fo’k; % ikjaxrrkdks lkFk laftouh:ih
gkezks eatqjh ,ae fo”o”kkUrh
Through Spirituality
rkfjd 18@11@2007 turk eutqjh&f”k”kq ,ae izLrqrh foHkkx
fl³rke ftYyk vLirky] flDde ljdkj xkUrksd AA
egk'k;]
lEiw.kZ cU/kqx.ka ueLdjkseha !!
1. gtwj gkeh lk³¡ NyeFkk³ fuoZkpu Ns= vUrZxr ,d vdq'ky ifjokjdk lEiw.kZ] dqlYrkdks dkeuk jk[kus] lQy ifjokjdk lEiw.kZ ifjokjdks rQZckV 'kqHk dkekeukg: fy,j ,d nqbZ fru cpug: gtqj &lE{k ;lSek ?kjdk gkezk Mk0 fM0 ih0 “kekZ vf/kdkjhT;qekfFk jk[us vuqefr ek³ ;lSek ?kjdk vknZ.kh; izeq[k fpdhRlk vf/kdkrjh egksn; Mk0 ft ykek lkFkS vf/kdkjh lkfgok ekQZr vuqefr fynS] izLrqr xfjgNkS dh xr rk% 19@11@2007 lkseckj dk R;l “kqHk fnuek Mk0 fM0 ih0 “kekZ vf/kdkjhT;qdks Evening Night Duty fFk,N] ;rk gkehpS vkQS vkQuS ?kjeS ;Lrks] R;Lrks Vsfyosjhr HkbZgkYN] iSlk ifu NSu xkMh ifu NSu] lYykg ifu feYnSu ;rk gkezk ckts] vkek ckckys r eykbZ vLirky dquh yxs fd yxsu~ Fkkg NSu\ l³xS ?kjdk lklqvkeklax r dfjou 10 cts lxS [kuk ][knk lEe ifu xoZorh fryk:ik Hka.Mkjh 21 o’kZ lk³NyeFkk³ ifr lqckl Hka.Mkjh firk ,oa llqjk fo”k.kqyky Hka.Mkjh 40 o’kZ lklq Jherh Qwyek;k Hka.Mkjh HkkbZ lqckl Hk.Mkjh] Ante Natal Care Card ek Mk0 lkgscys ys[ksdks 18@11@07 dks Expected date of delivery (Msfyojh rkjh[k) Hk, ifu iMsdsys nq[;ks ifu Hkfuu~ lcS vk&vkQuks yxuhek C;Lr Hk;kSa A vdLekr ysoj isu Hk,N vfu r Hk;ks dUrfotksd fd ukuh mYVk ijsdksys ifgyk&[kqVVk ifN lEiw.kZ “kfjj r vk;ks rj nSodks fnC;n`"Vh vfruS fr{.k ,ao vdSZ J`"Vhdks n`"Vh iks fFk;ks fd ftYyk vLirky flaxrkeek vkQSa cU/kd Hk,ifu f'k”kq ,ao iz”kqfr foHkkx bZUpktZ Mk0 fM0 ih0 “kekZ vf/kdkjhT;qdks le{k lEkZi.k f'kok; fodYi Hk,u HkkX;dks] fonEouk] dlys dlykbZ fdu dljh ;ks vo.kZuh;] vdYiuh; N] vr% Mk0 fM0 ih0 “kekZ vf/kdkjhT;q foekjh fryk:ik Hk.MkjhykbZ gsuZ vkm¡nk vkm¡nS ysoj Vsoyys] ogk¡ykbZ ds dLrks ikj;ks f”ko:Ik ?kkj.k xjsj HkUu FkkYu Hk;ks fd ;ks foekjhdks lEkLr ifjokjx.k esjks ofjifjvkoks] vfu ogk¡dS lgdehZ ifjpkfjdkykbZ vkQSys gkrek xyksc yxk,j fn”kk funZ’k xnSZ vkQS Labour head Light dks equh clh ifgyk foekjhdks General Check Up ifN gkezks gsypsd;kbZ ,ao ykijokghys gkehys vkQuS ?kj vkxuek vkbZldsdks vdksZ iz”kkUr] HkkbZpq³] vferkHk] Hk.Mkjh] pkefyax] M+k0 Ykkek] M+k0 vf/kdkjh vusd ,ao bZR;knh bZR;knhdks v/;kRehDrkys Hk`.k gR;kkjk ,ao jktuSfrdrkys ifu ykiZokg ,ao gsypsd;kbZ f”k”kq ,ao izLrqrh foHkkxdk M+k0 vf/kdkjh lkgcys f'ko:Ikr /kkj.k xjsdks fFk;ks jkrks jkrks vuqgkj] Bwyk