1

1111 .... 7777

pwœ²¡jL hÉ¡¢dpwœ²¡jL hÉ¡¢dpwœ²¡jL hÉ¡¢dpwœ²¡jL hÉ¡¢d 60 ¢j¢eV60 ¢j¢eV60 ¢j¢eV60 ¢j¢eV

1z 1z 1z 1z A¢d−hn−el A¢d−hn−el A¢d−hn−el A¢d−hn−el E−ŸnÉ E−ŸnÉ E−ŸnÉ E−ŸnÉ (Session Objectives) :::: A¢d−hn−el −n−o AwnNËqeL¡l£l¡ ¢e−jÀ ¢m¢Ma ¢hou…¢m hÉ¡MÉ¡ Ll−a f¡l−he -

� a¡−cl Hm¡L¡u ¢h¢iæ pwœ²¡jL hÉ¡¢d…¢m ¢m¢fhÜ Ll−he � j¤MÉ pwœ²¡jL hÉ¡¢d…¢ml mre J EfpNÑ…¢m ¢Q¢q²a Ll−a f¡l−he � HC hÉ¡¢d…¢m fË¢a−l¡−dl Ef¡u � −l¡N eSlc¡l£ fËe¡m£l fËpwn¡ Ll−he

2z 2z 2z 2z A¢d−hn−el A¢d−hn−el A¢d−hn−el A¢d−hn−el j§m ¢nr¡ j§m ¢nr¡ j§m ¢nr¡ j§m ¢nr¡ (Key Learning Point) :::: � f¢ÕQjh−‰ Seü¡ÙÛÉ ¢houL ¢LR¥ pwœ²¡jL hÉ¡¢d…¢m qm - X¡C¢lu¡, ¢eE−j¡¢eu¡, jÉ¡−m¢lu¡,

q¡j Hhw kr¡ � HC hÉ¡¢d…¢ml fËd¡e mre J EfpNÑ � X¡C¢lu¡ fË¢a−l¡−dl ¢h¢iæ Ef¡u � eSlc¡l£ fËe¡m£ L¡−Sl SeÉ abÉ plhl¡q Ll−he

3z 3z 3z 3z −S−e l¡M¤e −S−e l¡M¤e −S−e l¡M¤e −S−e l¡M¤e (Hand Out) xxxx f¢ÕQjh−‰f¢ÕQjh−‰f¢ÕQjh−‰f¢ÕQjh−‰llll pwœ² pwœ² pwœ² pwœ²¡¡¡¡jL hÉ¡¢d xjL hÉ¡¢d xjL hÉ¡¢d xjL hÉ¡¢d x pwœ²¡jL hÉ¡¢d hm−a ¢L −h¡T¡u ? pwœ²¡jL hÉ¡¢d qm −p…¢m k¡ HLSe hÉ¡¢š²l −b−L AeÉ hÉ¢š² L¡−R R¢s−u f−s z ¢h¢iæ hÉ¡L−V¢lu¡ J BcÉ fË¡Z£ (Protozoa), Ae¤L̈m f¢l−h−n jn¡ - j¡¢R, h¡ AeÉ¡eÉ hÙ¹¥l j¡dÉ−j R¢s−u f−s z −l¡−Nl BnËu c¡a¡

j¡dÉj f¢l−hn (Sm¡nu , j¡¢R jn¡ )

Figure 1: Triangle (Triad) of Disease

¢LR¥ pwœ²¡jL hÉ¢LR¥ pwœ²¡jL hÉ¢LR¥ pwœ²¡jL hÉ¢LR¥ pwœ²¡jL hÉ¡¢dl j§MÉ mre¡¢dl j§MÉ mre¡¢dl j§MÉ mre¡¢dl j§MÉ mre J EfpNÑ J EfpNÑ J EfpNÑ J EfpNÑ : : : : −l¡N−l¡N−l¡N−l¡N mre J EfpNÑmre J EfpNÑmre J EfpNÑmre J EfpNÑ ¢eu¿»−el Ef¡u¢eu¿»−el Ef¡u¢eu¿»−el Ef¡u¢eu¿»−el Ef¡u

