lgMz'Ns cfwf/e't :jf:Yo ;]jf

sfo{qmd @)^$
 ljifo j:t'
 k[i7e"ld
 sfo{qmdsf] kl/ro
 sfo{qmd ;+rfng x'g] lhNnfx?
 sfo{qmdsf] p2]Zo
 lgMz'Ns pkrf/ ;]jf kfpg] nlIft ;d"x
 lgMz'Ns :jf:Yo ;]jf
 c:ktfn tyf k|f=:jf=s]=x?df nlIft ;"dx
klxrfg k|lqmof / kl/efiff
 c:ktfn tyf k|f=:jf=s]=x?df lj/fdL btf{
z'Ns
 :jf:Yo rf}sL tyf pk :jf:Yo rf}sLx?df
lj/fdL btf{ z'Ns
 c:ktfn tyf k|f=:jf=s]=x?df kl/rokqsf]
Aoj:yf

 k[i7e"ld

 æk|To]s gful/snfO{ sfg"gdf Joj:yf eP

adf]lhd cfwf/e"t :jf:Yo ;]jf lgMz'Ns ?
kdf kfpg] xs x'g]5Æ
-g]kfnsf] cGtl/d ;+ljwfg @)^#_
 sfg"gL Aoj:yf
 cfwf/e"t :jf:Yo ;]jfsf] AofVof

 xfn lgMz'Ns sfo{qmd k|fyldstfdf

k/]sf]
 cfd gful/s,
 k[i7e"ld
qmdzM =
 :jf:Yo ;]jfdf g]kfnL hgtfsf] kx'Fr k'¥ofO{
:j:Yo ;dfhsf] lgdf{0f u/L u'0f:t/ o'Qm
hLjg ofkg u/fpg
 g]]kfnsf :jf:Yo ;]jfsf sfo{qmdx? /fli6«o
:jf:Yo gLlt @)$*, bf]>f] bL3{sfnLg
:jf:Yo of]hgf -@)%$–&$_ ;x>fAbL ljsf;
nIo -@)))_ tyf :jf:Yo If]q sfo{qmd
sfof{Gjog of]hgf -@))$–@))(_ cg';f/
lgb]{lzt eO{ sfof{Gjogdf 5g\ .
 lgMz'Ns :jf:Yo ;]jf sfo{qmdnfO{
lgb]{lzt ug{ @)^#/*/@( ut] g]kfn ;/sf/
dlGqkl/ifb\ 4f/f lg0f{o eO{ sfof{Gjogdf
 sfo{qmdsf] kl/ro
 g]kfn ;/sf/n] cf=j= @)^#.)^$ b]lv
æ@% z}of ;Ddsf c:ktfn tyf k|fylds :jf:Yo
s]Gb|x?df u/Lj, c;xfo lj/fdLx?nfO{ cfsl:ds
tyf cGt/+u ;]jf lgMz'Ns ?kdf k|bfg ug]{
sfo{qmd ;j} lhNnfdf ;'?jft u/]sf] / o; aif{
klg of] sfo{qmd lg/Gt/ 5 .
 o;} u/L o; cf=a= )^$.^% b]lv #%
lhNnfx?sf @% z}of ;Ddsf c:ktfn / k|fylds
:jf:Yo s]Gb|x?df pQm u/Lj c;xfo
lj/fdLx?nfO{ jlx/+u ;]jf ;d]t lgMz'Ns ug]{
sfo{qmd z'? u/]sf]
 o:sf ;fy} rfn' cf=a= )^$.^% b]lvg} z'?
ug]{ u/L d'n'se/sf :jf:Yo rf}sL tyf pk
:jf:Yo rf}sLx?df cfd gful/snfO{ lgMz'Ns
 sfo{qmdsf] kl/ro
qmdzM ===

o; k|sf/sf] ;]jf ;+rfng x'g] $)

lhNnfsf cfsl:ds
-Emergency_ tyf cGt/+u -Indoor_
;]jf ut jif{ b]lvs} lg/Gt/tf
ePsf]n] @)^$ >fj0f b]lv g}
lg/Gt/ ;+rfng, alx/+u -OPD_ ;]jf
z'? x'g] #% lhNnfdf @)^$ cflZjg
dlxgf b]lv ;+rfng x'g] sfo{qmd
/x]sf] / :jf:Yo rf}sL tyf pk :jf:Yo
rf}sLx?df cfd gful/snfO{
lgMz'Ns :jf:Yo ;]jf ;+rfng
 sfo{qmdsf] kl/ro
qmdzM == =

