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Government of Nepal

Medical Education CommissionSanothimi, Bhaktapur

Nepal

Journal of Medical Education Commission

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JMEC

ISSN : 2717-5073

Year 1 Volume 1 Issue 1 July 2020 jif{ ! cª\s ! ;ª\Vof ! c;f/ @)&&

Government of Nepal

Medical Education CommissionSanothimi, Bhaktapur

Nepal

Journal of Medical Education Commission

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JMEC

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Opinions expressed in this journal are those of the authors and do not represent the official version of Medical Education Commission.

Published by:

Government of Nepal

Medical Education CommissionSanothimi, Bhaktapur

Nepal

July 2020

© Medical education Commission

Web site : www.mec.gov.np

Email : jmec@mec.gov.np

Phone Number : 01-6639413, 6639414, 6639415, 6639416

Printed atDharma Printing PressNew Baneshwor, KathmanduContact No. : +977 9851002157

Editorial Board of JMEC

ChiEf Editor

Prof. Aarati Khanal Shah

Editors

Prof. Ramesh Prasad Aacharya

Prof. Sangha Ratna Bajracharya

Dr. Sandhya Chapagain

Mr. Bishnu Prasad Adhikari

Mr. Shankar Adhikari

Editorial

About the first issue

The first Issue of the Journal of Medical Education Commission (JMEC) marks one of the milestones in the history of Medical Education Commission of Nepal as a landmark for the promotion of the area of academics in the field of health professionals’ education. It is an addition to the regulatory roles and responsibilities of the commission to contribute for the cause of quality education. JMEC is open to all academicians who want to publish their scientific works and opinions in the field of health professionals’ education ranging from basic to advanced research generating innovative ideas, facts and figures,and preferably having high impacts and applicability.

This first issue of the journal has been published with minimal editorial revisions and contains articles from imminent authors both in English and Nepali languages. It encompasses wider areas of knowledge and information rangingfrom history of medical education, rationale of establishment of medical education commission to challenges of a resident in COVID-19 pandemic and many more.

JMEC is a biannual scientific journal which intends to provide the common platform for researchers and academicians to share their ideas and scientific works.It will be developed to a peer reviewed journal on medical education with international standard.

JMEC Editorial Board extends sincere gratitude to Right Honourable Prime Minister (Chairperson, MEC), Honourable Minister of Education, Science and Technology (Co-Chairperson, MEC), Honourable Minister of Health and Population (Co-Chairperson, MEC) and Vice Chairperson of MEC for their message for this first issue of the Journal. Our sincere thanks to all authors for their contribution. We also appreciate the support of all Staff of Medical Education Commission who made it possible to start this publication during lockdown which will remind us COVID-19 pandemic.

With a very happy note, the first issue of JMEC is in your hand.

With warm regards,JMEC Editorial Board10th July 2020

Table of Content s.N. title Writer's Name Page No.

1 Emerging Trends In Health Professional Education

Eurek Ranjit Hemang Dixit Sanjaya Mani Dixit

1

2 Online Monitoring and Evaluation of Medical Institutions: Shall We Move Forward Now?

Prof. Dr. Dilip Sharma 11

3 ‘New Normal’ in Medical Education Prof. Ramesh P Aacharya 13

4 Effective Construction of MCQ Prof. Sangha Ratna Bajracharya 17

5 Is Length of Stay in Emergency Services a Predictor of Outcome of Admitted Patients in Intensive Care Unit?

Neupane RP Shrestha TM Aacharya RP

19

6 Challenges to Residency Training During COVID-19 Pandemic

Dr Prasanna Ghimire Dr Pragya Gautam Ghimire

25

7 Medical Profession and Quality Medical Education

Prof. Dr Gehanath Baral 27

8 Specialty Post Graduate Medical Education In Nepal :Gaps in Training Opportunity, Current Regulations and Reciprocation with The Global Standard

Prof. Aarati Khanal Shah 30

9 Physiotherapy in Woman’s Health Dr Krishna Jha 35

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18 Journal of Medical Education Commission (JMEC)

89

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Medical Education

Emerging Trends In Health Professional Education

Eurek ranjit1, hemang dixit2, sanjaya Mani dixit3

AbstractThis article attempts to provide an overview of history of health professional education, current scenario and activities planned for the future and gives critical suggestions to improve health professional education. The formation of Medical Education Commission has envisioned a new dawn in medical education in Nepal. It is high time to improve the health professional education which can be initiated with undergraduate and postgraduate medical courses with gradual corresponding expansion in other professional courses such as dentistry, pharmacy and nursing. Along with time, much needs to be improved to provide proper education, professional and practical skills to the healthcare students. Correlation needs to be done with the alternative systems for the overall benefit of the future healthcare professionals and the patients.

Keywords:Academy of Health Sciences, BP Koirala Institute of Health Sciences, Medical Education Commission, Nepal Medical Council, Patan Academy of Health Sciences, Post Graduate, Private Medical Colleges, Tribhuvan University

introductionThe introduction of Western medicine in Nepal took place from the time that Jung Bahadur was the Prime Minister of Nepal and has over the years expanded its presence in various parts of Nepal. The Western form of medical education was accepted in Nepal since a century is apparent from the fact that around 1928 Dr. Krishna Raj Mukherjee was appointed as the head of an institution called Nepal Medical School.1 The same institution was possibly renamed as the Civil Medical School in 1934 to

start the training of compounders and dressers in Nepal.

Institute of Medicine (IOM), Tribhuvan University (TU) was the only institution providing graduate medical education during the Panchayat period. Around 1986 there was a failed attempt to start private medical college with affiliation to a religious group in India2. So the medical education sector saw no development till the 1990s. Establishment of multiparty democracy in 1990s paved the way for development of medical colleges with the establishment of Kathmandu University (KU), which started providing affiliation to private medical and dental colleges; this allowed the Nepali students to persue medical, dental and pharmacy

Corresponding AuthorEurek RanjitLecturer of Pharmacology at Kathmandu Medical College, eranjit2077@gmail.com

1 Eurek Ranjit, Lecturer, Department of Pharmacology; Kathmandu Medical College Teaching Hospital, Kathmandu.

2 Hemang Dixit, Former Dean, Institute of Medicine, Tribhuvan University3 Sanjaya Mani Dixit, Assistant Professor, Department of Pharmacology; Kathmandu Medical College

Teaching Hospital, Kathmandu.

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education in Nepal which have now expanded to an increase in institutions providing health professional education. KU has to be credited for initiation in the expansion of medical education in Nepal, with Manipal College of Medical Sciences being the first medical college affiliated by KU.3,4 After Nepal became a Federal Democratic Republic with the promulgation of new Constitution of Nepal in 2015, the constitution has decreed health as a right of Nepali people5. The country has been administratively divided into Seven Pradesh (state) with health and education both considered as national and provincial responsibility. The division of responsibilities between central and provincial governments is yet to be planned. The necessity of this article has been felt as there have been negligible review papers which have covered this area. Literature review on this topic yields negligible current articles. This article is based on literature review and prospective collection of evidences and literature related to health professional education.

Government of Nepal has two dedicated ministries namely Ministry of Health and Population and Ministry of Education,Science and Technology dedicated to provide health care service to the Nepali population as well as to create new healthcare professionals. There are however, other stakeholders, apart from the Government of Nepal and above mentioned ministries which are involved in providing health care services and developing new health care professionals. The private sector, which has established many medical, dental, pharmacy, lab technology and other healthcare institutions appear vital with regards to service and education provided to the Nepali people. Since the increase in medical colleges is mostly private and urban-centric, they have very little to offer to the most remote and inaccessible communities6. Government’s Home and Defence Ministries run a number of hospitals in different parts of the country which cater to armed personnel as well as to the general public. Health and educational service provided by various Non-Governmental Organizations (NGOs) and

private health professionals comes next who are running medical, dental and other professional facilities. A number of nursing colleges are attached with such NGOs.

Existing facilitiesThe current facilities available for the students in the government and private sector institutions running health professional courses are as follows:

Government sector:Tribhuvan University: Institute of Medicine (TU-IOM): Seven medical colleges and six dental colleges are affiliated to TU-IOM. TU-IOM also runs other health professional courses in Pharmacy (leading to Bachelor of Pharmacy), Public Health, Nursing, Radiography, Medical Laboratory Technology and Ayurveda (alternative healthcare) programmes. Other universities, opened in the last decade, i.e. Pokhara University and Purbanchal University also run programmes in pharmacy, public health. Additionally, TU-IoM runs programme in Nutrition (Diploma in Nutrition).

deemed Universities:Bisweshwor Prasad Koirala Institute of Health Sciences (BPKIHS) runs many programmes. Patan Academy of Health Sciences (PAHS) currently has the MBBS and the nursing programmes which it inherited from IoM, Lalitpur Nursing Campus, which was formerly affiliated to Tribhuvan University is now under PAHS.PAHS has recently started some post graduate (PG) programmes - MDGP. Karnali Academy of Health Sciences (KAHS) currently runs middle and basic level courses. Pokhara Academy of Health Sciences runs PG courses in pharmaceutical sciences and is said to be initiating other PG level courses soon. In certain cases, the government’s announcement, though praiseworthy, does not match with adequate planning and infrastructure. The Rapti Academy of Health Sciences (RAHS) was announced without appropriate hospital, personnel or adequate finances.

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The Government has announced the establishment of Academy of Health Sciences(AHS) at Bardibas and another Institution in Rajbiraj in the name after late Gajendra Narayan Singh. Bagmati state government has also announced that it will establish an AHS at Bharatpur where there are already two private medical colleges. In the past the health facilities were named after the reigning monarch and the prime-minister. This trend of naming hospitals after PMs or political leaders is being continued. It would be much more rational to name the Medical Institute t according to place where it is situated .

Basic and Middle level courses are also conducted under Council for Technical Education and Vocational Training (CTEVT) by both government and private institutions in different parts of the country. CTEVT started with the idea of producing technical human resource for the nation. Dr. Adhikari back in 2006 claimed that with the health assistants trying to get into MBBS courses, the purpose of establishing them was somehow nullified2. The same is now being seen in other professions like Nursing and Pharmacy too.

other sectors:University: KU is a university in the public sector, initiated by individuals on a non-profit basis as a social cause. The PM of Nepal is the Chancellor with Education Minister, representatives of National Planning Commission and a number of ministerial secretaries being members of the Senate. It first started the MBBS and BDS courses at affiliated colleges in 1994 and 1997. Its own courses run under KUSMS (Kathmandu University School of Medical Sciences) in medicine and dental surgery also began in 2001 and 2011 respectively. Presently, besides these two programs at Dhulikhel, it has affiliatd 9 medical and 5 dental colleges located around the country. Together with these the Bachelor Degree in Nursing are run at nine of its affiliated colleges. Pharmacy and Physiotherapy degree courses are also being conducted at its central

campus in Dhulikhel. MSc in nursing is also being run at both KU and TU Campuses. Nursing and Public Health Programs are also being conducted by both Pokhara and Purbanchal Universities. Kathmandu University is also running postgraduate courses in Pharmaceutical Sciences, and has also initiated PhD programs in pharmaceutical sciences as well.

Private and Public Mix:With the setting up of different programmes and colleges in different parts of the country, the government came up with the concept of Private and Public Mix. Training of the health professionals has proved to be an attractive area for both the government and private parties alike for investing their resources2. It is as a result of this that health services are being provided in more outlying parts of the country. This is very essential, as the present Constitution of Nepal has made healthcare as a basic right of the people. The public health insurance plan was started by the central government in 2016/17 in Kailali, Baglung and Ilam.7 Health Insurance Board has implemented this in 49 districts as of December 2019.8 The commitment has been made towards providing Health Insurance to the all the people of the country.

Current situationThe current situation is that Nepal’s health service as well as health professional education requires gradual improvement. There is a grave shortage of human resources for health in almost all the fields and more so in rural areas possibly because health personnel prefer to be under the Federal rather than the state government. To provide standard and up-to-date services one needs not only proper equipment but also various levels of multi-disciplinary health care professional and support services, which is lacking in Nepal. Healthcare professionals of different fields and grades are invariably absent with or without leave! Another reason for shortage is that not enough are being employed. Despite annual production of a

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relatively large number of healthcare professionals, there have been no corresponding increase in terms of job opportunities, thereby leaving many professionals unemployed and tempting to move abroad for better opportunities. Another aspect of unemployment of different health professionals is contributing to the increased demand for higher-degree courses2. A recent headline in Jan. 2020 on English daily was: “State-run hospitals short of nurses. Need 46,000 nurses, but 15,000 have been hired so far’!9

Looking into the field of medicine, the private colleges have helped a lot in creating the human resources for health with annual intakes varying between 80-150 students. Lately, medical colleges in Nepal are being strictly scrutinized and that medical colleges which created facilities for and successfully taught 150 students have been restricted to intake 100 students annually. This was done to all medical colleges by setting the yearly admission limit on the intake of the students. Something that ought to be decided based on the individual institution’s capacity was done by keeping all the medical colleges in one basket. While all institutions might not have the capacity to enrol 150 students, institutions exist within the nation which could very well cater to the needs of 150 students in a batch in terms of faculty members, staff, patient load and infrastructure too. The NMC also had a rule of making it obligatory for medical college having intakes of 150 per year to establish subspecialty facilities and to go about starting subspecialty courses in the country too. Whatever will happen to the subspecialty development now that the seats have been decreased is something left undecided.

Lately, 10% of admissions are being provided as scholarship quotas in medicine, dentistry and nursing by various private institutions in Nepal. The general public of Nepal, specifically those who desire to study medicine and their parents welcome the move of allocating 75% scholarship seats in the state funded medical colleges, as envisioned in the

National Medical Education Act.10 The practical aspect of this allocation is yet to be felt. At the same time there are voices being raised by other professionals as to whether our nation needs only medical personnel in the country and should the state funding go only to those who wish to study medicine. The nation might need to address the issue separately.

Despite years of providing government-funded scholarships to students, government is finding it tough to get the medical professionals to far-flung areas. We wonder if 75% scholarship seats could be allocated in the way that Budhanilkantha School gets its best students, getting one student each from the underprivileged far flung districts as far as possible. There might be loop holes to close even before that is implemented, in that there has been a trend of getting citizenship from fraternal villages, where people go for the very first time in their life, so that they can get quotas in different fields. It may be noted that in the People’s Republic of China, it was customary to select students by the commune where they lived.11 When people are arguing for and against the quota system, getting the students merely based on place based on quota system might have its flaws and may keep the brilliant deserving students at bay. Another approach for providing quota could be based on financial level of the student’s family in addition to criteria such as ethnicity.

Looking back at who are at loss following the decrease in the student seats, it is the Nepali students, Nepali economy and Nepali patients who have suffered the most. The Nepali students have had to go abroad to turn their dreams into reality quite like the olden days. They are going abroad mostly to India, Pakistan, China and Bangladesh for studies in medical and allied health education. For a long time, Nepal has witnessed a strong lobbying to send students to the neighbouring countries, with the allurements that it was very cheap out there in comparison with the costs here. There have been cases noted of educational consultancies sending

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students to colleges, which are yet to receive affiliation from Universities. Few years back there was a news of 37 different medical and dental colleges blacklisted in Bangladesh, which had enrolled more than 200 Nepali students.12 At a time when Nepal could become a hub for Health Services Education just as the Philippines has become one for the United States and China. Students who could have been educated at good quality colleges in Nepal are having to go to other countries, with some institutions even outside the monitoring domain or capacity of respective councils. Institutions in Nepal could instead cater to educational needs of students from India, Sri Lanka, Maldives, African and Middle East countries.1

Secondly, the faculties trained specifically for Pre-clinical Science subjects are being restricted, irrespective of their bonds for service in the institutions concerned, and without due consideration to the years of service and the years of experience provided to medical colleges. Non-medical/Non-clinical faculty teaching vital subjects such as pharmacology, biochemistry, anatomy, physiology, microbiology, statistics who were and still are instrumental in providing education in medical colleges and have already contributed by educating the medical fraternity and are the anchor for such study are being biasedly restricted. Recent changes in the rules set up by the Nepal Medical Council had decreased the number of overall faculties required in medical college and limited the number of non-clinical faculties to one per department. With such rule being contrary to the general trend of gathering expertise on a particular subject area from varied background, will the MEC with its newly acquired powers undo such changes. It seems to be the need of the time to see all faculties as equal and given equal opportunities in terms of promotion and pay scale too. In such a situation will the colleges always resort to acquire retired senior faculties from outside to be allowed to function?

Decisions on some proposed medical colleges are

in limbo e.g. B & C Medical College, Man Mohan Memorial Medical College, Aswini Medical College (Nepal Medicity) and Police Medical College. Medical colleges planned outside the Valley can be given permission. Those within the Valley could at this time start with training for allied health service personnel. Some could be given affiliation for training Post Graduates provided they have the required faculty and are affiliated with recognized university. Another worrying aspect about health personnel training in Nepal is regarding the clinical or practical exposure that the students exposed to. The question arises as to whether students are being provided relevant and required clinical and practical exposure in all the health related fields that is necessary for proper functioning. Regrettably this is not so in many instances. It is claimed that institutions in foreign lands have many patients, but if the students cannot interact properly because of the language problem, then what is the use? Are the educational agencies still sending the students out of the country on false promises whilst the respective concerned Councils or the Government have limited resources to control such practices? There have been cases of students returning to Nepal after few years of study, because the respective councils do not recognise these institutions. NMC and NPC (Nepal Pharmacy Council) seems to have done a decent job aiming at decreasing this problem by issuing No Objection Certificate (NOC) only to those who seek to go to proper colleges and Universities.

Outward flow of HRH (Human Resources for health)Many express concern about the 'Brain Drain' of trained medical, dental or nursing professionals to developed countries where the remunerations are much greater than in Nepal. Can one blame the new doctors or nurses, considering the expenditure entailed on their studies here? Our government itself seems to be making likely possible ties with different governments to send human resources for health to other nations. This can be linked with

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Nepali government trying to get the Nepali nurses to Japan for providing domestic care to their senior citizens.13It is a reality that not only nurses but also doctors and other professionals are, following their education and training in Nepal going out of the country for greener pastures elsewhere. There should be no problem with this if the person doing so has not studied on a government scholarship. Even those who have, if they have served and fulfilled their bond commitments they should be free to go where they please. Even though brain drain is being taken as a negative aspect, on the other side, the healthcare field might also develop from exchange of expertise via those professionals who return from developed countries in the similar way as agricultural sector was improved by people who returned having worked in various countries like Israel for a number of years.

reform of Medical / health sciences EducationThe call for the regulation of medical education has been going on for almost three decades. There was first the concept of having an 'Apex Body' to regulate medically related studies. The clamour for changes in medical education has been going on since the time that the IoM, TU was established when the course was started in 1978. An attempt was made to start a medical college soon after this. The possibility was examined but permission was not given. After the student unrest of 1979 (2036 BS) during the tenure of Prof. Surya Bahadur Shakya as Vice Chancellor of TU, there was talk of forming a Technical University which would include an Institute of Medicine or an Institute of Health Sciences. Nepal Medical Association realizing the need for the reform in medical education had taken an initiative to organize a national workshop in 2008. It proposed the ideas of single MBBS entrance examinations, evidence based ratio of undergraduate versus post graduate medical student, national policy for number of doctor to be produced and establishment of single medical university which would look after medical and allied health profession.14 The government felt it the need of

the time to address the issues related to medical education and formed various commissions to look into the matters multiple times in a short span of few years. The Kedar Bhakta Mathema Commission was formed in January2015, which submitted its report in June 2015 and prepared a draft of an act. Another committee was formed under the chairmanship of Dr.Shiba K. Rai for the regulation of fees charged by private medical colleges. Yet another committee headed by Dr. Bhagwan Koirala worked to prepare a draft of National Medical Education Act.15

Meanwhile a Medical Education Probe Committee submitted a report to PM Sher Bahadur Deuba on the irregularities happening in the country in the sector of medical education and the need to reform the sector.16

Nepal Government on 28th Feb. 2017 made many changes in the six health related councils that regulate the standards and various aspects of functioning in health related fields. On 1st March the following day, a number of VC's of Deemed Universities were also appointed. It is debatable whether this was a signal of impending changes in the future or just tactics to delay matters. It all seems to have fallen by the wrong side. Besides that, in the last few years, the country also witnessed the seventeen hunger strikes that Dr. Govinda KC has undertaken primarily for the re-organisation of medical education in Nepal.17

New set Up: formation of Medical Education CommissionSome measures have been taken by the different Nepali bodies concerned with the production of health professionals in our country. Attempts have been made to put the criteria and requirements in order. Both the Nepal Medical Council and the Nepal Nursing Council came up with more stringent rules and regulations for the training of students for their respective professions. The qualities of medical colleges need to be developed to be at par or even better than that of neighbouring countries. The report of the Mathema Commission was tabled and

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subsequently comments on this were made by the both the SK Rai and Bhagwan Koirala Committees formed by the government to scrutinize it. The actions being currently undertaken are said to be on these. Then after much discussion and 'political shuttle cocking' in the Legislature-Parliament, the National Medical Education Ordinance as per Article 114 of the Constitution had been endorsed by PM Sher Bahadur Deuba's cabinet and forwarded to the President Bidhya Devi Bhandari on 23rd October for authentication as Parliament had been dissolved for the national election. This was later done on 10th November 2017. The National Medical Education Act 2075, catering to essential requisites and realistic fulfilments of health professional education led to the formation of MEC with its multiple responsibilities.

The formation of MEC is seen as a new dawn that might bring about the much-awaited changes in the field of medical education in Nepal. Before the MEC formation and coming into action medical and dental colleges were regulated by three main bodies, the Ministry of Education, the Universities and the Nepal Medical Council. It was the poor communication and collaboration among these bodies which caused chaos in medical education system in the nation.14 On top of that a lack of national policy clearly stating the number of doctors needed or the medical colleges to be allowed to produce such human resources worsened the case further. Though the newly opened medical and dental colleges helped provide a platform for students to study within the nation itself, the academicians at different times have pointed out the need to improve the quality of the education and the need to revise the education system in the country. Now that MEC is formed, everyone is eyeing at MEC to work out details and make the whole process, smoother. Apparently, with changes in the Health Professional & Education Act, the terms of reference for NMC has also been changed. NMC’s role in direct monitoring medical education matters is likely to decrease as it falls under the domain of the newly formed MEC.