q¡j SÆl, N¡−u g¥pL¥¢s, p¢cÑ - L¡¢n, −Q¡M m¡m q−u k¡Ju¡ z

V£L¡Lle Hhw ¢iV¡¢je A, Kod

¢eE−j¡¢eu¡ (ARI - Acute

Respiratory Infection ) ü¡p- fË¡nÄ¡−pl q¡l 60 - 50 - 40 (p¡le£ 2 −cM¤e )

h¡pÙÛ¡e, Lðm

2

jÉ¡−m¢lu¡ −L¡−e¡ ÙÛ¡−el −k −L¡−e¡ SÆlC jÉ¡−m¢lu¡ q−a f¡−l z AeÉœ, Ly¡f¤¢e ¢c−u SÆl, pwœ²j−el fË¡b¢jL Ù¹−l HL¢ce A¿¹l SÆl B−p z fËQä j¡b¡ hÉ¡b¡J q−a f¡−l z

pwqa j¡¢R - jn¡ ¢eu¿»e

kr¡ c¤C pç¡−ql −hn£ L¡¢n h¡ SÆl J L¡¢n Hhw SÆl z c¤h¡l b¤b¤ fl£r¡l fË−u¡Se

Ru j¡p d−l m¡N¡a¡l DOTS Kod −M−a q−h

X¡C¢lu¡ HL¢c−e 3 h¡−ll −hn£ f¡am¡ f¡uM¡e¡, −R¡V h¡µR¡−cl −r−œ j¡ h¡ A¢ii¡hL a¡ mrÉ l¡M−he

f¢l−o¡¢da Sm, ¢höÜ Sm

j¡l¡aÈL X¡C¢lu¡ k¢c −L¡−e¡ h¡µR¡l 14 ¢c−el −hn£ HLe¡N¡−s f¡am¡ f¡uM¡e¡ qu a−h a¡ j¡l¡aÈL X¡C¢lu¡l l©f −eu z HC h¡µR¡−L A¢hm−ð q¡pf¡a¡m ¢e−u −k−a q−h z k¢c −L¡−e¡ h¡µR¡l f¡uM¡e¡u lš² B−p - a−h Bj¡n−ul mre z k¢c h¡µR¡l hup 2 j¡−pl Lj qu a−h H¢V …l¦aÆl hÉ¡L−V¢lu¡ O¢Va pwœ²je z H¢V ¢hf−cl pw−La !

AeÉœ p¢hÙ¹¡−l hm¡ B−R

X¡C¢lu¡ Hhw ¢Xq¡C−XÊne X¡C¢lu¡ q−m fË¢a¢V h¡µR¡lC ¢X -q¡C−XÊne qJu¡l pñ¡he¡ b¡−L z a¡C ¢ejÀ¢m¢Ma mre…¢m fl£r¡ Ll¦e - −cM¤e J Ae¤ih Ll¦e x-

• h¡µR¡¢Vl p¡d¡le AhÙÛ¡ mr Ll¦e : h¡µR¡V¡ ¢L ¢e−Ù¹S h¡ A°QaeÉ q−u B−R ? A¢ÙÛl h¡ ¢MV¢M−V q−u B−R ?

• h¡µR¡¢Vl −Q¡M ¢ej¢‹a ? • h¡µR¡¢V−L f¡e Ll−a ¢ce z

−p ¢L f¡e Ll−R e¡ h¡ f¡e Ll−a f¡l−R e¡ ? a¡s¡a¡¢s f¡e Ll−R Hhw fËQä −aø¡u B−R ?

• −f−Vl Q¡js¡ d−l −cM¤e z Q¡js¡¢V ¢L avre¡v ü¡i¢hL AhÙÛ¡u ¢g−l Bp−R e¡ ¢L a¡l −b−L −h¢n pju ¢e−µR z