Bwyk vk¡[kkys ,ao f”kjek f”kjoUnh Vksihys r lk¡PpS egk :n Lo:IkuS Hkku gqUFk;ks ekukSa e`xykbZ ,d xk¡leS lfdfnUNq uh cslh r¡ eykbZ uftLdkgS Hkus tLrks :Ik ns[;kSa vkekdks R;ks lkuks ifo= okVksek vfM+,dks Vkm¡dksykbZ n{krkiw.kZ:iys uQwVkbZ] nkfgus gkrdks rtZuh e/;dks lkFk vuksfedk vfu v³xq"BkyspS fn"kkfuns'kxjs>S cks/k gqUFk;ksdk lkFkS 3 1/2 KG otudks ukfr fudkyh fnuq Hk;ks vfu HkUnk HkUnS gquq gqUFk;ks dM+ jkÅ<+ ifu fFk,N vfu R;lifN lkFkh (IyslsVk½ ifu lgtS fudkYuq Hk;ks] R;lifN lcSykbZ dkÅUlsyh³ v: foekjhykbZ ifu H;kkmnS 2 cts Ik'pkr vk,dks lcS bZetSUlh dslg:ykbZ cksykmu vkmus LokLFk; lgdehZykbZ mins”k}kjk ifjpkjhdkekQZr ry Hk[kjSZ flfDde ljdkjys tUekbZ fn,dks Trainee Cum Emergency Centre ykbZ ifu Hk;kmuq Hk;ks lkFk lkFkS gkehykbZ ,s0 ,su0 fl0 bZUVªkussVy] iksLVusVy okjs NYyZx iknSa ;ks ekfFk vaxzsthek of.kZr dFkk lkxjdks lkj ;ljh gkehykbZ HkUuq gqUN %
2. RCH Programme in
the India Independence like
a) National Family Planning Programme in the year 1951-52.
b) Family Planning + Maternal Child Health in the year 1957 –
77.
c) Family Planning + Expended Programme of Immunization –
ICDS in the year 1978-79 (Beginning of the Immunization Programme in
d) Family Planning Programme : Family Welfare Programme
in the year 1975-76
e) Family Welfare Programme Universal Immunization
Programme in the year 1985 – 86.
f) Family Welfare Programme – Child Survival Safe Motherhood Programme in the year 1992-93.
g) Finally the Programme is again reincarnated into programme called Reproductive Child Health Programme been launched in the year 15th October, 1997 during the Nurshima Rao Govt. as a Prime Minister which is still continuing all over India (including Sikkim).
As per Dr. D. P. Adhikari RCH programme in India is not new and India is the first country to adopt the Official Family Planning Programme in the year 1951 to reduce the Birth Rate to a level as per the requirement of the national economy at present with 2.4% of the world’s land area 7th in London and population second to China in population over production progress, (Danger to the National economy to combaced), Substantial achievements have been made in this direction by reducing Birth Rate of 40.8 % during 1951 to 27.2 in 1997. IMR was reduced from 147 in 1951 to 71 in 1997. Similarly, life expectancy has gone up from 37 yrs to 63 years as per current estimates.
