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Training for basic nutrition

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Basic training on nutrition

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Training for basic nutrition

  1. 1. Orientation for PD Hearth & GMP on Basic Nutrition Venue: Muktagacha ADP Hall Room World Vision Bangladesh Date: 24-25 January,2015
  2. 2. Awa‡ekb - 1 •f~wgKv
  3. 3. evsjv‡`‡ki mvwe©Kcywó cwiw¯’wZ: cywó cwiw¯’wZ: evsjv‡`k wPÎ Z_¨m~Î 1eQ‡ii Kg eqmxwkï g„Zy¨nvi 43/1000RxweZ Rb¥ wewWGBPGm 2011 5eQ‡ii Kg eqmxwkï g„Zy¨nvi 53/1000RxweZ Rb¥ wewWGBPGm 2011 Rb¥KvjxbKg IR‡bi wkï 36% GbGjweGm, 2004 Le©Zv (÷vw›Us) gvivZ¥K -15% wewWGBPGm 2011 ga¨g †_‡K gvivZ¥K-41% K…kKvq (IqvmwUs) gvivZ¥K-4% wewWGBPGm 2011 ga¨g †_‡K gvivZ¥K-16% ¯^í IRb gvivZ¥K -10% wewWGBPGm 2011 ga¨g †_‡K gvivZ¥K-36% ïaygvÎ gv‡qi `yaLvIqv‡bvi nvi 64% wewWGBPGm 2011 cwic~iK Lvevi MÖn‡Yi nvi 21% wewWGBPGm 2011 Lvevi ˆZix I LvIqv‡bvi Av‡M mvevb w`‡q nvZ ‡avqvi nvi <5% Shewa -B Health Impact Study, Midline Report November, 2009
  4. 4. RvZxqcywó †mev/b¨kbvj wbDwUªkb mvwf©‡mm(GbGbGm)-Gi j¶¨ I D‡Ïk¨ j¶¨: • gv, wkï, wK‡kviwK‡kvix Imgv‡Ri myweavewÂZ RbM‡Yi cywói cÖwZ AwaKZi†Rvi w`‡q evsjv‡`‡ki mvgwMÖK Acywói gvÎv Kwg‡q Avbv|
  5. 5. mywbw`©ó D‡Ïk¨vejx: • gv I wkï‡`i Acywó Kgv‡bvi j‡¶¨ GKwU mve©Rbxb g~javivi mgwš^Z cywó †mev c¨v‡KR ev¯Íevqb Kiv • Acywó wbimb Kivi j‡¶¨ wewfbœ mswkøó gš¿Yvjq mg~‡ni g‡a¨ mgš^q mvab Kiv (gš¿Yvjq mg~n †hgb- • Lv`¨ I `y‡h©vM e¨e¯’vcbv, K…wl, gwnjv I wkï welqK, Z_¨, wk¶v, grm¨ I cÖvYxm¤ú`, ¯’vbxq miKvi, • cjøx Dbœqb I mgevq) • ¯^v¯’¨ I cwievi cwiKíbv †mev e¨e¯’vi wewfbœ ¯Í‡i gvbm¤§Z †mev cÖ`vb, e¨e¯’vcbv I ZË¡veavb (mycviwfkb) wbwðZ Kivi Rb¨ `¶ gvbe m¤ú` ˆZixKiv • ¯^v¯’¨Z_¨ e¨e¯’vcbvi mv‡_ †hvMm~Î ¯’vcb Kivi Rb¨ Z_¨ c×wZ Ges M‡elYv†Rvi`vi Kiv
  6. 6. •Awa‡ekb- 2 •Lv`¨ I cywó
  7. 7. Lv`¨Icywó Lv`¨: • Lv`¨ n‡”Q Ggb KZ¸‡jvcÖ‡qvRbxq Dcv`v‡bi mgwó hv MÖn‡Yi gva¨‡g kix‡ii¯^vfvweK e„w× I Kg©¶gZv eRvq _v‡K, ¶qc~iY I wewfbœ Kv‡Ri Rb¨ cÖ‡qvRbxq kw³ †hvMvb †`q Ges m‡ev©cwi †ivM cÖwZ‡iva ¶gZv ˆZixK‡i| cywó: • cywó n‡”Q Ggb GKwU cÖwµqv hvi gva¨‡g MÖnY Kiv Lv`¨, †kvwlZ n‡q kix‡iZvcI kw³ Drcbœ K‡i, kix‡iie„w× mvab K‡i,kix‡i†ivM cÖwZ‡iva¶gZv m„wó K‡i|
  8. 8. cywóKi Lv`¨ Ges Giv wKfv‡em¤cwK©Z: • †h me Lv`¨ †L‡j kix‡iZvcI kw³ Drcvw`Z nq, †`‡ni MVb e„w× nq, kixi mej, Kg©¶g I wb‡ivM _v‡K Zv-BcywóKi Lv`¨| • Lv`¨ I cywó G‡K Ac‡ii mv‡_ RwoZ| ‡h ‡Kv‡bv Lv`¨ MÖnY Ki‡jBn‡e bv, ZvAek¨Bn‡Z n‡e cywó m¤§Z Ges wbivc`| cywó m¤§Z Lv`¨ MÖnb bv Ki‡j†ivM cÖwZ‡iva ¶gZv K‡g hvq Ges kix‡iwewfbœ ai‡bi †ivM msµgY nq| cywó m¤§Z Lvevi MÖnb Ki‡jkixiI gb DfqB fvj _v‡K|
  9. 9. Lv‡`¨i Dcv`vb I Drm: • †k¦ZmvievkK©iv (Kv‡e©vnvB‡WªU) • Drm: fvZ, iæwU,Avjy, gywo, wPov, ˆL,wPwb, gay BZ¨vw` • †Zj I Pwe© • Drm:†Zj, gvQ- gvs‡mi Pwe©, gvLb, wN BZ¨vw` • Avwgl (‡cÖvwUb) • Drm:gvQ,gvsm, wWg, `ya, Wvj, ev`vg,exwPBZ¨vw` • wfUvwgb • Drm:`ya, wWg, KwjRv, me ai‡bikvK-me&wR, dj BZ¨vw` • LwbR Dcv`vb • Drm:gvQ,gvsm, KwjRv, `ya, wWg, Mvp meyR kvK- me&wR, jeY BZ¨vw` • Cvwb
  10. 10. KvR Abyhvqx Lv‡`¨i †kªYx wefvM: • ZvcI kw³ Drcv`bKvix Lv`¨: (kK©ivI Pwe© RvZxq Lvevi †hgbt fvZ, i“wU, Avjy, ¸o, wPwb, wgwóAvjy, cvDi i“wU, †Zj, gvLb, wN, Pwe©, gay, ¸o, we¯‹zU, ev`vg, bvi‡Kj BZ¨vw`) • kix‡ii¶qc~iY I e„w×KviK Lv`¨: (Avwgl RvZxq Lvevi †hgbt gvQ, gvsm, mqvweb I Ab¨vb¨ Wvj, `ya, wWg, wm‡gi exwP, †QvUgvQ, eogvQ, KwjRv BZ¨vw`) • †ivM cÖwZ‡ivaKvix Lv`¨: (wfUvwgb I LwbR m¤§„× Lvevi †hgbt Mvp njy` I meyR i‡Oi me ai‡bi kvKI djg~j, cvKv Avg, cvKv Zvj,cvKv †cu‡cu, cvKv KuvVvj, Avbvim, †cqviv, AvgjwK, Avgov, Kjv,†jey, MvRi, wgwóKzgov, wkg, †QvUgvQ, `ya, wWg, KwjRv BZ¨vw`)
  11. 11. mylg Lv`¨ I Gi ˆZixi †KŠkj mylg Lv`¨: • myylg Lv`¨ n‡”Q †mB Lv`¨ hv‡Z Lv‡`¨i me cywó Dcv`vb †`‡ni cÖ‡qvRbgZ, eqm I wj½ †f‡` mwVK gvÎvq _v‡K| A_v©r mylg Lv`¨ n‡jv Ggb GKwU Lvevi hv kw³`vqK, kixie„w×KviK I †ivM cÖwZ‡ivaK| cÖ‡Z¨‡Kimvg‡_©¨i Dci wbf©i K‡i†h †m wK ai‡bimylg Lvevi †L‡Z cv‡i| †ewk LiP K‡i †hgb mylg Lvevi LvIqv hvq, †Zgwb AíLi‡PI mylg Lvevi LvIqv hvq|
  12. 12. Lv`¨wcivwgW
  13. 13. Lvev‡iiˆewPΨ wKfv‡eLvev‡i ˆewPΨAvbvhvq?: • Lvevi Ggb n‡Z n‡e †hb †mB Lvevi cwigv‡Y mwVK nq Ges me iKg cywó _v‡K • cwigvY gZ/Dchy³ A_©vr GB me Lvevi h‡_ó cwigvY kw³, Avwgl Ges Abycywói (micro nutrient) Pvwn`v c~iY Ki‡e • GKBLvevi †L‡Z fvj jvM‡e bv ZvB gv‡S gv‡S wfbœ wfbœ ai‡bi Lvevi †`qv fvj, G†Z Lvev‡ii iæwP evo‡e
  14. 14. g‡bivL‡Z n‡e: • gvQ, gvsm, wWg, KwjRv A_ev Wvj, ev`vg, exwP BZ¨vw` RvZxq Lvevi cÖwZw`b †L‡Z n‡e hv ˆ`wnK e„w× I ¶q c~i‡b mnvqZv K‡i • Mvp meyR kvK-me&wR, jvjI njy` i‡Oi dj Ges wewfbœ ai‡bi kvK- me&wR I dj (†hgb- KPz kvK, cyuB kvK, jvj kvK, WvUv kvK, wgwó Kzgov, MvRi Ges cvKv Avg, cvKv KvuVvj, cvKv †cu‡c, †jey, †cqviv, AvgjwK, Avgov, Rv¤^yiv BZ¨vw`) G¸‡jvi †h †Kvb GK cÖKvi kvK- me&wR I dj cÖwZw`b Aek¨B †L‡Z n‡e KviY GB me Lvevi †_‡K wewfbœ ai‡bi wfUvwgb cvIqv hvq hv kixi‡K AmyL weïL Gi nvZ †_‡K i¶v K‡i • 1 Kvc `ya A_ev `y‡ai ˆZwiLvevi cÖwZw`b bv n‡jI mßv‡n 3-4 w`b †L‡Z n‡e • Aek¨B Av‡qvwWb hy³ jeb w`‡q me iKg ivbœv Ki‡Z n‡e
  15. 15. Awa‡ekb- 3 Abycywó
  16. 16. Abycywó GesAbycywói Dcv`vb Abycywó: • gyL¨ cywó Dcv`vbmg~n †hgb-kw³`vqK Lv`¨(kK©iv), e„w×KviK Lv`¨ (Avwgl) Ges Abycywó Dcv`vbmg~n †hgb- wfUvwgb Ges LwbR Dcv`vbmg~n G me wb‡qB nq ¯^v¯’¨Ki Lvevi| GLv‡b g¨v‡µv(gyL¨) ej‡Z ÒeoÓ Ges gvB‡µv ej‡ZÒ‡QvUÓ eySv‡bv nq| fvjfv‡e KvR KiviRb¨ Avgv‡`i kix‡i†h mKj Abycywó Dcv`vbmg~n cÖ‡qvRb, GB Awa‡ek‡b †m¸‡jvi cÖwZ `„wócvZ Kiv n‡e| Abycywó Dcv`vbmg~n Avgv‡`i AwZ mvgvb¨ cwigv‡b cÖ‡qvRb, wKš‘ G¸‡jv GZB ¸i“Z¡c~Y© †h wbw`©ó cwigvY MÖnY Kiv bv n‡jGKRb gvbyl Amy¯’ A_ev kvixwiK ev gvbwmK cÖwZeÜx n‡Z cv‡i| mvaviYZ cÖwZw`b 100wgwj Gi†ewk ev Kg n‡j gyL¨ I Aby ejv nq|
  17. 17. AbycywóiDcv`vb: Lv‡`¨ A‡bK ai‡biAbycywó Av‡Q Zvi g‡a¨ ¸iæZ¡c~Y© n‡”Q- • wfUvwgb G • wfUvwgb we (Kg‡c·) • wfUvwgb wm • wfUvwgb wW • AvqiY • Av‡qvwWb • wRsK • K¨vjwmqvg • AviI Ab¨vb¨
  18. 18. wfUvwgb-G,AvqiY, Av‡qvwWb, wR¼ Ges K¨vjwmqvg Gi Drm,AfveRwbZ mgm¨v,cÖwZ‡iva I cÖwZKvi
  19. 19. Av‡qvwWb hy³ je‡Yi e¨envi I msi¶Y, je‡Y Av‡qvwW‡bi gvb wbY©q Av‡qvwWbhy³ je‡Yi e¨enviI msi¶Y: • Av‡qvwWbhy³ jeY ivbœvq Ges Lvev‡i cÖwZw`bB e¨envi Ki‡Zn‡e • jeY †Kbvi mgq Aek¨BAv‡qvwWbhy³ je‡Yi cÖZxKwPý †`‡L wb‡Z n‡e • ¯^vfvweK ivbœvq je‡Yi Av‡qvwWb n«v‡mi cwigvY LyeB Kg| Z‡e ivbœvi †klgyû‡Z© jeY e¨envi Kiv DwPZ| Ab¨_vq AwaK Zv‡c Av‡qvwW‡bi Kvh©KvwiZv bó n‡q †h‡Z cv‡i • evRv‡ii †Lvjv jeY †Kbv DwPZ bv
  20. 20. Contd. • jeY M‡j †M‡j Zv‡Z Av‡qvwWb _v‡K bv • jeY †iv‡` wKsev mu¨vZmu¨v‡Z RvqMv‡Z ivL‡j Av‡qvwW‡bi cwigvb K‡g †h‡Z _v‡K • GRb¨ jeY mZK©Zvi mv‡_ msi¶Y I c¨v‡KU Ki‡Zn‡e Ges je‡Y Av‡qvwW‡bi cwigvY cix¶vK‡i†`L‡Z n‡e • Av‡qvwWbhy³ jeY m~h© iwk¥ †_‡K `~‡i XvKbvhy³ Kuv‡Pi ‡evZj ev cv‡Î msi¶Y Ki‡Zn‡e
  21. 21. je‡Y Av‡qvwW‡bi Dcw¯’wZhvPvB Kivi cix¶v:
  22. 22. •Awa‡ekb- 4 •wK‡kvi-wK‡kvix‡`i cywó
  23. 23. ˆK‡kviKvj I ˆK‡kviKv‡j cywói¸i“Z¡ ‰K‡kviKvj: • ‰kkeKvj†_‡K †hŠe‡b c`vc©‡bi ga¨eZ©xmgq (10-19 eQi)-‡K ˆK‡kviKvjejv nq Ges GB eq‡mi †Q‡j-†g‡q‡`i‡K wK‡kvi-wK‡kvixejv nq| ‰K‡kviKvjRxe‡bi AZ¨šÍ ¸iæZ¡c~Y© G mgq Zv‡`iwewfbœ ai‡Yi kvixwiKI gvbwmK cwieZ©bN‡U, ZvB G mgq Zv‡`icywó Pvwn`vI e„w× cvq| ‡`‡ni myôz I ¯^vfvweK e„w×i R‡b¨ Zv‡`i ¯^v‡¯’¨i we‡kl cwiPh©v KivcÖ‡qvRb| GKB mv‡_ Zv‡`i‡K Lv`¨ I cywó m¤ú‡K© m‡PZb K‡i M‡o †ZvjvI GKvšÍ Ri“ix|
  24. 24. ˆK‡kviKv‡j cywói¸i“Z¡¡: • Ach©vß cywói Kvi‡Y ˆK‡kviKvjxb¯^v‡¯’¨i Dci †bwZevPK cÖfve c‡o hv A‡bK †iv‡Mi Kvib n‡q Øvivq Ges `xN©¯’vqx †iv‡Mi SzuwK e„w× K‡i| †hgb: • Avqi‡Yi Afv‡e ˆK‡kviKvjxbkvixwiKe„w× wejw¤^Z n‡Z cv‡i| we‡kl K‡iwK‡kvix‡`ikvixwiKe„w× I gvwm‡Ki Kvi‡Y kix‡iAvqi‡Yi Pvwn`v †e‡o hvq • AvqiY NvUwZi Kvi‡Y kvixwiKI gvbwmK e„w× e¨vnZ nq, ¯^vfvweK Ávb e„w×i weKvk K‡g hvq Ges cov‡jLvi cÖwZ g‡bv‡hvM A‡bKvs‡k K‡g hvq d‡j ¯‹z‡j hvevi AvMÖn nvwi‡q †d‡j • wK‡kvixAe¯’vq Mf©aviY, (we‡kl K‡i gv hw` Acywó‡Z †fv‡Mb I †eu‡U nb) gv I wkï Df‡qi ¯^v¯’¨ SzuwKi g‡a¨ c‡o hvq
  25. 25. ‰K‡kviKvj: D”PZv, IRbI ˆ`wnK MV‡bicwieZ©b: • D”PZvi †¶‡Î cwieZ©b • ‡gvU D”PZvi 15-20% GB mg‡q nq • †g‡q‡`i PvB‡Z †Q‡j‡`i ˆ`wnKe„w× †`ix‡Zïiæ nq • IR‡bi†¶‡Î cwieZ©b • ‡gvU IR‡bi 25-50% GB mg‡q nq • ˆ`wnKMVbI KvVv‡gvi †¶‡Î cwieZ©b • cÖvq 45% kix‡iiKvVv‡gvi (gvsk‡ckx) Ask we‡klGB mg‡q †hvM nq • Rb¥ †_‡K ˆK‡kviKv‡jig‡a¨, kix‡iinv‡oi MV‡bi 90 fvM m¤úbœ nq • †g‡q‡`i Zzjbvq †Q‡jiv GB mgq Zzjbv g~jK fv‡e †ekx gvsk ‡ckx jvf K‡i
  26. 26. ‰K‡kviKvjxb ‰ewPΨgq Lvev‡ii ¸i“Z¡ • ‰K‡kviKvjxb Lv`¨ˆewPΨ: • ˆK‡kviKv‡jLvevi Ggb n‡Z n‡e †hb †mB Lvevi cwigv‡Y mwVK nq Ges G‡Z Lv‡`¨i 6 wU Dcv`vbB _v‡K • GKB Lvevi †L‡Z fvj jvM‡e bv ZvB gv‡S gv‡S wfbœ wfbœ ai‡Yi Lvevi †`qv fvj G†Z Lvev‡ii iæwP _vK‡e • ˆK‡kv‡i†Q‡j-†g‡qiv †jLvcov I ‡Ljva~jv wb‡q e¨¯Í _v‡K ZvB Zv‡`iN‡i ˆZixKiv cywóKi Lvevi ‡L‡Z w`‡Z n‡e • D‡jL¨ †h, ˆK‡kv‡i†Q‡j-†g‡q‡`ig‡b n‡e †hiv¯Ívi †Lvjv Lvevi, PvbvPzi, AvPvi, gyovjx, PUcwU, wPc&m, AvBmwKªg, ‡KK, †Kvgj cvbxq- Rym, G¨vbvR©x wWªsK BZ¨vw` gyL‡ivPK Lvevi Lvq G¸‡jv‡Z Pwe© I kK©ivi gvÎv †ekx _v‡K hv cieZ©xRxe‡b ¯’zjZv, ü`†ivM Ges Wvqv‡ewU‡mi g‡Zv †iv‡Mi SuzwK evwo‡q †`q
  27. 27. ‰K‡kviKvjxb Acywó cÖwZ‡iv‡aKibxq: • mylg Lvevi LvIqv (Ggb GKwU Lvevi hv kw³`vqK, kixie„w×KviK I †ivM cÖwZ‡ivaK) • Wv³vi ev ¯^v¯’¨Kgx©i civgk©Abyhvqx AvqiY dwjK GwmW (IFA) U¨ve‡jU LvIqv • cÖ‡Z¨K wK‡kvi-wK‡kvix‡KWv³v‡ii civgk©Abyhvqx Qq gvm AšÍi AšÍi K…wgbvkK ewo MÖnY Kiv • Lvevi LvIqvi Av‡M I c‡i mvevb I wbivc` cvwb w`‡q nvZ ‡avqv
  28. 28. ‰K‡kviKvjxb Acywó cÖwZ‡iv‡aKibxq: • ¯^v¯’¨m¤§Z cvqLvbv e¨envi Kiv Ges RyZv ev m¨v‡Ûj c‡o cvqLvbvq hvIqv • gvwm†Ki mgq cwi®‹vi-cwi”Qbœ _vKv| Zv‡`i‡K g‡b ivL‡Z n‡e †h G mgq me ai‡biLvevi LvIqv hvq Ges me ¯^vfvweK KvR Kg© Kiv hvq • †`ix‡Z we‡q • wK‡kvix‡KwU‡Ubvm wUKvi 5wU †WvR m¤ú~b© Kiv