 s]lGb|o, If]qLo, c~rn c:ktfndf ;d]t

u/Lj c;xfo lj/fdLnfO{ :jf:Yo ;]jf
lgMz'Ns k|bfg ug{ ah]6 Aoj:yf
ul/Psf]
 pQm c:ktfnx?df lhNnf :t/sf :jf:Yo
;+:yfaf6 k|]if0f ePsf lj/fdLx?nfO{
;d]t lgMz'Ns :jf:Yo ;]jf k'¥ofpg]
Aoj:yf ldnfOg]
 sfo{qmd tyf ;]jf z'?jft ug{ :jf:Yo
;+:yfn] ;DalGwt ;ldltsf] a}7s /fvL
 sfo{qmd ;+rfng x'g]
lhNnfx?
 &% lhNnfsf ;Dk"0f{ :jf:Yo rf}sL tyf pk
:jf:Yo rf}sLx?df cfd gful/snfO{
cTofjZosLo :jf:Yo ;]jf k"0f{ ?kdf
lgMz'Ns x'g]
 #% lhNnfsf @% z}of ;Ddsf c:ktfn / k|
f=:jf=s]Gb|df u/Lj c;xfo lj/fdLx?nfO{
cfsl:ds, cGt/+u tyf alx/+u ;]jf lgMz'Ns
x'g]
 cGo $) lhNnfsf] xsdf ut cf=a=sf]
lg/Gt/tf cg';f/ u/Lj c;xfo lj/fdLx?nfO{
 p2]Zo
 cfd g]kfnL gful/sx?sf] :jf:Yo ;]jfsf] clwsf/
;'lglZrt ug]{ .
 u/Lj c;xfo gful/ssf] clwsf/ ;'lglZrt ub}{ :jf:Yo
;]jfdf pgLx?sf] kx'Fr j[l4 ug]{ .
 cfd gful/snfO{ :jf:Yo ;]jf pknAw u/fO{ /f]u
nfUg] b/ -Morbidity) / d[To" x'g] b/ -Mortality) sd
ug]{ .
 gful/sx?sf] :j:Yo hLjg ofkgsf] nflu :jf:Yo ;]jfdf
/fHosf] bfloTj jf]w ;'lglZrt ug]{ .
 cTofjZos :jf:Yo ;]jf u'0f:t/Lo Pj+ k|+efjsf/L ?
 lgMz'Ns pkrf/ ;]jf kfpg]
nlIft ;d"x
s_ :jf:Yo rf}sL tyf pk :jf:Yo rf}sLx?sf
;Gbe{df M
 cfd gful/s
v_ @% z}of ;Ddsf] c:ktfn / k|
f=:jf=s]Gb|x?sf] ;Gbe{df M
 != clt ul/j, c;xfo gful/s

 @= u/Lj
 #= ckfË gful/s
 $= ^) jif{ dflysf Ho]i7 gful/s

 %= dlxnf :jf:Yo :jo+ ;]js

 lgMz'Ns :jf:Yo ;]jf
 lj/fdL btf{ z'Ns -:jf:Yo rf}sL /
pk :jf:Yo rf}sLdf_
 z}of z'Ns -c:ktfn / k|

f=:jf=s]Gb|df_
 :jf:Yo ;+:yfdf pknAw ;Dk"0f{

:jf:Yo ;]jf
 cf}iflw -cTofjZosLo cf}ifwL_

-cg';"lr cg';f/_
 uf+p3/ lSnlgsaf6 pknAw x'g]
 c:ktfn tyf k|f=:jf=s]Gb|
x?df nlIft ;d"x klxrfg k|s[of
;d"xsf] kl/efiff
ul/j
 lj/fdLnfO{ cfly{s cj:yfsf] b[li6sf]0fn] ltg
;d"xdf ljeflht ul/G5 . o; ;Gbe{df lj/fdLsf] 3/
kl/jf/sf] hUuf hldg jf cGo ;DktLsf] cfo:yf,
Aofkf/ cyjf /f]uhf/af6 k|fKt x'g] cfDbfgLn]
s_ ^ dlxgf eGbf sd vfg k'Ug] -clt u/Lj_ -sf]
8 g+= !_
v_ ^ dlxgf eGbf a9L t/ aif{ lbg ;Dd vfg
gk'Ug] -u/Lj_ -sf]8 g+= @_
u_ aif{ lbg eGbf j9L vfg k'Ug] -;DkGg_
 ;d"xsf] kl/efiff
c;xfo M
x]/ ljrf/ ug]{ sf]xL AolQm jf cleefjs gePsf]
j];fx/f -sf]8 g+= !_
ckfË M
g]kfn ;/sf/sf] kl/efiff leq kg]{ ckfË -sf]8 g+=
#_
Ho]i7 gful/s M
^) aif{ dflysf g]kfnL gful/s -sf]8 g+= $_
dlxnf :jf:Yo :jo+ ;]js M
 klxrfg ug]{ k|
lqmof qmdzM ==