Fertility rate of 6 in 1951 has come down to 3.5 in 1995, like this, though the achievements are significant in this direction still the Indian population is increasing by about 16 million every year. Our target is to achieve the replacement level of a TFR (Total Fertility Rate ) of 2.1% by 2026 at all
BY FAMILY PLANNING PROGRAMME
AIM :
· HEALTH FOR ALL BY 2000 AD :
Ø Is to provide people of
PHC services by 2000 AD
Ø Programme was accepted by
the world in WHO at ALMA ATTA declaration
(
COMPONENTS ESSENTIALS OF PHC( HEALTH FOR ALL)
(1) MCH now called RCH care and contraception (F.P)
(2) Mother’s immunization (against tetanus) and
(3) Infant’s immunization against six major killer diseases.
Ø BCG injection 0.1ml intradarmally against six major killer diseases , our left arm deltoid region at birth, 1st week or one month of infants to protect child from childhood TB and tuberculous- Mennijitis.
Ø Opv First dose inj + DPT -1=1ml (lateral aspect of thigh) at 6th weeks (2nd months).
Ø Opv- Second dose , inj +DPT-2 at 10th week (3rd month)
Ø Opv- Third dose, inj + DPT -3 at 14th week (4th month)
Ø Injection measles (subcutaneousl) - .5ml on infant’s arm or lateral aspect of mid thigh at- 9th month.
CHILDREN
Ø Opv (Booster), injection +DPT (booster) = 16 to 24 months
Ø Injection DT (2nd dose of DT should be given at interval of one months if there is no DPT injection at 5-6years.
Ø Injection tetanus toxoid subcut. at 10-16yrs. 2nd dose is given 1month against if there is no DPT or DT or TT given.
FOR PREGNANT WOMEN
Ø Injection tetanus oxoid 2 doses or booster doses from 16-36 weeks.
Ø Success of BCG vaccinations :
Ø Vesicle (small circumscribed elevated area of epidermis with (serous fluid)
AND
Ø Pustule (small elevated circumscribed. pus containing lesion of skin) within 6-8 weeks.
Ø Pustule may burst over the skin and finally heal by white scar.
Ø Infant not showing this white scar within 3-4 months of BCG vaccination is Revaccinated.
Ø Standard 3 doses of 0.5 ml (2 drops ) are dropped on back of the tongue of infants from a dropper attached and polio containing vial.
Ø Minimum 3 doses brings protection against polio paralysis, breast feeding isn’t withheld if infant becomes sick after 1st dose, 2nd dose, if given when baby becomes fit.
Ø Generally 1st dose of polio is given on 2nd month , 2nd doses -3rd month, 3rd doses – 4th month of baby, Can be given earlier at 0.7 days. So, PPI is to achieve 100% coverage at the National level. No single child is left.
3. Protection of Food Supply : Proper Nutrition :-
10 kg mothers weight is aimed during pregnancy by taking
the following given items : -
ADEQUATE CHAPATTI ( WHEAT ROTTIES)
RICE
DAL
VEGETABLES
FRUITS
Mill & boiled Water to get three Kg baby.
Hospital personal assumes that Husband is the father or partner of the wife’s RCH care rj gkeh ;ks ekfFk Mk0 fM0 ih0 “kekZ vf/kdkjhT;qdks }kjk Hkfu,dks rRoykbZ dfrdks vuqHko j vuqdj.k ,ao vuqlj.k xfjjgsNkS] R;ks RRkodks lR;pS rkfjd 19@11@2007 lkseckj 2 cts ogk¡dks csyqdh dks (Evening Night Duty) ekQZr gkehys vkQuks gsYFkpsØjkbZ ,aoe ykijokfgdks laftouh:ih eatqjh cU/kqg:ykbZ fn jgsNkSa A
4. Adequate supply of safe drinking water, personal hygiene and basic sanitation.
5. Health education to people on RCH care. (IEC)
6. Prevention & control of locally endemic diseases like TB, scabies, RTI, STI, UTI (STD),WI, malaria, leprosy, filarial, goiter etc.