  29. 29. wK‡kvi-wK‡kvixi ‰`wbKbg~bv Lv`¨ ZvwjKv (250 wg:wj:evwUi wnmve) mKv‡jiLvevi mKv‡ji bvmÍv (mKvj11Uv) `ycy‡iiLvevi weKv‡jibvmÍv iv‡ZiLvevi -gvSvix mvB‡Ri 2wU iæwU A_ev 1 evwU fvZ -1 evwU meRx A_ev -1wUwWg -‡h †Kvb †`kx †gxmygxdj -evox‡Z ‰Zix bv¯Ív RvZxq Lvevi -2/3evwU fvZ -1evwU kvK&-mwâ -1evwU Nb Wvj -1 UzKiv gvQ/ gvsm/KwjRv -`ya w`‡q ‰Zix Nb†h †Kvb Lvevi (cv‡qk I `B BZ¨vw`)/ ‡h †Kvb ‡`kx †gxmygx dj/ evox‡Z ‰Zix bv¯Ív RvZxq †h†KvbLvevi| -2/3evwU fvZ -1 evwU kvK&- mwâ -1evwU NbWvj - (hw` m¤¢e nq 1 UzKivgvQ/gvsm) * GQvovI wK‡kvix‡`iˆ`bw›`b Lv`¨ZvwjKvq AvqiY mg„×Lvevi _vKvevÃbxq|wK‡kvixivWv³vi ev ¯^v¯’¨Kgx©icivgk© Abyhvqxmßv‡n 2wUK‡iAvqiY dwjKGwmW U¨ve‡jU Ges Qqgvm AšÍi AšÍi K…wgbvkKewo Lv‡e|
  30. 30. Awa‡ekb - 5 Mf©eZxI cÖm~wZ gwnjv‡`i cywó
  31. 31. cÖvßeq®‹ gwnjviAcywó‡Z †fvMvi cwiYwZ: • ‡ivM cÖwZ‡iva ¶gZv K‡g hvq • Kg©¶gZv K‡g hvq • kvixwiKMVb†QvU nIqvq mšÍvb cÖm‡e RwUjZv I wec` †`Lv †`q • cÖmeKvjxb I cÖme-cieZ©x RwUjZvGes i³¶i‡Yi d‡j gv‡qi g„Zy¨ SuywK †e‡o hvq • Mf©eZxgwnjv Acywó‡Z fzM‡j Kg IRb wb‡q mšÍvb Rb¥v‡bvi Ges beRvZ‡Ki g„Zz¨i SuywK †e‡o hvq
  32. 32. Kg Rb¥ IR‡bi wkïi fqvenZv: • g„Zy¨ SuywK †e‡o hvq • evievi †ivMvµvš— nq • ˆ`wnKI gvbwmK e„w× e¨vnZ nq • Kg©¶gZv K‡g hvq
  33. 33. Mf©Kvjxb hZœ I Mf©eZx gwnjv‡`icywó GescÖm~ZxKvjxbcwiPh©vI cÖm~wZgv‡qi cywó
  34. 34. Mf©eZxgwnjv‡`i IRbcwigv‡cicÖ‡qvRbxqZv Ges KiYxq Mf©Kvjxb mg‡qIRb †bqvi ¸i“Z¡: • Mf©eZxgwnjvi cywói Ae¯’v wbb©q I G e¨vcv‡i mwVK w`K wb‡`©kbv cÖ`v‡bi Rb¨ • Mf©eZxgwnjvi IRb e„w× wbwðZ Kivi Rb¨ • GKwU my¯’ I ¯^vfvweK IR‡bi wkïiRb¥ wbðZ Kivi Rb¨ • Mf©KvjxbI cÖmeKvjxb RwUjZv Kgv‡bvi Rb¨ • gvZ„ I wkï g„Zz¨i nvi Kgv‡bvi Rb¨
  35. 35. Mf©ve¯’vq IRb e„w×i ‡gwWwmb Bbw÷wUD‡Ui mycvwikgvjvmg~n: Mf©avi‡bic~e©eZ©xIRb Ae¯’v ewWgvm Bb‡W· mycvwikK…Z†gvU IRbcvDÛ (†KwR) 2qI 3qUªvBg÷vi (wZbgvm) Gi mgq IRbe„w×i mycvwikmg~n(cvDÛ) {MoIRb(cvDÛ/‡KwR)} Kg IRb 18.5Gi bx‡P 28-40(11-16) 1 (1-1.3) ¯^vfvweKIRb 18.5-24.9 25-35(10-14) 1 (0.8-1) gvÎvwZwi³IRb 25-29.9 15-25(6-10) 0.6(0.5-0.7) ¯’zjKvq (mKj†kÖbx AšÍfy©³) 30Ges Gi Dc‡i 11-20(5-8) 0.5(0.4-0.6) Source: ‡gwWwmb Bbw÷wUDU
  36. 36. Mf©eZxgwnjvi ¯^vfvweK IRb e„w×i Rb¨ hv hv cÖ‡qvRb: • 20 eQi eqm c~Y© nevi Av‡M Mf©aviY bv Kiv • `yB mšÍv‡bi †ewk mšÍvb bv †bqv • wkïieqm 2 eQi c~Y© bv nIqv ch©šÍ cybivq Mf©aviY bv Kiv • wbqwgZ Mf©Kvjxb ¯^v¯’¨†mev (ANC) Ges ¯^v¯’¨Kg©x‡`i civgk© MÖnY Kiv • Mf©ve¯’vq ¯^vfvwe‡Ki †P‡q GKUz †ewk Lv`¨ Ges mylg Lv`¨ MÖnY Kiv| we‡klZcÖvYxR Lvevi (`ya,wWg,KwjRv) Ges Mvp meyR kvK mewR I †gŠmygx †`kx djg~j †ewk LvIqv • Mf©Kvjxbmg‡q, h‡_ó wekªvg †bqv, KóKi cwikªgeR©b Kiv Ges fvix †Kvb wRwbm bv †Zvjv • Mfv©e¯’vq wbqwgZ AvqiY I dwjK GwmW wgwkªZewo I Av‡qvwWbhy³ jeY LvIqv
  37. 37. Mf©ve¯’vq IRb e„w×bv nIqvi KviYmg~n: • wkï I wK‡kvixeq‡m `xN©¯’vqx Acywó‡Z Ges i³¯^íZvq†fvMv • wK‡kvixev Aí eq‡m Mf©aviY Kiv • Nb Nb mšÍvb aviY Kiv • Mf©ve¯’vq Kg Lv`¨ MÖnY I mylg Lv`¨ MÖnY bv Kiv • Mf©Kvjxbmg‡q i³ ¯^íZvq†fvMv • wewfbœ †iv‡Mi msµgY I K…wg‡Z AvµvšÍ nIqv • kvixwiKcwikªg†ewk Kiv I gvbwmK D‡Ø‡M _vKv • Lv`¨ msµvšÍ Kzms¯‹vi I cwiev‡i Amg Lv`¨ e›Ub
  38. 38. Mf©eZxI cÖm~wZgwnjv‡`i mnvqZvq cwiev‡ii Ab¨vb¨ m`m¨‡`i(¯^vgx, kvïox,bb`) KiYxq: • Mf©Kvjxb‡mev MÖn‡bi Rb¨ Mf©eZx gwnjvi mv‡_ †mev †K‡›`ª hvIqv • AvqiY dwjK GwmW LvIqvi Rb¨ Mf©eZx gwnjv‡K g‡b Kwi‡q †`qv • Mf©eZxgwnjv / `y»`vbKvix gv‡K AwZwi³ Lvevi †L‡Z DrmvwnZ Kiv • N‡iiˆ`bw›`b UzwKUvwK Kv‡RMf©eZx gwnjv‡K mvnvh¨ K‡i Zvi Kv‡Ri †evSv Kgv‡bv • nvmcvZv‡j cÖme Kiv‡bvi wel‡q Mf©eZx gwnjv‡KDrmvwnZ Kiv Ges mn‡hvMxZvKiv • nvmcvZv‡j cÖm‡ei Rb¨ hvZvqvZ e¨e¯’vi cÖ¯‘wZ †bqv
  39. 39. Mf©eZxI cÖm~wZgwnjv‡`i mnvqZvq cwiev‡ii Ab¨vb¨ m`m¨‡`i(¯^vgx, kvïox,bb`) KiYxq: • R‡b¥i GK N›Uvi g‡a¨ wkï‡Kgv‡qi `ya LvIqv‡bvi Rb¨ Mf©eZx gwnjv‡KDrmvwnZ Kiv Ges mn‡hvMxZv Kiv • R‡b¥i mv‡_ mv‡_ (GK NÈvig‡a¨)wkï‡K gv‡qi kvj`ya LvIqv‡bv wbwðZ Kiv • gv wkï‡K h‡_ó mgq wb‡q mwVK wbq‡g (position & attachment) `ya LvIqv‡Z cv‡i Zvi Rb¨ `y»`vbKvix gv‡K my‡hvM K‡i †`qv
  40. 40. Awa‡ekb-6 Gi 1g Ask gv‡qi `ya LvIqv‡bv I wkï cywó
  41. 41. kvj `ya, gv‡qi `y‡ai DcKvwiZv,ïaygvÎ gv‡qi `ya LvIqv‡bv kvj `ya: • wkï R‡b¥i cicÖ_g 3-5 w`‡bi g‡a¨ gv‡qi ¯Íb †_‡K njy` i‡Oi Nb AvVv‡jv †h `ya †ei nq Zv‡K kvj`yae‡j| kvj`y‡a cÖPzi cwigv‡Y wfUvwgb-G Ges Ab¨vb¨ wfUvwgb _v‡K hv wkïi †ivM cÖwZ‡iva ¶gZv e„w× K‡i| wkïi R‡b¥i ciciB(1 N›Uvi g‡a¨) wkï‡Kkvj`ya LvIqv‡bv we‡klcÖ‡qvRb| gv‡qi `y‡ai DcKvwiZv: `jxq KvR
  42. 42. ïaygvÎ gv‡qi `ya LvIqv‡bv: • Rb¥ †_‡K c~Y© 6 gvm chšÍ© ‡Kvb wkï‡K ïaygvÎ gv‡qi `ya †`qv, evB‡ii †Kvb Lvevi ev Ggb wK GK ‡dvuUv cvwbI bv †`qv, wkïicywó i¶viRb¨ Gmgq ïaygvÎ gv‡qi `yaB h‡_ó|
  43. 43. gv‡qi `ya †`qvi mgqmwVK cwRkbI G¨vUvP‡g›U: mwVK cwRkb(Ae¯’vb)Gi 4 wU g~j evZv©: • wkïigv_v I kixiGKB jvB‡b _vK‡e • wkïikixigv‡qi mv‡_ wbweofv‡e jvMv‡bv _vK‡e • gv wkïi mg¯Í kixifv‡jvfv‡e a‡i _vK‡e • wkï hLb ¯Í‡bi w`‡K G‡Mv‡e ZLb Zvi bvK †evuUv eivei _vK‡e
  44. 44. Contd. mwVK G¨vUvP‡g›U (ms‡hvM)Gi 4 wU g~jevZv©: • wkïigyL eo K‡inv Kiv _vK‡e • wb‡Pi †VvuU evB‡ii w`‡K Dëv‡bv _vK‡e • wkïi_yZwb gv‡qi স্ত‡b †j‡M _vK‡e • স্ত‡bi Kv‡jv Askwb‡Pi w`‡Ki†P‡q ‡Vuv‡Ui Dc‡ii w`‡K †ekx †`Lv hv‡e
  45. 45. Qwe1: mwVK ms¯’vcb Qwe 2: fzj ms¯’vcb
  46. 46. Qwe 1: mwVK ms¯’vcb Qwe 2: fzj ms¯’vcb
  47. 47. gv‡qi ey‡Ki `ya†M‡j†ei Kiv: wb¤œwjwLZ†¶‡Î gv‡qi `ya †M‡j †eiKivi cÖ‡qvRb: • gv‡qiv hLb evB‡i KvR Ki‡Z hvb • Kg IR‡bi Rb¥ †bqv wkïhviv gv‡qi `ya †U‡b †L‡Z cv‡i bv • gvivZ¥KAmy¯’ wkï hvivgv‡qi `ya †U‡b †L‡Z cv‡i bv • gv‡qi ey‡K `ya R‡g ¯—b dz‡j ‡M‡j • gv‡qi ¯Í†bi †euvUv †d‡U †M‡j ev Nvu n‡j
  48. 48. gv‡qi `ya †M‡j†ei Kivi wbqgvejx: • gv‡qi nvZ mvevb w`‡q fvjfv‡e ay‡Z n‡e • `ya †M‡j ivLvi cvÎwU eo gyLIqvjv GKwU evwU ev Kvcn‡Z n‡e Ges Zv fvjfv‡e cwi¯‹vi K‡i wb‡q gv‡K Avivg`vqK fv‡e em‡Z n‡e • ey‡ov Av½yj ¯Í‡bi Dc‡ii Kv‡jvAs‡k I evKx 4wU Av½yj ¯Í‡bi bx‡P Kv‡jv As‡kAv‡¯Í Av‡¯Í evi evi Pvc w`‡Z n‡e Ges Qvo‡Z n‡e, Gfv‡e evi evi Ki‡Z n‡e • cÖ_‡g `ya bv Avm‡jI c‡i †dvuUvq †dvuUvq `ya †ei n‡q Avm‡e| ¯Í‡bi wewfbœ As‡kNywi‡q Nywi‡q Pvc w`‡q `ya †ei Ki‡Zn‡e| †evuUvq Pvc †`qv DwPZ bq| †evuUvq Pvc w`‡q ev †evuUv †U‡b `ya †ei Kiv hvq bv
  49. 49. Contd. • GK ¯Íb †_‡K Kgc‡¶ 3-5 wgwbU ch©šÍ `ya †ei Kiv †h‡Z cv‡i| †mB ¯Í‡bi `ya hLb Avi †ekx K‡i†ei n‡e bv ZLb Av‡iK ¯Íb †_‡K `ya †ei Ki‡Zn‡e • cÖ_g K‡qKw`b gv‡qi `ya †M‡j †ei Ki‡Z20-30 wgwbU mg‡qi cÖ‡qvRb n‡Z cv‡i
  50. 50. • wPÎ: nvZw`‡q`ya†M‡j†ei Kivic×wZ Kvc/evwUimvnv‡h¨
  51. 51. Mvjv‡bv`ya wkï‡KevwU /Kv‡cimvnv‡h¨ LvIqv‡bv Ges msi¶Y Kivi c×wZ: wkï‡K gv‡qi `ya LvIqv‡bvi mgq wKQz Amyweav I Zvi mgvavb
  52. 52. ¯Íbdz‡j DVv (GbMR©‡g›U): j¶Y cÖwZ‡iva mgvavb  ¯Íbdz‡jD‡V,Dò I jvj‡Pnq, gv ¯—‡b e¨_v I nvjKv R¡i Abyfe K‡ib Ges ¯—‡bi †evuUv ¯—‡bi Kv‡jv As‡kwg‡khvq|  ¯—b k³n‡qhvq  mwVK ms‡hvM Ges Ae¯’vb †g‡b gv‡qi`yaLvIqv‡Zn‡e  wkï‡K R‡b¥i ci hZ ZvovZvwo m¤¢egv‡qi`yaLvIqv‡Zn‡e  wkïi Pvwn`v Abyhvqx gv‡qi `ya w`‡Z n‡e| w`‡b I iv‡Z 24 N›Uvq Kgc‡¶ 8-12 evi LvIqv‡Z n‡e  wkï‡K GK ¯—‡bi `ya LvIqv‡bv †kl n‡j Ab¨ ¯—‡b `yaLvIqv‡Z n‡e  ‡evZ‡j `ya LvIqv‡bv ‡_‡K weiZ _vK‡Z n‡e GgbwK PzlwbI e¨envi Kiv hv‡ebv  dzjv Kgv‡bvi Rb¨ ¯—‡b ch©vqµ‡g VvÛv Ges Mig cvwb‡Z †fRv Kvco w`‡q ‡muK w`‡Zn‡e  ¯—b ‡P‡c wKQy `ya ‡M‡j †ei Ki‡Zn‡e  wkï‡K evievi Ges †ekx¶Y a‡i gv‡qi`yaLvIqv‡Zn‡e  mwVK ms‡hvM Ges Ae¯’vb †g‡bgv‡qi`yaLvIqv‡Zn‡e
  53. 53. ¯Í‡bi ‡euvUvq Nuv ev †d‡U hvIqv: j¶Y cÖwZ‡iva mgvavb  ‡evuUvqe¨_v nq  ¯—‡bi †euvUvq dvUj (Crack) ‡`Lv hvq  KL‡bv KL‡bvi³¶iY n‡Zcv‡i  mwVK ms‡hvM Ges Ae¯’vb Abyhvqxey‡Ki `yaLvIqv‡Zn‡e  ‡Rvi c~e©K wkï‡K ¯—b †_‡K Avjv`vKiv hv‡ebv  G mgq wX‡j-Xvjv †cvkvK cwiavbKi‡Z n‡e  mwVK ms‡hvM I Ae¯’v‡bi welqwU wbwðZKi‡Zn‡e  ‡d‡U hvIqv †euvUvq gv‡qi `ya jvwM‡q evZv‡m ïKv‡Z n‡e
  54. 54. h‡_ócwigv‡Y`ya ‰Zwibv nIqv: j¶Y cÖwZ‡iva mgvavb  wkï hw` KvbœvKvwU K‡i, w`‡b-iv‡Z 6 ev‡ii †ewk cÖ¯ªve bv K‡i, wVK gZ bv Nygvq Ges IRb wVKfv‡e bv ev†o Zvn‡j eyS‡Z n‡e wkï wVK gZ `yacv‡”Qbv  wkï‡KGK¯—‡bi `yaLvIqv‡bv †klK‡ic‡ii ev‡i Ab¨¯—‡bi `yaLvIqv‡Z n‡e  wkï hv‡Z fv‡jvfv‡e gv‡qi `ya Pzl‡Z I Uvb‡Z cv‡i Zv †Lqvj ivL‡Z n‡e  wkï hLbB PvB‡e ZLbB Zv‡K `yaw`‡Zn‡e  wkï‡K †evZj (wdWvi) ev Pzlwb †`qvhv‡ebv  Qq gv‡mi †fZi †Kvb iK‡gi evB‡ii Lvevi Ggb wK GK†duvUv cvwbI †`qv hv‡e bv  `ya †`qvi mgq gv I wkïi Ae¯’vb I ms‡hvM wVK Av‡Q wKbv Zv c©h‡eÿb Ki‡Z n‡e| fzj _vK‡j wVK K‡iw`‡qgv‡K wkwL‡qw`‡Z n‡e  hw` mwVK ms‡hvM I Ae¯’vb wVK _v‡K A_P wkï `ya Kg cv‡”Q- Zvn‡j Wv³v‡ii civg‡k©i Rb¨ †idvi Ki‡Z n‡e  ev‡i ev‡i †ekx mgq wb‡q gv‡qi `ya LvIqv‡Z n‡e G‡Z gv‡qi eyK Lvwj n‡j Av‡iv †ewk cwigv‡Y `ya ˆZwi n‡e ¯¬vBW6.4.4 ¯—‡bi †euvUvmgZjev wfZ‡i†XvKv‡bv:
  55. 55. ¯Í‡bi †euvUv mgZj ev wfZ‡i†XvKv‡bv: j¶Y cÖwZ‡iva mgvavb  ¯—‡bi †euvUv mgZj n‡e ev wfZ‡i †XvKv‡bv _vK‡e  Mf©Kvjxb 3q wZb gvm (3rd trimester) Gi mgq †_‡K ¯—b Massage K‡i ev wbcj †ei Kivi (Nipple evert) c×wZ †bqv †h‡Z cv‡i  gv‡K Avk¦¯Í Ki‡Z n‡e †h wKQz wbqg †g‡b Pj‡j GUv wVK n‡q hv‡e Ges wkï wVKgZ `yacv‡e  gv‡K ej‡Z n‡e wkï ¯—‡bi †euvUv †_‡K bq, †m ¯—‡bi Kv‡jv Ask †_‡K `ya †U‡b †bq| GRb¨ wkï‡K gv‡qi `ya †`qvi mgq gv I wkïi mwVK ms‡hvM Ges Ae¯’vb †g‡b gv‡qi `ya LvIqv‡bv †`wL‡q w`‡Z n‡e  ev‡i ev‡i wkï‡K `ya Pzl‡Z w`‡j †euvUv Av‡¯Í Av‡¯Í Dc‡i D‡V Avvm‡e
  56. 56. wkï‡K gv‡qi `ya †`qvie¨vcv‡i wKQz Kzms¯‹vi/ fzj aviYv, weGgGm †KvW wkï‡K gv‡qi `ya †`qvie¨vcv‡iwKQz Kzms¯‹vi/ fzj aviYv: • gv‡qi cÖ_g `ya hv Nb I njy`vf i‡Oi, †`L‡Z Lvivc jv‡M wkï‡K GUv LvIqv‡j Zvi †c‡Ui AmyL n‡e • ‡Kvb gv Acywó‡Z f~M‡j Zvi wkï ch©vß cwigv‡Y `ya cv‡ebv • ‡Kvb wkïi cvZjvcvqLvbv n‡j gvÕi kvK LvIqv hv‡e bv • wPKb gv‡q‡`i †P‡q †gvUv ev ¯^v¯’¨evb gv‡q‡`i `ya †ewk cwigv‡Y ˆZwinq • MixeI MÖv‡gi gv‡q‡`i `ya Kg ˆZwinq
  57. 57. mgvavb: • gv‡q‡`i ‡evSv‡Z n‡e G¸‡jv fzj aviYv, cÖwZwU gvÕi ey‡K Zvi wkïi Rb¨ ch©vß cwigv†Y `ya _v‡K| ïayGi Rb¨ cÖ‡qvRb wKQz wbqg-Kvbyb †g‡b Pjv Ges gv‡qi Lvev‡ii cÖwZ †Lqvj ivLv|