 u/Lj au{sf] klxrfg / k|df0fLs/0f ug]{ sfo{ :jf:Yo

If]qsf] dfq geO{ cGo If]q vf;u/L :yfgLo lgsfo,
/fhg}lts kf6L{, ;DalGwt cGo sfof{no, k|
zf;g, ;+3 ;+:yf, ;dfh;]jLx?sf] xf] .
 u/LjL lgjf/0f sfo{qmd, ;fd'bflos cf}iflw
sfo{qmd, ;fd'bflos :jf:Yo jLdf sfo{qmds}
;Gbe{df klg klxrfg u/L 5"6 lbg] sfo{ z'? ul/
;lsPsf]
 o;/L ;/sf/L lgsfoaf6 klxrfg tyf k|df0fLs/0f
ePsfx?sf] xsdf ;f]xL k|df0fsf] cfwf/df u/Lj dfGg]
 klxrfg ug]{ k|lqmof
u/Lj egL Aojl:yt tj/n] klxrfg / k|
df0fLs/0f geO{ ;s]sf] cj:yfdf lj/fdL
cfkm}n] cfˆgf] cfly{s l:yltaf/] kmf/fd
cg';f/ ljj/0f pknAw u/fpg] 5g\ ;f]xL
cfwf/df pkrf/df ;+nUg :jf:YosdL{ /
;DalGwt lj/fdL cfkm}n] lgDgfg';f/ ug'{
kg]{ x'G5 .

 pkrf/sf nflu cfpg] nlIft lj/fdLx?nfO cg';"lr @

cg';f/sf] kmf/fd e/L pkrf/df ;+nUg
:jf:YosdL{n] l;kmfl/; ug]{ / ;+:yf k|d'vn]
:jLs[t u/]sf] x'g' kg]{
 lgMz'Ns ;]jf pknAw u/fp+bf cfjZos 7flgPdf
 c:ktfn tyf k|f=:jf=s]Gb|
x?df
lj/fdL btf{ z'Ns
cfsl:ds tyf cGt/+u M
 u/Lj egL k|df0fLs/0f ePsf jf :jf:Yo sdL{n] klxrfg
u/]sf -s_ au{df kg]{x?nfO{ btf{ z'Ns jfkt z'Ns
nufpg x'g] 5}g . t/ -v_ ju{df k/]sfx?sf] xsdf eg]
?= %).– btf{ z'Ns ltg'{ kg]{
 bf]xf]/L cfPsfx?sf] xsdf -s_ jf -v_ b'j} ju{sf] nflu
g} lgMz'Ns x'g]
 c;xfo, Ho]i7 gful/s, ckfË tyf dlxnf :jf:Yo
:jo+ ;]ljsfx?nfO{ klg
-s_ au{df h:t} lgz'Ns btf{ ul/g]
 -s_ au{df hlt hgf btf{ ePsf 5g\ ;f] cg';f/ k|lt
AolQm ?= !)).– / -v_ au{df hlt btf{ ePsf 5g\ ;f]
 c:ktfn tyf k|
f=:jf=s]Gb|x?df
lj/fdL btf{ z'Ns
alx/+Ë M
 k|fylds :jf:Yo s]Gb|x?df k|lt lj/fdL ?=
@.–
 c:ktfnx?df k|lt lj/fdL ?= #.– df gj9fO{
lng' kg]{
of] b/ #% lhNnfsf] alx/+usf] ;j} lj/fdLsf] nflu nfu' x'g]
g]kfn ;/sf/n] pknAw u/fpg] M
 X-ray ;]jf gePsf k|f=:jf=s]Gb|x?df k|lt
lj/fdL ?= %.–,
 X-Ray ;]jf ePsf k|f=:jf=s]Gb|x?df ?
= !).–
 c:ktfnx?df ?= !%.– alx/+usf] ;j}
lj/fdLsf] nflu
:jf:Yo rf}sL tyf pk :jf:Yo
rf}sLx?df lj/fdL btf{ tyf
;]jf z'Ns

