
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 J^©dVr ‘{hbmbo AmâZmo Zm‘ Cn Ho$ÝÐ‘m XVm© JamEH$r N>Z² ^Zo ‘mÌ {VZr OZZr gwajm ¶moOZm (¶{X ì¶dhm¶© N>
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 J^©dVr ‘{hbmH$mo AmoOZ àË¶oH$ ANC Om±MH$mo ~obm Zm{nÝN> a MCP H$mS>©‘m boIoa am{IÝN>&
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39
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J^m©dñWmH$mo ~obm aº$mënVm
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 ANM-bo aº$ narjUH$mo n[aUm‘ MCP H$mS>©‘m bo»ZoN>Z² a Amdí¶H$ nmBbm MmëZoN>Z²&
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40
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41
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ImZwnX©N>&
 gå^d Ê n¶m©á {^Q>m‘rZ "gr'-¶wº$ ’$bhê$, OñV¡- A‘bm, Aå~H$, {Zå~y A{Z H$m±Mmo AmnbmB© n{Z Amhma
Vm{bH$m‘m gm‘ob JZw©nN>© {H$Z{H$ ¶r ’$bhê$bo eara‘m ’$bm‘ gmoñZo à{H«$¶mbmB© ~‹T>mC±XN>Z²&
 J^©dVr ‘{hbmbo N>moQ>mo-N>moQ>mo AÝVamb‘m KarKar ImZm ImBahZwnN>©&
 Vr ‘{hbmbo H$åVr‘m n{Z MmanëQ> gånyU© Amhma A{Z EH$nëQ> A{V[aº$ Amhma {bZwnX©N>&
 J^©dVr ‘{hbmbo {VZH$mo n[admaH$m gXñ¶hê$bo ImBgHo$n{N> g~¡^ÝXm Am{Ia‘m hmoBZ Va Vr gXñ¶hê${gV¡ ImZm
ImZwnX©N>&
 J^m©dñWmH$mo ~obm Cndmg ~ñZw hþ±X¡Z& ¶g Ad{Y ImZm ImZ n{Z ~ÝX JZw© hþ±X¡Z&
Amam‘…
 J^©dVr ‘{hbmbo {XC±gmo H$åVr‘m n{Z XþB KÊQ>m A{Z am{V H$åVr‘m n{Z 8 KÊQ>m Amam‘ JZw©nN>©&
 {XZ^[a Z¡ EH$-EH$ {N>Z Amam‘ JX£ {Z¶{‘V {H«$¶mH$bmnhê$ JX£ OmZwnN>©&
ì¶{º$JV ga-g’$mB©…
 ì¶{º$JV ga-g’$mB©bo J^m©dñWm‘m gL²>H«$‘UH$mo gå^mdZmbmB© KQ>mC±XN>&
 àË¶oH$ {XZ H$b AWdm Q>çy~dobH$mo g’$m nmZrbo ZwhmCZwnN>©&
 nmoIarH$mo nmZr‘m ZwhmCZw hþ±X¡Z&
 Amdí¶H$ naoH$mo IÊS>‘m n[admaH$m gXñ¶hê$bo J^©dVr ‘{hbmH$mo {ZpåV ZwhmCZo nmZrH$mo ì¶dñWm J[a{XZwnN>©&
 ñVZ a àOZZ AL²>Jhê$bmB© g’$m am»ZwnN>©&
 J^m©dñWmH$mo ~obm g’$m, Za‘, IHw$bmo gwVrH$m dñÌhê$ à¶moJ JZw©nN>©&
J^m©dñWmH$mo ~obm nmbZ JZwn© Z} Ho$hr AÝ¶ gwPmChê$…
 J^m©dñWmH$m àW‘ a ApÝV‘ VrZ ‘hrZm ¶m¡Z gånH©$ ñWm{nV JZw© hþ±X¡Z&
 J^m©dñWmH$mo ~obm ‘X-‘{Xam A{Z gwVu godZ JZw© hþ±X¡Z&
 n[admaH$m gXñ¶/Aê$bo n{Z J^©dVr ‘{hbmH$mo AJm{‹S> ‘XnmZ dm Yy‘«nmZ JZw© hþ±X¡Z&
 S>m³Q>aH$mo g„mhAZwgma ‘mÌ Am¡f{Yhê$ godZ JZw©nN>©&
42
 C’$mZ} dmhZ/g‹S>H$hê$‘m J^m©dñWmH$m àW‘ a ApÝV‘ VrZ ‘hrZmgå‘ ¶mÌm JZ©Xo{I Omo{JZwnX©N>&
Cƒ Omo{I‘ ÊH$m J^m©dñWmhê$

Ho$hr J^©dVr ‘{hbmhê$ Cƒ Omo{I‘ AWdm O{Q>b J^m©dñWm‘m ahoH$m hþÝN>Z²& ¶r ‘{hbmhê$bmB© ñdmñÏ¶ Ho$ÝÐhê$‘m
nwè¶mBZwnX©N>& {ZåZ{b{IV pñW{Vhê$‘m J^m©dñWm Cƒ Omo{I‘‘m naoH$mo hþZg³N>…
 ‘{hbm 20 df©^ÝXm H$åVr C‘oaH$s {N>Z² ^Zo
 ‘{hbm 40 df©^ÝXm ~ogr C‘oaH$s {N>Z² ^Zo
 ‘{hbmH$m n{hë¶¡~mQ> VrZOZm gÝVmZ N>Z² ^Zo
 ‘{hbm Yoa¡ hmoMmo AWdm Yoa¡ A½bmo earaH$s A{Z AË¶ÝV H$åVr AWdm AË¶ÝV Yoa¡ AmoOZH$s {N>Z² ^Zo&
Cƒ Omo{I‘‘m naoH$s J^©dVr ‘{hbmH$mo {ZpåV-
{ZåZ{b{IV R>mC±hê$~mQ> àgdnyd©H$m godmhê$ CnbãY JamCZ g{H$ÝN>…
 Cn-Ho$ÝÐ‘m nÄOrH$aUÛmam àgdnyd©H$m MmadQ>m Om±Mhê$&
 Amdí¶H$Vm naoH$mo IÊS>‘m ANM -{gV g„mh Jaoa A{V[aº$ Om±Mhê$&
 ANM-H$mo g„mhAZwgma Kaobw hoaMmhH$mo ~obm {deof Ü¶mZ {XBZwnZ} hþÝN>&
 AmnmVH$mbrZ pñW{V‘m J^©dVr ‘{hbmbmB© IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa AñnVmb/{O„m
AñnVmb‘m b¡OmZwnX©N>&
 J^©dVr ‘{hbm a {VZH$mo n[admaH$m gXñ¶hê$bmB© gmV¡ {XZ Mm¡~rg¡ KÊQ>m ì¶mnH$ AmnmV àgy{V Ed‘²² ZdOmV hoaMmh
godm (Comprehensive Emergency Obstetric & Newborn Care, CEmONC) M¶Z JZ} g„mh {XZwnX©N>&
 S>m³Q>a{gV gag„mh {bBEH$mo A{Z S>m³Q>aH$m g„mhhê$ nmbZ J[aEH$mo gw{ZpíMV JZ© ASHA-bo J¥h-n[a^«‘Uhê$bmB©
àmW{‘H$Vm {XZo{N>Z²&
AmnmV nXm© a AmnmV Znar ñdmñÏ¶ Ho$ÝÐ‘m b¡OmZw…
J^m©dñWmH$mo ~obm VËH$mb¡ ñdmñÏ¶ Ho$ÝÐ‘m nwè¶mCZwnZ} ñdmñÏ¶gå~ÝYr g‘ñ¶m N> ^Zo Ë¶gbmB© AmnmVH$mbrZ g§àfo U
(Emergency Referral) ^{ZÝN>&
J^m©dñWmH$mo ~obm Ka‘m AdbmoH$Z Jaon{N> Ho$hr KÊQ>m dm EH$ {XZH$mo {ZpåV ñdmñÏ¶ Ho$ÝÐ‘m nwè¶mCZwnZ} pñW{V N> ^Zo
Ë¶gbmB© AZmnmVH$mbrZ g§àfo U (Non-Emergency Referral) ^{ZÝN>&
AmnmVH$mbrZ g§àfo U (Emergency Referral)
‘{hbm‘m IVamH$m {MÝhhê$ H$gar IwQ>çmCZo Mm{bZwnZ} nmBbm
¶mo{Z~mQ> aº$òmd- Hw$Z¡ n{Z ‘mÌm, Hw$Z¡ aº$òmd - Hw$Z¡ n{Z ‘mÌm (AË¶ÝV Z{OH¡$H$mo ñdmñÏ¶ Ho$ÝÐ, OñV¡- IÊS>
n{Z g‘¶‘m amVmo AWdm O‘o H $m aJV dm àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/àW‘ g§àofU
D$VH$hê$) J^m©dñWmH$mo Hw$Z¡ n{Z EH$mB© (FRU)/gXa AñnVmb/{O„m
g‘¶‘m, ZÌ ^Zo {eew AWdm AñnVmb‘m VËH$mb¡ b¡OmZwnN>©&
Am‘mH$mo n{Z ‘¥Ë¶w hþZo gå^mdZm
hþ±XN>
43
AmnmVH$mbrZ g§àfo U (Emergency Referral)
J^©‘m {eewH$mo hbMb ZhþZw àMÊS> noQ> ì¶Wm{gV¡ dm ì¶Wm{~Z¡
{eewbo hbMb JX£Z/bmÎmr hmÝX¡Z
Q>mCH$mo Xþ»Zw, [aL²>Q>m MëZw, Y{‘bmo Xo»Zw àMÊS> Q>mCH$mo Xþ»N> a Y{‘bmo Xop»N>Z,²
dm àMÊS> Q>mCH$mo Xþ»ZwH$mo gmW¡
Am±ImH$mo AJm{‹S> H$mbm Yã~mhê$
Xop»N>Z-² ¶r g~¡ ‘yÀN>m© nZwH© $m AWdm
‘yÀN>m© nZw©^ÝXm A{KH$m àmapå^H$ IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/àW‘
bjUhê$ hþZg³N>Z² g§ à o f U EH$mB© (FRU) /gXa
AñnVmb/{O„m AñnVmb‘m
gw{ÞEH$mo AZwhma/hmVIwÅ>m hËHo$bmH$mo nN>m{‹S> a nmCH$mo ‘mÏbmo VËH$mb¡ {bEa OmZwnN>©
^mJ‘m {WÀXm Im‹S>b nN>©
‘yÀN>m© nZw©/eara ~mC±{‹S>Zw Am±Imhê$ npëQ>ÝN>Z², AZwhma a

AL²>Jhê$ ~Q>m[aÝN>Z², eara H$måN>
a H$R>moa hþÝN>, ‘wÆ>rhê$ H${gÝN>Z²
AZmnmVH$mbrZ g§àofU (Non-Emergency Referral)

Ma‘ aº$mënVm (7 gm/dl AWdm
Ë¶mo^ÝXm H$åVr) {O~«mo Yoa¡ nh|bmo, H$‘Omoar, eara IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU
gm‘mÝ¶ê$nbo gw{ÞZw AñnVmb‘m A{Z Amdí¶H$ nao gXa
AñnVmb/{O„m AñnVmb‘m b¡OmZw
44
aVm¢Yr (am{V Am±Im ZXo»Zo)
J^©dVr ‘{hbmbmB© gm±P naon{N> ANM g‘j AWdm àmW{‘H$ ñdmñÏ¶
Am±Imbo Hw$Z¡ MrO Xo»Z Jmõmo hþÝN> Ho$ÝÐ‘m b¡OmZwnN>©
ß¶mam{gQ>m‘mob Q>çmãboQ> {XZwhmog,² 48

Ádamo ËdMmH$mo Vmn‘mZ 100 {S>J« r KÊQ>m{^Ì n{Z Vmn‘mZ H$åVr ZÊ
’$maoZhmBQ>^ÝXm ~ogr nwJoH$mo N> IÊS> ñdmñÏ¶ àmW{‘H$ Ho$ÝÐ/J«m‘rU
AñnVmb‘m b¡OmZwnN>©
‘yÌ Ë¶mJ JXm© nr‹S>m hþZw AWdm nmoboH$mo ‘yÌ WmåZ Zg³Zo pñW{V hþÝN> a KarKar {VZbmB© n¶m©á nmZr {nCZ {XZwhmog&² 24
AZw^d hþZw ‘yÌ Ë¶mJ JZ}© BÀN>m hþÝN>, ‘yÌ Ë¶mJ KÊQ>m{^Ì n{Z Hw$Z¡ amhV ZnmE IÊS> àmW{‘H$
ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/àmW{‘H$
JXm© nr‹S>m dm nmoboH$mo AZw^d hþÝN> ñdmñÏ¶ Ho$ÝÐ‘m b¡OmZwnN>©
AmoOZ KQ²>Zw {Z¸¡$ g‘¶md{Y‘m n{Z AmoOZ ~T²>X¡Z IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU
AñnVmb/gXa AñnVmb‘m b¡OmZwnN>©
ËdMm {MbmCZo / bw V mo / I{Q>am dm eara {MbmC±N> gmW¡ ËdMm amVmo hþÝN>, {nbmo {ZñHo$H$mo ^mJ‘m {XZ‘m XþBXo{I
{nbmohê$ {ZpñH$Zw n[admaH$m AÝ¶ gXñ¶hê$bmB© n{Z bwVmo VrZnëQ> VmVmo nmZrbo go³Zo g„mh
bmJoH$mo hþZg³N> {XZwnN>©&
{MbmCZo dm bwVmo {ZñHo$H$mo pñW{V‘m
ANM/àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ‘m
b¡OmZwnN>©&
nrn ^[aEH$mo {nbmohê$ (Ry>bmo) {ZñH$Zw Yoa¡dQ>m Am±Im ÊH$m Ry>bmo {nbmohê$
(‘Yw‘ohH$mo Om±M Amdí¶H$ nZ©g³N>)
n{hbo n{Z àgy { Vgå~ÝYr Zam‘« m n{hbm Hw$Z¡ J^©nmV, ‘¥V {eewH$mo OÝ‘ IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU
pñW{Vhê$ ahoH$mo AWdm ZdOmVH$mo ‘¥Ë¶w AWdm n{N>„mo AñnVmb/gXa AñnVmb‘m
J^m©dñWm‘m O{Q>bVmH$mo H$maUbo b¡OmZwnN>©&
Amdí¶H$ {gOo[a¶Z àgd
{eewH$mo Añdm^m{dH$ pñW{V‘m OÝ‘ noQ>H$mo Om±Mn{N> ANM AWdm S>m³Q>aÛmam

gÝXohOZH$/AñWm¶r {ZXmZ
45
~hþgL²>»¶H$ J^©YmZ (EH$^ÝXm ~‹T>r no Q >H$mo Om± M n{N> ANM AWdm
^«yU) S>m³Q>aÛmam gÝXohOZH$/AñWm¶r
{ZXmZ
ídoVòmd AWm©V² goVmo Vab {ZpñH$Zw ¶mo{Z~mQ> goVmo Vab {ZpñH$ÝN>, àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ‘m b¡OmZwnN>©
JwámL²>Jhê$ {MbmC±N>Z²
gwa{jV àgdH$mo ¶moOZm

gwa{jV àgdH$m ¶moOZmhê$‘m {ZåZ{b{IV Hw$amhê$ gm‘ob hþÝN>Z²…
 n{N>„mo ApÝV‘ ‘m{gH$ MH«$ (LMP)-‘m{W AmYm[aV Ano{jV àgd {‘{V (EDD)-H$mo JUZm JZw©nN>©&
 Ano{jV àgd {‘{V~mao n[admabmB© OmZH$mar a g„mh {XZwnN>©&
 H$hm± àgd JamCZo hmo Ë¶mo Ho$ÝÐbmB© {MpÝhV a M¶Z JZw©nN>©&
 gm‘mÝ¶ a O{Q>b àgd‘m Amdí¶H$ nZ} Hw$amhê$bmB© Ü¶mZ‘m amIoa Ho$ÝÐbmB© {MpÝhV a M¶Z JZw©nN>©&
 KaXo{I Ho$ÝÐgå‘ ¶mVm¶mV gmYZH$mo ì¶dñWm&
 ANM-{gV OÝ‘ ¶moOZmhê$~mao Hw$amH$mZr JZw©&
 J^m©dñWmH$mo ~obm AmBnZ©g³Zo Hw$Z¡ AmnmV pñW{VH$mo {ZpåV n¡gm ~MV J[aam»Z g~¡ J^©dVr ‘{hbmhê$ a {VZH$m
n[admahê$bmB© ghm¶Vm JZw©nN>©&
 àgdH$mo {ZpåV J^©dVr ‘{hbm AWdm {VZH$m A{^^mdH$hê$H$mo Ka‘m AWdm g§ñWmZ‘m Om±Xm Amdí¶H$ g~¡ H$mJO-nÌhê$ ~mo³Z
CZrhê$bmB© gh¶moJ a g„mh {XZwnX©N> Ogbo J^©dVr ‘{hbmbmB© {ZaÝVa godmhê$ àmá ^BahZo Hw$am gw{ZpíMV JamC±XN>&
àgdA{K H$åVr‘m n{Z EH$nëQ> J^©dVr ‘{hbmbmB© Ho$ÝÐ‘m b¡OmZw A{Z godm àXmVm{gV {VZbmB© n[aM¶ JamCZw ~oe hmo&
gwa{jV àgdH$mo ¶moOZm‘m ASHA-H$mo ^y{‘H$m
 àgd ¶moOZm Xmoòmo àgdnyd© Om±Mn{N> A{J«‘ ê$n‘m ~ZmBEH$mo hþZwnX©N>&
 gwa{jV àgdH$mo ¶moOZm J^©dVr ‘{hbm, {VZH$mo n[admaH$m gXñ¶hê$ a n[admaH$m AÝ¶ {ZU©¶ J«hUH$Vm©hê${gV
gag„mh Jaoa ~ZmBEH$mo hþZwnN>©&
 Voòmo {V‘mhr (gmV ‘hrZmn{N>) n[adma a ANM-{gV ¶moOZm‘m{W nwZ{d©Mma JZw©nN>©&
 àgdH$mo {ZpåV g§ñWmZH$mo M¶Z A{Z ¶mVm¶mV gmYZH$mo ì¶dñWm {ZpíMV JZw©nN>©&
 gwa{jV àgdH$mo {ZpåV Cn¶wº$ g§ñWmZ {MpÝhV JZw©nN>©&
gwa{jV àgdH$mo {ZpåV {dH$ënhê$
Hw$Z¡ IVamH$mo {MÝh dm O{Q>bVm N> {H$ N>Z¡ …
J^©dVr ‘{hbm a {VZH$mo n[admabmB© ¶ñVmo g§ñWmZ‘m OmZo g„mh {XZwnN>© Ogbo gmV {XZ 24 KÊQ>¡ ì¶mnH$ AmnmVH$mbrZ
àgy{V Ed‘² ZdOmV hoaMmh (CEmONC)-H$m godmhê$ àXmZ JX©N>&
46
Hw$Z¡ O{Q>bVmhê$ N>Z¡ Z² ^Zo…
J^©dVr ‘{hbm a {VZH$mo n[admaH$m gXñ¶hê$bmB© Ë¶mo g§ñWmZ‘m OmZo g„mh {XZwhmog² OwZ gmV¡ {XZ 24 KÊQ>¡ Iw„m ahÝN>
A{Z Ohm± S>m³Q>a a Zg©hê$H$mo Q>mobrbo àgd JamC±N>Z² A{Z Am‘m a {eewH$mo CnMma a hoaMmh JX©N>Z²&
Amdí¶H$ naoH$mo IÊS>‘m J^©dVr ‘{hbmbmB© AP CƒñVar¶ CnMma Ho$ÝÐ‘m nR>mCZH$m bm{J Ë¶mo g§ñWmZ‘m ¶mVm¶mV
gmYZH$mo gw{dYm ahoH$mo hþZwnN>©&
¶{X Hw$Z¡ O{Q>bVmhê$ N>Z¡ Z²² A{Z J^©dVr ‘{hbm a {VZH$mo n[admaH$m gXñ¶hê$ g§ñWmZJV àgdH$mo {ZpåV OmZ A{ZÀNw>H$ N>Z² ^Zo…
Hw$eb OÝ‘ n[aMmaH$ (SBA)-Ûmam àgd g#mmbZ JamCZ ^Zr J^©dVr ‘{hbm a {VZH$mo n[admabmB© g„mh {XZwhmog²&
Hw$eb OÝ‘ n[aMmaH$ SBA Vr ì¶{º$ hþZ² Ogbo-
 ñdm^m{dH$ àgd JamCZ g³N>Z²&
 IVamH$m {MÝhhê$ {MpÝhV JZ©g³N>Z² A{Z g‘¶‘¡ ñdmñÏ¶ Ho$ÝÐ‘m nR>mCZg³N>Z²&
 {eam{^Ì gwB© bJmCZg³N>Z²&
 EÝQ>r~m¶mo{Q>³g {XbmCZg³N>Z²&
 Amdí¶H$ naoH$mo IÊS>‘m ^JN>oXZ (eposiotomy) ‘aå‘V JZ©g³N>Z²&
Ka‘¡ àgdH$mo pñW{V‘m OÝ‘H$mo V¶mar
‘m{W C„oI J[aEH$m‘Ü¶o Hw$Z¡ n{Z {dH$ën gå^d N>¡Z A{Z J^©dVr ‘{hbmbo Ka‘¡ àgd JZ} pñW{V AmE {ZåZ{b{IV
Hw$amhê$‘m{W Ü¶mZ {XZwnN>©…
 àgd H$moR>m O{Vg³Xmo g’$m hþZwnN>©&
 Ë¶mo H$moR>m em¡Mmb¶H$mo Z{OH$ AWdm Hw$Z¡ Aì¶dpñWV dm KaH$mo Hw$Z¡ ‘¡bmo R>mC±‘m hþZw hþ±X¡Z&
 5 ñdÀN>Vm (AWm©V².- ñdÀN> hmV, ñdÀN> ñWmZ, ñdÀN> ãboS>, ñdÀN> YmJmo a ñdÀN> Zm{^VÝVw) ahoH$mo gw{ZpíMV
JZw©nX©N>&
 àgdH$mo ~obm A{Z Zm{^VÝVw H$mQ²>Xm Vm{b‘àmá ì¶{º$ AWdm Hw$eb OÝ‘ n[aMmaH$ (SBA) CnbãY hþZwnN>©&
 {eewbmB© bonQ²>ZH$mo {ZpåV g’$m gwVr dñÌ A{Z H$å~b V¶ma am{IEH$mo hþZwnX©N>&
 Amdí¶H$ naoH$mo IÊS>‘m ñdmñÏ¶ Ho$ÝÐ‘m nR>mCZH$m bm{J n¡gm V¶ma am{IEH$mo hþZwnN>©&
J^m©dñWm‘m ‘bo[a¶m
‘bo[a¶m (Am¡bo Ádamo) Ho$ hmo?
‘bo[a¶m ECQ>m OrdmUwO{ZV {~‘mar hmo& gL²>H«${‘V nmoWr bm‘IwÅ>o (Anopheles)-bo ‘m{ZgbmB© Q>mo³Xm Ë¶gH$mo è¶mbÛmam
aJV{^Ì naOrdrhê$ ngon{N> ‘m{Zg ‘bo[a¶mbo AmH«$mÝV hþÝN>&
J^©dVr ‘{hbm‘m{W ‘bo[a¶mH$m Agahê$ J^©ñW {eew‘m{W ‘bo[a¶mH$m Agahê$
· aº$mënVm · J^©nVZ
· aJV‘m {MZrH$mo ‘mÌm KQ²>Zw (hypoglycaemia) · g‘¶nyd© àgd
· OpÝS>g · {eewH$mo d¥{Õ‘m {dH¥${V dm ~mYm AmCZw (IUGR)
· {H$S²>Zr {~{J«Zw dm H$‘Omoa hþZw · J^©ñW {eewH$mo ‘¥Ë¶w hþZw
· gmg {bZ Jmõmo hþZw
47
J^m©dñWm‘m ‘bo[a¶m ÊH$mo IÊS>‘m J^©dVr ‘{hbmbmB© CnMmaH$mo {ZpåV VËH$mb¡ Z{OH¡$H$mo ñdmñÏ¶ Ho$ÝÐ‘m b¡OmZwnX©N>&
‘bo[a¶mH$mo amoH$Wm‘…
 H$V¡ nmZr ZO{‘¶mog² AWdm nmZr à¶moJ ZÊa ZWw{à¶mog² ^ÝZo Hw$am‘m gmdYmZ ahZwnX©N>&
 J^©dVr ‘{hbm AWdm ñVZnmZ JamCZo ‘{hbmg{hV ZdOmVH$mo {ZpåV Am¡f{Y¶wº$ ‘ÀN>‹S>XmZrH$mo à¶moJbmB© ~‹T>mdm
{XZwnX©N>&
 Zmbr AWdm Zhahê$‘m nmZr OåZ {XZw hþ±X¡Z&
JwUñVar¶ àgdnydH© $m hoaMmhhê$ gw{ZpíMV JZ} H$m¶©‘m ASHA-H$mo ^y{‘H$m
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48
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49
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50
Voòmo MaU…
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51
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52
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55
 ¶g Vm{bH$mbmB© 6 hámH$mo gånyU© gwËHo$ar AdñWm^[a nmbZ Adí¶ JZw©nN>©&
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 Am±Imhê$H$mo C{MV hoaMmhbo ZdOmVbmB© gL²>H«$‘U~mQ> ~MmCZg³N>&
 g‘¶‘¡ Imon (Q>rH$m)-hê$ {XbmE {VZrhê$bo ZdOmVH$mo amoJà{VamoY j‘Vm ~‹T>mC±N>Z²&
 ZdOmV Ed‘² {eew AñdñWVmH$mo EH$sH¥$V à~ÝYZ (Integrated Management of Neonatal and Childhood Illness,
IMNCI) ZdOmVH$mo OrdZ ~MmCZo ECQ>m à^mdH$mar V[aH$m hmo&
ZdOmVH$mo hoaMmhH$m CnmXmZhê$…
 Cnamoº$ Cnm¶hê$ gw{ZpíMV JZ© g‘¶AZwgma J¥h-^«‘U JZw©&
 Ka‘¡ àgdH$mo pñW{V‘m OÝ‘n{N> VËH$mb¡ Amdí¶H$ hoaMmh gw{ZpíMV JZw©&
 OpÝ‘Zo{~{ÎmH¡$ ZdOmVH$mo Om±M JZw© Og‘m ZdOmVH$mo AmoOZ ZmßZw, C{MV Vmn‘mZ H$m¶‘ am»Z bwJmbo ~oZw©, Vmn‘mZ
ZmßZw, ídgZ JÝVr JZw© Am{X gm‘ob ahoH$m hþÝN>Z²&
 {eewbmB© 6 ‘{hZmH$mo C‘oagå‘ Ho$db Am‘mH$mo XÿY IwdmCZo g„mh {XZw&
 ñVZnmZgå~ÝYr Hw$Z¡ g‘ñ¶m aho Ë¶gH$mo g‘mYmZ JZw©&
 ZdOmVbmB© Ý¶mZmo am»Zo g„mh {XZw&
 Am±Im, ËdMm a Zm{^VÝVwH$mo C{MV hoaMmh~mao Am‘m a n[admaH$m gXñ¶hê$bmB© gag„mh {XZw A{Z Amdí¶H$
ghm¶Vm àXmZ JZw©&
 ZdOmV‘m IVamH$mo bjU {MpÝhV JZw© A{Z CnMmaH$mo {ZpåV VËH$mb AñnVmb nwè¶mCZw&
 n[admaH$m gXñ¶hê$bo H$gar ZdOmVH$mo hoaMmh JZ©g³N>Z² ^Þo~mao Amdí¶H$ g„mh {XZw&
 g‘¶ ZnwJr OÝ‘oH$m, H$åVr OÝ‘-AmoOZH$m, AñdñW ZdOmVhê$H$mo C{MV hoaMmhH$mo g„mh {XZw A{Z Amdí¶H$ nao
ghm¶Vm àXmZ JZw©&
60
 g‘¶‘¡ Imon {XBEH$mo gw{ZpíMV JZw©&
ZdOmVH$mo hoaMmhH$mo {ZpåV J¥h-^«‘Uhê$H$mo g‘¶-Vm{bH$m
 ZdOmVbmB© Ý¶mZmo am{I>>±X¡N> a CgbmB© ñVZnmZ ‘mÌ JamB±X¡N> ^Þo Hw$am gw{ZpíMV JZ© ASHA-bo J¥h-^«‘U JZ}{N>Z²&
{eewbmB© ñVZnmZ JamCZ Am‘mbmB© àmoËgm{hV JZ}{N>Z²& ~moVb~mQ> XÿY IwdmCZo, Mm±‹S>¡ ZwhmB{XZo, ‘wI~mQ> Aê$ ImZoHw$am
IwdmB{XZo OñVm hm{ZH$maH$ {H«$¶mH$bmnbmB© {VZbo amo³ZwnN>&© KarKar J¥h-^«‘U JXm© ZdOmV‘m gL²>H$« ‘UH$mo Hw$Z¡
gL²>Ho$V AWdm AÝ¶ {~‘marhê$ {MpÝhV JZ© ‘XV nmBÝN>&
 g§ñWmZJV OÝ‘H$mo pñW{V‘m- g~¡ ZdOmV a 14 {XZ nyam JaoH$m gwËHo$ar Am‘mhê$H$mo {ZpåV ASHA-bo Voòmo, gmVm¢ a
14Am¢ {XZ J¥h-^«‘U JZ}{N>Z²&
 Ka‘¡ àgdH$mo pñW{V‘m - g~¡ ZdOmV a 14 {XZ nyam JaoH$m gwËHo$ar Am‘mhê$H$mo {ZpåV ASHA-bo n{hbmo (àgdH$mo
24 KÊQ>m{^Ì), Voòmo, gmVm¢ a 14Am¢ {XZ J¥h-^«‘U JZ}{N>Z²&
 g§ñWmZJV a Ka‘m àgd Xþd¡ pñW{V‘m - g~¡ ZdOmV a 42 {XZ nyam JaoH$m gwËHo$ar Am‘mhê$H$mo {ZpåV ASHA-bo
21Am¢, 28Am¢ a 42Am¢ {XZ J¥h-^«‘U JZ}{N>Z²&
 H$åVr OÝ‘-AmoOZ ÊH$m, g‘¶ ZnwJr OÝ‘oH$m A{Z AñdñW ZdOmVhê$H$m bm{J A{V[aº$ ^«‘Uhê$H$mo
Amdí¶H$Vm nX©N>&
¶g à{ejU‘m {gH$mBZo hmV YwZo gånyU© à{H«$¶mAZwgma hmV YmoBgHo$a ‘mÌ ASHA-bo ZdOmVH$mo Om±M JZ© g³Zo{N>Z&²
hmV YwZo gånyU© à{H«$¶m…
Amdí¶H$ gm‘J«rhê$… gm~wZ, EH$ ~mëQ>r g’$m nmZr, hmVmo¶wº$ ‘J
à{H«$¶m…
1. Xþd¡ hmVH$m Am¢R>r, Mwam, Zm‹S>r K‹S>r AWdm AÝ¶ Hw$Z¡ JhZm dm {’$Vmhê$ ’w$H$mëZwhmog²& bwJmH$m ~mhþbmhê$ Hw${hZmgå‘
nQ>çmCZwhmog²&
2. hmV a nmIwamhê$ Hw${hZmgå‘ g’$m nmZrbo {ÔmCZwhmog²&
3. {ÔoH$m hmV a nmIwamhê$‘m Hw${hZmgå‘ am‘«ar gm~wZ bJmCZwhmog² a {’>>±$O {ZpñH$ZoJar XëZwhmog²&
4. Xþd¡ hmVH$m hËHo$bmhê$bmB© AKm{‹S>Xo{I n{N>pëVa KñZwhmog² A{Z Am¢brH$m Monhê$bmB© n{Z XëZwhmog²&
5. Xþd¡ hmVH$m nmoahê$bmB© XëZwhmog²&
6. Xþd¡ hmVH$m ~w‹T>r Am¢brhê$bmB© XëZwhmog²&
7. Xþd¡ hmVH$m ZL²>hê$bmB© hËHo$bm‘m Xboa KñZwhmog²&
8. Xþd¡ nmIwamhê$bmB© {~ñVma¡ ‘wpÝVa KñX¡ Xþd¡ Zm‹S>rbmB© XëZwhmog²&
9. àË¶oH$ MaUbmB© H$åVr‘m n{Z 10 nëQ> Xmohmoè¶mCZwhmog²&
10. AmâZm hmV a nmIwamhê$bmB© g’$m nmZrbo nyU©ê$n‘m H$åVr‘m n{Z VrZnëQ> YwZwhmog²&
11. Hw${hZmhê$bmB© ‘wpÝVa nmaoa hmVhê$bmB© ‘m{W CMmboa hmdmbo gwH$mCZwhmog²&
12. hmVhê$bmB© gwH$mCZ Vm¡{b¶m AWdm Hw$Z¡ bwJm à¶moJ ZJZw©hmog² A{Z hmVhê$ YmoBgHo$n{N> ^wB± AWdm ’$mohmoa
MrOhê$bmB© hmVbo ZNw>Zwhmog²&
61
hmV YwZo à{H«$¶m‘m g§b½Z MaUhê$
ídmgamoY (Asphyxia)
ZdOmV OÝ‘on{N> Cg‘m {ZåZ{b{IV‘Ü¶o Hw$Z¡ n{Z bjU Xo{IE CgbmB© ídmgamoY AWdm gmg {bZ Jmõmo ÊH$mo
~wÂZwnX©N>…
 ZéZw
 H$‘Omoa amoXZ
 gmg Z{bZw
 H$‘Omoa ídgZ AWdm ñ¶m± ñ¶m± hþZw
ghr g‘¶‘m ghr nmBbm ZMm{bE dm Cnm¶ ZJ[aE ZdOmVH$mo {ZpåV ídmgamoY AË¶ÝV IVaZmH$ hþZg³N>& ZdOmV ~m±À¶mo Z¡ ^Zo n{Z
CgbmB© {d{^Þ g‘ñ¶mhê$ hþZg³N>Z², OñV¡- ~w{Õ‘ÝXVm (~m¡{ÕH$ Aeº$Vm) AWdm eara a AL²>Jhê$ ~mC±{‹S>Ea ‘yÀN>m© nZ} Am{X&
àgdH$mo ~obm ídmgamoYH$m MoVmCZr‘ybH$ {MÝhhê$…
 XrK©bpå~V/H${R>Z àgd&
 h[a¶mo AWdm nh|bmo aL²>JH$mo ~m³bmo Vab CËgO©Z&
 n{hbm Zm{^ {ZpñH$Zo AWdm Km±Q>rd[an[a Zm{^ ~o{õEH$mo pñW{V&
 g‘¶ ZnwJr àgd hþZw
 àgdH$mo ~obm ZmZr ¶ñVmo pñW{V‘m hþZw Og‘m n{hbm CgH$mo Q>mCH$mo {ZpñH>>±$X¡Z&
 ZmZr ¶ñVmo pñW{V‘m hþZw Og‘m ZmZr n{hbm {ZpñH>>±$X¡Z&
62
OÝ‘on{N> ZdOmVbmB© Om±ÀZw
{eew "OpÝ‘Zo{~{ÎmH¡$' Mm{bZwnZ} nmBbmhê$
¶{X {eew Ka‘¡ OpÝ‘EH$mo hmo A{Z àgdH$mo ~obm ASHA CnpñWV {N>Z² ^Zo,
 nmZr {ZpñH$En{N> VabbmB© AdbmoH$Z JZw©hmog²/Am‘mbmB© Ë¶g~mao gmoÜZwhmog²&
 ¶{X Ë¶mo Vab nh|bmo/h[a¶mo N> ^Zo, Q>mCH$mo {ZpñH$Zo{~{ÎmH¡$ (gånyU© {eewH$mo àgdA{KZ¡) JOH$mo Qw>H«$m AWdm g’$m
{H$Q>mUwa{hV bwJmbo {eewH$mo ‘wI g’$m J[a{XZwhmog²&
 {eew OpÝ‘Zo{~{ÎmH¡$ OÝ‘H$mo g‘¶ (goHo$ÝS>/{‘ZQ>) bo»Zwhmog² a g‘¶H$mo JUZm ewé JZw©hmog²&
OÝ‘on{N> AWdm OÝ‘oH$mo àW‘ 30 goHo$ÝS> A{Z àW‘ 5 {‘ZQ>{^Ì {eewH$mo AdbmoH$Z JZw©hmog²& ¶g Om±MH$mo CÔoí¶
{eewH$m AL²>J-àË¶L²>Jhê$H$mo J{V{d{Y a {eewbo R>rH$g±J gmg ’o$[aahoH$mo N> {H$ N>¡Z A{Z amoBahoH$mo N> {H$ N>¡Z ^Zr
AdbmoH$Z JZw© hmo&
Or{dV a ‘¥V OÝ‘ Om±M
30 {‘ZQ>‘m Om±M
amoXZ AL²>Jhê$H$mo J{V{d{Y ídgZ
N> N> N>