ORS Hhw Zinc

3

¢e−Ql a¡¢mL¡¢V ¢h¢iæ −l¡N, a¡−cl mre J fË¢a¢V ARI Hl ¢eu¿»−el Ef¡u B−R z

¢nöl hup¢nöl hup¢nöl hup¢nöl hup ¢nöl nÄ¡p fËnÄ¡p …−e −cM¤e¢nöl nÄ¡p fËnÄ¡p …−e −cM¤e¢nöl nÄ¡p fËnÄ¡p …−e −cM¤e¢nöl nÄ¡p fËnÄ¡p …−e −cM¤e 0 −b−L 2 j¡p 60 h¡ a¡l A¢dL / ¢j¢eV 2 j¡p −b−L 12 j¡p 50 h¡ a¡l A¢dL / ¢j¢eV 12 j¡p −b−L 5 hRl 40 h¡ a¡l A¢dL / ¢j¢eV

2 x ¢eE−j¢eu¡ 2 x ¢eE−j¢eu¡ 2 x ¢eE−j¢eu¡ 2 x ¢eE−j¢eu¡ (ARI) Hl mre Hl mre Hl mre Hl mre ¢e−jÀ f¢ÕQjh−‰l jÉ¡−m¢lu¡ fËhe Hm¡L¡…¢ml e¡j −cJu¡ qm-

f¤l¦¢mu¡ (11¢V fË¡b¢jL ü¡ÙÛÉ −L¾cÊ)

h¡Nj¤¢ä, pcl, h−¾c¡u¡e, ¢plL¡h¡c, T¡mc¡-2 hml¡jf¤l, T¡mc¡ -1, Suf¤l, hsh¡S¡l, j¡eh¡S¡l 1 J 2

Smf¡C…¢s (13 ¢V fË¡b¢jL ü¡ÙÛÉ −L¾cÊ)

Ešl ma¡h¡¢s, j¡m, L¡¢mwfw, p¤¤Le¡, g¡m¡L¡V¡, L¥p¡lNË¡j, Nl¦h¡b¡e, l¡SN”, jue¡…¢s, j¡¢Vu¡¢m, j¡c¡¢lq¡V, B¢mf¤lc¤u¡l 1 J 2

hy¡L¥s¡ (5¢V fË¡b¢jL ü¡ÙÛÉ −L¾cÊ) l¡e£hy¡d, l¡uf¤l, M¡al¡, −hmf¡q¡s£, ¢qlhy¡d

f¢ÕQjh−‰l 4¢V −Sm¡l 37¢V fË¡b¢jL ü¡ÙÛÉ −L¾cÊ

c¡¢SÑ¢mw (8¢V fË¡b¢jL ü¡ÙÛÉ −L¾cÊ) e„¡mh¡¢s, p¤¤Le¡, L¡¢pÑu¡w, ¢j¢lL, gy¡¢p−cJu¡, L¡¢mwfw-1, gy¡¢p−cJu¡ - K l¡SN”

X¡C¢lu¡ ¢eu¿»−eX¡C¢lu¡ ¢eu¿»−eX¡C¢lu¡ ¢eu¿»−eX¡C¢lu¡ ¢eu¿»−ellll ¢h¢iæ Ef¡u ¢h¢iæ Ef¡u ¢h¢iæ Ef¡u ¢h¢iæ Ef¡u :::: Sm −n¡de, Sm ¢hö¢ÜLle, Sm plhl¡q, ü¡ÙÛÉ¢hd¡e ORS Hhw Zinc Sm ¢hö¢Ü Ll−el fÜ¢aSm ¢hö¢Ü Ll−el fÜ¢aSm ¢hö¢Ü Ll−el fÜ¢aSm ¢hö¢Ü Ll−el fÜ¢a : : : : L) Sm −Ry−L −n¡de x k¢cJ f¡−el B−N Sm g¥¢V−u ¢e−m a¡l j−dÉ b¡L¡ −l¡N pª¢øL¡l£ S£h¡e¤ eø q−u k¡u z ¢L¿¹¥ NË¡j¡’−m HC fÜ¢a j¡e¤o hÉhq¡l L−le e¡ z SÆ¡m¡¢el Lj¢a Hhw BL¡n−Ry¡u¡ c¡−jl SeÉ HC fÜ¢al hÉhq¡l p£¢ja z HR¡s¡J h¡lwh¡l Bp¡ heÉ¡l SeÉ j¡e¤−ol fË¡b¢jL fË−u¡Se…¢mJ −jV¡−e¡ j¤n¢Lm q−u f−s z Hja¡hÙÛ¡u SÆ¡m¡e£ −S¡N¡s L−l Sm −g¡V¡−e¡ Apñh z p¡d¡leax NË¡−jl j¡e¤−ol¡ L¡fs h¡ f¤−l¡−e¡ n¡¢s à¡l¡ −Ry−L Sm f¢lú¡l L−le z N−hoe¡N¡−l fl£r¡u −cM¡ −N−R −k, NË¡−j hÉhq©a p¡d¡le, Ljc¡j£ p§a£l n¡¢s−L Q¡l −b−L BV iy¡S L−l