  58. 58. gv‡qi`y‡ai weKí/‡eª÷wgé mvem&wUwUDU(we Gg Gm) †KvW: • weKíwkï Lv`¨ evRviRvZ Kivi RvZxq I AvšÍR©vwZK bxwZgvjv Abyhvqx †h mKj Kg©KvÛ wbwl× †NvwlZ n‡q‡Q Zvwb¤œiƒc: • gvZ„`y» weKí,wkïLv`¨, evwbwR¨Kfv‡e cª¯‘ZK…ZwkïievowZ Lv`¨ ev e¨env‡ii miÄvgvw`i weÁvcb wjd‡jU, n¨vÛwej ev Abyiƒc †Kvb `wjj weZiY KiviRb¨ ‡Kvb ¯^v¯’¨ †mev †K‡›`ª ev Jla weµq †K›`ª e¨envi Kiv • Dcnvi mvgMÖx, wWmKvD›U Kzcb, g~j¨n«vm ev webvg~‡j¨ †Kvb mvgMÖx cÖ`vb ev cª`v‡bi Rb¨ †Kvbiƒc cÖ¯Íve Kiv • ‡Kvb †mwgbvi, Kbdv‡iÝ, wm‡¤úvwRqvg, Kg©kvjv, cÖwkÿY, ‰eÁvwbK mfv, wkÿv mdi ev AvšÍR©vwZK m‡¤§j‡b †hvM`vbmn D”P wkÿvq ev †Kvb M‡elbvg~jK Kg©Kv‡Û AskMÖn‡Yi Rb¨ †Kvb e¨w³ ev m¦v¯’¨ †mev‡K‡›`ªi †Kvb Kg©KZ©v-Kg©Pvixev ¯^v¯’Kg©x‡K †Kvbiƒc Avw_©K ev Ab¨ †Kvb myweav cÖ`vb Kiv
  59. 59. Contd. • ‡Kvb ¯^v¯’¨Kg©x ev Zvi cwiev‡ii †Kvb m`m¨‡K Avw_©K cÖ‡jvfb ev Ab¨ †Kvb Dcnvi cÖ`vb Kiv • wkï‡`iRb¨ †Kvb ai‡bicÖwZ‡hvwMZv ev †Kvb Abyôv‡bi Av‡qvRb ev Ab¨ †Kvbiƒc mnvqZv cÖ`vb Kiv • gvZ„`y» weKí,wkï Lv`¨ I evwbwR¨Kfv‡e cª¯‘ZK…Zwkïi evowZ Lv`¨,gvZ„`y» A‡c¶v DËg ev gvZ„`y†»i mgK¶ Giƒc avibv †`qv ev wek¦vm m„wói D‡Ïk¨ †Kvb Kg©m~Px cwiPvjbv Kiv • ‡Kvb Mf©eZx gwnjv, gvZ„`y»`vbKvix ev wkïigv‡q‡`i mv‡_ mivmwi †hvMv‡hvM Kiv ev †Kvb ai‡bicÖ‡jvfb g~jK cÖ¯Íve Kiv • ‡h ‡Kvb c‡Y¨i we‡klZ:wkï c‡Y¨i (‡hgb, Wvqcvi, Kvco, ‡Ljbv, cyZzj, cÖmvab mvgMÖx, Uq‡jwUªR BZ¨vw`)cÖPv‡ii mgq gvZ„`y» weKí,wkï Lv`¨ ev Zve¨env‡ii miÄvgvw`i cÖPvi m¤úwK©Z †Kvb ai‡biwjd‡jU ev Dcnvi mvgMÖx weZiY Kiv • `y‡hv©‡Mi mgq †Kvb cÖwZôvb ev AvkÖq‡K‡›`ª weZiY Kiv
  60. 60. • Awa‡ekb 6 Gi 2q Ask • wkïi evowZ Lvevi (6-23 gvm ) I wkïi ¯^vfvweK Lvevi (24-59 gvm)
  61. 61. evowZLvevi wK, mwVKmg‡qevowZLvevi ïiæ Kivi ¸iæZ¡ Ges evowZLvev‡ii DcKvwiZv evowZLvevi: • wkïieqm 6 gvm c~Y© nevi ci gv‡qi `y‡ai cvkvcvwk Zv‡K ‡h Lvevi LvIqv‡bv nq Zv‡K ÒevowZLveviÓ e‡j| wkïi6 gvm eq‡mi ci †_‡K Zvi mwVKfv‡e †e‡o IVvi Rb¨ ïay gvÎ gv‡qi `ya h‡_ó bq Kv‡RB ZLb gv‡qi `y†ai cvkvcvwk evowZ Lvevi †`qv cÖ‡qvRb| ZvB6 gvm c~Y© nIqvi ci ‡_‡K gv‡qi `y†ai cvkvcvwk cÖwZw`b wkïieqm Abyhvqx mwVK cwigv‡b cywóKi evowZ Lvevi LvIqv‡bv ïiæ Ki‡Zn‡e|
  62. 62. mwVK mg‡q evowZLvevi ïiæ Kivi ¸iæZ¡: • 6 gvm (c~Y©) nIqvi Av‡M wkï‡KevowZ Lvevi w`‡j wkï gv‡qi `ya LvIqv Kwg‡q ‡`q d‡j †m mwVK cywó cvq bv, ‡mRb¨ 6 gv‡mi ci †_‡K evowZ Lvevi ïiæ Ki‡Znq • wkïikvixwiKe„w×i mv‡_ mv‡_ hZUzKz kw³/cywói cª‡qvRb nq Zv ïaygvÎ gv‡qi `y‡a cvIqv hvq| Z‡e 6 gv‡mi ci †_‡K gv‡qi `ya wkïiRb¨ h‡_ó bq †mRb¨ Zv‡K 6 gv‡mi ci †_‡K evowZ Lvevi ïiæ Ki‡Z nq • 6 gvm (c~Y©) n‡j wkïevowZ Lvevi mn‡R †L‡Z, wPev‡Z I wMj‡Z wk‡L Ges Lvevi nRg Ki‡Z cv‡i| †mRb¨ evowZ Lvevi ïiæKiviGUvB mwVK eqm • 6 gvm (c~Y©) nIqvi mv‡_ mv‡_ evowZ Lvevi LvIqv‡bvi Af¨vm bv Ki‡jc‡i wkï †L‡Z wkL‡e bv, Zvi mwVK Pvwn`v c~iY n‡e bv d‡j †m Acywó‡Z fzM‡e
  63. 63. evowZLvev‡ii DcKvwiZv: • gv‡qi `y‡ai cvkvcvwk evowZ Lvevi †`qv ïiæ Ki‡jwkïicÖ‡qvRbxq cywó wbwðZ nq • wkïikvixwiKI gvbwmK e„w× `ªæZnq Ges eyw× fvj nq • mwVK evowZ Lvevi †L‡j wkïi AmyL Kg nq Ges mvavib AmyL †_‡K ZvovZvwo †m‡i D‡V
  64. 64. evowZLvevi LvIqv‡bvi mycvwikgvjv • wkï‡`i evowZLveviLvIqv‡bviwKQz mycvwikgvjv: • wewfbœai‡bi Lvevi-wewfbœ ai‡bicvwievwiK Lvevi †_‡K wkïiRb¨ evowZ Lvevi ˆZwiKi‡Z n‡e| NvUwZ c~i‡bi Rb¨ wfUvwgb ÒGÓ Ges ÒAvqibÓ mg„× Lvevi LvIqv‡Z n‡e • Lvev‡iicwigvb- Qq gv‡mi ci†_‡K wkï Lye ZvovZvwo ev‡o| ZvBZvi Lvev‡ii cwigvbI ‡mfv‡e evov‡Z n‡e • Lvev‡iiNbZ¡- wkï eo n‡q DVvi mv‡_ mv‡_ Zvi Pvwn`v Abyhvqx Lvev‡ii NbZ¡ evov‡Z n‡e • Lvev‡iievi- wkïi‡e‡o DVvi mv‡_ mv‡_ ‡h‡nZz Zvi Lvev‡ii cwigvbI evo‡e †mRb¨ †m LveviUzKz Zv‡K mwVK wbq‡g ev‡i ev‡i w`‡Z n‡e
  65. 65. Contd. • wkïi Bkviv ey‡S (Responsive Feeding) LvIqv‡bv-wkï‡K †Rvi bv K‡i †m hv‡Z Lvev‡i Drmvn I Avb›` cvq,‡mfv‡e LvIqv‡Z n‡e • mwVK/¯^v¯’¨m¤§Zfv‡eevowZLveviˆZwi I msi¶Y- cwi¯‹vi cwiQbœZvi mv‡_ evowZ Lvevi ˆZwiI Lvevi ‡X‡K msi¶Y Ki‡Zn‡e • Amy¯’Zvi mg‡q I Amy¯’Zvi c‡i LvIqv‡bv-Amy¯’Zvi mg‡q gv‡qi `ya LvIqv evwo‡q w`‡Z n‡e I Amy¯’Zvi c‡i AwZwi³ evowZ Lvevi w`‡Z n‡e
  66. 66. wewfbœai‡bi Lvevi wewfbœ Lvev‡ii ZvwjKv†_‡K Kgc‡¶ 4wU wfbœ ai‡biLvevi wb‡q wkïi Rb¨ cÖwZ w`‡bi Lvevi ˆZwiKi‡Zn‡e Ges GiwfZi w`‡b AšÍZc‡¶t 1wU cÖvYxR Lvevi _vK‡Z n‡e- • km¨RvZxq Lv`¨-‡hgb fvZ,iæwU, wPov, Avjy, mywR • wewfbœ ai‡biWvjRvZxq Lvevi I ev`vg • `ya Ges `ya w`‡q ˆZwi Lvevi • cªvYxR Lvevi- gvQ, gvsm, gyiMxiKwjRv • wWg • Mvp meyR I jvjkvK;GQvovI njy` I Kgjv i‡Oi me&wR I dj, †hgb- wgwó Kzgov, MvRi, cvKv Avg, cvKv †cu‡c • Ab¨vb¨ kvK me&wR I dj †hgb: jvD, wSsMv, dzjKwc, Kjv,‡cqviv BZ¨vw`
  67. 67. Lvev‡ii cwigvY- eqm cwigvb KZevi w`‡bi †gvU Lvevi 6-8 gvm eqm (c~Y©) 250 wg: wj: (1 †cvqv) evwUi Avav (1/ 2) evwU 2-3evi gv‡qi ey‡Ki `ya (wkï hZevi PvB‡e) + cvwievwiK Lvevi (cÖvbxR Lvevi †hgb: wWg, gyiwM, gvsm, KwjRv, gvQ + kK©iv RvZxqLv`¨ †hgb: Pvj, Mg, AvjyBZ¨vw` + wewfbœ ai‡bi WvjRvZxq Lvevi I ev`vg †hgb: gmy‡ii Wvj, gy‡Mi Wvj, wm‡gi wewP, ev`vg BZ¨vw` + iwOb kvK-mewR I dj+Ab¨vb¨kvK-me&wRI dj) 9-11 gvm eqm (c~Y©) 250 wg: wj: (1 †cvqv) evwUi Avav (1/ 2) evwU 3 evi + 1-2 evi N‡i ‰Zix cywóKi bv¯Ív cvwievwiK Lvevi (cÖvbxR Lvevi †hgb: wWg, gyiwM, gvsm, KwjRv, gvQ + kK©iv RvZxq Lv`¨ †hgb: Pvj, Mg, Avjy BZ¨vw` + wewfbœ ai‡bi WvjRvZxqLvevi I ev`vg †hgb: gmy‡ii Wvj, gy‡Mi Wvj, wm‡gi wewP, ev`vg BZ¨vw` + iwOb kvK-mewR I dj+Ab¨vb¨ kvK-me&wR I dj) Ges 1-2 evi cywóKi bv¯Ív 12-23 gvm eqm (c~Y©) 250 wg: wj: (1 †cvqv) evwUi GK (1)evwU 3 evi + 1-2 evi N‡i ‰Zix cywóKi bv¯Ív cvwievwiK Lvevi (cÖvbxR Lvevi †hgb: wWg, gyiwM, gvsm, KwjRv, gvQ + kK©iv RvZxq Lv`¨ †hgb: Pvj, Mg, Avjy BZ¨vw` + wewfbœ ai‡bi WvjRvZxq Lvevi I ev`vg †hgb: gmy‡ii Wvj, gy‡Mi Wvj, wm‡gi wewP, ev`vg BZ¨vw` + iwOb kvK-me&wR I dj + Ab¨vb¨ kvK-me&wR I dj) Ges 1-2 evi cywóKi bv¯Ív
  68. 68. • Lvev‡iiNbZ¡- wkïeo n‡q DVvi mv‡_ mv‡_ Zvi Pvwn`v Abyhvqx Lvev‡ii NbZ¡ evov‡Z n‡e| • evowZ Lvev‡i NbZ¡ hZ†ewk mwVK nq Zvi cywógvbI ZZ†ewk nq| gvLv‡bv LveviwU Ggb n‡e †hb ZvPvgP/nvZ w`‡q Zzj‡j mn‡R c‡o bv hvq (Qwe ) • wkïieqm evovi mv‡_ mv‡_ Lvev‡ii NbZ¡I evov‡j Zvi h_vh_ cywó wbwðZ nq • ZijLvev‡ii †P‡q Nb Lvev‡i †ewk cwigv‡b kw³, Avwgl I Ab¨vb¨ cywó _v‡K, hv wkï‡K†e‡o DV‡Z mvnvh¨ K‡i
  69. 69. Contd. • wkïi†cU †QvU nIqvi Kvi‡Y Zviv†ewk cwigv‡b Lvevi †L‡Z cv‡i bv,(†m Rb¨ Lvevi †ewk cvZjv †hgb:cvZjv Wvj, Rym, mywR ev Ab¨ †Kvb Zijn‡j wkïi†cU f‡i , †m Avi †L‡Z Pvq bv) ZvB Lvevi Nb n‡jAí cwigvY Lvev‡iB wkï h‡_ó cywó cvq • Lvev‡ii NbZ¡ mwVK bv n‡j Lvev‡ii cywógvb Kg nq hv wkïi†e‡o DVv‡K evavMÖ¯’ K‡i • wkïicywó mwVKfv‡e wbwðZ bv n‡jZvi AmyL-wemyL Gi SuywK †e‡o hvq| G‡Z Zvi cwiev‡ii wPwKrmv I Ily‡ai LiP †e‡o hvq
  70. 70. Lvev‡ii evi: • wkïi‡e‡o DVvi mv‡_ mv‡_ Zvi Lvev‡ii cwigvbI evo‡e Ges LveviUzKz Zv‡K mwVK wbq‡g ev‡i ev‡i w`‡Z n‡e| • wkïieqm Abyhvqx mwVK wbq‡g ev‡i ev‡i Lvevi w`‡j wkïi mwVK cywó wbwðZ nq, wkïmwVKfv‡e †e‡o I‡V Ges wkï Lvevi †L‡Z AvMÖnx nq • wkïicvK¯’jx/‡cU †h‡nZy †QvU †m Rb¨ Zv‡K AíAí K‡i Lvevi I bv¯Ív ev‡i ev‡i w`‡Z n‡e
  71. 71. • wkïi Bkviv ey‡S (Responsive Feeding) LvIqv‡bv:wkï‡K †Rvi bv K‡i †m hv‡Z Lvev‡i Drmvn I Avb›` cvq,‡mfv‡e LvIqv‡Z n‡e| • Aíeqmx wkï‡Kgy‡L Zz‡j LvIqv‡Z n‡e hviv GKUz eo Zv‡`i wb‡R wb‡R †L‡Z mvnvh¨ Ki‡Zn‡e • Zv‡`iB”Qv I cQ›` Abyhvqx cywóKi Lvevi w`‡Z n‡e| wkï‡K bvbv ai‡bi Lvevi mgq wb‡q ax‡i ax‡i Drmvn w`‡q wkï‡K LvIqv‡Z n‡e, †Rvi K‡i LvIqv‡bv DwPZ bq • wkï‡K K¬všÍev NygšÍ Ae¯’vq LvIqv‡bv DwPZ bq
  72. 72. Contd. • LvIqvi mgq wkï‡Kwewfbœ ai‡bi †Ljbv w`‡q e¨¯Í ivLv hv‡e bv, G‡Z †m LvIqvq Drmvn nvwi‡q †dj‡e • LvIqvi mgq gv wkïi mvgbv mvgwb em‡e Ges Zv‡K †L‡Z †kLv‡e I Drmvn †`‡e, G‡Z wkï wb‡R †L‡Z AvMÖnx n‡e, Lvevi wPb‡Z wkL‡e, wewfbœ ai‡biLvevi ‡m mwVK cwigv‡b ‡L‡Z cvi‡e • Zviwb‡R wb‡R LvIqvi Af¨m M‡o DV‡e, G‡Z gv‡qi Kv‡Ri Pvc K‡g hv‡e
  73. 73. • mwVK/¯^v¯’¨m¤§Zfv‡e evowZLveviˆZwi I msi¶Y: ¯^v¯’¨m¤§Z Ges h_vh_fv‡e evowZ Lvevi ˆZwiI msi¶Y Ki‡Zn‡e| • ¯^v¯’¨m¤§Zfv‡e evowZ Lvevi ˆZwiI msi¶Y Ki‡j,†c‡Ui AmyL, RwÛm, wbD‡gvwbqv, R¡i I Ab¨vb¨ AmyL †_‡K i¶vcvIqv hvq • ¯^v¯’¨m¤§Zfv‡e evowZ Lvevi ˆZwiI msi¶Y bv Kivid‡j wkïAmy¯’ nq Ges Zvi ¶zav K‡g hvq d‡j Acywó‡Z ‡fv‡M Ges GK mgq gvivI †h‡Z cv‡i • Lvevi ˆZwi I wkï‡K Lvevi LvIqv‡bvi Av‡M mvevb w`‡q nvZ ay‡q wb‡Z n‡e • Lvevi ˆZwiiciciBwkï‡K Lvevi LvIqv‡Z n‡e| Lvevi ˆZwiI LvIqv‡bvi mgq cwi®‹vi evmb-cÎ e¨envi Ki‡Z n‡e
  74. 74. • Amy¯’Zvi mg‡q I Amy¯’Zvi c‡i LvIqv‡bv:wkïi Amy¯’Zvi mgq I Amy¯’Zvi ci mwVKfv‡e LvIqv‡j wkï ZvovZvwo AmyL †_‡K †m‡i D‡V, Acywó †_‡K i¶vcvq, cieZ©x‡Z AmyL-wemyL Kg nq| • wkïiAmy¯’Zvi mgq k³ Lvevi Kwg‡q †`qv DwPZ bq, Zv‡K Nb Nb gv‡qi `ya w`‡Z n‡e hv‡Z †m †ewk cwigv‡b `ya cvq Ges Zvi cQ‡›`i wewfbœ ai‡bi evowZ Lvevi AíAí K‡i ev‡i ev‡i w`‡Z n‡e • wkïiAmy¯’Zvi cicy‡e©i IRb wd‡i bv cvIqv ch©šÍ Zv‡K Kgc‡ÿ 2 mßvn (14w`b) AwZwi³ cwigv‡b evowZ Lvevi w`‡Z n‡e • wkï †m‡i DV‡j Zvi IRb e„w× †c‡q‡Q wKbv ZvwbwðZ Ki‡Zn‡e • Amy¯’Zvi mg‡q mwVK wbq‡g gv‡qi `ya I evowZ Lvevi bv LvIqv‡j †ivM cÖwZ‡iva ¶gZv K‡g wM‡q †ivM Av‡iv †e‡o hvq Ges ev‡i ev‡i AmyL nIqvi m¤¢vebv _v‡K • kvixwiK I gvbwmK e„w× evuavMÖ¯’ nq
  75. 75. 24-59 gvm eqmxwkï‡`i Lvev‡ii ZvwjKv 24-59 gvm (c~Y©) eqmx wkï‡`i cÖwZw`bLvev‡ii aib I cwigvb- (250 wg: wj: (1 †cvqv) evwU wnmv‡e) mKv‡jiLvevi mKv‡ji bv¯Zv `ycy‡ii Lvevi weKv‡jibv¯Zv iv†ZiLvevi gvSvixmvB‡Ri 1wUiæwU+ 1wUwWg A_evme&wR ‡h†Kvb †gŠmygx ‡`kxdjA_ev evwo‡Z ‰Zix bv¯Zv fvZ(1evwU) + kvK/me&wR( 1evwU)+2 †UwejPvgP NbWvj+1 UzKiv gvQ/gvsm `yaw`‡qNbKiv‡h †KvbLvevi(cv‡qk, `BBZ¨vw`) A_ev‡h †Kvb†gŠmygx ‡`kxdjA_ev evwo‡Z‰Zix bv¯Zv fvZ(1evwU)+ kvK/meRx (1 evwU)+2†Uwej PvgPNbWvj+ hw`m¤¢enq 1UzKivgvQ /gvsm
  76. 76. wkï‡K LvIqv‡bvi e¨vcv‡i wKQz Kzms¯‹vi/avibv: • wkïiAmyL n‡j Zvi LvIqv eÜ K‡i†`qv • wkïiWvqwiqv n‡j gv‡qi `ya Lv‡”Q Ggb wkïigv kvK-me&wR LvIqv eÜ K‡i †`qv • Wvqwiqv n‡j¯^vfvweK Lvevi ‡L‡Z bv †`qv • `vgx Lvev‡i cywó †ekx • 6 gv‡mi Av‡M wkï‡K evowZ Lvevi LvIqv‡bv fvj • evowZ Lvev‡i wkïi Wvqwiqv/ cvZjvcvqLvbv nq
  77. 77. wkïi †L‡Z bv PvIqvi KviY I Zvi mgvavb KviY mgvavb gv wkï‡K †Rvi K‡i ZvZovZvwo LvIqv‡Z Pvb ZvovZvwo Kivi Rb¨ wkï‡K †Rvi Kiv hv‡e bv, Zvi gy‡L hZUzKz Lvevi Av‡Q †mUv †Mjv ch©šÍ ˆah©¨a‡i A‡c¶v Ki‡Z n‡e| cwiev‡ii Ab¨vb¨ m`m¨‡`i‡K gvÕi Kv‡Rmvnvh¨ Ki‡Zej‡Z n‡e LvIqv‡bvimgqgvwkï‡KDrmvn†`bbv LvIqvi mgq wkï‡K Drmvn w`‡Z n‡e, cÖksmv Ki‡Z n‡e †h Zv‡K †hUv †L‡Z †`qv n‡q‡Q †mUv †L‡Z Lye fv‡jv-gRv| GQvovI Zv‡K bvbvbfv‡e Drmvn w`‡Z n‡e †hgb, GB †Zv fv‡jv †Q‡‡j wK my›`i Lv‡”Q,†`LGBmwâUvwKmy›`i, GBdjUv KZiwObBZ¨vw` c~Y© Qq gv‡mi ci †_‡K cÖ_g cÖ_g wkky‡K Lvevi w`‡j gyL †_‡K †m Lvevi †ei K‡i †`q, gv ev cwiev‡ii Ab¨ m`m¨ g‡b K‡ibwkï†L‡ZPv‡”Qbv ïiæ‡ZB LvIqv ‡kLvi mgq wkï Ggb Ki‡Z cv‡i, GUv ¯^vfvweK| ‡mRb¨ cÖ_g Kqgvm ˆah©¨a‡i†ek mgqwb‡qwkky‡KLvIqv‡Z n‡e wkïi Lvevi k³ n‡j †m Zv wPev‡Z ev wMj‡Zcv‡ibv| ‡mRb¨ïiæ‡Z wkï‡KPUKv‡bvbig Lveviw`‡Z n‡e