N>¡Z N>¡Z N>¡Z
Or{dV OÝ‘
N>¡Z N>¡Z N>¡Z

N>¡Z N>¡Z N>¡Z
‘¥V OÝ‘
¶r g~¡ "N>¡Z'-bo ‘¥V {eewH$mo OÝ‘~mao KmofUm JX©N>Z²& Vr‘Ü¶o Hw$Z¡ ECQ>¡ n{Z "N>' Ê Or{dV {eewH$mo OÝ‘ ÊH$mo KmofUm
JZ©g{H$ÝN>&
63
ZdOmVH$mo n{hbmo Om±M
ASHA-bo {ZåZ{b{IV Hw$amhê$ ~wÂZH$m bm{J àgdH$mo àW‘ 24 KÊQ>m{^Ì n{hbmo Om±M JZ}{N>Z²…
 ZdOmVbo H$gar ñVZnmZ J[aahoH$mo N> A{Z CgbmB© H$gar ñVZnmZ JamB±X¡N>&
 {eew amoEH$mo gwÝZwhmog² A{Z CgbmB© Hw$Z¡ g‘ñ¶m N> {H$ N>¡Z Ë¶mo ~wÂZo à¶mg JZw©hmog²&
 Zm{^VÝVw gw³Im a g’$m N> {H$ N>¡Z Ë¶mo Om±M JZw©hmog²&
ZdOmV OÝ‘on{N> Cg‘m {ZåZ{b{IV OÝ‘-{dH¥${Vhê$ N>Z² {H$ N>Z¡ Z² Ë¶mo {MpÝhV JZwh© mog…²
 ZdOmVH$m AL²>Jhê$ bwbm dm ~mL²>{JEH$m N>Z² {H$ N>¡ZZ²&
 ZdOmVH$mo Q>mCH$mo‘m Jm±R>mo N> {H$ N>¡Z&
 ZdOmVH$mo AmoR> Iw±‹S>mo naoH$mo N> {H$ N>¡Z&
 AÝ¶ Hw$Z¡ Añdm^m{dH$Vmhê$&
ZdOmVH$mo earaH$mo Vmn‘mZH$mo XoIaoI…

 ZdOmVH$mo gm‘mÝ¶ Vmn‘mZ 97.7 {S>J«r ’$maoZhmBQ> hmo&
 ZdOmV‘m gm‘mÝ¶ Vmn‘mZH$mo gr‘m 97 {S>J«r ’$maoZhmBQ>Xo{I 98.6 {S>J«r ’$maoZhmBQ>gå‘ hþ±XN>&
 ¶{X ZdOmVH$mo Vmn‘mZ 97 {S>J«r ’$maoZhmBQ>^ÝXm H$åVr Va 95 {S>J«r ’$maoZhmBQ>^ÝXm ~ogr N> ^Zo ZdOmVH$mo earaH$mo
Vmn‘mZ KQ²>X¡ JBahoH$mo a CgH$mo eara {Mgmo hþ±X¡ JBahoH$mo ~wÂZg{H$ÝN>&
 ¶{X ZdOmVH$mo Vmn‘mZ 95 {S>J«r ’$maoZhmBQ> AWdm Ë¶mo^ÝXm H$åVr N> ^Zo CgH$mo eara {Mgmo ÊH$mo a CgbmB©
AënVmn (Hypothermia) ÊH$mo ~wÂZg{H$ÝN>&
 ¶{X ZdOmVH$mo Vmn‘mZ 99 {S>J«r ’$maoZhmBQ> AWdm Ë¶mo^ÝXm ~ogr N> ^Zo CgH$mo eara VmVmo ÊH$mo AWdm CgbmB©
CƒVmn (Hyperthermia) ÊH$mo ~wÂZg{H$ÝN>&
 ZdOmVbmB© F$Vw/‘m¡g‘AZwgma bwJm‘m am‘«ar ~oõoa am»ZwnX©N>&
 ZdOmVbmB© Am‘m{gV ËdMm‘m ËdMm Q>±gmEa am»ZwnX©N>&
 ZdOmVbmB© KarKar ñVZnmZ JamBahZwnN>©&
 H$moR>m~mQ> {ÔoH$m AWdm {Mgmo bwJm/H$å~bhê$ hQ>mCZwnX©N>&
 ZdOmVH$mo Zm{^VÝVw ZgwHo$gå‘ A{Z ZPaogå‘ AWdm OÝ‘on{N> H$åVr‘m n{Z 5 Xo{I 7 {XZgå‘ CgbmB© ZZwhmB{XZ
^Zr n[adma a Am‘mbmB© g„mh {XZwnN>©& ~é {VZrhê$bo Za‘ bwJm hëH$m VmVmo nmZr‘m {ÔmEa Ë¶gbo ZdOmVH$mo
eara nw{N>{XZg³N>Z²&
 ¶{X ZdOmV‘m {ZåZ{b{IV bjUhê$ XoIm nao CgbmB© PÅ>¡ ñdmñÏ¶ Ho$ÝÐ‘m (Ohm± ZdOmVH$mo {ZpåV Cn¶wº$ CnMma
gw{dYm CnbãY N>) b¡OmZw Amdí¶H$ N>…
- ZdOmVH$m IwÅ>mhê$ {Mgmo ÊH$m N>Z², {~ñVma¡ eara {Mgmo hþ±X¡N> A{Z ZdOmVbo ñVZnmZ JZ©g{H$ahoH$mo N>¡Z&
- AñnVmb {bEa Om±Xm ZdOmVbmB© ñVZnmZ JamBahZwnN>© a CgbmB© bwJm‘m am‘«ar bno{Q>EH$mo hþZwnN>©&
 ZdOmVH$mo eara VmVmo ÊH$mo N> A{Z ZdOmV‘m {ZåZ{b{IV bjUhê$ XooIm naoH$m N>Z² ^Zo CgbmB© VËH$mb¡
64
ñdmñÏ¶ Ho$ÝÐ‘m (Ohm± ZdOmVH$mo {ZpåV Cn¶wº$ CnMma gw{dYm CnbãY N>) b¡OmZw Amdí¶H$ N>…
- N>Q>nQ>mBahoH$mo N>
- {N>Q>mo{N>Q>mo gmg ’o$X£N>
- AZwhma {~ñVma¡ amVmo ^¶mo
- {~ñVma¡ AË¶{YH$ W{H$V a nh|bmo ^¶mo
- AZwhma a AÝ¶ AL²>Jhê$ ~mC±±{‹S>Ea eara H$m{‘ahoH$mo N>
- ~ohmoe ^¶mo
ZdOmVH$mo earaH$mo Vmn‘mZ 97 {S>Jr« ’$maoZhmBQ>^ÝXm H$åVr Va 95 {S>J«r ’$maoZhmBQ>^ÝXm ~ogr N> ^Zo {ZåZ{b{IV
nmBbmhê$ MmëZwnN>…©
 Kaobw {d{Yhê$Ûmam H$moR>mH$mo Vmn‘mZ ~‹T>mCZwhmog² (OñV¡, ECQ>m ^m±‹S>m‘m AmJmo hmboa H$moR>mH$mo EH$ Hw$Zm‘m am{I{XZwhmog²,
Am{X)
 Hw$Z¡ {ÔoH$m H$å~b dm bwJmhê$ N>Z² ^Zo VËH$mb¡ hQ>mB{XZwhmog² A{Z Iw„m T>moH$m/Â¶mbhê$ ~ÝX J[a{XZwhmog²&
 ZdOmVbmB© H$L²>Jmê$ {d{YÛmam Ý¶mZmo amIoH$mo gw{ZpíMV JZw©hmog²& ¶g {d{YH$m MaUhê$ {ZåZ{b{IV hþZ²…
- Am‘mH$mo {ZpåV A‹S>og bm½Zo ì¶dñWm J[a{XZwnX©N>&
- Am‘mbmB© Amam‘{gV ~ñZ dm A‹S>og bmJoa gwËZ ^ÞwnN>©&
- ZdOmVH$mo Q>monr, H$Q²>Qw> a ‘moOm N>mo‹S>ao Aê$ bwJmhê$ Imo{b{XZwnN>©&
- ZdOmVbmB© Q>monr a ‘moOm bJmB{XBEH$mo N>¡Z ^Zo Ë¶mo Adí¶ bJmB{XZwnN>©& Q>monr nmBEZ ^Zo g’$m Za‘ gwVr
bwJmbo Q>mCH$mo N>mo{n{XZwnN>©&
- Am‘mH$mo N>mVr‘m XþB ñVZH$mo ~rM‘m ZdOmVbmB© CÎmmZmo nmaoa, IwÅ>m gmoPmo nmaoa grYm gwVmCZwnN>© Vm{H$
Am‘mH$mo earaH$mo ËdMm{gV ZdOmVH$mo earaH$mo ËdMm Q>m±{gEH$mo hmog²&
- ZdOmVbmB© gmg ’o$Z© Agw{dYm Zhmog² ¶gH$maU ZdOmVH$mo Q>mCH$mobmB© EH$n{Å> Kw‘mB{XZwnN>©&
- Am‘mH$mo Mmobmo dm Am±Mbbo ZdOmVbmB© N>m{o n{XZwnN>© A{Z Ë¶g‘m{W Am‘m a ZdOmV Xþd¡bmB© EH$gmW
ECQ>m H$å~b dm emb Amo‹T> mB{XZwnN>©&
 ZdOmVbmB© H$L²>Jmê$ {d{Ybo Ý¶mZmo am»ZwH$mo gmWgmW¡ CgbmB© {ZaÝVa ñVZnmZ JamBahZwnN>©&
 30 {‘ZQ>gå‘ ¶mo {d{Y AßZmEn{N> ZdOmVbmB© H$L²>Jmê$ {d{Y~mQ> hQ>mEa CgH$mo earaH$mo Vmn‘mZ ZmßZwnN>©&
- ¶{X ZdOmVH$mo earaH$mo Vmn‘mZ gm‘mÝ¶ ^¶mo ^Zo CgbmB© Ý¶mZmo bwJmhê$bo bnoQ>oa Am‘mg‘j gwpånZwnN>©& CgbmB©
{ZaÝVa ñVZnmZ JamBahZ ^Zr Am‘mbmB© ~VmCZwnN>©&
- ¶{X ZdOmVH$mo earaH$mo Vmn‘mZ Ë¶ñV¡ ah²¶mo AWdm AP KQ²>¶mo ^Zo CgbmB© H$L²>Jmê$ {d{Y AßZmC±X¡ A{Z {ZaÝVa
ñVZnmZ JamC±X¡ VËH$mb¡ AñnVmb nwè¶mCZwnN>©&
- ¶{X ZdOmVH$mo earaH$mo Vmn‘mZ ~T²>¶mo Va ñdm^m{dH$ Vmn‘mZgå‘ nwJoZ ^Zo AP¡ 30 {‘ZQ>gå‘ H$L²>Jmê$ {d{Y
AßZmCZwnN>© a {ZaÝVa ñVZnmZ n{Z JamBahZwnN>©&
 ’o$[a Vmn‘mZ ZmßZwhmog²&
 AP¡ n{Z Vmn‘mZ ñdm^m{dH$ AdñWm‘m nwJoH$mo N>Z ¡ ^Zo H$L²>Jmê$ {d{Y AßZmC±X¡ A{Z {ZaÝVa ñVZnmZ JamC±X¡ ZdOmV
a Am‘m Xþd¡bmB© PÅ>¡ AñnVmb nwè¶mCZwnN>©&
65
 ¶{X earaH$mo Vmn‘mZ ñdm^m{dH$ ^¶mo ^Zo ZdOmVbmB© Ý¶mZmo bwJm‘m bnooQ>oa Am‘mbmB© gwpånZw{XZwhmog²& {eewbmB©
{ZaÝVa ñVZnmZ JamBahZ ^Zr Am‘mbmB© ~VmCZwhmog²&
 Am‘m~mhoH$ n[admaH$m AÝ¶ gXñ¶hê$bo n{Z gag’$mB© H$m¶‘ amIoa H$L²>Jmê$ {d{Y AßZmCZg³N>Z²&
ZdOmVH$mo earaH$mo Vmn‘mZ 99 {S>Jr« ’$maoZhmBQ> AWdm Ë¶mo^ÝXm ~ogr N>, AWm©V² CgH$mo eara Vm{VEH$mo (Hyperthermia) N>
^Zo…
 ‘m¡g‘ VmVmo N> ^Zo ZdOmVH$m bwJmhê$ a Q>monr ’w$H$m{b{XZwhmog²&
 H$moR>mH$mo VmVmo hmdm ~m{ha {ZñH$Z nmAmog² ^Zr T>moH$m a Â¶mbhê$ Imo{b{XZwhmog²&
 H$moR>m‘m Hw$Z¡ AË¶{YH$ Cî‘m (VmVmonZ) â¶m±³Zo Hw$Z¡ MrO N> ^Zo Ë¶gbmB© hQ>mB{XZwhmog²&
 ZdOmVbmB© {ZaÝVa ñVZnmZ JamBahZwnN>©&
 30 {‘ZQ>gå‘ nI}n{N> ZdOmVH$mo earaH$mo Vmn‘mZ ZmßZwnN>©&
- ZdOmVH$mo earaH$mo Vmn‘mZ ñdm^m{dH$ ^¶mo ^Zo J‘u ‘m¡g‘‘m ZdOmVbmB© A{V[aº$ bwJmhê$ Amo‹T>mEa amIoH$mobo
CgH$mo earaH$mo Vmn‘mZ ~‹T>oH$mo {W¶mo ^Zr Am‘mbmB© am‘«ar ~VmB{XZwnN>©& ¶g pñW{V‘m Am‘mbo ZdOmVbmB©
{ZaÝVa ñVZnmZ JamBahZwnN>©&
- ¶{X ZdOmVH$mo earaH$mo Vmn‘mZ Ë¶{V Z¡ ah²¶mo dm ~T²>¶mo ^Zo ZdOmVbmB© Ádamo AmEH$mo ~wÂZwnN>© a CgbmB©
{ZaÝVa ñVZnmZ JamC±X¡ VËH$mb¡ ñdmñÏ¶ Ho$ÝÐ‘m nwè¶mCZwnN>©&
ZdOmVbmB© bwJmbo bnoQ>²Zw a Ý¶mZmo am»Zw…

Amdí¶H$ gm‘J«rhê$…
 ECQ>m g’$m, nwamZmo, Za‘ ~oZ} bwJm (3 ’$sQ> x 3 ’$sQ>)&
 bwJm nmVbmo N> ^Zo Ë¶gbmB© 3 ’$sQ> x 3 ’$sQ> Zmn‘m nQ>çmCZwhmog²&
MaUhê$…
1) ZdOmVbmB© Nw>ZA{K hmVhê$ {Z¶‘ nmbZ Jaoa am‘«ar YwZwnN>© a Ë¶gn{N> hmVhê$bmB© gwH$mCZwnN>©&
2) A{K {bBEH$mo bwJm g’$m R>mC±‘m am»Zwhmog²&
3) ECQ>m Hw$ZmbmB© {^Ìn{Å>/‘wpÝVa Am§{eH$ ê$n‘m nQ>çmCZwhmog²&
4) {eewbmB© bwJmH$mo H$åVr^ÝXm H$åVr A§e‘m ¶g àH$mabo am»Zwhmog² Vm{H$ CgH$mo Q>mCH$mo bwJmH$mo nQ>çmBEH$mo A§e‘m
ahmog²& bwJmH$mo nQ>çmBEH$mo A§ebo {eewH$mo {ZYma a H$mZbmB© nyU©ê$nbo N>moßZwhmog² (‘Xa Q>oaogmbo OñV¡) A{Z Ë¶gbmB©
À¶mnw‘m AS²>¶mCZwhmog² Vm{H$ Hw$Z¡ n{Z ^mJ Iwëbm Zahmog²&
5) bwJmH$mo ‘w{Zëbmo Hw$ZmbmB© ZdOmVH$mo eara‘m{W N>mVrgå‘ VmÝZwhmog²&
6) bwJmH$mo ECQ>m Hw$Zm ECQ>m hmV‘m{W~mQ> VmÝZwhmog² a Ë¶gbmB© {eewH$mo {nR>çy±‘w{Z g‘oQ²>Zwhmog²&
7) bwJm {nR>çy±‘m nQ>çmBEH$mo Zhmog² ^ÝZo Hw$amH$mo »¶mb am»Zwhmog²&
8) A~ bwJmH$mo AH$m}n{Å>H$mo A§ebmB© n{Z Ë¶gar Z¡ bnoQ²>Zwhmog²&
66
Z³em/{MÌ MaU
1) W‘m©{‘Q>a {bZwhmog², Ë¶gbmB© Mm¡‹S>m ^mJn{Å>~mQ>

g‘mËZwhmog² a MpåH$bmo N>oCbmB© {H$Q>mUwa{hV éB©H$mo S>ëbmbo
g’$m JZw©hmog²&
2) W‘m©{‘Q>abmB© ImoëZ Ë¶gH$mo Jwbm’$s ~Q>ZbmB© EH$nëQ>

{WÀZwhmog²& VnmBªbo Ë¶gH$mo {S>ñßbo {dÝS>mo‘m "188.8',
Ë¶gn{N> ECQ>m g§¶moOH$ {MÝh (-) a n{N>„monëQ> {bBEH$mo
Vmn‘mZ, VrZdQ>m g§¶moOH$ {MÝh (---) a ‘mÏbmo Xm{hZo
Hw$Zm‘m ‘F’ Xo»ZwhþZoN>&
3) W‘m©{‘Q>abmB© R>m‹S>mo nmaoa g‘mËZwhmog² A{Z Ë¶gH$mo MpåH$bmo

^mJbmB© H$mIrH$mo ~rM‘m am{I{XZwhmog² a Ë¶gbmB© nmIwambo
Mo{n{XZwhmog²& pñW{V Z~X²{bZwhmog²&
4) W‘m©{‘Q>abo Vmn‘mZ [aH$S>© J[aahoH$mo ~obm àË¶oH$ 4

goHo$ÝS>‘m ECQ>m AmdmO AmEH$mo gwÝZwhþZoN>& Ë¶mo AmdmO
VrZnëQ> gwZon{N> {S>ñßbo‘m hoZw©hmog²& ‘F’ MpåH$Zw a gL²>»¶m
~X²{bZw ~ÝX Ên{N> W‘m©{‘Q>a H$mIr~mQ> hQ>mCZwhmog²&
5) {S>ñßbo {dÝS>mo‘m Vmn‘mZ nT²>Zwhmog²&
6) Ë¶mo Vmn‘mZbmB© ’$ma‘‘m bo»Zwhmog²&
7) Jwbm’$s ~Q>ZbmB© EH$nëQ> {WMoa W‘m©{‘Q>a ~ÝX JZw©hmog²&
8) W‘m©{‘Q>aH$mo MpåH$bmo ^mJbmB© {H$Q>mUwa{hV éB©H$mo S>„mbo

g’$m JZw©hmog²&
9) W‘m©{‘Q>abmB© ¶WmñWmZ Ë¶gbmB© am{IZo R>mC±‘m
am{I{XZwhmog²&
67
Mm±S‹ >¡ A{Z Ho$db ñVZnmZ JamCZw
 ñVZH$mo n{hbmo XÿY AWm©V² H$mobmoñQ´‘ O{Vg³Xmo Mm±‹S>mo ({eewH$mo OÝ‘H$mo EH$ KÊQ>m{^Ì‘m) IwdmCZwnN>©&
 H$mobmoñQ´>‘bo n{hbmo Imon (Q>rH$m) àXmZ JZ} hþZmbo Ë¶gbmB© Zï> JZw©/â¶m±³Zw hþ±X¡Z&
 6 ‘{hZmgå‘ Ho$db Am‘mH$mo XÿY Z¡ IwdmCZwnN>©&
 AÝ¶ ImZoHw$am dm Vabhê$, OñV¡- {MZrnmZr, ‘h, JmB©/~m¼mH$mo XÿY, {S>ã~mH$mo XÿY A{Z nmZrg‘oV {XZw hþ±X¡Z&
 ZmZrbmB© 24 KÊQ>m‘m {XC±gmo a am{V H$åVr‘m 8-10 nëQ> ñVZnmZ JamCZwnN>©& ZmZrbo O{hbo MmhÝN CgbmB© ñVZnmZ
JZ© {XZwnN>©&
 ñVZnmZbo Am‘m a ZmZr~rM Agb gå~ÝY ñWm{nV JZ© ‘XV JX©N>&
{ZåZ{b{IV Hw$amhê$ ¶mX am»ZwnN>…©

 Cnamoº$ Hw$amhê$~mao gag„mh {XZwH$m gmWgmW¡ Amdí¶H$ pñW{VAZwgma ñVZnmZ JamCZo à{H«$¶m~mao n{Z Am‘mbmB©
am‘«ar {gH$mCZwnX©N>&
 ñVZnmZ~mao A{Z ñVZnmZ{gV gå~pÝYV g‘ñ¶mhê$~mao Amdí¶H$ nmBbmhê$ MmëZwhmog² a AÝ¶ {ddaUhê$H$mo {ZpåV
AÜ¶m¶ 9 hoZw©hmog²&
68
ZdOmV‘m IVamH$m bjUhê$…
 ZdOmV‘m {ZåZ{b{IV‘Ü¶o Hw$Z¡ n{Z IVamH$mo bjU Xo{IE CgbmB© VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m (Ohm± ZdOmVH$mo
{ZpåV Cn¶wº$ CnMmaH$mo gw{dYm CnbãY N>) {bEa OmZwnN>©&
 ZdOmV‘m IVamH$m {MÝhhê$bmB© H$gar IwQ>çmCZo-
IVamH$m {MÝhhê$ H$gar ~wÂZo
· Zm{^VÝVw~mQ> aº$òmd · Zm{^VÝVw~mQ> Hw$Z¡ ‘mÌm‘m aJV {ZpñH$ahoH$mo N> {H$ ^Zr Om±M JZw©hmog²&
· ZdOmVbmB© Nw>±Xm {Mgmo AZw^d · ZdOmVH$mo Vmn‘mZ 95 {S>J«r ’$maoZhmBQ> dm Ë¶mo^ÝXm H$åVr N> {H$?
hþÝN> AWdm ZdOmVH$mo earaH$mo W‘m©{‘Q>abo ZmßZwhmog²&
Vmn‘mZ gm‘mÝ¶^ÝXm H$åVr N>
· XÿY H$åVr Im±X¡N>/XÿY ImZ ~ÝX · ¶{X ZdOmVbo H$åVr XÿY ImBahoH$mo N> AWdm XÿY ImZ g{H$ahoH$mo
JaoH$mo N>/{XZ‘m 6 nëQ>^ÝXm N>¡Z ^Zr Am‘m/n[admaH$m gXñ¶hê$bo ^ÝN>Z² ^Zo CgbmB© VnmBªH$mo
H$åVr ‘yÌË¶mJ JX£N> gm‘wÞo XÿY IwdmCZy ^Þwhmog²&
· Am‘mbo ñVZnmZH$mo ghr {d{Y AßZmC±Xm n{Z ZdOmVbo XÿY VmÝZ dm {ZëZ
g{H$ahoH$mo N> {H$ N>¡Z Ë¶mo Om±ÀZwhmog² a ¶{X ZdOmVbo XÿY VmÞ dm {ZëZ
g{H$ahoH$mo N>¡Z ^Zo CgbmB© ñVZnmZ‘m g‘ñ¶m ^BahoH$mo ~wÂZg{H$ÝN>&
· ¶{X ZdOmVH$mo ZmH$ ^[aEH$mo N> A{Z ñVZH$mo XÿY VmÞ a {ZëZ Jmõmo
^BahoH$mo N> ^Zo EH$ {MåQ>r ZyZ hmboa C‘m{bEH$mo a {Mgmo nm[aEH$mo
nmZr‘m éB© {ÔmEa Ë¶gbo ZdOmVH$mo ZmH$ g’$m J[a{XZwnN>©& ZmH$
g’$m J[a{XEn{N> ZdOmVbo XÿY VmÞ a {ZëZg³¶mo ^Zo A~ ñVZnmZ‘m
CgbmB© Hw$Z¡ g‘ñ¶m ZÊH$mo ~wÂZwnN>©&
· ZdOmVbo {XZ^[a‘m H${VnëQ> ‘yÌË¶mJ JX£N> ^Þo~mao Am‘mbmB© gmoÜZwhmog²&
¶{X ZdOmVbo am‘«ar ñVZnmZ JX£N> ^Zo Cgbo {XZ^[a‘m 6 nëQ> ‘yÌË¶mJ
JaoH$mo hþZwnN>©&
· bJmVma amoBahoH$mo N>/‘Ywamo gmoa‘m ¶g~mao Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYoa {ZåZ{b{IV Hw$amhê$H$mo Om±M
amoBahoH$mo N>, AWm©V² édmB H$‘Omoa a nw{ï> JZw©nN>©-
N>/éZ ~ÝX Jè¶mo · ZdOmV bJmVma amoBahoH$mo N> {H$ N>¡Z
· ZdOmV ‘Ywamo gmoa‘m AWm©V² H$‘Omoa àH$mabo amoBahoH$mo N> {H$ N>¡Z
· ZdOmVbo éZ nya¡ ~ÝX Jè¶mo {H$?
· ËdMmH$m ‘mo{S‹ >Zo ^mJhê$ ({VK«m/ · {VK«m/H$mIr/{ZVå~hê$‘m Hw$Z¡ {Mam naoH$mo dm amVmo ÊH$mo N> {H$
H$mIr/{ZVå~hê$)-‘m {Mam hoZwh© mog²&
naoH$mo dm amVmo ÊH$mo N>
· Ho$hr nh|bm Am±Imhê$ a ËdMm ¶g~mao Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYoa {ZåZ{b{IV Hw$amhê$H$mo Om±M
a nw{ï> JZw©nN>©-
· hËHo$bm a n¡Vmbmhê$ nh|bm dm {’$H$m ÊH$m N>Z² {H$
· Am±Imhê$ nh|bm ÊH$m N>Z² {H$? hoZw©hmog²&
69
· AL²>Jhê$ bwbmo hþZw · nmIwam a IwÅ>mhê$ CMmboa N>moS²>Zwhmog² a Vr AL²>Jhê$ Am’¡$ PX£N>Z² {H$ hoZw©hmog²&
· gwñV AWdm AMoV ¶g~mao Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYoa {ZåZ{b{IV Hw$amhê$H$mo Om±M
· ¶{X ZdOmV OmJoH$mo AdñWm‘¡ {ZXmEH$mo OñVmo JN>© ^Zo D$ gwñV ÊH$mo
~wÂZwnN>©&
· ZdOmVbo bJmVma ho[aahoH$mo N> Va d[an[a Ho$ ^BahoH$mo N> ^Þo ~w{PahoH$mo
N>¡Z ^Zo D$ gwñV ÊH$mo ‘m{Z{bZwnN>©&
· ¶{X ZdOmV Om{JahoH$mo N>¡Z ^Zo D${gV ~mV Jaoa, Wßn‹S>r ‘maoa AWdm
CgH$mo n¡VmbmbmB© WnWnmEa CgbmB© OJmCZo à¶mg JZw©hmog²& D$ Om{JahoH$mo
N> {H$ N>¡Z Ë¶mo hoZw©hmog²&
· ¶{X ZdOmVbo bJmVma ho[aah²¶mo a ’o$[a gwñV ^¶mo ^Zo D$ gwñV AdñWm‘¡
ahoH$mo ‘m{Z{bZwnN>©&
· AMoV ZdOmV Om½X¡Z& ¶ñVmo ZdOmVbmB© Nw>±Xm, nr‹S>m {X>>±Xm dm H$mohr
H$amC±Xm n{Z Hw$Z¡ à{V{H«$¶m hþ±X¡Z&
· nagå‘ nw½Zo ~mÝVm JZw© A{Z noQ> ¶g~mao Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYoa {ZåZ{b{IV Hw$amhê$H$mo Om±M
’w$pëbZw a nw{ï> JZw©nN>©-
· ~mÝVm Jè¶mo ^Zo Ë¶mo Ho$hr nagå‘ nw½N> {H$ nw½X¡Z&
· ZdOmVH$mo noQ> gm‘mÝ¶^ÝXm ’w${„EH$mo N> {H$?
· Ádamo · ZdOmVH$mo earaH$mo Vmn‘mZ 99 {S>J«r ’$maoZhmBQ> N> {H$ Ë¶mo^ÝXm ~‹T>r N>
W‘m©{‘Q>abo ZmßZwhmog²& ZdOmVbmB© CƒVmn (Hyperthermia) ÊH$mo hmo
{H$ Ádamo AmEH$mo hmo, {MpÝhV JZ} ghr à{H«$¶m AßZmEa Ë¶mo ~wÂZwnN>©&
· N>mVr {^Ìn{Å> nñZw ¶g~mao Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYoa {ZåZ{b{IV Hw$amhê$H$mo Om±M
· ZdOmV/{eew emÝV ZÊgå‘ n{I©Zwhmog²&
· ZdOmVbo H$gar gmg ’o$[aahoH$mo N> Ë¶mo am‘«ar hoZw©hmog²&
· ZdOmVbo gmg ’o$[aahoH$mo ~obm CgH$mo N>mVr a noQ>/^w±‹S>r ~m{haV’©$ R>o{bE
Ë¶gbo ñdm^m{dH$ ídgZ gL²>Ho$V JX©N>& ZdOmVhê$‘m N>mVrbmB© A{bH${V
{^ÌV’©$ VmÞo àd¥{Îm ahoH$mo hþÝN>&
· ZdOmVbo gmg ’o$Xm© CgH$m H$aL²>Jhê$ {^ÌV’©$ Vm{ZE ZdOmVH$mo N>mVr
{^Ìn{Å> nñZo g‘ñ¶m ahoH$mo ~wÂZg{H$ÝN>&
70
· {N>Q>m{o N>Q>mo gmg ’o$Zw© · ZdOmV emÝV ZÊgå‘ n{I©Zwhmog²&
· ZdOmVbo bwJmhê$ bJmEH$mo N> ^Zo Cgbo gmg ’o$Xm© hþZo CVma-M‹T>mChê$bmB©
am‘«ar ~wÂZ g{H>>±$X¡Z& Ë¶g pñW{V‘m ZdOmVH$m bwJmhê$ ‘mpñVa
gm[a{XZwnN>©&
· {S>{OQ>b Q>mB‘a/Zm‹S>r K‹S>r ImoëZwhmog² a Ë¶gbmB© AH$m} hmVbo g‘mVoa
ZdOmVH$mo noQ>/^w±‹S>rH$mo Z{OH$ am»Zwhmog²&
· A~ ZdOmVbo 1 {‘ZQ>‘m H${VnëQ> gmg ’o$X£N> Ë¶mo JÝVr JZ© ewé
JZw©hmog²& {ZpíMV hþZbmB© Ë¶hr à{H«$¶m Xmohmoè¶mCZwhmog²&
· ZdOmV/{eewbo 1 {‘ZQ>‘m H${VnëQ> gmg ’o$X£N> ^Þo Hw$am‘m AmídñV
Ên{N> Ë¶mo boIoa am»Zwhmog²&
· ¶{X ZdOmVbo 1 {‘ZQ>‘m 60 nëQ>^ÝXm ~ogr gmg ’o$[aahoH$mo N> ^Zo
Cgbo {N>Q>mo{N>Q>mo gmg ’o$X£N> ^Þo ~w{PÝN>&
· eara a AL²>Jhê$ ~mC±{S‹ >Zw ¶g~mao Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYoa {ZåZ{b{IV Hw$amhê$H$mo Om±M
a nw{ï> JZw©hmog²-
· Am±Imhê$ npëQ>EH$m N>Z²/‘mpñVa ’${H©> ±$X¡N>Z²&
· AZwhma a Aê$ AL²>Jhê$ Vm{ZEH$m N>Z²/eara‘m VZmC N>&
· eara H$R>moa ÊH$mo N/H$R>moa hþ±X¡N> A{Z H$måX¡N>
· ‘wÆ>rhê$ H${gEH$m N>Z² dm H${g>>±X¡N>Z²&
· ZmH$H$m nmoamhê$ ’¡${bZw ¶g~mao Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYoa {ZåZ{b{IV Hw$amhê$H$mo Om±M
(Nazal flaring) a nw{ï> JZw©hmog²-
· ZdOmV emÝV ZÊgå‘ n{I©Zwhmog² a Ë¶gn{N> AdbmoH$Z JZw©hmog²&
· àË¶oH$nëQ> gmg {b>>±Xm ZmH$H$m nmoamhê$ XþBn{Å> ’¡${bE ^Zo ZdOmV/
{eewbmB© ZmH$H$m nmoamhê$ ’¡${bZo g‘ñ¶m N> ^Zr ~wÂZwnX©N>&
· Km±Q>r ¿¶ma¿¶ma hþZw ¶g~mao {ZpíMV hþZH$m bm{J Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYao {ZåZ{b{IV
Hw$amhê$H$mo Om±M a nw{ï> JZw©hmog²-
· ZdOmV emÝV ZÊgå‘ n{I©Zwhmog²&
· ZdOmVH$mo Km±Q>rH$mo N>oC‘m ahoa AmdmO gwÞo Moï>m JZw©hmog²&
· ZdOmVbo gmg N>moS²>Xm CgH$mo Km±Q>r~mQ> {gQ>r ~OoH$mo OñVmo H$mo‘b
AmdmO AmBahoH$mo N> {H$ N>¡Z Ë¶mo gwÝZwhmog²&
· ñdm^m{dH$^ÝXm H$åVr hbMb ¶g~mao Am‘m/n[admaH$m gXñ¶hê$bmB© gmoYoa {ZåZ{b{IV Hw$amhê$H$mo Om±M
a nw{ï> JZw©hmog²-
· OmJoH$mo AdñWm‘m ZdOmVbo hmVIwÅ>mhê$ MbmC±N> A{Z Q>mCH$mobmB©
EH$n{Å>~mQ> AH$m}n{Å> 1 {‘ZQ>‘m Yoa¡nëQ> Kw‘mC±N>&
· ¶{X ZdOmVH$mo earaH$m J{V{d{Yhê$ gm‘mÝ¶^ÝXm H$åVr ÊH$mo gÝXoh
71
Ê Ë¶g~mao {ZpíMV hþZ Am‘mbmB© gmoÜZwhmog²&
· ¶{X ZdOmVbo ñdm^m{dH$^ÝXm H$åVr hbMb JaoH$mo Am‘mbmB© n{Z
bm½N> ^Zo ZdOmV‘m Ë¶mo bjU N> ^Zr ~wÂZwnN>©&
· ËdMm‘m 10 dQ>m AWdm · ZdOmVH$m bwJmhê$ ’w$H$mboa Om±M JZw©hmog²&

Ë¶mo^ÝXm ~ogr I{Q>amhê$ N>Z² dm · ZdOmVH$mo gånyU© eara A{Z {deofJar N>mo{nEH$m ^mJhê$, OñV¡-
eara‘m ECQ>m Ry>bmo {nbmo H$mZH$m nN>m{‹S>, H$mIr, noQ> a {VK«mH$mo H$mnH$mo am‘«ar Om±M JZw©nN>© a 10
{ZpñH$EH$mo N> dQ>m dm Ë¶mo^ÝXm ~‹T>r ËdMm I{Q>amhê$ (nrn ^[aEH$m I{Q>am) dm ECQ>m
Ry>bmo {nbmo {ZpñH$EH$mo N> {H$ hoZw©hmog²&
· eara‘m 10 dQ>m^ÝXm H$åVr · ZdOmVH$m bwJmhê$ ’w$H$mboa Om±M JZw©hmog²&