4

k¢c Sm Ry¡L¡ qu a−h a¡ à¡l¡ S−m −l¡N pª¢øL¡l£ S£he¤ (¢h−noax L−ml¡l S£h¡e¤ ) dÆwp q−u k¡u z

M) l¡p¡u¢eL Ef¡−u Sm −n¡de x HL ¢mV¡l (4 NÔ¡p ) S−m ¢ae hs Q¡jQ (6 −R¡V Q¡jQ) ¢hÔ¢Qw f¡EX¡l (30 %) −jn¡e z HC ¢jnËe¢V c§¢oa S−m ¢j¢n−u Sm −n¡de Ll¦e z ¢jnËe¢Vl - ¢ae −gy¡V¡ / 0 . 6 ¢j¢m HL ¢mV¡l S−m −jn¡e 6 ¢j¢m 10 ¢mV¡l S−m 60 ¢j¢m 100 ¢mV¡l S−m

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2) ORS HhwHhwHhwHhw Zinc

3z ü¡ÙÛÉ¢hd¡−el Ef¡u 3z ü¡ÙÛÉ¢hd¡−el Ef¡u 3z ü¡ÙÛÉ¢hd¡−el Ef¡u 3z ü¡ÙÛÉ¢hd¡−el Ef¡u xxxx −n±Q¡N¡−ll ¢eu¢ja hÉhq¡l, EyQ¥ −n±Q¡N¡l °al£, jm - j§œ aÉ−Nl SeÉ −n±Q¡N¡−ll hÉhq¡l - ü¡ÙÛÉ¢hd¡e Ef¡−ul A¿¹NÑa z 4z Sm plhl¡q x4z Sm plhl¡q x4z Sm plhl¡q x4z Sm plhl¡q x p¤¤l¢ra Ef¡−u Sm pwNËq, emL̈f EyQ¥ L−l hy¡d¡−e¡ J a¡l ašÄ¡hd¡e ab¡ Sm l¡M¡l SeÉ hs SÉ¡¢l−Le ¢hale - HCph Ef¡u Ahmðe Ll−m X¡C¢lu¡l fË¡c¤Ñi¡h Lj−h z −l¡N eSlc¡l£ −l¡N eSlc¡l£ −l¡N eSlc¡l£ −l¡N eSlc¡l£ (Disease Surveillance) H¢V HL¢V Qmj¡e fË¢œ²u¡ z H−a Seü¡ÙÛÉ Eæu−el SeÉ f¢lLÒfe¡, h¡Ù¹h¡ue Hhw j§mÉ¡u−el E−Ÿ−nÉ abÉ pwNËq, ¢h−nÔoe J hÉ¡MÉ¡ Ll¡ qu z HC fË¢œ²u¡¢V Seü¡ÙÛÉ ANË¡¢dL¡l pjpÉ¡ ¢Q¢q²aLle J −Ny¡s¡−aC −l¡−Nl fË¡c¤Ñi¡h pð−å paLÑ qJu¡l SeÉ Sl¦l£ z abÉ pwNË−ql SeÉ ü¡ÙÛÉ hÉhÙÛ¡u hý fÜ¢a B−R z

6

� fËSee J ¢nö ü¡ÙÛÉ ¢houL abÉ (RCH) pwNË−ql SeÉ hÔL J −Sm¡ Ù¹−l fË¢a j¡−p °hWL qu z HR¡s¡J −f¡¢mJ, jÉ¡−m¢lu¡, kr¡, L¥ù Hhw HIV (NACO) Bm¡c¡ fË¢a−hce (Report) B−p z CHCMI Hhw ICDS Hl ¢eSü fË¢a−hce fÜ¢a B−R z