The commission includes representatives from the National Planning Commission, Ministry of Health, Ministry of Education, Science and Technology TU, KU, BPKIHS, PAHS, CTEVT, Nepal Health Research Council, Nepal Nursing Association, Nepal Health Professional Council, NMC, Nepal Pharmacy Council, Nepal Medical Association and organisations of private medical and dental colleges and experts to represent various other aspects.18

Provision have been made for appointing heads to supervise and co-ordinate in the following areas -

1. Standards and criteria,2. Accreditation,3. Planning and coordination,4. Academic innovation and research,5. Examination, and6. Alternative Graduate Medical Education

program.

The question arises as to the decisions of the commission as the seven State authorities also have responsibilities in the different fields. With the fairly large membership of the commission will it be able to function properly? What will be the percentage required for quorum? Will the Chairman have adequate time to call meetings or will that responsibility be delegated to the Vice-Chairman most of the time?

General recommendationThe democratic reformation of 1990s ushered the initiation of private medical colleges, with Kathmandu University being a pioneer by providing affiliation to private medical colleges. This has directly caused on increase in private medical and healthcare institutions, and have greatly contributed to the increase in healthcare professionals, provided direct employment to thousands of Nepali and have directly contributed to the improvement in healthcare indicators of Nepal and Nepali population 19. With such contributions made by private medical colleges, it is recommended that government work collaboratively with private sector rather than just

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view it authoritatively and hinder overall progress of healthcare sector in Nepal.

Voices for setting up of a Health Sciences / Medical University have been in the air in Nepal for some time. This concept is being implemented in Pakistan, India and some of States there e.g. Tamil Nadu, Haryana already boast of one. Even during the time that Dr. Ram Baran Yadav was President of Nepal some voices had been heard regarding the setting up of a Medical University in Nepal with which all the colleges teaching subjects allied to healing could be aggregated together. It is recommended that academy of health sciences established in various parts of Nepal be upgraded to Health Sciences University in the future. If this is done, it will bring about better-trained and competent HRH not only to work in Nepal but also globally. Enhancing the standards of medical / health related colleges providing education and training to future generations of healthcare professionals to provide better patient care in the hospitals of the country would ultimately benefit the patient who we all strive to care for.

Healthcare institutions, especially medical colleges in Nepal should be stabilized, with patronization of Government, as and when necessary, rather than former and latter being suspicious of each other. The development of healthcare institutions within Nepal would mean development of financial, educational and healthcare sector. Nepali students who could have been admitted in institutions within the country are going abroad to seek health professional education due to limited number of seats in medical colleges in Nepal, spending foreign exchange for their educational needs, when they could be undergoing their specific trainings in Nepal.

For a long time, there were thoughts of the Common Entrance and Final Examinations for programmes of different universities. The MEC also decided to conduct common MBBS entrance examination for students seeking to pursue medical education back

in 2018.20 However, for the last two years it did not see any fruition.21 Dr. Kedar Bhakta Mathema, who led a high-level commission in 2015, was for streamlining the entrance examinations being held independently by different universities, saying that it would make the exams more competitive and have better quality checks. At the same time, there was emphasis on the need to ensure a fair entrance and fair selection of the candidates.22As the existing facilities for admission to MBBS or PG courses vary with the different universities it is imperative that entrance examinations should be held at least twice in a year or that all the universities should align to start their courses together. If students are made to wait for six or more months even after passing their entrance exams, the probability is that they will go to foreign countries to fulfil their dreams since the students are always eager to start their studies right away. This is likely to have occurred for the 2020 session, since a large number of students are supposed to have taken “No Objection Certificate” from Nepal Medical Council so far by January 2020. This applies to other fields of health related educational programs too.

One presumes that MEC will monitor various areas of healthcare profession such as pharmacy, public health, nutrition, physiotherapy and other allied professions. Whether the name Medical Education Commission tries to limit itself to the regulation of medical education or would it have a broader perspective to cover entire health professional education is yet not clear. MEC could have been named Health Education Commission, so that all other allied health sciences could come under one umbrella body. This could open the door for multi-professional development of all health related professions within the nation, which is the need of today. The focus, which should be on health professional education has been restricted and centred on medical education only. On this day and age, a medical doctor can hardly give proper care or health service without a health team consisting of nurses and other allied personnel e.g. health

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laboratory & radiology technicians, physiotherapist, nutritionists and pharmacists.

the futureOur country is presently at the crossroads. The government has not only put a brake to the development of medical colleges but has also announced that it intends to take over these private institutions over a course of ten years. This decision is similar to the decision of Government of Nepal back in 1972, which had implemented the National Education System Plan, under which most of the educational institutions established by the private groups were taken over by the government. 2 Such practice implemented authoritatively might lead to inhibition of development of healthcare institutions rather than develop it. It seems that the government is trying to chew more than what it can ever manage. With all these factors, is Nepal going to be short of HRH to implement the proposed development of our health services for its people? Are the locally trained doctors all going to be urban based for their private practice?

Does Nepali population not deserve better health services? Is the dream of medical tourism in Nepal just a mirage? A large number of students do in fact study with support from the government and are obliged to provide service to the state by working for a number of years. When will the government be able to effectively utilize the healthcare resources they educated and trained? A multi-professional collective effort comprising of private, public sector and the Government needs to be taken to develop the healthcare professional education.

AcknowledgementsWe would like to thank Dr. Ramesh Kant Adhikari, Dr.Shekhar Babu Rizyal and Dr. Pushpa Raj Sharma for their help by going over this article and giving their comments.

references1. Dixit H. History of Health Professional

Education in Nepal. J Kathmandu Med Coll [Internet]. [cited 2020 Jul 2]. 2018;6(4):161–6. Available from: https://www.nepjol.info/index.php/JKMC/article/view/20122

2. Adhikari R K. Privatization in Technical Education: The Case of Education of Health Professionals in Nepal. Regional Health Forum. 2006; 10:59-64.

3. Ranjit E, Dixit SM, Dixit H. Transformation of councils for peoples’ health in federal setup in Nepal. J Kathmandu Med Coll. 2018 Jul 27;7(1):30–8.

4. Dixit SM, Ranjit E, Dixit H. Post-graduation in medicine and allied health sciences in Nepal. J Kathmandu Med Coll. 2019 Feb 13;7(3):114–25.

5. Constitution of Nepal [Internet]. [cited 2020 Jul 2]. Nepal; 2015. Available from: http://www.lawcommission.gov.np/en/archives/981

6. Urgent need for reform in Nepal’s medical education - The Lancet [Internet]. [cited 2020 Jul 2]. Available from: https://www.thelancet.com/journals / lancet /ar t ic le /PIIS0140-6736(16)32423-0/fulltext

7. Health insurance in Nepal [Internet]. [cited 2020 Jul 2]. Available from: https://thehimalayantimes.com/opinion/health-insurance-in-nepal/

8. Why are Patients Rejecting Nepal’s Free Healthcare? [Internet]. [cited 2020 Jul 3]. Available from: https://globalpressjournal.com/asia/nepal/patients-give-nepals-government-health-insurance-mixed-reviews-citing-free-service-long-waits/

9. State-run hospitals short of nurses [Internet]. [cited 2020 Jul 3]. Available from: https://thehimalayantimes.com/kathmandu/state-run-hospitals-short-of-nurses/

10. Ministry directs TU to allocate 75 percent of seats in medical colleges to scholarship students [Internet]. [cited 2020 Jul 3]. Available from: https://kathmandupost.com/

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national/2019/09/06/ministry-directs-tu-to-allocate-75-percent-of-seats-in-medical-colleges-to-scholarship-students

11. Health care in China, 1973. Hearing, Ninety-third Congress, first session ... May 4, 1973. - Princeton University Library Catalog [Internet]. [cited 2020 Mar 22]. Available from: https://catalog.princeton.edu/catalog/SCSB-7052307

12. Nepalis enrolled in blacklisted Bangladesh colleges [Internet]. [cited 2020 Jul 3]. Available from: https://thehimalayantimes.com/nepal/nepalis-enrolled-blacklisted-bangladesh-colleges/

13. Nepal, Japan sign labor agreement - Setopati [Internet]. [cited 2020 Jul 3]. Available from: https://en.setopati.com/social/142662

14. Magar A. View of Need of Medical Education System Reform in Nepal [Internet]. [cited 2020 Jul 3]. J Nepal Med Assoc 2013;52(191):I-II Available from: https://www.jnma.com.np/jnma/index.php/jnma/article/view/2314/1656

15. Medical commission submits report to PM - Nepali Headlines,Nepal News, Nepali News, News Nepal [Internet]. [cited 2020 Jul 3]. Available from: https://nepaliheadlines.com/medical-commission-submits-report-pm/

16. Probe committee suggests reforms in medical education [Internet]. [cited 2020 Feb 24]. Available from: https://thehimalayantimes.com/kathmandu/probe-committee-suggests-reforms-medical-education/

17. Dr Govinda KC begins his 17th hunger strike in Dadeldhura [Internet]. [cited 2020 Feb 24]. Available from: https://thehimalayantimes.

com/nepal/dr-govinda-kc-begins-his-17th-hunger-strike-in-dadeldhura/?sa=X&ved=2ahUKEwi4vJa574nnAhVSilwKHQXMCfwQFjAAegQICBAB

18. Medical Education Commission gets full shape – OnlineKhabar [Internet]. [cited 2020 Feb 24]. Available from: https://english.onlinekhabar.com/medical-education-commission-gets-full-shape.html

19. Ranjit E. Pharmacy Practice in Nepal. Can J Hosp Pharm [Internet]. 2016 [cited 2020 Jul 3];69(6):493–500. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28123197

20. MEC to hold common entrance examination for MBBS, BDS courses - The Himalayan Times [Internet]. [cited 2020 Feb 24]. Available from: https://thehimalayantimes.com/kathmandu /medical-education-commission-to-hold-common-entrance-examination-for-mbbs-bds-courses/

21. Medical commission will not hold common entrance test [Internet]. [cited 2020 Feb 24]. Available from: https://kathmandupost.com/national/2018/08/19/medical-commission-will-not-hold-common-entrance-test

22. Study under way to conduct common entrance test and to revise fees of medical colleges [Internet]. [cited 2020 Feb 24]. Available from: https://kathmandupost.com/national/2019/06/17/study-under-way-to-conduct-common-entrance-test-and-to-revise-fees-of-medical-colleges

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Online Monitoring and Evaluation of Medical Institutions: Shall We Move Forward Now?

Prof. dr. dilip sharma

introductionMonitoring and evaluation is one of the important aspects in regulating medical education. It includes collecting, storing and transforming the data into strategic information, so that the information can be used to make informed decisions on program management, program improvement, policy formation, and advocacy.

Till the date, onsite inspections of different colleges and institutes are done by different professional councils and universities every year before the commencement of the academic program. Onsite inspection allows us to directly evaluate institutes, colleges and teaching hospitals, which in turn enables us to cross check patients’ data and other documents submitted by them. Additionally, it gives us an opportunity to have direct interaction with students, administrative staffs and faculties. However, there are several drawbacks associated with the onsite inspections. Primarily, there exists logistic issues mainly related with travel arrangements. Secondly, senior faculties get irritated during the time of inspection. Thirdly, it is

a tedious process as many staffs are engaged in it. Fourthly, the process itself seems repetitive as it is undertaken twice or thrice a year and there are only few changes to it.

Several biases might exist while undertaking the onsite inspection. There is a chance of bias when the inspector is related with the institutes being inspected. Additionally, time constraint can result in bias as it limits the possibility of going through each document and details thoroughly. Moreover, financial concerns may also result in biases as verifying each document before allocating seats is a complicated process which can be expensive.

What should we do today?Medical Education commission (MEC) is the supreme body for the regulation of medical education. In this era of technology, online (web based or software based) evaluation and monitoring of medical institutes shall be introduced by MEC, not only in principle but in practice. The following Figure 1 shows benefits of online evaluation and monitoring .

Figure1: Benefits of online Monitoring & Education (M&E)

The Director, Directorate of Standards and Accreditation, Medical Education Commission Email : dir.std@mec.gov.np

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how to do it?A software needs to be developed in order to initiate online evaluation and monitoring. The developed software should include a format for inspection. Additionally, a database should be created which should be linked up with the MEC. Finally, a web-based link should be created between MEC and the following:

• Daily outpatient data• Daily inpatient data• Online PIS of faculty attendance• Academic calendar with attendance of students

(institutions need to submit it monthly)

Virtual meetings can be conducted with the institutes and academic activities can be monitored with the help of CCTVs. For example, CCTVs can be installed in all classes and exam halls. Those CCTVs can be linked up with the MEC database. Furthermore, class attendance and results can be submitted monthly in order to strengthen the system further.

What infrastructures/equipment/human resources are required for online evaluation and monitoring?

The Fig 2 shows the requirement of infrastructures, equipment and human resources are required:

Figure 2: Requirements for the online M&E system

online seat allocation methodInstitutions will be provided with the user id and the password, or they can register online with an approval from MEC. Consequently, institutions should fill up the inspection form with the details and the photos as mentioned in the form. Then the MEC will verify the database of the respective institutions can ask for further explanations or details if needed. In case of any concerns or if required, MEC can send an authorized person for physical verification as well as onsite interaction with the college administration, faculties, or students. Forms and software will be linked with the benchmark and decoding will be done in order

to allocate the seats automatically. In case of any complaints against a medical institution, MEC can evaluate either by web-based database or onsite verification.

Conclusion

Web-based continuous monitoring and direct evaluation of medical institution is important whilst considering the present context and rapidly evolving technological era. Furthermore, it is cost-effective, more transparent and less complicated.

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‘New Normal’ in Medical Education Prof. ramesh P Aacharya

AbstractMedical education is adversely affected during COVID-19 pandemic. Alternative teaching learning activities using online technology have been practiced throughout. It is not yet time to conclude whether online teaching can replace traditional teaching in some of the subjects. However, online teaching is an accepted alternative and the process of paradigm shift has already started globally. Like in other walks of life, medical education has entered to ‘new normal’. The importance of human touch in clinical teaching-learning cannot fade away but the opportunities for the students will be far less than the pre-COVID-19 era. Medical Education Commission can have coordinating and facilitating role to ensure the quality of health professional education during this transformation process.

Keywords: Online classes, COVID-19, New normal, Teaching-learning methodologies.

BackgroundEducation at all levels has become uncertain due to the closure of schools, colleges and universities and has changed dramatically during the crisis of COVID-19 pandemic. Moreover, due to the ongoing chaos at the teaching hospitals; medical education has been affected probably more than other academic programs. After half year COVID-19 crisis, it is likely that life won’t revive back to previous status. The changed status has been labelled as ‘New normal’ in various walks of life. In this context, this article is an attempt to explore the situation in medical education.

In Nepal, after the end of protracted lockdown phase, ‘new normal’ has started as less restrictive than ‘stay-home orders’ but far different from previous normal as efforts must continue to keep the risks of corona virus transmission as low as possible. So far, the date for restarting academic institutions cannot be anticipated.

Effects of COVID-19 in medical educationIn the sector of medical education, academic programs of undergraduate level, has been mostly affected. There are two pertinent reasons for halting

medical education - firstly, medical students’ safety may be jeopardized during clinical rotations putting them at risk of exposure to COVID-19 positive patients, and secondly, infected students may themselves become the portal of spread of the disease.1

In the society, there is a consensus that education must continue and there are genuine reasons to ensure the continuity of medical education:2

1. Learning the science and art of medicine is a stepwise process - it is imperative that a student completes one milestone before embarking on the next.

2. If clinical rotations are deferred for the current student cohort and clubbed with others, the density of learners would impair the clinical learning experience.

3. Recognizing the possibility that the current pandemic may take a reasonable time to abate, there may arise a paucity of healthcare staff.

United States Medical Licensing Examination (USMLE) program has already announced that it will suspend Step 2 Clinical Skills (CS) testing for an additional 12-18 months.3 It has not only created

Director, Directorate of Planning, Coordination and Academic Upgrading Medical Education Commission, Sanothimi, Bhaktapur, Email: dir.plan@mec.gov.np

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a major disruption to the education and assessment of all medical students and graduates who seek to train and practice in the United States but also has consequences resulting in deficit human resource for the coming years. This sort of halt and disruption will gradually be a global problem.

It is necessary for the medical education system to have adaptation through technological innovation so it can meet the needs of healthcare learners during COVID‐19 pandemic and even beyond.4

opportunities for academic upgradingIn response to the COVID-19 pandemic, medical educators have scrambled to conform curricula to social distancing mandates.5

• The online infrastructures are a rare chance for risk-averse medical institutions to modernize how we train our future physicians-starting by modifying the tradition of classroom lecture.

• Institutions should capitalize on new digital infrastructures and curricular flexibility to facilitate the eventual rollout of flipped classrooms6 - a system designed to cultivate not only knowledge acquisition but problem-solving skills and creativity.

The medical education system emphasizes the need for achievement of core competencies rather than mere completion of a stipulated time period in a subject. Obviously, technology-based education is more feasible in preclinical teaching.7 However, medical teaching, by using technology-based teaching techniques are complementary to conventional face-to-face education. Despite the educational value and diversity of the online options, bedside clinical with a ‘live’ patient cannot be replaced as several clinical and communication skills are to be mastered.

Online academic activities can be accomplished by online lectures, video-based vignettes, virtual simulators and webcasting etc. Clinical vignettes are patient-related cases and scenarios that have educational value for a wider audience. Any case

that illustrates a key point or points about diagnosis, management, or therapeutic decision making can make a good clinical vignette. A webcast is a media presentation distributed over the internet using streaming media technology to distribute a single content source to many simultaneous listeners/viewers. Essentially, webcasting is "broadcasting" over the internet.

With the advancement of information technology and the provisions of online educational resources, educational institutions worldwide are witnessing a massive trend towards the integration of technology in teaching, learning activities.8 In the recent years, the teaching-learning process is undergoing a paradigm shift in from ‘teacher‐led instruction’ to ‘student‐centred learning’, whereby the teacher’s role is as an expert in the field who guides and facilitates students' active engagement in their own learning process. The concept of blended learning as a combination of best features of both traditional and online learning was described by Finn and Bucceri back in 2004.9 A study conducted in nursing education revealed that blended learning combined with flipped classrooms allows students to become self‐directed autonomous learners and enhances competencies effectively.10 Mandatory closure of academic institutions during COVID-19 pandemic, has compelled us to utilize these innovative concepts in a faster pace. This is high time, to identify the effective and potentially implementable areas to incorporate them in the curriculum accordingly so that it will have academic endorsement.

It is not feasible for an individual institution to create and implement in short time4 but it opens up the areas of collaborations between the institutions. ‘Live patient contact’ is an irreplaceable tenet of clinical teaching but extraordinary times demand exceptional measures. Since the medical educators have been pushed inevitably to rely on technology-based learning, they should not only embrace it but also develop and evaluate its sustainability and application in preclinical as well as clinical settings.

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Regarding the opportunities for students, this period of ‘no teaching’ can be the period of ‘greatest learning’. They had firsthand observation of the principles of epidemiology in practice. They became aware of the dynamics of pandemic, use of personal protective equipment (PPE), habit of using mask and importance of hand hygiene. Similarly, faculties had perfect opportunity to learn, develop and evaluate the suitability and application of technology-based learning.

Alternative engagements for studentsHere is the list of some of the academic activities of the institutions to engage health professional students during the lockdown period:

1. Modification of the academic schedule - Preponing scholarly work and deferring clinical rotations to a later date.

2. Involvement in Tele-health consultations.3. Participation in health awareness and

involvement in community works like contact tracing, health education etc.

4. Attending webinars on COVID-19.5. Video-based trainings for:

a. Donning and doffing of PPE,b. Proper use of mask,c. Hand washing.

role of Medical Education CommissionThe responsibilities of academic arrangements is generally shouldered by the concerned colleges under the academic guidance of the university and academy. However, the medical education commission (MEC) can have coordinating role by organizing and facilitating consultative meetings and dissemination of experiences of newer teaching-learning methodologies. In addition, the commission can formulate core curriculum framework identifying feasible subjects for online courses, flipped learnings and blended learnings. In India, in the context of persisting pandemics the monitoring agency has been suggested for reverse use of its monitoring ‘war room’ for teaching

learning activities2 so that centrally operated virtual session can be utilized by all the colleges.

Limitations of it based online educationAs mentioned earlier, online education cannot entirely replace the traditional system of teaching-learning in medical education. It has following limitations:

1. Technical limitations -a. Can be supplemental to clinical teaching

but cannot be a replacement.b. No possibility of hands on practice.c. Poor technical skills of faculties and

students.d. Inadequate infrastructure like internet

service.e. Difficulty in supervision, monitoring and

formative assessment of student.

6. Organizational limitations –a. Poor understanding, encouragement and

facilitation by the authorities.b. Virtual learning environment or a simulation

laboratory is costly and time taking.c. Lack of institutional strategies.d. Lack of designated curriculum for online

education.e. Missing collaboration between the

institutions.

Anticipated ‘New Normal’With ongoing pandemic for almost half year of continuing lockdown, it is likely that colleges will remain closed even after the end of lockdown. Here are potential situations as new normal in medical education:

• Online courses, e-courses, virtual simulators will become part of teaching learning methodology.

• Minimal ‘live’ patient contact for medical students and even for postgraduate residents.

• Non-clinical, paraclinical subjects may gradually be more popular than medical, dental, nursing and laboratory science.

• Certain specialties like pulmonology, critical

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care, emergency medicine, otorhinolaryngology, dentistry, ophthalmology etc. may lose their popularity as subject of choice.