ËdMm I{Q>amhê$ · ZdOmVH$mo gånyU© eara A{Z {deofJar N>mo{nEH$m ^mJhê$, OñV¡-
H$mZH$m nN>m{‹S>, H$mIr, noQ> a {VK«mH$mo H$mnH$mo am‘«ar Om±M JZw©hmog² a 10
dQ>m^ÝXm H$åVr ËdMm I{Q>amhê$ (nrn ^[aEH$m I{Q>am) {ZpñH$EH$m NZ²>
{H$ hoZw©hmog²&
· Zm{^ amVmo hþZw AWdm Ë¶g~mQ> · ZdOmVH$mo Zm{^H$mo n[ad[aH$mo ^mJ amVmo ÊH$mo N> AWdm Ë¶g~mQ> nrn
nrn ~½Zw ~{JahoH$mo N> {H$ Ë¶mo am‘«ar hoZw©hmog²&
¶{X Am‘m/n[admaH$m gXñ¶hê$bo Cnamoº$‘Ü¶o Hw$Z¡ n{Z IVamH$m {MÝhhê$ {MpÝhV Jao ZdOmVbmB© VËH$mb¡ Z{OH¡$H$mo
AñnVmb‘m (Ohm± ZdOmVH$mo {ZpåV Cn¶wº$ CnMma gw{dYm CnbãY N>) b¡OmZw Amdí¶H$ N>&
Zm{^H$mo hoaMmh…
 ZdOmVH$mo Zm{^VÝVw‘m gL²>H«$‘U hþZo Yoa¡ gå^mdZm hþÝN& gL²>H«$‘UH$mo H$maUbo {eewH$mo ‘¥Ë¶w n{Z hþZg³N>, ¶gH$maU
C{MV hoaMmhbo gL²>H«$‘UbmB© amo³XN>&
 Zm{^‘m Hw$Z¡ MrO bJmB{XZw hþ±X¡Z& Ë¶mo Am’¡$ gw³N>&
 Zm{^bmB© Hw$Z¡ n{Z gL²>H$« ‘U~mQ> OmoJmCZ {eewbmB© g’$m bwJm bJmB{XEH$mo gw{ZpíMV JZw©nN>©&
 ¶{X {eewH$mo ‘yÌ dm AÝ¶ Hw$Z¡ WmoH$bo Zm{^ {ÔoH$mo IÊS>‘m Ë¶gbmB© g’$m nmZrbo YmoEa g’$m bwJmbo nw{N>{XZwnN>©&
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ZdOmVH$mo ËdMmH$mo hoaMmh…
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9) {eewbmB© Jmo’$Z~mQ> {ZH$mëZwhmog² a Am‘mg‘j gwpånZwhmog²&
10) AmoOZ bo»Zwhmog²&
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 OwZ ‘m{Zghê$ {~am‘r N>Z² dm OgbmB© gXu, ImoH$s bmJoH$mo N>, Ádamo AmEH$mo N>, ËdMmH$mo gL²>H«$‘U ÊH$mo N>,
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 Yoa¡ ‘m{Zghê$H$mo KwB±Mmo bm½Zo R>mC±hê$‘m n{Z ZdOmVbmB© b¡OmZw hþ±X¡Z&
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C{MV hoaMmh gw{ZpíMV JZ© Am‘m a n[admaH$m gXñ¶hê$bmB© g„mh {XZwhmog²&
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N> ^Zo Amdí¶H$ nmBbmhê$ MmëZwhmog² A{Z C{MV hoaMmhH$mo {ZpåV Am‘m a n[admaH$m gXñ¶hê$bmB© g„mh {XZwhmog&²
- ¶{X ZdOmVH$mo AmoOZ amVmo joÌ‘m N> AWm©V² OÝ‘-AmoOZ 2 {H$bmoJ«m‘ dm Ë¶mo^ÝXm H$åVr N> ^Zo ZdOmVbmB©
AñnVmb nR>mCZwhmog²&
- {ZYm©[aV ^«‘UH$mo Voòmo, gmVm¢, 14Am¢ 28Am¢ a 42 Am¢ {XZ ZdOmVH$mo AmoOZ ZmßZwhmog², Ë¶gbmB© HBPNC ’$ma‘
(’$ma‘ 6)-‘m bo»Zwhmog² a Amdí¶H$ nmBbm MmëZwhmog²&
 ZdOmV g‘¶ ZnwJr OpÝ‘EH$mo hmo ^Zo C{MV hoaMmhH$mo {ZpåV Am‘m/n[admaH$m gXñ¶hê$bmB© gag„mh {XZwhmog²&
 ZdOmVbmB© ~r.gr.Or. a Amo.nr.^r. (n{hbmo ImoamH$) A{Z honmQ>mB{Q>g ~r (n{hbmo ImoamH$) a AÝ¶ g~¡ Imonhê$
{ZYm©[aV g‘¶AZwgma {XBEH$mo gw{ZpíMV JZw©hmog² A{Z Vr g~¡bmB© MCP H$mS>©‘m bo{IEH$mo gw{ZpíMV JZw©hmog² VWm
Am‘m/n[admaH$m gXñ¶hê$bmB© Amdí¶H$ gag„mh {XZwhmog²&
76
^mJ-Zm¡
ñVZnmZ JamCZw A{Z Ë¶ggÝ~ÝYr g‘ñ¶mhê$H$mo ì¶dñWmnZ
ñVZnmZ JamCZwH$mo n[a^mfm…

ñVZnmZ JamCZw ^ZoH$mo ZdOmV dm gmZmo ZmZrbmB© {S>ã~mH$mo XÿY/CËnm{XV XÿY (’$‘y©bm XÿY) Hw$Z¡ ~moVb dm AÝ¶ Hw$Z¡
^m±‹S>mÛmam ZIwdmEa gmoP¡ Am‘mH$mo ñVZ~mQ> (XÿY {ZH$mboa) XÿY IwdmCZo à{H«$¶m hmo& ñVZnmZ JamCZw {eewH$mo C{MV d¥{Õ
a {dH$mgH$mo {ZpåV ECQ>m AmXe© a AVwbZr¶ {d{Y hmo& ¶mo à{H«$¶m Am‘mH$mo g‘J« àOZZgå~ÝYr ñdmñÏ¶H$m ‘hÎdnyU©
njhê${gV n{Z K{Zð> ê$nbo Omo{‹S>EH$mo hþÝN>&
Mm±S‹ >¡ ñVZnmZ ewé JamCZw A{Z H$mobmoñQ´‘ IwdmCZwH$mo ‘hÎd…
 {eew OpÝ‘Zo{~{ÎmH¡$ CgbmB© ñVZnmZ JamC±Xm Ë¶gbo ZdOmVH$mo ‘¥Ë¶wbmB© amo³Z ‘hÎdnyU© ^y{‘H$m IoëXN>&
 ZdOmVH$mo OÝ‘H$mo EH$ KÊQ>m{^Ì¡ ñVZnmZ JamCZ ewé JZm©bo ñVZH$mo XÿY CËnmXZbmB© ~‹T>mC±N>&
 àW‘ XÿY, OgbmB© H$mobmoñQ´>‘ n{Z ^{ZÝN, AË¶ÝV nm¡{ï>H$ hþÝN> A{Z Ë¶gbo {~‘marhê$H$mo amoH$Wm‘ JX©N>&
 Mm±‹S>¡ Am‘m{gV ËdMm{gV ËdMm Q>mg± oa am{IEH$mo gånH©$bo ZdOmVbmB© Ý¶mZmo am»N> A{Z D$ ~m±ÀZo gå^mdZmbmB©
~‹T>mC±XN>&
 Mm±‹S>¡ ñVZnmZ JamCZ ewé JXm© Ë¶gbo Am‘mbmB© àgdn{N> {N>Q>mo VL²>{J«Z ‘XV JX©N>&
 H$mobmoñQ´>‘ ~m³bmo, nh|bmo XÿY hmo OwZ AË¶ÝV nm¡{ï>H$ hþÝN> A{Z ZdOmVH$mo Amdí¶H$VmH$mo {ZpåV ‘mÌ ~{ZZo JX©N>&
 H$mobmoñQ´>‘bo ZdOmVH$mo àW‘ ‘b-‘yÌ {ZH$mëZ ‘XV JX©N> Ogbo nmMZ Zbr~mQ> n{hbmo H$mbmo {XgmbmB© nyU©ê$nbo
~m{ha {ZH$mëXN>&
 H$mobmoñQ´>‘‘m àeñV à{V{nÊShê$> (Antibodies) hþÝN>Z² A{Z Ë¶g‘m d¥{Õ-{dH$mgH$m JwUhê$ hþÝN>Z²& ¶r d¥{Õ-
{dH$mgH$m JwUhê$bo ZdOmVH$mo nmMZ àUmbrbmB© {dH${gV Vwë¶mCZ ‘XV JX©N>Z² A{Z ZdOmVH$mo amoJ à{VamoYH$
j‘VmbmB© ~‹T>mC±N>Z²&
 H$mobmoñQ´>‘‘m à{V{nÊS>hê$ (Antibodies) hþÝN>Z² Ogbo ZdOmVH$mo Km±Q>r, ’$mo³gmo a AmÝÐmhê$‘m hþZo gL²>H«$‘UbmB©
amo³XN>Z²&
 H$mobmoñQ´>‘bo OrdmUw a {dfmUwhê$bmB© ‘mZ} ídoV aº$H$Uhê$H$mo ajm JX©N>&
{eewhê$bmB© ñVZnmZ JamCZwH$mo ‘hÎd…
 OÝ‘H$mo bJÎm¡ ñVZnmZ JamC±Xm Ë¶gbo ZmZrH$mo g‘J« ñdmñÏ¶H$mo {dH$mg‘m ‘XV nwè¶mC±N>&
 OÝ‘H$mo bJÎm¡ ñVZnmZ (H$mo bmoñ Q´ >‘g{hV) A{Z Am‘m a ZdOmV~rMH$mo ËdMm{gV ËdMmH$mo gånH©$ bo
ZdOmV ‘¥Ë¶whê$H$mo amoH$Wm‘ JZ© ‘hÎdnyU© ^y{‘H$m IoëXN>&
 ñVZH$mo XÿY àmH¥${VH$ ImÚ hmo OwZ {eewH$mo {ZpåV gwa{jV hþ±XN>&
 ñVZH$mo XÿY~mQ> {eewbo AmâZmo OrdZH$m ewéH$m ‘{hZmhê$H$m bm{J Amdí¶H$ gånyU© nwï>H$mar a nm¡{ï>H$ nXmW©hê$ àmá
JX©N>& ¶gH$maU 6 ‘{hZmH$mo C‘oagå‘ Ho$db Am‘mH$mo XÿY IwdmCZwnX©N>&
 ñVZH$mo XÿYbo {eewH$mo g§doXZmË‘H$ a kmZgå~ÝYr {dH$mg JamC±XN>&
 Ho$db Am‘mH$mo XÿY IwdmCZmbo nImbm AWdm {Z‘mo{Z¶m OñVm gmYmaU {~‘marhê$bo hþZo {eew ‘¥Ë¶wbmB© KQ>mC±XN>&
 Ho$db Am‘mH$mo XÿY IwdmCZmbo {eew {~‘mar AdñWm~mQ> {N>Q>mo VL²>{J«ÝN>&
 {eewbmB© Aê$ Hw$Z¡ ImÚ, OñV¡- {MZrnmZr, ‘h, JmB©/~m¼mH$mo XÿY, {S>ã~m~ÝX XÿY a nmZrg‘oV {XZw hþ±X¡Z&
77
 ZdOmVbmB© 24 KÊQ>m‘m {XC±gmo a am{V H$åVr‘m n{Z 8-10 nëQ> ñVZnmZ JamCZwnN>©& ¶gH$m gmW¡, Cgbo O{hbo
MmhÝN> Ë¶g~obm n{Z ñVZnmZ JamCZwnN>©&
Am‘mhê$H$mo {ZpåV ñVZnmZ JamCZwH$mo ‘hÎd…

 ñVZnmZ JamCZmbo Am‘mH$mo g‘J« ñdmñÏ¶H$mo {dH$mg‘m ‘XV nw½XN>>&
 ñVZnmZbo J^m©e¶H$mo gL²>Hw$MZ‘m ‘XV JX©N> OgH$mo H$maUbo J^©’y$b g{Ob¡g±J ~m{ha {ZpñH$ÝN>&
 àgdn{N> ñVZnmZ JamCZmbo àgdn{N> hþZo AË¶{YH$ aº$òmdH$mo Omo{I‘bmB© KQ>mC±N>&
 ñVZnmZbo J^m©e¶H$mo ³¶mÝga a ñVZ ³¶mÝgaH$mo Omo{I‘bmB© KQ>mC±N>&
 ñVZH$mo XÿY nyU©ê$nbo {Z…ewëH$ nmBÝN>, ¶gH$maU ¶gbo n[admaH$mo Am{W©H$ g§gmYZH$mo ~MV JX©N&
B - Best (gdm}Îm‘)
R - Relation (gå~ÝY)
E - Easily Digestable (g{Ob¡ nÀZo)
A - Adequate (n¶m©ßV)
S - Safe (gwa{jV)
T - Temperature, time saving (Vmn‘mZ, g‘¶ ~MV JZ})
F - Fresh (VmOm)
E - Easily Available (g{Ob¡ nmBZo)
E - Economic ({H$’$m¶Vr dm Am{W©H$ ê$nbo bm^àX)
D - Demand Feeding (O{V~obm Mm{h¶mo C{V ~ob¡ nmBZo)
I - Immunity (amoJà{VamoYH$ j‘Vm)
N - Nutrition and No-infection (nmofU¶w³V A{Z gL²>H«$‘U hþZ Z{XZo)
G - Growth (d¥{Õ)
EH$‘mÌ ñVZnmZ JamCZw (Exclusive Breasfeeding) ^ZoH$mo Ho$ hmo?

EH$‘mÌ ñVZnmZ JamCZw ^ÞwH$mo AW© {ZåZ{b{IV hmo…
 ZdOmVH$mo OÝ‘H$mo EH$ KÊQ>m{^Ì‘m ñVZnmZ ewé JamCZw&
 {eewbo 6 ‘{hZmgå‘ ñVZH$mo XÿY ‘mÌ àmá JX©N>& CgbmB© Aê$ Hw$Z¡ Vab dm R>mg o nXmW© {XZw hþ±X¡Z- H$hm±gå‘ ^Zo
nmZrg‘oV {XZw hþ±X¡Z, Va AndmXñdê$n ORS AWdm {^Q>m{‘Z, I{ZO ÐdU a Am¡f{Yhê$H$m WmonmMm{h>>± {XZg{H$ÝN>
(òmoV… {díd ñdmñÏ¶ gL²>JR>Z)& {XC±gmo a am{V {eewbo O{hbo MmhÝN> CgbmB© ñVZnmZ JamCZwnN>©&
 ~moVb, {Zßnb dm MwgZrhê$ à¶moJ JZw© hþ±X¡Z&
78
ñVZH$mo XÿY H$gar CËnmXZ hþÝN>
ñVZ{^Ì ghm¶H$ D$VH$, J«pÝW D$VH$ a ~mogmobo
ñVZ ~{ZEH$mo hþÝN>& J«pÝW D$VH$bo XÿY
~ZmC±N>& XÿY-Z{bH$mhê$bo ^ÊS>maUH$mo
J«pÝW {ZpåV XÿYbmB© {N>Ð hê$‘m nwè¶mC±N>Z²&
XÿYme¶ AWdm XÿY Oå‘m hþZo R>mC±hê$
E[aAmobm (H$mbmo Koam) XÿY-Z{bH$mhê$^ÝXm Mm¡S‹ >mXma hþÝN>Z² A{Z
ñVZmJ« (‘wÝQ>m) XÿY bmB© gL²>J «h Jaoa am»N>Z ²& Xÿ Ybo
{N>Ðhê$bmB© N>mo‹S>oa 10-20 dQ>m gmZm
XÿY-^ÊS>ma Z{bH$mhê$~mQ> Êa ñVZmJ« (‘wÝQ>m)-‘m
àdoe JN>&© ñVZmJ« Z¡ ñVZH$mo Qw>ßnmo dm
Z{bH$m AJ«^mJ hmo Ohm±~mQ> XÿY ~m{ha {ZpñH$ÝN>&
E[aAmobm (H$mbmo Koam) ñVZmJ«H$mo d[an[a
H$mbmo ËdMm ÊH$mo joÌ hmo& XÿYH$m
^ÊS>mahê$ E[aAmobmH$mo ‘wpÝVa hþÝN>Z²&
ghm¶H$ D$VH$hê$bo J«pÝW D$VH$, Z{bH$m
ghm¶H$ D$VH$ a {N>Ðhê$bmB© ghm¶Vm nwè¶mC±XNZ²>&
ñVZH$mo XÿY H$gar CËnmXZ hþÝN>?

 J^© ~gon{N> ñVZhê$ {ZaÝVa ~T²>X¡ OmÝN>Z² A{Z XÿY CËnmXZH$mo V¶marH$mo {ZpåV {dH${gV hþÝN>Z²&
 J^m©dñWmH$mo ~obm A{Z àgdn{N> ewéH$m Ho$hr {XZ h‘m}Zhê$Ûmam XÿY Amny{V© g#mmbZ hþÝN>&
 Xmoòmo {V‘mhrH$mo ~obm, bJ^J 16 hámgå‘‘m, Am‘mH$mo earabo ñVZH$mo àW‘ XÿY CËnmXZ JZ©WmëN> OgbmB©
"H$mobmoñQ´>‘' ^{ZÝN>& ¶gH$maU H$mobmoñQ´>‘ OÝ‘H$mo ~obm ~{ZÝN>&
 ZmZr g‘¶ ZnwJr OpÝ‘EH$mo N> ^Zo n{Z Am‘mH$mo eara XÿY CËnmXZ JZ© V¶ma ÊH$mo hþÝN>&
 àgdH$m Ho$hr hámn{N> XÿY ~ZmCZo h‘m}Zhê$H$mo òmd A{Z ñVZH$mo XÿY-CËnmXZH$mo {ZaÝVaVm Amny{V© a ‘mJ‘m{W â
nX©N>& ZmZrÛmam XÿY Mw{gZo {H«$¶mbo XÿY CËnmXZ a Ë¶gH$mo àdmhbmB© {Z¶ÝÌU JX©N>&
 ZmZrbo ñVZH$mo XÿY MwñXm g§doXZmË‘H$ AmdoJhê$ ñVZmJ«~mQ> ‘pñVîH$‘m nw½XN>Z²&
 Ë¶gH$mo à{V{H«$¶m‘m h‘m}Zhê$ òm{dV hþZWmëN>Z² A{Z òmd-H$mo{eH$mhê$bmB© XÿY CËnmXZ JZ© bJmC±N>Z²&
ñVZnmZH$mo ~obm ghr AdñWmZ
 ñVZnmZH$mo ~obm Am‘mH$mo ghr AdñWmZ-
- Am‘m Amam‘Xm¶H$ pñW{V‘m ~ñZo{N>Z² A{Z {eewbmB© ñne© JZ}{N>Z², {eew‘m{W Ü¶mZ {XZo{N>Z² A{Z AmË‘{dídmgH$m
gmW ñVZnmZ JamCZo{N>Z²&
- Am‘mbo {eewH$mo Q>mCH$mo dm H$m±YbmB© ‘mÌ hmoBZ, CgH$mo nya¡ earabmB© Z¡ hmVbo am‘«ar AS²>¶mBam»Zo{N>Z²&
- Am‘mbo {eewbmB© AmâZmo eara{gV j¡{VO ê$n‘m AS²>¶mEa am»Zo{N>Z²&
- {eewH$mo AZwhmabo ñVZbmB© N>moEH$mo hþZwnN>© a CgH$mo ZmH$ ñVZmJ«H$mo {dnarV ahoH$mo hþZwnN>©&
 ñVZnmZH$mo ~obm {eewH$mo ghr AdñWmZ-
- {eewH$mo À¶mnwbo ñVZbmB© N>moEH$mo hþZwnN>©& ‘wI nya¡ IwboH$mo hþZwnN>© A{Z ñVZmJ«H$mo d[an[aH$moo H$mbmo Koam (E[aAmobm)-
H$mo A{YH$m§e ^mJ Z¡ {eewH$mo ‘wI{^Ì ahoH$mo hþZwnN>©> a V„mo AmoR> ~m{han{Å> ’$H}$H$mo hþZwnN>©&
- {eewbo J{hamo ê$n‘m XÿY VmÞoN>, ~rM~rM‘m amo{H$ZoN>, XÿY {ZboH$mo Xo»Z a gwÞg{H$ÝN>&
79
- {eew emÝV a gVH©$ ahoa Am‘mH$mo earag±J Q>m±{gahZoN>& Am‘mbo J^m©e¶‘m gL²>Hw$MZ ÊH$mo AZw^d JZ© g³Zo{N>Z²&
Am‘mH$mo ñVZH$mo ‘wÝQ>m~mQ> Ho$hr XÿY ~m{ha {ZñH$ZoN> OwZ XoIon{N> XÿY {ZpñH$ahoH$mo Hw$am Wmhm hþZoN>&
- ñVZnmZ JamBgHo$n{N> ñVZ Za‘ ÊH$mo A{Z ñVZH$mo ‘wÝQ>m ~m{han{Å> Vm{ZEH$mo hþZoN>&
ñVZnmZ JamCZH$mo {ZpåV ghr AdñWmZ
 
ñVZnmZgå~ÝYr ‘hÎdnyU© Hw$amhê$
 {eewbmB© àW‘ 6 ‘{hZmgå‘ Ho$db Am‘mH$mo XÿY IwdmCZwnN>©& CgbmB© Aê$ Hw$Z¡ ImÚ dm Vabhê$, OñV¡- {MZrnmZr,
‘h, JmB©/~m¼mH$mo XÿY, {S>ã~m~ÝX XÿY A{Z nmZrg‘oV {XZw hþ±X¡Z& gm‘mÝ¶ AmoOZH$mo {eewbmB© 24 KÊQ>m‘m {XC±gmo a
am{V H$åVr‘m n{Z 8-10 nëQ> ñVZnmZ JamCZwnN>©& ZmZrbo O{hbo MmhÝN> Ë¶g~obm CgbmB© ñVZnmZ JamCZwnN>©&
 {eewbo O{V ~obmgå‘ ñVZnmZ JZ©MmhÝN> CgbmB© ñVZnmZ JZ© {XZwnN>&© {eewbmB© ECQ>m ñVZ~mQ> H$åVr‘m n{Z 15
{‘ZQ> ñVZnmZ JZ© {XZwnN>©&
 H$åVr AmoOZH$mo A{Z g‘¶ ZnwJr OpÝ‘EH$m {eewhê$bmB© 24 KÊQ>m‘m {XC±gmo a am{V 10-12 nëQ> ñVZnmZ
JamCZwnN>©& Cgbo O{hbo MmhÝN> Ë¶g ~obm n{Z ñVZnmZ JamCZwnN>©&
 {eew {ZXmEH$mo N> ^Zo CgbmB© OJmEa ñVZnmZ JamCZwnN>©&
 àË¶oH$nëQ> ñVZnmZ JamCZwA{K Am‘mbo EH$ {Jbmg nmZr {nCZwnN>©& {eew OpÝ‘Zo{~{ÎmH¡$ AWdm OÝ‘H$mo EH$
KÊQ>m{^Ì‘m ñVZnmZ JamCZ ewé JZw©nN>©&
 ~moVb, {Zßnb dm MwgZrhê$ à¶moJ JZw© hþ±X¡Z&
ñVZnmZ JamCZo ghr pñW{Vhê$

 PmobwL²>Jo pñW{V (ñdñW Am‘m a g~¡ ZmZrhê$H$mo {ZpåV ì¶dhm¶©)
 H$moëQ>o naoH$mo pñW{V (AñdñW Am‘mhê$H$mo {ZpåV ì¶dhm¶©)
 nmIwambo AS²>¶mEH$mo pñW{V (Oåë¶mhm, g‘¶ ZnwJr OpÝ‘EH$m, H$åVr OÝ‘-AmoOZH$m a AñdñW ZmZrhê$H$m bm{J ì¶dhm¶©)
80
ñVZnmZ JamCZo {d{Yhê$ ñVZnmZ JamCZo {d{Yhê$
· Pmo b w L ² > Jo pñW{V… Am‘mbo · H$moëQ>o naoH$mo pñW{V… Am‘m H$moëQ>o
{eewbmB© nmIwamhê$H$mo â‘m naoa T>pëH$EH$s N>Z² A{Z {eew
AS² >¶mEa amIo H $s N>Z² A{Z Am‘m{Va AZwhma nmaoa T>pëH$EH$mo
nmIwamH$mo AJ«^mJbo {eewH$mo N>& Am‘mbo {eewH$mo Q>mCH$mo a
Q>mCH$mo bmB© AS²>¶mEH$s N>Z²& Km±Q>rbmB© nmIwam a ECQ>m {gamZrbo
PmobwL²>Jmo ~ZmBEH$mo nmIwam‘w{Z ghmam {XEH$s N>Z²&
{gamZr am{I{XE AWdm Am‘mbo
AP ~‹T>r ghmam {XZH$m bm{J H$moëQ>o naoH$mo pñW{V
AmâZmo {VK«m A{bH$ CMm{bZ² PmobwL²>Jo pñW{V
^Zo AP Yoa gw{dYmOZH$ hþZoN>&
H$moëQ>o naoH$mo pñW{Vbo am{Ì-hoaMmhbmB© g{Obmo Vwë¶mC±N>&
g~¡ ZmZrhê$H$m bm{J Agb pñW{V
ñVZnmZ JamCZo {d{Yhê$ ñVZnmZ JamCZo {d{Yhê$

· {dnarV nmIwambo AS²>¶mEH$mo · nmIwambo AS²>¶mEH$mo pñW{V… Am‘m
pñW{V… Am‘m ~goH$s NZ² A{Z ~goa n{N>pëVa A‹S>og bmJoH$s N>Z²&
{eewH$mo Q>mCH$mobmB© ECQ>m hmVbo Xm{hZo n {Å>H$mo {ZpåV, {eew H $mo
ghmam {XEa {eewH$mo earabmB© ECQ>m Q>mCH$moH$mo n{N>„mo ^mJ Am‘mH$mo
nmIwamH$mo AJ«^mJbo AS²>¶mEH$s N>Z² Xm{hZon{Å> N> A{Z CgH$mo eara
(nmIwambo AS²>¶mEH$mo pñW{V OñV¡), Xm{hZo nmIwam‘m N>& CgH$m IwÅ>mhê$
Va Xm{hZo nmIwambo AS²>¶mEH$s N>Z² n{N>pëVa N>Z²& {eewbmB© Xm{hZo
^Zo {eewbmB© Xo~«on{Å>H$mo ñVZ~mQ> ñVZ~mQ> XÿY IwdmB±X¡N>& g{ObmoH$mo
XÿY IwdmCZo{N>Z² A{Z Xo~«o nmIwambo {ZpåV nmIwam‘w{Z ECQ>m {gamZr nmIwambo AS²>¶mEH$mo pñW{V
{dnarV nmIwambo AS²>¶mEH$mo pñW{V
AS²>¶mEH$s Ê Xm{hZo ñVZ~mQ> XÿY am»Zg{H$ÝN>& Xo~«o ñVZ~mQ> XÿY
IwdmCZo{N>Z²&> IwdmC±Xm {eewbmB© ghmam {XZ Xo~«o
nmIwam à¶moJ JZw©nN>©&
Yoa¡ gmZmo a AñdñW ZmZrhê$H$mo {ZpåV Cn¶moJr
Oåë¶mhmhê$H$mo {ZpåV, AWdm g§b½ZVm‘m Hw$Z¡ H${R>ZmB N> ^Zo Cn¶moJr
ñVZnmZ AdbmoH$ZH$m {ZpåV gwPmChê$
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{eewH$mo ‘wI ñVZ{gV am‘«ar Omo{S‹ >EH$mo N>, ñVZH$mo ‘wI nyUê© $nbo Imo{bEH$mo N>Z¡ , ñVZH$mo ‘wÝQ>md[an[aH$mo
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‘wI{^Ì N>, V„mo AmoR> ‘wpÝVa ’${H©$EH$mo N>& AmoR>hê$ ñVZH$mo ‘wÝQ>md[an[a N>Z²&
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ñVZnmZ JamC±Xm hþZo gm‘mÝ¶ g‘ñ¶mhê$ a {VZrhê$H$mo ì¶dñWmnZ
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 6 ‘{hZmH$mo C‘oan{N> gånyaH$ Amhma IwdmCZ ewé JZw©&
 {~am‘r AdñWm‘m {Z¶‘AZwgma IwdmCZw&
 {~‘marhê$H$mo amoH$Wm‘H$m bm{J Amdí¶H$ ì¶dñWmnZ JZw©&
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 AñdñW ZmZrhê$bmB© ñdmñÏ¶ godmhê$H$m bm{J àmoËgm{hV JZw©nN>©&
 nmofUgå~ÝYr Amdí¶H$Vmhê$ nyam JZ©H$m bm{J Am±JZdm‹S>r Ho$ÝÐhê$~mQ> àXmZ J[aZo godmhê$gå‘ CZrhê$bmB©
nwè¶mCZwnN>©&
Ho$db ñVZnmZ JamCZwH$mo AW©…
 {eew OpÝ‘Zo{~{ÎmH¡$ O{Vg³Xmo Mm±‹S>mo (OÝ‘H$mo EH$ KÊQ>m{^Ì) CgbmB© Am‘mH$mo àW‘
nh|bmo ~m³bmo XÿY (H$mobmoñQ´>‘) IwdmCZw&
 6 ‘{hZmH$mo C‘oagå‘ Ho$db ñVZH$mo XÿY IwdmCZw&
 AÝ¶ Hw$Z¡ Vab dm R>mog ImÚhê$, OñV¡- {MZrnmZr, ‘h, JmB©/~m¼mH$mo XÿY, nmCS>a
XÿY, nmZrg‘oV Z{XZw&
 am{V a {XC±gmo {eewbo O{hbo MmhÝN> Ë¶g ~obm ñVZnmZ JamCZw&
gånyaH$ Amhma IwdmCZw…
bJ^J 6 ‘{hZmH$mo C‘oa nw½Xm {eew‘m D$Om© a nmofH$ VÎdhê$H$mo Amdí¶H$Vm ~T²>ZWmëN> OwZMm{h>>± ñVZH$mo XÿYbo nyam
JN>©, Va gmWgmW¡ Amdí¶H$ gånyU© ‘mJ nyam JZ©H$m bm{J gånyaH$ ImZmhê$H$mo n{Z Amdí¶H$Vm nX©N>& ¶g C‘oaH$mo {eew
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({díd ñdmñÏ¶ gL²>JR>Z, WHO, https://www.who.int/health-topics/complementary-feeding)
 6 ‘{hZm (180 {XZ) nyam Ên{N> {ZaÝVa ñVZnmZ JamCZwH$mo gmWgmW¡ Cn¶wº$ gånyaH$ ImZm IwdmCZ ewé JZw©nN>©&
6 ‘{hZm (180 {XZ) nyam hþZw^ÝXm A{K gånyaH$ ImZm IwdmCZw hþ±X¡Z&
 gånyaH$ ImZmH$mo gmWgmW¡ 2 df©gå‘ {ZaÝVa ñVZnmZ JamCZw Omar am»ZwnN>©&
gånyaH$ ImZm {H$Z Amdí¶H$ N…
 6 ‘{hZmH$mo C‘oagå‘ ZmZrH$mo bm{J ñVZH$mo XÿY Z¡ gdm}Îm‘ hþÝN> {H$Z{H$ ¶gbo ZmZrbmB© Amdí¶H$ nm¡{ï>H$ VÎdhê$
àXmZ JN>©& 6 ‘{hZm nyam Ên{N> nm¡{ï>H$ VÎdhê$H$mo Amdí¶H$Vm nyam JZ© ñVZnmZ JamCZw ‘mÌ n¶m©á hþ±X¡Z {H$Z^Zo
¶mo C‘oaXo{I ZmZr ~T²>X¡OmÝN> a AP ~‹T>r g{H«$¶ hþ±X¡OmÝN>&
 Hw$nmofUbmB© amoH$Wm‘ JZ© A{Z ZmZrH$mo gdm}Îm‘ d¥{Õ a {dH$mg gw{ZpíMV JZ©H$mo {ZpåV n{Z gånyaH$ ImZm IwdmCZ
ewé JZw© Amdí¶H$ N>& gånyaH$ ImZmbo ñVZH$mo XÿYH$mo {ZpåV gånyaH$H$mo H$m‘ JX©N> A{Z n¶m©á ‘mÌm‘m àmo{Q>Z, D$Om©
a AÝ¶ nm¡{ï>H$ VÎdhê$ àXmZ JX©N> OwZMm{h>>± ZmZrH$mo d¥{ÕH$mo {ZpåV Amdí¶H$ hþÝN>Z²&
 ZmZrbmB© Amdí¶H$ naoH$mo A{Z ImZmH$mo CnbãYVmAZwgma ImZmH$mo ~m³bmonZ a {d{dYVmbmB© ~‹T>mC±X¡ b¡OmZwnZ}
hþÝN>& {^Q>m{‘Z "E' n¶m©á ‘mÌm‘m nmBZo ’$b a gmJgãOrhê$ à{V{XZ {XZwnN>©& ZmZrbmB© n¶m©á ~mogmo a Vob¶wº$
Amhma {XZwnN>©& gånyaH$ ImZm‘m ImÚmÞ, Xmbhê$, ‘Q>a, XÿY, Jo‹S>mJw‹S>r, ‘mgw, gmJgãOr, ’$bhê$, Vob, ~mogmo a
{MZr gm‘ob J[aEH$mo hþZwnN>©&
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gm‘ob JZw©nX©N>& nmVbmo ImZmhê$bo ZmZrbmB© n¶m©á D$Om© {X>>±X¡ZZ²& 6 Xo{I 9 ‘{hZmH$mo ZmZrbmB© ~m³bmo Va {Mßbmo {‘{lV
ImZmH$mo Amdí¶H$Vm nX©N>&
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Xe ‘{hZmH$mo ZmZrbmB© Vr g~¡ ImZm {XZg{H$ÝN> OwZ ImZm d¶ñH$hê$bo ImÝN>Z²& ImZmbmB© nmVbmo ~ZmCZw hþ±X¡Z&
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Xmb {XZwhmog² Va XmbH$mo nmZr hmoBZ&)
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{XZo Nw>Å>¡ ^m±‹S>m am»Zg{H$ÝN>&
C‘oa H${VnëQ> ‘mÌm

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12- 24 ‘{hZm {XC±gmoH$mo ^moOZ, am{VH$mo ^moOZ, Ë¶g~rM H$Mm¡am^ÝXm ~‹T>r ImZm&
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 Am±JZdm‹S>r Ho$ÝÐ~mQ> {XBZo ImZm ZmZrbmB© IwdmBE n{Z Ka‘m {XBZo ImZm KQ>mCZw hþ±X¡Z&
3) H${VnëQ> ImZm {XZo… {XBEH$mo gånyaH$ ImZmH$mo ‘mÌm nm¡{ï>H$ VÎdhê$H$mo Ñ{ï>bo d¶ñH$hê$bmB© Mm{hZo ImZmH$mo bJ^J
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ImZH$m bm{J {T>nr ZJZw©hmog² AWdm ZmZrà{V Z[agmCZwhmog²& ZmZrbmB© IwdmC±Xm Y¡¶©erb ~Þwhmog², ‘wñHw$amCZwhmog²,
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~mogmo dm Vob gm‘ob JZw©hmog²& Ka‘m Hw$Z¡ n{Z ImZ¶mo½¶ Vob N> ^Zo Ë¶hr n¶m©á hþ±XN>&
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Ë¶{V Z¡ ~‹T>r ajmË‘H$ JwU hþÝN>& Ë¶gar Z¡, ZmZrhê$bo ‘mgw, AÊS>m, ‘mN>m Yoa¡ ‘Z namC±N>Z² a ¶r g~¡ AË¶ÝV nm¡{ï>H$
a ajmË‘H$ hþÝN>Z²&
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 gmJgãOrhê$ nH$mCZwA{K YmoEa H$mQ²>ZwnN>©&
 gmJgãOrhê$ A{bH${V VmN²>ZwnN>©&
 gmJgãOrhê$ ‘Ü¶‘ AmH$ma‘m H$mQ²>ZwnN>©&
 ImZmhê$ H$åVr^ÝXm H$åVr nmZr‘m am‘«ar nH$mCZwnN>©&
 ImZm H$åVr Am±M‘m nH$mCZwnN>©&
 Mm‘bbmB© nH$mCZwA{K YwZwnN>©& Mm‘bbmB© KarKar YwZw hþ±X¡Z&
gånyaH$ ImZm IwdmCZo gmVdQ>m {Z¶‘
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nëQ> IwdmCZwhmog²
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hmoBZ Va Xmb {XZwhmog²
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6 ‘{hZm‘m ewé
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A{V[aº$ ImZm IwdmCZwhmog² ñdmñÏ¶H$mo {ZpåV n{Z Agb
{~am‘r naoH$mo ~obm IwdmCZw…