  78. 78. KviY mgvavb wkïi KLbIKLbILvev†ii ¯^v` cQ›`nqbv Lvev‡i gkjv †gkv‡bvi Av‡M wkïi Rb¨ 1 UzKiv gvQ/gvsm Zz‡j ivL‡Z n‡e| Svj A_ev jeb †ewk n‡j Wvj ev cvwb‡Z ay‡q wb‡Z n‡e| †Lqvj Ki‡Z n‡e †Kvb LveviwU wkï †ekx gRv K‡i Lvq, †mB Abyhvqx LveviwU ˆZix Ki‡Zn‡e wkïAmy¯’_vK‡j †L‡ZPvqbv wkï †hUv †L‡Z cQ›` Ki‡e Zvi Rb¨ †mUv ivbœv Ki‡Z n‡e, †mUv †hb big nq Ges ev‡i ev‡i Aí Aí K‡i Zv‡K †L‡Z w`‡Z n‡e| hLb †m †m‡i DV‡e ZLb Zv‡K wewfbœ ai‡bi Lvevi, GKUz †ewk K‡i ev‡i ev‡i w`‡Z n‡e wkï hLb K¬všÍ _v‡K ev hLb wkïi Nyg Nyg fve_v‡K ZLb†m†L‡ZPvqbv Gmg‡qwkï‡KLvIqv‡bvhv‡e bv,Zvi †R‡MDVviRb¨A‡c¶vKi‡Zn‡e wkïi Lvevi †ek cvZjv K‡i ˆZwi Kiv n‡j Zv‡Z wkïi †cUf‡ihvq ‡m Rb¨ wkïi Lvevi cvZjv K‡i ˆZwi Kiv DwPZ bq| Zv‡K PUKv‡bv Lvevi ev Zvi eqmAbyhvqxNb‡Z¡iLvevi w`‡Z n‡e
  79. 79. KviY mgvavb wkïi †cU †ek †QvU, wkï hw` Lvevi Av‡M wPcm&, Rym, cvwb ev Ab¨ †Kvb Zij Lvevi w`‡q †cU fwi‡q †d‡j Zvn‡j Zvi Rb¨ ˆZixKiv N‡ii Lvevi†L‡Z Pvq bv ‡m Rb¨ Lvevi Av‡M Gme wRwbl w`‡q wkïi †cU fwZ© Kiv DwPZ bq| Lvevi Ges bv¯Ívi gvSLv‡b 2 N›Uv weiwZ _vKv fv‡jv, †mRb¨ cieZ©x Lvevi †`qvi g‡a¨ AšÍZ:2-3 N›Uv †`ix Kiv DwPZ A‡bK¸‡jv Lvevi hw` GKmv‡_ †gkv‡bv nq Zvn‡j A‡bK mgq wkï †L‡Z Pvqbv A‡bK¸‡jv Lvevi GK mv‡_ †gkv‡bv hv‡e bv| wewfbœ ai‡bi Lvevi Avjv`vfv‡e PUKv‡Z n‡e †hgb, wgwwó RvZxq Lvevi jebv³ Lvev‡ii mv‡_ †gkv‡bv hv‡e bv| Avevi meyR kvK-mwâ gvQevwW‡gimv‡_ bv †gkv‡bvfv‡jv wkï hLb wb‡R †L‡Z Pvq ZLb hw` Zv‡K wb‡R †L‡Z †`qv bv nq wkï hLb wb‡R †L‡Z Pvq ZLb Zv‡K wb‡R †L‡Z w`‡Z n‡e| ‡m‡¶‡Î wkï Zvi nvZ w`‡q ai‡Z cv‡i Ggb Lvevi w`‡Z n‡e, Z‡e Lvev‡iiAv‡M mvevbw`‡q wkïinvZ ay‡q w`‡Zn‡e wkï hLb †Ljbv ev eÜz‡`i wb‡q e¨¯Í _v‡K ZLb †m †L‡Z Pvq bv Lvevi mgq wkï‡K †Ljbv w`‡q e¨¯Í ivLv hv‡ebv ev eÜz‡`i mv‡_ †Ljvi mgq Zv‡K LvIqv‡bv DwPZ bq| wkï LvIqv †_‡K Ag‡bvh‡vMx nq Ggb mewKQzmwi‡q†dj‡Z n‡e wkïiLvevigRvbv n‡j †m†L‡Z Pvq bv LvIqv‡bvi Av‡M gv‡K Zvi Lvevi †P‡L †`L‡Z n‡e †h LveviwU gRv wKbv GKB Lvevi cÖwZ w`b cÖwZevi Lvevi mgq w`‡j (†hgb- mywRI wLPyox)wkï†L‡Z Pvqbv eo‡`i gZ wkï‡`iI wewfbœ ai‡bi, wewfbœ ¯^v‡`i, wewfbœ i‡OiI wewfbœNb‡Z¡i Lveviw`‡Zn‡e|
  80. 80. •Awa‡ekb-7 •Acywó
  81. 81. AcywóGes AcywóicÖKvi†f` Acywó: • cª‡qvR‡bi Zzjbvq AwZwi³ wKsev Achv©ß Lv`¨ MÖn‡Yi d‡j †`‡n †h Ae¯’vi m„wó nq Zv‡K Acywó e‡j| • Avgv‡`i †`‡k mvavibZ: Lv`¨ MÖn‡bi Achv©ßZviKvi‡Y Acywó †`Lv †`q|Acywó GKwU eo ai‡Yi¯^v¯’¨ I mvgvwRK mgm¨v| wek¦ Ry‡o cÖwZeQi cÖvq wÎk j¶wkïcuvP eQi eqm nIqvi Av‡MB gviv hvq Ges Gi cÖvq 45 kZvskBAcywói Kvi‡Y N‡U|
  82. 82. • AcywóicÖKvi†f`:Acywó‡KcÖavbZ`yBfv‡M fvMKivnq|h_v: • AwZcywó/¯’zjZv(Over-nutrition):cÖ‡qvR‡biZzjbvq†ewkLvevi MÖnYA_ev/ GesKg kvixwiKcwikÖ‡giKvi‡YAwZcywóimgm¨v †`Lv†`q| AwZcywófwel¨‡Zwkï‡`iü`‡ivM,D”Pi³Pvc,Wvqv‡ewUmGes Ab¨vb¨ †ivMmn g„Zz¨iSuywKevovq| • Kgcywó(Under-nutrition): Acvh©ßLv`¨MÖnbA_ev/Ges NbNb msµg‡bi(‡ivM)Kvi‡YKg cywóimgm¨v †`Lv†`q| GAe¯’vqmeiK‡gicywó Dcv`v‡biNvUwZ †`Lv†`q|cÖ‡qvRbxqLv`¨Dcv`vb†hgb;&Avwgl,kK©iv, †Zj,wfUvwgbevLv`¨cÖvYILwbRjeYBZ¨vw` Dcv`v‡biNvUwZiKvi‡Y cywónxbZvij¶Y†`Lv†`q| – I‡qmwUs/K©„kKvq:D”PZvAbycv‡ZIRbKg – ÷vw›Us/Le©vK…wZ:eqmAbycv‡ZD”PZvKg – AvÛviI‡qU/KgIRb:eqmAbycv‡ZIRbKg • gvB‡µvwbDwUª‡q›UevAbycywóiAfve
  83. 83. Acywói cÖavb KviYmg~n: • `vwi`ªZv • Lv‡`¨i Ach©vßZv • Kg Rb¥ IRb • Nb Nb Amy¯’Zv we‡kl K‡i msµvgK †iv‡M †fvMv • gv‡qi cywó Áv‡bi I wkïi h_v_© cwiPh©vi Afve
  84. 84. gvivZ¥K ZxeªAcywó‡Z AvµvšÍ wkïi DcmM mgyn©: • ‡ivMv, cvZjv kixi,†`‡L g‡b n‡e ey‡ov n‡q †M‡Q • ey‡Ki cvuR‡ii nvo I kix‡iiAb¨vb¨ nvo mn‡RB †Pv‡L ‡`Lv hvq • nv‡Zi Pvgov¸‡jv Sz‡j c‡o • †cQb †_‡K Nvo I cvR‡ii nvo ¯úó †Pv‡L c‡o Ges kix‡iibx‡Pi As‡ki Pvgov fvR fvR n‡q Sz‡j c‡o • wLUwL‡U †gRvR nq • wkïwU G‡Kev‡i PzcPvc, `ye©j GgbwK Kvbœv KiviI kw³ †bB • Kv‡iv Kv‡iv `yB cvA_ev kixi dz‡j hvq| `yB cv‡qi cvZvq Pvc w`‡j Av½yj ‡W‡e hvq ( evBj¨vUvivj wcwUs BwWgv)
  85. 85. evBj¨vUvivj wcwUsBwWgv †ivMx‡`iwb‡Pi j¶Y¸‡jv _vK‡Z cv‡i: • gyb ‡dm ev Puv‡`i g‡Zv †MvjgyL • Wvg©v‡Uvwmm: Pvgovq mv`v-Kv‡jv †Qvc‡Qvc `vM (gvivZ¥K †¶‡Î) • `ye©j • LvIqvi iæwP bó nIqv • Pz‡ji is cwieZ©b • Lye mn‡R wei³ nq Ges Kv‡Q †M‡j †Ku‡` †d‡j
  86. 86. Acywói djvdj: • wkïikvixwiKe„w× I gvbwmK weKvk e¨vnZ nq • †ivM cÖwZ‡iva ¶gZv K‡g hvq, d‡j †`n `ªæZ†ivMvµvšÍ nq • Acywó‡Z AvµvšÍ wkï‡`ifwel¨‡Z Kg©ÿgZv K‡g hvq • Acywó `xN©‡gqv`x n‡j gvivZœK Amy¯’Zv ev g„Zz¨ n‡Z cv‡I Acywó‡ZAvµvšÍwkï‡`i cªwZ¸iæZ¡ cÖ`v‡bi cÖ‡qvRbxqZv: • gvivZ¥K ZxeªAcywó ev m¨vg -Gi Kvi‡Y g„Zz¨ nvi A‡bK †ewk (cÖvq 9 MzY), G Kvi‡Y G welqwUi w`‡K mK‡jiB evowZ bRi w`‡Z n‡e hv‡Z gvivZ¥K ZxeªAcyó wkïi g„Zz¨SyuwK Kwg‡q Avbv m¤¢e nq • gvSvix I gvivZ¥K Acywó‡Z AvµvšÍ wkï‡KwPwýZ K‡i cÖvYNvZx Ae¯’vq †cŠQv‡bi Av‡MB wPwKrmvi e¨ve¯’v Kiv
  87. 87. Acywói Pµ Ges Gi cÖwZ‡iva/cÖwZKv‡ii Dcvqmg~n Acywói Pµ
  88. 88. Acywói cÖwZ‡iva/cÖwZKv‡ii Dcvqmg~n wK‡kvixi cywó: • 18 eQ†ii Av†M we†q bv †`qv • †`wi†Z ev”Pv †bqv • cywóKi Lvevi LvIqv • 'AvqiY dwjK GwmW' U¨ve‡jU LvIqv Mf©eZx I `y»`vbKvix gv‡qi cywó: • Mf©eZximwVK ‡mev • cywóKi Lvevi LvIqv • wekªvg †bqv • 'AvqiY dwjK GwmW' U¨ve‡jU LvIqv
  89. 89. Acywói cÖwZ‡iva/cÖwZKv‡ii Dcvqmg~n wkïi cywó: • R‡b¥i mv‡_ mv‡_ (1 N›Uvi g‡a¨) wkky‡K ïaygvÎ gv‡qi `ya ‡`qv • R‡b¥i ci †_‡K c~Y© 6 gvm ch©bÍ wkky‡K kyaygvÎ gv‡qi `ya ‡`qv • wkïieqm 6 gvm c~Y© n‡j 181Zg w`b †_‡K cvwievwiKevowZ Lvevi LvIqv‡bv ïiæ Kiv • wkï‡K 6 gvm †_‡K 2 eQi ch©šÍ cvwievwiK evowZ Lvev‡ii cvkvcvwk gv‡qi `ya LvIqv‡bv Aek¨BPvwj‡q hvIqv
  90. 90. Acywói cÖwZ‡iva/cÖwZKv‡ii Dcvqmg~n Amy¯’ wkï‡K LvIqv‡bv: • Gmgq Nb Nb gv‡qi `ya w`‡Z n‡e hv‡Z †m†ewk cwigv‡Y `ya cvq • wkïiAmy¯’Zvi mgq Aí AíLvevi ev‡i ev‡i w`‡Z n‡e • Zv‡K cvwievwiK Lvevi I Zvi cQ‡›`i Lvevi w`‡Z n‡e • wkïiAmy¯’Zvi cihLb Zvi ¶yav †e‡o hv‡e ZLb 14 w`b ch©šÍ Zvi evowZ Lvev‡ii cwigvY evov‡Z n‡e| Zv‡K wewfbœ ai‡Yi AwZwi³ Lvevi w`‡Z n‡e gvSvix I gvivZ¥K Acywó‡Z AvµvšÍwkïi Rb¨Kibxq: • gvSvix I gvivZ¥K Acywó‡Z AvµvšÍ wkï‡KwbKUeZx© ¯^v¯’¨ †K‡›`ª †cÖiY Ki‡Zn‡e
  91. 91. •Awa‡ekb 8 •wkï'i cywói Ae¯’v wba©viY Ges ‡MÖv_ gwbUwis I cÖ‡gvkb
  92. 92. wkïi cywóAe¯’v wba©viY: • wkïiicywó Ae¯’v wba©viY Kivig~j welq njmwVK kvixwiK cwigvcmg~n (Anthropometry)| cÖv_wgK ch©v‡q A‡bK wkïiv Acywó‡Z f~M‡jI Zv‡`i †Kvb jÿb( wK¬wbK¨vjwPý) †`L‡Z cvIqv hvq bv, †h Kvi‡Y gvivZ¥K ch©v‡q ‡cuŠQv‡bvi c~‡©eB Avgv‡`i mgq gZ Acywó mbv³ K‡i Zv‡`iwPwKrmvi Rb¨ †idvi Kiv c&ª‡qvRb|
  93. 93. mvwe©Kcywói Ae¯’v wbY©‡qi cš’v: : • cywóRwic(Nutrition Survey): †hgb-RvZxqchv©‡qcywó Rwic • cywó Ae¯’vi chv©qµwgK bxwi¶Y( Nutrition Surveillance):wbw`ó© Rb‡Mvwôi cywóMZ Ae¯’vi myPK mgy‡ni cwieZ©b Ges †h welq¸‡jv Øviv cÖfvweZ nh Zv avivevwnKfv‡e cÖKvk Kiv ev Zz‡j aiv • wkïi e„w×cwiex¶Y (Growth Monitoring): †hgb- wkïi e„w× cwiex¶Y (GMP) • wkïi cywóiAe¯’vhvPvBKiY (Nutrition Screening): m¦v¯’¨Kgx©MY evox evox wM‡qev wewfbœ ¯^v¯’¨‡K‡›`ª gyqvK cwigvc I BwWgv hvPvB Ki‡Yigva¨‡g wkï‡`icywói Ae¯’v wbY©q K‡ib
  94. 94. cywó Ae¯’vwba©vi‡Yic×wZ¸‡jv nj: • kvixwiK(Anthropometry) cwigv‡ci gva¨‡g • Wv³vix jÿY mg~n (Clinical) ch©‡e¶‡Yi gva¨‡g • Lv`¨ MÖnY (Dietery Diversity ) g~j¨vq‡bi gva¨‡g • ˆRe-ivmvqwbK (Bio-Chemical) cix¶vigva¨‡g cyywó Ae¯’vwba©vi‡Y mev©waKe¨eüZc×wZnj kvixwiK cwigvc| †Kbbv, • G c×wZwU AZ¨šÍmnR, †Kvb cÖKvi KvUv-‡Qovi cÖ‡qvRb nq bv • G c×wZ‡Z A‡c¶vK…Z ¯^í`¶‡jvK Ges mnRjf¨ hš¿vw` w`‡q cywó Ae¯’v wbiƒcY Kiv hvq • G c×wZ‡Z mwVK I mywbw©`ó cywó Ae¯’v wbiƒcb Kiv hvq • G c×wZ‡Z mKj gvÎvi Acywói Ae¯’v mwVKfv‡e wbiƒcb Kiv hvq
  95. 95. kvixwiK (Anthropometry) cwigvcmg~n: • ga¨evûi cwiwai (gyqvK) cwigvc • IRb cwigvc • D”PZv cwigvc kvixwiK (Anthropometry) cwigv‡c e¨eüZmiÄvgvw`: • gyqvK †Uc • IRb gvcvi hš¿ • mëvi †¯‹j • BDwb‡¯‹j • ev_iæg †¯‹j • j¤^v/D”PZv cwigvcK †evW© • ¯^v¯’¨ I cywó KvW©
  96. 96. wkïi cywóAe¯’v wba©vi‡Yi cwigvcK: 5 eQ‡ii Kg eqmx wkï‡`icywó Ae¯’v wba©vi‡Yi cwigvcK¸†jv n‡jv - • eq‡mi Zzjbvq IRb (Weight for Age):hw` wkïiIRb eq‡mi Zzjbvq Kg nq Zv‡K Kg IRb (Underweight) ejvnq • eq‡mi Zzjbvq D”PZv (Height for Age):hw` wkïiD”PZv eq‡mi Zzjbvq Kg nq Zv‡K Le©Kvq /‡e‡U' (Stunted) ejv nq • D”PZvi Zzjbvq IRb (Weight for Height): hw` wkïiIRb D”PZvi Zzjbvq Kg nq Zv‡K ¶xYKvq (Wasted) ejv nq| mvaviYZ nvmcvZv‡j Kiv nq • hw` 6-59 gvm eqmx wkïiga¨evûi cwiwa(Mid Upper Arm Circumference)<12.5 ‡mwg nq
  97. 97. wkïi kvixwiK e„w×ej‡Z wKeySvq: • wkkyieqm evovi mv‡_ mv‡_ Zvi IRb I D”PZv e„w× cvIqv‡K wkïi e„w× ejv nq| wkï hw` ch©vß Lv`¨ cvq, †ivM bv _v‡K, cÖ‡qvRbxq ¯^v¯’¨‡mev I wUKv cvq Ges hZœgq cwi‡ek cvq, Zvn‡j wkï ¯^vfvweK fv‡e †e‡o D‡V| ‡hfv‡e wkïi e„w×nq: eqm cÖwZ gv‡m Mo IRb e„w× Rb¥ n‡Z 6 gvm 600 -800 Mªvg 7 - 12 gvm 300 -400 MÖvg 13 - 24 gvm 150 -200 MÖvg
  98. 98. ‡MÖv_ gwbUwis I cÖ‡gvkb • ‡MÖv_ gwbUwis I cÖ‡gvkb: wkïiIRb wbqwgZ cwigvc Kiv, wkïi ¯^v¯’¨ I cywó Kv‡W©i Q‡K †iLv AvuKv, IR‡bi cwieZ©bj¶¨Kiv Ges †m Abyhvqx gv‡K civgk© ‡`qv I e¨e¯’v †bqv‡K †MÖv_ gwbUwis I cÖ‡gvkb e‡j| wkïi Achv©ß e„w×, e„w× bv nIqv ev IRb K‡g hvIqvi cÖ_g j¶Y ‡`Lv hvIqv gvÎ mwVK c`‡¶‡ci gva¨‡g h_vh_ e„w× wdwi‡q Avbv †MÖv_ gwbUwis I cÖ‡gvkb Gi j¶¨| • ‡MÖv_gwbUwis I cÖ‡gvkb KLb ïi“ Kiv DwPZ: • wkïi R‡b¥i cici Rb¥Kvjxb IRb wb‡q IRb cwiex¶Y ïiæ Kiv DwPZ| wkïi `yB ermi eqm ch©šÍ gv‡m 1 evi GB IRb cwiex¶Y Kiv nq|
  99. 99. wkï e„w×i gvBj djK : wkïi e„w× wVKgZ n‡”Q wKbv Zv †`Lvi Rb¨ Avgiv wbqwgZ wkïi e„w× cwigvc Kwi| GB e„w× cwigv‡c wewfbœ c×wZ e¨envi Kiv n‡q _v‡K| †hgb- 1.Lvwj ‡Pv‡L ch©‡e¶‡Yi gva¨‡g • mvnvh¨ Qvovem‡Z cv‡i 3.8-9.2 (M‡o 6) gvm • nvZ I nvuUy w`‡q nvgv¸wo w`‡Z cv‡i 5.2-13.5 (M‡o 8.5) gvm • mvnvh¨ wb‡qnvuU‡Z cv‡i5.9-13.7 (M‡o 9.2) gvm • GKv GKv nvuU‡Z cv‡i 8.2-17.6 (M‡o 12.1) gvm 2.kvixwiK cwigv‡ci gva¨‡g • wkïi e„w× cwiex¶‡Yi me‡P‡q mnR kvixwiKcwigvcmg~n nj wkïi IRb I D”PZv cwigvc • wkï e„w×i me‡P‡q mnR cwigvcK n‡jv eqm Abycv‡Z wkïi IRb e„w× cwigvc