• Most of the clinical skills will be learnt after starting the job.

• Tele-consultation will be a common practice and will be included in the curriculum.

ConclusionsTill date, it is not yet time to conclude whether online teaching can replace traditional teaching in some of the subjects. However, online teaching is an accepted alternative and the process of paradigm shift has already started globally. In due course of time, it is likely that online teaching becomes a standard mode of pre-clinical education and virtual simulation technology be an integral part of clinical education. Of course, the importance of human touch in clinical teaching-learning cannot fade away but the opportunities for the students will be far less than the pre-COVID-19 era. In Nepal, Medical Education Commission can have coordinating and facilitating role to ensure the quality of health professional education during this transformation process.

references1. Rose S. Medical Student Education in the Time of

COVID-19 [published online ahead of print, 2020 Mar 31]. JAMA. 2020;10.1001/jama.2020.5227. doi:10.1001/jama.2020.5227

2. Sahi PK, Mishra D, Singh T. Medical Education Amid the COVID-19 Pandemic [published online ahead of print, 2020 May 14]. Indian Pediatr. 2020;S097475591600181.

3. USMLE Step 2 CS Suspended for at Least 1 More Year - Medscape - May 28, 2020.

4. Newman NA, Lattouf OM. Coalition for medical education-A call to action: A proposition to adapt clinical medical education to meet the needs of students and other healthcare learners during COVID-19. J Card Surg. 2020;35(6):1174-1175. doi:10.1111/jocs.14590

5. Chen CH, Mullen AJ. COVID-19 Can Catalyze the Modernization of Medical Education. JMIR Med Educ. 2020;6(1):e19725. Published 2020 Jun 12. doi:10.2196/19725

6. Ramnanan CJ, Pound LD. Advances in medical education and practice: student perceptions of the flipped classroom. Adv Med Educ Pract. 2017;8:63-73. Published 2017 Jan 13. doi:10.2147/AMEP.S109037

7. Moszkowicz D, Duboc H, Dubertret C, Roux D, Bretagnol F. Daily medical education for confined students during COVID-19 pandemic: A simple videoconference solution [published online ahead of print, 2020 Apr 6]. Clin Anat. 2020;10.1002/ca.23601. doi:10.1002/ca.23601

8. Harahap, F., Nasution, N. E. A., & Manurung, B. (2019). The effect of blended learning on student's learning achievement and science process skills in plant tissue culture course. International Journal of Instruction, 12(1), 521–538.

9. Finn, A., & Bucceri, M. (2004). A case study approach to blended learning. Los Angeles, CA: Centra Software.

10. Halasa S, Abusalim N, Rayyan M, et al. Comparing student achievement in traditional learning with a combination of blended and flipped learning. Nurs Open. 2020;7(4):1129-1138. Published 2020 Mar 31. doi:10.1002/nop2.492

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Effective Construction of MCQ Prof. sangha ratna Bajracharya

AbstractMultiple choice Question is one of the most common tools for assessing knowledge that satisfies the criteria of validity, reliability, practicability and objectivity. Among many types of MCQs, Single best response type MCQ (Type A) is most commonly practiced for educational evaluation. The effectiveness of MCQ depends upon its meticulous construction following the basic rules. This paper focuses on ten basic rules that facilitate formulation of MCQs along with the common flaws that needs to be overcome with caution.

Key words: Evaluation, MCQ rules, flaws

introductionMultiple choice question (MCQ) is one of the most common tools used for measuring cognitive abilities.1,2 It fulfils most of the criteria of a good assessment tool including validity, reliability, practicability and objectivity. The validity and educational impact of MCQs can be improved if the questions focus on concepts which are important and relevant either because of the frequency with which they appear in the workplace or because of the critical need to know the answer.3 How good an MCQ is to assess those criteria depends on the way it is formulated. Although there are many types of MCQs, we are focusing here on MCQ-Type A (Single best response type MCQ) which is the most common type of MCQ used for educational evaluation.4

MCQ (Item) has two major parts: Stem and Options (Alternatives). Options can also be divided into Key and distractors. Example:Which of the following receptors shows highest sensitivity to adrenaline? st

em

Item

a. Alfa-1

Dis

tract

ors

Opt

ions

/Alte

rnat

ives

b. Alfa-2

c. Beta-1

d. Beta-2 Key

Basic rules of Writing MCQsThe MCQs items should abide by the following ten basic rules. These rules can be grouped into three major headings:5,6

rules for items1. Item should focus on an important concept2. Proper content coverage should be assured

in order to determine the extent to which the estimate of true ability is reproducible and accurate.

3. Relevant content should be included based on desired outcome, which may demand not only the knowledge but also the understanding and application of knowledge

rules for stem1. Cover the option rule: The entire question or

theme should be included in the stem so that one can assume the answer before looking at the options.

2. Proper item shape should be maintained so that stem appears relatively longer than options, but without unnecessary details.

3. Avoid negatively phrased stem (e.g. those with ‘not’ or ‘except’)

rules for options1. Options should be in a single continuum and

homogenous in terms of category as the correct answer, similar length and consistent with the

Directorate of Examination, Medical Education Commission, Bhaktapur, Nepal. Email : dir.exam@mec.gov.np

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stem.2. Distractors should be plausible so that none

of the options seems to be totally false and all the alternatives should be attractive to the uninformed examinees.

3. Avoid mutually exclusive or implicitly overlapped alternatives

4. Mix up the order of correct answer, so that correct answers are distributed to the same proportion among alternatives (a, b, c, d) within a set of questions.

technical flaws during Construction of items:The technical flaws in item can be broadly divided into two types7: testwiseness and irrelevant difficulty. Flaws related to testwiseness make it easier for some students to answer the questions correctly based on their test-taking skills alone. These flaws occur in items that are unfocussed and not following the ‘Cover-the- option’ rule. On the other hand, flaws related to irrelevant difficulty make the question difficult for reasons unrelated to the trait (eg. risk taking behavior) that is the focus of the assessment.

Flaws Related to Testwiseness1. Grammatical cues: one or more distractors

don’t follow grammatically from stem.2. Logical cues: a subset of the options is

collectively exhaustive.3. Absolute terms: terms such as ‘always’ or

‘never’ are mostly in wrong distractor. ‘All of the above’ or ‘None of the above’ should be avoided.

4. Long correct answer: correct answer tends to be more longer, more specific and more complete than other distractors.

5. Word repeats: a word or phrase included both in the stem and in the options.

6. Convergence strategy: the correct option tends to include the most elements in common with other options.

Flaws Related to Irrelevant Difficulty1. Options are complicated, long and equivocal.2. Numeric data are not stated consistently (e.g.

Neither ascending, nor descending).3. Vague frequency-term in the option (e.g. rarely,

usually).4. Language in the option not aligned with the

stem; or options are in illogical order.

5. Stems are tricky and are unnecessarily complicated.

6. The answer to an item is ‘hinged’ to the answer of a related item.

ConclusionThe effectiveness of MCQs depends on its construction. An MCQ with relevant, focused and clear stem along with well-aligned plausible distractors helps fulfil its criteria of a good assessment tool. For an effective construction of MCQ, not only following basic rules but also avoiding possible flaws are of utmost importance.

Conflict of interestNone

fundingnone

references1. Premadasa IG. A reappraisal of the use

of multiple choice questions. Medical Teacher. 1993;15(2-3):237–42.

2. Mohammed O. Al-Rukban. Guidelines for the construction of multiple choice questions tests. J Family Community Med. 2006 Sep-Dec; 13(3): 125–133.

3. Coughlin P.A., Featherstone C.R. How to Write a High Quality Multiple Choice Question (MCQ): A Guide for Clinicians. Eur J Vasc Endovasc Surg. 2017;54:654-8

4. Mohamed Elhassan Abdalla, Abdelrahim Mutwakel Gaffar, Rasha Ali Sulaiman, editors. Constructing A-Type Multiple Choice Questions (MCQs): Step By Step Manual. Jazan, Saudi Arabia: Blueprints In Health Profession Education Series; 2011. p. 8-11

5. Carlos Fernando Collares. Guidelines for writing multiple choice question.Netherlands:EBMA; 2016.

6. Bhattarai MD. Multiple choice questions and open ended questions for written assessment. 1st ed. Kathmandu; 2005. p. 2-4

7. Susan MC and David BS. Constructing written test questions for basic and clinical Sciences. . 3rd ed. Philadelphia: NBME; 2002. p. 19-26

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Is Length of Stay in Emergency Services a Predictor of Outcome of Admitted Patients in

Intensive Care Unit? Neupane rP1, shrestha tM1, Aacharya rP1

AbstractBackground: Access block and overcrowding leading to prolonged stay in emergency room is a common problem of Emergency services of Tribhuvan University Teaching Hospital (TUTH) Kathmandu. Those patients who stayed longer in emergency department might affect continuing care and the ultimate outcome of patients.

objective: To evaluate the association of length of stay in emergency services and outcome of admitted patients in Intensive Care Unit (ICU) at the predefined cut-off value of 6 hours.

Methods: It was a prospective cross sectional study done in TUTH, Kathmandu for six months. Data were collected from records from adult emergency services, ICU and hospital record section. Patient outcomes were compared between those admitted to ICU within 6 hours and after 6 hours stay in the emergency.

results: A total of 264 patients were enrolled over 6 months. Male patients were slightly more (55.6%) than female and majority (52.6%) of patients were of 60 years and above. About one-third (35.0%) patients were admitted to ICU within 6 hours of stay in emergency services. It was found that there was no significant association between length of stay in emergency services and outcome of admitted total patients in ICU (p= 0.559). Age was found independent predictor for outcome (p= <0.01).

Conclusions: Emergency service length of stay is not predictor for outcome of admitted patients in ICU.

Key words: Emergency services, Intensive care unit, Length of stay, Mortality.

introductionTribhuvan University Teaching Hospital (TUTH), is a tertiary hospital and receives the patients from various corners of Nepal and gets around 40,000 patients per annum in emergency services. Each day, around 150 patients attend emergency for treatment and out of them around 16% patients get admitted

to wards, high dependency bed and Intensive Care Unit (ICU). Access block and overcrowding leading to prolonged stay in emergency room is a common problem of emergency services in TUTH.

Outcome of ill patients depends upon the time, process and management.1-3 The length of stay in emergency department and interventions before admission either in ward, intensive care or high dependency unit influence the patient outcome.4-6 Emergency Services is a source of patients admitted in wards and intensive care units. 7

Access block and overcrowding are related with harm to the patient including increased length

Corresponding Author:Dr. Ram Prasad NeupaneAssistant Professor,Department of General Practice and Emergency MedicineTribhuvan University Teaching Hospital, Kathmandu, NepalEmail: rpneupane@hotmail.com

1 Tribhuvan University Teaching Hospital, Kathmandu, Nepal

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of stay, increased medical errors, morbidity and mortality.8-17 The critically ill patients benefit from close involvement by ICU physician and one to one nursing, 18-21 elements of care not often present in emergency services. The positive impact of ICU admission on patient survival is more evident during the first 72 hours of critical illness.22 Two observational studies, one in the USA23 and the other one in Australia24 found that time in emergency department (ED) was an independent risk factor for ICU mortality.

A retrospective analysis of patients with sepsis presenting to the ED between 1997 and 2005 at Australasian and New Zeland hospitals suggested similar findings.25 Some other studies reported a five times higher risk of death, and a two times longer stay among patients not immediately admitted to the ICU.26 It has been shown that patients meeting ICU admission criteria and treated in the ICU, had a survival benefit.22 however some studies show no clear association between delayed admission and poor outcome.27

This sort of outcome study is a common area of research but so far no such studies are done in Nepal. Local situation and resource factors might influence generalisability and the comparison of studies that relate length of stay in emergency services to patient outcome.

Health care systems are required to cope with increasing demand for services with limited resources.28 This is demonstrated by access block in emergency service, where patients in emergency services may experience difficulty in getting admitted in wards/ICU in a timely fashion.8,28-30

In Nepal, definition of emergency services access block is length of stay in emergency services for more

than six hours and is regarded as a key performance indicator. However, there is little data to support the use of any particular time frame as an indicator of quality of care.

Emergency services overcrowding, access block and increased emergency department length of stay show broader health system issues, such as reduced inpatient bed numbers, high bed occupancy and increased number of patient flow.

The objective of this study is to compare the association between length of stay in emergency services and outcome of patients admitted from emergency services directly to ICU at the predefined cut-off value of 6 hours.

MethodssettingTribhuvan University Teaching Hospital, Kathmandu, Nepal, tertiary referral hospital. The emergency services has approximately 40,000 patient presentations per annum.

inclusion Criteria• Age more than 18 years• Patients who were admitted from the emergency

services to ICU services.

Exclusion criteria• Patients who were admitted from the emergency

services to other wards/units and later, transferred to ICU.

• Those patients who were in observation unit of emergency services.

study design and periodIt was a prospective cross sectional study determining association of length of stay in emergency services and outcome of admitted patients in ICU at the predefined cut-off value of 6 hours. Data were collected from records of emergency services, ICU and hospital record section. Comparison was done with respect to outcome of patients from emergency services to ICU services within 6 hours of length of stay in emergency services with those staying more than 6 hours. Comparison was done with regard to hospital outcome in terms of mortality during hospital stay.

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data analysis and statistics.Data were analyzed using SPSS Statistics 17 by Chi-square test.

resultsA total of 264 patients were enrolled in the study. Out of them, 44.4 % patients were female and 52.6% patients were of 60 years and above. About one-third (35.0%) patients were admitted to ICU within 6 hours of stay in emergency services.

125

139

less than 60 yrs

equal or morethan60 yrs

Figure 1: Age wise distribution of admitted patients in ICU

147

117

Gender

Male

Female

Figure 2: Gender wise distribution of admitted patients in ICU

93

171

Emergency length of stay

less than 6 hours

equal or more than 8 hrs

Figure 3: Emergency length of stay of admitted patients in ICU

Length of stay

Outcome

TotalExpired

Left Against Medical Advice D

isch

arge

d

<=6 hrs16 0 64 80

(20.0%) 0.0% 80.0% 100.0%

> 6 hrs30 3 115 148

(20.3%) (2.0%) (77.7%) (100.0%)

Table 1: Association of outcome and length of stay in emergency services in ICU admitted patients.

P=0.559

discussionThis study explored the association of length of stay in emergency services and outcome of admitted patients to ICU. Association between length of stay in emergency services and outcome in terms of mortality was not statistically significant. Our study conclusion was consistent with Manthous et al.31 That study done in critically ill patients in Connecticut in USA showed outcomes of critically ill patients transferred from emergency department to medical intensive care unit within 24 hour were not better than those who remained in emergency services for longer durations. Another study “the effect of emergency department delay on outcome in critically ill medical patients: evaluation using hospital mortality and quality of life at 6 months” by Saukkonen et al32 showed no clear association between delayed admission and poor outcome.

Don et al29 found that delayed admission to acute hospital beds is associated with worse outcomes. Two observational studies, one in the USA23 and one in Australia24 found that time in ED was an independent risk factor for ICU mortality. Young et al showed that a five times higher risk of death, and a two times longer stay among patients not immediately admitted to the ICU.

Simchen et al22 reported that the positive impact of ICU admission on patient survival is more evident

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during the first 72 hours of critical illness. It has been shown that patients meeting ICU admission criteria and treated in the ICU, compared to those treated out of the ICU, had a survival benefit.

A retrospective analysis of patients with sepsis presenting to the ED between 1997 and 2005 at Australian and New Zeland hospitals also showed time in ED was an independent risk factor for hospital mortality.25

Age was found statistically significant for outcome when analyzed in those admitted patients. However, Sex was not found to be predictor for outcome.

There is no association of mortality outcome and length of stay in emergency services might be due to patients were treated with the same line of management irrespective of place of patients treated. In emergency, patients were well prioritized by triaging the presented patients. To generalize this conclusion, such type of study with longer duration and in multiple centres should be done.

ConclusionsLength of stay in emergency services is not a predictor for outcome in terms of mortality of admitted patients in ICU services. However, other confounding factors might have influenced the outcome and deserve further study.

Ethical considerationsEthical approval was taken from Institutional review board (IRB) of Institute of Medicine, Kathmandu, Nepal.

Conflict of interests:None

funding:None

Authors' contributionsRPN - Conceptualized the study, involved in data collection, statistical analysis and preparation

of manuscript. TMS - Data collection, statistical analysis and preparation of manuscript. RPA – Manuscript layout, review and revision. All authors reviewed and agreed upon the final version of the manuscript.

AcknowledgementsWe would like to acknowledge the patients and their attendants participating in our study as well as all the staff of the department of general practice and emergency medicine who supported this study directly and indirectly.

references1. Rivers E, Nguyen B, Havstad S et al. Early

goal- directed therapy in the treatment of severe sepsis and septic shock. N. Engl. J. Med. 2001; 345: 1368-77.

2. Engoren M. The effect of prompt physician visits on intensive care unit mortality and cost. Crit. Care Med. 2005; 33:727-32.

3. Hochman JS, Sleeper LA, Webb JG et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. N. Engl. J. Med. 1999; 341: 625-34.

4. Rapoport J, Teres D, Lemeshow S et al. Timing of intensive care unit admission in relation to ICU outcome. Crit. Care Med. 1990; 18: 1231-5.

5. Goldhill DR, McNarry AF, Hadjianastassiou VG et al. The longer patients are in hospital before Intensive Care admission the higher their mortality. Intensive Care Med. 2004; 30: 1908-13.

6. Nguyen HB, Rivers EP, Havstad S et al. Critical care in the emergency department: a physiologic assessment and outcome evaluation. Acad. Emerg. Med. 2000; 7: 1354-61.

7. The Victorian Intensive Care Data Review Committee. Intensive care for adults in Victorian public hospitals 2002. Report to

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Public. Victorian Government Department of Human Services, Melbourne, Victotoria; 2004 sect. 18-19.

8. Richardson DB. The access-block effect: relationship between delay to reaching an inpatient bed and inpatient length of stay. Med. J. Aust. 2002; 177: 492-5.

9. Richardson DB. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med. J. Aust. 2006; 184: 213-16.

10. Sprivulis PC, Da Silva JA, Jacobs IG et al. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med. J. Aust. 2006; 184: 208-12.

11. Croskerry P, Sinclair D. Emergency medicine: a practice prone to error? CJEM 2001; 3: 271-6.

12. Schull MJ, Vermeulen M, Slaughter G et al. Emergency department crowding and thrombolysis delays in acute myocardial infarction. Ann. Emerg. Med.2004; 44: 577-85.

13. Fee C, Weber EJ, Maak CA et al. Effect of emergency department crowding on time to antibiotics in patients admitted with community-acquired pneumonia. Ann. Emerg. Med.2007; 50: 501-9, 9 el.

14. Pines JM, Hollander JE. Emergency department overcrowding is associated with poor care for patients with severe pain. Ann. Emerg. Med.2008; 51: 1-5.

15. Liew D, Kennedy MP. Emergency department length of stay independently predicts excess inpatient length of stay. Med. J. Aust 2003; 179: 524-6.

16. Mowery NT, Dougherty SD, Hildreth AN et al. Emergency department length of stay is an independent predictor of hospital mortality in trauma activation patients. J. Trauma 2011; 70: 1317-25.

17. Fatovich DM, Nagree Y, Sprivulis P. Access block causes emergency department overcrowding and ambulance diversion in perth, Western Australia. Emerg. Med. J 2005; 22:351-4.

18. Pronovost P, Angus D, Dorman T, Robinson K, Dremisizov T, Young T. Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review. JAMA 2002; 288: 2151-62.

19. Multz A, Chalfin D, Samson I. A “closed” medical intensive care unit (MICU) improves resource utilization when compared with “open” MICU. Am. J. respir. Crit. Care Med. 1998; 157: 1468-73.

20. Carson S, Stocking C, Podsadecki T. Effects of organizational change in the medical intensive care unit of a teaching hospital: a comparison of “open” and “closed” formats. JAMA 1996; 276: 322-8.

21. Thorens J, Kaelin R, Jolliet P. Influence of the quality of nursing on the duration of weaning from mechanical ventilation in patients with Chronic Obstructive Pulmonary Disease. Crit. Care Med. 1995; 23: 1807-15.

22. Simchen E, Sprung CL, Galai N, Zitser-Gurevich Y, Bar-Lavi Y, Gurman G, Klein M, Lev A, Levi L, Zveibil F, Mandel M, Mnatzaganian G. Survival of critically ill patients hospitalized in and out of intensive care units under paucity of intensive care unit beds. Crit. Care Med.2004; 32: 1654-61.

23. Chalfin D, Trzeciak S, Likourezos A, Baumann B, Dellinger P. Impact of delayed transfer of critically ill patients from the emergency department to intensive care unit. Crit. Care Med. 2007; 35: 1477-83.

24. Duke G, Green J, Briedis J. Survival of critically ill medical patients is time-critical. Crit. Care Resusc.2007; 6: 261-7.

25. The Australian Resuscitation in Sepsis Evaluation (ARISE) Investigators. The outcome of patients with sepsis and septic shock presenting to emergency departments in Australia and New Zealand. Crit. Care Resusc. 2007; 9: 8-18.

26. Young MP, Gooder VJ, McBride K, James B, Fisher ES. Inpatient transfers to the intensive care unit: Delays are associated with increased

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mortality and mortality. J. Gen. Intern. Med. 2003; 18: 77-83.

27. Sprung CL, Geber D, Eidelman LA, Baras M, Pizov R, Nimrod A, Oppenheim A, Epstein L, Cotev S. Evaluation of triage decisions for intensive care admission. Crit. Care Med. 1999; 27: 1073-79.

28. Richardson D, Mountain D. Myths versus facts in emergency department overcrowding and hospital access block. Med. J. Aust. 2009; 190: 369-74.

29. Don L, Danny L, Emergency KM. Department length of stay independently predicts excess inpatient length of stay. Med. J. Aust. 2003; 179: 524-6.