KarKar {~am‘r hþZw Hw$nmofUH$mo à‘wI H$maU hmo& ¶gH$maU-
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‘mÌm KQ>mCZw hþ±X¡Z&
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 àË¶oH$ ‘{hZm Am±JZdm‹S>r Ho$ÝÐ‘m ZmZrH$mo AmoOZ ZmßZw A{Zdm¶© N>&
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N>…dQ>m ‘hÎdnyU© Hw$amhê$ N>Z² Ogbo {~‘marbmB© amoH$Wm‘ JX©N>Z²…
 hmV YwZw… ZmZrbmB© IwdmCZwA{K, ZmZrH$mo ImZm ~ZmCZwA{K A{Z {Xgm JaoH$mo ZmZrbmB© g’$m J[a{XEn{N> hmV Adí¶
YwZwnN>©& KarKar bm½Zo nImbmbmB© amo³Z ¶mo EH$‘mÌ g~¡^ÝXm Cn¶moJr Cnm¶ hmo&
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 ZmZrH$mo ImZm nH$mBgHo$n{N> IwdmCZwA{K Adí¶ Mm»ZwnN>©&
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2) ‘waB©H$mo Ywbmo a ^wQ>oH$mo XmbH$mo YwbmobmB© 3…1 AZwnmV‘m {‘gmEa ECQ>m ^m±‹S>mo‘m 7-10 {XZgå‘ N>monoa am»Zg{H$ÝN>&
¶mo {‘lUbmB© ImaoH$mo {KC AWdm Vob‘m ^wQ>oa Ë¶gn{N> XÿY AWdm nmZr‘m nH$mEa ({MZr dm ZyZ hmboa) Ira ~ZmEa
IwdmCZg{H$ÝN>&
3) newH$mo XÿY AWdm {S>ã~m~ÝX XÿY gånyaH$ ImÚH$mo A§e ZÊH$mobo Ë¶gbmB© Xhr AWdm Ira ~ZmCZH$m bm{J à¶moJ
JZ©g{H$ÝN> A{Z {¶Zrhê$ ^mV AWdm amoQ>r{gV {‘gmEa n{Z {XZg{H$ÝN>& Amdí¶H$ nao XþB df©n{N> ZmZrhê$bmB© Wmoa¡
newH$mo XÿY {XZg{H$ÝN>& Va Ë¶gH$mo {ZpåV ~moVb à¶moJ JZw© hþ±X¡Z A{Z newH$mo XÿY {nCZ ZmZrhê$bmB© {T>nr bmCZw
hþ±X¡Z&
4) ZmZrhê$bmB© AË¶{YH$ ’$bH$mo ag, XmbH$mo nmZr, gãOrH$mo gyn {XZw hþ±X¡Z Og‘m àeñV nmZr hþÝN>&
5) ZmZrhê$bmB© {~ñHw$Q>, {Mßg, MH$boQ>, {Mgmo no¶, Ho$H$, nopñQ´>g, gg² Am{X {XZw hþ±X¡Z&
6) {^Q>m{‘Z "S>r' Km‘H$mo àH$meH$mo ‘XVbo ËdMmH$m ‘w{Z„m Vhhê$‘m ~{ZZo hþZmbo 4 ‘{hZmn{N> ZmZrbmB© ‘Ü¶‘ Km‘H$mo
àH$me‘m am»Z ^Zr n[admaH$m gXñ¶hê$bmB© g„mh {XZwnN>©& Va, Am±Im a ËdMmbmB© j{V ZnwJmog² ^Þo gw{ZpíMV
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97
H${bbmo ZmZr‘m aº$mënVm…
YoaOgmo ‘m{‘bmhê$‘m Hw$nmofU a aº$mënVm EH$AH$m©{gV gå~pÝYV ahoH$m hþÝN>Z²& ¶gH$maU
¶gbmB© {ZYm©aU JZw© AË¶ÝV ‘hÎdnyU© Hw$am hmo& Ë¶mo ^moH$ Zbm½ZwH$mo ECQ>m H$maU hþZg³N>&
¶gH$mo {ZpåV aº$ narjU A{Zdm¶© hþÝN Va Ë¶ñVmo ÊH$mo N>Z¡ ^Zo n{Z AdbmoH$Z J[ahoXm©
{’$¸$m dm nh|bmonZ ‘mÌ Xo{IE n{Z CnMma ewé JZ©g{H$ÝN>&
aº$mënVm dm aJVH$mo H$‘r IwQ>²Q>çmCZw…

ZmZrhê$‘m aº$mënVm ÊH$mo N> {H$ ^Zr IwQ>çmCZH$m bm{J-
gm‘mÝ¶V¶m n¡Vmbm dm hËHo$bmH$mo ËdMm‘m nh|bmonZ hþZw aº$mënVmH$mo ECQ>m {MÝh hmo& ZmZrbmB© aº$mënVm N> {H$ N>Z¡ ^Zr
~wÂZ ZmZrH$mo hËHo$bmH$mo ËdMmbmB© hoZw©hmog²&
 ZmZrH$mo hmVH$mo hËHo$bmbmB© {~ñVma¡ gmoPmo Jar CMmëZwhmog²&
 Am¡¢brhê$bmB© n{N>pëVa VmZoa Z’¡$bmCZwhmog², Ë¶gmo JXm© {’$¸$mnZ dm nh|bmonZ AmCZg³N>>&
 ZmZrH$mo hËHo$bmH$mo aL²>JbmB© AmâZmo hËHo$bm A{Z Aê$ ZmZrhê$H$mo hËHo$bmH$mo aL²>J{gV Xm±Oao hoZw©hmog²& ¶{X ËdMm
Aê$H$mo ^ÝXm {’$H$m dm nh|bmo ÊH$mo N> ^Zo CgbmB© aº$mënVm ÊH$mo N>&
Hw$nmofU {ZYm©aU…
g~¡ {~am‘r ZmZrhê$‘m Hw$nmofUH$mo bjU N> {H$ N>Z¡ Ë¶mo {ZYm©aU JZw©nX©N>&
 eara R>m‹S>¡ gwHo$a JEH$mo ñnï> bjU N> {H$ N>¡Z, hoZw©hmog²&
 XþB IwÅ>m‘m nmZr O‘oa ’w${„EH$mo N> {H$ N>¡Z, hoZw©hmog²&
 C‘oaAZwgma AmoOZH$mo {hgm~ Jaoa Hw$nmofUH$mo MaU {ZYm©aU JZwh© mog² (Am±JZdm‹S>r H$‘©Mmarg±J)&
eara R>mS‹ >¡ gwH$o H$mo {MpÝhV JZw…©

Jå^ra ê$n‘m gwHo$a JEH$mo ZmZr Iy~¡ nmVbmo A{Z hÈ>r a N>mbm‘mÌ Xo{IZo hþÝN> a CgH$mo
eara‘m Hw$Z¡ ~mogmo hþ±X¡Z& Ho$hr ZmZrhê$ Yoa¡ nmVbmo hþÝN>Z² Va eara R>mS‹ >¡ gwH$o H$mo Xo{I>>±X¡Z& eara
R>m‹S>¡ gwHo$a JBahoH$mo Vr ZmZrhê$bmB© {MpÝhV JZ© {ZåZ{b{IV Cnm¶hê$bo ‘XV JX©N>Z² OgbmB©
PÅ>¡ CnMma JZw© AWdm AñnVmb nR>mCZw Amdí¶H$ hþ±XN>…
 eara R>m‹S>¡ gwHo$a JEH$mo N> {H$ N>¡Z Ë¶mo hoZ©H$mo {ZpåV ZmZrH$m bwJmhê$ ’w$H$m{b{XZwnN>©& H$m±YH$mo ‘m§gnoer, hmV, {ZVå~
(MmH$) a IwÅ>mH$mo ‘m§gnoer Jå^ra ê$nbo gwHo$a JEH$mo N> {H$ N>¡Z Ë¶mo hoZw©nN>©&
 ZmZrbmB© Z{OH$~mQ> hoaoa {ZVå~‘m M~u N> {H$ N>¡Z ~wÂZwnN>©& R>m‹S>¡ gwHo$a Om±Xm {ZVå~ a {VK«mH$mo N>mbm‘m Yoa¡ ‘wOmhê$
dm MmCar nX©N>Z²&
 R>m‹S>¡ gwHo$a OmZo g‘ñ¶m N> ^Zo n{Z ZmZrH$mo AZwhma ñdm^m{dH$ ahoH$mo hþZg³N>& ¶ñVmo pñW{V‘m ZmZrH$mo noQ> Ry>bmo Êa
’w${„EH$mo hþZg³N>&
 ZmZrH$m Xþd¡ IwÅ>m gw{ÞEH$m N>Z² {H$ {ZYm©aU JZw©hmog²& àË¶oH$ IwÅ>mH$mo MaUH$mo ‘mÏbmo ^mJ‘m ~w‹T>r Am¢brbo Ho$hr
goHo$ÝS>gå‘ hëH$m {WMoa hoZw©hmog²& {WMoa Am¢br hQ>mEn{N> ZmZrH$mo IwÅ>m‘m ImëS>mo Xo{I¶mo ^Zo gw{ÞEH$mo ahoN> ^Zr
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98
Hw$nmofUH$mo ñVa {ZYm©aU JZw…©
 àË¶oH$ ZmZrH$mo {ZpåV Am±JZdm‹S>r H$‘©Mmar (AWW)-bo d¥{Õ Om±M Vm{bH$m à¶moJ JX©{N>Z²& JmC±H$mo àË¶oH$ ZmZrH$mo
AmoOZ ZmßZwnN>© a d¥{Õ Vm{bH$m‘m CgH$mo AmoOZ hoZw©nN>©&
 nm±M df©Xo{I ‘w{ZH$m ~mbH$ a ~m{bH$mhê$H$mo {ZpåV ~o½b¡ d¥{Õ Vm{bH$m hþÝN>& C‘oaAZwgmaH$mo AmoOZ nÎmmo bJmCZo a
Hw$nmofUH$mo XOm© {MpÝhV JZ} à{H«$¶m…
- Xo~«on{Å>H$mo R>m‹S>mo Aj ZmZrH$mo AmoOZH$mo Zmn hmo&
- Vm{bH$mH$mo j¡{VO Ajbo ZmZrH$mo C‘oa hám, ‘hrZm a df© Xem©C±N>&
- Vm{bH$mH$mo OwZ {~ÝXþ‘m ZmZrH$mo AmoOZH$mo Ajbo ZmZrH$mo C‘oaH$mo AjbmB© ôQ²N> Ë¶gbo Hw$nmofUH$mo XOm© XoImC±N>&
dH«$ aoImhê$ AWm©V² ~m“m aoImhê$ (Curves) -H$mo gå~ÝY‘m Ë¶mo {~ÝXþ H$hm± N> Ë¶mo {ZYm©aU JZwh© mog…²
 Ë¶mo {~ÝXþ Voòmo dH«$ aoImH$mo g~¡^ÝXm ‘w{Z N> ^Zo ZmZrH$mo AmoOZ AË¶ÝV H$åVr N>&
 Ë¶mo {~ÝXþ Xmoòmo a Voòmo dH«$ aoImH$mo ~rM‘m AWdm R>rH$ Voòmo dH«$ aoIm‘m N> ^Zo ZmZrH$mo AmoOZ ‘Ü¶‘ H$åVr N>&
 Ë¶mo {~ÝXþ n{hbmo a Xmoòmo dH«$ aoImH$mo ~rMH$mo joÌ‘m AWdm Xmoòmo dH«$ aoImH$mo R>rH$ ‘m{W N> ^Zo ZmZrH$mo d¥{Õ
gm‘mÝ¶ N>&
Hw$nmo{fV ZmZrH$mo {ZpåV g‘wXm¶ ñVaH$m hoaMmhhê$…
H$åVr AmoOZH$m g~¡ ZmZrhê$bo {ZåZ{b{IV Hw$amhê$ àmá JaoH$mo hþZwnN>©…
 nmofUgå~ÝYr gag„mh, Og~mao n{hë¶¡ MMm© J[aEH$mo N>&
 g~¡ {H${g‘H$m {~‘marhê$H$mo VËH$mb CnMma&
 AmoOZ ~‹T>Ho $mo gw{ZpíMV JZ© AWdm pñW{V {~{J«> X± ¡ JEH$mo n{hë¶¡ gw{ZpíMV JZ©H$m bm{J R>rH$ g‘¶‘m AmoOZ ZmßZw&
- H¥${‘ZmeH$ Q>çmãboQ²>g Aë~oÝS>mOmob (Albendazole)… XþB df©^ÝXm H$åVr C‘oaH$mo ZmZrH$mo bm{J AmYm Aë~oÝS>mOmob
Q>çmãboQ> A{Z XþB df©^ÝXm ‘m{W C‘oaH$m g~¡ ZmZrhê$H$m bm{J ECQ>m Q>çmãboQ>&
- AmBaZ a ’$mo{bH$ E{gS> Q>çmãboQ²>g… VrZ ‘{hZmgå‘ {XZ‘m ECQ>m Q>çmãboQ>&
- {^Q>m{‘Z "E'-H$mo EH$ ImoamH$… ¶{X Ë¶mo {XBEH$mo N>¡Z ^Zo&
99
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ZdOmV a ZmZrhê$bmB© bm½Zo {~‘marhê$H$mo EH$sH¥$V ì¶dñWmnZ
gå^m{dV OrdmUwO{ZV gL²>H$« ‘U (0 Xo{I 59 {XZ) A{Z
gmYmaU IVamH$m {MÝhhê$ ( 2 ‘{hZmXo{I 5 df©)
IMNCI Vm{bH$m H$gar à¶moJ JZ}…

IMNCI Vm{bH$mhê$ à¶moJ Jaoa CnMmaH$mo {ZYm©aU, dJuH$aU a ì¶dñWmnZ J[aZwnN>©& ¶g Vm{bH$mH$m 3 dQ>m bha hþÝN>Z²&
- n{hbmo bha… ¶gbo {eewH$m {MÝh a bjUhê$ {ZYm©aU JZ} {ZYm©aU MaUhê$ Xem©C±N>&
- Xmoòmo bha… ¶gbo {~‘marH$mo dJuH$aU Xem©C±N> Ogbo {~‘marH$mo Vrd«Vm~mao {ZU©¶ {bZw ^Þo ~wPmC±N>& dJuH$aUhê$bmB©
amVmo, nh|bmo a h[a¶mo aL²>Jbo Xem©BÝN>&
- Voòmo bha… ¶gbmB© {eew‘m ÊH$m bjUhê$H$mo dJuH$aUH$mo AmYma‘m CnMma {MpÝhV JZ© à¶moJ J[aÝN>&
IMNCI Vm{bH$m‘m aL²>Ûmam Xem©BEH$mo dJuH$aUH$mo AW©…
amVmo bha‘m Xem©BEH$mo dJuH$aUH$mo AW© hmo {eew‘m Vrd« dJuH$aU N> A{Z D$à{V VËH$mb Ü¶mZ {XEa CgbmB© PÅ>¡
AñnVmb dm S>m³Q>aH$hm± nR>mCZw Amdí¶H$ N>&
nh|bmo bha‘m Xem©BEH$mo dJuH$aUH$mo AW© hmo {eewbmB© Ka‘m {deof CnMmaH$mo Amdí¶H$Vm N> A{Z Ka‘¡ CgH$mo hoaMmh
J[aZwnZ}~mao Am‘m/n[admaH$m gXñ¶hê$bmB© {gH$mCZw Oéar N>&
h[a¶mo bha‘m Xem©BEH$mo dJuH$aUH$mo AW© hmo {eewbmB© Hw$Z¡ Am¡f{YH$mo Amdí¶H$Vm N>¡Z A{Z Ka‘¡ C{MV hoaMmh Jaoa
bjUhê$H$mo CnMma JZ©g{H$ÝN>&
ZdOmV/{eew‘m (0-59 {XZ) gå^m{dV OrdmUwO{ZV gL²>H$« ‘U -H$mo Om±MH$m MaUhê$-

1) ZdOmV/{eewbmB© Om±M JZ©A{K hmV YwZo gånyU© à{H«$¶mhê$ nmbZ Jaoa hmVhê$ YwZwnN>©&
2) 0-59 {XZH$m g~¡ ZdOmV/{eewhê$ (ñdñW AWdm AdñW)-bmB© gå^m{dV OrdmUwO{ZV gL²>H«$‘U ÊH$mo N> {H$
N>¡Z ~wÂZH$m bm{J Om±M JZw©nN>©&
3) ZdOmV/{eewbmB© eara a AL²>Jhê$ ~mC±{‹S>Zo g‘ñ¶m N> {H$ N>¡Z H$gar ~wÂZo-
{eewH$mo eara dm AL²>Jhê$ ~mC±{‹S>Zo g‘ñ¶m N> {H$ N>Z¡ ^Zr ~wÂZ {ZåZ{b{IV ~w±Xmhê$H$mo Om±M JZw© A{Z Am‘m, ~m~m,
n[admaH$m gXñ¶hê$ a AÝ¶ hoaMmhH$Vm©hê$ (H$mohr N>Z² ^Zo)-bmB© gmoYoa nw{ï> JZw©nN>©-
- {eewH$m Am±Imhê$ ‘mpñVa npëQ>EH$m dm npëQ>ahoH$m N>Z² {H$ N>¡ZZ²&
- AZwhma a Aê$ AL²>Jhê$‘m VZmC N> {H$ N>Z¡ &
- eara H$R>mao ÊH$mo/^BahoH$mo A{Z H$m{‘ahoH$mo N> {H$ N>Z¡ &
- ‘wÆ>rhê$ H${gEH$m/H${gBahoH$m N>Z² {H$ N>¡ZZ²&
4) 1 {‘ZQ>‘m gmg H$gar JÝVr JZ}-
- ZdOmV/{eew emÝV ZÊgå‘ n{I©Zwhmog²&
- ZdOmV/{eewH$mo eara‘m bwJmhê$ N>Z² ^Zo ZdOmV/{eewbo gmg ’o$Xm© hþZo CVma-M‹T>mCbmB© am‘«ar ~wÂZg{H$Þ& ¶ñVmo
pñW{V‘m ZdOmV/{eewH$m bwJmhê$ ’w$H$m{b{XZwnN>©&
100
- {S>{OQ>b Q>mB‘a/Zm‹S>r K‹S>r Mmbw JZw©hmog² A{Z Ë¶gbmB© ZdOmV/{eewH$mo noQ>H$mo Z{OH$ am»Zwhmog²&
- A~ ZdOmV/{eewH$mo noQ> 1 {‘ZQ>‘m H${VnëQ> ‘m{W CR²>N> a ‘w{Z OmÝN> Ë¶mo JÝVr JZw©hmog²& noQ> EH$nëQ> CR>oH$mo a
‘w{Z JEH$mobmB© EH$ gmg ‘mÞwnN>©&
- 1 {‘ZQ>‘m> ZdOmV/{eewbo H${VnëQ> gmg ’o$è¶mo Ë¶mo hoZh©w mog² A{Z {ZpíMV hþZH$m bm{J Ë¶mo à{H«$¶mbmB© Xmohmoè¶mCZwhmog&²
- ZdOmV/{eewbo 1 {‘ZQ>‘m H${VnëQ> gmg ’o$è¶mo ^Þo Hw$am‘m AmídñV Ên{N> Ë¶gbmB© boIoa am»Zwhmog²&
¶{X 0-59 {XZH$mo {eewbo 1 {‘ZQ>‘m 60 dm Ë¶mo^ÝXm YoanëQ> gmg ’o$è¶mo ^Zo {eewbo {N>Q>m{o N>Q>mo gmg ’o$aoH$mo ~wÂZwnN>&©
5) ZdOmV/{eewH$mo N>mVr {^Ìn{Å> ngoH$mo H$gar ~wÂZo-
- ZdOmV/{eewbo H$gar gmg ’o$[aahoH$mo N> Ë¶mo am‘«ar hoZw©nN>©&
- gmg ’o$Xm© Hw$Z¡ n{Z ZdOmV/{eewH$mo N>mVr a noQ> ~m{haV’©$ R>o{bE Ë¶gbo ñdm^m{dH$ ídgZ gL²>Ho$V JX©N>&
ZdOmV/{eewhê$ (0-50 {XZH$m)-‘m N>mVr Ho$hr {^ÌV’©$ nñZo àd¥{Îm hþÝN>&
- gmg ’o$Xm© ZdOmV/{eewH$m H$aL>hê$H$mo ‘w{Z„mo ^mJ {^ÌV’©$ Vm{ZE ZdOmV/{eew‘m N>mVr {^Ì ngoH$mo g‘ñ¶m N>
^Zr ~wÂZwnN>©&
6) ZmH$H$m nmoamhê$ ’¡${bZw
- ZdOmV emÝV ZÊgå‘ n{I©Zwhmog² a Ë¶gn{N> AdbmoH$Z JZw©hmog²&
- àË¶oH$nëQ> gmg {b>>X± m ZmH$H$m nmoamhê$ XþBn{Å> ’¡${bE ^Zo ZdOmV/{eewbmB© ZmH$H$m nmoamhê$ ’¡${bZo g‘ñ¶m N>
^Zr ~wÂZwnX©N>&
7) Km±Q>r ¿¶ma¿¶ma hþZw
- ZdOmV emÝV ZÊgå‘ n{I©Zwhmog²&
- ZdOmVH$mo Km±Q>rH$mo N>oC‘m ahoa AmdmO gwÞo Moï>m JZw©hmog²&
- ZdOmVbo gmg N>moS²>Xm CgH$mo Km±Q>r~mQ> {gQ>r ~OoH$mo OñVmo H$mo‘b AmdmO AmBahoH$mo N> {H$ N>¡Z Ë¶mo gwÝZwhmog²&
8) ZdOmV/{eewH$mo Zm{^ amVmo ÊH$mo N> AWdm Ë¶g~mQ> nrn ~{JahoH$mo N> {H$ ^Zr H$gar ~wÂZo-
- ZdOmV/{eewH$mo Zm{^ amVmo ÊH$mo N> AWdm Ë¶g~mQ> nrn ~{JahoH$mo N> {H$ Ë¶mo am‘«ar hoZw©hmog²&
- Om±M JXm© ZdOmV/{eewH$mo Zm{^bmB© ZNw>Zwhmog²&
9) ZdOmV/{eewH$mo ËdMm‘m I{Q>amhê$ (nrn ^[aEH$m I{Q>am) AWdm Ry>bmo {nbmo {ZpñH$EH$mo N> {H$ ^Zr H$gar ~wÂZo-
- ZdOmV/{eewH$m bwJmhê$ ’w$H$m{b{XEa am‘«ar Om±M JZw©nN>©&
- ZdOmVH$mo gånyU© eara A{Z {deofJar N>m{o nEH$m ^mJhê$, OñV¡- H$mZH$m n{N>„m ^mJhê$, H$mIr, noQ> a {VK«mH$mo
H$mnbmB© am‘«ar Om±M JZw©hmog² a 10 dQ>m dm Ë¶mo^ÝXm ~‹T>r ËdMm I{Q>amhê$ (nrn ^[aEH$m I{Q>am) dm ECQ>m Ry>bmo
{nbmo {ZpñH$EH$mo N {H$ hoZw©hmog²&
- ËdMm‘m I{Q>amhê$ (nrn ^[aEH$m I{Q>am) N>Z² ^Zo H${VdQ>m N>Z² JÝVr JZw©hmog²&
10) ZdOmV/{eewbmB© Ádamo AmEH$mo N> AWdm eara AË¶{YH$ {Mgmo ÊH$mo N> ^Zr H$gar ~wÂZo?
- ZdOmV/{eewH$mo earaH$mo Vmn‘mZ 99 {S>J«r ’$maoZhmBQ> dm Ë¶mo^ÝXm ~ogr N> {H$ W‘m©{‘Q>abo Zmnoa hoZw©hmog²&
à{H«$¶mAZwgma CƒVmn (Hyperthermia) ÊH$mo N> {H$ Ádamo AmEH$mo N> Ë¶mo am‘«ar ~wÂZwnN>©&
101
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11) ZdOmV/ZmZr gwñV ({ZpîH«$¶) AWdm AMoV ÊH$mo N> ^Zr H$gar ~wÂZo-
- ZdOmV OmJoH$mo AdñWm‘m n{Z {ZXmEH$mo OñVmo Jè¶mo ^Zo Ë¶mo gwñV ZdOmV hmo ^Zr ~wÂZwnN>©&
- ZdOmVbo {ZaÝVa ho[aahoH$mo N> Va d[an[a Ho$ ^BahoH$mo N> ^Þo Hw$am Xo{IahoH$mo N>¡Z ^Zo D$ gwñV ÊH$mo ~wÂZwnN>©&
- ¶{X ZdOmV OmJoH$mo N>¡Z ^Zo ~mV Jaoa, Wßn‹S>r ‘maoa dm CgH$mo IwÅ>m‘m {~ñVma¡ WnWnmEa CgbmB© OJmCZo à¶mg
JZw©hmog²&
- ZdOmV Om{JahoH$mo N> {H$ N>¡Z Ë¶mo hoZw©hmog²&
- ¶{X ZdOmVbo EH$nëQ> hoaoa ’o$[a AMoV ^¶mo ^Zo D$ gwñV ÊH$mo ‘m{Z{bZwnN>©&
- AMoV ZmZr Om½X¡Z& CgbmB© Nw>±Xm AWdm nr‹S>m {X>>±Xm AWdm H$amC±Xm Cgbo Hw$Z¡ à{V{H«$¶m OZmC±X¡Z&
12) ZdOmV/ZmZrH$m J{V{d{Yhê$ ñdm^m{dH$ ahoH$mo H$gar ~wÂZo-
- OmJoH$mo AdñWm‘m ZdOmV/ZmZrbo hmVIwÅ>mhê$ MbmC±N> A{Z Q>mCH$mo 1 {‘ZQ>‘m Yoa¡nëQ> A{Kn{N> h„mC±N>&
- ZdOmV/ZmZrH$m J{V{d{Yhê$ ñdm^m{dH$^ÝXm H$åVr N>Z² ^Þo gÝXoh OmJoH$mo IÊS>‘m {ZpíMV hþZ Am‘mbmB©
gmoÜZwhmog²&
- ¶{X ZdOmV/ZmZrbo ñdm^m{dH$^ÝXm H$åVr MbIob JX£N> ^Þo Am‘mbmB© n{Z bm½¶mo ^Zo Ë¶mo bjU ZdOmV/
ZmZr‘m N> ^Þo Hw$am ~wÂZg{H$ÝN>&
ASHA-bo ZdOmV/ZmZrH$mo AñdñWVm {ZYm©aU J[aahoH$mo ~obm Am‘m, ~m~m, n[admaH$m gXñ¶hê$ a AÝ¶ XoIaoIH$Vm©hê$
(H$mohr N>Z² ^Zo)-bo {XEH$mo àË¶oH$ OmZH$marbmB© ImVm/a{OñQ>a‘m boIao am»ZwnN>&©
102
ZmZrbmB© gå^m{dV OrdmUwO{ZV gL²H$« ‘U ÊH$mo N> {H$ Ë¶mo {ZYm©aU JZ} MaUhê$
{MÝhhê$
{ZåZ{b{IV‘Ü¶o Hw$Z¡ bjU ô{Q>EH$mo dJuH$aU
IÊS>‘m…
· eara a AL²>Jhê$ ~mC±{‹S>Zo AWdm ZdOmV‘m ¶r‘Ü¶o Hw $ Z¡ n{Z
· {N>Q>mo {N>Q>mo gmg ’o$Z} (1 {‘ZQ>‘m bjUhê$ Xo{ IE ¶mo VrabmB©
60 nëQ> dm Yoa¡) AWdm n{hë¶mCZwhmog²
gå^m{dV Jå^ra
· N>mVr {Z³H¡$ {^Ìn{Å> ^m{gEH$mo AWdm
OrdmUwO{ZV
· ZmH$H$m nmoamhê$ ’w${„Zo AWdm
gL²>H$« ‘U
· Km±Q>r ¿¶ma¿¶ma hþZo
· CR>Ho $mo dm ’w${„EH$mo Vmbw AWdm
· ËdMm‘m 10 dm Ë¶mo^ÝXm Yoa I{Q>am
dm ECQ>m Ry>bmo {nbmo AWdm
· CgbmB© Nw>X± m {Mgmo dm VmVmo AZw^d
hþZw AWdm
· gwñV dm AMoV N> AWdm
· ñdm^m{dH$^ÝXm H$åVr MbIob
ZdOmV‘m Cnamoº$‘Ü¶o Hw$Z¡ n{Z
bjUhê$ ZXo{IE ¶mo VrabmB©
n{hë¶mCZwhmog²
amVmo Zm{^ dm Ë¶g~mQ> nrn ~{JahoH$mo ñWmZr¶ OrdmUwO{ZV

dm 10 dQ>m^ÝXm ~‹T>r ËdMm I{Q>amhê$ gL²>H$« ‘U
’$moQ>mo 1 ’$moQ>mo 2 ’$moQ>mo 3 ’$moQ>mo 4
ZdOmVH$mo ñdm^m{dH$ Zm{^H$mo amVmonZ noQ>H$mo ZdOmVH$mo eara‘m 10 Zm{^~mQ> nrn ~{JahoH$mo
Zm{^ ËdMm{Va ’¡${bahoH$mo dQ>m^ÝXm Yoa¡ I{Q>amhê$
103
ì¶dñWmnZ
{MÝhhê$ dJuH$aU ì¶dñWmnZ

{ZåZ{b{IV‘Ü¶o Hw$Z¡ bjU · 0-29 {XZH$mo ZdOmVbmB© H$moQ´>r‘mo³gmOmob {XZg{H$ÝZ&
ô{Q>EH$mo IÊS>‘m… · 1 ‘{hZm-59 {XZ - AmoOZ 3-4 {H$.J«m. - 1
H$moQ´>r‘mo³gmOmob (120 {‘.J«m.) Q>çmãboQ>H$mo n{hbmo
· eara a AL²>Jhê$ ~mC±{S‹ >Zo ImoamH$ {XZwhmog² (IwdmCZw gå^d Ê)&
AWdm · ZdOmVbmB© {ZaÝVa ñVZnmZ JamBahZw ^Zr Am‘mbmB©
· {N>Q>mo {N>Q>mo gmg ’o$Z} (1 gå^m{dV g„mh {XZwnN>©&
{‘ZQ>‘m 60 nëQ> dm Yoa¡) Jå^ra · ZdOmVbmB© Nw>±Xm {Mgmo AZw^d hþÝN> ^Zo CgbmB© ËdMm{gV
AWdm ËdMm gånH©$Ûmam Ý¶mZmo am{IEH$mo gw{ZpíMV JZw©hmog²&
· N>mVr {Z³H¡$ {^Ìn{Å> OrdmUwO{ZV
gL²>H$« ‘U · ZdOmVbmB© CnMmaH$mo {ZpåV VËH$mb¡ AñnVmb
^m{gEH$mo AWdm
nR>mCZwhmog²&
· ZmH$H$m nmoamhê$ ’w${„Zo
AWdm
· Km±Q>r ¿¶ma¿¶ma hþZo · 0-29 {XZH$mo ZdOmVbmB© H$moQ>´ r‘mo³gmOmob {XZg{H$ÝZ,
· CR>oH$mo dm ’w${„EH$mo Vmbw AñnVmb nR>mCZwnX©N>&
AWdm · 1 ‘{hZm-59 {XZ - AmoOZ 3-4 {H$.J«m. - Ka‘¡
· ËdMm‘m 10 dm Ë¶mo^ÝXm
Yoa I{Q>am dm ECQ>m Ry>bmo
H$moQ´>r‘mo³gmOmob (120 J«m‘) Q>çmãboQ> 2 {XZgå‘ {XEa
{nbmo AWdm CnMma JZwn© Z}N& XþB ImoamH$~rM 12 KÊQ>mH$mo AÝVamb hþZoN>&
· CgbmB© Nw>X± m {Mgmo dm VmVmo · n{hbmo ImoamH$ {XEH$mo àË¶oH$ 12 KÊQ>mn{N> ZdOmVbmB©
AZw^d hþZw AWdm Aê$ VrZ ImoamH$ H$moQ´>r‘mo³gmOmob Q>çmãboQ> IwdmCZwnN>©&
· gwñV dm AMoV N> AWdm
· ñdm^m{dH$^ÝXm H$åVr ñWmZr¶ · n{hbmo ImoamH$ {XEH$mo XþB {XZ{^Ì‘m ZdOmVH$mo AdñWm
MbIob OrdmUwO{ZV PZ² {~{J«¶mo ^Zo CgbmB© VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m
amVmo Zm{^ dm Ë¶g~mQ> nrn gL²>H$« ‘U (Ohm± ZdOmVH$mo C{MV CnMma godmhê$ CnbãY N>Z²)
~{JahoH$mo dm 10 dQ>m^ÝXm b¡OmZwnN>©&
~‹T>r ËdMm I{Q>amhê$ · Am¡f{YH$mo n{hbmo ImoamH$ {XEn{N> 2 {XZ (36-48
KÊQ>m)-{^Ì‘m J¥h-^«‘U JZw©nN>©&
· AdñWm‘m gwYma Am¶mo ^Zo Ë¶mo Am¡f{Y AP¡ VrZ
{XZgå‘ (ImoamH$ Vm{bH$mAZwgma) {XZwhmog²&
· ¶{X AdñWm Ë¶ñV¡ ah²¶mo dm AP {~{J«¶mo ^Zo ao’$ab
pñbn/goVmo H$mJO‘m Amdí¶H$ OmZH$mar âoa ZmZrbmB©
VËH$mb¡ Z{OH¡$H$mo AñnVmb (Ohm± ZdOmVH$mo C{MV
CnMma godmhê$ CnbãY N>Z²) nR>mCZwhmog²&
104
H$moQ>´r‘mo³gmOmob (120 {‘.J«m.)-H$mo n{hbmo ImoamH$
C‘oa AmoOZ Am¡f{YH$mo n{hbmo ImoamH$
0 Xo{I 29 {XZ ¶mo C‘oaH$m ZmZrhê$bmB© H$moQ´>r‘mo³gmOmob {XZw hþ±X¡Z
1 ‘{hZmXo{I 59 {XZ 3 {H$bmoJ«m‘Xo{I 4 {H$bmoJ«m‘ 1 Q>çmãboQ>
2 ‘{hZmXo{I 11 ‘{hZm 29 4 {H$bmoJ«m‘Xo{I 10
2 Q>çmãboQ>
{XZ {H$bmoJ«m‘^ÝXm ~ogr
1 df©Xo{I 5 df© 10 {H$bmoJ«m‘Xo{I 19 {H$bmoJ«m‘^ÝXm ~ogr 3 Q>çmãboQ>
Ka‘¡ H$moQ>´r‘mo³gmOmob (120 {‘.J«m) {XEa ZmZr (1 ‘{hZm-59 {XZ)-H$mo CnMma

24 KÊQ>m‘m gånyU©
C‘oa AmoOZ {XC±gmo am{V
ImoamH$ 2 ImoamH$~rM 12 KÊQ>mH$mo
1 ‘{hZmXo{I 59 3-Xo{I 4 1 1 AÝVamb hþZwnN>©
2 dQ>m Q>çmãboQ>
{XZ {H$bmoJ«m‘ Q>çmãboQ> Q>çmãboQ>
{ZåZ{b{IV Hw$amhê$bmB© ‘Z‘m am»ZwnN>-

©
1) ¶{X ZmZr 1 ‘{hZm^ÝXm H$åVrH$mo N> ^Zo CgbmB© Hw$Z¡ Am¡f{Y Z{XB© AñnVmb‘m (Ohm± ZmZrhê$H$mo C{MV CnMmaH$mo
ì¶dñWm CnbãY N>) b¡OmZwnN>©&
2) H$moQ´>r‘mo³gmOmob ‘m{WH$mo Vm{bH$mAZwgma {XZwnN>©-
- ZmZrH$mo AmoOZ 3 {H$bmoJ«m‘^ÝXm H$åVr N> ^Zo ZmZrbmB© Hw$Z¡ Am¡f{Y Z{XB© VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m (Ohm±
ZmZrhê$H$mo C{MV CnMmaH$mo ì¶dñWm CnbãY N>) b¡OmZwnN>©&
- ¶{X AmoOZ Ë¶mo^ÝXm ~ogr Z¡ N> ^Zo n{Z Ë¶{V Z¡ ImoamH$ {XBZwnN>©&
- Hw$Z¡ àH$mabo n{Z AmoOZ Wmhm nmCZw gå^d ZÊ ZmZrbmB© Hw$Z¡ Am¡f{Y Z{XB© VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m (Ohm±
ZmZrhê$H$mo C{MV CnMmaH$mo ì¶dñWm CnbãY N>) b¡OmZwnN>©&
3) gwñV ÊH$mo AWdm AMoV ZdOmV/ZmZrbmB© H${hë¶¡ Am¡f{Y {XZw hþ±X¡Z, ~é ZmZrbmB© Hw$Z¡ Am¡f{Y Z{XB© VËH$mb¡
Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrhê$H$mo C{MV CnMmaH$mo ì¶dñWm CnbãY N>) b¡OmZwnN>©&
4) ZmZrbmB© Am¡f{Y {XEn{N> Ë¶g~mao Am¡f{Y ^ÊS>maU a{OñQ>a‘m boIoa am»ZwnN>©&
5) ZmZrbmB© AñnVmb b¡OmZwnaoH$mo pñW{V‘m ZdOmV/ZmZrH$mo Zm‘, A{^^mdH$H$mo Zm‘, R>oJmZm, C‘oa, {b“, dV©‘mZ
AmoOZ, bjUhê$, dJuH$aU, {XBEH$mo Am¡f{YH$mo Zm‘, Am¡f{YH$mo e{º$ a ImoamH$ ao’$ab pñbn/goVmo H$mJO‘m boIoa
am»ZwnN>©&
6) ZdOmV/ZmZrbmB© Am¡f{Y {XZ Zg{H$EH$mo pñW{V‘m Ë¶gH$mo H$maU ao’$ab pñbn/goVmo H$mJO‘m bo»ZwnN>©&
7) AÝË¶‘m, ao’$ab pñbn/goVmo H$mJO‘m ASHA-bo Cn-Ho$ÝÐH$mo Zm‘ a {‘{V C„oI JZw©nX©N>&
105
8) ZmZrbmB© Ka‘¡ Am¡f{Y {XEa CnMma JZw©nè¶mo ^Zo n{hbmo ImoamH$ Am‘mH¡$ AKm{‹S> {XZwnN>© A{Z XþB {XZH$mo {ZpåV VrZ
ImoamH$Mm{h>>± Am‘mbmB© {XBam»ZwnN>©&
Jå^ra OrdmUwO{ZV gL²>H$« ‘U ÊH$mo IÊS>‘m ASHA-bo Ho$ JZwn© N>?