7. Appropriate treatment of communicable disease & injuries.
MATERNAL AND CHILD HEALTH CARE (MCH)
Infant Immunization & contraception is the essential component of PHC or primary health care MCH care programme covers including promotion of pre-pregnancy better health.
1. Antenatal ( ANC care )
2. Intranatal ( Delivery Care)
3. Postnatal ( Post Delivery care)
4. Infant Care ( Immunization, Breast feeding, Oral re-hydration
Salt care ( uqu] fpuh] ikuh ) for diarrhoeal diseases
5. Contraception ( Family Planning care ) MTP ( Maternal
TERMINATION OF PREGNANCY :
Ø All above components of RCH care ensures Child Survival & Safe motherhood (CSSM)
MCH CARE HAS TWO Important COMPONENTS.
6. Quality Health educating to couple community & Community.
7. Quality services to women during pregnancy, childbirth, post child birth care & Neonatal care.
8. Reproductive Health program was given to the world community at ICPD meeting at Cairo 1994 for Human Development in India Child component is added thus, this RCH Programme becomes extended MCH (maternal child health care) or Family welfare programme or child survival safe motherhood programme covering packages are :-
(A)PREPODUCTIVE YEARS – Health care of adolescent girl including safe age of the marriage above 18 yrs. and care of teenage pregnancy and prevention of general health care including STD/AIDS from near Health care centres. Govt. of
(B) REPRODUCTIVE YEARS
(1) Contraception: Widely available Family Planning services to prevent unwanted pregnancies.
(2) Legal abortion (MTP) (Facilities for safe abortion and unwanted pregnancies.
(3) Effective material care to insure safe motherhood and child survival.
(4) Effective nutritional education to all and services to vulnerable groupes.
(5) Services to promote child survival
(6) Prevention and treatment of Gynecological problems i.e. menstrual disorders or infertility.
III POST REPRODUCTIVE YEARS
1. Prevention and care of genital prolapse.
2. Education on Menopause
3. Screening and treatment of cancers :
a. Cervical cancer
b. Breast cancer
c. Colon Cance
d. Throat Cancer
e. Brain Cancer and
f. May be whole body cancer screening.
Community participation in RCH Programme and acceptance of target free approach (contraception) Is the bottom up programme.
GOALS (CSSM : CHILD SURVIVAL AND SAFE MOTHERHOOD)
1. Quality life of mother through safe reproductive Health care
& education.
2. Healthy Child to mother & its healthy development
PILLARS OF CSSM PROGRAMME.
Pre-reproductive Years :
1. Meeting Health needs of adolescent girls
2. Raising age of Girl marriage beyond 18 years to 21 years
3. Women empowerment.
Reproductive Years
1. Providing Family planning services: Educate to all couples to have 1-2 child family during 20-45 years age of whole women reproductive life.
2. Every pregnancy is planned by choice through spirituality but not by chance or random iris-responsibility.
3. Providing universally quality, ANC, 80% delivery to institution by train Dhai’s for 100%. Safe delivery
MMR ( Maternal Motarlity Rate) to reduce below 100 / lakhs life birth level which are the National Social demographic goals by 2010 AD.
Referring all high risk pregnancies to 1st RC ( Referral Centre) or STNM/ CRH/AIIMS.
Five cleans during delivery. like .
a. Clean Hand
b. Clean Hand and Clean labour table.
c. Clean blade or Instruments for cutting cord during delivery.
d. Clean thread to tied cut cord.
e. Clean environment.
LOW RISK PREGNANCY ACCOUNTS 60% AND HIGH RISK ACCOUNTS FOR 40% IN
HIGH RISK PREGNECIES ARE .
1. Maternal Height below 145 cm ( 4’- 10”)
2. Grant Multipara: more than 4 viable pregnancy.
3. Teenage Prey ( 0-19) years and at are above 35 years.
4. Bad obstritical H/o ( History) still birth, repetitive Pregnancy Cases, previous sciessirion section and operative procedure.