  100. 100. IRb ‡bqvi avcmg~n: • wkïieqm wba©viY • mwVKfv‡e wkïi IRb †bqv Gbs¯^v¯’¨ I cywó Kv‡W©mwVKfv‡e IRb emv‡bv • wkïiIRb ‡iLvi MwZ e¨vL¨v KivGes wkïwVKgZ evo‡Q wKbv Zv eyS‡Z cviv • gv‡qi mv‡_ wkïi e„w×, weKvk I cieZx©c`‡¶c wb‡q Av‡jvPbv Kiv
  101. 101. • wkïieqm wba©viY: • wkïigv evevi KvQ †_‡KmwVK R‡b¥iZvwiL ‡R‡b ‡bIqv| B wc AvB KvW© †`‡LmwVK Rb¥ZvwiL msMÖn Kiv|gv evev mwVKfv‡e ej‡Zbv cvi‡j B‡f›U K¨v‡jÛv‡ii mvnv‡h¨ mwVK eqm wbb©q Kiv| • mwVKfv‡ewkïiIRb †bqv: • IRb †bqvi Rb¨ wewfbœai‡bi IRb hš¿ e¨enviKiv nq| mwVKfv‡ewkïiIRb wb‡Z n‡j ‡¯‹jwU mwVK ¯’v‡b ivL‡Z n‡e Ges †¯‹jwU‡Z wiwWs ‡bqvi cÖwZwU avc AbymiY K‡i IRb gvc‡Zn‡e|
  102. 102. • ¯^v¯’¨I cywóKv‡W© IRbemv‡bv - • Rvbyqvix 2012- iæwebvi IRb wQj 4.5 †KwR| GB IRb emv‡bvi Rb¨ Rvbyqvix 2012- Gi Kjvg †ei K‡i Ges Kjvg a‡i Av½yj 4.5 †KwRi Ni ch©šÍ wb‡q †h‡Z n‡e Ges H ey`ey‡` †cw݇ji `vM w`‡q f‡i †dj‡Z n‡e| GLb Av‡Mi gv‡m Kv‡W© ‡h ey`ey` f‡i †djv n‡qwQj Zvi mv‡_ ‡iLv Gu‡K GB ey`ey` †hvM Ki‡Z n‡e| GB †iLv‡K wkïi IRb-‡iLv e‡j| • 2012 mv‡ji †deªyqvix gv‡m iæwebvi IRb wQj 5.1 †KwR| GLb Zvi IRb 5 †KwR Ges Gi Dc‡i 500 MÖvg `v‡Mi gv‡S| GB Ask 4wU †QvU ey`ey` w`‡q fvM Kiv Av‡Q| GB cÖwZwU ey`ey` 100 MÖvg aiv nq| G †¶‡Î 5 wK‡jvMÖv‡gi ci cÖ_g mgZj †iLvi Dci ‡h ey`ey` cvIqv hv‡e †mLv‡b 5.1 wK‡jvMÖvg ai‡Z n‡e| †deªæqvix 2012- Gi Kjvg AbymiY K‡i Avcbvi Av½yj GB we›`y‡Z wb‡q †cwÝj w`‡q ey`ey`wU c~iY Ki‡Zn‡e| GLb Av‡Mi gv‡mi c~iY Kiv ey`ey‡`i mv‡_ GB ey`ey` †iLv w`‡q †hvM Ki‡Z n‡e|
  103. 103. Contd. • 2012 mv‡ji gvP© gv‡m iæwebvi IRb wQj 5.8 †KwR| GLb wkïi IRb 5.5 †KwR Ges 6 †KwRi g‡a¨co‡e| Avcbvi Av½yj gvP© 2012- Gi Kjvg eivei Dc‡i wb‡q Ges 5.8 †KwRi N‡i ey`ey‡` `vM emv‡Z n‡e| GB N‡ii ey`ey` c~iY Ki‡Zn‡e| Av‡Mi gv‡mi ey`ey‡`i mv‡_ †iLv w`‡q GB ey`ey` †hvM Ki‡Zn‡e|
  104. 104. • wkïi IRb †iLv MwZ e¨vL¨vKiv: • gv‡m gv‡m ¯^v¯’¨ I cywóKv‡W© emv‡bv IR‡bi †dvuUv †hvM K‡i ‡h ‡iLv cvIqv hvq, †mUvB wkïi IRb †iLv| GB †iLvwU DaŸ©gywL, mgZj ev wb¤œgywL n‡Z cv‡i| cÖwZ gv‡m wkïiIRb e„w×i ai‡bi Dci wbf©i K‡i Zvi IRb †iLvi MwZ DaŸ©gywL, mgZj A_ev wb¤œgywL n‡e| IRb-†iLv e‡j ‡`‡e wkïwUi kvixwiKe„w× ¯^vfvweK wK bv| • gv‡qi mv‡_ wkïi e„w×,weKvk IcieZx© c`‡¶cwb‡qAv‡jvPbv Kiv: • IRb‡iLv we‡kølY K‡i ¯^v¯’¨Kg©x wkïi¯^v¯’¨ i¶v ev DbœwZ Kivi Rb¨ wK Kiv DwPr †m wel‡q gv‡K aviYv w`‡Z cvi‡e| Acywói mgm¨v _vK‡jm¤ú~iK Lvevi LvIqv‡bv I evowZ h‡Zœi Rb¨ ¯^v¯’¨Kg©x gv‡K civgk© †`q| wkïi †Kvb Amy¯’Zv _vK‡jZv‡K Wv³v‡ii wbKU cvVv‡Z n‡e|
  105. 105. gv‡qi mv‡_wkïi e„w×,weKvk I cieZx© c`‡¶c wb‡qAv‡jvPbv Kiv: • IRb‡iLv we‡kølY K‡i ¯^v¯’¨Kg©x wkïi¯^v¯’¨ i¶v ev DbœwZ Kivi Rb¨ wK Kiv DwPr †m wel‡q gv‡K aviYv w`‡Z cvi‡e| Acywói mgm¨v _vK‡j m¤ú~iK Lvevi LvIqv‡bv I evowZ h‡Zœi Rb¨ ¯^v¯’¨Kg©x gv‡K civgk© †`q| wkïi†Kvb Amy¯’Zv _vK‡j Zv‡K Wv³v‡ii wbKU cvVv‡Z n‡e|
  106. 106. kvixwiK (gyqvK, IRb, BwWgv I D”PZv ) cwigv‡ci avcmg~n wkïi gyqvK (MUAC) cwigv‡ci avcmg~n wbgœiƒc:
  107. 107. BDwb‡¯‹†jIRb†bqvi wbqgvejx: – IRb cwigv‡ci †¯‹jwU Qvqvhy³ ¯’v‡b (N‡ii wfZ‡i, Rvbvjvi cv‡k ev cwi¯‹vi Av‡jv Av‡Q Ggb ¯’v‡b), mgZj Ges k³ gvwU‡Z emvb| hw` cwigvcK‡¯‹‡ji cv bv _v‡K, Z‡eIRb cwigv‡ci mgq †¯‹jwUi bx‡P Kv‡ViˆZix ó¨vÛ e¨envi Kiæb – ‡¯‹jwU ÒAbÓ KiæbGes Ò0.0 kg” Display ‡Z bv Avmv ch©šÍ A‡c¶v Kiæb – IRb †bqvi Av‡M wkï/ gv‡qi RyZv, m¨v‡Ûj, Uzwc, fvix Rvgv-Kvco, Mnbv-MvwU BZ¨vw` Mv‡q _vK‡j Lyj‡Z Aby‡iva Kiæb – †¯‹‡j 0.0 wiwWs _vKv Ae¯’vq mvnvh¨Kvix‡K/gv‡K †¯‹‡ji Dci †mvRv n‡q `uvov‡Z ejyb • †¯‹jwUi wVK gvSLv‡b (cv‡qi Qvc wPwýZ ¯’v‡b) wkï/gv‡K †mvRv n‡q `vuov‡Z Ges kvšÍ _vK‡Z Aby‡iva Kiæb
  108. 108. Contd. – gv‡K †¯‹‡ji Dci `vuov‡bv Ae¯’vq †mvjvi †¯‹jwU GK †m‡K‡Ûi Kg mgq a‡i †X‡K ivLyb| Gi ciciBwWm‡cø‡Z gv‡qi †Kv‡j ev”Pvi Qwe mn 0.0 †`Lv hv‡e (gv‡qi †Kv‡j ev”Pvi Qwe mn 0.0 †`Lv †M‡j eyS‡Z n‡e †h †¯‹jwU e¨env‡ii Rb¨ Dc‡hvMx n‡q‡Q) – GBevi gv †¯‹j †_‡K †b‡g `vuov‡eb Ges `yB †m‡K‡Ûi Kg mg‡qi g‡a¨ wWm‡cø‡Z ev”Pvmn gv‡qi Qwei cvkvcvwk wZbwU WU (---)Avm‡e – ZLb gv wkï‡K†Kv‡jwb‡q †¯‹‡ji Dci `uvov‡eb Ges Aímg‡qi ga¨B wWm‡cø‡Z wkïiIRb cvIqv hv‡e Ges wkïiGB IRb LvZvq wjL‡Z n‡e
  109. 109. Contd. – mvnvh¨Kvixi wbKU nB‡Zev”Pv‡K gv‡qi †Kv‡j wdwi‡q †`qvi ci Avevi wWm‡cø‡Z wkïmn gv‡qi Qwei cvkvcvwk (0.0) Avm‡e • GB fv‡e mvnvh¨Kvix (wK‡kvix ev gv) †¯‹‡ji Dci `uvov‡bv Ae¯’vq ch©vqµ‡g GKwU K‡i ev”Pv mvg‡bi w`‡K †Kv‡j wb‡eb Ges wWm‡cø †`‡L IRb Rvb‡eb| (g‡b ivL‡Z n‡e †h mvnvh¨Kvix hw` Ab¨ ev”Pv †bIqvi Rb¨ †¯‹j †_‡K †b‡g Av‡mb Zvn‡j wWm‡cø‡Z Avevi gv‡qi †Kv‡j ev”Pvmn wZb WU (---)†`Lv hv‡e)
  110. 110. BDwb‡¯‹†j†¯‹‡jwkïi IRb cwigvc
  111. 111. ˆ`N¨© I D”PZv cwigvc: • ‰`N©¨ I D”PZv cwigvc Kiv nq wkï‡`ieqm Abyhvqx| †¯‹jwU‡K gvwU‡Z Avbyf~wgK Ae¯’vq †i‡L wkï‡K †ev‡W©i Dci wPr K‡i ïB‡q ˆ`N©¨Ges †¯‹‡j `vuov‡bv Ae¯’vq wkï‡`iD”PZv cwigvc Kiv nq| – `yÕeQ‡ii Kgeqmx wkï‡`i ‰`N©¨ cwigvcKivnq|
  112. 112. `yÕeQ‡ii†ekx wKš‘ 5 eQ‡iiKgeqmxwkï‡`i D”PZv cwigvc Kivnq|
  113. 113. BwWgvi Dcw¯’wZ cwigv‡cic`‡¶c¸‡jv wbgœiƒc: • BwWgviDcw¯’wZwbY©qKiviRb¨Dfqcv‡qicvZvqwZb†m‡K‡Ûi(¸b‡Z n‡e1001,1002,1003)Rb¨e„×v½ywji¯^vfvweKPvccÖ‡qvMKi‡Znq,hw` Dfqcv‡qicvZvqAMfxiM‡Z©im„wónq,Zvn‡jeyS‡Zn‡ewkïwUiBwWgv i‡q‡Q| • ‡bvU: • BwWgvAek¨B e„×v½ywjiPvcw`‡qcix¶vKi‡Zn‡e,ïay†Pv‡L†`‡LBwWgv ejvhv‡ebv • GK cv ‡dvjv_vK‡jZvwe‡ePbvq†bqvhv‡ebv|
  114. 114. cywó Ae¯’v wba©viY wb‡gœv³eqm Abyhvqx‡g‡q‡`iIRbPv‡U©igva¨‡g wkï‡`iIcywóiAe¯’v wbY©qKivhvq–
  115. 115. wb‡gœv³eqmAbyhvqx‡Q‡j‡`iIRbPv‡U©i gva¨‡g wkï‡`i cywóiAe¯’v wbY©qKivhvq –
  116. 116. wb‡gœv³ eqmAbyhvqx‡g‡q‡`iD”PZv Pv‡U©i gva¨‡g wkï‡`i cywóiAe¯’v wbY©qKiv hvq–
  117. 117. wb‡gœv³ eqmAbyhvqx‡Q‡j‡`iD”PZv Pv‡U©i gva¨‡gwkï‡`i cywóiAe¯’v wbY©qKiv hvq–
  118. 118. •Awa‡ekb 9 •Lv`¨ wbivcËv, Lvev‡ii ¸bMZgvb Ges wbivc` Lvevi
  119. 119. Lv`¨wbivcËv wK,Lv`¨wbivcËvi ¯Í¤ • Lv`¨wbivcËv: • cÖwZwUgvby‡li my¯’ I ¯^vfvweK Rxeb hvÎvi Rb¨ chv©ß, wbivc` I cywóKi Lv‡`¨i mve©¶wbK cÖvc¨Zv‡K Lv`¨ wbivcËve‡j| mnR fvlvq ejv hvq, Lv`¨ RbM‡bi Rb¨ mnRjf¨ I mnRcÖvc¨ n‡e Ges Zv‡`i µq ¶gZvi g‡a¨ _vK‡e| • Lv`¨wbivcËvi g~j wZbwU¯Í¤¢: • Lv‡`¨imnRjf¨Zv: cÖwZwbqZ ch©vßLvev‡ii mnRjf¨Zv • Lv‡`¨icÖvc¨Zv: cywó m¤§Z Avnv‡ii Rb¨ mwVK Lv`¨ µ‡qi ch©vß mvg_©¨/m¤ú` _vKv • Lv‡`¨ie¨envi: cywó Ges h‡Zœi †gŠwjK Ávb Kv‡R jvwM‡q Lv‡`¨i h_v_© e¨envi Ges cvkvcvwk ch©vßcvwb I cq:wb¯‹vk‡bi e¨e¯’v _vKv
  120. 120. wbivc` Lvevi I wbivc`cvwb Ges Gi cÖ‡qvRbxqZv • wbivc` Lvevi: • wbivc` Lvevi n‡jv †mB Lvevi hv mwVK wbq‡g, cwi¯‹vi I wbivc`fv‡e msMªn, weÁvbm¤§Z Dcv‡q cÖwµqvRvZ, msi¶b Kiv nq Ges Lv‡`¨ †ivMRxevbyi Dcw¯’wZi SzuwK Kg _v‡K| Drcv`b †_‡K ïiæ K‡i Avnvi Kiv ch©šÍ cÖ‡Z¨K av‡c Lv`¨ wbivc` I cwi¯‹vi ivLv DwPZ | • wbivc` cvwb: • wbivc` cvwb n‡jv eY©nxb, MÜnxb, ¯^v`nxb †mB cvwb hvi ms¯ú‡k© Avgv‡`i ¶wZ nq bv A_©vr †h cvwb‡Z ¶wZKviK`ªe¨,wewfbœ ivmvqwbK c`v_©,kw³kvjx GwmW I ¶vi BZ¨vw` †ivM m„wóKvix (‡hgb - K¨vÝvi) Ges wewfbœ ai‡bi RxevYyi (†hgb:e¨vK‡Uwiqv, fvBivm) cwigvb ¯^xK„Z¶wZKviKgvÎv †_‡K Kg _v‡K|
  121. 121. wbivc` Lvevi I wbivc`cvwbi cÖ‡qvRbxqZv: • evwm-cuPv, dv½vm cov ev`yM©Ühy³ Lvevi LvIqv hv‡e bv|Zv†L‡j †c‡Ui I Hepatitis A & EAmyL †`Lv w`‡Zcv‡i • gvwQcovLvevi †L‡j Wvqwiqv, Avgvkq,K‡jiv, UvBd‡qW BZ¨vw` †ivM n‡Zcv‡i • wewfbœ Lvevi evwgwó RvZxq Lvevi G is ‡gkv‡bvhv‡ebv| wewfbœ Lvev‡i †h me is e¨enviKivnq ‡m¸‡jv hw` ivmvqwbK evKvc‡oiis nqZvn‡j K¨vÝviI wKWbx †ivM †`Lv w`‡Zcv‡i • U‡g‡Uv,gUiïuwU, cvKvKjv,gvQI wewfbœ Lv`¨‡Km‡ZRevcvKvKivi Rb¨ †hme ivmvqwbKc`v_© e¨envi Kivnq (‡hgbdigvwjb, Kve©vBW) Zv†_‡K K¨vÝvimneûiKg †ivM n‡Zcv‡i • wbivc` cvwbe¨env‡i‡c‡Ui cxovevWvqwiqv, RwÛm, Avgvkq, UvBd‡qW, Pg©‡ivM BZ¨vw` cvwbevwnZ †ivM msµgY n‡ebv • †hmg¯Í Lv`¨ ivbœvK‡i LvIqv nqbv (†hgbt mvjv`, mewR) †m¸‡jv wbivc` cvwb‡Z wVKgZ†avqvbvn‡j Zvi gva¨‡gGes `~wlZ cvwb, gvwUA_ev Av½y‡ji gva¨‡g K…wgi wWg gyLc‡_ A‡š¿ cÖ‡ekK‡i
  122. 122. wbivc` Lvevi I cvwbwbwðZKivi Rb¨ KiYxq welqmg~n: • cwi”QbœZv eRvq ivLyb: • nvZ cwi®‹vi K‡i cÖwZevi Lvevi ‰Zix Icwi‡ekb Kiæb • wkï‡`i gjg~Î cwi®‹vi Kivi ci nvZ cwi¯‹vi Kiæb • cï cvwL cwiPhv©i ci nvZ cwi¯‹vi Kiæb • LvIqvi Av‡M Ges wkï‡KLvIqv‡bvi Av‡M fvjfv‡e nvZ ay‡q wbb • LvIqv‡bvi Rb¨ e¨eüZ evwU I PvgP/e¨env‡ii Av‡M mvevb I cvwb w`‡q cwi¯‹vi K‡i ay‡q wbb • Lvevi Rb¨ e¨eüZ evmbÑcÎ ay‡q wbb • ivbœNi I Lv`¨ †cvKvgvKo gy³ Kiæb • memgq UvUKv Lvevi wbev©Pb Kiæb • nuvwP ev Kvwk†`qvi mgq bvK I gyL †X‡K ivLyb
  123. 123. Contd. • KuvPv Ges ivbœv Kiv Lv`¨Avjv`v ivLyb: • ivbœv Kiv Lvevi †_‡K KvuPv gvQ, gvsm, mewR Avjv`v ivLyb Lvevi KvUvi Rb¨ cwi¯‹vi Qywi/ewU e¨envi Kiæb • XvKbv hy³ cv‡Î ivbœv KivLveviivLyb • wbivc` LveviIcvwb wbwðZKivi Rb¨KiYxq welqmg~n: • fvjfv‡e wm×K‡i ivbœv Ki“b: • gvsm, wWg fvj K‡i wm× K‡i ivbœv Kiæb • cybivq Mig Kivi mgq fv‡jvfv‡e Mig Kiæb| m¤¢e n‡j fvj K‡i dzwU‡q wbb • `ya fv‡jvfv‡e dzwU‡q cvb Kiæb
  124. 124. Contd. • wbivc` ZvcgvÎvq msi¶Y Ki“b: • ivbœvKiv Lvevi N‡ii ZvcgvÎvq 2 N›Uvi †ekx bv ivLv • wiwd«Rv‡iUi _vK‡jI j¤^v mgq Lv`¨ msi¶Y bv Kiv • wkï‡`i Lvevi UvUKv nIqv evÂbxq Ges ivbœvi ci msi¶b Kiv DwPZ bq
  125. 125. Contd. • wbivc` cvwb e¨envi Ki“b: • ivbœv I Lvevi †ejvq memgq wbivc` cvwb e¨envi Kiæb • cvwb cvb Kivi c~‡e© dzwU‡q †bqv DwPZ| hw` m¤¢e bv nq Zvn‡j weøwPs cvDWvi, wdUwKwi, cvwb weï×Kib ewo e¨envi K‡i Rxevbygy³ Kiæb Ges cwi®‹vi cv‡Î ivL‡Z ejyb • cyKzi wKsev b`xi cvwb cvb bv Kiv • hw` KvuPv †L‡Z Pvb Zvn‡j dj I kvK wbivc` cvwb‡Z fv‡jvfv‡e ay‡q wbb • wbivc` cvwb w`‡q me&wR I dj g~j KvUvi c~‡e© Kgc‡¶ 30 wgwbU 1 Pv PvgP Lvevi jeY w`‡q wfwR‡q ivL‡j, kvK-mewR I dj g~‡j Aew¯’Z ivmvqwbK c`v‡_©i ¶wZKicÖfve eûjvs‡k K‡g hvq • cÖwµqvRvZ Lvevi/ c¨v‡KURvZ †gqv` (Expiry date) cvin‡j Lv‡eb bv
  126. 126. Lv`¨ I cvwbevwnZ †ivMGes Lv`¨ I cvwbevwnZ †iv‡Mi msµgY†_‡K euvPvi Dcvq • Lv`¨I cvwbevwnZ†ivM: • cvZjvcvqLvbv • K‡jiv • Avgvkq • UvBd‡qW • Lv‡`¨ welwµqv • RwÛm/†ncvUvBwUm • ‡cvwjI gvBjvBwUm