©
 0-59 {XZH$mo ZdOmV/ZmZrbmB© gå^m{dV OrdmUwO{ZV gL²>H«$‘U ÊH$mo ghr àH$mabo (ZdOmV a ZmZrhê$bmB© bm½Zo
{~‘marhê$H$mo EH$sH¥$V ì¶dñWmnZ AWm©V² IMNCI-H$mo {ZYm©aU Vm{bH$mAZwgma) {ZYm©aU JZw©hmog²&
 0-59 {XZH$mo ZdOmV/ZmZr‘m XoIm naoH$m bjUhê$H$mo AmYma‘m gå^m{dV OrdmUwO{ZV gL²>H$« ‘UbmB© ghr àH$mabo
(IMNCI-H$mo dJuH$aU bhaAZwgma) dJuH$aU JZw©hmog²&
 0-59 {XZH$mo ZdOmV/ZmZr‘m gå^m{dV OrdmUwO{ZV gL²>H«$‘UH$mo dJuH$aUH$mo AmYma‘m C{MV CnMmaH$mo (IMNCI-
H$mo ì¶dñWmnZ bhaAZwgma) ì¶dñWmnZ JZw©hmog²&
- gå^m{dV Jå^ra OrdmUwO{ZV gL²>H$« ‘U ÊH$mo IÊS>‘m ZmZr (1 ‘{hZmXo{I$ 59 {XZH$mo)-bmB© H$moQ´>r‘mo³gmOmob
(120 {‘.J«m.)-H$mo n{hbmo ImoamH$ (IwdmCZg{H$E) {XZwhmog²&
- ao’$ab pñbn/goVmo H$mJO‘m OmZH$mar ^Zw©hmog² a ZmZrbmB© CnMmaH$mo {ZpåV VËH$mb¡ Z{OH¡$H$mo AñnVmb (Ohm±
ZmZrH$mo C{MV CnMmaH$mo ì¶dñWm N>) nR>mCZwhmog²&
- ñWmZr¶ OrdmUwO{ZV gL²>H«$‘U (earaH$mo Hw$Z¡ AL²>J‘m) ÊH$mo N> ^Zo ZmZr (1 ‘{hZmXo{I 59 {XZH$mo)-bmB© Ka‘¡
XþB {XZgå‘ IMNCI Vm{bH$mAZwgma H$moQ´>r‘mo³gmOmob (120 {‘.J«m.) Am¡f{Y IwdmEa CnMma JZw©hmog²&
- ZmZrH$mo {~‘marbmB© ghr àH$mabo nwZ…{ZYm©aU JZ©H$m bm{J Am¡f{YH$mo n{hbmo ImoamH$ ewé JaoH$mo 2 {XZ (36 Xo{I
48 KÊQ>m)-{^Ì J¥h-^«‘U JZw©hmog² A{Z (IMNCI-H$mo {ZYm©aU, dJuH$aU a ì¶dñWmnZ bhaAZwgma) Amdí¶H$
nmBbm MmëZwhmog²&
 XþB {XZn{N> (36-48 KÊQ>m‘m) J¥h-^«‘U JZw©hmog² A{Z ZmZrH$mo {~‘mar ghr àH$mabo nwZ…{ZYm©aU a dJuH$aU
JZw©hmog²&
 pñW{V‘m gwYma AmE AP¡ VrZ {XZgå‘ Ë¶hr Am¡f{Y (ImoamH$ Vm{bH$mAZwgma) {XZwhmog²&
 pñW{V Ë¶ñV¡ aho AWdm AP {~{J«E ao’$ab pñbn/goVmo H$mJO‘m Amdí¶H$ {ddaUhê$ boIoa ZmZrbmB© VËH$mb¡
Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrH$mo C{MV CnMmaH$mo ì¶dñWm N>) nR>mCZwhmog²&
ZdOmV a ZmZrhê$bmB© bm½Zo {~‘marhê$H$mo EH$sH¥$V ì¶dñWmnZ - gmYmaU IVamH$m {MÝhhê$ (2 ‘{hZmXo{I 5 df©)
 ZmZrhê$‘m Hw$Z¡ gmYmaU IVamH$m {MÝhhê$ N>Z² {H$ ^Zr g~¡ ZmZrhê$bmB© Om±M JZw©nN>©&
 gmYmaU IVamH$m {MÝhhê$bo Jå^ra {~‘marV’©$ gL²>Ho$V JX©N>Z²&
 AñdñW ZdOmV/ZmZrbmB© Om±M JZ©A{K {Z¶‘hê$AZwgma hmV am‘«ar YwZwnX©N>&
 ZmZr‘m gmYmaU IVamH$m {MÝhhê$ N>Z² ^Zr H$gar ~wÂZo-
106
gmYmaU IVamH$m {MÝhhê$
(2 ‘{hZmXo{I 5 df©) H$gar ~wÂZo
· ZmZr ñVZnmZ JZ© dm {nCZ · ZmZrbo ñVZnmZ JZ© dm {nCZ ZgHo$H$mo Hw$am Am‘m, ~m~m, n[admaH$m gXñ¶
Ag‘W© N> AWdm Aê$ H$mohr XoIaoIH$Vm© (H$mohr N> ^Zo)-bo ^ÝN>Z² ^Zo ASHA-bo CZH$mo
gm‘wÞo Z¡ ZmZrbmB© ñVZnmZ JamCZy dm Ho$hr {nCZ {XZy ^ÞwnN>&© ZmZrbo ñVZH$mo
XÿY MwñZ dm nmZr {ZëZg³N> {H$ g³X¡Z Ë¶mo AdbmoH$Z JZw©hmog²& ZmZrbo MwñZ
dm {ZëZgHo$Z ^Zo CgbmB© ñVZnmZ JZ© dm {nCZ g‘ñ¶m hþ±X¡N> ^Zr ~wÂZwnX©N>&
· 6 ‘{hZm^ÝXm H$åVr C‘oaH$mo ZmZrH$mo ZmH$ {g>>J± mZbo ^[aEH$mo N> A{Z MwñZ a
{nCZ CgbmB© g‘ñ¶m ^BahoH$mo N> ^Zo EH$ {MåQ>r ZyZ hmboa C‘m{bEH$mo a n{N>
gobmBEH$mo nmZr‘m éB©H$m S>„m {ÔmEa Ë¶gbo CgH$mo ZmH$ g’$m J[a{XZwnN>&© ¶mo
à{H«$¶mn{N> Cgbo ñVZnmZ JZ©g³¶mo ^Zo CgbmB© ñVZnmZ‘m Hw$Z¡ àH$maH$mo
g‘ñ¶m N>¡Z ^Zr ~wÂZwnN>©&
· ZmZrbo g~¡ WmoH$ ~mÝVm ZmZrbo Oo-O{V ImBahoH$mo/{nBahoH$mo N> Ë¶mo g~¡ ~mÝVm Jaoa AmoH$ëX¡N> {H$ ^Zr Am‘m,
JX£N> ~m~m, n[admaH$m gXñ¶hê$ a AÝ¶ XoIaoIH$Vm©hê$ (H$mohr N>Z² ^Zo)-bmB© gmoÜZwhmog²&
· eara a AL²>Jhê$ ZmZrH$mo AZwhma a AÝ¶ AL²>Jhê$ ~mC±{‹S>Zo g‘ñ¶m N> {H$ ^Þo nw{ï> JZ©H$m bm{J
~mC±{‹S> >±X¡N>Z² Am‘m, ~m~m, n[admaH$m gXñ¶hê$ a Aê$ XoIaoIH$Vm©hê$ (H$mohr N>Z² ^Zo)-bmB©
gmoÜZwhmog²-
· Am±Imhê$ npëQ>EH$m/‘mpñVa npëQ>ahoH$m N>Z² {H$
· AZwhma a Aê$ AL²>Jhê$‘m VZmC AmEH$mo/AmBahoH$mo N> {H$
· eara H$R>moa ÊH$mo/^BahoH$mo a H$m{‘ahoH$mo N> {H$
· ZmZrH$mo dV©‘mZ {~‘mar‘m CgH$mo AZwhma a Aê$ AL²>Jhê$ ~mC±{‹S> >X± ¡N>Z² {H$, ¶{X
hmo ^Zo ¶gbmB© IVamH$mo {MÝh ‘m{Z{bZwnN>©&
· gwñV dm AMoV hþZw · OmJoH$mo AdñWm‘m ZmZr {ZXmEH$mo OñVmo JN>© ^Zo ZmZr gwñV ÊH$mo ~wÂZwnX©N>&
· ZmZrbo ho[aahoH$mo N> Va d[an[a Ho$ ^BahoH$mo N> ^Þo Xo»X¡Z ^Zo ZmZr gwñV ÊH$mo
~wÂZwnN>©&
· ZmZr OmJoH$mo N>¡Z ^Zo CgbmB© ~mV Jaoa, Wßn‹S>r ‘maoa AWdm ZmZrH$mo IwÅ>m‘m
hëH$m WnWnmEa CgbmB© OJmCZo Moï>m JZw©hmog²& ZmZr Om½N> {H$ Om½X¡Z hoZw©hmog²&
· ZmZrbo hoN>© Va ’o$[a AMoV hþÝN> ^Zo ZmZr gwñV ÊH$mo ~wÂZwnZ} hþÝN>&
· AMoV ZmZr Om½X¡Z& CgbmB© Nw>±Xm dm nr‹S>m {X>>±Xm dm H$amC±Xm n{Z Cgbo Hw$Z¡
à{V{H«$¶m OZmC±X¡Z&
107
 ¶{X ZmZr‘m Hw$Z¡ n{Z ECQ>m gmYmaU IVamH$mo {MÝh N> ^Zo Ë¶gbmB© Jå^ra {~‘marH$mo ê$n‘m {bZwnZ} hþÝN>& ZmZrbmB©
AmnmVH$mbrZ pñW{VH$mo AmYma‘m AñnVmb (Ohm± ZmZrhê$H$mo C{MV CnMmaH$mo ì¶dñWm N>) b¡OmZwnN>©&
 Ádamo AWdm Vrd« ídgZgå~ÝYr gL²>H$« ‘Uhê$~mhoH$ Aê$ AñdñWVmhê$bmB© n{Z ZmZr‘m gmYmaU IVamH$mo {MÝhH$mo
ê$n‘m {bZg{H$ÝN>& ZmZrbmB© Ádamo dm Vrd« ídgZgå~ÝYr gL²>H«$‘U N>¡Z ^Zo n{Z Ë¶mo ZmZrbmB© AmnmVH$mbrZ
pñW{VH$mo AmYma‘m AñnVmb (Ohm± ZmZrhê$H$mo C{MV CnMmaH$mo ì¶dñWm N>) b¡OmZwnN>©&
gmYmaU IVamH$m {MÝhhê$ Xo{IEH$mo pñW{V‘m ASHA-bo Ho$ JZ}{N>Z?

²
 2 ‘{hZmXo{I 5 df©H$mo {~am‘r ZmZr‘m gmYmaU IVamH$m {MÝhhê$ (IMNCI Vm{bH$mAZwgma) {ZYm©aU JZw©hmog² A{Z Hw$Z¡
gmYmaU IVamH$m {MÝhhê$ Xo{IE ZmZrbmB© AmnmVH$mbrZ pñW{VH$mo AmYma‘m AñnVmb (Ohm± ZmZrhê$H$mo C{MV
CnMmaH$mo ì¶dñWm N>) nR>mCZwhmog²&
108
^mJ-Mm¡Y
ZdOmV a ZmZrhê$bmB© bm½Zo {~‘marhê$H$mo EH$sH¥$V ì¶dñWmnZ - Ádamo
- Vm{bH$m à¶moJ Jaoa CnMmaH$mo {ZYm©aU, dJuH$aU a ì¶dñWmnZ JZw©nN>&© ¶g Vm{bH$mH$m VrZdQ>m bha hþÝN>Z²&
- n{hbmo bha… ¶gbo {eewH$mo eara‘m ÊH$m {MÝh a bjUhê$ {ZYm©aU JZ©H$m bm{J {ZYm©aU MaUhê$ Xem©C±N>&
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 0-59 {XZH$mo ZdOmV/ZmZrbmB© Ádamo AmEH$mo IwQ>çmEn{N> CgbmB© VËH$mb¡ AñnVmb (Ohm± C{MV CnMmaH$mo gw{dYm
CnbãY N>) nR>mCZwhmog²&
 2 ‘{hZm-5 df©H$mo ZmZrbmB© Ádamo AmEH$mo am‘«ar {ZYm©aU JZw©hmog² (IMNCI Vm{bH$mH$mo {ZYm©aU bhaAZwgma)&
 2 ‘{hZm-5 df©H$mo ZmZrbmB© Ádamo AmEH$mo N> {H$ N>¡Z IwQ>çmCZwhmog² (IMNCI Vm{bH$mH$mo dJuH$aUH$mo bhaAZwgma)&
- 2 ‘{hZm-5 df©H$mo ZmZrbmB© Ádamo AmE Ë¶gH$mo CnMma ÁdamoH$mo dJuH$aUH$mo AmYma‘m (IMNCI Vm{bH$mH$mo
ì¶dñWmnZ bhaAZwgma) JZw©nN>©&
- ¶{X Vrd« Ádamogå~ÝYr {~‘mar N> ^Zo Vmn‘mZ KQ>mCZ ZmZrbmB© ‘m{WH$mo Vm{bH$mAZwgma (IwdmCZ g{H$E)
H$moQ´>r‘mo³gmOmob (120 {‘.J«m.)-H$mo n{hbmo ImoamH$ A{Z ß¶mam{gQ>m‘mob (500 {‘.J«m.)-H$mo n{hbmo ImoamH$
{XZwhmog²&
- ao’$ab pñnb/goVmo H$mJO‘m OmZH$mar ^Zw©hmog² a ZmZrbmB© AmnmVH$mbrZ pñW{VH$mo AmYma‘m Z{OH¡$H$mo AñnVmb
(Ohm± C{MV CnMmaH$mo gw{dYm CnbãY N>) nR>mCZwhmog²&
- ‘bo[a¶m ÊH$mo IÊS>‘m ‘m{W ~VmBEH$mo Vm{bH$mAZwgma Cn¶wº$ Am¡f{Y {XEa nmBbm MmëZwhmog²&
- ¶{X ZmZrbmB© haoH$ {XZ a gmV {XZgå‘ Ádamo AmBah²¶mo ^Zo ao’$ab pñbn/goVmo H$mJO‘m OmZH$mar ^Zw©hmog² a
CnMmaH$mo {ZpåV CgbmB© VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m nR>mCZwhmog²&
114
^mJ-nÝY«
{~am‘r ZmZrhê$H$mo {ZYm©aU, ì¶dñWmnZ a g§àfo U
2 ‘{hZmXo{I 5 df©H$m ZmZrhê$‘m Vrd« ídgZgå~ÝYr gL²>H$« ‘U (ARI)
nh|bmo bha‘m Xem©BEH$mo dJuH$aUH$mo AW© hmo {eewbmB© Ka‘m {deof CnMmaH$mo Amdí¶H$Vm N> A{Z Ka‘¡ CgH$mo hoaMmh
J[aZwnZ}~mao Am‘m/n[admaH$m gXñ¶hê$bmB© {gH$mCZw Oéar N>&
2 ‘{hZmXo{I 5 df©H$m ZmZrhê$‘m Vrd« ídgZgå~Yr gL²>H$« ‘U

1) ZdOmV/ZmZrbmB© Om±M JZw©A{K {Z¶‘AZwgma hmVhê$ am‘«ar YwZwhmog²&
2) EH$ {‘ZQ>‘m ídgZ H$gar JÝVr JZ}-
- ZdOmV/{eewH$mo eara‘m bwJmhê$ N>Z² ^Zo ZdOmV/{eewbo gmg ’o$Xm© hþZo CVma-M‹T>mCbmB© am‘«ar ~wÂZg{H$Þ& ¶ñVmo
pñW{V‘m ZdOmV/{eewH$m bwJmhê$ ’w$H$m{b{XZwnN>©&
- {S>{OQ>b Q>mB‘a/Zm‹S>r K‹S>r Mmbw JZw©hmog² A{Z Ë¶gbmB© ZdOmV/{eewH$mo noQ>H$mo Z{OH$ am»Zwhmog²&
- A~ ZdOmV/{eewH$mo noQ> 1 {‘ZQ>‘m H${VnëQ> ‘m{W CR²>N> a ‘w{Z OmÝN> Ë¶mo JÝVr JZw©hmog²& noQ> EH$nëQ> CR>oH$mo a
‘w{Z JEH$mobmB© EH$ gmg ‘mÞwnN>©&
- 1 {‘ZQ>‘m> ZdOmV/{eewbo H${VnëQ> gmg ’o$è¶mo Ë¶mo hoZh©w mog² A{Z {ZpíMV hþZH$m bm{J Ë¶mo à{H«$¶mbmB© Xmohmoè¶mCZwhmog&²
- ZdOmV/{eewbo 1 {‘ZQ>‘m H${VnëQ> gmg ’o$è¶mo ^Þo Hw$am‘m AmídñV Ên{N> Ë¶gbmB© boIoa am»Zwhmog²&
115
amoJ {MpÝhV JXm© Am‘m, ~m~m, n[admaH$m AÝ¶ gXñ¶hê$ a XoIaoIH$Vm©hê$ (H$mohr N>Z² ^Zo)-bo {XEH$mo àË¶oH$ CÎma a
AdbmoH$Zhê$bmB© ImVm bo»ZwnN>&©
· ¶{X ZmZrH$mo C‘oa 2 ‘{hZmXo{I 12 ‘{hZm nwJoH$mo N> A{Z Cgbo EH$ {‘ZQ>‘m 50 dm Ë¶mo^ÝXm Yoa¡
nëQ> gmg ’o$è¶mo ^Zo Cgbo {N>Q>mo{N>Q>mo gmg ’o$aoH$mo ~wÂZwnN>©&
· ¶{X ZmZrH$mo C‘oa 12 ‘{hZmXo{I 5 df© nwJHo $mo N> A{Z Cgbo EH$ {‘ZQ>‘m 40 dm Ë¶mo^ÝXm Yoa¡ nëQ>
gmg ’o$è¶mo ^Zo Cgbo {N>Q>mo{N>Q>mo gmg ’o$aoH$mo ~wÂZwnN>©&
3) ZdOmV/{eewH$mo N>mVr {^Ìn{Å> ngoH$mo H$gar ~wÂZo-

- ZdOmV/{eewbo H$gar gmg ’o$[aahoH$mo N> Ë¶mo am‘«ar hoZw©nN>©&
- ZdOmVbo ñdm^m{dH$ ê$n‘m gmg ’o$Xm© N>mVr a noQ> nyU©ê$nbo ~m{han{Å> R>o{bÝN>Z²& 0-59 {XZH$mo ZdOmV/{eewbo
gmg ’o$Xm© N>mVr Wmoa¡ {^Ìn{Å> nñZg³N>&
- gmg ’o$Xm© ZdOmV/{eewH$m H$aL>hê$H$mo ‘w{Z„mo ^mJ {^ÌV’©$ Vm{ZE ZdOmV/{eew‘m N>mVr {^Ì ngoH$mo g‘ñ¶m N>
^Zr ~wÂZwnN>©&
- 1 df©^ÝXm ‘m{WH$m ZmZrhê$bo gmg ’o$Xm© N>mVr {^Ìn{Å> nñZw ñdm^m{dH$ hmoBZ&
- ¶{X Hw$Z¡ ZdOmV/{eewbmB© ImoH$s, gXu a N>mQo >mo-N>moQ>mo ídgZ{gV¡ N>mVr {^Ìn{Å> Vm{ZZo g‘ñ¶m N> ^Zo Ë¶mo Jå^ra
{Z‘mo{Z¶mH$mo bjU hmo& ¶ñVmo pñW{V‘m ZmZrbmB© CnMmaH$mo {ZpåV A{Zdm¶©ê$n‘m AñnVmb dm S>m³Q>aH$hm± nwè¶mCZwnN>&©
4) emÝV {eew‘m Km±Q>r ¿¶ma¿¶ma hþZ-w
- ZdOmV emÝV ZÊgå‘ n{I©Zwhmog²&
- ZdOmVH$mo Km±Q>rH$mo N>oC‘m OmZwhmog² a AmdmO gwÞwhmog²&
- ZdOmV/{eewbo gmg â¶m±³Xm CgH$mo Jbm‘m ‘Ywamo {gQ>rH$mo OñVmo (gmB© gmB©) AmdmO AmC±XN¡ > {H$ Ü¶mZ bJmEa gwÞhw mog&²
5) ZmZr‘m gmYmaU IVamH$m {MÝhhê$ H$gar {MpÝhV JZ} ("gmYmaU IVamH$m {MÝhê$' AÜ¶m¶ C„oI JZwh© mog)² -
- ZmZr ñVZnmZ JZ©/{nCZ Ag‘W© N>
- ZmZrbo g~¡WmoH$ ~mÝVm JX£N>
- eara a AÝ¶ AL²>Jhê$ ~mC±{‹S> >±X¡N>Z²
- gwñV/AMoV
6) ImoH$s{gV¡ Ádamo ("gmYmaU IVamH$m {MÝhê$' AÜ¶m¶ C„oI JZwh© mog)²
- ZmZrbmB© ImoH$s{gV¡ 3 {XZXo{I Ádamo AmBahoH$mo N> {H$ N>Z¡ Ë¶g~mao Am‘m, ~m~m, n[admaH$m gXñ¶hê$ a AÝ¶
XoIaoIH$Vm©hê$ (H$mohr N>Z² ^Zo)-bmB© gmoÜZwhmog²&
- ZdOmVH$mo earaH$mo Vmn‘mZ W‘m©{‘Q>a à¶moJ Jaoa ZmßZwhmog² a Ë¶gbmB© boIoa am»Zwhmog²&
- ZmZrbmB© 14 {XZXo{I bJmVma ImoH$s bm{JahoH$mo N> {H$ N>¡Z Ë¶g~mao Am‘m, ~m~m, n[admaH$m gXñ¶hê$ a AÝ¶
XoIaoIH$Vm©hê$ (H$mohr N>Z² ^Zo)-bmB© gmoÜZwhmog²&
116
{MÝh/bjUhê$ ¶{X Ë¶ñVm Hw$Z¡ {MÝh dm bjUhê$ dJuH$aU
Xo{IE ¶mo VrabmB© n{hë¶mCZwhmog²
Hw$Z¡ gmYmaU IVamH$mo
Vrd« {Z‘mo{Z¶m dm Vrd«
{MÝh AWdm N>mVr
{~‘mar
{^Ìn{Å> ngoH$mo
Cnamoº$‘Ü¶o Hw$Z¡ n{Z {MÝh

dm bjUhê$ XoIm Znao ¶mo
VrabmB© n{hë¶mCZwhmog² a
nh|bmo ~mH$g‘m OmZwhmog²
{N>Q>mo-{N>Q>mo gmg ’o$Zw© {Z‘mo{Z¶m
Cnamoº$‘Ü¶o Hw$Z¡ n{Z {MÝh dm

bjUhê$ XoIm Znao ¶mo VrabmB©
n{hë¶mCZwhmog² a h[a¶mo ~mH$g‘m
OmZwhmog²
Hw$Z¡ gmYmaU {MÝh ZXo»Zw, N>mVr

{^Ìn{Å> ngoH$mo dm {N>Q>mo-{N>Q>mo ImoH$s a gXu
gmg ’o$aoH$mo bjU ZXo{IZw
117
Vrd« ídgZgå~ÝYr gL²>H$« ‘U (ARI) -H$mo ì¶dñWmnZ…
{MÝh/bjUhê$ dJuH$aU ì¶dñWmnZ
Hw$Z¡ gmYmaU IVamH$mo {MÝh Vrd« {Z‘mo{Z¶m AWdm · H$moQ´>r‘mo³gmOmob (120 {‘.J«m)-H$mo n{hbmo ImoamH$ {XZwhmog²
AWdm N>mVr {^Ìn{Å> ngoH$mo Jå^ra {~‘mar (IwdmCZ g{H$E)
- 1 ‘{hZmXo{I 59 {XZ, AmoOZ- 3 Ho$OrXo{I 4 Ho$Or- 1 Q>çmãboQ>
- 2 ‘{hZmXo{I 11 ‘{hZm 29 {XZ, AmoOZ-4 Ho$OrXo{I 10
Ho$Or^ÝXm ~ogr- 2 Q>çmãboQ>
- 1 df©X{o I 5 df©, AmoOZ- 10 Ho$OrXo{I 19 Ho$Or^ÝXm ~ogr- 3
Q>çmãboQ>
· ao’$ab pñbn/goVmo H$mJO‘m OmZH$mar âoa VËH$mb¡ Z{OH¡$H$mo
AñnVmb‘m (Ohm± C{MV CnMmaH$mo gw{dYm CnbãY N>) nR>mCZwhmog²&
{N>Q>mo{N>Q>mo gmg ’o$Zw© {Z‘mo{Z¶m · àW‘ XþB {XZgå‘ H$moQ>´ r‘mo³gmOmob (120 {‘.J«m.) Q>çmãboQ>
{XZwhmog² a Ka‘¡ ZmZrH$mo CnMma JZw©hmog&²
- 1 ‘{hZmXo{I 59 {XZ, AmoOZ- 3 Ho$OrXo{I 4 Ho$Or- {XZ‘m
XþBnëQ> Jaoa 2 Q>çmãboQ>
- 2 ‘{hZmXo{I 11 ‘{hZm 29 {XZ, AmoOZ-4 Ho$OrXo{I 10
Ho$Or^ÝXm ~ogr- {XZ‘m XþBnëQ> Jaoa 4 Q>çmãboQ>
- 1 df©X{o I 5 df©, AmoOZ- 10 Ho$OrXo{I 19 Ho$Or^ÝXm ~ogr-
{XZ‘m XþBnëQ> Jaoa 6 Q>çmãboQ>
- 12 KÊQ>mH$mo AÝVamb‘m Am¡f{YH$m XþB ImoamH$ {XZwnN>©
- ZmZrbmB© H$moQ>´ r‘mo³gmOmob (120 {‘.J«m.)-H$mo n{hbmo ImoamH$
{XEH$mo 12 KÊQ>mn{N> Aê$ VrZ ImoamH$ A{Zdm¶© ê$n‘m {XZwnN>©&
- H$moQ´>r‘mo³gmOmob (120 {‘.J«m.)-H$mo n{hbmo ImoamH$ {XEH$mo 2
{XZ{^Ì‘m pñW{V AP {~{J«¶mo ^Zo ZmZrbmB© VËH$mb¡ Z{OH¡$H$mo
AñnVmb‘m (Ohm± C{MV CnMmaH$mo gw{dYm CnbãY N>) nR>mCZwnN>&©
- H$moQ´>r‘mo³gmOmob (120 {‘.J«m.)-H$mo n{hbmo ImoamH$ {XEH$mo 2
{XZ (36-48 KÊQ>m)-n{N> J¥h-^«‘U JZwh© mog&² ñdmñÏ¶H$mo
pñW{V‘m gwYma AmEZ dm AP {~{J«¶mo ^Zo ao’$ab pñbn/goVmo
H$mJO‘m OmZH$mar âoa VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m nR>mCZwhmog&²
Hw$Z¡ gmYmaU IVamH$mo {MÝh ImoH$s dm gXu · ImoH$s a gXuH$mo CnMmaH$mo {ZpåV Ka‘¡ ì¶dñWmnZH$mo g„mh
ZXo{IZw, N>mVr {^Ìn{Å> ZngoH$mo, {XZwhmog&²
{N>Q>m{o N>Q>mo gmg Z’o$Zw© · 14 {XZ dm Ë¶mo^ÝXm Yoa g‘¶gå‘ ‘Ü¶‘ ñVaH$mo ImoH$s a gXu
bm{Jaho ZmZrbmB© CnMmaH$mo {ZpåV AñnVmb b¡OmZwnN>©>&
· ZmZrbmB© 3 {XZ^ÝXm Yoa g‘¶Xo{I Ádamo{gV¡ ImoH$s a gXu bmJo
ao’$ab pñbn/goVmo H$mJO‘m OmZH$mar âoa Z{OH¡$H$mo AñnVmb‘m
nwè¶mCZwnN>©&
118
H$moQ>´r‘mo³gmOmob (120 {‘.J«m.)-H$mo n{hbmo ImoamH$
1 ‘{hZmXo{I 59 {XZ 3 Ho$OrXo{I 4 Ho$Or 1
2 ‘{hZmXo{I 11 ‘{hZm 29 {XZ 4 Ho$OrXo{I 10 Ho$Or^ÝXm ~‹T>r 2
1 df©Xo{I 5 df© 10 Ho$OrXo{I 19 Ho$Or^ÝXm ~‹T>r 3
H$moQ>´r‘mo³gmOmob (120 {‘.J«m.) {XEa Ka‘¡ CnMma
C‘oa AmoOZ 24 KÊQ>m‘m {XC±gmo am{V

Oå‘m ImoamH$
1 ‘{hZmXo{I 59 {XZ 3 Ho$OrXo{I 4 Ho$Or 2 1 1
2 ImoamH$~rM 12 KÊQ>mH$mo
2 ‘{hZmXo { I 11 4 Ho $ OrXo { I 10 AÝVamb hþZwnN>©
4 2 2
‘{hZm 29 {XZ Ho$Or^ÝXm ~‹T>r
10 Ho $ OrXo { I 19 6
1 df©Xo{I 5 df© 3 3
Ho$Or^ÝXm ~‹T>r
{ZåZ{b{IV Hw$amhê$bmB© ¶mX am»Zwhmog…²
1) CnMmaA{K ZmZrH$mo dV©‘mZ AmoOZ nÎmmo bJmCZwnN>© a AmoOZH$mo AmYma‘m CgbmB© H$moQ>´r‘mo³gmOmob {XZwnX©N>&
2) ‘m{W ~VmBEH$mo Am¡f{YH$mo ImoamH$AZwgma H$moQ>´r‘mo³gmOmob {XZwnN>&©
- ¶{X C‘oaAZwgma AmoOZ H$åVr N> ^Zo AmoOZAZwgma Am¡f{YH$mo ImoamH$ {XZwnN>©&
- ¶{X C‘oaAZwgma AmoOZ ~ogr N> ^Zo C‘oaAZwgma Am¡f{YH$mo ImoamH$ {XZwnN>©&
- ¶{X AmoOZ Wmhm nmCZ Zg{H$E ZmZrbmB© VËH$mb¡ AñnVmb (Ohm± ZmZrhê$H$mo C{MV CnMmaH$mo ì¶dñWm N>)
nwè¶mCZwnN>©&
3) gwñV dm AMoV ZmZrbmB© Am¡f{Y {XZw hþX± Z¡ & ¶ñVmo pñW{V‘m ZmZrbmB© VËH$mb¡ AñnVmb (Ohm± ZmZrhê$H$mo C{MV
CnMmaH$mo ì¶dñWm N>) nwè¶mCZw AË¶mdí¶H$ N>&
4) Am¡f{Y {XEn{N> Ë¶g~mao Am¡f{Y ^ÊS>maU a{OñQ>a‘m bo»ZwnZ}N>&
ImoH$s a gXuH$mo Ka‘¡ J[aZo ì¶dñWmnZ
- ¶{X ZmZrH$mo ZmH$ ~ÝX ^¶mo A{Z ñVZnmZ‘m ~mYm nw½X¡N> ^Zo ZmZrH$mo ZmH$ g’$m J[a{XZo g„mh {XZwhmog²&
- nmZr C‘mboa Ë¶gbmB© gobmCZwhmog² a Ë¶g‘m EH$ {MåQ>r ZyZ {‘gmCZwhmog²& Ë¶mo nmZr‘m éB© {ÔmCZwhmog² a Ë¶mo éB©bo
ZmH$ g’$m J[a{XZwhmog²&
- ZmZr {~am‘r N> ^Zo n{Z CgbmB© gm‘mÝ¶ Amhma {XBahZwnN>©&
- ZmZrbo gm‘mÝ¶ ‘mÌmH$mo ImZm ImZ ZgHo$ CgbmB© H$åVr ‘mÌmH$mo ImZm KarKar {XBahZwnN>©&
119
- ¶{X ZmZr 6 ‘{hZm^ÝXm H$åVr C‘oaH$mo N> ^Zo CgbmB© bm‘mo g‘¶gå‘ {ZaÝVa ñVZnmZ JamBahZwnN>©&
- 6 ‘{hZm^ÝXm Yoa C‘oaH$mo ZmZrbmB© ImoH$s bmJo {ZåZ{b{IV àH$mabo Ka‘¡ CnMma JZ©g{H$ÝN>…
- n[aemo{YV {nCZo nmZr‘m {MZr, AXþdm a VwbgrH$m nmVhê$ {‘gmBdar C‘mboa no¶ ~ZmCZwnN>© a Ë¶gbmB©
gobmEa A{bH${V {Zå~wH$mo ag {‘gmCZwnN>© A{Z ‘ZVmVmo AdñWm‘¡ ZmZrbmB© IwdmCZwnN>©&
AWdm
- ewÕ {nCZo nmZr‘m {MZr, AXþdm a nw{XZmH$m nmVhê$ {‘gmBdar C‘mboa no¶ ~ZmCZwnN>© a Ë¶gbmB© gobmEa
Ë¶g‘m A{bH${V {Zå~wH$mo ag {‘gmCZwnN>© A{Z ‘ZVmVmo AdñWm‘¡ ZmZrbmB© IwdmCZwnN>©&
AWdm
- ewÕ {nCZo nmZr‘m gm¢’$, Ab¢Mr, AXþdm a {MZr {‘gmEa {M¶m ~ZmCZwnN>© a Ë¶gbmB© gobmEa
‘ZVmVmo AdñWm‘m ZmZrbmB© IwdmCZwnN>©&
 ZmZr‘m {ZåZ{b{IV‘Ü¶o Hw$Z¡ bjU XoIm nao ZmZrbmB© VËH$mb¡ AñnVmb nwè¶mCZwhmog²& Vr bjUhê$ hþZ²-
- ZmZr AP ~ogr {~am‘r ^¶mo
- ñVZH$mo XÿY/Hw$Z¡ Vab ImZ g³X¡Z
- {N>Q>mo{N>Q>mo gmg ’o$X£N>
- N>moQ>mo ídgZ
 ¶{X Vmn‘mZ 100 {S>J«r ’$maoZhmBQ> dm Ë¶mo^ÝXm ~ogr N> AWdm Ádamo 3 {XZ^ÝXm Yoa g‘¶gå‘ AmBah²¶mo ^Zo ZmZrbmB©
VËH$mb¡ AñnVmb nwè¶mCZwnX©N>&
Vrd« ídgZgå~ÝYr gL²>H$« ‘U (ARI) hþX± m ZmZrhê$H$mo {ZpåV ASHA-H$mo ^y{‘H$m
- 2 ‘{hZmXo{I 5 df©gå‘H$mo ZmZrbmB© Vrd« ídgZgå~ÝYr gL²>H«$‘U ÊH$mo hmo {H$ hmoBZ Ë¶mo am‘«ar (IMNCI
Vm{bH$mH$mo {ZYm©aU bhaAZwgma) {ZYm©aU JZw©hmog²&
- 2 ‘{hZmXo{I 5 df©gå‘H$mo ZmZr‘m Vrd« ídgZgå~ÝYr gL²>H«$‘UbmB© bjUhê$H$mo AmYma‘m am‘«ar (IMNCI
Vm{bH$mH$mo dJuH$aU bhaAZwgma) dJuH$aU JZw©hmog²&
- ¶{X ZmZrbmB© Vrd« {Z‘mo{Z¶m ÊH$mo N> ^Zo Vm{bH$mAZwgma H$moQ´>r‘mo³gmOmob (120 {‘.J«m.)-H$mo n{hbmo ImoamH$
(IwdmCZ g{H$E) {XZwhmog²&
- ao’$ab pñbn/goVm H$mJO âoa ZmZrbmB© Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrhê$H$mo {ZpåV C{MV CnMma CnbãY N>)
nR>mCZwhmog²&
- ¶{X ZmZrbmB© {Z‘mo{Z¶m ÊH$mo N> ^Zo Ka‘¡ CgH$mo CnMma JXm© ‘m{W ~VmBEH$mo Vm{bH$mAZwgma H$moQ´>r‘mo³gmOmob
(120 {‘.J«m.) {XZwhmog²&
 H$moQ´>r‘mo³gmOmob (120 {‘.J«m.)-H$mo n{hbmo ImoamH$ {XEH$mo 2 {XZn{N> (36-48 KÊQ>m{^Ì‘m) ZmZrbmB© hoZ©
OmZwhmog² A{Z {~‘marH$mo ì¶ñWmnZH$mo {ZpåV (IMNCI Vm{bH$mH$mo {ZYm©aU, dJuH$aU a ì¶dñWmnZ bhahê$-
AZwgma) nwZ…{ZYm©aU a dJuH$aU JZw©hmog² A{Z Amdí¶H$ nmBbm MmëZwhmog²&
120
 ñdmñÏ¶‘m gwYma Am¶mo ^Zo ~m±H$s VrZ {XZgå‘ (ImoamH$hê$H$mo Vm{bH$mAZwgma) Am¡f{Y {XZwhmog²&
 ñdmñÏ¶‘m gwYma AmEZ ^Zo AWdm AP {~{J«¶mo ^Zo ZmZrbmB© VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrhê$H$mo
{ZpåV C{MV CnMmaH$mo gw{dYm N>) nR>mCZwhmog²&
- ¶{X ZmZr‘m ImoH$s a gXuH$m ‘mÌ bjUhê$ N>Z² ^Zo ZmZrbmB© gwa{jV Kaobw Cnm¶hê$Ûmam CnMma JZw©nN>©&
- ¶{X ZmZrbmB© 14 {XZ dm Ë¶mo^ÝXm ~ogr g‘¶Xo{I ImoH$s bmJoH$mo N> ^Zo ZmZrbmB© Z{OH¡$H$mo AñnVmb‘m (Ohm±
ZmZrhê$H$mo {ZpåV C{MV CnMmaH$mo gw{dYm N>) nR>mCZwhmog²&
- ¶{X ZmZrbmB© Ádamo{gV¡ ImoH$s a gXu n{Z bmJoH$mo N> ^Zo ao’$ab pñbn/goVmo H$mJO {ddaU ^Zw©hmog² a ZmZrbmB©
Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrhê$H$mo {ZpåV C{MV CnMmaH$mo gw{dYm N>) nR>mCZwhmog²&
121
^mJ-gmoõ
ZdOmV a ZmZrhê$bmB© bm½Zo {~‘marhê$H$mo
EH$sH¥$V ì¶dñWmnZ - nImbm
nh|bmo bha‘m Xem©BEH$mo dJuH$aUH$mo AW© hmo {eewbmB© Ka‘m {deof CnMmaH$mo Amdí¶H$Vm N> A{Z Ka‘m CgH$mo
hoaMmh J[aZwnZ}~mao Am‘m/n[admaH$m gXñ¶hê$bmB© {gH$mCZw Oéar N>&
nImbm (Diarrhoea) Ho$ hmo?