5. Mal presentation and Twin Pregnancy also unengaged head in primi pregnancy .
6. Hemorrhages in pregnancy.
7. Anemia, diabetisem, Heart diseases and other medicals during her pregnancy.
8. High B.P. at and above 140/90 mmhg. Previous / present, any convulsive disorder ( during pregnancies )
9. Intra uterine growth restricted baby and Post dated. Regencies in RH -ve women, foetal malformation.
10. Un-planned pregnancy, Seeking MTP (Maternal termination of pregnancy.
Bqyk Bqyk] ,ao Li"B “kCng:ys xnkZ [ksjh rdfjou 16&18 tuleqg] ;wok ckcq] vkek] ,ao 3 tuk csMek vkjeys lqrsjS mT;kyks eqgkjys ekukS fxrk ikB lqfujgsdks>S ;l fupksM+ykbZ lqUnFks vfu Nksjkdks fo;ksxys nqf[kr vkekykbZ ifu lkUrkouk fnanS ;lks HkUuq Hk;ks %&
d- cM+nks tu”ka[;k MjykXnks lEL;k gquxbZ jgsN] vc r gkeh tu la[;kdS r nkslzks uEojek NkS] ifgyk pkbZuk N j tc lEe gkeh lCkS jk"Vªh;Lrjdks MseksxzkQh Qj MMR( Maternal Motility Rate) =1 dks Yk{;ek dfVCn/k gqnSukS rc lEe czgek.M+] jk"Vªh; ,ao gkezks flfDde jkT;ys ifu ;l tu la[;kdks Tokykeq[khckV ck¡pu dfBu iNZ, ifjjgsN j ;ks Yk{; MMR=1 dk [kkfrj Hkkjr ljdkjys 1983 lkyek ,mVk furhjkt r;kj xjsdks fFk;ks fd 1996 lky lEe MMR = 1 rj ;lykbZ Qsjh 2006 lEedks fufEr oM+kbz,dks fFk;ks Qsjh jk"Vªh; Lrjdk tula[;k fo”ks"k”kx; HkUNu~ fd tc lEe 60 % of eligible couple (;ksX; nkeirh½ ys iq.kZ:iys ifjokj fu;kstudks iq.; dk;Zek gkr feykmNu~ vfu mfg gkezks Hkkjrdks ;ks fo"k;&lqfp pS MMR=1 vfu gkezks Hkkjrdks MMR=1 HkUuqdks vdksZ:ipS ek= 1-48 (1981½ N] vfu MMR=1 HkUuqdks vdksZ:ipS rikbZ gkehys gkeh nqbZdks iDdk ifjokj dk;e xuqZgqUN A ;fn MMR pS ,d HkUnk ifu de Hk, HkUu lfdUN fd tula[;kdks iqujmRiknu js[kk ifjiqrhZHkUnk de gqu tkUN A tu la[;k fo”ks"k”kx; HkUNu~ gkezks tu la[;k dks es:n.MpS Late Expanding ekuS N A tlek e`R;qnj /kVnS /kVnS tkUN A tcdh tUehus nj /kVu ek= [kksaPN] ;lek tu la[;k cfM+uS jgUN fdudh eqR;q HkUnk thou tUesdks la[;k cslhuS HkbZ fnUN] vUrksxRok vc gkehys gkehnqbZ = nqbZ ykbZ bye bye xnsZ gkehnqbZ gkezk ,duS vusdkSdks vkRek lkFkrkys ek= Hkkjr ,ao flfDde ljdkjykbZ lkFk fnbZ] fo”ko&czgek.M+] jk"Vªh; ,ao jkT; Lrjek vkQuks lkthnkjh Lo:i lcqr xokg gks vfu gkezks flfDdeykbZ jke jkT; ,ao lwbZtjykbZUMdks egkebZe eq[; ea=hdks