30. Forero R, Hillman K, McCarthy S et al. Access block and overcrowding. Emerg. Med. Australas. 2010; 22: 119-35.

31. Lisa Tilluckdharry, Sumit Tickoo, Yaw Amoateng-Adjepong, Constantine A. Manthous et al. Outcomes of Critically ill patients: Based on duration of emergency department stay. American Journal of Emergency Medicine 2005; 23: 336-39.

32. Saukkonen KA, Varpula M, Rasanen P, Roine RP, Voipio-pulkki LM, Pettila V et al. the effect of emergency department delay on outcome in critically ill medical patients : evaluation using hospital mortality and quality of life at 6 months. J. Intern Med. 2006; 6: 586-91.

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Challenges to Residency Training During COvID-19 Pandemic

dr Prasanna Ghimire, dr Pragya Gautam Ghimire

Severe acute respiratory syndrome corona virus -2 (SARS- CoV-2) infection initially started in Wuhan in December 2019 but eventually spread worldwide affecting primarily many European countries and United states1. It resulted in significant morbidity and mortality worldwide. The World Health Organization had declared it as pandemic on 21st March, 20202 As the disease burden appears to have declined recently in the Western countries, a surge has been noted in various South Asian and South American countries. Nepal reported its first imported case from Wuhan, China on January 13, 2020. By June 29th 2020, there were already 13248 cases with 29 deaths from Covid-19 in Nepal.

Although all the sectors were impacted by the pandemic, the health sector were most to be challenged with. The health system even in the most developed countries seemed ill-prepared to address these pandemics. Nepal government’s effort to curb the situation was appreciable, however the sudden influx of migrant workers from other countries had resulted in a havoc. Major challenges included limited diagnostic capacity, inadequately trained personnels, poor health infrastructure of the hospitals and meagre intensive care facilities 3.

Nepal government had assigned various hospitals according to the level of care to be provided to the Covid patients with highest level III status to three hospitals which included Nepalgunj Medical

College Teaching Hospital, Kohalpur; BP Koirala Institute of Health Sciences, Dharan and Tribhuvan University Teaching Hospital, Kathmandu. A major role of medical institutions besides providing health care services is also training of medical graduates and post graduates. Residents are a pivotal workforce in any medical institution where they are trained under guidance of preceptors and faculties.

The COVID-19 pandemic has also impacted in the overall training of residents in their respective programs. As most of the health care institutions have postponed all elective cases and procedures, this has resulted residents’ limited exposure to varied cases. Hands on training are mostly affected.

Due to the necessity of adequate protection and safety of residents and faculties, the regularly conducted classes, workshops and meetings had to be provided by alternate means. A major change has been in transformation of various programs to be conducted online by means of web conferencing software. As medical education had to be carried out continuously along with the hospital duties with minimal staffs, this became a challenge to the running programs. Major platform for education during this period were via webinars and online classes. Active participation from residents were encouraged though not forced during this period. Many faculties from various institutions envisioned the need for a common platform for engaging their residents and faculties and exchanging academic information 4Although face to face interactions were not possible, a Web based learning still has been fruitful for many residents.

In our institution which is a COVID – 3 level hospital, we assigned different groups which included few residents and a faculty to be present for the clinical

Nepalgunj Medical College and Teaching Hospital

For correspondenceDr Prasanna GhimireAssociate Professor of RadiologyNepalgunj Medical College and Teaching Hospital, Banke, NepalEmail: drprasannaghimire@gmail.com

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duties so that exposure to any potential case was limited. Each group would be performing the duties which would then be replaced by another group after completion of a one-week duty. Implementation of this approach had a benefit when faculty and residents were exposed to COVID-19 cases and had to stay in quarantine with however the regular hospital services being least affected.

COVID-19 pandemic course is unknown to all thus creating mental stress to all health workers. During this pandemic, mental stress was imminent amongst the residents and faculties who had to perform clinical duties being concerned of not only their own safety but also of friends and family members. Social stigma looming in common people had created concern even for lodging and fooding among residents.

It is imperative for the academic co-ordinators, faculties, preceptors to be more flexible and considerate during this period of uncertainty. A moral and mental support is warranted to the residents who form the major backbone of the frontline

workforce in academic institutions. Besides, novel techniques for strengthening academic training and modification in the curriculum is to be sought for coming sessions.

references:1. Hua J, Chen R, Zhao L, Wu X, Guo Q, He C,

et al. Epidemiological features and medical care-seeking process of patients with COVID-19 in Wuhan, China. ERJ Open Res. 2020;6(2).

2. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-60.

3. Pokharel S, Raut S, Rijal KR, Adhikari B. Coronavirus Disease 2019 Pandemic – Public Health Preparedness in Nepal and One Health Approach. Disaster Med Public Health Prep. 2020:1-2.

4. Crosby DL, Sharma A. Insights on Otolaryngology Residency Training during the COVID-19 Pandemic. Otolaryngology–Head and Neck Surgery. 2020:0194599820922502.

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Medical Education

Medical Profession and Quality Medical Education

 Prof. dr Gehanath Baral

ABstrACtMedical profession is a noble profession of scientific knowledge and its application in the society. Medical education uplifts this profession by various delivery models and regulations. Higher medical education differs from nomenclature despite of the acquired knowledge and skill in each country or region.

introductionMedical professionalism is the specific knowledge, skill and attitude displayed to the society and people while undertaking medical practice. Thus it has inherent contract between health professional and society, individual patient or regulatory authority. Thus the medical profession is the regulated social contract in medical education and practice. It has two facets: individual and institutional. One facet refers to a set of values, behaviours and relationships that underpin the trust the public has in doctors, with doctors being committed to integrity, compassion, altruism, continuous improvement, excellence and teamwork. Other facet refers to the integration of professional culture of individuals to the entire institutional system like curricula and internal stakeholders for its completeness. It addresses right from the entry system, recommended/validated curriculum, teaching-learning methodology to evaluation system.1,2

Medical profession is an occupation aimed at protecting, promoting and restoring good health with a focus on identifying, diagnosing and treating illnesses using scientific and highly specialized

knowledge where caring for the patients is the first concern that applies principle based practices like transferable scientific knowledge and skill, continuous evolution, ethical and competent act, and benefit to individual and society. A medical professional is a qualified doctor who abides and is fully committed to the ethical principles and values of the medical profession.

Medical professionalism comprises all the basic ethical and deontological principles that sustain the commitment of the medical professionals to the society they serve. These principles evolve with social changes and also help to sustain the trust of people on their doctors. Medicine has to be practiced in a way that the patient’s rights are always first and this principle provides a firm ground to the trust that the patient has on his/her doctor. The principles that also apply to this medical ethical behaviour are those of autonomy, beneficence, non-maleficence and justice. Doctors must keep their knowledge, skills and judgement at the service of the people they work for, with the firm aim of promoting health, prevent and treat illness and improve their wellbeing. The medical professional should therefore be committed to using their knowledge and the resources available in the best possible way; being compassionate when faced with suffering; staying up to date and continuously improving the service they provide; and contributing with other health professionals and institutions in order to improve health and promote wellbeing.3,4

CORRESPONDENCEDr Gehanath BaralProfessor of Obstetrics & GynecologyNobel Medical College, Kathmandu UniversityEmail: gehanath@gmail.comMobile: +977-9841228829

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Thus the principles, values and commitments from medical professionalism are always for the people and society that has to be respected and reciprocated. It has been delivered in the structured way from different sectors as service as well as business that brings conflict on trust and access at times. Medical professionalism evolves with quality medical education and its methodology.

disCUssioNEducation model depends on the real need. Our real need will be addressed by quality product but politicized or virtual need will be fulfilled by quantity product that is assigning risk to the society and demoralizing individual in front of society. Simulation learning is a part of skill learning but not the sole learning method. This is the preliminary methodical step. Non-touch learning never provides human touch and value.5

Medical service is unconditional act with good faith that doesn’t always follow the theory of economics and business. Trainings follow the economic theory but not the medical services. Patients are not customers like in business. Goods and services are evolving everyday in medical sectors and people (patients) tend to own the services claimed to be best for the life that doesn’t always follow the negative relationship of price and demand that is observed in non-medical products. Medical services do not always follow the economic theory of relationship like customer and provider because it doesn’t deal with warranty, guaranty or certainty. It moves with good faith and unconditional act. Medical devices, training and education are destined for the people (external customer) and the physicians (internal customer).6-8

Specialty training is must; and sub-specialty is the demand of time and the addendum on the existing specialty. Medical education and trainings are delivered according to the desired target within the defined territory. Competency based trainings would be a real time training applicable directly to the people and society.9

There is a huge gap between the demand of highly skilled health professionals and their supply for most of the specialties in Nepal. The Specialty Health Services to the people in most of the sub-specialties have not been fully developed even in the oldest Medical Teaching Institute like Institute of Medicine. Currently, Medical Education Commission of Nepal has been entrusted by an act of parliament for developing and establishing a system of higher medical education through its National Board of Medical Specialties.10-12

There is variation in entry system, medical degree, duration of study, practice licensing and structure of medical education all over the world. It has been practiced and regulated differently in different countries and regulated differently by their regulatory bodies. Because of increasing mobility of medical trainees, doctors and specialists, there is notable difference in its recognition, equivalence and competency. Education system adopted in each country or region is as per need of the land and administrative procedures may obviously vary. Similar competency level may not have equivalent nomenclature across the country or region that conflicts in medical practice at times. 13

The models of medical education may include

(1) the traditional (post-Flexnerian) model;(2) the organ system approach developed at Western

Reserve University School of Medicine;(3) the flexible or elective model originally

developed in the 1950s in response to the traditional model;

(4) the community-based or primary care model; and

(5) accelerated medical education programs, including(a) three-year M.D. curricula,(b) baccalaureate-M.D. programs, and(c) M.D.-Ph.D. programs.14

The fellowship programs are of variable length of competency-based training in certain specialty that would be recognized by respective regulatory

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authority based on their own bench mark.

CoNCLUsioNMedical Profession and the society it serves depend on quality medical education and training that varies I its model and nomenclature from place to place. The model adopted as per the need of society and regulatory authority.

rEfErENCEs1. Baral G. Medical professionalism. Nep

J Obstet Gynecol. 2019;14(28):4-5. https://doi.org/10.3126/njog.v14i1.26620

2. Passi V, Doug M, Peile E, Thistlethwaite J, Johnson N. Developing medical professionalism in future doctors: a systematic review. International Journal of Medical Education. 2010; 1:19-29. DOI: 10.5116/ijme.4bda.ca2a

3. Sendín R. Definition of the medical profession. CGCOM, 2010. URL: https://www.cgcom.es/noticias/2010/12/10_12_13_medical_professional

4. World Medical Association. Medical ethics manual. 3e. 2015.

5. Baral G. Education with Human Touch. Nep J Obstet Gynaecol. 2017;12(24):4. DOI: https://doi.org/10.3126/njog.v12i2.19940

6. Baral G. Specialty training in Medicine. Nep J Obstet Gynecol. 2019;14(29):5-6.10.3126/njog.v14i2.28432

7. Leng S. Patients are NOT Customers. The health care blog. March 2015 [cited 5 December 2019] URL: https://thehealthcareblog.com/blog/2015/03/21/patients-are-not-customers/

8. Lee DR. The Basics of Demand and Supply. FEE Foundation for Economic Education.

October 1998 [cited 1 December 2019]. URL: https://fee.org/articles/demand-and-supply/

9. Blueston J, Fowler R, Johnson P, Smith J, editors. Clinical training skills course – reference manual. Baltimore: Jhpiego Corporation. 2010.

10. Bhattarai MD. Facilitation of free residential training inside the country – The fundamental health service responsibility of the Government and its regulatory body. J Nepal Med Assoc. 2015;53(197):40-69.

11. Medical Education Commission Act 2075. Available from: http://mec.gov.np/en/category/reports

12. Dangal G, Baral G. Need of Fellowship Training in Nepal: Obstetrics and Gynecology Sub-specialties Are Not Left Behind. Nep J Obstet Gynecol. 2019;14(29):62-64. DOI: 10.3126/njog.v15i2.28443

13. Marjo WM, Burdick W, Alofs L, Burgers C & Olle ten Cate (2013) Stages and transitions in medical education around the world: Clarifying structures and terminology, Medical Teacher, 35:4, 301-307, DOI: 10.3109/0142159X.2012.746449

14. Jane S.Takeuchi, Nina M.Smith, and Allyn M.Mortimer. Innovative models of medical education in the united states today: an overview with implications for curriculum and program evaluation. In:Medical Education and Societal Needs: A Planning Report for the Health Professions. Institute of Medicine (US) Division of Health Sciences Policy. Washington (DC): National Academies Press (US); 1983. URL: https://www.ncbi.nlm.nih.gov/books/NBK217683/

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Specialty Post Graduate Medical Education In Nepal :Gaps in Training Opportunity, Current Regulations and

Reciprocation with The Global Standard

Prof. Aarati Khanal shah

AbstractAs stated by World Federation for Medical Education –WFME “ The objective of Post Graduate medical education is to train the medical professionals after the basic medical degree in the field of their medical practice of interest so that they develop competencies under supervision and are able for independent practice after completion of training”.

Medical education is a life-long learning process and is ever changing .As per the WFME, while setting the standard for Post Graduate medical education in any country or region, it must be specified and should have the modification or supplementation as per the Institutional, National or Regional need but should comply with the Global standard.1

This article tries to discuss the gaps in specialty training opportunity, along with current regulation laid down in Medical education in the country reciprocating in the context of Global Standard.

Key Words : Specialty, Training Nepal, National, Global Standard

introductionAim of Post Graduate Medical Education(ME) is to train the medical professionals after the basic medical degree so that they develop competencies under supervision and are able for independent practice after completion of training preferably in their field of interest.

Medical Education in Nepal started as far as 1934 but it was in 1978 the formal basic Medical Course MBBS stated in IOM,TUTH .It required a great effort and planning to be a good and structured educational course. Since then there is a surge of medical colleges and quite a number of MBBS Graduates are being produced in the country and being posted all over Nepal providing service to the rural as well as urban population.2

The contribution of these medical doctors is quite significant but with the growing need of the country and advancement of technology, diagnostics, newer therapeutic advancement in the medical field globally, there is a need for post graduate specialist medical training to provide independent and adequate focused specialist care. Realising this fact the post graduate residency programme in General practice as MDGP was started in 1982 which set the milestone for Specialist training in the country. 3,4

Why specialty training in Nepal ?Undergraduate and post Graduate specialist registered at Nepal Medical council shows a huge gap between these two cadres .About less than 20 percent of the MBBS and Dental Graduates get opportunity for Specialty training as there are limited seats availed by Universities, Academias and Medical colleges. If we go through the present status of Council registration, the gap is quite evident .

CorrespondenceProf Aarati Khanal Shah,Director,National Board Of Medical Specialties (NBMS)/MECe-mail dir.spe@mec.gov.np

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Table 1 : Total Registered Medical and Dental doctors at Nepal Medical Council uptil 31/12/2019Male female total

MBBS 15485 7661 23146 Under Graduate(UG)BDS 1118 2082 3200 UGtotal 16,603 9743 26346 UGMD/MS 5213 1972 7185 Post Graduate(PG)MDS 317 256 573 PGtotal 5530 2228 7758 PG

source : Nepal Medical Council5 available at nmc.org.np

This shows there is a very limited number of seats prevailing for specialist training present for specialty medical education thus rationalizes the need for creating more opportunities for Specialty Training in the country to fulfill this gap.

In the country, in the total health care providers there are only about 4% of doctors, 12% nurses excluding ANM,s, 47% paramedics and 0.92 % public health officers. This poses challenge to health system to provide the more and more skilled human resource.6

As per Ministry of Education, Science and Technology(MOEST), which has published National Education Policy as Rastriya Sikchya Niti (2076) states that it will facilitate the best practices in Government as well as other feasible Institutes for education to provide the equal opportunity for all aspiring for higher education without any discrimination. It will facilitate education at all levels and further states the need for quality education in well established centres It visions for competency basd curriculum which will produce the skilled, competent, and service oriented human resources including the medical field . It has stressed the need for establishing a system for monitoring, supervision and evaluation.7

National Standard Regulation Guidelines for Post Graduate (specialty training) in reciprocation with Global Standard in Medical Education :

discussionEnvisioning the above facts in the context of Nepal there is a huge need for Specialty training,

fulfilling the gap and focussed specialist care .This requires the guidelines which are in accordance with the local context yet also taking into consideration of Regional and Global Standard. Nepal Medical Council was established in BS 2020 (1964) by Nepal Medical Council Act 1964, and has got the mandate for standardization of medical education,standardization of medical practices,encouraging the medical doctors to follow the code of medical ethics and disciplinary action if violation of medical ethics occur.8 Before the commencement of Medical Education Act 2075, Nepal Medical Council had the Regulatory Authority role for Standardization as well as Accreditation of Medical Institutions for medical education in the country. For maintaining the quality of Medical Education in the country it had published the Guidelines on Regulations for Post Graduate Medical Education for MD/MS/, and DM/MCH (revision 2017) which has laid down the requirements for National standard as well as reciprocating with Global standard.9

During the 2017 revision process it has taken the considerations of Guidelines as laid down by World Federation of Medical Education, (WFME revision 2012), South East Asia Public Health Education Institute,s Network (SEAPHEIN) and South East Asia Regional Association of Medical Education (SEARAME) It also had incorporated the social responsibility in medical education as aimed by Second Long Term Health Plan 2017(SLTHP-2017) and included the aspects of community, and rural posting.10 The 2017 revision has laid down the emphasis on newer concepts like competency

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based learning, computer assisted learning as well as simulation based learning and skilled laboratory. Similarly it has included that the curriculum in medical education should be focusing on highly competent, service oriented professionals.

WFME standards are the consensus of global experts in medical education and in general has divided into 3 areas albeit Basic Medical Education, Post Graduate (specialist) Medical Education and Continuing Professional Development.

Table 2 : WFME Trilogy of Standards : Areas for Rationing

Basic medical educationPost Graduate

(Specialty) Medical EducationContinuing Medical Education

1 Mission and objectives Mission and outcomes Mission and outcomes2 Educational Programmes Training process Learning Methods3 Assesment of students Assesment of Trainees Planning and Documentation4 Students Trainees Individual Doctor5 Academic staff/Faculty Staffing CPD Providers6 Educational Resources Training Settings and Process Competencies/evaluation of

methods7 Programme evaluation Evaluation and Training process Evaluation of methods and

competencies8 Governance and Administration Governance and administration organisation9 Continuous renewal Continuous renewal Continuous renewal

Ref : https://wfme.org/standards/attachment/wfme-trilogy-of-standards_new/11

In the context of Nepal there is a huge need for specialty and subspecialty training and fulfilling the needed medical specialists in the country which requires establishment of newer post graduate medical training facilities but maintaining the uniform yet meeting the global standard.

National Board Of Medical Specialties –NBMS as alternative Specialty Training 12

“National Board Of Medical Specialties” has been established by the National Medical Education Commission act 2075, and has thus opened the new horizon for alternative Specialty Training which envisions many important proceedings and will incorporate and accreditate the Institutions beyond the University and Academia domain which will fulfill the criterias and requirements for standardization laid down by Nepal Medical Commission Accreditation unit and by National Board itself. Further National Educational Policy, 2076 also broadens its scope as the policy mentions in Section 10.17(3), National Board to start and run

the Academic specialty programme in an innovative and nationally and internationally recognized model. 12,11

In a situation where there is a continuous demand of freshly passed out Medical Graduates to increase the number of seats for specialty academic training, the Specialty programme to be started by National Board will be very appropriate, will address the increasing demand in the country, will utilize the expertise infrastructure and equipments available in the country,

But the challenge is to start with meeting the benchmark of Global standard and modelling it to local scenario. It intends to fulfill the Triage criteria of WFME for specialty training as the aspiring candidates from NBMS will be a mobile medical workforce and will be in the International Job market as well.

There is a Need for regulating the Academic Specialty (fellowship) programme run by Boards

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other than NBMS like college of Physicians and surgeons of Pakistan (CPSP) and alike to abide by the national regulations and criteria to maintain the uniformity and academic standard to persue in the country as these programme provide opportunity for Specialty Training and exposure as per the International curriculum and structure to the Nepalese students.13,14,15,16,17

summaryMedical education is a life-long learning process and is ever changing .As per the World Federation of Medical Education (WFME) while setting the standard for Post Graduate Medical Education/Specialty Training in any country or region, it must be specified and should have the modification or supplementation as per the Institutional or National need but should comply with the Global/Regional standard. In the context of Nepal there is a huge gap in availability for getting opportunity for Specialist Training for fresh Medical Graduates. So there should be opening the door for more Specialist training opportunities based on competency based curriculum which should be abided by the Guidelines and regulations already laid down by Nepal Medical Council,revision 2017. And further more now Medical Education Commission (MEC) has been commenced in action, the Post Graduate specialty and Subspecialty Training Institutes and centres will need to follow the rules and Regulations set by MEC.