  127. 127. Lv`¨ I cvwbevwnZ †iv‡Mi msµgY†_‡K euvPvi Dcvq: • evwm-cuPvI †LvjvLvevi LvIqvhv‡ebv| ivbœv Kiv LveviMig Ae¯’v‡ZB‡L‡Z n‡e|VvÛv n‡jLveviAvevi MigK‡i‡L‡Z n‡e • cvwb cÖ‡qvR‡b dzwU‡qwbivc`Ki‡Z n‡e|cvwb Kgc‡¶ 10wg: dzwU‡qcvb Ki‡Z n‡e • KuvPv dj,me&wRwbivc`cvwb w`‡qfvjfv‡eay‡q†L‡Z n‡e • Lvevi cwi¯‹vi ¯’v‡bI †X‡K ivL‡Z n‡e • LvIqvmn M„n¯’vwjimKjcwi¯‹viI cwi”QbœZvi Kv‡R wbivc` cvwb e¨enviKi‡Z n‡e
  128. 128. Lv`¨ I cvwbevwnZ †iv‡Mi msµgY†_‡KeuvPvi Dcvq: • ‡hLv‡b †mLv‡b gj Z¨vMKiv hv‡e bv Ges ev”Pv‡`i wbw`©ó RvqMvq cvqLvbv Kivi Af¨vm Ki‡Zn‡e • cvqLvbvi ci I Lvevi Av‡M mvevb w`‡q mwVK wbq‡g `yB nvZ cwi¯‹vi K‡i ay‡Z n‡e • ¯^v¯’¨m¤§Z cvqLvbv e¨envi Ki‡Zn‡e • m¨v‡Ûj c‡i cvqLvbvq †h‡Z n‡e • evwoi AveR©bv wbw`©ó RvqMvq cuy‡Z †dj‡Z n‡e A_ev cywo‡q †dj‡Z n‡e • M„ncvwjZ cï cvwLi gj g~Î wbw`©ó ¯’v‡b †dj‡Z n‡e
  129. 129. ¯^v¯’¨ m¤§Zfv‡eLvevi ˆZix KivGes cwi¯‹vi I ¯^v¯’¨ m¤§Zfv‡eLvevi msi¶Y • Mí
  130. 130. nvZ †avqvi ¸i“Z¡ Ges KLb KLb Aek¨B nvZ ay‡Z n‡e • nvZ†avqvi ¸i“Z¡: • Lv`¨mvgMÖx Icvwb msµwgZ nIqv Gov‡Z • gy‡L Rxevby cÖ‡ekKiv‡bv Gov‡Z • Wvqwiqv msµgb Gov‡Z • K…wgi msµgb Gov‡Z • Pg©‡ivM msµgbGov‡Z • KLb KLb Aek¨BnvZay‡Z n‡e: • Lvevi ˆZix/ ivbœv KiviAv‡M • †KvbLvevi aivi evwkï‡K LvIqv‡bvi Av‡M gv/hZœKvix I wkïi nvZay‡q wb‡Z n‡e • cvqLvbv/Uq‡jU e¨envi Kivi c‡i • wkïi cvqLvbvcwi¯‹vi Kivi c‡i (evAb¨ †KvbcvqLvbv) • Mevw` cï-cvLx aivi c‡i Ges Zv‡`i cvqLvbvcwi¯‹vi Kivic‡i
  131. 131. • GQvovIwbgœwjwLZmg‡q nvZ †avqv Avek¨K: • wkïimw`© cwi¯‹vi Kivi c‡i • nvuwP†`qvi c‡i • KvuPvgvQ- gvsm aivic‡i • ‡ivMx‡K †`Lvi Av‡M I c‡i • gqjv wb‡q KvRev †Ljv Kivic‡i • UvKv-cqmv aivi c‡i
  132. 132. nvZ †avqv cÖ`k©b:
  133. 133. • Awa‡ekb: 10 • cÖZ¨¶ cywóKvh©µg Ges `~‡h©vMKvjxb mvov cÖ`vb
  134. 134. cÖZ¨¶ cywóKvh©µg (Direct or Nutrition Specific Intervention) • cÖZ¨¶cywó Kvh©µg, cywó welqK ms‡e`bkxj Kvh©µg (Nutrition Sensitive Intervention)¸‡jv n‡ZwfbœZi| cywó welqK ms‡e`bkxj Kvh©µg¸‡jvi j¶¨ n‡jv cywónxbZvi wKQzKvib‡K cÖfvweZKiv,hv Kv‡ivcywó Ae¯’vi Dci mivmwi cÖfve †dj‡ZI cv‡i A_ev bvI ‡dj‡Z cv‡i|D`vniY ¯^iæc hw` †KvbMixe cwievi‡KRxweKvqb Kvh©µ‡gi AvIZvq Zv‡`i Lv`¨ Drcv`bIAvqe„w× Kivhvq, Zvn‡j Zv‡`i cywó Ae¯’vi DbœwZ n‡e| Z‡eLv`¨ Drcv`bevovm‡Ë¡Ihw` ZvivZvbv‡L‡q wewµ K‡i†`q, Zvn‡j Zv‡`i cywó Ae¯’vi DbœwZ bvINU‡Z cv‡i • cÖZ¨¶cywó Kvh©µgGKRb e¨w³i cywó Ae¯’vi Dcimivmwi cÖfve†d‡j|D`vnib ¯^iæc hw` GKRb gvAvqib dwjK G¨vwmWU¨ve‡jULvq, Zvn‡j Zvikix‡ii Avqib Ae¯’vi Dcimivmwi cÖfveco‡e|hw` GKRbwkï‡K eqmAbycv‡Z mylg cwic~iK LveviLvIqv‡bv nqZvn‡j wkïwUi kvixwiK I gvbwmKe„wׇZ mivmwi BwZevPK cÖfveco‡e
  135. 135. cÖZ¨¶ cywóKvh©µg mg~‡ni ZvwjKv: ‡¶Î cÖgvwYZcÖZ¨¶cywó Kvh©µg beRvZK I wkïiLv`¨ (IYCF) 1| R‡b¥i GK N›Uvig‡a¨ wkï‡K ey‡Ki `ya LvIqv‡bv 2| 0-c~Y©6 gvmeqm ch©šÍ ïaygvÎ gv‡qi `ya LvIqv‡bv 3| 6-23 gvmeqmxwkï‡`i eqm‡f‡` mylg cwic~iK Lvevi cÖ`vb(mgqgZ,cwigvbgZGes wewfbœ cÖKv‡ii) e¨w³MZ cwi”QbœZv (Hygiene) 4| Riæix mgq¸‡jv‡Z mvevbw`‡q nvZ‡avqv wµwgbvkK (Deworming) 5| eQ‡i`yBevi wkï‡K (24-59 gvm) K…wgbvkK Jla LvIqv‡bv
  136. 136. ‡¶Î cÖgvwYZcÖZ¨¶cywóKvh©µg Abycywóm¤úyiY (MicronutrientSupplementation) 6|6-59gvmeqmxwkï‡`i eQ‡i `yBeviwfUvwgb G LvIqv‡bv 7|Mf©eZx I `y»`vbKvixgvI wK‡kvix‡`iAvqib dwjK G¨vwmW U¨ve‡jU LvIqv‡bv 8|6-23 gv‡mi wkï‡KAbycywócvDWvi LvIqv‡bv 9|Wvqwiqve¨e¯’vcbvq IAviGm I wRsKLvIqv‡bv cywómg„×K…ZLvevi MÖnb (Consumptionof Nutrient-rich,Fortifiedfoods) 10|wkï(6-23gvm), wK‡kvixGesMf©eZx I `y»`vbKvixgv‡Kcywómg„×LveviLvIqv‡bv 11|cÖ‡Z¨KLvbvqAv‡qvwWbhy³jebI wfUvwgbG mg„׆Zj †L‡ZDrmvwnZ Kiv ZxeªAcywóe¨e¯’vcbv (Management of Acute Manlnutrition) 12|6-59gvm eqmx wkï‡`igvivZ¥K ZxeªAcywó wPwýZKivI Dchy³¯’v‡b†idviKiv 13|6-59gvm eqmx wkï‡KRvZxqch©v‡qi bxwZgvjvAbyhvqxgvSvwiZxeªe¨e¯’vcbv Kiv gvZ… cywó(Maternal Nutrition-PLWs) 14|Mf©eZxI cÖm~wZgv‡qi ch©vßLv`¨ MÖnYI wekÖvg
  137. 137. `~‡h©vMKvjxbev RiæixAe¯’vq cywóMZcÖ¯‘wZGes mvov cÖ`vb ¯¬vBW10.5.1 mgwš^Z wbqwgZ Kvh©µ g:  †mev†K›` ª, KwgDwbwUGesevwo‡Z cÖZ¨ÿ cywó Kvh©µ ‡gi gvbDbœqb GeswbwðZKi b  cÖvmw½K ` ߇i ( grm¨ Awa` ßi , cÖvYxm¤ú` Awa` ßi , WASH BZ¨vw` ) cywó wel qK ms‡e` bkxj Kvh©µ g wbqwgZ Pvwj ‡q hvI qv AZ¨vek¨Kxq Kvh©µ g:  mgš^q Ki v (RvZxq, Dc‡Rj v ch©v‡q)  cywó Z_¨ Kvh©µ g (cÖavb ` ߇i g~j myPK¸ ‡j vi wbqwgZ ch©‡eÿ b)  cywó wel ‡q (` ~‡h©vM Kj xb mg‡q cywó Kvh©µ gI AšÍf ©y³ ) ` ÿ Zv Dbœqb Kvh©µ g evov‡bv/ Dbœqb wd«‡Kv‡qwÝ evov‡bv +  cÖ‡qvR‡b Ri æi x wf wˇZ wbw` ©ó wKQzcywó Kvh©µ g ev¯Íevqb Ki ‡Z n‡e| †hgb: ey‡Ki ` ya LvI qv‡bvi Rb¨ A¯’vqxZvey, ey‡Ki ` y‡ai cwi cyi K †Kvb Lvevi †mBmgq weZi Yn‡”Q wKbvZvch©‡eÿ b Ki vBZ¨vw`  Ab¨vb¨ cÖvmw½K ` ߇i cywó wel qK ms‡e` bkxj Kvh©µ g wbwðZ Ki v ( †hgb- ch©vß cwi gv‡Y me ai ‡bi Lv` ¨ weZi Y, msi ÿ Y/cvwb BZ¨vw` )  Ae¯’vcwi eZ©‡bi wbqwgZ ch©‡eÿ Y  mvovcÖ` v‡bi cÖf ve g~j ¨vqb Ges cÖ‡qvR‡b Lvc LvI qv‡bv ` ~‡h©vM c~e©eZ©x Ae¯’vq wd‡i †M‡j mvov cÖ` vb Kgv‡bv + ‡dBR 0: cÖ¯‘ZKvj xb mgq, ` ~‡h©vMc~e©eZ©xAe¯’v ‡dBR 1: ` ~‡h©v‡Mi ci cÖ_g 3 w` b ‡dBR 2: ` ~‡h©v‡Mi ci cÖ_g 2 mßvn ‡dBR 3: ` ~‡h©v‡Mi ci 1-6 gvm ` ~‡h©vMc~e©Ae¯’vq wd‡i Avmv ` ~‡h©vM mvovcÖ` vb
  138. 138. • Awa‡ekb 11 • `~‡h©vMKvjxb Acywói KviY, Lv`¨ mnvqZvGesIYCF Gi bxwZmg~n
  139. 139. `y‡h©vM ev Riæix Ae¯’vq Acywói KviY I KiYxq: • Acywói KviY‡K wZbwU eo fv‡M fvM Kiv hvqÑ • Lv‡`¨i Ach©vß mieivn • AcÖZzj ‡mev • ¯^v¯’¨ e¨e¯’vi Kvh©KvixZviAfve
  140. 140. ` y‡h©v‡Mi c~e©vf vm ` y‡h©vMKvj xb cÖ¯‘wZ ` y‡h©vM cÖvK…wZK ` y‡h©vM gvbe m„ó ` y‡h©vM e¨e¯’vcbv/Ki Yxq Lv` ¨ wbi vcËv ¯^v¯’¨ †mev hZœ ¯^í †gqv` xLv` ¨ wbi vcËv ` xN©†gqv` xLv` ¨ wbi vcËv cywó wbi vcËv(¯^í I ` xN©‡gqv` x) gvB‡µ vwb‡qvwUª‡q›U wbi vcËv g¨v‡µ vwb‡qvwUª‡q›Uwbi vcËv 1. †Rbv‡i j dzWwWw÷ ªweDkb 2. ‰` wbK RxebhvÎ vq mnvqZv 3. wm‡j KwUf wdwWs†cÖvMÖvg K) mvwcø‡g›Uvi x L) †_i vwcDwUK 4. gvB‡µ vI g¨v‡µ vwbDwUª‡q›Umi ei vn wbi vc` I cywóKi Lv‡` ¨i wbi wew”Qbœmi ei vn/mnRj f ¨Zv gvby‡l i µ q ÿ gZv e„w× Ki v Lv‡` ¨i m‡e©v”Pe¨envi wbwðZ Ki v ` y‡h©vMKvj xb cywó e¨e¯’vcbvi avi v
  141. 141. `y‡h©v‡M gvB‡µvwbDwUª‡q›U(Micronutrient)-Gi Afve I cÖwZ‡iv‡a KiYxq `y‡h©v‡M mPivPi †hme gvB‡µvwbDwU‡q›U-Gi Afve nq Zv n‡jvÑ • K) Av‡qvwW‡bi Afve /Iodine deficiency disorder • L) Avqi‡Yi Afve /Iron deficiency Anemia • M) wfUvwgb ÔGÕ Gi Afve /Vitamin A deficiency • N) wRsK Gi Afve/Zinc deficiency
  142. 142. dzW dwU©wd‡Kkb (Food Fortification): • wZbwUc×wZ‡ZLv`¨‡KcywóDcv`vbmg„×Kivm¤¢eÑ • evRviRvZKivic~‡e©,cÖwµqvRvZKv‡jwewfbœLv‡`¨iwKQz wKQy ¸iZ¡c~Y©gvB‡µvwbDwUª‡q›Ubónq|†hgb-KviLvbv/wgj¸‡jv‡Zavb†_‡K Pvjevbv‡bvimgqPv‡jiDc‡ijvj‡P-ev`vgxAveiYhvwfUvwgbwe mg„×Zv bó n‡qhvq|Kv‡RB evRviRvZKivic~‡e©,cÖwµqvRvZKv‡jLv`¨k‡m¨i ¸Yv¸Y hv‡Zbóbvnq†mw`‡K Avgv‡`iwe‡kl†LqvjivL‡Zn‡e| • ‡hLv‡`¨hZUzKzcwigvYcywóDcv`vbwe`¨gvbZvi†_‡K cwigvYevov‡bvi gva¨‡gI dzW dwU©wd‡KkbKivhvq|†hgb-`y‡aimv‡_ AwZwi³K¨vjwmqvg †hvMK‡i,AvUvimv‡_ AvqiY†hvMK‡i| • dzWdwU©wd‡Kkb-GiAv‡iKwUDcvqn‡jv,wKQzwKQz Lvev‡ii mv‡_H Lv‡`¨we`¨gvb†bBGgb†KvbbZzbcywóDcv`vb†hvMKiv|†hgb-mqvweb †Z‡jimv‡_ wfUvwgbG †hvMKiv,je‡Yimv‡_ Av‡qvwWb†hvMKiv|
  143. 143. ¯¬vBW11.3.3 wf UvwgbGmvwc- ‡g‡›Ukb(Supplementation):  Rb‡Mvwô †h A‡j ¯’vqxf v‡e emevmK‡i †mLv‡b wf Uvwgb GGi Af ve Av‡Q  emevmi Z Gj vKvi gvby‡l i g‡a¨ wf Uvwgb-G Gi Af veRwbZ DcmM©¸ ‡j v (i vZKvbv †i vM/weUUm¯úU) we`¨gvb Av‡Q  H Gj vKvq Acywó/Wvqwi qvi cÖ‡Kvc †ekxAvKv‡i we`¨gvb _vK‡j  e¨vcK AvKv‡i nvg Qwo‡q _vK‡j Eqm wf UvwgbGK¨vcm~j -Gi gvÎ v LvI qv‡bvi mgqm~wP wkï 6-11 gvm wkï 12-59 gvm cÖm~wZ gv cÖm‡ei ci ci B (2 mßv‡ni g‡a¨) 100,000 AvBBD 2,00,000 AvBBD 2,00,000 AvBBD 1wUbxj i ‡Oi wf Uvwgb GK¨vcmyj LvI qv‡Z n‡e 4-6 gvmci ci eQ‡i 2 evi 1wUK‡i j vj i ‡Oi wf Uvwgb GK¨vcmyj LvI qv‡Z n‡e cÖm‡ei 2 mßv‡ni g‡a¨ gv‡K 1wU j vj i ‡Oi wf Uvwgb GK¨vcmyj LvI qv‡Z n‡e  ORS GeswRsK mvwcø‡g›Ukb Gi e¨e¯’vKi ‡Z n‡e  cÖvK…wZK `~‡hv©‡Mi ci eZ©x‡Z nvg Gi cÖKUZvI RwUj ZvKgv‡bvi Rb¨ 1 eQ‡i i bx‡Pwkï ‡`i Rb¨ we‡kl nvg K¨v‡¤úB‡bi e¨e¯’vKi ‡Z n‡e
  144. 144. AvqiY mvwc‡g‡›Ukb(Supplementation): • Mf©ve¯’vq iv‡Zi Lvev‡ii ciciB1wU K‡iAvqiY dwjK GwmW U¨e‡jU †L‡Z n‡e • ev”Pv nevi ci †_‡K wZb gvm eqm ch©šÍ cÖwZw`b 1wU K‡i Avqib ewo ‡L‡Z n‡e
  145. 145. `y‡h©vMKvjxb Lv`¨ I cywómnvqZv cÖ`vb • †Rbv‡ij dzW wWmwUªweDkb • wm‡jw±f wdwWs †cÖvMÖvg ¯¬vBW11.4.1 1) †Rbv‡ij dzWwWmwUªweDkb:  `y‡h©v‡MAvµvšÍgvby‡l i Lv`¨ msKU-Gi mgqLv`¨ weZi YKi v|  mvavi YZ Lyeeo AvKv‡i i †Kvb`y‡hv©M†hgb- f ~wgK¤úev¶i vqgvbyl ZxeªLv`¨ msK‡U†f v‡M  GmgqGBcÖwµqvqgvby‡l i N‡i N‡i Lvevi †cuŠ‡Q†`qvi †PóvKi vnq 2) wm‡j w±f wdwWs†cÖvMÖvg: GB†cÖvMÖvg `yBai ‡Yi n‡Z cv‡i Ñ  mvwc-‡g‡›UkbwdwWs†cÖvMÖvg (Supplementary Feeding Programme) Ges  ‡_i vwcDwUK wdwWs†cÖvMÖvg (Therapeutic Feeding Programme)
  146. 146. mvwc-‡g‡›UkbwdwWs†cÖvMÖvg: GB‡cÖvMÖvg2ai‡Yi n‡Zcv‡iÑ K) e-vs‡KUwWmwUªweDkb- GKUvwbw`©óGj vKvi Acywói SzuwK‡Z _vKvmevB‡K(wkï 6gvm†_‡K5 ermi eqmxwkï,meMf ©eZxI cÖm~wZgvmn) cywóKi Lv`¨weZiYKiv L) Uv‡M©‡UWwWmwUªweDkb-hvivgvSvwi gvÎvi Acywó((Moderate Malnutrition) ‡Z f zM‡QZv‡`i‡K cywóKi Lvevi weZi‡Yi gva¨‡g,AwZwi³ gvÎvi Acywó(Severe Malnutrition) †_‡Ki¶vKiv ‡_ivwcDwUKwdwWs†cÖvMÖvg: GB†cÖvMÖvgwUhvivAwZwi³ gvÎvi Acywó‡Zf yM‡QZv‡`i Rb¨cÖ‡hvR¨|
  147. 147. • eZ©gv‡b wkï‡`i (0-5 eQi eqm ch©šÍ) eq‡mi Zzjbvq IRb wb‡q cywó Ae¯’v wbY©‡qi †ÿ‡Î wek¦ ¯^v¯’¨ ms¯’v 2006 †idv‡iÝ (WHO- 2006 Reference)Abyhvqx Z score c×wZAbymiY Kiv n‡q _v‡K| Z score c×wZ‡Z Acywó †MÖW wb¤œiƒc : cywóAe¯’v Z score c×wZ ¯^vf vweK +2 z ‡_‡K- 1 z Aí cywó -1 z ‡_‡K- 2 z gvSvwi Acywó -2 z ‡_‡K– 3 z gvivZ¥KAcywó - 3 z Gi Kg
  148. 148. `y‡hv©‡M Riæix Ae¯’vq IYCFGibxwZmg~n • g~jbxwZ 1: `y‡hv©‡Mi Ae¯’v‡ZI R‡b¥i cin‡Z Qq gvm eqm ch©šÍ wkï‡K ïaygvÎ gv‡qi `ya-BLvIqv‡Z n‡e • g~jbxwZ 2: Aek¨B wkïi`yB ermi eqm ch©šÍ gv‡qi `ya LvIqv‡Z n‡e • g~jbxwZ 3: `y‡hv©‡Mi †Kvb ai‡bi †eª÷ wgé mvew÷wUDU (BMS) ev `y‡aiK…wÎg weKí Lv`¨ LvIqv‡Z DrmvwnZ Kiv hv‡ebv • g~jbxwZ 4: wkï‡`i ˆ`wbK e„w× ¯^vfvweK ivLvi Rb¨ 6gvm eq‡mi ci (180w`b) †_‡KBgv‡qi `y‡ai cvkvcvwk N‡ii ˆZixmnRcvP¨ cywóKi evowZ Lvevi LvIqv‡Z n‡e • g~jbxwZ 5: wkï‡`iAwffveK‡`i/ †mev cÖ`vbKvix‡`i Kv‡Q cywóKi, mnRcvP¨ Lvevi ˆZixime Dcv`vb mnRjf¨ n‡Z n‡e