� Sl¦l£ AhÙÛ¡u / −l¡−Nl fË¡c¤Ñi¡h q−m fË¢a¢ce ¢hno fË¢a−hce °al£ qu z

� pwqa −l¡N eSlc¡l£ fËLÒf (IDSP) Hl abÉ V£L¡Lle A¢ik¡e J X¡C¢lu¡ S¢ea jªa¥É−L a¥me¡ Ll¡l SeÉ 2008 H −j¢ce£f¤l heÉ¡ J 2009 H BCm¡l fl hÉhq©a qu z

pLm fkÑ¡−u X¡š²¡l−cl p−‰ ¢LÓ¢eL −b−L ¢e¢cÑø g−jÑ Hhw N−hoe¡N¡l −b−L N−hoe¡N¡l g−jÑ fË¢a−hce hÔL fË¡b¢jL ü¡ÙÛÉ −L¾cÊ h¡ a¡l E−ÜÑ f¡W¡−e¡ qu z HC fË¢a−hce …¢m fË¡b¢jL Ù¹−l p−¾cq BL¡−l Ef-ü¡ÙÛÉ −L−¾cÊ f¡W¡−e¡ qu z k¢c −L¡−e¡ ¢hfkÑ−ul fl Ef-ü¡ÙÛÉ −L¾cÊ −M¡m¡ b¡−L a¡q−m, HC abÉ…¢m ¢eu¢ja f¡W¡−e¡ k¡u z a−h k¢c ANM −L Akb¡ AÙÛ¡u£ h¡pÙÛ¡e…¢m−a ¢e−u k¡Ju¡ qu a−h HC abÉ f¡Ju¡ k¡−h e¡ Hhw −l¡−Nl fË¡c¤Ñi¡h B−N −b−L ByQ Ll¡ k¡−h e¡ z a−bÉl Evp xa−bÉl Evp xa−bÉl Evp xa−bÉl Evp x SPHERE Guidelines

IMNCI ¢Qœ f¤¢Ù¹L¡, q¡a hC Hhw −mM¢Qœ hC 4z 4z 4z 4z A¢d−hneA¢d−hneA¢d−hneA¢d−hne f¢lLÒfe¡ f¢lLÒfe¡ f¢lLÒfe¡ f¢lLÒfe¡ (Session Plan):

pjupjupjupju A¢d−hn−eA¢d−hn−eA¢d−hn−eA¢d−hn−el L¡kÑ ¢hhle£l L¡kÑ ¢hhle£l L¡kÑ ¢hhle£l L¡kÑ ¢hhle£

fËbj 10 ¢j¢eV AwnNËqeL¡l£−cl L¡−R A¢d−hn−el E−ŸnÉ hÉ¡MÉ¡ L−l fË¢nrL öl¦ Ll−he z flhaÑ£ 7 ¢j¢e−V fË¢nrL hÉ¡¢dl ¢œ−L¡e e„¡ hÉhq¡−l L−l jÉ¡−m¢lu¡ ¢Li¡−h qu a¡ hÉ¡MÉ¡ Ll−he z −l¡−Nl BnËu c¡a¡

j¡dÉj f¢l−hn (Sm¡nu, j¡¢R, jn¡ ) HC p−œ −S¡l −cJu¡ q−h pwœ²¡jL hÉ¡¢d L¡−L h−m a¡l Efl - H−a pju m¡N−h ¢ae ¢j¢eV

11 - 15 ¢j¢eV â¥a ¢Q¿¹e x fË¢nrL AwnNËqeL¡l£−cl ¢eS-¢eS Hm¡L¡l p¡d¡le pwœ²¡jL hÉ¡¢d…¢m ¢Q¢q²a Ll−a hm−he z ph Ešl…¢m Q¡−VÑ ¢m¢fhÜ Ll¡ q−h z k¢c −L¡e AfËaÉ¡¢na Ešl B−p a¡J hÉ¡MÉ¡ L−l ¢c−a q−h z