The National Board of Medical Specialties –NBMS established as per the Chikitsa Sikchya Ain 2076, aims to start the Specialty and Subspecialty Academic programme in the country as well as regulating the Programme outside NBMS Board from Institutes outside the country in accordance with rules and regulations laid down by the Government and Medical education Commission.

references1. Postgraduate Medical Education .WFME Global

standards for Quality improvement.Available from http:// www.wfme.org

2. Dixit H.History of Health professional Education in Nepal.J Kathmandu Med Coll .available from http://www.nepjol.info/index,php/JKMC

3. H.Neupane,Niki S,Bishow S.Fellowship Training In Nepal.J Nepal Health Res Counc 2018;16(40):345-50

4. Dixit H.Developement of Medical Education in Nepal.Kathmandu University Medical Journal.2009;7(25):8-10

5. NMC .available at nmc.org.np.6. Blair George. Human resource Information

System assessment Report:Nepal Ministry of Health and Population and NHSSP II,Strengthening Heath system Improving services2011

7. National Education Policy (Rastriya Sikchya Niti 2076 ) .Published by Ministry of Education Science and Technology,2019

8. Nepal medical Council .Regulations for Subspecialty Postgraduate Medical Education (DM/MCH Programms ) 2017 .Published by Nepal Medical Council,second edition 2017

9. Nepal medical Council .Regulations for Postgraduate Medical Education (MD/MS )Programms 2017 .Published by Nepal Medical Council,second edition 2017.also available at nmc.org.np/files/4/regulations for MD/MS/pdf

10. Nepal health Sector Programme II (NHSP II)2010-2015.Implementation plan .Ministry of Health and population,Govt of Nepal;2010

11. WFME Trilogy of standards .available at https://wfme.org/standards/attachment/wfme-trilogy-of-standards_new/

12. Medical Education Commission Act 2075.available from :http://mec.gov.np

13. Baral G. Specialty Training in medicine.Nep J Obstet gynecol.2019;14(29):56.10.3126/njog.v1412.28432

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14. Dangal G, Baral G. Need of Fellowship Training in Nepal :Obstretics and Gynaecology subspecialties Are Not Left Behind.Nep J Obstet Gynaecol.2019;14(29):62-64

15. Fellowship in Emergency medicine (FEM) BPKIHS.Edusanjal available at https://edusan j a l . com/cou r se / f e l l owsh ip - in -emergency-medicine-fem-bpkihs

16. Fellowship in emergency medicine (FEM) Prospectus 2017.patan academy of health

sciences school of Medicine 2017 .available at http://www.pahs.edu.np/pahs-fellowship-program/

17. Bhattarai MD.Facilitation of Free Residential training inside country-the fundamental health service responsibility of Government and and its regulatory body.J Nepal med assoc.2015;53(197):40-69

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Physiotherapy in Woman’s Health dr Krishna Jha

introductionIn a developing country like Nepal where studies have shown women have high fertility rate of 5.6. and their health is a negelected dimension, Baker J in 1994 concluded that more than 90% of women nationwide do not receive any obstetric care during their last pregnancy. The maternal mortality rate is 515/100,000 live births, one of the highest rates worldwide. Both the government and the private sector should take action geared to improve women's health. The action should begin with formulation and implementation of a reproductive health care strategy that includes improved maternal care, increased access to family planning, legalized abortion, and legislation to improve the status of women and physiotherapy care.

Women's Health Physiotherapy is a broad concept derived from the clinical area of Obstetrics and Gynaecology and it includes care of women in relation to childbirth, both antenatally and postnatally. The scope of practice has now increased to include all health concerns of women like incontinence, pelvic & vaginal pain, prenatal and postpartum musculoskeletal pain, osteoporosis, rehabilitation following breast surgery, lymphedema, education, prevention, wellness and exercise. All females across the life span, from the young athlete, the childbearing woman, the menopausal and elderly woman receive benefit from physical therapy. Unfortunately many women visits physiotherapist after problems already occurring, after childbirth or a referral.

All Women’s Health & Continence Physiotherapists have post graduate training in the range of health issues faced by women throughout every stage of their life. They identify and address specific health problems and use a variety of non-surgical treatments. A thorough assessment and in-depth discussion is being done about the most effective treatment technique recommended for particular health issue. Diagnosis and treatment plans are evidence-based practice, and are delivered in a safe and supportive environment. Treatment may involve simple exercises, ultrasound or massage and follow up rehabilitation activities may be recommended such as a guided exercise program or clinical Pilates. For example pelvic floor muscles strengthening exercises, dietery changes to prevent irritation of bladder and practical tip are a part of physiotherapy session for urinary incontinence. The recommended program will help the patient identify, exercise, re-train or repair internal muscles such as those in the pelvic floor, and ultimately help to improve quality of life.

Women's health physiotherapy is all about 'muscle coordination' and treating pelvic floor muscles that have become either underactive (hypotonic) or overactive (hypertonic). An underactive muscle is one that is weak and lengthened, it might have been stretched significantly after giving birth, which can cause urinary incontinence or vaginal prolapse, whereas an overactive muscle is shortened and has little stretch to it. Muscles become overactive because the brain is constantly sending messages to those muscles to contract. For example, if there are symptoms of bladder urgency or painful sex, the muscles will be used more and become shorter. It can make the vagina or back passage tighten up which can increase pain. Women with vaginismus and vulvodynia, which can cause painful sex, may benefit from women's health physiotherapy to

CorrespondenceDr Krishna JhaPT (B.PT,M.PT-Neuroscience)H.O.D Physiotherapy DepartmentManmohan Memorial Medical college and Teaching Hospital, Swoyambhu, Kathmandu, NepalEmail id- physiodrkrishna@gmail.comMob +977 9864531765

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release these muscles and reduce symptoms. Manual therapy and trigger point release definitely helps the women. Every physiotherapy program is different and is customized to the patient’s needs. Women have unique physical and physiological attributes that physiotherapists take into consideration.

• Some of the issues that are positively impacted by physiotherapy include Prenatal and postnatal issues, lower back pain or abdominal muscle separation (Diastesis Recti)

• Bladder and bowel dysfunction, including incontinence

• Pelvic/perineal area pain• Painful intercourse• Coccydinia• Pelvic floor muscle dysfunction• Pelvic organ prolapse• Nerve compression syndromes

Physiotherapists also provide Pregnancy education, Pool exercise classes, Clinical Pilates and Individual exercise prescriptions. Regular physical activity is vital for good physical and mental health. It aids in improving overall health and fitness, maintaining a healthy weight, reducing the risk for many chronic diseases and Promoting good mental health. At least 30 minutes of moderate-intensity physical activity on most, preferably all days is required for good health. Family responsibilities, cultural or social beliefs, economic or employment status, level of education are few barriers to physical exercise mostly women face. In Nepal, women often have a domestic workload and care-giver roles for other family members which may limit the time available for them to engage in physical activity.

Physical activity during pregnancy benefits a woman's overall health. Pregnancy is one of the most important period in the life of a women, a family and a society. Therefore a great attention is given to antenatal care by the health care system of most countries. Pregnancy associated osteoporosis, nerve compression, muscle cramps,pelvic floor drop, increase in joint laxity

and diastesis recti and gestational diabetes are few associated complications. A physiotherapist will be guiding the pregnant women with different exercises according to first, second and third trimester. Moderate-intensity physical activity by healthy women during pregnancy maintains or increases cardiorespiratory fitnessas well. Strong scientific evidence shows that the risks of moderate-intensity activity done by healthy women during pregnancy are very low, and do not increase risk of low birth weight, preterm delivery, or early pregnancy . Evidence suggests that physical activity reduces the risk of pregnancy complications, such as preeclampsia and gestational diabetes, antenatal depression and reduces the length of labor. Physical activity also helps women achieve and maintain a healthy weight during the postpartum period, and when combined with caloric restriction, helps promote weight loss.

Cardiovascular diseases account for one-third of deaths among women around the world and half of all deaths in women over 50 years old in developing countries. Diabetes affects more than 70 million women in the world and its prevalence is projected to double by 2025. Osteoporosis is a disease in which bones become fragile and more likely to break and is most prevalent in post-menopausal women. Breast cancer is the mostly commonly diagnosed cancer in women. Women who engage in regular exercise have been shown to have a reduced risk of breast cancer. A study comparing a group of women who were self-selected to participate in an exercise regimen versus a sedentary group found that “the moderate-intensity physical activity program enhanced potentially valuable health and social cognitive improvements relative to those who did not participate.”

According to the American College of Obstetrics and Gynecology, physical activity not only improves cardiovascular health, but also helps to keep blood pressure, weight, and cholesterol in control. The American College of Obstetrics and Gynecology educational bulletin recommends that

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both premenopausal and menopausal women need exercises in order to prevent osteoporosis.

ConclusionIn summary Evidence Based guided Physiotherapy benefits-

• In lowering blood pressure and cholesterol and maintenance of a healthy weight.

• Social engagement• Prevention of Insomnia(sleep disturbances)• Reduced risk of fractures.

• Improved psychological health by reducing levels of stress, anxiety and depression.

• Contribute to building self-esteem and confidence and can provide a vehicle for social integration and equality for women in society.

• Improves the overall quality of life.

And Optimum physical and mental wellbeing and safe delivery can be obtained practicing physiotherapy.

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g]kfndf lrlsT;f lzIffM cj;/ / r'gf}tL

k|f=8f= >Ls[i0f lu/L♦

!= k[i7e"ld

dfgj hLjgsf nflu :jf:Yo ckl/xfo{ / cleGg ljifo xf] . :j:y gful/ssf] kl/sNkgf ubf{ dfgj :jf:Yo tyf :jf:Yo lzIffnfO{ k|fyldstfdf /flvG5 . dfgj :jf:Yo / lzIffsf] ljifosf ;Gbe{df lrlsT;f lzIff cGof]Gofl>t ¿kdf hf]l8P/ cfFp5 . dfgj :jf:Yo;Fu k|ToIf ;/f]sf/ /xg] ePsfn] o;sf] u'0f:t/ tyf ;fGble{stfsf ;DaGwdf hgrf;f] /xG5 . u'0f:t/Lo lrlsT;f lzIffn] bIf :jf:Yo hgzlQm pTkfbg ug]{ / bIf hgzlQmn] u'0f:t/Lo lrlsT;f ;]jf k|bfg ug{;Sg] ljZjf; cfd ;j{;fwf/0fdf /x]sf] kfOG5 .

g]kfnsf] ;+ljwfgn] df}lns xsdfkm{t\ ;a} gful/ssf nflu ;j{;'ne cfwf/e"t :jf:Yo ;]jfsf] ;'lglZrttf u/]sf] 5 . :j:y gful/sn] /fi6«sf] cfly{s, ;fdflhs, /fhgLlts, ;f+:s[lts nufotsf ;du| kIfx¿sf] ljsf;df dxTjk"0f{ e"ldsf v]N5g\ . o;sf nflu /fli6«o cfjZostf cg'¿k lrlsT;f lzIffsf] k|jw{g ug{' ckl/xfo{ x'G5 . :jf:Yo ;]jfdf cfd hgtfsf] ;xh kx'F+r k'¥ofpg ef}uf]lns ;Gt'ng sfod /fVb} lrlsT;f lzIffnfO{ ;dfj]zL, ;dtfd"ns, u'0f:t/o'Qm / k|efjsf/L agfpg' cfjZos b]lvG5 .

o; ;Gbe{df lrlsT;f lzIff k|bfg ug]{ lzIf0f ;+:yfx¿sf] lgodg u/L u'0f:t/, k];fwld{tf / Jofj;flostfsf] clej[l4 ug{' Psftkm{ cfjZos b]lvG5 eg] csf]{tkm{ ef}uf]lns ;Gt'ng / ;fdflhs Gofo sfod ub}{ lrlsT;f lzIff tyf ;]jfsf] lj:tf/ ug{' klg plQs} h?/L b]lvG5 . b'u{d / ljkGg ;d'bfosf ljBfyL{x¿sf] ;dfg kx'F+r ;'lglZrt u/L lrlsT;f lzIffnfO{ hftLo, juL{o, If]qLo, eflifs, wfld{s, n}ª\ lus / ef}uf]lns ¿kdf ;dfj]zL agfpg ljutb]lv g} ljleGg k|of; ePsf] kfOG5 .

g]kfndf lrlsT;f lzIffsf] k|f/De ;g\ !(## -!(()_ df g]kfn /fhsLo cfo'j]{b ljBfno :yfkgf u/]/ ul/Psf] xf] . To;kl5 qmda4 ¿kdf l;len d]l8sn :s'n, gl;{ª / x]Nycl;:6]G6 :s'n, cx]j :s'n, cgld :s'nx¿ :yfkgf eP . tTkZrft\ ;g\ !(&@ df lrlsT;f zf:q cWoog ;+:yfg :yfkgf eO{ ;fdfGo lrlsT;f, kmfd]{;L, /]l8of]u|fkmL, x]NyNofj, gl;{ª, cfo'j]{b ljifodf k|df0fkq txsf sfo{qmd ;~rfngdf cfP . ;j{k|yd :gfts txsf] sfo{qmdsf] ¿kdf ;g\ !(&^ df laPg gl;{ªsf] cWofkg ;'? eof] . To;}u/L ;g\ !(&* df lqe'jg ljZjljBfno, lrlsT;f

zf:q cWoog ;+:yfgaf6 PdlalaP;sf] cWofkg ;'? eof] . ;g\ !((# df la= kL= sf]O/fnf :jf:Yo lj1fg k|lti7fg, ;g\ @))@ df lrlsT;f lj1fg /fli6«o k|lti7fg, ;g\ @))* df kf6g :jf:Yo lj1fg k|lti7fg :yfkgf eP . To;}u/L s0ff{nL k|b]zsf] h'Dnfdf :jf:Yo lj1fg k|lti7fg, u08sL k|b]zsf] kf]v/fdf kf]v/f :jf:Yo lj1fg k|lti7fg, k|b]z g+= % sf] bfªdf /fKtL :jf:Yo lj1fg k|lti7fg :yflkt ePsf 5g\ . k|To]s k|b]zdf sDtLdf Pp6f ;/sf/L d]l8sn sn]h :yfkgf ug]{ g]kfn ;/sf/sf] gLlt /x]sf] ;Gbe{df k|b]z g+= & sf] s}nfnL u]6fdf, s0ff{nL k|b]zsf] ;'v]{tdf, k|b]z g+ % sf] a'6jndf / k|b]z g+= @ df dxf]Q/Lsf] alb{af;df gofF d]l8sn sn]h :yfkgfsf nflu k|oTg eO/x]sf] 5 .

lghL lzIf0f ;+:yfsf ¿kdf ;g\ !(($ df kf]v/fl:yt dl0fkfn sn]h ckm d]l8sn ;fOG;]hsf] :yfkgfaf6 ;'? eof] . lrlsT;f lzIf0f ;+:yfsf] ljsf;sf] qmddf xfn ^ cf]6f ;fj{lhgs d]l8sn sn]h -8]G6n;d]t_ / @ cf]6f 8]G6n sn]h ;~rflnt 5g\ . xfn;Dd cfo'j]{b afx]s :gfts / :gftsf]Q/;lxt ;fj{hlgs * / lghL !& j6f ;lxt hDdf @% j6f lrlsT;f lzIf0f ;+:yf ;~rfngdf /x]sf 5g\ .

pko{'Qmnufotsf k|of;x¿sf jfah'b klg lrlsT;f lzIffsf If]qdf ljBdfg ljleGg ljs[lt, lj;ª\ult Pjd\ lje]bx¿ /x]sf] jf:tljstf, hgu'gf;f] Pjd\ ;/f]sf/jfnfx¿sf] tT;DaGwL rf;f]nfO{ ;Daf]wg ug]{ k|of;:j¿k g]kfn ;/sf/sf] lrlsT;f If]qsf] Pp6f dxTjk"0f{ gLltut b:tfj]hsf] ¿kdf /fli6«o lrlsT;f lzIff P]g, @)&% th{'df eO{ sfof{Gjogdf cfPsf] 5 .

lrlsT;f lzIff If]qdf ;'wf/sf nflu ljleGg ;dodf gful/s ;dfh, ;Da4 bjfj ;d"x Pjd\ ;/f]sf/jfnfx¿af6 k|:t't dfux¿sf] ;Daf]wg tyf ;fdlos cfjZostf kl/k"lt{sf] k[i7e"lddf ul7t ljleGg cfof]u, sfo{bn / ;ldltsf k|ltj]bgx¿af6 k|fKt ;'emfj tyf /fli6«o cfjZostfsf cfwf/df @)&$ ;fn sflQs @$ ut] /fli6«o lrlsT;f lzIff ;DaGwdf Joj:yf ug{ cWofb]z hf/L ePsf] / ;f]xL cWofb]zdf plNnlvt k|fjwfgcg';f/ lrlsT;f lzIff cfof]usf] :yfkgf ePsf] lyof] .

g]kfn ;/sf/ tyf ;/f]sf/jfnfsf] rf;f] / ;lqmo kxndf pQm cWofb]zsf] ;dofjlw ;dfKt x'g} nfUbf ;+3Lo ;/sf/n]

pkfWoIf, lrlsT;f lzIff cfof]u

- 39 -

k|lt:yfkg ljw]os NofO{ lrlsT;f lzIff cfof]unfO{ lqmofzLn agfpg ;+3Lo ;+;bsf b'j} ;bgaf6 kfl/t u/L @)&% ;fn kmfu'g !) ut]sf lbg k|df0fLs/0f;d]t eO{ /fli6«o lrlsT;f lzIff P]g, @)&% sfof{Gjogdf cfPsf] 5 . o; P]gcg';f/ ljZjljBfno, k|lti7fgnufot cGo ;DalGwt lgsfox¿sf] lglb{i6 :jfoQtf / :jtGqtfnfO{ cfTd;ft u/L /fli6«o:t/df ;Da4 ;a} lgsfox¿;Fu ;dGjo / ;xsfo{ ug]{ Pjd\ cGt/f{li6«o :t/sf lgsfox¿;F+u ;d]t ;dGjo, ;xsfo{ / ;fem]bf/L ub}{ ;dfj]zL / u'0f:t/Lo lrlsT;f lzIffsf] ;'lglZrttf ug{' cfof]usf] d'Vo Wo]o /x]sf] 5 .

;+ljwfg k|bQ ;a}sf nflu :jf:Yo eGg] xssf] dd{ / efjgfnfO{ sfof{Gjog ug{ lrlsT;f lzIff tyf :jf:Yo ;]jfdf a[xb\ ;'wf/sf lgldQ g} /fli6«o lrlsT;f lzIff P]g, @)&% cfPsf] ;j{ljlbt g} 5 . lrlsT;f lzIff d"ntM u'0f:t/Lo :jf:Yo ;]jf k|jfxsf] nflu xf] . of] k|ToIf¿kdf gful/ssf] hLjg / :jf:Yo;F+u hf]l8Psf] ljifo xf] . ljutsf bzsx¿df g]kfnn] :jf:Yo ;]jfsf If]qdf pNn]vgLo pknlAwx¿ xfl;n u/]sf] klg 5 . :jf:Yosf ;"rsfª\sx¿df klg pNn]vgLo k|ult ePsf] b]lvG5 . @)$* sf] /fhgLlts kl/jt{gkl5 vf;u/L v'nf cy{tGqsf] l;4fGt cjnDag ul/Psf] / lrlsT;f lzIff tyf :jf:Yo ;]jf k|jfx ug]{ ;Gbe{df lghLIf]qsf] e"ldsf h'g ¿kdf lj:tf/ ePsf] b]lvG5 tbg'¿k /fHosf] nufgLdf eg] ck]lIft j[l4 x'g g;s]sf] clxn]sf] jf:tljstf xf] . o;sf tdfd ;sf/fTds kIf /xFbf /xFb} klg s]xL ;d:ofx¿ hl6n ¿kdf pTkGg ePsf 5g\ .

vf;u/L u'0f:t/Lo :jf:Yo hgzlQm pTkfbgdf x|f;, lrlsT;f lzIff cfly{s ¿kdf ljkGg tyf ;j{;fwf/0f hgtf kx'FreGbf aflx/ ePsf], lrlsT;f lzIff tyf :jf:Yo ;]jf cToGt} dxFuf] ePsf], ljgf k|If]k0f :jf:Yo hgzlQmsf] pTkfbg x'g]u/]sf], gS;fª\sg ljgf g} lzIf0f ;+:yfsf] :yfkgf x'g]u/]sf nufotsf ;d:ofx¿ l;h{gf ePsf 5g\ . oL ;d:ofx¿ plrt tl/sfn] ;dfwfg ul/Pg eg] o;n] eljiodf ljs/fn ¿k lng] lglZrt 5 .

:jf:Yo lzIff / ;]jf lj:tf/df sbd rfNg l9nf eO;Sof] eg]/ ljleGg tx / tKsfsf ;r]t gful/s, gful/s ;dfhsf k|j'4 JolQmTjx¿nufot /fhgLlts bnx¿n] o;nfO{ ;zQm ¿kdf /fli6«o d'4f agfpFb} cfPsf 5g\ . o;sf] ;dfwfgsf] lgldQ lrlsT;f lzIffsf] If]qdf /fHon] nufgL j[l4 ug]{, lgodg tyf cg'udg sfo{ PsLs[t / r':t agfpg], lzIf0f ;+:yfsf] :yfkgf / ;~rfngnfO{ Jojl:yt ug]{, lrlsT;f lzIff / ;]jf u'0f:t/Lo agfpg], k];fwld{tf, ;+:yfut hjfkmb]lxtf a9fpg], ef}uf]lns ;Gt'ng / ;fdflhs Gofo sfod u/L ljkGgnufot ;a} ju{sf ljBfyL{sf] ;dfg kxF'+r

;'lglZrt ug{sf] nflu ljleGg ;dodf ul7t lrlsT;f lzIff ;DaGwL /fli6«o gLlt th{'df pRr:t/Lo sfo{bnsf] k|ltj]bg nufot ljleGg cfof]u, ;ldlt tyf sfo{bnsf] dd{ / efjgfnfO{ ;d]t ;d]6]/ lrlsT;f lzIff cfof]usf] :yfkgf ug{ /fli6«o lrlsT;f lzIff P]g @)&% cfPsf] 5 . o;nfO{ ;+3Lo ;/sf/n] agfPsf] dxTjk"0f{ P]gsf] ¿kdf lng ;lsG5 . of] P]g lgdf0f{sf] qmddf hgtfsf] ;jf{lws rf;f] / ck]Iff b'a} lyof] eg] clxn] sfof{Gjogdf d"t{ ¿k lnFb} uPsf] 5 .

lrlsT;f lzIffsf If]qdf a[xb\ ;'wf/sf lgldQ bL3{sfnLg ;f]r / sfo{gLltsf] cfjZostf 5 . d"ntM lgDg ;f]rsf ;fy cfof]unfO{ cufl8 a9fOof] eg] g]kfnsf] lrlsT;f lzIffn] km6\sf] dfg]{df b'Odt 5}g M

!= lrlsT;f lzIffdf u'0f:t/ sfod ug]{@= ljkGgnufot ;a} ju{sf ljBfyL{x¿sf] ;dfg kxF'+r

;'lglZrt ug]{#= lrlsT;f lzIffsf If]qdf ef}uf]lns ;Gt'ng sfod ug]{$= /fHonfO{ cfjZos kg]{ :jf:Yo hgzlQmsf] bL3{sfnLg

k|If]k0f u/L of]hgfa4 ¿kdf u'0f:t/Lo hgzlQm pTkfbg ug]{

%= PsLs[t lgodg k|0ffnLsf] ljsf; u/L k|efjsf/L sfof{Gjog ug]{

^ :jf:Yo If]qnfO{ gfkmfd"nsaf6 qmdzM ;]jfd"ns If]qdf ¿kfGt/0f ub}{ n}hfg] .