  149. 149. • g~jbxwZ 6:`y‡h©v‡M wkï‡`i †mevAch©vß nqZv‡`i AwffveK‡`i gvbwmK `ywðšÍvi Kvi‡b| GgZve¯’vqZv‡`i g‡bvej evwo‡q †ZvjvLyeB ¸iæZ¡c~Y© • g~jbxwZ 7:wkï‡`i †ivMgy³ I Drdzjø ivL‡Z n‡e, hv‡ZZvivgv‡qi ey‡Ki `ya cvb Ki‡Zcv‡iGes cvkvcvwkAb¨ LveviI mwVKfv‡e MÖnYKi‡Zcv‡i • g~jbxwZ 8:mwVKch©‡e¶‡Yi gva¨‡g,Acywói wkKvi wkï‡`i Lyu‡R †ei Ki‡Z n‡eGes wPwKrmv w`‡Z n‡e,hv‡ZZv‡`i Ae¯’v µgvbœ‡qAviI Lviv‡ci w`‡K bv hvq| Acywói KviY mwVKfv‡e Luy‡R †ei Ki‡Zn‡eGes ZvicÖwZKviKi‡Z n‡e • gyjbxwZ 9:`y‡h©v‡Mi Pig Ae¯’vq (acutephase), Lye `ªæZ`y‡hv©M †gvKv‡ejvic`‡¶cwb‡Z n‡ehv‡Zwkï‡`i cywó‡Z †Kvbai‡Yi e¨vNvZbv Av‡m| wkï‡`i Awffve‡Ki Dc‡iI j¶¨ ivL‡Z n‡e • g~jbxwZ 10: `y‡h©v‡M wkï‡`i Ges wK‡kvi‡`i mwVKgvÎvi cywó wbwðZ Ki‡Z n‡j Pjgvb cwiex¶Y evContinuous monitoring cÖ‡qvRb
  150. 150. `~‡h©vMKvjxbmg‡q¯^v¯’¨Kg©x‡`i f~wgKv/KiYxq: • `y‡h©v‡M AvµvšÍ cwievi IAcywó wkKvi wkï‡`i wPwýZ Kiv, ZvwjKvf~³ Kiv, mswkøó nvmcvZvjKZ©„cÿ‡K AeMZKiv, wPwKrmv †`qvGes cÖ‡qvR‡b nvmcvZv‡j†cÖiY • Gmg‡qcywóKi I mnRcvP¨ Lvevi m¤ú‡K© AvµvšÍ cwievi‡K Rvbv‡bv, ˆZwii e¨vcv‡i cÖwkÿY cÖ`vbI Lvevi MÖn‡YDrmvnx Kiv • `y‡h©v‡Mi Kvi‡Y m„ó AcywóRwbZ msµvgK †ivM¸‡jv cÖwZKv‡iicÖ‡qvRbxq e¨e¯’vMÖnY, AvµvšÍ †ivMx wPwýZ KivI cÖv_wgKwPwKrmv cÖ`vb • `y‡h©v‡Mi Kvi‡Y m„ó AcywóRwbZ msµvgK †ivM¸‡jv cÖwZKv‡iicÖ‡qvRbxq e¨e¯’vMÖnY, AvµvšÍ †ivMx wPwýZ KivI cÖv_wgKwPwKrmv cÖ`vb • `y‡h©vM AvµvšÍ GjvKvqwe`¨gvb¯^v¯’¨ AeKvVv‡gv¸‡jv‡K(‡hgb-KwgDwbwU wK¬wbK, BDwbqb Dc-¯^v¯’¨ †K›`ª, cwieviKj¨vY †K›`ª)Riæix ¯^v¯’¨ †mev,Lv`¨ I cywó mieiv‡ni Dc‡hvMx K‡i †Zvjv
  151. 151. • Awa‡ekb 12 • †hvMv‡hv‡Mi gva¨‡g AvPiY cwieZ©b (wewmwm) GesKvD‡Ýwjs
  152. 152. • †hvMv‡hv‡Migva¨‡g AvPiYcwieZ©bev wewmwm: • AvPiY cwieZ©b †hvMv‡hvM n‡”Q Ggb GKwU cÖwµqv hv ¯^xK…Z †hvMv‡hvM gva¨‡giIci wfwË K‡i wk¶vg~jKZ_¨vw`i mvnv‡h¨e¨w³iAvPiY cwieZ©bAvbq‡b mvnvh¨K‡i|
  153. 153. AvPiYcwieZ©‡bi avcmg~n:  Ávb(Knowledge)  Aby‡gv`b(Approval)/Acceptance  B”Qv(Intention)  PP©v(Practice)  GW‡f v‡Kwm(Advocacy)
  154. 154. • KvD‡Ýwjs: • KvD‡Ýwjs n‡”Q GKwU cÖwµqv hvi gva¨‡g cwiPh©vMÖnYKvixi ( Mf©eZx gwnjv,`y»`vbKvix gv)/ ‡mevMÖnxZvi mgm¨v¸‡jv wK †m¸‡jv g‡bv‡hv‡Mi mv‡_ †kvbv, Zv‡K mnvbyf~wZ †`Lv‡bv Ges Zvicihyw³, Z_¨I civg‡k©i Øviv mgm¨vmg~n wbim‡bi Dcvq Lyu‡R †eiK‡i ‡mevMÖnxZv‡K welqwU we‡ePbv Ki‡Z DrmvwnZ K†iwbw`©ó wm×všÍ wb‡Z mnvqZv Kiv| • KvD‡Ýwjs Gi ¸iæZ¡: • ‡mevMÖnxZvi AvZ¥wek¦vm AR©b Ki‡Z mvnvh¨ K‡i • mgm¨vi mgvavb K‡i • fyj aviYv `~i Ki‡Zmvnvh¨ K‡i • Af¨vm/ AvPiY cwieZ©‡bev bZyb †Kvb Af¨vm/ AvPiY MÖn‡Y mnvqZv K‡i
  155. 155. KvD‡Ýwjs Kivi c×wZ/KvD‡Ýwjs Kivi `¶Zvmg~n • mdjfv‡eKvD‡Ýwjs Kivi avc: • Av‡jvPbvi cwi‡ek ˆZixKiv • ‡mevMÖnxZvi K_v †kvbv • Av‡jvPbvi ga¨†_‡K mgm¨v¸†jv wPwýZ Kiv • mwVK wm×všÍ wb‡Z mnvqZv Kiv • ‡mevMÖnxZv wK ey‡S‡Qb ZvhvPvB K‡i †`Lv • AvZ¥wek¦vm/Av¯’v ˆZixKiv • KvDwÝwjs mdj n‡Z cÖ‡qvRb Z_¨/cÖgvb wfwËK DcKvwiZv ev myweav e¨vLv Kiv|
  156. 156. KvD‡Ýwjs Kivi `¶Zvmg~n: • (KvDwÝwjs)Kivi Rb¨Avš—te¨vw³ †hvMv‡hvM cÖ‡qvRb, Avš—te¨vw³†hvMv‡hvM 2cÖKvit • K_vbv e‡j†hvMv‡hvM Kiv (Non-verbal communication) • K_ve‡j †hvMv‡hvM Kiv (Verbal communication) • K_vbv e‡j †hvMv‡hvMKiv(Non-verbal communication): • AskMÖnYKvix‡`i‡KwRÁvmvKiæb,K_v bv e‡j†hvMv‡hv‡Mi †KŠkjej‡ZwKeySvq? Zv‡`i DËi†kvbvi c‡ieY©bvKiæb,K_vbv e‡j†hvMv‡hvM Kivi †KŠkjej‡Z†evSvq A½ fw½igva¨‡gAvPiY, Awfe¨w³Ges K_vbv e‡jwKQycÖ`k©bKiv|
  157. 157. K_v bv e‡j†hvMv‡hv‡Mi mgqAvgv‡`i‡K wbgœwjwLZ welq¸‡jv j¶¨ivL‡Z n‡e| • Awfb‡qigva¨‡g `¶Zv cÖ`k©bKiv: • AskMÖnYKvix‡K K_v bv e‡j †hvMv‡hv‡Mi 5wU †KŠkj †`Lvb • ‡h †Kvb GKRb AskMÖnYKvix‡K mvnv‡h¨i Rb¨ ejyb| Zv‡K GKwU cyZzj w`‡q ewm‡q gv wkï‡K `ya LvIqv‡”Q Ggb Awfbq Ki‡Z ejyb • cÖ`k©‡Y GKevi †hvMv‡hvM‡K mvnvh¨ Ki‡e Ges Ab¨evi †hvMv‡hv‡Mi cÖwµqv‡K evav w`‡e c×wZwU 2 eviB Ggb fv‡e Ki‡Z n‡e †hb AskMÖnYKvixiv†Kvb wKQy aviYvKi‡Z bv cv‡i †h GB cÖwµqvwU wK‡mi Rb¨ n‡”Q • K_v bv e‡j †hvMv‡hv‡Mi c×wZwU AskMÖnYKvix‡`i mbv³ Ki‡Z ej‡Z n‡e Ges ej‡Z ejv n‡e †h †KvbwU †hvMv‡hv‡M mvnvh¨ Ki‡Q Ges †KvbwU Ki‡Q bv
  158. 158. K_vbve‡j †hvMv‡hvMKiv(Non- verbal communication):  gvI KvD‡Ýj i `yR‡bi gv_vGKBAe¯’v‡bivLv/ GKBAe¯’v‡bem‡Zn‡e(Keep yourhead level)  †Pv‡Li w`‡KZvwK‡qK_vej v(PayAttention)  ‡Kvbevav_vKvhv‡ebv(RemoveBarriers)  mgqwb‡qK_vej v(TakeTime)  mwVKf v‡egv‡K¯úk©K‡i K_vej v(Appropriate Touch)
  159. 159. K_ve‡j †hvMv‡hvMKiv(Verbalcommunication):  †LvjvcÖkœKiv(Askopenouestions)  mnvbyf~wZ†`Lv‡bv(Usingresponsesandgestureswhichshowinterest)  gv‡qi K_vi c~bive„wËKiv(Reflectbackwhatthemothersays)  gv‡qi Abyf~wZeySv(Showthatyouunderstandhowshefeel)  wePvig~jKkãe¨envi †_‡KweiZ_vKv(Avoidusingjudgingwords)
  160. 160. • †LvjvcÖkœKiv(Ask open ouestions): • ‡Lvjv cÖkœ mvaviYZ LyeB DcKvix|cÖ‡kœi Dˇi gv Aek¨B Avcbv‡K wKQy Z_¨ w`‡e| †Lvjv cÖkœ mvavibZ ïiæ nq ÔwKfv‡e, wK, KLb, †Kv_vq, †KbÓ GB me kã w`‡q| †hgb ÓwKfv‡e Avcwb wkï‡K LvIqv‡”Qb?Ó • cÖkœ †evaK wRÁvmv bv Kiv fvj| gv‡qi KvQ †_‡K hv Avkv Kiv nq gv ZvB DËi ‡`q Ges DËiwUn¨vu ev bv nq| e× cÖkœ mvaviYZ ïiæ nq: ÒAvcwb wK †L‡q‡Qb? Avcbvi wkï‡K ey‡Ki `ya LvIqvb? • mnvbyf~wZ†`Lv‡bv (Using responses and gestures which show interest): • GKRb gv‡qi mv‡_ K‡_vcK_b Pvwj‡q hvIqvi Rb¨ Avcbv‡K †evSv‡Z n‡e †h Avcwb Zvi K_v g‡bv‡hvM mnKv‡i ïb‡Qb Ges K_v †kvbvi AvMÖnI Avcbvi Av‡Q|Avcwb †h Zvi K_v AvMÖn wb‡q ïb‡Qb GUv †evSv‡bvi Rb¨ gv‡S gv‡S Zvi w`‡K ZvKvb, gv_v bvovb Ges nvwm w`b|
  161. 161. • wePvig~jKkãe¨envi†_‡K weiZ_vKv (Avoid usingjudging words ): • KvD‡Ýwjs-Gi mgq wePvig~jKkã cwinviKi‡jAvmj Z_¨ cvIqv hvq bv| G Rb¨wePvig~jKkã cwinvi Kiv DwPZ|evsjv fvlvq wKQy wKQykã ejv †h‡Zcv‡i †hgb - fvj, g›`, wVK, fyj, Lvivc, h‡_ó, h_vh_ fv‡e BZ¨vw` G¸‡jv wePvig~jKkã|
  162. 162. gv‡qi AvZ¥wek¦vmAR©‡bi avcmg~n • AvZ¥wek¦vmevov‡bvi avcmg~n: • MvwjWªv(GALIDRAA): • G-Greet(MÖxU) • A-Ask and Assess(Avm&K GÛA¨v‡mm) • L-Listen(wj‡mb) • I-Identify(AvB‡WbwUdvB) • D-Discuss (wWmKvm) • RA-Recommend and Negotiate Actions(wiK‡gÛ GÛ †bMvwk‡qU GKkbm) • A-Appoinment(G¨vcq›U‡g›U)
  163. 163. •Awa‡ekb 13 •cyywówelqK†idv‡ij I d‡jv-Avc
  164. 164. • †idv‡ijwK: • ¯^v¯’¨ Icywó †mevcÖ`v‡b wb‡qvwRZ KwgDwbwU I †mev ‡K›`ªmg~n†_‡KwPwKrmviRb¨ D”PZiwPwKrmv †K‡›`ª †ivMx cvVv‡bv†K, †idv‡ijejv nq|†idv‡ij GKwU wbqwgZ I AZ¨šÍ cÖ‡qvRbxq KvR| cÖv_wgK ¯Í‡ii†hme†mev ‡K›`ª cywó †mev cÖ`vb Ki‡Q †mme†mev ‡K›`ª †_‡K D”PZi†mev ‡K‡›`ª †ivMx †idvi Kiv GKwUwbqwgZ Kvh©µgn‡q c‡o| myôy †mev cÖ`v‡bi Rb¨GB †idvi KiviKvRwUI myPviæiƒ‡cm¤úbœ nIqvi cÖ‡qvRb Av‡Q|
  165. 165. • Acywó‡ZAvµvšZ wkï‡`i mbv³KiY: • KwgDwbwU wK¬wb‡KwbqwgZ wb‡P ewY©Z ‡mev cÖ`v‡bi mg‡q: • K.wkï‡`ikvixwiKe„w× gwbUwis I cÖ‡gvk‡bi (wRGgwc) †mk‡b • L.cuvP eQ‡ii Kg eqmx wkï‡`iwbqwgZ ¯^v¯’¨ cwi`k©‡bi mg‡q • 2.m¨v‡UjvBU wK¬wb‡K ev BwcAvB mvB‡U wbqwgZ wUKv`vb I K¨v‡¤úBb Pvjv‡bvi mgq wkïi Acywó g‡b nIqvq • 3.Dc‡Rjv m¦v¯’¨‡K‡›`ª I Ab¨vb¨ m¦v¯’¨‡K‡›`ªi gva¨‡g • 4. evwo cwi`k©‡bi gva¨‡g
  166. 166. • †idv‡ij- Gi avcmg~n: • ‡idv‡ij cÖwµqv wb‡gœv³ 4wU av‡cm¤úbœ nq| avcmg~n n‡jv: avc 1 Acywói gvÎ v / RwUj ZvI cÖ‡qvRYxq ‡mev wPwýZKi Y avc 2 ‡mevm¤ú‡K©wm×všÍMÖnY avc 3 mwVK †mev‡K›`ªwPwýZKi YI †i dvi Ki v avc 4 †i dvi wbwðZ Ki v cÖ‡qvRb Abymv‡i †i dvi
  167. 167. miKvix†mev†K‡›`ª†i dvi Kivi ‡d¬v-PvU©: KwgDwbwUwK¬wbK Dc‡Rj v¯^v¯’¨ Kg‡c­ · †Rj vm`i nvmcvZvj I gvI wkï Kj ¨vb †K›`ª(Gg wmWwe- Dwm) BDwbqb ¯^v¯’¨†K›`ª †K›`ª†K›`ª†K›`ª †K›`ª†K›`ª m›Uvi ‡m›Uvi GBPGd Wwe- D wm KwgDwbwU/ MÖvg ‡Rj vch©vq Dc‡Rj vch©vq BDwbqb ch©vq KwgDwbwUch©vq
  168. 168. • †hmeAe¯’vq†ivMx †idvi Kiv cÖ‡qvRb: • mvaviYZ `yB Kvi‡b †ivMx†idvi Kiv cÖ‡qvRb| †m¸‡jv n‡jv: • †mev‡K‡›`ªi †mev`v‡bimxgve×Zv †mev`vbKvixi Afve GesIlyacÎ I Ab¨vb¨miÄvgvw`i Ach©vßZv
  169. 169. KwgDwbwUch©v‡qZxeªAcywóAvµvšÍwkï GesMf ©eZxI Abyש6 gvmeqmxwkï †`i `y»`vbKvi x(PLW) gwnj v‡`i mbv³ Ki YI wPwKrmvi Rb¨ †i dvi Ki v: Uv‡M©UMÖæc cÖvß Z_¨ Ki bxq 6-59 gvm ga¨ evûi cwi wa (gyqvK)< 11.5 †mwg (j vj ) wPwKrmvcÖ`vbKvi xKwgDwbwUm¦v¯’¨Kgx©:  RwUj ZvAv‡QwKbv, Zvwba©vi YKi ‡eb  RwUj Zv mn Zxeª Acywó n‡j m¦v¯’¨‡K‡›`ª cvVv‡eb  RwUj Zv bv_vK‡j , Lvevi I Jl ‡ai gva¨‡g wPwKrmvcÖ`vbKi ‡eb 6-59 gvm `yBcv‡qi cvZvq cvwb _vK‡j (BwWgv)  m¦v¯’¨‡K‡›`ª†i dvi Ki ‡eb 6-59 gvm ga¨ evûi cwi wa (gyqvK) 11. †mwg - < 12.5 †mwg (nj y`) wPwKrmvcÖ`vbKvi xKwgDwbwUm¦v¯’¨Kgx©:  gvSvwi gvÎ vi Acywói wkï ‡K cywó-mg„× Lvevi I Jl ‡ai gva¨‡g wPwKrmv/ evN‡i ˆZwi Lvevi wel ‡q e¨envwi K wb‡`©kbvcÖ`vb Ki ‡eb Mf ©eZxI `y»`vbKvi xgwnj v ga¨ evûi cwi wa(gyqvK) < 21.0 †mwg wPwKrmvcÖ`vbKvi xKwgDwbwUm¦v¯’¨Kgx©:  Mf ©eZxi †Kvb RwZj Zv_vK‡j ¯’vbxq †mev †K‡›`ª†i dvi cywó- mg„× Lvevi N‡i ˆZwi Lvevi wel ‡q e¨envwi K wb‡`©kbv cÖ`vb Ki ‡eb
  170. 170. †idvivj w¯¬c: KwgDwbwU m¦v¯’¨Kgx©i KvQ†_‡KAvDUwiP†m›Uv‡i cvVv‡bvi †idvivj w¯¬c: wkï ‡`i Rb¨ †idvivj w¯¬c: ¯^v¯’¨ †K‡›`ª†i dvi Ki v wkï i bvg ............................................................ eqm(gvm) ................ wj ½(wUK wPý w`b) ‡g‡q /cyi yl Mªv‡gi bvg ........................................ BDwbqb ............................................. wkï i gv/cwi Ph©vKvi xi bvg ................................................................................. Zvwi L ....................... ga¨ evûi cwi wa (gyqvK) <11.5 †m.wg (j vj ) ga¨ evûi cwi wa (gyqvK) 11.5 †m.wg<12.5 †m.wg (nj y`) wkï < 6 gvm cv‡q cvwb (BwWgv) (wUK wPý w`b) nu¨v bv whwb †i dvi K‡i ‡Qb (bvg) ...................................................................................
  171. 171. KwgDwbwUm¦v¯’¨Kgx©i KvQ†_‡K¯^v¯’¨ †K‡›`ªcvVv‡bvi †idvivj w¯¬c: Mf©eZxI `y×`vbKvixgwnjv‡`i †idvi Kivi w¯¬c : ¯^v¯’¨ †K‡›` †idvi Kiv gwnjvi bvg................................................................. eqm(eQi).......... Mªv‡gi bvg..............................................BDwbqb............................................ m¦vgxi bvg............................................................................. ZvwiL......................... ga¨evûi cwiwa(gyqvK)<21.0†m.wg Mf ©Kvj (gvm) ------------------ wkïi eqm(gvm) ---------------------- whwb†idvi K‡i‡Qb (bvg).....................................................................