7

hÉ¡¢d…¢m q−h ¢ejÀl©f x � q¡j � X¡C¢lu¡ � jÉ¡−m¢lu¡ � kr¡ � ¢eE−j¡¢eu¡

16 - 40 ¢j¢eV ¢Q¿¹¡ Ae¤p¡−l L¡S (Mind Mapping) - B−Nl a¡¢mL¡¢V hÉhq¡l L−l Hh¡l fË¢nrL f§−hÑ E−õ¢Ma pwœ²¡¢ja hÉ¡¢d …¢m hÉ¡MÉ¡ Ll−he z fË¢a¢Vl SeÉ pju m¡N−h 5 - 7 ¢j¢eV z −k p¡lZ£¢V °al£ B−R a¡l fËbj c¤C p¡¢l Ec¡qle ül©f hÉhq¡l Ll¡ −k−a f¡−l

� X¡C¢lu¡ - −cJu¡ R¢h…¢ml p¡q¡−kÉ hÉ¡MÉ¡ Ll¦e z � jÉ¡−m¢lu¡ - Hm¡L¡u −cM¡ k¡Ju¡ mre …¢m B−m¡Qe¡ J hÉ¡MÉ¡

Ll¦e z � kr¡ - B−m¡Qe¡ hÉ¡MÉ¡ Ll¦e z � ¢eE−j¡¢eu¡ - ¢i¢XJl j¡dÉ−j hÉ¡MÉ¡ Ll¦e z

41 - 45 ¢j¢eV hÉ¡¢d Hhw a¡l mre…¢m −cM¡l fl fË¢nrL Hp−hl fË¢a−l¡−dl Ef¡u…¢m B−m¡Qe¡ Ll−he J a«a£u p¡le£−a ¢m¢fhÜ Ll−he z V£L¡Lle, j¡¢R, jn¡ ¢eu¿»e CaÉ¡¢c pð−å pw¢rç i¡−h hm−a q−h z

46 - 55 ¢j¢eV B−N −b−L −gÓ„ hÉ¡e¡l ¢qp¡−h °al£ ¢Qœ hÉhq¡l L−l fË¢nrL X¡C¢lu¡ ¢eu¿»−el Ef¡u …¢m hÉ¡MÉ¡ Ll−he z −kje- Sm Ry¡L¡, ¢hö¢ÜLle, ORS hÉhq¡l CaÉ¡¢c z

56 - 60 ¢j¢eV ü¡ÙÛÉ eSlc¡l£ hÉhÙÛ¡ L¡−L h−m, fË¢nrL a¡ h¤¢T−u −c−he z p¢œ²u l©−f abÉ pwNËq, ¢h−nÔoe Hhw a¡l Efl ¢i¢š L−l fc−rf −eJu¡

Water

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8

−k−a f¡−l a¡ p¢hÙ¹¡−l −h¡T¡−he z −L¡el©f p−¾cq / fËnÀ b¡L−m fË¢nrL a¡ c§l L−l −c−he z

5z fˢnre fܢa 5z fˢnre fܢa 5z fˢnre fܢa 5z fˢnre fܢa (Training Method) x x x x

A¢d−hn−eA¢d−hn−eA¢d−hn−eA¢d−hn−el Awnl Awnl Awnl Awn fÜ¢afÜ¢afÜ¢afÜ¢a

ü¡ÙÛÉ Hhw hÉ¡¢dl Ef¡c¡e L¡−XÑl j¡dÉ−j cmNa L¡S

p¤¤l¢ra ü¡ÙÛÉ ¢h¢dl AiÉ¡p q¡a −d¡Ju¡, R¢h à¡l¡ X¡C¢lu¡, ¢eE−j¡¢eu¡, ORS /

Zinc ¢höÜ Sm CaÉ¡¢cl hÉ¡MÉ¡

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6z6z6z6z fË−u¡Se£u p¡jNË£ fË−u¡Se£u p¡jNË£ fË−u¡Se£u p¡jNË£ fË−u¡Se£u p¡jNË£ (Materail Required) x x x x

� f§−hÑ fËÙ¹¥a L¡XÑ (ü¡ÙÛÉ J hÉ¡¢dl Ef¡c¡e) � f§−hÑ fËÙ¹¥a R¢h (X¡C¢lu¡) � −h¡XÑ . � j¡LÑ¡l −fe � Q¡VÑ � CD Player Hhw Projector