{XZ‘m VrZ dm Ë¶mo^ÝXm Yoa¡nëQ> nmVbmo dm nmZrgarH$mo {Xgm Ê Ë¶gbmB© "nImbm' ^Zoa n[a^m{fV J[aÝN>&
àË¶oH$ {XZ VrZ dm Ë¶mo^ÝXm Yoa¡nëQ> (AWdm gm‘mÝ¶ ì¶{º$bmB© ^ÝXm Yoa¡nëQ> dm KarKar) nmVbmo AWdm Vab {Xgm Ê
Ë¶gbmB© nImbm ^Zoa n[a^m{fV J[aÝN>& Vab ZÊa Za‘ dm R>mog {Xgm KarKar AmE Ë¶mo nImbm hmoBZ, A{Z ñVZnmZ
JaoH$m {eewhê$bo Ë¶mJ JaoH$mo nmVbmo, À¶mnÀ¶mn naoH$mo {XgmbmB© n{Z nImbm ^{Z>>±X¡Z ({díd ñdmñÏ¶ gL²>JR>Z, WHO
AZwgma, https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease)&
nImbmbmB© O{Vg³Xmo Mm±‹S>mo {ZYm©aU JZw© ‘hÎdnyU© Hw$am hmo {H$Z^Zo nImbmH$mo H$maUbo eara‘m nmZrH$mo H$‘r A{Z Hw$nmofU
hþZg³N> OwZ ZdOmV a {eewH$mo ‘¥Ë¶wH$mo H$maU ~{ZZg³N>&
ZdOmV/ZmZrbmB© nImbm bmJoH$mo hmo {H$ hmoBZ Ë¶mo {ZYm©aU JZ} MaUhê$…
1) ZdOmV/ZmZrbmB© Om±M JZwA © {K {Z¶‘hê$ nmbZ Jaoa hmVhê$ am‘«ar YwZnw N>&©
2) ZdOmV/ZmZrH$mo {XgmH$mo àH$ma ~X²br ÊH$mo N>, KarKar {Xgm hþX± N¡ >, A{Z {Xgm‘m Yoa¡ nmZr N> {H$ N>Z¡ Ë¶g~mao
Am‘m, ~m~m, n[admaH$m gXñ¶hê$ a AÝ¶ XoIaoIH$Vm©hê$ (H$mohr N>Z² ^Zo)-bmB© gmoÜZwhmog&²
122
3) ¶{X hmo ^Zo, ZdOmV/ZmZrH$mo {Xgm‘m aJV N> {H$ ^Zr Am‘m, ~m~m, n[admaH$m gXñ¶hê$ a AÝ¶ XoIaoIH$Vm©hê$
(H$mohr N>Z² ^Zo)-bmB© gmoÜZwhmog&²
4) ZdOmV/ZmZr gwñV AWdm AMoV N> {H$ Om±M JZwh© mog² ("gå^m{dV Jå^ra OrdmUwO{ZV gL²>H$« ‘U' ^mJ hoZh©w mog)²
5) ZdOmV/ZmZr AemÝV AWdm EH¡${N>Z‘m PH$m} ‘mÝZo ÊH$mo N> {H$ ^Zr H$gar ~wÂZo-
- ¶{X ZdOmV/ZmZr O{hbo n{Z AemÝV hþÝN> dm amoBahÝN>, AWdm CgbmB© Nw>±Xm dm earabmB© MbmC±Xm PH$m} ‘mÝN>&
- ¶{X ZdOmV/ZmZr ñVZnmZH$mo ~obm emÝV ahÝN> Va ñVZnmZ JamCZ ~ÝX JXm© ’o$[a AemÝV ~ÝN> dm PH$m} ‘mÝN>&
6) ZdOmV/ZmZrH$m Am±Imhê$ ^mpñgEH$m N>Z² ^Zr H$gar ~wÂZo-
- ¶{X ZmZrH$m Am±Imhê$ ^m{gEH$m N>Z² ^Þo ASHA-bmB© bm½¶mo ^Zo CZbo Am‘m, ~m~m, n[admaH$m gXñ¶hê$ a AÝ¶
XoIaoIH$Vm©hê$ (H$mohr N>Z² ^Zo)-bmB© gmoÜZwnN>©&
7) eara‘m {ZO©brH$aU (Dehydration) dm nmZrH$mo H$‘r ÊH$mo N> {H$ ^Zr H$gar ~wÂZo-
- ZdOmV/ZmZrbmB© H$mI‘m {bZ a CgH$m bwJmhê$ ‘mpñVa CMmëZ ^Zr Am‘mbmB© ^Þwhmog²&
- ZdOmV/ZmZrH$mo Zm{^ a noQ>H$mo nmíd©^mJH$mo ~rMH$mo ECQ>m A§ebmB© MwÞwhmog²&
- Ë¶gn{N> noQ>H$mo Ë¶g joÌH$mo ËdMmbmB© ~w‹T>r Am¢bm a Mmoa Am¢bmbo EH$ goHo$ÝS> R>m‹S>mo àH$mabo {M‘moQ²>ZwnN>©&
Am¢bmhê$H$mo Qw>ßnmobo {M‘moQ²>Zw hþ±X¡Z, Ë¶gmo JXm© ZmZrbmB© Xþ»Zg³N>&
- Ë¶gn{N> ËdMmbmB© N>moS²>ZwnN>© a Ë¶gbmB© AmâZmo ñdm^m{dH$ pñW{V‘m ’${H©$Z H${V g‘¶ bm½N>, hoZw©nN>©&
¶{X ËdMmbmB© N>moS²>Zo{~{ÎmH¡$ Ë¶mo AmâZmo ñdm^m{dH$ pñW{V‘m ’${H©$¶mo ^Zo Ë¶mo ñdm^m{dH$ N>&
¶{X ËdMm VËH$mb¡ ZÊa 2 goHo$ÝS>{^Ì ñdm^m{dH$ pñW{V‘m ’${H©$¶mo ^Zo ËdMm {~ñVma¡ AmâZmo ñdm^m{dH$
pñW{V‘m ’${H©$ahoH$mo ^Þg{H$ÝN>&
¶{X ËdMmbmB© AmâZmo ñdm^m{dH$ pñW{V‘m ’${H©$Z 2 goHo$ÝS>^ÝXm Yoa g‘¶ bm½¶mo ^Zo ËdMm AmâZmo ñdm^m{dH$
pñW{V‘m Iy~¡ {T>bmo ’${H©$ahoH$mo ~wÂZg{H$ÝN>&
8) nImbm {ZYm©aU JXm© Cnamoº$ bjUhê$~mhoH$ ZdOmV/ZmZr‘m {ZåZ{b{IV bjUhê$ n{Z N>Z² {H$ N>Z¡ Z² hoZn©w N>- ©
- Am±gw gwHo$H$mo N> {H$
- ‘wI a {O~«mo gw³Im dm EH$X‘¡ gw³Im ÊH$m N>Z² {H$
- 24 KÊQ>m‘m 6 nëQ>^ÝXm H$åVr ‘yÌË¶mJ JX£N>/‘yÌË¶mJ nQ>¸¡$ J[aahoH$mo N>Z¡ &
{MÝhhê$ dJuH$aU
{ZåZ{b{IV‘Ü¶o XþBdQ>m {MÝhhê$
· gwñV AWdm AMoV Vrd« {ZO©brH$aU
· ^m{gEH$m Am±Imhê$
123
· {M‘moQ>oH$mo ËdMm Iy~¡ {T>bmo ’${H©$ÝN>
{ZåZ{b{IV‘Ü¶o XþBdQ>m bjUhê$

· AemÝì, PH$m} ‘mÞo
Ho$hr {ZO©brH$aU
· {M‘moQ>oH$mo ËdMm {T>bmo ’${H©$ÝN>
Ho$hr AWdm Vrd« {ZO©brH$aUbmB© dJuH$aU JZ©H$m bm{J {MÝhhê$
{ZO©brH$aU ÊH$mo N>Z¡
n¶m©á N>¡ZZ²
14 {XZ dm Ë¶mo^ÝXm Yoa g‘¶Xo{I nImbm Vrd« {ZaÝVa nImbm
{Xgm‘m aJV Vrd« aJV‘mgr
nImbmH$mo ì¶dñWmnZ (0-59 {XZ)

{ZåZ{b{IV‘Ü¶o XþBdQ>m ¶{X Vrd« {ZO©brH$aU dm Ho$hr {ZO©brH$aU Ê

bjUhê$ · 0-29 {XZ - ¶g C‘oaH$mo ZmZrbmB© Hw$Z¡ Am¡f{Y {XZg{H>>$± X¡Z&
· gwñV dm AMoV ao’$ab pñbn/goVmo H$mJO ^Zw©hmog² A{Z {eewbmB© ñVZnmZ
· ^m{gEH$m Am±Imhê$ JamC±X¡ VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrhê$H$mo C{MV
Vrd«
· {M‘moQ>oH$mo ËdMm Iy~¡ CnMmaH$mo gw{dYm N>) nR>mCZwhmog²&
{ZO©brH$aU
{T>bmo ’${H©$ÝN> · 1 ‘{hZmXo{I 59 {XZ - 3-4 Ho$Or - ECQ>m H$moQ´>r‘mo³gmOmob
Q>çmãboQ> (120 {‘.J«m.)-H$mo n{hbmo ImoamH$ (IwdmCZ g{H$¶mo
^Zo) {XZwnN>©, ao’$ab pñbn/goVmo H$mJO ^Zw©nN>© A{Z {eewbmB©
ñVZnmZ JamC±X¡ VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrhê$H$mo
C{MV CnMmaH$mo gw{dYm N>) nR>mCZwnN>©&
{ZåZ{b{IV‘Ü¶o XþBdQ>m · 0-29 {XZ - ¶g C‘oaH$mo ZmZrbmB© Hw$Z¡ Am¡f{Y {XZg{H>>$± X¡Z&
bjUhê$ Ho$hr ao’$ab pñbn/goVmo H$mJO ^Zw©hmog² A{Z {eewbmB© ñVZnmZ
· AemÝV, PH$m} ‘mÝZo JamC±X¡ VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrhê$H$mo C{MV
{ZO©brH$aU
· ^m{gEH$m Am±Imhê$ CnMmaH$mo gw{dYm N>) nR>mCZwhmog²&
· 1 ‘{hZmXo{I 59 {XZ - 3-4 Ho$Or - ECQ>m H$moQ´>r‘mo³gmOmob
124
· {M‘moQ>oH$mo ËdMm {T>bmo Q>çmãboQ> (120 {‘.J«m.)-H$mo n{hbmo ImoamH$ (IwdmCZ g{H$¶mo
’${H©$ÝN> ^Zo) {XZwnN>©, ao’$ab pñbn/goVmo H$mJO ^Zwn© N>© A{Z {eewbmB©
· ¶moOZm "H$'-AZwgma Ka‘m Vab ImÚhê$ {XZwnN>©&

· XþB {XZn{N> J¥h-^«‘U JZw©hmog² A{Z ZmZrbmB© nwZ…{ZYm©aU a
dJuH$aU JZw©hmog² a Amdí¶H$ nmBbm MmëZwhmog²&
Ho $ hr AWdm Vrd« · AdñWm‘m gwYma Am¶mo ^Zo O~gå‘ nImbm MëN> V~gå‘
{ZO©brH$aUbmB© dJuH$aU {ZO©brH$aU n¶m©á Vabhê$ (nmZr a AmoAmaEg) IwdmBahZo g„mh {XZwhmog²&
JZ©H$m bm{J {MÝhhê$ ÊH$mo N>Z¡ · ZdOmV/ZmZrH$mo emar[aH$ AdñWm OñVmH$mo Ë¶ñV¡ ah²¶mo dm
n¶m©á N>¡ZZ² AP {~{J«¶mo ^Zo ao’$ab pñbn/goVmo H$mJO âoa ZmZrbmB©
AmnmVH$mbrZ pñW{VH$mo AmYma‘m VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m
(Ohm± ZmZrhê$H$mo C{MV CnMmaH$mo gw{dYm N>) nR>mCZwhmog²&
14 {XZ dm Ë¶mo^ÝXm Yoa Vrd« {ZaÝVa · AmnmVH$mbrZ pñW{VH$mo AmYma‘m AñnVmb nR>mCZwnN>©&
g‘¶gå‘ nImbm MëZw nImbm
{Xgm‘m aJV Vrd« aJV‘mgr · 0-29 {XZ - ¶g C‘oaH$mo ZmZrbmB© Hw$Z¡ Am¡f{Y {XZg{H>>$± X¡Z&
ao’$ab pñbn/goVmo H$mJO ^Zw©hmog² A{Z {eewbmB© ñVZnmZ
JamC±X¡ VËH$mb¡ Z{OH¡$H$mo AñnVmb‘m (Ohm± ZmZrhê$H$mo C{MV
CnMmaH$mo gw{dYm N>) nR>mCZwhmog²&
· 1 ‘{hZmXo{I 59 {XZ - 3-4 Ho$Or - ECQ>m H$moQ´>r‘mo³gmOmob

Q>çmãboQ> (120 {‘.J«m.)-H$mo n{hbmo ImoamH$ (IwdmCZ g{H$¶mo
^Zo) {XZwnN>©, ao’$ab pñbn/goVmo H$mJO ^Zw©nN>© A{Z {eewbmB©
125
{ZåZ{b{IV Hw$amhê$ ¶mX am»Zwhmog- ²
 gwñV dm AMoV ZdOmV/ZmZrbmB© Am¡f{Y H${hë¶¡ {XZw hþ±X¡Z A{Z VËH$mb¡ AñnVmb (Ohm± ZmZrhê$H$mo {ZpåV C{MV
CnMmaH$mo gw{dYm N>) nR>mCZwnN>©&
 ZmZrbmB© Am¡f{Y {XEn{N> Ë¶g~mao Am¡f{Y ^ÊS>maU a{OñQ>a‘m boIoa am»ZwnN>©&
Hw$Z¡ {ZO©brH$aU ÊH$mo dm nImbm bmJoH$mo N>Z¡ ^Zo ZmZrbmB© Ka‘¡ CnMma JZw©nN>© (¶moOZm "H$'-AZwgma Vabhê$
IwdmEa) A{Z Ë¶gAZwgma gag„mh {XZwnN>&©
¶moOZm "H$'
 ZdOmV/ZmZrbmB© KarKar bm‘mo g‘¶gå‘ ñVZnmZ JamBahZwnN>©&
 ZdOmV/ZmZrbo àË¶oH$nëQ> nmVbmo dm nmZrgarH$mo {Xgm Jaon{N> CgbmB© 5 Må‘M AmoAmaEg IwdmCZwnN>©&
nmZrbmB© 20 {‘ZQ>gå‘ C‘mëZwhmog², Ë¶gbmB© gobmCZwhmog² a Ë¶mo nmZr ZdOmV/ZmZrbo O{V ImZg³N> ImZ {XZwhmog²&
 ZdOmV/ZmZrbo ~mÝVm Jè¶mo ^Zo 10 {‘ZQ>gå‘ n{I©Zwhmog² a Ë¶gn{N> {~ñVma¡ IwdmCZwhmog²&
 ZmZrbmB© AmoAmaEg {XEn{N> Ë¶g~mao Am¡f{Y ^ÊS>maU a{OñQ>a‘m bo»Zwhmog²&
 XþB {XZn{N> J¥h-^«‘U‘m OmZwhmog² A{Z ZmZrbmB© C{MV àH$mabo (IMNCI Vm{bH$mH$m bhaAZwgma {ZYm©aU, dJuH$aU
a ì¶dñWmnZ ñVåÂZwgma) nwZ…{ZYm©aU a dJuH$aU JZw©hmog²&
 AdñWm‘m gwYma Am¶mo ^Zo O~gå‘ nImbm MëN>, V~gå‘ ZmZrbmB© àeñV ‘mÌm‘m Vab (nmZr a AmoAmaEg)
IwdmBahZo g„mh {XZwhmog²&
 ZdOmV/ZmZrH$mo AdñWm OñVmH$mo Ë¶ñV¡ ah²¶mo dm AP {~{J«¶mo ^Zo, ao’$ab pñbn/goVmo H$mJO ^Zw©hmog² a ZmZrbmB©
VËH$mb¡ AñnVmb (Ohm± ZmZrhê$H$mo {ZpåV C{MV CnMmaH$mo gw{dYm N>) nR>mCZwhmog²&
 Ka‘¡ ì¶dñWmnZH$mo ~obm {ZåZ{b{IV‘Ü¶o Hw$Z¡ ECQ>m dm Ë¶mo^ÝXm Yoa¡ bjUhê$ nmBE ZdOmV/ZmZrbmB© AñnVmb
nR>mCZwnN>&© -
- ZdOmV/ZmZr AP¡ Yoa AñdñW ÊH$mo N>
- gwñV ÊH$mo N>
- ñVZnmZ JZ©g³X¡Z
- {Xgm‘m aJV
- Ádamo AmEH$mo N>
- 8 KÊQ>mXo{I ‘yÌË¶mJ JaoH$mo N>¡Z
ZmZrH$mo {~‘marH$mo {ZYm©aU a ì¶dñWmnZ - nImbm (2 ‘{hZm-5 df©)
{MÝhhê$ dJuH$aU
{ZåZ{b{IV‘Ü¶o XþBdQ>m {MÝh
· gwñV AWdm AMoV
Vrd« {ZO©brH$aU
· {nCZ Zg³Zo ÊH$mo N> dm H$‘Omoa àH$mabo {nC±X¡N>
· {M‘moQ>oH$mo ËdMm AË¶ÝV {T>bmo ’${H©$ÝN>
126
{MÝhhê$ dJuH$aU
{ZåZ{b{IV‘Ü¶o XþBdQ>m {MÝh
· AemÝV, PH$m} ‘mÝZo
· ^m{gEH$m Am±Imhê$ Ho$hr {ZO©brH$aU
· CËgwH$ Êa {nC±N>, {VIm©EH$mo
· {M‘moQ>oH$mo ËdMm {~ñVma¡ ’${H©$ÝN>
Ho$hr AWdm Vrd« {ZO©brH$aUbmB© dJuH$aU JZ©H$m bm{J {MÝhhê$ {ZO©brH$aU N>Z¡
n¶m©á N>¡ZZ²
· 14 {XZ dm Ë¶mo^ÝXm Yoa g‘¶gå‘ nImbm MëZw
Vrd« {ZaÝVa nImbm
· {ZO©brH$aU ÊH$mo N>
· 14 {XZ dm Ë¶mo^ÝXm Yoa g‘¶gå‘ nImbm MëZw
{ZaÝVa nImbm
· {ZO©brH$aU ÊH$mo N>¡Z
· {Xgm‘m aJV aJV‘mgr
aJV‘mgr a Vrd« {ZaÝVa nImbmH$mo ì¶dñWmnZH$mo {ZpåV {ZO©brH$aUH$mo dJuH$aU Adí¶ J[aZwnX©N>&
AmoAmaEg V¶ma nmZw©A{K hmVhê$ gm~wZ a nmZrbo am‘«ar YwZwnN>©& AmoAmaEg V¶ma nmZ©H$m bm{J n{hbm 1 ß¶mHo$Q>
AmoAmaEg g’$m ^m±‹S>m‘m {bZwhmog² A{Z Ë¶g‘m 1 {bQ>a ewÕ {nCZo nmZr hmëZwhmog²& Ë¶gn{N> ECQ>m Ry>bmo g’$m Må‘Mbo
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Ë¶gbmB© 24 KÊQ>m{^Ì‘m nya¡ à¶moJ JZ© Zg{H$E â¶m±{H${XZwnN>©&
127
AmoAmaEg…
· ¶{X ZmZr 2 ‘{hZmH$mo N> ^Zo Cgbo àË¶oH$nëQ> nmVbmo dm nmZrgarH$mo {Xgm Jaon{N> 1/4 {JbmgXo{I 1/2 {Jbmg
AmoAmaEg {XZwnN>©&
· ¶{X ZmZr 2 df© dm Ë¶mo^ÝXm Yoa C‘oaH$mo N> ^Zo Cgbo àË¶oH$nëQ> nmVbmo dm nmZrgarH$mo {Xgm Jaon{N> 1/2 {JbmgXo{I
1 {Jbmg AmoAmaEg {XZwnN>©&
Ka‘¡ ~ZmBEH$mo EH$ dm Ë¶mo^ÝXm Yoa¡ no¶hê$…
· ¶{X ZmZr 6 ‘{hZm dm Ë¶mo^ÝXm Yoa¡ C‘oaH$mo N> ^Zo ZmZrbmB© Ka‘¡ ~ZmBEH$mo EH$ dm Ë¶mo^ÝXm ~ogr no¶hê$ {XZwhmog²,
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· ZmZrbo àË¶oH$nëQ> nmVbmo dm nmZrgarH$mo {Xgm Jaon{N> CgbmB© Ka‘¡ ~ZmBEH$mo ECQ>m no¶ {XZwnN>©&
- 1 df©^ÝXm H$åVr C‘oa Ê 1/2 H$n
- 1 df©^ÝXm ~ogr C‘oa Ê 1 H$n
· nmZrbmB© 20 {‘ZQ>gå‘ C‘mëZwhmog², Ë¶gbmB© gobmCZwhmog² A{Z ZdOmV/ZmZrbo O{V ImZg³N> Ë¶{V Ë¶mo nmZr ImZ
{XZwhmog²&
ì¶dñWmnZ - nImbm (2 ‘{hZm - 5 df©)

{ZåZ{b{IV‘Ü¶o XþBdQ>m {MÝh$ · VËH$mb¡ AñnVmb nR>mCZwnN>© A{Z AñnVmb
· gwñV, AMoV b{JahoH$mo ~obm n{Z CgbmB© {ZaÝVa AmoAmaEg
· ^m{gEH$m Am±Imhê$ IwdmBahZ ^Zr Am‘mbmB© g„mh {XZwnN>©&
Vrd« {ZO©brH$aU
· {nCZ Zg³Zo ÊH$mo N> dm
H$‘Omoa àH$mabo {nC±X¡N>
· {M‘moQ>oH$mo ËdMm AË¶ÝV {T>bmo
’${H©$ÝN>
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· AemÝV, PH$m} ‘mÝZo Q>çmãboQ> {XZwnN>©&
· ^m{gEH$m Am±Imhê$ · 4 KÊQ>mn{N> J¥h-^«‘U JZw©hmog² A{Z ZmZrH$mo
Ho$hr {ZO©brH$aU {~‘marbmB© am‘«ar {ZYm©aU JZw©hmog² a Ë¶g¡AZwgma
· CËgwH$ Êa {nC±N>, {VIm©EH$mo
dJuH$aU a CnMma JZw©hmog²&
· {M‘moQ>Ho $mo ËdMm {~ñVma¡ ’${H©$ÝN>
· AdñWm‘m gwYma AmE 2 {XZn{N> J¥h-^«‘U JZw©hmog²&
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128
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AZwgma) dJuH$aU JZw©hmog²&
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- ZmZrbmB© {ZO©brH$aU ÊH$mo N>Z¡ ^Zo Ka‘¡ nImbmH$mo CnMma JZw©hmog² (¶moOZm "H$'-AZwgma Vabhê$ IwdmCZwhmog)² A{Z
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g„mh {XZwhmog²&
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- ZmZrbmB© {ZO©brH$aU ÊH$mo N¡Z> ^Zo nImbmH$mo CnMma Ka‘¡ JZw©nN>©& ZmZrbmB© ¶moOZm "H$'-AZwgma Vabhê$ A{Z
{OL²>H$ Q>çmãboQ> (20 {‘.J«m.) {XZwhmog² a Ë¶gAZwgma g„mh {XZwhmog²&
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dJuH$aU a ì¶dñWmnZ bhaAZwgma) JZw©hmog² a Ë¶g¡AZwgma nmBbm MmëZwhmog²&
131
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 AdñWm‘m gwYma AmE O~gå‘ nImbm MëN> V~gå‘ ZmZrbmB© àeñV Vabhê$ IwdmCZo g„mh {XZwhmog²&
- AdñWm OñVmH$mo Ë¶ñV¡ ah²¶mo dm AP {~{J«¶mo ^Zo ao’$ab pñbn/goVmo H$mJO‘m OmZH$mar ^Zw©hmog² A{Z VËH$mb¡
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- Vrd« {ZaÝVa nImbm MboH$mo pñW{V‘m ao’$ab pñbn/goVmo H$mJO‘m OmZH$mar ^Zw©hmog² A{Z VËH$mb¡ Z{OH¡$H$mo
AñnVmb (Ohm± ZmZrhê$H$mo C{MV CnMmaH$mo gw{dYm CnbãY N>) AmnmVH$mbrZ AmYma‘m nR>mCZwhmog²&
- {Xgm‘m aJV N> ^Zo ‘m{W ~VmBEH$mo Vm{bH$mAZwgma àW‘ XþB {XZgå‘ ZmZrbmB© Ka‘¡ H$moQ´>r‘mo³gmOmob (120
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 Am¡ f{YH$mo n{hbmo Imo amH$ {XEH$mo Xþ B {XZn{N> (36-48 KÊQ>m{^Ì) J¥ h-^« ‘U JZw © hmo g² A{Z ZmZrH$mo
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132
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134
 E‘Q>rnr EoZ (Medical Termination of Pregnency, MTP Act) (g§emoYZ 2002) A{Z PC & PNDT (Pre-conception
& Post Natal Diagnostics Techniques of Pregnency, MTP ) EoZ (g§emoYZ 2003)-H$m ‘hÎdnyU© VÏ¶hê$~mao
OmZH$mar àXmZ JZw©&
 J^©nmVn{N> J[aZwnZ} hoaMmh~mao ‘{hbmbmB© g„mh {XZw&
 VËH$mb AñnVmb nR>mCZH$m bm{J IVamH$m {MÝhhê$ {MpÝhV JZw©&
 J^©nmVn{N> Voòmo a gmVm¢ {XZ ‘{hbmbmB© hoZ© OmZw&
 ‘m{W ~VmBEH$m VÏ¶hê$~mao J¥h-^«‘UH$mo ~obm MMm© JZw© A{Z ‘m{gH$ ~¡R>H$ hþ±Xm ‘m{WH$m Hw$amhê$~mao Aê$bmB©
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135
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n[adma {Z¶moOZ
n[adma {Z¶moOZH$mo Amdí¶H$Vm a ‘hÎd

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n[adma {Z¶moOZH$m ’$mBXmhê$ {ZåZ{b{IV hþZ²…
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¶gbo ZmZrhê$bmB© JwUñVar¶ {ejm {XbmCZ n{Z ‘XV JX©N>&
g‘mObmB© hþZo ’$mBXmhê$…
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JX©N> A{Z g‘mOH$mo g‘J« {dH$mg‘m ¶moJXmZ {XÝN>&
XoebmB© hþZo ’$mBXmhê$…
XoeH$mo g‘J« {dH$mgH$mo {ZpåV n{Z n[adma {Z¶moOZbo Yoa¡ ‘hÎd am»XN>& C{MV n[adma {Z¶moOZbo XoeH$mo g‘J« Am{W©H$
d¥{Õ‘m ‘XV nwè¶mC±N> {H$Z^Zo OZgL²>»¶m d¥{Õ‘m AmEH$mo õmgbo XoeH$mo à{Vì¶{º$ Am¶bmB© ~‹T>mCZo JX©N>&
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 n{hbmo ZmZrH$mo OÝ‘‘m {dbå~
 XþBOZm ZmZrH$mo OÝ‘~rM H$åVr‘m n{Z 3 df©H$mo AÝVamb H$m¶‘ am»Zo
 ZmZrhê$ ZOÝ‘mCZ MmhZo
 20 df©H$mo C‘oa^ÝXm A{K J^© ~ñ¶mo ^Zo Am‘m a ZmZr Xþd¡H$mo {ZpåV Ë¶mo Omo{I‘nyU© hþÝN>&
n[adma {Z¶moOZ H$m¶©H$« ‘‘m CnbãY J^©{ZamoYH$ {d{Yhê$

1. AÝVamb {d{Yhê$ (Spacing Methods)- gwB©Ûmam J«hU JZ©g{H$Zo J^©{ZamoYH$ MPA (AÝVam H$m¶©H«$‘); godZ J[aZo
g§¶ºw $ Jmobrhê$ (Combined Oral Contraceptive Pills, COCs) (Mala-N), ZZ²-h‘m}Zb goÝQ>H$« mo‘oZ {nëg (Non-hormonal
Centchroman Pills) (Chhaya), àmoOpñQ>Z AmoZbr {nëg (Progestin Only Pills, POPs)-g{hV godZ J[aZo J^©{ZamoYH$
Jmobrhê$ (OCPs); {ZamoY (Condom) A{Z BÝQ´>m-¶yQ>amBZ H$ÝQ´>mgopßQ>^ {S>^mBg (IUCD 380A A{Z 375)&
136
gwB©Ûmam {bZg{H$Zo MPA Ho$db àmoOpñQ>Z Jmobrhê$ IUCD 380 A (10 df©gå‘ à^mdH$mar) A{Z
(AÝVam H$m¶©H«$‘) (Only Progestin Pills)
IUCD 375 (5 df©gå‘ à^mdH$mar)
godZ J[aZo g§¶wº$ Jmobrhê$ goÝQ>H«$mo‘oZ (Centchroman) {ZamoY (Condom)