liuk ,ao ogk¡dks lEeLr ea=he.Myx.kdks clq/kSo dqVqEc ,ao fo'ko “kkfUr LFkkiukdks vkRe cks/kys iDdk ifduS Mk0 fM0 ih0 “kekZ vf/kdkjhT;q }kjk jfpr] of.kZr ,ao jatks reksxq.keqDr lr fpRr vkuUn lfpnkuUn dks ije vkuUnys 19@11@2007 lkseokjdks ;l ve`r iq.; frfFkykbZuS dyh;qxdks vUr ,ao lR; ;qxdks jke jkT; liukdks vkxeuykbZ lEkLr oU/kqxu }kjk vkRelkFk xfjfnus lfou; iqdkj ,ao vuqjks/k ;l eap}kjk xuqZ gqUN A ogk¡ys ;l le;dks vUrdks lR; fimuq uS ;l vktdks ;qxdks gtqjg:dks vkRekKku ,oa fo”o pjkpj muS ijeijes”oj ije iqT; dqynsork] bZ"Vnsork] xzke nsorkdk lkFkS HkUuq gks Hkus
TO LOVE NATURE IS TO LOVE GOD
I SAY LOOK NATURAL
LOVE NATURAL
BE NATURAL
TELL NATURAL
DO NATURAL
EAT NATURAL
LIVE NATURAL
AND FINALLY GO
NATURAL TO OUR HOME & OTHERS WILL COME NATURAL
WELL FOLLOW NATURAL
WILL BE NATURAL
AND THEN WILL BE NATURE
NATURAL AND THERE WILL NOT BE ANY UNNATURAL
FINALLY I APPEAL TO ALL MY UNIVERSAL NATURAL PLEASE FOLLOW SPIRITUAL TO MADE ITSELF PEACE UNIVERSAL
THROUGH GOAL OF THE WORLD
LEADER WHO ARE PURELY NATURAL NOT BY TODAY’S NATURAL
NATURAL AGAIN WILL TURN INTO UNNATURAL
SO PLEASE FOLLOW MY SINCERE NATURAL APPEAL FOR GLOBAL PEACE THROUGH SPIRITUALITY
dk lkFk lkFkS ogk¡ leLr dqy nsork bZ"Vnsork] xzke nsorkdk vkRrek lkFkS M+k fM0 ih0 “kekZ vf/kdkjh T;w HkUuq gqUN A ;l lftyS cq>ulfdus ldu [kksTus pkgus ,ao cq>u upkgus ;ks lkxj ,ao fo”o “kkfUrdks eSys ;lS 19@11@2007 dks ve`r lkseokjdks fnu ykbZ uS ekus esjks lefo/kku&lkxjdks xkBks vkRe lkFk xnsZ xfjfnus fouez vuqjks/kxnsZ ogk¡ vdksZ cqgkjhykbZ gsuZ God Bless You HkUnS tkuq Hk;ks A
jke jkT;dks,d nqbZ gqu ldyku] ekQZr turk iqdkj lk;n iq.kZ gqu lDN A
gtqjdks fo”oklh
lk³NyFkk³ dk ldq'ky lifjokjdk lEiw.kZ lnL;x.k A
fryk:ik Hka.Mkjh 21 o’kZ lk³NyeFkk³ ( xoZorh efgyk tldks 3 1/2 kg dks Nksjk Vkmdks vM+dsj uky csfj,j Breeze Presentation ½
ifr lqckl Hka.Mkjh
firk ,oa llqjk fo”k.kqyky Hka.Mkjh
lklq Jerh Qwyek;k Hka.Mkjh
HkkbZ lqckl Hk.Mkjh
firk ,ao llqjk fo”.kqyky Hk.Mkjh 40 lky lklq Jherh Qwyek;k Hk.MkjhykbZ
ekQZr
M+k fM0 ih0 “kekZ vf/kdkjh
firk euksjFk vf/kdkjh
ekrk pUnz dyk vf/kdkjh
Incharge Maternity
Incharge STD
Gangtok,
19/11/2007
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