@= lrlsT;f lzIff If]qsf] j:t'l:ylt ljZn]if0f -sWot Analysis_lrlsT;f lzIff If]qsf] ;an Pjd\ ;sf/fTds kIf, sdhf]/ Pjd\ ;'wf/fTds kIf, cj;/ / r'gf}tLx¿sf] ljZn]if0f u/]/ ubf{ lgDgfg';f/ b]lvG5 M

s= ;an Pjd\ ;sf/fTds kIf -Strength_

lrlsT;f lzIff If]qdf ePsf] ljsf; / lj:tf/n] d'n'sdf o; If]qdf kxF'+r a9fpg'sf ;fy} d'n'ssf] ljsf;sf nflu cfjZos kg]{ :jf:Yo hgzlQm pTkfbgdf klg plQs} of]ubfg k'/\ofPsf] 5 . cfkm\g} b]zdf ljleGg ljwfx¿df cWoog ug]{ cj;/ ljBfyL{x¿n] kfpg' csf]{ ;sf/fTds kIf xf] . o;n] /fHosf] 7'nf] wg/flz ljb]l;gaf6 /f]s]sf] 5 eg] csf{lt/ /fi6«sf] cfly{s ultljlwdf ;d]t pNn]Vo nfe xfl;n ePsf] 5 .

lzIf0f ;+:yfx¿n] pknJw u/fPsf 5fqj[lQaf6 ul/a t/ h]x]gbf/ ljBfyL{x¿n] lrlsT;f lzIff cWoog ug]{ ;'cj;/ k|fKt u/]sf 5g\ . Psflt/ /f]huf/Lsf] l;h{gf ePsf] 5 eg] csf{lt/ :yfgLo ;d'bfon] ;xh ¿kdf :jf:Yo ;]jf k|fKt

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ug{ ;kmn ePsf 5g\ . ljb]zL ljBfyL{ cWoogsf nflu cfpg] ePsfn] lrlsT;f lzIffsf] /f]hfOsf] d'n'ssf ¿kdf b]znfO{ kl/lrt u/fpg ;lsg] b]lvG5 . o;sf ;fy} j}b]lzs d'b|f cfh{g ug{ klg d2t k'u]sf] cj:yf Pp6f ;sf/fTs kIf xf] eg] csf]{ ;sf/fTds kIf eg]sf] o; If]qdf lghL If]qsf] nufgL a9\b} hfg' klg xf] .

v= ;'wf/of]Uo Pjd\ sdhf]/ kIf -Weakness_lrlsT;f ;]jf k|ToIf ¿kdf dfgj :jf:Yo;Fu hf]l8g] ePsfn] o; k|sf/sf] dxTjk"0f{ Pjd\ ;+j]bgzLn ljifodf plrt lgodg / lgu/fgL h?/L x'G5 . cfjZos lgodg / lgu/fgL lagf g} lghL If]qnfO{ k|j]z u/fp+Fbf o;n] cg]sg hl6ntf Nofpg ;S5 . lrlsT;f lzIffsf] If]qdf cGt/f{li6«o cg'ej / :yflkt d"NodfGotfnfO{ cWoog ubf{ ljZj :jf:Yo ;ª\u7gn] ælrlsT;f lzIffdf ;/sf/sf] cleefjsLo lhDd]jf/L x'g'k5{Æ / ælrlsT;f lzIffnfO{ clgolGqt v'nf ahf/df 5f]8\g ldNb}gÆ eg]sf] ;Gbe{ dggLo 5 . g]kfndf lrlsT;f lzIffsf] If]qdf b]lvPsf sltko ljs[lt, lj;ª\ult Pjd\ sdLsdhf]/Lx¿ 7'nf] r'gf}tL /x]sf] kfOG5 .

o; If]qdf vf;u/L u'0f:t/Lo :jf:Yo hgzlQm pTkfbgdf x|f; x'g', lrlsT;f lzIffdf cfly{s ¿kdf ljkGg tyf ;j{;fwf/0f hgtf kx'+FreGbf aflx/ x'g', lrlsT;f lzIff tyf :jf:Yo ;]jf cToGt} dxF+uf] x'g', ljgf k|If]k0f :jf:Yo hgzlQmsf] pTkfbg x'g', gS;fª\sg ljgf g} lzIf0f ;+:yfsf] :yfkgf x'g', ;DalGwt kIfx¿df Jofj;flos k];fwld{tfsf] sdL x'g', lzIf0f ;+:yfx¿n] cfjZosLo dfkb08 k"/f gug{', ;]jfd"nseGbf gfkmfd'vL ;+:sf/ a9]sf] b]lvg', ljBfyL{ egf{sf nflu lnOg] k|j]z k/LIffsf] kf7\oqmd / dfkb08df ljljwtf x'g', PsLs[t Sofn]G8/sf] cefj x'g', ljBfyL{x¿df cgfjZos cfly{s ef/ x'g', lzIf0f z'Nssf] cfwf/ ;dfg / :ki6 gx'g', l;6 lgwf{/0f j:t'k/s / j}1flgs gx'g' h:tf ;d:ofx¿sf] ;dfwfgsf nflu PsLs[t ;+oGqsf] cefj x'g'h:tf ;'wf/of]Uo jf sdhf]/ kIfx¿ ljBdfg 5g\ .

u= cj;/ -Opportunity_

lrlsT;f lzIffsf If]qdf ;/f]sf/jfnfsf] rf;f] a9\g', :jf:Yo / lzIffnfO{ gful/ssf] cfwf/e"t df}lns xssf] ¿kdf ;+j}wflgs k|Tofe"lt lbg', /fli6«o lrlsT;f lzIff P]g @)&% hf/L x'g', lrlsT;f lzIff cfof]u u7g x'g', ;/sf/L nufgLdf sDtLdf Ps k|b]z Ps d]l8sn sn]h :yfkgf ug]{ gLlt lgdf{0f x'g', k|b]z ;/sf/x¿n] lrlsT;f lzIffsf] lj:tf/nfO{ k|fyldstfdf /fVg', ljb]zL ljBfyL{x¿;d]t cWoogsf nflu cfpg] jftfj/0f aGb} hfg', ljBfyL{ Pjd\ cleefjsx¿sf] klxnf] /f]hfOsf] ljifoIf]q lrlsT;f lzIff x'g', ;/sf/n] o;If]qdf nufgL a9fpg] k|lta4tf hgfpg' /

cfd hg;d'bfosf] o; If]qdf ljZjf; / e/f];f x'g' g} o; If]qsf] ljsf;sf nflu ljz]if cj;/ xf] .

3= r'gf}tL -Threat_:jf:Yo / lzIffnfO{ gful/ssf] cfwf/e"t df}lns xssf] ¿kdf k|Tofe"t ul/Psf] ;+j}wflgs efjgfnfO{ Jojxf/df ptfg{', ;a} lzIf0f ;+:yfx¿sf nflu kf7\oqmd, lzIf0f ljlw, d"Nofª\sg k4ltsf nflu Go"gtd\ ;femf dfkb08 tof/ ug{', lzIf0f ;+:yfx¿sf] Jojl:yt ¿kdf lgodg ug{', /fli6«o lrlsT;f lzIff P]gsf k|fjwfgx¿nfO{ ;fdlos ¿kdf sfof{Gjog ug{', lzIf0f ;+:yfx¿nfO{ ;]jfd"ns agfpg', lrlsT;f lzIffsf] u'0f:t/nfO{ ;du| ;dfhsf] j[xQ/ lxt;Fu hf]8\g', g]kfnsf] :jf:Yo hgzlQmnfO{ 1fg, l;k / k|fljlws ¿kn] ;Ifd, dfgjLo ¿kdf ;+j]bgzLn, ;fdflhs ¿kdf pQ/bfoL agfpg' h:tf uxg r'gf}tLx¿ xfd|f] ;fd' /x]sf 5g\ .

#= ljBdfg gLltut tyf sfg'gL Joj:yf

lrlsT;f lzIffsf If]qdf ePsf d'Vo gLltut Pjd\ sfg'gL Joj:yfx¿ lgDgfg';f/ 5g\ M

#=! g]kfnsf] ;+ljwfg

g]kfnsf] ;+ljwfgdf lzIff / :jf:Yosf ;DaGwdf d"ntM lgDglnlvt k|fjwfgx¿ /x]sf 5g\ M

� wf/f #! -#_ df ckfª\utf ePsf / cfly{s ¿kn] ljkGg gful/snfO{ sfg'gadf]lhd lgMz'Ns pRr lzIff kfpg]

� wf/f #% df k|To]s gful/snfO{ /fHoaf6 cfwf/e"t :jf:Yo ;]jf lgMz'Ns k|bfg ug]{

� wf/f $) -@_ df blnt ljBfyL{nfO{ k|fyldsb]lv pRr lzIff;Dd sfg'gadf]lhd 5fqj[lQ;lxt lgMz'Ns lzIff pknAw u/fpg]

#=@ /fli6«o lrlsT;f lzIff P]g, @)&%

� lrlsT;f lzIffsf] If]qdf /fHon] nufgL j[l4 ug]{, lgodg tyf cg'udg sfo{ PsLs[t / r':t agfpg]

� lzIf0f ;+:yfsf] :yfkgf / ;~rfngnfO{ Jojl:yt ug]{ � lrlsT;f lzIff / ;]jf u'0f:t/Lo agfpg] � k];fwld{tf, ;+:yfut hjfkmb]lxtf a9fpg], ef}uf]lns ;Gt'ng / ;fdflhs Gofo sfod u/L ljkGg nufot ;a} ju{sf ljBfyL{sf] ;dfg kx'Fr ;'lglZrt ug]{

#=#= /fli6«o :jf:Yo gLlt, @)&^

gful/s :jf:Yosf nflu :jf:Yo ;]jfx¿ ;j{;'ne Pj+ k|efjsf/L ¿kdf k|jfx ug{ cfjZos bIf hgzlQmsf] of]hgf, pTkfbg, k|flKt, ljsf; tyf pkof]u ug]{ .

- 41 -

#=$= kGw|f}F of]hgf -@)&^–)*!_

nIo M ;a} txdf ;an :jf:Yo k|0ffnLsf] ljsf; / lj:tf/ ub}{ hg:t/df u'0f:t/Lo :jf:Yo ;]jfsf] kx'F'Fr ;'lglZrt ug{] .

p2]Zo!= ;+3, k|b]z / :yfgLo txdf ;a} lsl;dsf :jf:Yo

;]jfx¿sf] ;Gt'lnt ljsf; / lj:tf/ ug'{@= ;j{;n'e / u'0f:t/Lo :jf:Yo ;]jfsf] nflu

;/sf/sf] pQ/bfloTj / k|efjsf/L lgodg clej[l4 ub{} gfkmfd"ns :jf:Yo If]qnfO{ ;]jfd"ns If]qsf] ¿kdf qmdzM ¿kfGt/0f ug{' .

#= ax'IfqLo ;dGjo tyf ;fem]bf/L;lxt :jf:Yo ;]jfdf gful/ssf] kx'Frdfly pkef]u a9fO{ ;]jf k|bfos / ;]jfu|fxLnfO{ yk lhDd]jf/ agfpFb} :j:y hLjgz}nL k|jw{g ug'{' .

dfly plNnlvt gLlt / p2]Zo k|fKt ug{ /fli6«o cfjZostfcg'¿k u'0f:t/Lo lrlsT;f lzIffdf ;j{;fwf/0fsf] kx'Fr a9fO{ u'0f:t/ / k];fwld{tf;lxtsf] :j:y / bIf hgzlQm ljsf; ub}{ ;+:yfut hjfkmb]xL clej[l4 u/L :j:y ;fdfhsf] ljsf; ub}{ lrlsT;f lzIffsf] If]qdf u'0f:t/Lo hgzlQm tof/ u/L cfd g]kfnL hgtfsf] :jf:Yo l:yltdf ;'wf/ NofP/ ;'vL g]kfnL ;d[4 g]kfnsf] kl/sNkgfnfO{ ;kmnLe"t agfpg] b"/b[li6 cufl8 a9fpg cfjZos b]lvG5 . o;sf nflu cfof]un] lgDg nIo / p2]Zo k|flKttk{m cu|;/ x'g'kg]{ b]lvG5 .

$= nIo / p2]Zo

s ck]lIft nIo

!_ lrlsT;f lzIffnfO{ u'0f:t/Lo agfpg]@_ lrlsT;f lzIffdf ef}uf]lns ;Gt'ng sfod ub}{ ;a}

ju{sf] ;dtfd"ns kx'+Fr ;'lglZrt ug]{#_ cGt/f{li6«o dfkb08cg'¿k :jf:Yo hgzlQmsf] k|If]k0f

u/L of]hgfa4 ¿kdf u'0f:t/Lo hgzlQm pTkfbg ug]{$_ kf7\oqmd, lzIf0f ljlw / d"Nofª\sgsf nflu Go"gtd\

dfkb08 lgwf{/0f ug]{%_ lrlsT;f lzIffsf] k|efjsfl/tfsf nflu PsLs[t lgodg

k|0ffnLsf] ljsf; ug]{^_ :jf:Yo If]qnfO{ gfkmfd"nsaf6 qmdzM ;]jfd"ns If]qdf

¿kfGt/0f ug]{ .

v ck]lIft p2]Zo

� lrlsT;f lzIffsf] If]qdf /fHosf] nufgL clej[l4 ug{' � lrlsT;f lzIffnfO{ g]kfnsf] /fli6«o cfjZostf cg'¿k

ljsf; ug{' � lrlsT;f lzIffsf] lgodgnfO{ PsLs[t tyf r':t

agfpg'

� lrlsT;f lzIf0f ;+:yfx¿sf] :yfkgf / ;~rfng;DaGwL sfo{nfO{ Jojl:yt ug{'

� lrlsT;f lzIffdf u'0f:t/, k];fwld{tf, ;+:yfut hjfkmb]lxtf, ef}uf]lns ;Gt'ng / ;fdflhs Gofo sfod ug{'

� ljkGg nufot ;a} ljBfyL{x¿sf] ;dfg kx'Fr ;'lglZrt ug{'

� ljZj:jf:Yo ;ª\u7gn] to u/]sf] Ps lrlsT;s a/fa/ Ps xhf/ hg;ª\Vof -!M!)))_ x'g] u/L lrlsT;s pTkfbg ug{'

� ljZj:jf:Yo ;ª\u7gn] to u/]cg';f/ Go"gtd @# :jf:YosdL{ a/fa/ bzxhf/ hg;ª\Vofsf] cg'kft agfpg'

� k|To]s k|b]zdf sDtLdf Ps d]l8sn sn]h :yfkgf ug{' � PsLs[t k|j]z k/LIff k|b]zut ¿kdf ;~rfng ug{' � lzIf0f ;+:yfx¿sf] juL{s/0f u/L j:t'ut / Jofjxfl/s ¿kdf z'Ns lgwf{/0f ug{'

� lzIf0f ;+:yfx¿sf] l;6 j:t'ut / kf/bzL{¿kdf lgwf{/0f ug{'

� k|Tofog, z'Ns / PsLs[t k|j]z k/LIffsf] dfkb08 tof/ u/L sfof{Gjog ug{'

� P]gn] tf]s]adf]lhdsf lgodfjnL, lgb]{lzsf / sfo{ljlw lgdf{0f ug{' .

%= ck]lIft /0fgLlts k|ltkmnx¿

%=! u'0f:t/Lo lrlsT;f lzIff xfl;n ug]{

u'0f:t/Lo lrlsT;f lzIff xfl;n ug{sf nflu ;a} ljZjljBfno / k|lti7fgx¿n] cnucnu ¿kdf ;~rfng ub}{cfPsf] k|j]z k/LIffsf] :yfgdf ;femf kf7\oqmd ljsf; u/L ;f]sf] cfwf/df PsLs[t k|j]z k/LIff ;~rfng ul/g] 5 . u'0f:t/sf] k|Tofe"ltsf nflu ;a} lzIf0f ;+:yfn] pkof]u ug]{ u/L kf7\oqmdsf] Go"gtd\ dfkb08 to u/L nfu' ul/g] 5 . cg';Gwfg tyf k|fl1s pGgog;DaGwL ;+oGq ljsf; u/L lgoldt ¿kdf cg';GwfgfTds Pjd\ k|jt{gfTds sfo{ ug'{kg]{ b]lvG5 .

lzIfsx¿sf nflu ;]jf k|j]z, j[lQ ljsf;, ;]jfsfnLg cWoog / tflnd, df}lb|s / u}/ df}lb|s k|f]T;fxgsf sfo{qmsf] dfkb08 tof/ ul/g] 5 . ljBfyL{x¿sf nflu k|j]z k/LIff, l;sfOd}qL jftfj/0f lgdf{0f, ljBfyL{ s]lGb|t lzIf0f ljlw, j:t'lgi7 tyf lg/Gt/ d"Nofª\sg k|0ffnLsf] ljsf; / sfof{Gjog ul/g] 5 .

;'ljwfo'Qm tyf kof{Kt ef}lts k"jf{wf/ u'0f:t/o'Qm lzIffsf] cfwf/ xf] . To;sf nflu cfof]usf tkm{af6 ;Da4 ;/f]sf/jfnfx¿;Fusf] ;dGjodf cfjZos dfkb08x¿ tof/ u/L k|fyldstfsf ;fy sfo{ cufl8 a9fOg] 5 .

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o;sf ;fy} ;a} lzIf0f ;+:yfx¿sf] lgoldt cg'udg / lgodg ul/g] 5 .

%=@ lrlsT;f lzIffdf ;dtfd"ns kx'Fr ;'lglZrt ug]{

lrlsT;f lzIffdf ;dtfd"ns kx'Fr ;'lglZrt ug{ 5fqj[lQsf] Joj:yf cfjZos x'G5 . ;f]sf nflu ah]6 th'{df u/L g]kfn ;/sf/ ;dIf k|:tfj ul/g] 5 . ;sf/fTds lje]bsf] gLlt sfof{Gjog u/L h]x]gbf/ / ul/a ljBfyL{sf nflu k|f]T;fxg / ;x'lnotsf sfo{qmdx¿ x'g cfjZos 5 .

cfjZostfcg';f/ ;x'lnot z}lIfs C0f pknJw u/fOg]5 . lrlsT;f lzIffdf b'u{d If]qsf] kx'Fr a9fpg sf]6f k|0ffnLsf] Joj:yf ul/g] 5 . nlIft ;d"xsf nflu 5'§f5'§} sf]6f lgwf{/0f ul/g] 5 . lrlsT;f lzIffdf /fHosf] nufgL clej[l4 u/]/ ;dtfd"ns kx'Fr ;'lglZrt ug'{k5{ .

lzIf0f z'Nssf] lgodg u/]/ ul/a tyf nlIft ju{nfO{ ljz]if ;'ljwfsf sfo{qmd Nofpg cfjZos 5 .

%=# cfjZostfsf cwf/df :jf:Yo hgzlQm pTkfbg

:jf:Yo hgzlQmsf] cfjZostf k|If]k0f u/L o;}sf cfwf/df hgzlQm pTkfbgsf dfkb08 to ub}{ ;DalGwt ljZjljBfno, k|lti7fg / lzIf0f ;+:yfx¿nfO{ cfjZos Joj:yfkgsf nflu lgb]{zg ul/g]5 . ;+:yf / JolQmsf] nufgLsf] k|fjwfg to u/L cfly{s cefjsf sf/0f al~rltdf k/]sf jf kg{;Sg] JolQmx¿sf nflu ;xof]u k'/\ofOg]5 . o;sf ;fy} ;+:yf jf JolQm;+Fu nfut ;xeflutfsf] cjwf/0ff sfof{Gjogdf NofP/ :jf:Yo hgzlQm pTkfbgdf ljz]if k|fyldstf lbg'k5{ .

%=$ lzIf0f ;+:yfx¿sf] :yfkgf

gS;fª\sgsf] cfwf/df gof+F lzIf0f ;+:yfx¿sf] :yfkgfsf nflu dfkb08;lxtsf] lgb]{lzsf tof/ ul/g]5 . To;/L :yfkgf x'g] lzIf0f ;+:yfx¿ e"uf]n tyf hg;ª\Vofcg's"n x'g] u/L Joj:yf ldnfpg cfjZos 5 .