xfn ;Dd :jf:Yo rf}sL tyf pk

:jf:Yo rf}sLx?df btf{ tyf ;]jf
z'Ns lnPsf]df cj pk|fGt pQm
btf{ tyf ;]jf z'Ns s'g} klg
nfUg] 5}g\ .
 c:ktfn tyf k|f=:jf=s]Gb|
x?df
kl/rokqsf] Aoj:yf
cfsl:ds tyf cGt/+u btf{ ePsfx?sf] xsdf
 ul/jx?sf] Aojl:yt tj/n] klxrfg / k|df0fLs/0f

gx'Gh]n ;Dd :jf:YosdL{x?n] klxrfg ubf{

cg';"lr # cg';f/sf] kl/ro kq tof/ u/L lbg'
kg]{
 o:tf] kl/ro kqsf] dfGotf Ps aif{ ;Dd sfod

/xg] . csf]{aif{ km]/L lj/fdL eO{ cfPdf

k'gd"{NofÍg u/L k'gM kl/ro kq lbg' kg]{
jlx/+usf] xsdf
 xfn To:tf] kl/ro kq agfO{/xg' gkg]{

ckfË / dlxnf :jf:Yo :jo+ ;]jsx?sf] cfˆg} kl/ro kq

 lgMz'Ns pknAw x'g]
;]jfx?
:jf:Yo rf}sL tyf pk :jf:Yo
rf}sLx?df M
 lj/fdL btf{
 k|ltsf/fTds tyf k|jw{gfTds ;Dk"0f{
:jf:Yo ;]jf
 pkrf/ d"ns ;]jf
 pkrf/sf nflu cfjZos kg]{ ;j} cTofjZos
cf}iflwx? (Essential Drugs) .
 8«]l;Ë, ;'rl/Ë (Dressing, Suturing) sf] nflu
cfjZos kg]{ ;Dk"0f{ cf}iflw÷;fdfu|Lx?
.

 #% lhNnfx?sf lhNnf c:ktfn / k|
f=:jf=s]Gbx?df M
cfsl:ds
cg';+wfg d"ns (Investigation)
k|f=:jf=s]Gb|df
/ut hfFr (Blood Test) TLC, DLC, Hb, Blood Sugar
lk;fj hf+r (Urine Test/R/ME)
PS;–/] (Plain x-rays) (pknAw ePdf)
c:ktfndf
/ut hfFr (Blood Test) TLC, DLC, Hb, Blood Suger, Blood Urea
lk;fj hf+r (Urine Test/R/ME)
PS;–/] (Plane x-rays)
pkrf/ d"ns
-s_ pkrf/sf nflu cfjZos kg]{ ;j} cTofjZos cf}iflwx?
(Essential Drugs)
   ;j} k|sf/sf cTofjZos cf}iflwx? -cf}iflw Aoj:yf ljefun]
;+:yfsf nflu tf]lsPsf_
-v_ 8«]l;Ë, ;'rl/Ë tyf Knf:6l/ª (Dressing, Suturing and
#% lhNnfx?sf lhNnf c:ktfn / k|
f=:jf=s]Gbx?df M
cGt/+u ;]jf
cg';+wfg d"ns (Investigation)
 cg';Gwfgdf k|of]u x'g] ;j} pknJw cTofjZos ;]jfx?
k|f=:jf=s]Gb|df
 TLC, DLC, Hb, ESR, Aldehyde Test, MP, CT, Gram's Stain, AFB Stain, Blood Suger,
Blood Urea, Semen Analysis, Stool R/M, Urine R/M
c:ktfndf
 TLC, DLC, Hb, ESR, Platelet Count, BT, CT, Aldehyde Test, MP, MF, VDRL (RPR), Rh
Factor, Blood Grouping & RH typing, Pregnancy Test, Gram's Stain, Creatinine, LFT,
Stool R/M, Stool occult blood, Urine Bile Salts, Urine Bile Salts, Urine Bile Pigments,
Urine for acetone, Urine R/M, AFB Stain, Blood Suger, Blood Urea, Uric Acid, Semen
Analysis
pkrf/ d'ns
cTofjZos cf}iflwx? (Essential Drugs)
 ;j} k|sf/sf cTofjZos cf}iflwx? -cf}= Jo=lj=n] ;+:yfsf nflu tf]lsPsf_
zNolrlsT;f (Surgery)
 pknJw ;j} k|sf/sf Minor Surgery x?
Obstetric Emergency pknAw ePdf
 CEOC (Comprehensive Emergency Obstetric Care)
 BEOC (Basic Emergency Obstetric Care)
 lgMz'Ns :jf:Yo ;]jf k|fKt ug]{ lj/fdLnfO{ ;fdfGo j]8 (General Bed) pknAw
u/fOg]5 .
 #% lhNnfx?sf lhNnf c:ktfn / k|
f=:jf=s]Gbx?df M
alx/Ë ;]jf
 cg';+wfgd"ns ;]jfx?M (Inves tigation)
k|f=:jf=s]Gb|df
 TLC, DLC, Hb, ESR, Aldehyde Test, MP, CT, Gram's Stain, AFB
Stain, Blood Suger, Blood Urea, Semen Analysis, Stool R/M, Urine
R/M
c:ktfndf
 TLC, DLC, Hb, ESR, Platelet Count, BT, CT, Aldehyde Test, MP,
MF, VDRL (RPR), Rh Factor, Blood Grouping & RH typing,
Pregnancy Test, Gram's Stain, Creatinine, LFT, Stool R/M,
Stool occult blood, Urine Bile Salts, Urine Bile Salts, Urine Bile
Pigments, Urine for acetone, Urine R/M, AFB Stain, Blood
Suger, Blood Urea, Uric Acid, Semen Analysis PS;–/] (Plane x-
rays)
pkrf/ d"ns
 -s_ pkrf/sf nflu cfjZos kg]{ ;j} cTofjZos cf}iflwx? (Essential