(Combined Oral Pills) (Mala-N) (N>m¶m)
¶mX am»Zwhmog²
CnbãY g~¡ J^©{ZamoYH$ {d{Yhê$‘Ü¶o COCs àgdn{N> 6 ‘{hZmgå‘ ñVZnmZ JamCZo ‘{hbmhê$bo J«hU JZw© hþ±X¡Z
{H$Z^Zo ¶gbo ñVZH$mo XÿYH$mo ‘mÌm a JwUñVabmB© Aga JX©N>& goÝQ>H$« mo‘oZ Jmobrhê$ (N>m¶m) a àmoOpñQ>Z AmoZbr {nëg
(POPs) àgdn{N> ‘{hbmbo Amam‘ AZw^d Jaon{N> Hw$Z¡ n{Z g‘¶ ewé JZ©g{H$ÝN>& gwB©Ûmam {bZg{H$Zo MPA (AÝVam
H$m¶©H«$‘) ‘{hbmbo àgdH$mo 6 hámn{N> {bZgp³N>Z² A{Z IUCD ¶mo{ZÛmam àgdH$mo bJÎm¡ AWdm 48 KÊQ>m{^Ì‘m
(A{Z eë¶{H«$¶mÛmam àgdH$mo bJÎm¡) à{dï> JamCZg{H$ÝN>& Ë¶gn{N> IUCD àgdH$mo 6 hámn{N> à{dï> JamCZg{H$ÝN>&
IUCD J^©nmV nyam Ên{N> 12 {XZ{^Ì‘m n{Z à{dï> JamCZg{H$ÝN>& Aê$ g~¡ AÝVamb H$m¶‘ am»Zo J^©{ZamoYH$
Jmobrhê$ J^©nmV nyam ÊH$mo bJÎm¡ AWdm 7 {XZ{^Ì {bZ ewé JZ©g{H$ÝN>&
2. ñWm¶r {d{Yhê$ (Limiting Methods) - ‘{hbm Zg~ÝXr AWm©V² ~ÝÜ¶mH$aU (Tubectomy) A{Z nwéf Zg~ÝXr
(Vasectomy)& ‘{hbm Zg~ÝXr àgd/J^©nmV nyam ÊH$mo bJÎm¡ AWdm 7 {XZ{^Ì JamCZg{H$ÝN> (OgbmB© àgdmoÎma/
J^©nmVmoÎma Zg~ÝXr ^{ZÝN>) O~{H$ nwéf Zg~ÝXr Hw$Z¡ n{Z g‘¶ JamCZg{H$ÝN>&
3. AmnmVH$mbrZ J^©{ZamoYH$ Jmobr (Ezy Pill)- ¶mo {Z¶{‘V J^©{ZamoYH$ {d{Y hmoBZ& A{Z¶mo{OV/Agwa{jV/~bOâVr
J[aEH$mo ¶m¡Z gånH©$ AWdm H$ÝS>m‘o ’w$Q>oH$mo dm gaoa ’w$³boH$mo pñW{Vhê$‘m 72 KÊQ>m{^Ì (O{V Mm±‹S>mo hþÝN> Ë¶{V Z¡ CÎm‘)
¶mo Jmobr godZ JZw©nX©N>& n{hbmo ZmZrH$mo OÝ‘n{N> 3 df©H$mo AÝVamb am»Zo gw{ZpíMV JZ©H$m bm{J A{Z XånVrhê$bo
XþBOZm ZmZrH$mo OÝ‘n{N> ñWm¶r n[adma {Z¶moOZH$mo {d{YH$mo BÀN>m JaoH$mo pñW{V>‘m VnmBªbmB© àmoËgm{hV J[a>>X± ¡N>&
àgdn{N>/J^©nmVn{N> IUCD à{d{ï>H$mo {ZpåV g„mh {XZ A{Z OgbmB© Amdí¶H$ N> CgbmB© gå~pÝYV ñdmñÏ¶ Ho$ÝÐ‘m
{bEa OmZ ^Zr VnmBªbmB© àmoËgm{hV J[aÝN>&
137
‘{hbmbmB© n[adma {Z¶moOZH$mo Amdí¶H$Vm
{d{^Þ ‘{hbm a XånVrhê$bmB© AmBnZ} n[adma {Z¶moOZH$m Amdí¶H$Vmhê$ {^ÝXm{^ÝX¡ hþÝN>Z²-
· d¡dm{hH$ pñW{V…
 A{ddm{hV … H$ÝS>mo‘ AWdm J^©{ZamoYH$ Jmobrhê$ dm AmnmVH$mbrZ J^©{ZamoYH$ Jmobrhê$&
 Zd{ddm{hV A{Z n{hbmo ZmZrH$mo OÝ‘ {T>bmo hmog² ^Þo MmhZm… H$ÝS>mo‘ dm J^©{ZamoYH$ Jmobrhê$&
· Î©a¡ gwËHo$ar ÊH$m (àgdn{N>) AWdm Î©a¡ J^©nmV JamEH$m ‘{hbmhê$ … H$ÝS>m‘
o , N>m¶m, IUCD (6 hámn{N>), MPA
(ZmZrH$mo OÝ‘H$mo O{Vg³Xmo Mm±‹S>mo 6 hám{^Ì)
· XþBOZm ZmZr~rM AÝVamb am»Z BÀNw>H$… H$ÝS>mo‘, J^©{ZamoYH$ Jmobrhê$, IUCD, gwB©Ûmam {bZg{H$Zo MPA
· Aê$ ZmZr OÝ‘mCZ A{ZÀNw>H$… nwéf a ‘{hbmH$mo {ZpåV Zg~ÝXr&
godZ J[aZo g§¶º

w $ J^©{ZamoYH$ Jmobrhê$ (Combined Oral Contraceptive Pills)
 godZ J[aZo g§¶wº$ J^©{ZamoYH$ Jmobrhê$ (COCPs) ECQ>m AñWm¶r {d{Y hmo OgH$mo à¶moJ ‘{hbmbo JZ©gp³N>Z²&
 godZ J[aZo g§¶wº$ J^©{ZamoYH$ Jmobrbo {ZfoMZbmB© amo³Z ‘XV JX©N>& ¶{X {ZfoMZ ^¶mo ^Zo ¶mo Jmobrbo J^m©e¶‘m
{Zfo{MV {S>å~mUw O‘oa ~ñZo à{H«$¶mbmB© amo³XN>&
 ewé JZw©A{K S>m³Q>a/ANM-Ûmam Adí¶ Om±M JamCZwnX©N>&
 nÎmm‘m 21 dQ>m goVmo Jmobr a 7 dQ>m I¡amo Jmobrhê$ hþÝN>Z²&
godZ J[aZo g§¶º w $ J^©{ZamoYH$ Jmobrhê$ (MALA-N)-H$mo godZ JXm© ¶mX am»ZwnZ} Hw$amhê$
 godZ JZw©A{K g‘m{áH$mo {‘{V A{Z nÎmm À¶m{VEH$mo dm ’$mQ>oH$mo {MÝhhê$ N>Z² {H$ Om±Moa hoZw©nN>©&
 n{hbmoMmo{Q> à¶moJ JXm©, ‘m{gH$ MH«$H$mo nm±Mm¢ {XZXo{I Jmobrhê$ ImZwnN>©&
 ECQ>m {Z{X©ï> g‘¶‘m {deofJar am{VH$mo ImZm ImBgHo$n{N> AWdm am{V gwËZA{K nÎmm‘m XoImBEH$mo VraAZwgma
Jmobrhê$ godZ JZw©nN>©&
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 ¶{X Hw$Z¡ ‘{hbmbo 2 dQ>m dm Ë¶mo^ÝXm ~ogr Jmobrhê$ godZ JZ© ^w{bZ²² AWdm {VZbo {Z{X©ï> g‘¶H$mo 2 {XZ AWdm
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- O{Vg³Xmo Mm±‹S>mo XþBdQ>m Jmobr godZ JZw©hmog² A{Z Jmobrhê$ {Z¶{‘V ê$n‘m godZ JZ© Omar am»Zwhmog²& {VZbmB© O{hbo
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XþBdQ>¡ Jmobr EH¡$Mmo{Q> godZ JZ©gp³N>Z²&
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JZw©nN>© AWdm Ë¶mo g‘¶md{Y‘m ¶m¡Z gånH©$ am»Zw hþ±X¡Z&
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nÎmm~mQ> Jmobrhê$ godZ JZ©WmëZwnN>©&
138
- ¶{X ‘{hbmbo n{hbmo gmVm~rM Jmobrhê$ godZ JZ© ^w{bZ²² A{Z ¶m¡Z gånH©$bmB© Agwa{jV Vwë¶mBZ² ^Zo {VZbo
A{V[aº$ gwajmH$mo {ZpåV AmnmVH$mbrZ J^©{ZamoYH$ Jmobrhê$ godZ JZw©nN>© a Ë¶mog±J¡ g§¶wº$ J^©{ZamoYH$ Jmobrhê$
n{Z godZ JZw©nN>©&
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 godZ JZw©A{K S>m³Q>a/ANM-Ûmam Om±M JamCZw Amdí¶H$ N>&
 ñVZnmZ JamCZo ‘{hbmhê$bo àgdn{N> 6 ‘{hZmgå‘ ¶mo Jmobr godZ JZw© hþ±X¡Z&
 ‘m¡{IH$ Jmobrhê$bo ¶m¡Z dm{hV gL²>H«$‘U dm {~‘marhê$H$mo gL²>H«$‘UbmB© amoH$Wm‘ JX£ZZ²&
 ‘m¡{IH$ Jmobrhê$H$mo godZ ~ÝX Jao J^© ~ñZg³N>, ¶gH$maU XånVrbo J^© ~gmog² ^Þo MmhoH$mo IÊS>‘m g§¶º
w $
J^©{ZamoYH$ Jmobrhê$H$mo godZ JZw© hþ±X¡Z&
 ¶r Jmobrhê$ n{hbmoMmo{Q> godZ JaoH$mo àW‘ 3 ‘{hZm{^Ì¡$S>m³Q>aH$mo g„mh Adí¶ {bZwnN>©&
Jmobrhê$H$m nmíd© à^mdhê$

¶r Jmobrhê$‘m Ë¶ñV¡ agm¶Zhê$ hþÝN>Z² OwZ agm¶Zhê$ ‘{hbm J^©dVr hþX± m {VZH$mo earabo CËnmXZ JX©N>& ¶gH$maU
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 godZ J[aZo J^©{ZamoYH$ Jmobrhê$ ASHA-{gV é. 1/- ‘m CnbãY hþÝN>Z²&
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CnbãY hþÝN>Z²&
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J^m©e¶‘m à{dï> JamBZo J^©{ZamoYH$ CnH$aU (Intra-Uterine Contraceptive Device, IUCD)
IUCD ßbmpñQ>H$ dm Vm±~mbo ~ZoH$mo ECQ>m gmZmo T AmH$maH$mo T>m±MmJV dñVw dm CnH$aU hmo
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 ¶gbo {ZfoMZbmB© amo³XN>&

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à{dï> JamCZg{H$ÝN>&
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 gwËHo$ar ‘{hbm Am’¡$bo Vmahê$H$mo AZw^d JZ© Zg³Zo hþZmbo gË¶mnZH$mo {ZpåV {VZr Cn-Ho$ÝÐ OmZwnZ} hþÝN>& IUCD
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Om±M JZw©nN>© A{Z Xmoòmo ‘m{gH$ MH«$ ewé hþZA{K IUCD AmâZ¡ R>mC±‘m N> ^Zr gw{ZpíMV hþZ ANM-H$hm± OmZwnX©N>&
 IUCD à{dï> JamEn{N> ‘{hbm 3 ‘{hZmH$mo AÝVamb‘m Om±M JamCZ ANM/S>m³Q>aH$hm± OmZwnN>©&
 J^©YmaU JZ©H$m bm{J S>m³Q>a/ANM-Ûmam IUCD hQ>mCZwnN>©&
 ¶mo godm Hw$Z¡ n{Z gaH$mar g§ñWmZ‘m {Z…ewëH$ CnbãY N> A{Z IUCD à{dï> JamEn{N> Hw$Z¡ àH$maH$mo emar[aH$ g‘ñ¶m
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 ñVZnmZ JamCZo Am‘mhê$bo n{Z IUCD à¶moJ JZ©g³N>Z²&
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IUCD à¶moJH$m AñWm¶r/àmapå^H$ g‘ñ¶mhê$…

 IUCD à{dï> JamEn{N> n{hbmo gmVm aº$òmd&
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VrZ ‘{hZmn{N> amo{H$ÝN>&
Cnamoº$ g‘ñ¶mhê$ g‘¶g±J¡ H$åVr hþ±X¡ JEa g‘má hþÝN>Z², ¶gH$maU IUCD à{dï> JamCZw‘m Hw$Z¡ g‘ñ¶m N>Z¡ &
OwZ ‘{hbmhê$bo IUCD à¶moJ JN>Z© ² A{Z {ZåZ{b{IV g‘ñ¶mhê$ Ê CZrhê$ VËH$mb¡ S>m³Q>aH$hm± OmZwnN>…©
 Ádamo ZAmB© AWdm Ádamog±J¡ noQ> ì¶Wm
 ¶mo{Z~mQ> XþJ©ÝY¶wº$ òmd
 2 ‘{hZmXo{I ‘m{gH$ Y‘© ZhþZw
140
IUCD à¶moJH$m ’$mBXmhê$…
 IUCD-bo ¶m¡Z gånH©$H$mo ~obm Ag{ObmonZ dm nr‹S>m hþZo g‘ñ¶mhê$ CËnÞ JX£Z&
 ³¶mÝga hþ±X¡Z&
 ~m±PmonZ ë¶mC±X¡Z&
 IUCD Q>mCH$mo/N>mVrV’©$ Cp³b>>±X¡Z&
 ¶mo ghþ{b¶V Z{OH¡$H$mo Cn-Ho$ÝÐ/àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa
AñnVmb/{O„m AñnVmb‘m {Z…ewëH$ CnbãY N>&
{ZamoY dm H$ÝS>m‘o (Condom)

 H$ÝS>m‘o nwéfhê$Ûmam à¶moJ J[aZo J^©{ZamoYH$ gmYZ hmo&
 ¶mo ¶m¡Z gånH©$ JXm© J^©{ZamoYH$H$mo ê$n‘m nwéfH$mo {bL²>J‘m bJmBZo nmVbmo a~aH$mo AmdaU hmo&
 H$ÝS>m‘o à¶moJ JZw©A{K Ë¶gH$mo ß¶mHo$Q>‘m g‘m{áH$mo {‘{V Om±ÀZwnN>©&
 ß¶mHo$Q>bmB© {dnarV Hw$Zmn{Å> Voòmo àH$mabo g‘mVoa ß¶mHo$Q>H$mo EH$ N>oCbmB© hëH$m {WÀZwhmog² Vm{H$ H$ÝS>mo‘ EH$ R>mC±~mQ>
AH$m} R>mC±‘m g{Ob¡ gZ©gH$mog² a Ë¶gar Ë¶mo ì¶dhma¶mo½¶ hþÝN>&
 ECQ>m H$ÝS>mo‘bmB© EH$nëQ> ‘mÌ à¶moJ JZ©g{H$ÝN>&
 H$ÝS>mo‘bmB© O{hbo n{Z Km‘H$mo àH$me/Vmn~mQ> Q>m‹T>mo A{Z gw³Im a {Mgmo R>mC±‘m am»ZwnN>©&
 H$ÝS>mo‘H$mo ~m{ha Vob, ôg{bZ dm Aê$ {Mßbmo nXmW©hê$ H${hë¶¡ bJmCZw hþ±X¡Z&
 H$ÝS>mo‘bmB© à¶moJ J[agHo$n{N> ECQ>m H$mJO‘m ~oõoa Ë¶gbmB© OVmgwH¡$ Zâ¶m±Ho$a ‘¡bm â¶m±³Zo T²>dmL> dm ‘¡bm {dgO©Z
J[aZo R>mC±‘m â¶m±³ZwnX©N>&
 H$ÝS>mo‘ O{hbo n{Z ECQ>m {Z{X©ï> {d{Ybo à¶moJ JZw©nN>©&
 H$ÝS>mo‘ à¶moJ JZ} ghr {d{Y OmÞH$m bm{J AÝdofm p³bZrH$/àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/
J«m‘rU AñnVmb/gXa AñnVmb/{O„m AñnVmb‘m OmZwnX©N>&
 ¶gbo {ZfoMZbmB© amo³ZwH$mo gmWgmW¡ àOZZgå~ÝYr gL²>H«$‘U A{Z ¶m¡Z dm{hV {~‘marhê$H$mo amoH$Wm‘ n{Z JX©N>&
 H$ÝS>mo‘ à¶moJ Jaoa n{Z ¶m¡ZH$mo AmZÝX nyU©ê$nbo àmá JZ©g{H$ÝN>&
 EH$^ÝXm ~‹T>r H$ÝS>mo‘H$mo à¶moJbo A{V[aº$ gwajm àXmZ JX£Z ~é Ë¶mo j{VJ«ñV hþZ dm ’$mQ²>Zg³N>&
 3 dQ>m H$ÝS>mo‘H$mo ECQ>m ß¶mHo$Q> é. 1/- ‘m ASHA-{gV CnbãY ahoH$mo hþÝN>&
 gXa AñnVmb/amÁ¶ gmYmaU AñnVmb/{O„m AñnVmb/‘o{S>H$b H$boO AñnVmb‘m H$ÝS>mo‘ {Z…ewëH$ nmBÝN>&
 Am¡f{Y ngb dm ‘o{S>H$b ñQ>mao hê$ A{Z ñQ>oeZar ngbhê$~mQ> n{Z H$ÝS>m‘o {H$Þ nmBÝN>&
goÝQ>H$« mo‘Zo (N>m¶m) Ho$ hmo?

N>m¶m EH$ àH$maH$mo godZ J[aZo J^©{ZamoYH$ Jmobr hmo Og‘m Hw$Z¡ h‘m}Z hþ±X¡Z& ¶mo Jmobr ~OmaH$m Ho$hr ngbhê$‘m "ghobr'
Q>çmãboQ>H$mo ê$n‘m CnbãY N>& Yoa¡^ÝXm Yoa¡ ‘{hbmhê$bmB© bm^ nwè¶mCZH$m bm{J ¶gbmB© OZñdmñÏ¶ àUmbr‘m "N>m¶m'
Zm‘‘m àñVwV J[aEH$mo N>& ñVZnmZ JamCZo a ñVZnmZ ZJamCZo Xþd¡ ‘{hbmhê$H$m bm{J ¶mo ECQ>m gwa{jV AÝVambH$mo
{dH$ën hmo A{Z ¶mo Q>çmãboQ> àW‘ VrZ ‘{hZm hám‘m Ho$db XþBnëQ> A{Z Ë¶gn{N> hám‘m EH$nëQ> {bZwnX©N>&
141
goÝQ>H$« mo‘Zo (N>m¶m) H$gbo à¶moJ JZ©g³N>Z?
² >
 g~¡ ‘{hbmhê$bo Am’y$ J^©dVr ZÊH$mo nw{ï> Jaon{N> goÝQ>H«$mo‘oZ (N>m¶m) à¶moJ JZ©g³N>Z²&
 Hw$Z¡ n{Z C‘oaH$s ‘{hbmbo, CZH$m N>moamN>moar ÊH$mo hmog² dm Zhmog², N>m¶m à¶moJ JZ©gp³N>Z²&
 OwZ ‘{hbmbmB© Mala-N/Mala-D-bo nmíd© à^md nmN>© {VZbo {dH$ënH$mo ê$n‘m ¶gbmB© MwÞgp³N>Z²&
 ñVZnmZ JamBahoH$m gwËHo$ar ‘{hbmhê$bo n{Z Ho$hr Amam‘H$mo AZw^d Jaon{N> ¶gH$mo à¶moJ JZ©g³N>Z²& goÝQ>H«$mo‘oZbo
ñVZH$mo XÿYH$mo ‘mÌm, JwUñVa a g§aMZmbmB© Hw$Z¡ Aga JX£Z&
‘{hbmhê$bo goÝQ>H$« mo‘Zo (N>m¶m) H$hm± àmá JZ©g³N>Z?

²
¶mo g~¡ OZñdmñÏ¶ Ho$ÝÐhê$‘m CnbãY N> A{Z S>m³Q>ahê$ (E‘~r~rEg a Ë¶mo^ÝXm ‘m{WH$m, Am¶wf), Hw$eb n[aMm[aH$mhê$
(SNs), ‘{hbm ñdmñÏ¶ ^«‘UH$mar (LHVs), ghm¶H$ n[aMm[aH$m YmB© (ANM)-bo àXmZ JZ©g³N>Z²& ¶mo ASHA-H$mo Am¡f{Y
~mH$g‘m n{Z hþÝN>& Va, n{hbmo ImoamH$ ñdmñÏ¶ Ho$ÝÐ‘m C{MV Om±Mn{N> Ho$db Hw$eb àXmVmÛmam Z¡ àXmZ J[aEH$mo hþZwnN>©&
CnbãYVm… goÝQ>H«$mo‘oZ (N>m¶m) XþB ß¶mHo$Q>‘m CnbãY N>Z²… ASHA Ûmam Amny{V© A{Z {Z…ewëH$ Amny{V©& àË¶oH$ ß¶mHo$Q>‘m
8 dQ>m Q>çmãboQ> hþÝN>Z²& ASHA Amny{V© Ka‘m {dVaUH$mo {ZpåV hþÝN> A{Z {Z…ewëH$ Amny{V© ñdmñÏ¶ Ho$ÝÐhê$‘m {dVaUH$mo
{ZpåV hþÝN>&
g‘¶-Vm{bH$m… goÝQ>H«$mo‘oZ (N>m¶m) àW‘ VrZ ‘{hZm hám‘m XþBnëQ> A{Z Ë¶gn{N> hám‘m EH$nëQ> {bZwnX©N>&
N>m¶mH$mo à¶moJ ewé JZ©H$mo {ZpåV ‘{hbmbmB© n{hbmo Jmobr ‘m{gH$ MH«$H$mo n{hbmo {XZ (OwZ aº$òmdH$mo n{hbmo {XZ hmo>)
{bZo A{Z Xmoòmo Jmobr VrZ {XZn{N> (aº$òmdH$mo Mm¡Wmo {XZ) {bZo g„mh {XBÝN>& godZH$mo ¶mo T>m±MmbmB© àW‘ VrZ
‘{hZm^[a Xmohmoè¶mBÝN>&
Mm¡Wmo ‘{hZmXo{I, godZ ewé JXm© n{hbmo Jmobr {bEH$mo {XZ Z¡, hám‘m EH$nëQ> {bZwnN>© A{Z ‘m{gH$ MH«${gV Hw$Z¡ gå~ÝY
ZamIr Ë¶gar Z¡ gmám{hH$ Vm{bH$mAZwgma godZ Omar am»ZwnN>©&
¶{X n{hbmo Jmobr {bBEH$mo {XZ àW‘ 3 ‘{hZm 3 ‘{hZmn{N>
AmBVdma AmBVdma a ~wYdma AmBVdma
gmo‘dma gmo‘dma a {~hrdma gmo‘dma
‘“bdma ‘“bdma a ewH«$dma ‘“bdma
~wYdma ~wYdma a e{Zdma ~wYdma
{~hrdma {~hrdma a AmBVdma {~hrdma
ewH«$dma ewH«$dma a gmo‘dma ewH«$dma
e{Zdma e{Zdma a ‘“bdma e{Zdma
Jmobr godZ JZw© Nw>Q>Ho $mo dm ^wbHo $mo pñW{V‘m bm^mWuhê$bmB© Ho$ g„mh {XZwnN>? ©
‘{hbmbo Jmobr godZ JZ© ^w{bZ²² ^Zo Ë¶mo Nw>Q>oH$mo Jmobr ¶mX hþZ{o ~{ÎmH¡$ {VZbo {bZwnN>© ^Zr VnmBªbo {VZbmB© ~VmCZwnN>&© ¶{X
{VZbo 1-2 {XZ (7 {XZ^ÝXm H$åVr) Q>çmãboQ> {bZ ^w{bZ²² ^Zo {VZbo ¶mX AmCZo{~{ÎmH¡$ Ë¶mo Nw>Q>oH$mo Q>çmãboQ> {bZwnN>©
A{Z gm‘mÝ¶ g‘¶-Vm{bH$mbmB© Omar am»ZwnN>©& ¶g~mhoH$, {VZbo nyU© gwajmà{V AmídñV hþZ n[anyaH$ {d{Y, OñV¡-
H$ÝS>mo‘ à¶moJ JZw©nN>©&
142
¶{X {VZbo 7 {XZ^ÝXm Yoa g‘¶ Jmobr {bZ ^w{bZ² ^Zo {VZbo Am’y${gV ÊH$mo ß¶mHo$Q> â¶m±{H${XZwnN>© a Z¶m± à¶moJH$Vm©bo
OñV¡ Z¶m± ß¶mHo$Q> {bEa ewé JZw©nN>,© AWm©V², àW‘ 3 ‘{hZmgå‘ hám‘m XþBnëQ> A{Z Ë¶gn{N> hám‘m EH$nëQ>&
goÝQ>H$« mo‘Zo (N>m¶m)-~mQ> hþZo ’$mBXm, nmíd©-à^md a gr{‘VVmhê$ Ho$ Ho$ hþZ?
²
’$mBXmhê$…
· N>m¶mbo ‘m{gH$ Y‘©H$mo ~obm hþZo aº$òmd H$åVr JamC±N> A{Z XþB ‘m{gH$ MH«$~rMH$mo AÝVambbmB© n{Z bm‘mo ~ZmC±N>&
aº$mënVm ÊH$s ‘{hbmH$mo bm{J ¶mo Cn¶moJr Hw$am hþ±XN>&
· ñVZnmZ JamCZo ‘{hbmhê$H$mo {ZpåV gwa{jV&
· OwZ ‘{hbmhê$bmB© h‘m}Zgå~ÝYr {d{Y {g’$m[ae J[a>>X± ¡Z {VZrhê$bo ¶mo {d{Y à¶moJ JZ©g³N>Z²&
nmíd©-à^mdhê$…
N>m¶mH$m AË¶ÝV Wmo]a¡ nmíd©-à^mdhê$ hþÝN>Z²& Ho$hr ‘{hbmhê$‘m àW‘ VrZ ‘{hZm ‘m{gH$ Y‘© {T>bmo hþZo JX©N>&
gr{‘VVm…
Aê$ godZ J[aZo Jmobrhê$ OñV¡ goÝQ>H$« mo‘oZ à¶moJ JZw©A{K n{Z àË¶oH$ bm^mWubo à{ejUàmá àXmVmÛmam Om±M JamCZwnN>©&
gwBÛ© mam {bZg{H$Zo J^©{ZamoYH$, MPA…
¶mo J^©{ZamoYH$ A~ gaH$mar ñdmñÏ¶ Ho$ÝÐhê$‘m AÝVam H$m¶©H«$‘H$mo ‘mÜ¶‘Ûmam CnbãY N>& ¶mo J^©{ZamoYH$ ñdmñÏ¶
Ho$ÝÐ‘m Hw$Z¡$ à{e{jV àXmVm (S>m³Q>a, Zg©, ANM)-Ûmam àXmZ JZ©g{H$ÝN>&
MPA Ho$ hmo?

MPA àË¶oH$ VrZ ‘{hZm‘m gwBÛ© mam {XBÝN>& ¶gbo bm‘mo g‘¶gå‘ J^©YmaUbmB© amo³XN> A{Z ZmZrhê$H$mo OÝ‘~rM
AÝVamb H$m¶‘ am»Z ‘XV JX©N>&
143
gwBÛ© mam {bBZo J^©{ZamoYH$ MPA H$gbo à¶moJ JZ©g³N>Z?²
· Hw$Z¡ n{Z C‘oaH$s ‘{hbm a {H$emoarhê$bo, A{Z N>mao mN>moar ÊH$m dm ZÊH$m 45 df©Xo{I ‘m{WH$m ‘{hbmhê$bo&
· àOZZ C‘oaH$m A{ddm{hV ‘{hbmhê$bo&
· OwZ ‘{hbmbo Î©a¡ J^©nmV JamEH$s N>Z² dm OgH$mo Î©a¡ J^©nVZ ÊH$mo N>&
· ñVZnmZ JamBahoH$m ‘{hbmhê$bo (ZmZrH$mo OÝ‘n{N> O{Vg³Xmo Mm±‹S>m,o 7 hámn{N> ewé JZ©g{H$ÝN>)&
· EMAmB©^r gL²>H$« {‘V ‘{hbmhê$bo, {VZrhê$bo Am¡f{Yhê$ {bBahoH$m hmoD$Z² dm ZhmoD$Z²&
MPA-H$m ’$mBXmhê$ Ho$ Ho$ hþZ?

²
· X¡{ZH$ ê$n‘m {bZwnX£Z, 3 ‘{hZm‘m Ho$db EH$nëQ> {bZwnX©N>&
· godZ J[aZo h‘m}ZO{ZV J^©{ZamoYH$ Jmobrhê$, OñV¡- Mala-N/Mala-D Am{X {bZ Ag‘W© ‘{hbmhê$bo à¶moJ
JZ©g³N>Z²&
· ñVZnmZ JamBahoH$m Am‘mhê$H$m bm{J gwa{jV hþÝN> {H$Z{H$ ¶gbo ñVZH$mo XÿYH$mo ‘mÌm a JwUñVa‘m Aga JX£Z&
· ¶gbmB© {bZ ~ÝX Jaon{N> J^©YmaU‘m Hw$Z¡ g‘ñ¶m CËnÞ hþ±X¡Z& ¶mo {d{YbmB© amoHo$n{N> ‘{hbmbo J^©YmaU JZ©gp³N>Z²&
· ¶m¡Z gånH©$/AmZÝX‘m Hw$Z¡ ~mYm {X>>±X¡Z&
· ‘m{gH$H$mo ~obm noQ> ~Q>m[aZw H$åVr hþÝN> (Ho$hr pñW{Vhê$‘m)
· ¶gbo ‘m{gH$ MH«$‘m n[adV©Z ë¶mC±N>, H${hboH$m{h>>± ‘m{gH$ aº$òmdbmB© amo{H${XÝN> OwZ hm{ZH$maH$ hþ±X¡Z& ¶gbo
dmñVd‘m ‘m{gH$H$mo ~obm hþZo aº$j¶bmB© H$åVr Jaoa aº$mënVmH$mo g‘ñ¶mbmB© ~T²>Z {X>>±X¡Z&
· Hw$Z¡ n{Z Am¡f{YbmB© ~mYm nwè¶mC±X¡Z&
· bm^mWuH$mo JmonZr¶Vm gw{ZpíMV JZ©g{H$ÝN>&
MPA-H$m Agahê$… Ho$hr ‘{hbmhê$bmB© {ZåZ{b{IV AZw^d hþZg³N>…

· ‘m{gH$ Y‘©H$mo A{Z¶{‘VVm- A{Z¶{‘V aº$òmd, Yoa¡ {XZgå‘ Yoa¡ aº$òmd
· AmoOZ ~T²>Zw
· Q>mCH$mo Xþ»Zw
· ‘ZmopñW{V‘m n[adV©Z AmCZw
gr{‘VVm…
· ¶gbo EMAmB©^r a àOZZ VÝÌH$mo gL²>H$« ‘U/¶m¡Z dm{hV gL²>H«$‘U~mQ> ajm JX£Z&
· {ZfoMZH$mo AdñWm ’${H©$AmCZbmB© n{N>„mo gwB©H$mo {‘{VXo{I 7-10 ‘{hZm bm½XN>&
‘{hbmbo MPA H$hm± àmá JZ©gp³N>Z² A{Z ¶mo H$gar {bZwnN>>©?

MPA {bZ ewé JaoH$s ‘{hbmbo àË¶oH$ VrZ ‘{hZm‘m Ë¶mo gwB© {bZwnX©N>& J^©{ZamoYH$hê$ {Z¶{‘V ê$n‘m à¶moJ JZw© ‘hÎdnyU©
Hw$am hmo ^Þo VnmBªbmB© Wmhm N>& MPA Vr Ho$ÝÐhê$‘m CnbãY hþÝN> Ohm± ¶mo {d{Y à¶moJ JZ© àXmVmhê$ à{e{jV ÊH$m
hþÝN>Z²& n{hbmo ImoamH$ Hw$Z¡ à{e{jV S>m³Q>aÛmam AWdm S>m³Q>aH$mo {ZJamZr‘m à{e{jV ñQ>m’$ Zg©/ANM-Ûmam {bZg{H$ÝN>&
VnmBªH$mo g‘wXm¶‘m Hw$Z¡ ‘{hbmbo n{hbmo ImoamH$ {bZ ewé Jaon{N> ASHA-H$mo ê$n‘m VnmBªH$mo ^y{‘H$m Vr ‘{hbmH$mo
144
pñW{VbmB© n{hë¶mCZw A{Z {VZbmB© Hw$Z¡ nmíd© à^mdhê$ ÊH$m N>Z² {H$ ^Zr ~wÂZw VWm AH$m} ImoamH$ H${hbo {bZwnZ} ^Zr
~VmCZw a {VZbmB© AH$m} ImoamH$H$mo {ZpåV ñdmñÏ¶ Ho$ÝÐ‘m nR>mCZw hmo> Ohm± à{e{jV àXmVmhê$ CnbãY ahoH$m hþÝN>Z²&
g‘¶-Vm{bH$m… ECQ>m gwB©bo H$åVr‘m n{Z 3 ‘{hZmgå‘ J^©{ZamoY JX©N>& n{hbmH$mo ImoamH$n{N> R>rH$ 3 ‘{hZm‘m gwB© {bZw
CÎm‘ hþZoN>& Va Ë¶mo {Z{X©ï> {‘{VH$mo 2 gmVmA{K dm 4 gmVmn{N> {bZg{H$ÝN>&
AmnmVH$mbrZ J^©{ZamoYH$ Jmobr…
 {ZåZ{b{IV n[apñW{Vhê$‘m AmnmVH$mbrZ J^©{ZamoYH$ Jmobr {bZg{H$Zo {df¶‘m bm^mWuhê$bmB© OmZH$mar {XZwnX©N>…
- Agwa{jV ¶m¡Z gånH©$ ñWm{nV ÊH$mo {W¶mo/ÊH$mo N>&
- {ZamoY ’w$p³bEH$mo dm ’$mQ>Ho $mo pñW{V‘m AmnmVH$mbrZ Jmobrhê$ à¶moJ JZ©g{H$ÝN>&
- ~bmËH$ma ÊH$mo pñW{V‘m AmnmVH$mbrZ J^©{ZamoYH$ Jmobrhê$ à¶moJ JZ©g{H$ÝN>&
 ‘{hbmbo Agwa{jV ¶m¡Z gånH©$H$mo bJÎm¡ AWm©V² ¶m¡Z gånH©$H$mo 12-24 KÊQ>m{^Ì ¶r Jmobrhê$ {bZwnX©N>&
 AmnmVH$mbrZ J^©{ZamoYH$ JmobrH$m nmíd© à^mdhê$ Ho$ hþÝN>Z² ^Zo ¶gbo AH$m} ‘{hZm ‘m{gH$ MH«$H$mo dmñV{dH$
{‘{VbmB© {T>bmo ~ZmB{XÝN>&
 ECQ>m Q>çmãboQ> ÊH$mo AmnmVH$mbrZ J^©{ZamoYH$ JmobrH$mo ß¶mHo$Q> é. 2/- à{V ß¶mHo$Q>H$mo ‘yë¶‘m ASHA- {gV
CnbãY ahoH$mo hþÝN>&
 gXa AñnVmb/amÁ¶ gmYmaU AñnVmb/‘o{S>H$b H$boO AñnVmb/{O„m AñnVmb‘m AmnmVH$mbrZ J^©{ZamoYH$
Jmobrhê$ {Z…ewëH$ CnbãY hþÝN>Z²&
AmnmVH$mbrZ J^©{ZamoYH$ Jmobr n[adma {Z¶moOZH$mo {d{Y hmoBZ&
Zg~ÝXr dm ~ÝÜ¶mH$aU (Sterilisation)
¶{X XånVrH$m XþBOZm ñdñW ZmZrhê$ N>Z² A{Z gmZmoMm{h>>± ZmZr H$åVr‘m n{Z 2 df©H$mo N> a CgbmB© g~¡ Imonhê$
{XBg{H$EH$mo N> ^Zo Vr XånVrbo ñWm¶r {d{Y AßZmCg³N>Z²&
nwéf Zg~ÝXr/Vasectomy
 ¶mo ECQ>m gmZmo eë¶{H«$¶m hmo Og‘m ewH«$Zbr (ewH«$mUw dhZ JZ} Zbrhê$)-bmB© ~m±{YÝN>&
 AñnVmb‘m ^Vu hþZw Amdí¶H$ N>¡Z& ¶mo eë¶{H«$¶m‘m A{YH$V‘ 15-20 {‘ZQ> g‘¶ bm½N>&
 eë¶{H«$¶mn{N> nmbZ JZw©nZ} {Z¶‘hê$…
- eë¶{H«$¶mn{N> H$åVr‘m n{Z 24 KÊQ>m ZwhmCZw hþ±X¡Z&
- eë¶{H«$¶mn{N> 15 {XZgå‘ ECQ>m T-nÅ>r bJmCZo A{Z Ë¶mo joÌbmB© g’$m am»Zo g„mh {XBÝN>& 15 {XZgå‘
gmBH$b MbmCZw dm Jõm¢ MrO CMmëZw hþ±X¡Z& nbL>‘m Amam‘ JZ} Amdí¶H$Vm nX£Z&
 eë¶{H«$¶mn{N> XånVrbo 3 ‘{hZmgå‘ H$ÝS>mo‘ Adí¶ à¶moJ JZw©nX©N>&
 3 ‘{hZmn{N> dr¶©H$mo Om±M JamCZwnN>©&
 nwéf Zg~ÝXr IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa AñnVmb/{O„m AñnVmb‘m J[aÝN> A{Z
Zg~ÝXr JamCZobo é. 1500/- nmC±N>&
145
 ¶{X gaH$maÛmam nÄOrH¥$V AñnVmbhê$ dm J¡agaH$mar gL²>JR>Zhê$‘m nwéf Zg~ÝXr JamB¶mo ^Zo n{Z Zg~ÝXr JamCZo
ì¶{º$bo é. 1500/- àmá JZ}N>&
 ¶mo eë¶{H«$¶mbo nwéfH$mo gm‘Ï¶©bmB© KQ>mC±X¡Z A{Z {VZrhê$bmB© emar[aH$ ê$n‘m H$‘Omoa n{Z ~ZmC±X¡Z& eë¶{H«$¶mH$mo
15 {XZn{N> g~¡ {H${g‘H$m H$m‘hê$ JZ©g{H$ÝN>&
 ¶gbo ¶m¡Z{H«$¶m AWdm ¶m¡Z AmZÝX‘m Hw$Z¡ Zam‘«mo Aga nmX£Z&
 ¶g eë¶{H«$¶mbo nËZrbmB© Ho$db J^©dVr hþZXo{I amo³N>&
‘{hbm Zg~ÝXr/Tubectomy:
 nwéf Zg~ÝXr^ÝXm ‘{hbm Zg~ÝXr Ho$hr H${R>Z hþÝN, Va¡n{Z ¶mo gwa{jV hþÝN>& ¶g‘m bJ^J 30 {‘ZQ> g‘¶ bm½N>&
‘{hbm Zg~ÝXr ‘{hbm‘m à¶moJ J[aZo ECQ>m ñWm¶r J^©{ZamoYH$ A{Z ~ÝÜ¶mH$aU {d{Y hmo& ¶mo ECQ>m eë¶{H«$¶m hmo
Og‘m J^m©e¶ Z{bH$m (Fallopian tube)-bmB© ~ÝX J[aÝN> dm H$m{Q>ÝN> Vm{H$ {S>å~me¶~mQ> {S>å~ J^m©e¶{Va OmZ
ZgH$mog², a Ë¶gmo hþ±Xm J^© ~ñZo Hw$Z¡ gå^mdZm ah±X¡Z&
 ¶g eë¶{H«$¶mH$mo {ZpåV ‘{hbm, AñnVmb‘m ^Vu hþZwnX©N>&
 ¶mo eë¶{H«$¶m ‘m{gH$ MH«$ ewé ÊH$mo gmV {XZ‘m, àgdH$mo 6 hámn{N> AWdm àgdH$mo 24 KÊQ>m{^Ì JZ©g{H$ÝN>&
 ¶mo eë¶{H«$¶mn{N> H$åVr‘m 7 {XZgå‘ ¶m¡Z gånH©$ am»Zw hþ±X¡Z&
 IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa AñnVmb/{O„m AñnVmb~mQ> ‘{hbm Zg~ÝXr JamCZo ~rnrEb/
AZwgy{MV Om{V/AZwgy{MV OZOm{V bm^mWuhê$bo é. 1000/- àmá JZ}N>Z²&
 gaH$maÛmam nÄOrH¥$V {ZOr AñnVmbhê$/J¡agaH$mar gL²>JR>Zhê$~mQ> ‘{hbm Zg~ÝXr JamCZo ~rnrEb/AZwgy{MV
Om{V/AZwgy{MV OZOm{V bm^mWuhê$bo é. 1500/- àmá JZ}N>Z²&
 ¶mo eë¶{H«$¶mbo ‘{hbmhê$H$mo emar[aH$ gm‘Ï¶©bmB© KQ>mC±X¡Z A{Z {VZrhê$bmB© emar[aH$ ê$n‘m H$‘Omoa n{Z ~ZmC±X¡Z&
eë¶{H«$¶mH$mo 7 {XZn{N> g~¡ àH$maH$m H$m‘hê$ JZ©g{H$ÝN>&
 ¶gbo ¶m¡Z{H«$¶m dm ¶m¡Z AmZÝX‘m{W Zam‘«mo Aga nmX£Z&
 6 ‘{hZm^ÝXm H$åVrH$m gmZm {eewhê$ ÊH$m ‘{hbmhê$bo ¶mo {d{Y AßZmCZg³N>Z²&
 ¶g eë¶{H«$¶mbo Ho$db J^©YmZ hþZXo{I amo³XN>&
 ¶mo ghþ{b¶V Z{OH¡$H$mo IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa AñnVmb/{O„m AñnVmb‘m CnbãY N>&
{ZåZ{b{IV VÏ¶hê$bmB© ¶mX am»ZwnX©N>…