%=% lzIf0f ;+:yfx¿sf] hjfkmb]lxtf

k|To]s ljZjljBfno, k|lti7fg jf cGo lzIf0f ;+:yfx¿n] cfof]usf] l;kmfl/;df :jf:Yo ;DaGwL ljifo x]g]{ g]kfn ;/sf/sf] dGqfnon] tf]s]sf] sDtLdf Pp6f lhNnfdf ;]jf If]qsf] ¿kdf sfd ug{'kg]{ Joj:yfnfO{ s8fOsf ;fy sfof{Gjog ul/g] 5 . To;sf nflu :yfgLo ;/sf/;Fu ;dGjofTds ¿kdf sfo{ ug{'kg]{ Joj:yf ldnfpg cfjZos 5 .

lzIf0f ;+:yfx¿n] cfo Joosf] kf/bzL{ 9ª\un] n]vf k/LIf0f tyf ;fdflhs k/LIf0f u/fO{ ;f]sf] k|ltj]bg cfof]udf k];

u/L cfˆgf] j]a;fO6df lgoldt ¿kdf cBfjlws u/L k|sfzg ug{'kg]{ k|fawfg agfO nfu' ul/g]5 . ;d'bfosf] ;xeflutfdf ;d'bfo:t/df lgMz'Ns :jf:Yo lzlj/ tyf lrlsT;f ;]jf k|bfgsf sfo{qmd ;~rfng ug{ sfo{ljlw agfO{ sfof{Gjogdf Nofpg cfjZos x'G5 .

%=^ k|Tofog;DaGwL sfo{

k|Tofog ;DaGwL sfo{sf nflu 5'§} lgsfo u7g geP;Ddsf nflu dfb08 tyf k|Tofog lgb]{zgfnon] ;f] sfo{ ug]{ s'/f P]gdf Joj:yf ePsfn] dfkb08;lxtsf] lgb{]lzsf tof/ u/L sfof{Gjogdf Nofpg cfjZos x'G5 .

%=& k];fwld{tf

lrlsT;f lzIff dfgjLo :jf:Yo;Fu ;DalGwt ;+j]bgzLn ljifo ePsfn] o;df k];fwld{tf cTofjZos x'G5 . To;sf nflu Psftkm{ ljBfyL{sf] k|j]zs} cj:yfb]lv ljrf/ k'/\ofpg'kg]{ x'G5 eg] csf{tkm{ lzIf0f Pjd\ Jofjxfl/s sfo{;Dkfbgsf ;a} kIfdf Vofn ul/g' plQs} cfjZos x'G5 .

k];fut sfg'gL Joj:yf / k];fwld{tfsf] ljifo ;DalGwt kf7\oqmdsf] cleGg cª\usf] ¿kdf /xg] Joj:yf ldnfOg] 5 . lzIfs gd'gfsf ¿kdf /xg'kg]{ Joj:yfnfO{ sfo{¿k lbg cfrf/;+lxtf tof/ u/L nfu' ul/g]5 . lzIfs ljBfyL{x¿sf] clej[lQ hfFr u/L ;f]cg';f/sf] Jojxf/ ePgePsf] cg'udg u/L u/fO{ k];fwld{tfsf] kfngf u/fOg]5 . lzIfs, ljBfyL{nufot ;DalGwt k];fsdL{;d]tsf] cfrf/;+lxtf tof/ u/L sfof{Gjogdf Nofpg'k5{ .

%=* ;]jfd"ns lzIf0f ;+:yf

/fli6«o lrlsT;f lzIff P]g @)&% df Joj:yf ePcg';f/ of] P]g k|f/De ePsf] !) jif{kl5 g]kfn /fHoleq ;~rflnt lrlsT;f ;DaGwL lzIf0f ;+:yf qmdzM u}/ gfkmfd"ns / ;]jfd"ns ;+:yfsf ¿kdf ¿kfGt/0f x'g] eGg] k|fjwfgnfO{ sfof{Gjogdf Nofpg cfjZos :j¿k / k|lqmof tof/ ug'{kg]{ b]lvG5 .

lghL nufgL tyf :jfldTjdf ;~rflnt lzIf0f ;+:yfnfO{ u}/ gfkmfd'vL agfpg ljsNk;lxtsf] cjwf/0ffkq ;d]t tof/ ul/g]5 . lzIf0f ;+:yfx¿n] Ifdtfcg';f/ lgMz'Ns / ;x'lnot :jf:Yo ;]jf pknJw u/fpg] u/L sfo{ljlw to ug'{kg]{ b]lvG5 .

^= pk;+xf/

lrlsT;f lzIffsf] jt{dfg cj:yfdf oy]i6 ;'wf/ Nofpg / /fli6«o lrlsT;f lzIff P]g, @)&% nfO{ sfof{Gjogdf NofO{

- 43 -

lrlsT;f lzIffdf u'0f:t/ sfod ug{, ;dfj]zL agfpg, ljBdfg j]lylt / lj;ª\ultx¿nfO{ x6fpg / af}l4s Ifdtf ePsfx¿nfO{ o; If]qdf cWoogsf nflu csif{0f ug{ dfly plNnlvt ljljw kIfn] ;an / sfof{Gjogsf b[li6n] pko'Qm b]lvG5 .

;Gbe{ ;fdu|L

� lrlsT;f lzIff ;DaGwL ;|f]t ;fdu|L, @)&^, lrlsT;f lzIff cfof]u, ;fgf]l7dL

� lrlsT;f lzIff ;DaGwL ljleGg cfof]u / sfo{bnsf] k|ltj]bgx¿

� g]kfnsf] ;ljwfg, @)&@, sfg'g cfof]u, sf7df8f}+ � /fli6«o lrlsT;f lzIff P]g, @)&%, g]kfn /fhkq, kmfu'g !), @)&%

� kGw|f}F of]hgf -@)&^–)*!_, /fli6«o of]hgf cfof]u, l;+xb/af/

- 44 -

d'n'ssf] :jf:Yo ;]jfsf] ;fj{hlgsLs/0fM ug}{kg]{ sfd

8f= xl/k|;fb nD;fn

ljifo k|j]z

;dfhdf ljljw ljz]iftf, Ifdtf / :jefj ePsf dflg; x'G5g\ . o;f] x'g'df ef}uf]lns, cfly{s, ;fdflhs, af}l4s, zf/Ll/s, j+zfg'ut cflb h:tf sf/0f lhDd]jf/ x'G5g\, h;n] ;|f]t / ;fwgsf] kx'Fr / cj;/df km/s kf5{ . k|fs[lts ¿kdf k|fKt ljljwtfsf sf/0f cj;/df km/s kg{'nfO{ :jfefljs ¿kdf lnO{ ;Daf]wg ug{'k5{ . t/ ;f]afx]s cGo sf/0fn] cj;/ k|flKtdf ljifdtf x'g' Gofo;ª\ut cj:yf xf]Og . k|Zg /fHon] pQm ljifdtf ;Daf]wg ug{sf nflu cfjZos jftfj/0f agfof] agfPg eGg] xf] . pbfx/0fsf nflu Pp6f ul/a kl/jf/df hGd]sf] afns jf aflnsfn] pko'Qm kf]if0f / vf]k, :t/Lo :jf:Yo ;]jf / lzIff, :jR5 jftfj/0f / ;kmf lkpg] kfgL h:tf cfwf/e"t ;]jf ;'ljwf kfpg ;s] ;s]gg\, kfpgsf nflu ;/sf/n] s] ub}{5 eGg] xf] . kl/jf/ ul/a ePs} sf/0fn] o:tf ;]jf ;'ljwfaf6 al~rt x'g'kg]{ cj:yf ;Eo ;dfhsf nflu :jLsf/of]Uo ljifo xf]Og .

;+;f/df /fHo / ;/sf/sf] e"ldsfsf af/]df ax; cfjZos 5}g . ax; t st{Josf af/]df cfjZos 5 . cfw'lgs /fHosf] st{Jo gful/ssf] cfwf/e"t ;]jf ;'ljwf ;'lglZrt ug{' xf] . jfb / bz{g t pQm nIo xfl;n ug{ cjnDag ul/Psf ljlw jf pkfo x'g\ . cfw'lgs /fHon] dfly elgPem}F km/s k[i7e"lddf /x]sfx¿nfO{ ;dfgdfq geP/ pko'Qm / Gofok"0f{ jftfj/0f l;h{gf ug{'k5{ . sltko cj:yfdf ;dfg jftfj/0fn] Gofo gug{ ;Sg] ePsfn] pko'Qm jftfj/0f rflxG5, h;leq w]/} sfo{x¿ ug{'k5{ . /fHon] pko'Qm jftfj/0f s;/L agfpg ;S5 t < vf]hLsf] ljifo xf] .

gful/sn] /fHoaf6 kfpg'kg]{ cfwf/e"t ;]jfleq w]/} ljifox¿ k5{g\ . o;}u/L oL ;]jf ;'ljwfsf] ;'lgZrttfsf nflu agfpg' kg]{ pko'Qm jftfj/0fleq klg w]/} sfo{x¿ k5{g\ . o; ;fgf] n]vdf oL ;a} ljifodf rrf{ ;Dej 5}g . o;df t gful/ssf] cfwf/e"t ;]jfleq kg]{, h'g cfw'lgs /fHon] gful/ssf nflu ;'lglZrt ug{'kg]{ pko'Qm jftfj/0fdf klg kb{5, :jf:Yo ;]jf / ;'ljwfsf] ;'lglZrttfsf af/]df ax; ug{ vf]lhPsf] 5 . d'n'ssf ;a}sf nflu :t/Lo :jf:Yo ;]jfsf] ;j{;'ne kx'Fr s;/L ;'lglZrt ug]{ af/]df ax; ug{ vf]lhPsf] 5 .

df}lns xs / /fHosf] st{Jo

ljZj ;d'bfon] gful/ssf ;fj{ef}d clwsf/ ;"rLs[t ul/;s]sf] 5 . dfgj ePsf lx;fan] lgjf{w¿kdf k|of]u ug{ kfpg] s]xL ljlzi6 clwsf/ ;dfj]z u/L ;+o'Qm /fi6« ;ª\3n] ;g\ !($* df dfgj clwsf/ 3f]if0ffkq cg'df]bg u/]sf] 5 . o;}u/L gful/ssf clwsf/x¿nfO{ df}lns xsdf ;"rLs[t u/]sf] 5 . /fHox¿ oL / o:t} cGo ljleGg 3f]if0ff tyf ;dembf/Lx¿sf x:tfIf/stf{ ePsf] x'gfn] o;sf k|fjwfg kfngf ug{df sfg'gL / g}lts ¿kdf afWo 5g\ . s'g} klg /fHo o; lsl;dsf] st{Joaf6 larlnt x'g kfpFb}gg\ . o:tf dfGotf / ;fj{ef}d l;4fGtx¿nfO{ /fHosf] ;+ljwfg / sfg'gdf ;dfj]z u/]/ gful/s xssf] ;'lgZrttf ug]{ st{Jo /fHosf] xf] .

gful/ssf] ;'/Iff, klxrfg / enfOsf nflu /fHosf] cjwf/0ff Jojxf/df cfPsf] xf] . ;'?df /fHosf] k|d'v sfo{ gful/ssf] ;'/Iff ug]{ ljifo;Fu ;DalGwt lyof] . /fHo alnof] aGb} uPkl5 o;n] k|jfx ug]{ ;]jf ;'ljwfdf qmdzM a9f]Q/L eof] . hf]g ns, ?;f]nufot cGo ljåfg\n] eg]h:t} /fHon] gful/s;Fu lnlvt tyf clnlvt s/f/gf -;Demf}tf_ u/]sf] x'G5 . oxL ;Demf}tfadf]lhd gful/sn] /fHonfO{ s/ ltg{'k5{ eg] /fHon] gful/snfO{ ;'/Iff Pjd\ cfwf/e"t ;]jf;'ljwf pknAw u/fpF5 . of] ;Demf}tfsf ;t{ / bfo/fdf hlt ljljwtf x'G5 gful/sn] ToxL cg'kftdf ;]jf ;'ljwf kfpF5g\ . oxL ;]jf ;'ljwfsf] dfqf, bfo/f / :t/Lotfn] /fHo / gful/ssf] cfk;L ljZjf; / ;DaGw lgwf{/0f ub{5 . /fHon] oxL ;}4flGts cjwf/0ffadf]lhd s/ nufpg] / gful/snfO{ ;]jf ;'ljwf k|bfg ub{5 . ;a} d'n's / JolQmsf nflu cfwf/e"t l;4fGt oxL g} xf] . t/ Jojxf/df km/s cEof; lsg t <

o; cjwf/0ffadf]lhd gful/ssf] df}lns xssf] ¿kdf /x]sf] :jf:Yo ;]jf ;'lglZrt ug]{ bfloTj /fHosf] xf] . ljZj :jf:Yo ;ª\u7gsf] ;g\ !($^ sf] ljwfgdf g} gful/ssf] :jf:Yo ;]jf k|fKt ug]{ xsnfO{ df}lns xs / clwsf/sf] ¿kdf lnPsf] 5 . gful/ssf] :jf:Yo ;]jf ;'lglZrt ug]{ sfo{nfO{ /fHosf] bfloTj / st{Josf] ¿kdf pNn]v ul/Psf] 5 . o;}u/L ;g\ !(&* sf] cNdfc6f ;Dd]ngn] :jf:Yo ;]jf dfgj clwsf/sf] ljifo xf] / of] ;/sf/sf] bfloTjdf /xg'k5{ eg]/ :jLsf/ u/sf] 5 -8f}/f8f], @)!(_ . JolQm x'Dnf,

8f= xl/k|;fb nD;fn, ;lrj, afudtL k|b]z, d'VodGqL tyf dlGqkl/ifb\ sfof{no, x]6f}8f . o; n]vdf JoSt wf/0ff n]vssf lghL larf/ x'g .

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tfKn]h'ª, sGrgk'/, df]/ª jf g]kfnsf] h'g;s} :yfgdf hGd] klg p;n] kfpg' kg]{ :jf:Yo ;]jf;'ljwf JolQmsf] ;DklQ jf cGo s'g} sf/0fn] k|efljt x'g'x'Fb}g . t;y{ /fHon] :jf:Yo ;]jfnfO{ lhDdf lnP/ cyf{Tf\ ;fj{hlgs ;]jfleq /fv]/ lgjf{w¿kdf pknAw u/fpg'k5{ . (https://www.health. state.mn.us) .

:jf:Yo ;]jf ;'ljwfsf] ;fj{hlgskgM ;}4flGts kIf

k"jL{o / klZrdf bfz{lgssf dtcg';f/ j:t' cfkm}dfF d"t{ jf cd"t{ -lkmlhsn jf gg lkmlhsn_ ¿kdf /xg ;S5 . uLtfdf >Ls[i0fn] ch{'gnfO{ dgsf af/]df ;lj:tf/ j0f{g ug{'ePsf] 5 ls j:t' h'g ¿kdf /x]df klg o;sf] k|of]u dfgjLo cfjZostf k"lt{sf nflu ul/G5g\ . dfgjLo hLjgsf] cg'kl:yltdf j:t' cfkm}Fdf lg/k]If cj:yfdf /xG5g\ . ha s'g} j:t' dfgj hLjg;Fu hf]l8G5, dflg;n] k|of]u ug{ vf]H5g\ jf k|of]u u5{g, clg dfq To;sf] pkof]lutf ;fk]lIft aGg k'Ub5 . egfOsf] cy{ hj j:t' dfgj hLjg;Fu hf]l8G5 To;kl5 dfq o;sf] cy{ / :jefjsf] rl/q / :j¿k lgwf{/0f ul/G5 . dfgj/lxt d?e"lddf afn'jf cfkm}Fdf lg/k]If x'G5 t/ ToxL afn'jf 3gf dfgj j:tLsf] j/k/ /x]df ax'd"No aGg k'Ub5 . oxL g} j:t'sf] ;fk]lIft :jefj xf] . t;y{ j:t' :yfg, ;do / dfgjLo cfjZostf;Fu hf]l8P/ a9L / sd dxTjk"0f{ aGb5 .

ljZjJofkL dfGotf, gful/ssf] cfjZostf / j:t'sf] pknAwtfsf cfwf/df /fHon] sfg'gåf/f j:t' k|flKt ug]{ ljlw / dfkb08 to u/]sf] x'G5 . o:tf j:t'dWo] sltko j:t' Joj:yfkg ug]{ lhDdf /fHo cfkmF}n] lnPsf] x'G5 eg] sltkonfO{ lghL If]qsf] bfo/fdf 5f]8]sf] x'G5 . s'g /fHon] lng] / s'gnfO{ lghLsf] lhDdfdf 5f8\g] eGg] ljifo /fhgLlts bz{g, /fHosf] wd{ / st{Jo lgwf{/0f u/]sf] x'G5 . /fHon] rfx]/ klg nfut, Ifdtf / l;4fGtsf sf/0fn] ;a} j:t'sf Joj:yfkg cfkm}n] ug{ ;Sb}g . /fHon] k|jfx ug]{ j:t'x¿ ;fj{hlgs j:t'sf] ¿kdf lrlgG5g\ . o:tf j:t' Joj:yfkgsf nflu cfjZos kg]{ nfut /fHosf tkm{af6 Joxf]g{'k5{ . ;fj{hlgs ;]jfsf ;Gbe{df klg l7s oxL cjwf/0ff nfu' x'G5 .

gful/ssf nflu k|jfx ug{'kg]{ j:t' jf ;]jfdWo] ;a} j:t' jf ;]jf /fHon] Joj:yf ug{'k5{ eGg'sf] cy{ o;df ;+nUg nfut / z'Ns /fHon] ltg{'k5{ eGg] xf] . o;f] ug{ ;s] t /fd|f] x'GYof] . ljZjsf sltko d'n'sdf of] ;Dej ePsf] klg 5 . t/ ;a} j:t' / ;]jf ;fj{hlgs agfpg / ;f]sf] ;'lglZrttf /fHoaf6 ug{ w]/} ;|f]t rflxG5, h'g gful/sn] lt/]sf] s/af6 g} ;ª\sng x'g] xf] . w]/} ;|f]t hDdf ug{ eGb} w]/} s/ nufpFb} hfFbf gful/snfO{ csf]{ ef/ ylkg] x'G5 . o;af6 ul/a / sdhf]/ cem a9L gsf/fTds ¿kdf

k|efljt x'G5g\ . t;y{ /fHon] Go"gtd ;]jf ;'ljwfnfO{ cfwf/e"t ;]jfleq /fv]/ To;sf] Joj:yf cfkm"n] ug]{ gLlt lng'k5{ . of] Go"gtd eGg] ljifo klg ;do, :yfg / Ifdtf ljz]if cg';f/ km/s km/s x'g ;S5 .

ca k|Zg p7g ;S5 /fHon] s'g j:t' jf ;]jfsf] lhDdf lng] / afFsL s'gnfO{ lghLsf] lhDdfdf 5f]8\g] t < o;sf] lgwf{/0fsf nflu s]xL l;4fGt / dfGotf to ePsf 5g\ . ;fdfGotof h'g j:t' jf ;]jf d'n'ssf ;a} gful/ssf nflu rflxG5g\ To:tf j:t' / ;]jf /fHosf] lhDdfdf /xg'k5{ . o:tf j:t' / ;]jfsf] rl/q ck|lt:kwL{ -Pp6fn] kfpFbf csf]{n] gkfpg] cj:yfsf] cGTo_ / cjlxis[t -z'Ns gltg]{n] gkfpg] cj:yfsf] cGTo_ agfpg'k5{ . o:tf j:t' / ;]jfdf ;+nUg nfut /fHon] Joxf]/]/ lognfO{ ;fj{hlgs agfpg'k5{ . :jf:Yo ;]jfnfO{ ;fj{hlgs j:t' jf ;]jfsf] ¿kdf sfod /fVg'k5{ eGg'sf] cy{ o;sf ;+nUg nfut / z'Ns /fHon] lt/]/ o;nfO{ ck|lt:kwL{ / cjlxis[t agfpg'k5{ . -vfg Ps]8dL, 8]leo6 @)!^, sfpn PG8 d]G8f]hf, xg{ @)!(, ljZj :jf:Yo ;ª\u7g_

dfly g} elg;lsof] ls :jf:Yo ;]jfnfO{ ;fj{hlgs j:t' / ;]jfcGtu{t /fVg' eg]sf] ;f] ;]jf ;'ljwf k|fKt ug{ nfUg] z'Ns /fHon] ltg{'k5{ / JolQm :jod\n] ltg{'kb}{g eGg' xf] . olb o:tf ;]jf ;'ljwf JolQmn] vl/b ug{'k5{ eGof} eg] sdhf]/ cfo ePsf] jf lakGgn] pQm ;]jf ;'ljwf of t vl/b ug{ ;Sb}g of ;Demf}tf u/]/ sd u'0f:t/Lo ;]jf ;'ljwf lnG5g\ h;sf] sf/0fn] JolQmsf] efjL hLjg gsf/fTds¿kdf k|efljt x'g;S5 . csf]{tkm{ wgL / Ifdtf ePsfn] a9L z'Ns lt/]/ ;]jf ;'ljwf lng] k|oTg ub{5g\ . clg ljleGg axfgfdf :jf:Yo ;]jf dxFuf] aGb} hfG5 lsgls wgLsf rxfgf k"/f ug]{ gfddf :jf:Yo ;]jf k|jfxdf cgfjZos ljifox¿ hf]l8g k'U5g\ . t;y{ :jf:Yo ;]jfnfO{ /fHosf tkm{af6 Joj:yf gu/L JolQm cfkm}Fn] u/ eGg'sf] cy{ sdhf]/nfO{ cem sdhf]/ cj:yfdf /fVg' xf] . ha JolQmsf] :jf:Yo sdhf]/ x'G5, hLjgsf cGo kf6fx¿ klg sdhf]/ x'g ;S5g\ . lsgls o:tf tTjx¿ b'irqmsf] /xG5g\ / Psn] csf]{nfO{ gsf/fTds cj:yfdf hfg ;xof]u ul//x]sf] x'G5 . d'n'sn] ul/a / lgd'vfk|lt s] slt dfqfdf Gofo u/]sf] 5 eg]/ x]g{sf nflu :jf:Yo ;]jf k|jfxdf ckgfOPsf] …;fj{hlgskgÚ x]bf{ k'U5 .