  172. 172. • d‡jv-Avc: • A‡bK mgqB ZxeªAcywó AvµvšÍ wkï Ges Mf©eZx I Abyש 6 gvm eqmx wkï†`i `y»`vbKvix gwnjv‡`i (PLW) Ges Ab¨vb¨ †ivMx‡K wPwKrmv ev †mev cÖ`vb K‡i GKwU wbw`©ó mg‡qi c‡i cyYivq cix¶v-wbix¶vi Rb¨ Avm‡Z ejv nq| †ivMxi Ae¯’v Abymi‡Yi Rb¨ Ges †m Abyhvqx cÖ‡qvRbxq e¨e¯’v cÖ`v‡bi GB cÖwµqv‡K Òd‡jv-AvcÓ ejv n‡q _v‡K| • KLb KLb d‡jvAvcKi‡eb: • Acyó wkïI gwnjv mbv³KiY I †idv‡ii ci • cywó e¨e¯’vcbvq Aš—f©z³ wkï I gwnjv‡`i ¯^v¯’¨‡K›`ª †_‡K evwo wd‡i †M‡j
  173. 173. • †idv‡ij I d‡jv-Avc†mevim¤úK©: • ¸YMZgvb m¤úbœ †mev wbwðZKi‡Yi `yÕ‡Uv Ab¨Zg Dcv`vb n‡”Q †idv‡ij I d‡jv-Avc| GKwU Kvh©Ki †idv‡ij e¨e¯’vi gva¨‡gB GKwU †mev ‡K›`ª †_‡K Acywó AvµvšÍ wkï Ges Mf©eZx I Abyש 6 gvm eqmx wkï†`i `y»`vbKvix gwnjv‡`i (PLW) Ges Ab¨vb¨ †ivMxi Pvwn`v c~i‡Yi m‡e©vËg e¨e¯’v Kiv †h‡Z cv‡i| Gfv‡e cÖv_wgK ¯Í‡ii †mev ‡K›`ª¸‡jv D”PZi ¯Í‡ii †mev ‡K›`ª mg~‡ni Rb¨ m¤ú~iK f~wgKv cvjb Ki‡Zcv‡i| Avevi GKB mv‡_ GKwU h_vh_ d‡jv-Avc e¨e¯’v GKwU †idv‡ij c×wZi cwic~iKwnmv‡e KvR Ki‡Z cv‡i| h_vh_ d‡jv-Av‡ci gva¨‡g †ivMxi cÖK…ZPvwn`v Abyhvqx †mev cÖ`vb wbwðZ Kiv m¤¢e| Gfv‡e †mevi ¸YMZgvb e„w× Kiv Ges Acywó `~i Kiv m¤¢e|
  174. 174. • Awa‡ekb14 • Kw¤úDUvi cwiwPwZ Ges Gg Gm Iqv©W (2007) Acv‡ikb
  175. 175. • Awa‡ekb 15 • GgGmG‡·j (2007) Acv‡ikb GesB-‡gBj Gi gva¨‡g †hvMv‡hvM
  176. 176. • Awa‡ekb 16 • KwgDwbwU wK¬wb‡Ki gvwmK cÖwZ‡e`b ˆZixi MvBWjvBb
  177. 177. • Awa‡ekb17 • mKj chv©‡qi †mev`vbKvixGes mycvifvBRviMYGi ˆ`bw›`bKvh©µ‡g cywó‡mev‡Km¤ú„³Kib
  178. 178. AZ¨vek¨Kxq cywó ‡mevmg~n • wK‡kvi-wK‡kvix‡`i Rb¨AZ¨vek¨Kxqcywó ‡mevmg~n: • †mev MÖn‡bi Rb¨ ‡mev ‡K‡›`ª AvMZwK‡kvi wK‡kvix‡`i‡K ‰K‡kviKvjxbmwVK cywói ¸iæZ¡m¤ú‡K© Av‡jvPbv Kiv • e¨w³MZ cwi¯‹vi cwi”QbœZv I cÖRbb ¯^v¯’¨ msµvšÍ wel‡q wK‡kvix†`i Z_¨†`qv Ges ¯^v¯’¨Ki Af¨vm MV‡b DØy× Kiv • wK‡kvix‡`igv‡S Avqib ewo I K…wgbvkK ewo weZiY Kiv • mKj wK‡kvi-wK‡kvix‡K‡`wi‡Z we‡q I 19 eQi eq‡mi Av‡M Mf©aviY bv Kivm¤ú‡K© KvD‡Ýwjs Kiv • wK‡kvix‡`icwigvYMZ I cywómg„× 3-5 evi Lvevi MÖnb m¤ú‡K© civgk© †`qv
  179. 179. • Mf©eZx I `y»`vbKvix gv‡q‡`i Rb¨ AZ¨vek¨Kxq cywó ‡mevmg~n: • Mf©eZxgwnjv‡`i Mf©Kvjxb mg‡q IRb MÖnY I IRb e„w× ch©‡eÿb Kiv • Mf©Kvjxbmg‡q gv‡q‡`i e¨w³MZ cwiPh©v (Self Care) I DbœZ wkï cwiPh©v wel‡q civgk© ‡`qv • Mf©eZxgv‡q‡`i‡K cwigvYgZ cÖ‡qvRbxq Lvevi MÖnY I wekÖv‡gi wel‡q civgk© ‡`qv • Mf©eZxgv‡q‡`i‡K Avqib I dwjK GwmW (AvBGdG) I K¨vjwmqvg U¨ve‡jU cÖ`vb Ges cÖm~wZ gv‡K cÖm‡ei ci †_‡K wZb gvm ch©šÍ Avqib I dwjK GwmW U¨ve‡jU (AvBGdG) cÖ`vb Kiv I LvIqv m¤ú‡K© civgk‡`qv • Abycywó m¤ú~iY (Micro-nutrient supplementation) m¤ú‡K© Z_¨cÖ`vb Ges Kibxqm¤ú‡K© civgk© †`qv
  180. 180. • Mf©eZxI `y»`vbKvixgv‡q‡`iRb¨ AZ¨vek¨Kxq cywó‡mevmg~n: • Mf©eZxgv‡q‡`i‡KcÖm‡eiciKLbwfUvwgbG K¨vcmyjLv‡eb†m e¨vcv‡i civgk©†`qv • wkï‡KmwVK wbq‡ggv‡qi`yaLvIqv‡bvm¤ú‡K©Mf©eZxgv‡q‡`i‡Kcivgk© †`qv • wkïR‡b¥i1NÈvig‡a¨wkï‡Kkvj`yaLvIqv‡bvïiæKivie¨vcv‡icÖm~wZgv‡K civgk©†`qv|¯^vfvweKev wmRvwiqvbcÖm‡eiciwkï‡Kgv‡qi`yaQvovAb¨ wKQybv†`qvi(gay,wgwkÖev wPwbicvwb,GgbwKcvwbIbv)e¨vcv‡igv I cwiev‡iiAb¨vb¨m`m¨‡`icivgk©†`qv • Mf©eZxgv‡q‡`i‡KwkïR‡b¥iciQqgvm(180w`b)ch©šÍïaygvÎgv‡qi`ya LvIqv‡bvi(Exclusive Breast feeding)Rb¨gv‡K DØy×Kiv • Mf©eZxgv‡q‡`i‡K wkïieqmQqgvmc~Y©n‡jwkï‡KDchy³cvwievwiK evowZLveviPvieviev Z‡ZvwaK LveviwgkÖ‡bLvIqv‡bviRb¨civgk©†`qv|G mg‡qgv‡K Dchy³cywó,Lv`¨ I ˆah©¨mnKv‡iwkï‡Kmgqw`‡qLvIqv‡bviRb¨ civgk©†`qv
  181. 181. wkïi Rb¨ AZ¨vek¨Kxqcywó‡mevmg~n: • `yB eQ‡ii Kgeqmx wkï‡`i mbv³ I †iwR÷v‡i ZvwjKvfz³ K‡iZv‡`i IRb MÖnY KivGes †iwR÷v‡i wjwce× Kivwkï‡`i kvixwiK e„w× msµvšÍ Growth Chart h_vh_fv‡e c~iY KivI wkï‡`i ˆ`wnK e„w× cÖvwßiwelqwU Growth Chart Gi gva¨‡ge¨vL¨vKiv • wkï‡`i kvixwiK e„w× msµvšÍ Growth Chart h_vh_fv‡e c~iY Kiv I wkï‡`i ˆ`wnK e„w× cÖvwßiwelqwU Growth Chart Gi gva¨‡ge¨vL¨vKiv • wkï‡`i gv‡qi `ya GesevowZ Lvevi LvIqv‡bvi e¨vcv‡iIYCF bxwZgvjvAbyhvqx gv‡q‡`i I cwiev‡ii Ab¨vb¨ m`m¨‡`iKvD‡Ýwjs Ges civgk© †`qv • ga¨evûi cwiwa (gyqvK) cwigvcKivi gva¨‡gAcyó wkï‡`i (SAM, MAM) mbv³ KivGes CMAM MvBWjvBb Abyhvqx civgk©cÖ`vbA_ev cÖ‡qvR‡b wbKUeZ©x SAMKb©v‡i †cÖib(†idvi) Kiv
  182. 182. • wkïi Rb¨ AZ¨vek¨Kxq cywó ‡mevmg~n: • fwZ©†hvM¨ 5 eQ‡ii Kg eqmx Acyó wkï‡`i cywó Kvh©µ‡g fwZ© Kiv I myweav‡fvMxi ch©vß Z_¨ msi¶Y wbwðZ K‡i myweav‡fvMx‡`i‡K ch©vß †ikb weZiY Kiv • †mev †K›`ª (IwUwc ev GmGdwc) †_‡K †hme myweav‡fvMx Ab¨ †K‡›`ª ev Kvh©µ‡g P‡j †M‡Q, †K‡›`ªAbycw¯’Z, Kvh©µg †_‡K S‡i c‡o‡Q, wPwKrmvq mvov †`qwb Ges wPwKrmvi ci †Q‡o ‡`qv n‡q‡Q Zv‡`i evwo cwi`k©Y wbwðZ Kiv • wkï‡`i wfUvwgb ÕGÕ K¨vcmyj LvIqv‡bvi Rb¨ wbqwgZ UvKv †`qv I civgk© †`qv • wkï‡`i LvIqv‡bvi cy‡e© nvZ †avqvi civgk© †`qv| ‡hme cwiev‡i wkï‡`i A¯^v¯’¨Ki cwi‡e‡k Lvevi †`qv nq Zv‡`i m¤ú‡K© cwiev‡ii m`m¨‡`i m‡½ Av‡jvPbv Kiv • wkïi hZœ, ¯^v¯’¨ I ¯^v¯’¨Ki e¨e¯’vi DbœwZ mva‡bi cÖ‡qvRbxqZv e¨e¯’v MÖnY Kiv
  183. 183. • Kg Rb¥ IRb m¤úbœ wkï‡`i Rb¨ AZ¨vek¨Kxq cywó ‡mevmg~n: • beRvZ wkï‡`i IRb gvcv, Kg Rb¥- IRb m¤úbœ wkï‡`i‡K mbv³ Kiv| G msµvšÍ Z_¨ ‡iwR÷v‡i wjwce× Kiv • wkï‡K ch©vß cwigv‡b Nb Nb gv‡qi `ya LvIqv‡bvi wel‡q gv‡K mKj cÖKvi civgk© †`qv (Ae¯’vb I wVKgZ ey‡K jvMv‡bv) • Kg Rb¥- IRb m¤úbœ wkï‡`i LvIqv‡bvi e¨vcv‡i gv‡K civgk© †`qv • Kvh©µ‡gi AMÖMwZ ch©‡eÿb Kiv, †m¸‡jv †iwR÷v‡i †iKW©KiY I cÖwZgv‡m wbqwgZ Kvh© m¤úv`b cÖwZ‡e`b (GgwcAvi)-G Z_¨vw` mwbœ‡ekb Kiv • gvivZ¥K Acywó‡Z AvµvšÍ wkï‡`i‡K ¯’vbxq nvmcvZvj ev SAM KY©v‡i †idvi Kiv
  184. 184. • mycvifvBRvi/Z`viKKvix‡`i `vwqZ¡ I KZ©e¨: • gvV ch©v‡q cywó †mev Kvh©µg wbqwgZcwi`k©bGes wbweofv‡ech©‡eÿb Kiv • gvV Kg©x (HA,CHCPand FWA) †`i cywó†mev msµvšÍ mKj KvRmivmwi ZË¡veavb Kiv, cÖ‡qvR‡b Zv‡`i‡K mnvqZv Kiv|Zv‡`i cywó‡mev `v‡bi `¶Zv Dbœqb Ges welqwfwËKÁvbe„w×i Rb¨ wewfbœKvh©Ki†KŠkj Aej¤^b Kiv • wbw`©ó ch©‡eÿb †PKwj‡ói gva¨‡g gvV Kg©x‡`i Kv‡Rich©‡eÿb, g~j¨vqbGes cÖ‡qvRbn‡jZv‡`i‡K mwVK civgk© †`qv • KwgDwbwUwK¬wbKI BDwbqb ¯^v¯’¨/ cwievi cwiKíbv‡K‡›`ª †mev MÖnxZv‡`i mv‡_ cywómsµvšÍ wel‡qAv‡jvPbvKiv • cÖwZwUKwgDwbwUwK¬wbKG IRbgvcK hš¿, nvBU †¯‹j,gyqvK †Uc BZ¨vw` Av‡Q wKbvGes ZvmwVK wbq‡ge¨envi n‡”Q wKbvZvch©‡e¶Y Kiv • †iwR÷vimg~nwbqwgZfv‡ecix¶v K‡i nvjbvMv` ivLvie¨e¯’v Kiv
  185. 185. • mycvifvBRvi/Z`viKKvix‡`i`vwqZ¡ I KZ©e¨: • wbqwgZfv‡e wkï I Mf©eZx gwnjv‡`i IRb e„w× m‡iRwg‡b hvPvB Kiv • wfUvwgbÔGÕ K¨vcmyj, Avqib U¨ve‡jU I K…wgbvkK ewo mswkøó DcKvi‡fvMx‡`i gv‡S wbqwgZfv‡e weZiY Kiv n‡”Q wKbv Ges Zv Zviv Lv‡”Q wKbv Zv hvPvB Kiv • wkïi eqm 6 gvm c~Y© nIqvi ci †_‡K evowZ Lvevi wb‡`©kbv Abyhvqx LvIqv‡bv n‡”Q wKbv Zv hvPvB Kiv • gvwmK Kvh©µ‡gi AMÖMwZi Dci wi‡cvU© wbf©yjfv‡e cÖ¯‘Z Kivi Rb¨ gvVKg©x‡`i mnvqZv Kiv| wi‡cvU©¸‡jv GKxf~Z Kiv (Compile)Ges Dc‡Rjvq †cÖib Kiv • gvV ch©v‡q Kvh©µ‡gi Pjgvb Ae¯’v Ges mgm¨v m¤^‡Ü ‡gwW‡Kj Awdmvi (cvewjK †nj_ wbDwUªkb), Ges Dc‡Rjv ¯^v¯’¨ I cwievi cwiKíbv Kg©KZ©v/ Dc‡Rjv cwievi cwiKíbv Kg©KZ©v †K wbqwgZfv‡e AeMZ Kiv Ges mgvav‡bi cÖ‡qvRbxq e¨e¯’v MÖnb Kiv
  186. 186. †gwW‡KjAwdmvi (cvewjK†nj_wbDwUªkb)Gi Kvh©cwiwa • cwiKíbv cÖYqb I Kg©m~wP msMVb welqK Kvh©µgmg~n: • gvV ch©v‡qi cywó †mev Kvh©µg Z`viwKi Rb¨ gvwmK Kg©cwiKíbv cÖYqb • cywó m¤ú‡K© Ávb e„w× Kivi Rb¨ gvV ch©v‡q cywó †mev cÖ`v‡b Kg©iZ gvVKg©x‡`i (CHCP, HA,FWA) Ges cÖ_g ch©v‡qi Z`viKKvix (HI, FPI, AHI, FWV ) †`i Rb¨ evrmwiK Kg© cwiKíbv cÖbqb Ges †mm¤ú‡K© Zv‡`i‡K AewnZ Kiv • Dc‡Rjv ¯^v¯’¨ I cwievi cwiKíbv Kg©KZv© Ges RvZxq cywó †mev Kvh©µg (GbGbGm)-Gi cÖwZwbwai m‡½ Av‡jvPbv K‡i gvV Kg©x (CHCP, HA , FWA) I Z`viKKvix (HI, FPI, AHI, FWV)‡`i Ávb I `ÿZv e„w×i Rb¨ cÖ‡qvRbxq cÖwkÿY cwiKíbv cÖYqb Kiv • Dc‡Rjv ch©v‡q IMCI & Nutrition Kb©vi Gi Kvh©µg‡K wbwðZ Kiv • RvZxq cywó †mev (GbGbGm) cÖ`Ë jwRw÷K mgq gZ wbw`©÷ ¯’v‡b mieivn wbwðZ Kiv • wbqwgZfv‡e cywó m¤úwK©Z wewfbœ KwgwUi (Dc‡Rjv ch©v‡q) mfv Abyôvb wbwðZ Kiv
  187. 187. • ev¯Íevqb I Z`viwK welqK Kvh©µgmg~n: • gvV ch©v‡qi cywó †mevKvh©µg cwi`k©b Ges ch©‡eÿb/ gwbUwis Kiv • cwi`k©b, ch©‡eÿb Ges Kvh©µ‡gi cÖwZ‡e`b mg~nch©v‡jvPbv K‡i Kv‡Ri AMÖMwZwbiæcb KivGes †m Abyhvqx cÖ‡qvRbxq e¨e¯’v MÖnbKiv • Dc‡Rjv ch©v‡q cywó †mev Kvh©µ‡gi mv‡_ mswkøó miKvwi-‡emiKvwi Kg©KZ©vmnmK‡jimv‡_ †hvMv‡hvM¯’vcbK‡i Kvh©µ‡gi myôev¯ÍevqbKiv Ges Kvh©µ‡gi mv‡_ mswkøóAb¨vb¨ wefv‡Mimv‡_cywóKvh©µ‡gi mgš^q Kiv • mKj Kvh©µ‡gi gwbUwis-Gi †PKwj÷mieivn KivI c~iYK…Z †PKwj÷msiÿY KivI cÖ‡qvRbxq ¯’v‡bKwc cÖ`vb Kiv|c~ibK…Z †PKwj÷mg~n †_‡K cÖ‡qvRbxq Z_¨ AvnibGes cÖ‡qvRbxq e¨e¯’v MÖnbKiv
  188. 188. • cwiex¶Y I g~j¨vqYwelqK Kvh©µgmg~n: • Kvh©µ‡gi gvwmK AMÖMwZ cÖwZ‡e`b ˆZixnIqvi ci RvZxq cywó †mev Kvh©µg (GbGbGm) G †cÖiY wbwðZ Kiv • Kv‡Ri AMÖMwZ m‡šÍvlRbK bq Ggb Kg© GjvKv wPwýZ Kiv Ges cÖ‡qvRbxq e¨e¯’v †bqv • gvV ch©v‡qi Z_¨/ DcvË hvPvB Kiv Ges Rvbvb • gvV ch©v‡qi †iwRóvimg~n mwVKfv‡e Ges mgqg‡Zv c~iYKiv n‡”Q wKbv Zv hvPvB Kiv • Kvh©µ‡gi AMÖMwZ ch©v‡jvPbv I g~j¨vqb Kiv • ¸`v‡gi cÖ‡qvRbxq JlaI Avbylvw½K `ªe¨vw`i w¯’wZ ch©v‡jvPbv c~e©K Pvwn`vˆZix K‡i †cÖiY Kiv
  189. 189. • DØy×Kib Ges Z_¨ e¨e¯’vcbv welqK Kvh©µgmg~n: • gvV ch©v‡q e¨envi cwieZ©‡bi Rb¨ †hvMv‡hvM (wewmwm)Kvh©µ‡gi cwiKíbv, msMVb I gwbUwis Kiv • GjvKvq gv I wkï ¯^v¯’¨ Dbœqb I cywówelqK cÖPvivwfhvb, DØy×KiY mfvi Av‡qvRb I AskMÖnY Kiv • Dc‡Rjv/ BDwbqb cwil`, †bZ…¯’vbxq ew³eM© I ag©xq †bZv‡`i AskMÖn‡Yi gva¨‡g mvgvwRK DØy×KiY Kg©m~wP cÖYqb Kiv • Z_¨, wk¶v I DØy×Ki‡Yi Rb¨ Avek¨K DcKiY msMÖn I mieivn wbwðZ Kiv • RvZxq cywó †mev (GbGbGm) ‡_‡K cÖvß wb‡`©kbv, Re GBW, MvBWjvBb, welq cyw¯— Kv I Ab¨vb¨ cywó‡mev Z_¨vw` mswk¬ó mK‡ji wbKU weZiY Kiv • gvV ch©v‡q Z_¨ msi¶Y, mieivn I e¨envi wbwðZ Kiv • gvwmK AMÖMwZ cÖwZ‡e`b, Kg© cwiKíbv I Acyó wkï‡`i wPwKrmvq e¨eüZ †iwR÷vimg~n mwVKfv‡e msi¶Y I e¨envi wbwðZ Kiv • cÖ‡qvRb Abyqvqx EaŸ©Zb KZ…©c¶‡K Kvh©µg msµvšÍ mKj Z_¨ mieivn Kiv
  190. 190. (RwUjZvmn ZxeªAcywó‡Z Avµvš— wkïi e¨e¯’vcbv) welqK Kvh©µgmg~n: • SAM I MAM wkï ev †ivMxi wPwKrmv I e¨e¯’vcbv wbwðZ Kiv • cÖ‡qvRbxq †ÿ‡Î SAM I MAM wkï ev †ivMx‡K‡Rjv ev †gwW‡Kj K‡jR nvmcvZvj †hLv‡b SAM BDwbU cÖwZwôZ n‡q‡Q †mLv‡b ‡idvi Kiv • RvZxqcywó †mev Kvh©µ‡gi Dc‡Rjv †dvKvj c‡q›U wn‡m‡e wbDwUªkb Kvh©µ‡gi mvwe©K †`Lv†kvbv Kiv
  191. 191. cÖwk¶b welqK Kvh©µgmg~n: • cywó welqK mKj cÖKvi cÖwkÿ‡Y AskMÖnY Kiv • cÖwkÿKcÖwkÿY(TOT) MÖnb K‡i cywó †mev Kvh©µ‡g Kg©iZ mKj Kg©x‡`i (CHCP, HAFWA, FWV, AHI, FPI, HI) cÖwkÿY cwiPvjbv Kiv
  192. 192. Dc‡Rjv cwievi cwiKíbvKg©KZ©v (UFPO)†`i Kvh©cwiwa: • KiYxq: • gvVch©v‡q cywó †mevKvh©µ‡gi cwiKíbv cÖYqbGesKg©m~Px msMVb Kiv • gvVKg©x‡`i Kv‡Ri cwi`k©b, ch©‡eÿb Ges g~j¨vqb Kiv • gvI wkï ¯^v¯’¨ Dbœqb I cywó welqK cÖPvivwfhvb, DØy×KiY mfvi Av‡qvRbKiv • GbGbGmn‡Z cÖvßwb‡`©kbv, job GBW, MvBWjvBb, †eªvwkIi IAb¨vb¨ cywó †mevZ_¨vw` mswkøó mKj‡KAewnZ Kiv • Kvh©µ‡gi gvwmK AMÖMwZ cÖwZ‡e`bch©v‡jvPbv Kiv • EaŸ©Zb KZ…©cÿ‡KKvh©µg msµvšÍ mKjZ_¨ mieivn Kiv • Kvh©µg myôfv‡e ev¯Íevq‡bi j‡ÿ¨ Dc‡Rjv ch©v‡qAb¨vb¨ miKvix wefv‡Mi mv‡_ Kvh©Kix †hvMv‡hvM ivLv
  193. 193. Dc‡Rjv ¯^v¯’¨ I cwievicwiKíbvKg©KZ©v‡`i (UHFPO) Kvh©cwiwa: • KiYxq: • mgMÖDc‡Rjv‡Zcywó †mev Kvh©µ‡gi gvV ch©v‡qi Kg©m~Px Ges wK¬wbK¨vj e¨e¯’vcbv wel‡qwel`Kg© cwiKíbvcÖYqb Ges mswkøó mKj‡K AewnZKiv • RvZxq cywó†mev Kvh©µg (GbGbGm)-Gi m‡½ Av‡jvPbvK‡i gvV Kg©x (CHCP, HA,FWA) IZ`viKKvix (HI,FPI, AHI,FWV) ‡`i ÁvbI `ÿZv e„w×i Rb¨ cÖ‡qvRbxq cÖwkÿYcwiKíbvcÖbqb KivGesZ`vbyhvqx cªwkÿb Kg©m~Px cwiPvjbvKiv • gvV ch©v‡q Kvh©µ‡gi KvwiMwimnvqZv I w`K wb‡`©kbv cÖ`vb| Kvh©µg cwi`k©b, ch©‡eÿb Ges g~j¨vqbmwVK fv‡en‡”Q wK bvZv Z`viK Kiv • Kvh©µ‡gi gvwmKAMÖMwZcÖwZ‡e`b ˆZix nIqvi ci RvZxq cywó †mev Kvh©µg (GbGbGm) G †cÖiY wbwðZ Kiv • cywó †mevKvh©µg ch©v‡jvPbv IKvh©µ‡gi AMÖMwZe„wׇZ Kvh©Ki f~wgKvcvjb Kiv
  194. 194. • KiYxq: • gvV ch©v‡q ¯^v¯’¨ Kg©x, cwievi cwiKíbv Kgx©mn Ab¨vb¨ gvVKg©x‡`i (K…wl, cïm¤ú`, grm¨ cvjb) g‡a¨ mgš^q ¯’vcb Kiv • gvV ch©v‡q wewmwm Kvh©µ‡gi cwiKíbv, msMVb I gwbUwis Kiv| cywówelqK cÖPvivwfhvb, DØy×KiY mfvi Av‡qvRb I AskMÖnY Kiv • Dc‡Rjv/ BDwbqb cwil`, †bZ…¯’vbxq e¨w³eM© Iag©xq †bZv‡`i AskMÖn‡Yi gva¨‡gmvgvwRK DØy×KiY Kg©m~wP cÖYqb Kiv • Z_¨, wk¶v I DØy×Ki‡Yi Rb¨ Avek¨K DcKiYmsMÖn I mieivn wbwðZ Kiv • Dc‡RjvcÖavb wn‡m‡e Kvh©µg cwiPvjbvKiv

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