 XþB dm Ë¶mo^ÝXm Yoa¡ ZmZrhê$ ÊH$m XånVrhê$bmB© n[adma {Z¶moOZH$m {d{Yhê$~mao g„mh {XZw Amdí¶H$ N>&
 Z V AñWm¶r Z ñWm¶r {d{Yhê$ Z¡ nyU©ê$nbo âmogm¶mo½¶ hþÝN>Z²& ¶r {d{Yhê$ Ag’$b n{Z hþZg³NZ² ^Þo VÏ¶{gV
n[admaH$m gXñ¶hê$ AdJV ahoH$mo hþZwnN>,© hþZ V ¶ñVm gå^mdZmhê$ H$åVr^ÝXm H$åVr Z¡ ahoH$m hþÝN>Z²&
 J¥h-^«‘U AWdm ~¡R>H$hê$ J[aahoH$mo ~obm bm^mWuhê$bmB© ¶r VÏ¶hê$~mao AdJV JamCZwnX©N>& {ZU©¶ {b>>±Xm a
Amdí¶H$ nmBbmhê$ MmëXm {VZrhê$bmB© ‘XV n{Z Adí¶ JZw©nN>©&
146
J«m‘rU ñVa‘m AWdm J«m‘rU ñdmñÏ¶ Ed‘² nmofU {Xdg‘m ASHA-~mQ> CnbãY godmhê$
n[adma {d{Y M¶Z~mao godZ J[aZo J^©{ZamoYH$ H$ÝS>mo‘ A{Z godZ J[aZo IUCD a J^©{ZamoYH$
{Z¶moOZH$mo g„mh Jmobrhê$H$mo nwZ…Amny{V© Jmobrhê$H$mo {dVaU Zg~ÝXrH$mo {ZpåV AßZmCZohê$H$mo
{ZpåV IEC nR>mCZw g~¡ OmZH$mar am»Zw
Cn-Ho$ÝÐ~mQ> CnbãY godmhê$

n[adma {d{Y M¶Z~mao godZ J[aZo Jmobrhê$ a IUCD, godZ n[adma Zg~ÝXrH$mo gh¶moJ,
{Z¶mo O ZH$mo g„mh {XZw IUCD- ‘m BÀNw>H$ Z¶m± J[aZo Jmobrhê$, {Z¶moOZ{gV {ZpåV à{ejU A{Z
{ZpåV IEC ì¶{º$hê$H$mo Om±M ECP a gå~pÝYV nR>mCZw C B D - H $ m o
H$ÝS>mo‘H$mo g‘ñ¶mhê$H$mo nwZ…Amny{V©
ì¶dñWm Om±M
àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ A{Z Ë¶mo^ÝXm ‘mÏbmo Ho$ÝÐ~mQ>> CnbãY godmhê$

n[adma {d{Y~mao Zg~ÝXr godmhê$‘m Zg~ÝXr go d mhê$, n[adma gh¶mo J , à{ejU A{Z
{Z¶mo O ZH$mo g„mh {XZw BÀNw > H$ Z¶m± UCD, go d Z J[aZo {Z¶moOZgå~ÝYr CBD-H$mo nwZ…Amny{V©
{ZpåV IEC ì¶{º$hê$H$m Om±M Jmobrhê$, ECP a g‘ñ¶mhê$H$mo
{ZamoYH$H$mo ì¶dñWm Om±M
n[adma {Z¶moOZ‘m ASHA-H$mo ^y{‘H$m…

n[adma {Z¶moOZH$mo gå~ÝY‘m ASHA-bo {ZåZ{b{IV ^y{‘H$mhê$ {Zdm©h JZ}{N>Z²…
 Cn¶wº$ n[adma {Z¶moOZ {d{Y AßZmCZ bm^mWuhê$bmB© ‘XV JZ}{N>Z²& Z¶m± gj‘ XånVrhê$bmB© {MpÝhV JZ}{N>Z² A{Z
{VZrhê$bo à¶moJ J[aahoH$m n[adma {Z¶moOZH$mo {d{Y~mao OmZH$mar OwQ>mCZo{N>Z²& {VZbo ¶g~mao W{nEH$mo OmZH$mar gj‘
XånVr a{OñQ>a‘m bo»Zo{N>Z² a Ë¶g~mao ANM-bmB© ~VmCZo{N>Z²&
 gj‘ XånVrhê$bmB© n[adma {Z¶moOZ {d{Yhê$H$mo Amdí¶H$Vm~mao g„mh {XZo{N>Z²&
 gj‘ XånVrhê$bmB© gaH$mar ñdmñÏ¶ Ho$ÝÐhê$‘m CnbãY n[adma {Z¶moOZH$m {d{Yhê$~mao OmZH$mar {XZo{N>Z²&
 gj‘ XånVrhê$bmB© {ZåZ{b{IV OñVm AñWm¶r {d{Yhê$~mao OmZH$mar àXmZ JZ}{N>Z²-
- godZ J[aZo J^©{ZamoYH$ Jmobr (Mala-N)
- J^m©e¶‘m à{dï> JamBZo J^©{ZamoYH$ CnH$aU (IUCD)
- H$ÝS>mo‘
- goÝQ>H«$mo‘oZ (N>m¶m)
147
- gwB©Ûmam {bZg{H$Zo J^©{ZamoYH$, MPA
- ‘m{Zghê$bmB© Zg~ÝXrH$mo {ZpåV àmoËgm{hV JZw© A{Z {VZrhê$bmB© Amdí¶H$ Cnm¶ AßZmCZo g„mh {XZw&
- nwéf Zg~ÝXr~mao g„mh {XZw a Amdí¶H$ nmBbm MmëZ àmoËgm{hV JZw©&
- ‘{hbm Zg~ÝXr~mao g„mh {XZw a Amdí¶H$ nmBbm MmëZ àmoËgm{hV JZw©&
148
^mJ-CÝZmBg
àOZZ VÝÌH$mo gL²>H$« ‘U/¶m¡Z dm{hV {~‘marhê$
A{Z EMAmB©^r/ES²>g
àOZZ VÝÌH$m gL²>H$« ‘Uhê$/¶m¡Z dm{hV {~‘marhê$…

 àOZZ VÝÌH$mo gL²>H$« ‘U (Reproductive Tract Infection, RTIs) àOZZ AL²>Jhê$‘m hþZo ¶ñVmo gL²>H$« ‘U hmo OwZ nwéf
a ‘{hbm Xþd¡bmB© hþZg³N>&
 gL²>H«${‘V ì¶{º$~mQ> ¶m¡Z gånH©$Ûmam ’¡${bZo gL²>H«$‘Uhê$bmB© ¶m¡Z dm{hV gL²>H«$‘U (Sexually Transmitted Infection,
STIs) ^{ZÝN>
àOZZ VÝÌH$mo gL²>H$« ‘U (RTI) ¶ñVmo eãX hmo Ogbo Mma àH$maH$m gL²>H$« ‘Uhê$bmB© g‘oQ>²N>, Vr hþZ…²
 ¶mo{Z‘m gm‘mÝ¶V¶m Ho$hr H$sQ>mUwhê$ hþÝN>Z² Ogbo Hw$Z¡ gL²>H$« ‘UH$m {MÝhhê$ CËnÞ JX£ZZ²² Va ¶{X ¶mo{Z‘m Z¶m±
àH$maH$m H$sQ>mUwhê$ ngoH$mo IÊS>‘m Ë¶gH$mo n[aUm‘ñdê$n ¶mo{Z‘m gL²>H«$‘UH$m bjUhê$ XoIm nX©N>Z²& ¶gH$maU
¶mo{Z‘m Vrd« gL²>H$« ‘Uhê$ hþZg³N>Z² (¶m¡Z gånH©$H$mo H$maUbo hmoBZ)&
 ì¶{º$JV A{Z ¶m¡ZmL²>Jhê$H$mo gag’$mB©‘m H$‘r, {deofJar ‘m{gH$ MH«$H$mo ~obm&
 gL²>H«${‘V gmWr{gV ¶mo{Z, ‘bÛma AWdm ‘wIÛmam Agwa{jV ¶m¡Z gånH©$
 {ZåZñVaH$mo MTP à{H«$¶m A{Z àgdn{N> IUCD-H$mo a MTP n{N> IUCD-H$mo AñdÀN> à{d{ï>&
¶m¡Z dm{hV {~‘marhê$à{V ‘{hbmhê$ ~‹T>r g§dXo Zerb hþZo H$maUhê$…

 gL²>H«${‘V dr¶© ¶mo{Z{^Ì bm‘mo g‘¶gå‘ a{hahÝN>&
 j‘VmH$mo A^mdH$mo H$maUbo gwa{jV ¶m¡Z gånH©$H$mo {ZpåV H$ÝS>mo‘ à¶moJ JZy© ^Zr nwéf gmWrbmB© ^Þ Zg³Zo&
 ¶mo{Z{^Ì bm‘mo g‘¶gå‘ Hw$Z¡ bjUhê$ XoIm nX£ZZ²&
àOZZ VÝÌH$mo gL²>H$« ‘Ubo hþZo H${R>ZmBhê$…

 ‘{hbmH$mo V„mo noQ>‘m nr‹S>m
 A{Z¶{‘V ‘m{gH$ MH«$
 ZdOmV‘m gL²>H«$‘U
 EMAmB©^r gL²>H«$‘UH$mo ~T²>Xmo gå^mdZm
 ZmZr OÝ‘mCZogå~ÝYr ~m±PmonZ dm g‘ñ¶mhê$
 J^©nVZ A{Z ‘¥V {eewH$mo OÝ‘
 ¶m¡ZmL²>Jhê$‘m ³¶mÝga
àOZZ VÝÌH$mo gL²>H$« ‘U/¶m¡Z dm{hV gL²>H$« ‘UH$m bjUhê$…

 nwéf a ‘{hbm Xþd¡‘m {ZåZ{b{IV {MÝh a bjUhê$ hþÝN>Z²-
- ‘yÌË¶mJ dm ‘bË¶mJ JXm© nmoëZo dm Xþ»Zo A{Z KarKar ‘yÌ AmCZo&
- ¶m¡ZmL²>Jhê$‘m Yoa¡ I{Q>amhê$ {ZpñH$Zo& Vr I{Q>amhê$ Xþ»Z dm ZXþ»Z n{Z g³N>Z²& noQ> a {VK«mH$mo H$mn‘m ÊH$m
J«pÝWhê$ gw{ÞZo a Xþ»Zo& ¶m¡ZmL²>JH$m N>oCN>mC {MbmCZo dm nmoëZo&
149
- eara‘m Hw$Z¡ {MbmCZo I{Q>amhê$ Z{ZñH$Zo
- ¶m¡ZmL²>Jhê$H$mo N>Co N>mC ‘mgw nbmCZo
- ‘wI‘m KmC hþZo
- ËdMm‘w{Z {JIm©hê$ {ZpñH$Zo
- gXu-ImoH$sH$m OñVm bjUhê$, Q>mCH$mo Xþ»Zo, WH$mZ, ~mÝVm AmCZo, Ádamo
 nwéfhê$‘m ‘mÌ Xo{IZo bjUhê$-
- {bL²>J~mQ> Añdm^m{dH$ AWdm Wmonm Wmonm òmd hþZo
 ‘{hbmhê$‘m ‘mÌ Xo{IZo bjUhê$-
- ¶mo{Z‘mJ©~mQ> Añdm^m{dH$ òmd (nh|bmo, h[a¶mo ~m³bmo, nrn OñVmo, XþJ©ÝY¶wº$, aJVOñVmo)
- ¶m¡ZmL²>JH$mo d[an[a I{Q>am AWdm KmChê$ hþZo
- VbnoQ>‘m nr‹S>m
- ¶mo{Z{^Ì dm Ë¶gH$mo d[an[a nmoëZo dm {MbmCZo
 àOZZ VÝÌH$mo gL²>H$« ‘U AWdm ¶m¡Z dm{hV gL²>H$« ‘U bwH$mCZo {~‘mar hmoBZ& Aê$ ñdmñÏ¶gå~ÝYr g‘ñ¶mhê$OñV¡
¶mo n{Z ECQ>m ñdmñÏ¶gå~ÝYr g‘ñ¶m hmo& Yoa¡ pñW{Vhê$‘m gL²>H$moM a gm‘m{OH$ AS²>MZhê$H$mo H$maUbo àOZZ
VÝÌH$m gL²>H«$‘U a ¶m¡Z dm{hV gL²>H«$‘Uhê$bmB© bwH$mCZo J[aÝN> A{Z am‘«ar CnMma J[a>>±X¡Z&
 ‘m{W C„oI J[aEH$m g‘ñ¶mhê$bo J«ñV ì¶{º$ CnMmaH$mo {ZpåV AÝdofm p³bZrH$/IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU
AñnVmb/‘hHw$‘m AñnVmb AWdm {O„m AñnVmb‘m OmZwnX©N>&
 Cnamoº$ ñdmñÏ¶ gw{dYmhê$ {O„m AñnVmb A{Z ‘o{S>H$b H$boO Ed‘² AñnVmbhê$‘m pñWV {H$emoa-{H$emoarhê$H$mo
ñdmñÏ¶ p³bZrH$‘m n{Z CnbãY N>Z²&
 ¶mo ghþ{b¶V {Z…ewëH$ CnbãY N>&
 ¶r ñdmñÏ¶ Ho$ÝÐhê$‘m JmonZr¶Vm H$m¶‘ am{IÝN>&
àOZZ VÝÌH$m gL²>H$« ‘Uhê$H$mo amoH$Wm‘…
 ‘m{gH$ MH«$H$mo ~obm go{ZQ>oar Ý¶mpßH$Z AWdm ß¶mS>H$mo à¶moJ A{Zdm¶© ê$n‘m JZw©nX©N>&
 go{ZQ>oar Ý¶mpßH$Zhê$ CnbãY ZÊ Ka‘¡ ~ZmBEH$m ß¶mS> à¶moJ JZ©g{H$ÝN>& Ka‘¡ ~ZmBEH$m ß¶mS> à¶moJ JZ} hmo ^Zo-
- Ho$db g’$m, gw³Im, Za‘ a gwVrH$m bwJmhê$ à¶moJ JZw©nN>©&
- àË¶oH$ à¶moJn{N> bwJmbmB© gm~wZ a nmZrbo YmoEa Km‘‘m gwH$mCZwnN>©&
- gw{H$gHo$n{N> Vr bwJmhê$bmB© g’$m R>mC±‘m am»ZwnN>©&
- Vr bwJm EH$^ÝXm A{YH$ ‘m{gH$ MH«$hê$H$mo bm{J à¶moJ JZ©g{H$Þ&
 ‘m{gH$ MH«$H$mo ~obm {ZåZ{b{IV gag’$mB©H$m {Z¶‘hê$bmB© am‘«ar nmbZ JZw©nN>©-
- gY¢ g’$m nmZrbo ZwhmCZwnN>©&
- nmoIar dm PrbH$mo nmZr‘m ZwhmCZw hþ±X¡Z&
- ‘yÌË¶mJ Jaon{N> A{Z àË¶oH$nëQ> ß¶mS> ’o$Xm© ¶m¡ZmL²>Jhê$bmB© g’$m nmZrbo YwZwnN>©&
- ‘m{gH$ MH«$H$mo ~obm gwVrH$mo noÝQ>r bJmCZwnN>© a Vr noÝQ>rhê$bmB© {Z¶{‘Vê$n‘m YmoEa Km‘‘m gwH$mCZwnN>©&
150
 dr¶© ñIbZn{N> {bL²>JbmB© g’$m nmZrbo YwZwnN>©& ‘wI, ‘bÛma a ¶mo{Z ‘¡WwZ JXm© gY¢ H$ÝS>mo‘ à¶moJ JZw©nN>©&
 gwa{jV J^©nmVH$mo {ZpåV nÄOrH¥$V AñnVmb‘m OmZwnN>©&
 g§ñWmZJV àgdH$mo {ZpåV àmoËgm{hV JZw©nN>©& IUCD-H$mo à{d{ï> gaH$mar AñnVmb dm nÄOrH¥$V ñdmñÏ¶ Ho$ÝÐ‘m
à{e{jV ñdmñÏ¶ godm àXmVmhê$Ûmam JamCZwnN>©&
 ¶m¡Z gmWrbo n{Z CnMma JamEH$mo gw{ZpíMV JZw©nN>©&
àOZZ VÝÌH$m gL²>H$« ‘U/¶m¡Z dm{hV gL²>H$« ‘Uhê$H$mo CnMma…
 ¶{X H$g¡bmB© àOZZ VÝÌH$mo gL²>H«$‘U/¶m¡Z dm{hV gL²>H$« ‘U ÊH$mo IÊS>‘m Cgbo O{Vg³Xmo Mm±‹S>¡ S>m³Q>a{gV g„mh
{bZwnN>© A{Z Ë¶gAZwgma CnMma ewé JamCZwnN>©& Cgbo S>m³Q>aH$mo gwPmCAZwgma nyam CnMma JamCZwnN>©&
 CnMmaH$mo {ZpåV AÝdofm p³bZrH$/ãbH$ àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/‘hHw$‘m AñnVmb AWdm {O„m
AñnVmb‘m OmZwnN>©&
 ¶g~mhoH$, Cnamoº$ ñdmñÏ¶ gw{dYmhê$ {O„m AñnVmb A{Z ‘o{S>H$b H$boO Ed‘² AñnVmbhê$‘m pñWV {H$emoa-
{H$emoarhê$H$mo ñdmñÏ¶ p³bZrH$‘m n{Z CnbãY N>Z²&
 gmWrbo n{Z CnMma JamEH$mo gw{ZpíMV JZw©nN>©& ¶r ghþ{b¶Vhê$ {Z…ewëH$ CnbãY N>Z²&
 ¶r ñdmñÏ¶ Ho$ÝÐhê$‘m JmonZr¶Vm H$m¶‘ am{IÝN>&
àOZZ VÝÌH$m gL²>H$« ‘U/¶m¡Z dm{hV gL²>H$« ‘Uhê$‘m ASHA-H$mo ^y{‘H$m…
 ~¡R>H$hê$ hþX± m àOZZ VÝÌH$m gL²>H$« ‘U/¶m¡Z dm{hV gL²>H$« ‘Uhê$~mao A{Z {VZrhê$H$m H$maUhê$~mao OmZH$mar àXmZ JZwh© mog&²
 àOZZ VÝÌH$m gL²>H«$‘U/¶m¡Z dm{hV gL²>H$« ‘Uhê$H$m H$maUbo hþZo gå^m{dV H${R>ZmBhê$~mao OmJê$H$Vm ’¡$bmCZwhmog²&
 àOZZ VÝÌH$m gL²>H«$‘U/¶m¡Z dm{hV gL²>H$« ‘Uhê$H$m {MÝh a bjUhê$~mao gag„mh {XZwhmog²&
 amoH$Wm‘H$m Cnm¶ a CnMmahê$~mao g„mh {XZwhmog²&
 {H$emoa a {H$emoarhê$, nwéf A{Z ‘{hbmhê$bmB© dmVmdaU a n[apñW{VH$mo AmYma‘m àOZZ VÝÌH$m gL²>H«$‘U/¶m¡Z
dm{hV gL²>H«$‘Uhê$gå~ÝYr g„mh {XZwhmog² {H$Z^Zo ¶mo g~¡H$m bm{J Amdí¶H$ N>& {H$emoa-{H$emoar, nwéf a
‘{hbmhê$ g~¡bo àOZZ VÝÌH$m gL²>H«$‘U/¶m¡Z dm{hV gL²>H$« ‘Uhê$~mao OmZH$mar am»ZwnX©N>& Va, dmVmdaU a
n[apñW{Vhê$bmB© Ü¶mZ‘m amIoa Z¡ gag„mh {XZwhmog²&
 àOZZ VÝÌH$m gL²>H«$‘U/¶m¡Z dm{hV gL²>H$« ‘Uhê$H$m {MÝh a bjUhê$ {MpÝhV JZw©hmog² A{Z Amdí¶H$ nmBbm
MmëZwhmog&²
 ¶{X H$mohr àOZZ VÝÌH$m gL²>H«$‘U/¶m¡Z dm{hV gL²>H«$‘Uhê$bo J«ñV ÊH$mo N> ^Zo CgbmB© CnMmaH$mo {ZpåV AÝdofm
p³bZrH$/IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa AñnVmb AWdm {O„m AñnVmb nR>mCZwhmog²&
 S>m³Q>aH$mo g„mhAZwgma CnMma JamEH$mo gw{ZpíMV JZ©wnN>©&
 ¶mo {df¶ Yoa¡ g§doXZerb ÊH$mobo JmonZr¶Vm H$m¶‘ am»ZwnX©N>&
EMAmB©^r a ES²>g (HIV/AIDS)
 Human Immuno Deficiency Virus (HIV) Ho$ hmo?-
- øy‘Z (Human) AWm©V² ‘m{Zg ‘mÌ ¶mo ^mBagÛmam AmH«$mÝV hþÝN>&
- ‘m{ZgH$mo earaH$mo amoJ à{VamoYH$ j‘Vm KQ²>Zw (Immuno Deficiency) ^Þmbo ¶ñVmo pñW{V ~w{PÝN> Og‘m earabo OrdmUw a
{dfmUwhê${gV b‹S>mBª JZ} j‘Vm Jw‘mC±N>, A{Z Ë¶gH$mo ’$bñdê$n eara‘m gL²>H«$‘Uhê$ hþÝNZ²> a {d{^Þ amoJhê$ bm½NZ²>&
 Acquired Immuno Deficiency Syndrome (AIDS) Ho$ hmo?-
151
- E³dm¶S>© (Acquired) AWm©V² ^mBag Hw$Z¡ ì¶{º$H$mo eara‘m AH$m} gL²>H«${‘V ì¶{º$~mQ> AmCZw&
- Bå¶wZmo (Immuno) AWm©V² ‘m{ZgH$mo earaH$mo amoJ à{VamoYH$ j‘Vm>&
- {S>{’${gEÝgr (Deficiency) AWm©V² amoJ à{VamoYH$ j‘Vm KQ²>Zw dm Zï> hþZw&
- ‘m{ZgH$mo earaH$mo amoJ à{VamoY j‘Vm KQ>oa Om±Xm {d{^Þ àH$maH$m amoJhê$H$mo gL²>H«$‘U hþ±XN>& ¶r g‘ñV amoJhê$H$mo
bjU g‘yhbmB© {gÝS´>mo‘ (Syndrome) ^{ZÝN>&
 EMAmB©^r gL²>H«${‘V ì¶{º$H$mo eara‘m {d{^Þ amoJhê$H$m bjUhê$ XoIm naoH$mo AdñWmbmB© ES²>g (AIDS) ^{ZÝN>&
 ES²>g {ZH$mo ZhþZo amoJ hmo&
EMAmB©^r ¶gar gX©N>…
 EMAmB©^r gL²>H«${‘V ì¶{º$g±J Agwa{jV (H$ÝS>mo‘ à¶moJ ZJar) ¶m¡Z gånH©$ am»Xm&
 eara‘m EMAmB©^r gL²>H$« {‘V ì¶{º$H$mo aJV dm aJVH$m CËnmXhê$ à{dï> JamC±Xm&
 EMAmB©^r gL²>H«${‘V ì¶{º$bo à¶moJ JaoH$mo BÝOo³eZ dm gwB© à¶moJ JXm©&
 EMAmB©^r gL²>H«${‘V J^©dVr ‘{hbm~mQ> ^«yUbmB©&
EMAmB©^r ¶gar gL²>H$« {‘V hþX± Z¡ AWdm gX£Z…
 gL²>H«${‘V ì¶{º${gV hmV {‘bmC±Xm, D$g±J¡ IobHw$X JXm© A{Z ECQ>¡ dmhZ‘m ¶mVm¶mV JXm©
 gL²>H«${‘V ì¶{º$bo à¶moJ JaoH$mo em¡Mmb¶ à¶moJ JXm©
 gL²>H«${‘V ì¶{º$bo à¶moJ JaoH$mo ^m±‹S>m‘m ImZm Im±Xm
 gL²>H«${‘V ì¶{º$bo à¶moJ JaoH$mo Hw$dm dm nmoIar à¶moJ JXm©
 gL²>H«${‘V ì¶{º$H$mo gXu, hmÀN²>¶y± dm ImoH$sÛmam
 gL²>H«${‘V ì¶{º${gV Mwå~Z dm Am{b“Z JXm© AWdm g±J¡ ~ñXm
 ‘ÀN>S‹ > AWdm Hw$Z¡ H$sambo Q>mo³Xm&
EMAmB©^r/ES²>gH$mo gÝX^©‘m Cnamoº$ g~¡ Z¡ àM{bV ^«‘nyU© {dMmahê$ hþZ² a ¶r ‘mÜ¶‘hê$~mQ> EMAmB©^r/ES²>g gX£Z&
EMAmB©^r gL²>H$« ‘UH$mo H$maUbo hþZo H${R>ZmBhê$…
 earaH$mo amoJ à{VamoYH$ j‘Vm KQ²>Xm-
- Hw$Z¡ n{Z {~‘marbo gL²>H«${‘V hþZo gå^mdZmhê$ ~‹T>ao OmÝN>Z²&
- {ZH$mo hþZo gå^mdZmhê$ KQ²>XN>Z² Ogbo ‘¥Ë¶wH$mo gå^mdZmbmB© ~‹T>mB{XÝN>&
 EMAmB©^rÛmam gL²>H$« {‘V hþZw ^ZoH$mo VËH$mb ‘¥Ë¶w hþZw hmoBZ& hþZ V EMAmB©^rH$mo Ë¶ñVmo Hw$Z¡ Am¡f{Y N>Z¡ , AmâZ¡ amoJ
à{VamoYH$ j‘Vm, S>m³Q>aH$mo g„mhAZwgma C{MV ì¶dñWmnZ A{Z OrdZe¡br‘m n[adV©Zhê$bo bm‘mo OrdZH$m
gå^mdZmhê$bmB© ~‹T>mCZg{H$ÝN>&
Om±M a CnMmaH$mo {ZpåV H$hm± OmZo?
 Hw$Z¡ ì¶{º$ EMAmB©^r gL²>H«${‘V ÊH$mo dm ZÊH$mo nw{ï> JZ© aº$ narjU Amdí¶H$ hþ±XN>&
 aº$ narjUH$mo {ZpåV H$mohr n{Z ñdoÀN>mbo IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa AñnVmb/{Oëbm
AñnVmb/EH$sH¥$V nam‘e© Ed‘²² narjU Ho$ÝÐ (ICTC)/ñd¶§godr nam‘e© Ed‘² narjU Ho$ÝÐ (VCTC)-‘m OmZg³N>Z²&
 narjUH$mo [anmoQ>© Ho$db amoJrbmB© {XBÝN> A{Z Ë¶gbmB© gånyU© Jmoß¶ am{IÝN>&
 aº$ narjUH$m n[aUm‘hê$H$mo AmYma‘m ICTC/VCTC ~mQ> g„mh {bEa Aê$ nmBbmhê$ Mm{bÝN>&
J^©dVr ‘{hbmH$mo EMAmB©^r narjUH$mo ‘hÎd
 J^©dVr ‘{hbm EMAmB©^r gL²>H«${‘V {N>Z² {H$ N>¡ZZ² ^Zr nw{ï> JZ© aº$ narjU Amdí¶H$ hþ±XN>&
152
 Cn¶wº$ Cnm¶hê$ AßZmEa Am‘m~mQ> ^«yU‘m EMAmB©^r gZ} gå^mdZmbmB© H$åVr JZ©g{H$ÝN>&
 aº$ narjU IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa AñnVmb/{O„m AñnVmb/EH$sH¥$V nam‘e© Ed‘²²
narjU Ho$ÝÐ (ICTC)-‘m J[aÝN>&
 narjUH$mo [anmoQ>© Ho$db J^©dVr ‘{hbmbmB© {XBÝN> A{Z [anmoQ>© Jmoß¶ am{IÝN>&
 aº$ narjUH$m n[aUm‘hê$H$m AmYma‘m ICTC-~mQ> g„mh {bEa Aê$ nmBbmhê$ Mm{bÝN>&
EMAmB©^r/ES²>g amoH$Wm‘ H$gar JZ}
EMAmB©^r/ES²>gbmB© ¶gar amoH$Wm‘ JZ©g{H$ÝN…>
 EH$‘mÌ {dídm{gbmo ¶m¡Z gmWrg±J ¶m¡Z gånH©$ amIoa
 ‘wI ‘¡WwZ, ¶mo{Z a ‘bÛma ‘¡WwZ JXm© O{hbo n{Z H$ÝS>mo‘ à¶moJ Jaoa
 nañna hñV‘¡WwZ Jaoa
 eara‘m aJV M‹T>mCZwnZ} pñW{V‘m gaH$maÛmam AZw‘mo{XV ãbH$ ã¶mL²>H$~mQ> aJV {bBEH$mo VWm Ë¶mo aJVH$mo bo~b‘m
"EMAmB©^r‘wº$' (HIV-free) ^Zr bo{IEH$mo N> dm N>¡Z Ë¶mo Om±M Jaoa
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¶m¡ZH$‘uhê$, gwB©Ûmam bmJw nXmW© {bZo Hw$bVrhê$, g‘{b“r nwéfhê$, H$m‘H$mo {ZpåV KaXo{I ~m{ha ~ñZohê$, EH$
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àOZZ VÝÌH$mo gL²>H$« ‘U/¶m¡Z dm{hV gL²>H$« ‘U ÊH$mo ì¶{º$ EMAmB©^rÛmam gL²>H$« {‘V hþZo gå^mdZm nm±MJwUm ~ogr
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EMAmB©^r/ES²>gH$mo gå~ÝY‘m ASHA-H$mo ^y{‘H$m…
 ~¡R>H$‘m ASHA-bo {ZåZ{b{IV Hw$amhê$~mao OmZH$mar {XZo{N>Z²-
- EMAmB©^r/ES²>g Ho$ hmo?
- EMAmB©^r H$gar ’¡${bÝN>? ¶mo H$gar ’¡${b>>±X¡Z?
- EMAmB©^r gL²>H«$‘Ubo hþZo gå^m{dV H${R>ZmBhê$
- EMAmB©^r Om±MH$mo ‘hÎd~mao ~VmCZo A{Z ¶g Om±MH$mo {ZpåV Z{OH¡$H$mo IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU
AñnVmb/gXa AñnVmb/{O„m AñnVmb‘m OmZ àmoËgm{hV JZ}
- H$ÝS>mo‘H$mo à¶moJ~mao OmJê$H$Vm ’¡$bmCZo
 EMAmB©^r Om±MH$mo ‘hÎd~mao g‘wXm¶‘m OmJê$H$Vm ’¡$bmCZo A{Z IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/
gXa AñnVmb/{O„m AñnVmb‘m OmZ àmoËgm{hV JZ}
 J^©dVr ‘{hbmH$mo {ZpåV EMAmB©^r Om±MH$mo ‘hÎd~mao OmZH$mar {XZo A{Z IÊS> àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU
AñnVmb/gXa AñnVmb/{O„m AñnVmb‘m OmZ àmoËgm{hV JZ}
 EMAmB©^r/ES²>gH$mo amoH$Wm‘H$m bm{J AßZmBZwnZ} Cnm¶hê$~mao OmJê$H$Vm ’¡$bmCZo
 ~¡R>H$ hþ±Xm AWdm J¥h-^«‘U‘m Om±Xm ASHA-bo ‘m{W ~VmBEH$m {df¶hê$~mao MMm© JZ}{N>Z²&
153
{ZåZ{b{IV VÏ¶hê$bmB© Ü¶mZ‘m am»ZwnX©N>…
 J«m‘rU joÌH$m ‘m{Zghê$bo ASHA-~mQ> à{V ß¶mHo$Q> 1 é{n¶m±H$mo Xabo H$ÝS>mo‘ {H$ÝZg³N>Z²&
 gXa AñnVmb AWdm {O„m AñnVmb‘m ‘mÌ H$ÝS>mo‘ {Z…ewëH$ nmBÝN>&
 ¶g~mhoH$, ñQ>oeZar ngb, Am¡f{Y ngb Am{X‘m n{Z H$ÝS>mo‘ {H$Þ nmBÝN>&
 H$ÝS>mo‘H$mo à¶moJ~mao Hw$Z¡ bm^mWubo OmÞ MmhoH$mo IÊS>‘m CgbmB© AÝdofm p³bZrH$/àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/IÊS>
àmW{‘H$ ñdmñÏ¶ Ho$ÝÐ/J«m‘rU AñnVmb/gXa AñnVmb/{O„m AñnVmb‘m nR>mCZwnN>©&
 ‘m{W C„oI J[aEH$m {df¶hê${gV gå~pÝYV OmZH$marhê$ {H$emoa-{H$emoarhê$bo, {deofJar J^©dVr ‘{hbmhê$bo a
nwéfhê$bo nmEH$mo hþZwnN>©, Va dmVmdaU a n[apñW{Vhê$bmB© Ü¶mZ‘m amIoa Z¡ g„mh {XZwnX©N>&
 ¶{X H$mohr Yoa¡ bOmBahoH$mo N> A{Z Ab½J¡ OmZH$mar {bZ MmhÝN>/MmhÝN>o ^Zo Ë¶ñVm ì¶{º$hê${gV ASHA-bo Ab½J¡
Hw$amH$mZr JZw©nN>©&
 ¶m¡ZH$‘uhê$, gwB©Ûmam bmJw nXmW© {bZo Hw$bVrhê$, g‘{b“r nwéfhê$, H$m‘H$mo {ZpåV KaXo{I ~m{ha ~ñZohê$, EH$
OZm^ÝXm Yoa ¶m¡Z gmWr am»Zohê$, EMAmB©^r gL²>H«${‘V Am‘mH$m ZmZrhê$ A{Z ¶m¡Z dm{hV gL²>H«$‘U/àOZZ VÝÌH$m
gL²>H«$‘UÛmam J«ñV ì¶{º$hê$ EMAmB©^rà{V g§doXZerb hþÝN>Z² AWm©V² CZrhê$bmB© EMAmB©^r {N>Q>mo gZ©g³N>&
 EMAmB©^r{gV gå~pÝYV g~¡ ì¶{º$JV OmZH$marhê$ nyU©ê$nbo Jmoß¶ am»ZwnX©N>&
154

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amÁ¶ ASHA àH$moð>, am{ï´>¶ ñdmñÏ` {‘gZ

EH$ amï´>r¶ ñdmñÏ¶ {‘eZ (NHM) a ASHA H$m¶©H«$‘ 1

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MaU-1 MaU-2 MaU-3 MaU-4

amï´>r¶ ñdmñÏ¶ {‘eZ (National Health Mission, NHM)

amï´>r¶ ñdmñÏ¶ {‘eZH$m Ano{jV n[aUm‘hê$

ASHA H$mo hþZ²?

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A‘m¡{IH$ gånH©$ ñWmnZm…

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ASHA A{Z gånH©$ ñWmnZmH$mo ‘hÎd…

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Omogå‘ nw{JEH$mo N>Z¡ {VZrhê$gå‘ nw½Zo H$m¶©‘m ASHA-H$mo ^y{‘H$m…

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{H$emoamdñWm Ho$ hmo?

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‘m{gH$ Y‘©gå~ÝYr JbV YmaUm…

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IMR 32* 22* 7* (Ho$abm)

MMR 113** 98** 43** (Ho$abm)

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