Drugs) .
 -v_ 8«]l;Ë, ;'rl/Ë tyf Knf:6l/ª (DRESSING, SUTURING AND
 lgMz'Ns pknAw x'g]
;]jfx?
hg:jf:Yo ;DaGwL ;]jfx?
 k|of]uzfnfaf6 lbO{b} cfPsf ;Dk"0f{ hg:jf:Yo
;DaGwL ;]jfx? h:t} cf}nf], sfnfhf/, Ifo/f]u,
s'i7/f]u cflb oyfjt lgMz'Ns lbO{g]
 ufp+3/ lSnlgsaf6 lbO{g] ;]jfx? ;fy}] btf{ z'Ns .
t/ ufp+3/ lSnlgs Aoj:yfkg ;ldlt oyfjt /fvL
lgodfg';f/ lgoldt j}7s u/L ufp+3/ lSnlgs k|
efjsf/L ?kdf ;+rfng ug'{ kg]{
 dlxnf :jf:Yo :jo+ ;]jsx?af6 ufp+a:tL :t/df lbO{g]
;]jfnfO{ cem ;'b[9Ls/0f ug{, dlxnf :jf:Yo :jo+
;]js lgb]{lzsfdf pNn]v eP cg';f/sf cTofjZos
cf}iflwx? lg/Gt/ ?kdf cfk"lt{sf] Aoj:yf u/L sf]l6«d
ljt/0f nufot ;Dk"0f{ ;]jfx? lgMz'Ns ?kdf pknAw
k|]if0f Aoj:yfkg
 lj/fdLnfO{ cfjZostf cg';f/ k|]if0f
-Referral_ u/L k7fpg' kg]{]{
 o;/L k|]if0f u/LPsf vf;u/L ul/a
lj/fdLnfO{ s]Gb| If]q tyf cGrn
:t/df lgMz'Ns sfo{qmdsf] nflu k|
fKt /sdaf6 ;]jf pknJw u/fpg' kg]{
 Ho]i7 gful/s, blnt, lk5l8Psf au{nfO{
;fdflhs ;dfj]zLs/0fdf k|fKt /sdaf6 vr{
ug{ ;lsg]
 :jf:Yo rf}sLdf lgMz'Ns ;]jf
xfnsf] ;]jf sfo{qmd ;+rfng kl5sf]
btf{ z'Ns btf{ z'Nscj:yf
lgMz'Ns x'g]

CDP nfu" gePsf :jf:Yo afx|} dlxgf cf}iflw

;+:yfdf # b]lv % dlxgf pknAw x'g]

;Dd dfq cf}iflw pknAw
x'g]

CDP nfu" ePsf
of] sfo{qmd kl5
lhNnfx?df cf}iflwsf] lgMz'Ns x'g]
d"No lnO{g] .
Full Course Treatment
  pknAw x'g]
pknAw gx'g] . u/Lj tyf ;fdfGo
 btf{ z'Ns / cf}iflw lj/fdLx?sf] kx'+r tyf
z'Nssf sf/0f lj/fdL :jf:Yo pkef]udf a[l4 x'g] .
wGojfb