:jf:Yo ;]jfnfO{ ;fj{hlgs :jefjdf g/fvL nfut / z'Nssf cfwf/df k|fKt ug]{ jftfj/0f agfpg' eg]sf] cfhsf] dfq geP/ ef]lnsf] ;dfh klg lje]bo'Qm agfO{ /fVg' xf] . ;dfhdf x'g] / gx'g]sf] larsf] b/f/ a9fpg dnhn ug{' xf] . o:tf] b/f/n] ;dfhdf åGånfO{ e';sf] cfuf]sf] ¿kdf leqleq} km}nfpg ;S5 . c;dfgo'Qm ;dfhdf lje]bsf/L :jf:Yo ;]jf x'g' eg]sf] r}tsf] v8]/Lsf] 88]nf]df k]6«f]n

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5s{g' h:t} xf] . 8f}/f8f] -@)!(_ s} efiffdf eGg] xf] eg] :jf:Yo ;]jfdf klAnsg]; sdhf]/ x'g' / ahf/ k|0ffnLn] ;~rfng ug{' eg]sf] gful/snfO{ l8hf:6/sf] cj:yftkm{ n}hfg' xf] .

;fj{hlgs :jf:Yo ;]jf ;'ljwf ;'lglZrttfsf nflu ;dfg / pko'Qm jftfj/0f

x/]sf /fHon] ;Dd'gt ;dfh lgdf{0f ug]{ nIo /fv]sf] x'g ;S5 . ;d[l4, ljsf; cflb h] h:tf] zAbfjnLaf6 ;d'Ggt ;dfh lgdf{0f ug]{ elgP tfklg c;n zf;ssf] rfxgf ;a} gful/ssf] enf] ug]{ g} xf] . /fhgLlts k|0ffnLn] ;dfhdf ;dfgtf xfl;n ug]{ ck]Iff /fVg' c:jefljs xf]Og . t/ clxn]sf] ;dfh c;dfgtfn] el/k"0f{ 5 . o:tf] c;dfgtf cj;/, ;DklQ, :yfg, hUuf hldgsf] pknAwtf / ;fdflhs Pjd\ j}olQms ¿kdf 5g\ . oLdWo] sltko c;dfgtfx¿ j+zfg'ut u'0f / :jefjsf sf/0f b]lvPsf 5g\ eg] sltko /fHo / ;/sf/n] ug{' kg]{ sfd gu/]sf sf/0fn] l;lh{t 5g\ . o:tf c;dfgtfx¿n] JolQmsf] cj;/ ;Lldt ug{, a9fpg jf 36fpg ;S5g\ .

/fHon] j:t' / ;]jfnfO{ ;fj{hlgs u/]/ dfq gk'Ug ;S5 . o:tf j:t' / ;]jf kx'Frof]Uo, :jLsf/of]Uo, ;fGble{s / :t/Lo x'g' cfjZos x'G5 . o:tf j:t' / ;]jfdf k|ToIf jf ck|ToIf z'Ns nfUg' x'Fb}gg\ . dfly elgPh:t} c;dfg cj:yfdf /x]sf JolQmx¿nfO{ ;dfg cj;/df ;fj{hlgs j:t' / ;]jf pknAw u/fP/ dfq k'Ub}g . km/s Ifdtf ePsfx¿nfO{ km/s vfnsf] jftfj/0f klg rflxG5, h;nfO{ pko'Qm jftfj/0f eGg] ul/G5 . t;y{ ;fj{hlgs j:t' / ;]jfsf] pknAwtfsf nflu ;dfg / pko'Qm vfnsf] jftfj/0f l;h{gf x'g' cfjZos 5 .

g]kfnsf] ;Gbe{df klg bz{g, l;4fGt / ljZjJofkL ¿kdf :yflkt dfGotfsf cfwf/df ;+ljwfg t :jf:Yo ;]jfnfO{ ;fj{hlgs j:t' / ;]jfsf] ¿kdf :jLsf/ ul/Psf] 5 . ;+ljwfgn] :jf:Yo ;]jfnfO{ ;dGoflos 9ª\uaf6 Joj:yf ug{ eg]sf] 5 h;sf] cy{ dfly elgPh:t} ;dfg / pko'Qm jftfj/0f l;h{gf x'g'k5{ . d'n'sn] Ps} k6s o;nfO{ k"0f{t ;fj{hlgs agfpgsf ;fy} ;f]sf] k|jfxdf ;dfg / pko'Qm jftfj/0f agfpg g;Snf t/ b[li6sf]0f s] 5 eGg] ljifo cToGt dxTjk"0f{ 5 . ;|f]t ;fwgsf] Ifdtf t lj:tf/} a9fpg ;lsG5, t/ l;4fGt / bz{gaf6 aGg] ;f]r agfpg nfdf] ;do nfUg ;S5 .

;/sf/sf] klxnf] st{Jo :jf:Yo ;]jfnfO{ k"0f{tM ;fj{hlgs j:t' / ;]jf agfpg] lbzfdf cufl8 a9\g] / ;f]sf] ;'lglZrttfsf nflu ;dfg / pko'Qm jftfj/0f l;h{gf ub}{ hfg] xf] . clxn];Dd d'n'sn] ;dfg jftfj/0f agfpg ;s]sf] 5}g, pko'Qm jftfj/0f agfpg t w]/} sfd ug{ afFsL 5 .

:jf:Yo ;]jfsf] ;fa{hlgsLs/0fM cj:yf / lbzf

d'n'sdf clxn] :jf:Yo ;]jf ;'ljwf k"0f{t ;fj{hlgs 5}g . of] s] sltdfqfdf ;fj{hlgs 5 eGg] ljifodf yk cWoog g} rflxG5 . o;}u/L :jf:Yo ;]jf s] slt dfqfdf lghLs/0f ePsf] 5 eGg] ljifo klg cg'Ql/t g} 5 . d'n'ssf] :jf:Yo ;]jfleq /x]sf o:tf y'k|} cg'Ql/t k|Zgx¿sf] pQ/sf nflu klg ca ;fy{s ax; rflxPsf] 5 . of] ax;sf] s]G›df :jf:Yo ;]jfsf] ;fj{hlgs/0fnfO{ /fVg'k5{ . o:tf] ax;df :jf:Yo ;]jf, o;sf] bfo/f / If]qnfO{ ;dfj]z ug{'kg]{ b]lvG5 . dfgjLo hLjgz}nL, ;do / k|ljlw;Fu :jf:Yo ;]jf ;fk]lIft klg aGb} uPsfn] o; ljifodf klg uxg cWoog rflxPsf] 5 .

:jf:Yo ;]jfk|jfxdf nfut jf z'Ns nfU5 . of] /sd s;n] s'g b/ / dfqfdf ltg]{ eGg] ljifon] :jf:Yo ;]jfsf] ;fj{hlgs/0fsf] dfqf / :j¿k lgwf{/0f u5{ . :jf:Yo ;]jf lng] qmddf JolQm jf 3/kl/jf/n] s]xL ltg{ kg]{ ls gkg]{ < olb ltg{ kg]{ ePdf pQm /sd s;nfO{ lbg] < ;/sf/L jf ;fj{hlgs lgsfonfO{ lbg] ls clxn] h:t} lghLnfO{ ;+:yf ;~rfng ug]{ cg'dlt lbO{ /sd klg pg}nfO{ lng lbg] < oL / o:t} k|Zgsf] pQ/af6 :jf:Yo ;]jfsf] ;fj{hlgsLs/0fsf] :j¿k / bfo/f lgwf{/0f x'G5 .

ljutdf ha :jf:Yo ;]jf lnPafktsf] nfut jf z'Ns JolQmaf6 c;'n pk/ ul/of] / :jf:Yo ;]jf k|jfxdf lghL ;+:yfnfO{ ;+nUg u/fOof] . oxL laGb'af6 g} d'n'sdf :jf:Yo ;]jfsf] ;fj{hlgsLs/0f sdhf]/ aGg'sf ;fy} :jf:Yo ;]jfdf lghLs/0f;d]t k|j]z eof] . :jf:Yo ;]jfsf] ;fj{hlgsLs/0fdf cfpg] sdhf]/L jf ljrngaf6 g} :jf:Yo ;]jfdf lghLs/0f jf :jf:Yo ;]jfsf] lghLs/0f x'g] xf] -8f}/f8f], @)!(_ . ;]jfu|fxLaf6 ;]jf z'Ns lnPs} cfwf/n] dfq :jf:Yo ;]jfdf lghLs/0f jf :jf:Yo ;]jfsf] lghLs/0fsf] bfo/f / :jefj lg¿k0f ug{ sl7g x'G5 . o;sf nflu uxg cWoog / ljZn]if0f rflxG5 . o;;Fu nufgLsf] :j¿k, If]q / k|ltkmn k|fKtstf{ h:tf ljifo hf]l8Psf x'G5g\ . km]l/ lghLs/0fleq klg ljleGg df]8n 5g\ . ;+:yfn] sdfPsf] gfkmf ;+:yfdf g} hDdf x'g] jf ;]o/xf]N8/n] kfpg] eGg] ljifon] klg km/s vfnsf] lghLs/0f hgfpg] ub{5 .

:jf:Yo ;]jfsf] ;fj{hlgsLs/0f, :jf:Yo ;]jfdf lghLs/0f / :jf:Yo ;]jfsf] lghLs/0fsf] dfqf / :j¿k Plsg ug{sf nflu :jf:Yo ;]jfsf nflu cfjZos nfut s;n] Joxf]g]{ / ;+:yfsf] Joj:yfkg s] s;/L ug]{ eGg] ljifodf cWoog rflxG5 . dfly g} elg;lsof] ls ljsl;t d'n'sx¿n] :jf:Yo ;]jfsf] ;fj{hlgsLs/0f klxNo} ul/;s] . pgLx¿n] :jf:Yo ;]jfdf lghL nufgLsf] af6f] ;'?jftL r/0fb]lv g} aGb u/] . t/ klg clxn] pgLx¿sf] lsgls :jf:Yo ;]jfsf] Ifdtfdf k|Zg p7]sf] 5 . t/ xfd|f] h:tf] cljsl;t cj:yfdf /x]sf

- 47 -

d'n'sx¿ :jf:Yo ;]jfdf lghLs/0f ls :jf:Yo ;]jfsf] lghLs/0f eGg] ljifodf cndlnO/x]sf 5g\ . vf;df ax; x'g' kg]{ ljifo t :jf:Yo ;]jfsf] ;fj{hlgsLs/0f lyof] .

g]kfnsf] :jf:Yo ;]jfdf xfn sfof{Gjogdf /x]sf] nufgLsf cfwf/df :jf:Yo ;]jfsf] ;fj{hlgsLs/0f, :jf:Yo ;]jfdf

lghLs/0f / :jf:Yo ;]jfsf] lghLs/0f eGg ldNg] b]lvG5 . h;nfO{ h:tf] nfU5 ;f]xL ;+:yf b]vfP/ pbfx/0f lbO{ JofVof ug{ ;lsg] cfwf/ pknAw 5g\ . t/ Pp6f jf:tljstf s] xf] eg] xfd|f] :jf:Yo ;]jfn] ;fj{hlgsLs/0fsf] :jefj u'dfpFb} uPsf] 5 . o;sf nflu b]xfosf ljifodf t'ngfTds cWoog pkof]uL x'g;S5 .

:jf:Yo ;]jfsf] ;fj{hlgsLs/0f :jf:Yo ;]jfdf lghLs/0f :jf:Yo ;]jfsf] lghLs/0f

!= :jf:Yo ;]jfsf] ;fj{hlgsLs/0f

:jf:Yo ;]jfsf] ;fj{hlgsLs/0fleq ;a}sf nflu :t/Lo :jf:Yo ;]jf ;xh, kx'Frof]Uo / ;fGble{s x'G5 . wgL ul/a ;a}sf nflu :t/Lo :jf:Yo ;]jf pknAw x'G5 . :jf:Yo ;]jf /fHosf] lhDdfdf /xG5 . /fHon] cfk"lt{sf] cjwf/0ff adf]lhd :jf:Yo ;+:yf vf]Ng] / ;~rfng u5{ . nlIft ;d"x ;a}n] /fHon] Joj:yf u/]sf] ;+:yfaf6 ;]jf ;'ljwf lng kfpF5g\ . ;a} ;+:yfsf] :t/ lglZrt dfkb08adf]lhd x'g] ePsfn] ;+:yf 5gf]6sf ljsNk cfjZos kb}{g / lbOFb}g klg . j]nkm]o/ cjwf/0ffdf cfwfl/t /fHodf :jf:Yo ;]jfsf] ;fj{hlgsLs/0f cfbz{ cj:yf xf] . t/ cfbz{ cj:yf eGb}df o;nfO{ xfl;n} ug{ g;lsg] eGg] klg xf]Og . k|ljlwn] NofPsf] kl/jt{g / e"d08nLs/0fsf] k|efjsf sf/0fn] dfgjLo :jefj / rfxgfdf kl/jt{g cfPsfn] :jf:Yo ;]jfsf] bfo/f / If]q a9fPsf] 5, h;n] s'g} g s'g} ¿kdf :jf:Yo ;]jfsf] ;fj{hlgsLs/0fdf x|f; NofO/x]sf] 5 . o;af6 ;+;f/sf x/]s d'n's s'g} g s'g} ¿kdf k|efljt alg/x]sf 5g\ . :jf:Yo ;]jfsf] ;fj{hlgsLs/0fdf cfpg] x|f;af6 g} :jf:Yo ;]jfdf lghLs/0fsf] ;'?jft x'G5 . k"0f{ lghLs/0fdf k'Ug'eGbf cl3 x'g] t :jf:Yo ;]jfdf lghLs/0f g} xf] . -o'lge;{n x]Ny se/]h ljZj :jf:Yo ;ª\u7g, @)!(_

@= :jf:Yo ;]jfdf lghLs/0f

:jf:Yo ;]jfsf] ;fj{hlgsLs/0fdf x|f; cfpg'sf k|d'v sf/0fdf pbf/Ls/0f / ahf/Ls/0fnfO{ lng] ul/G5 . l8k]l;{of] -@)@)_ n] Xjf6 cf/ cfu{'d]G6;Og km]j/ ckm k|fOe]6fOlhª klAns u'8\;df eg] h:t} ;'?df xfdLsxfF klg ;fj{hlgs ljQdf k/]sf] ef/ sd ug{, ;+:yfnfO{ k|lt:kwL{ agfpg, yk ldtJooL aGg / :t/Lo ;]jf k|bfg ug{ h:tf sf/0fx¿ b]vfP/ :jf:Yo ;]jfdf lghL ;+:yfnfO{ k|j]z u/fOof] . jf:tjdf oxL g} lghLs/0fsf] ;'?jft lyof] . uf]n':6 PG8 Hofsf]A;g -@))^_ sf] wf/0ff klg o:t} b]lvG5 . o; qmddf ;fj{hlgs ;+:yfsf] x|f; / lghL ;+:yfsf] a9f]Q/L b'Ocf]6f sfd Ps} k6s x'G5g\ . ;]jfu|fxL;Fu ;]jf z'Ns

lnP/ ;~rfng vr{sf] hf]xf] ug{'nfO{ cGoyf gdflgPnf . t/ ;+:yf ;~rfngsf qmddf cfpg] gfkmf ;+:yfdf eGbf JolQmdf s]lG›t x'g] k4lt a:of] eg] lghLs/0ftkm{sf] ofqf l56f] x'G5 . o;n] ;+:yf lgdf{0f klg ub}{g . xfdLsxfF ePsf] klg oxL xf] JolQm aGg] t/ ;+:yf gaGg] kl/kf6L xfjL /Xof] . d'n'sdf sDkgL 5g\ t/ ;fj{hlgs k|s[ltsf ;+:yf 5}gg\ . :jf:Yo h:tf If]qdf lghL nufgLnfO{ cg'dlt lbP klg ltgsf sfo{ ;fj{hlgs x'g' kg]{ lyof] t/ ;f] x'g ;s]g . d'n'sdf ;a} a]lylt dfq 5g\, Pp6f klg ;+:yf 5}gg eGg] klg xf]Og . s]xL ;+:yf aGg] qmddf klg 5g\ t/ ltgsf sfo{nfO{ klg ;fj{hlgs agfpg ;lsPsf] 5}g . d'n'sleq clxn]sf] :jf:Yo ;]jfdf lghLs/0f tLa| ultdf eO/x]sf] 5 .

#= :jf:Yo ;]jfsf] lghLs/0f

o;df d'n'ssf] :jf:Yo ;]jf lghLs/0fsf clws ljz]iftf;lxt ;~rflnt x'G5 . jhf/sf] dfucg';f/sf] :jf:Yo ;]jf pknAw x'G5 / ahf/n] lgwf{/0f u/]sf] d"Nodf ;~rflnt x'G5 . gofFgofF k|ljlw, ;]jfsf] ljljwLs/0f, hgzlQm cflbh:tf cfwf/df d"No lgwf{/0f ul/G5 . :jf:Yo ;]jf ;Dk"0f{ ¿kdf lsga]r ul/g] j:t' jf ;]jf h:tf] aGg k'U5 . l;4fGttM ahf/sf] dfuadf]lhdsf] :jf:Yo ;]jf, ahf/s} dfuadf]lhdsf hgzlQm tyf ahf/n] lgwf{/0f u/]sf] z'Ns / ahf/s} dfuadf]lhd Joj:yfkg eg]s} :jf:Yo ;]jfsf] k"0f{ lghLs/0f xf] .

log} tLgcf]6f ljifosf] ax;af6 d'n'ssf] :jf:Yo ;]jfsf] lbzf to ug{ ;lsG5 . ;fgf tyf v'›f dl;gf ljifodf ax; u/]/ d'n'ssf] :jf:Yo ;]jfdf ;'wf/ x'g ;Sb}g . n/Ldf /flvPsf sf/x¿ hlt /fd|f] eP klg ofqfsf] cj:yf n/Lsf] Ifdtf / u'0f:t/n] k|efj kf5{ . :jf:Yo ;]jfsf d"n ljifodf k|j]z gu/L v'›f dl;gf ljifodf Wofg lbg' eg]sf] n/Ldf /x]sf sf/sf Ifdtfdf af/]df k|z:t dfqfdf ax; u/]h:t} xf] . ;fdfGo k|Zgsf cfwf/df o;sf] lbzf to x'g;S5 . s] :jf:Yo ;]jf JolQmsf] ;DklQ / x}l;otadf]lhd kfpg] ljifo xf] < s] :jf:Yo ;]jfgfkmfd"ns Joj;fo xf] < s] :jf:Yo ;]jfdfu / cfk"lt{sf] cfwf/df d"No lgwf{/0f u/]/ lsga]r

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ul/g] j:t' xf] <

ljZj :jf:Yo ;ª\u7g / cGo :yflkt ljZjJofkL dfGotfcg';f/ :jf:Yo ;]jf ;fdflhs j:t' xf], ;fj{hlgs j:t' xf] . t;y{ of] ;a}sf ;j{;'ne / ;xhof]Uo x'g'k5{, :jf:Yo ;]jf ahf/Ls/0f x'g] j:t' xF'b} xf]Og . ToxL eP/ :jf:Yo ;]jf k};f ltbf{ kfOg] / gltbf{ gkfOg] vfnsf] x'g' x'Fb}Gf -o'lge;{n x]Ny se/]h ljZj :jf:Yo ;ª\u7g,@)!(_ . :jf:Yo ;]jf ahf/n] lgwf{/0f u/]sf] d"Nodf cfwfl/t x'G5 eGbf wgLn] dfq ;]jf kfpg ;S5g\ . 7'nf 7'nf sDkgLn] gfkmfd"ns Joj;fo 7fgL nufgL ug{ ;S5g\ . o;n] ;dfhdf cem b/f/ a9fpg ;S5 .

g]kfnsf] ;Gbe{df pko'Qm df]8n s'g xf] t<

g]kfnsf] ;Gbe{df :jf:Yo ;]jfsf] ;Dk"0f{ Joj:yfkg tTsfn} ;fj{hlgs :j¿kdf Nofpg sl7g 5 . ljsl;t d'n'sx¿n] nfdf] cEof; kl5 oxfF;Dd cfOk'u]sf x'g\ . t/ klg ;a} d'n'sdf pxL ¿kdf :jf:Yo ;]jfdf k"0f{ ;fj{hlgsLs/0f x'g ;s]sf] 5}g . xfd|f] h:tf] sd ljsl;t d'n'sdf :jf:Yo ;]jfdf ;fj{hlgsLs/0f bL3{sfnLg ;f]rsf] ljifo xf], bL3{sfnLg nIo xf] . /fHon] OdfGbf/ k|of; u/\of] eg] o;nfO{ k|fKt ug{ ;do nfUg ;S5 . t;y{ clxn] xfdLn] rfx] jf grfx] klg xfdLsxfF :jf:Yo ;]jfdf lghLs/0fsf s]xL g s]xL ljz]iftf;d]t ldnfP/ sfd ug{'kg]{ cj:yf 5 . l8k]l;{of] -@)@)_ n] Sjf;L u'8\; eg]h:t} g]kfnsf] ;Gbe{df klg :jf:Yo ;]jfdf s'g} g s'g} k|sf/sf] lghLs/0f clxn]sf] afWotf h:t} xf] . o;nfO{ ;fj{hlgs lghL ;fem]bf/L jf ;'wfl/Psf] ;ˆ6 lghLs/0f jf ;fj{hlgs lghLs/0feGbf km/s kb}{g . s] s:tf ljifo jf kIfdf lghLs/0fsf tTjx¿ k|j]z ug{ lbg] s'gdf glbg] eGg] ;"Id ljZn]if0f u/]/ cufl8sf sfdx¿ to ug{'k5{ .

xfd|f] ;Gbe{df tTsfn} :jf:Yo ;]jf ;fj{hlgsLs/0f ;Dej 5}g . of] lbzfdf cufl8 a9\gsf nflu klg tTsfn, dWosfn / bL3{sfndf ug{'kg]{ sfd to ug{ cfjZos 5 . tTsfndf cg'udg / lgodg a9fpg], ;+:yfsf] gfkmf ;+:yfdf g} nufgL ug]{ jftfj/0f agfpg], lghL nufgLsf ;+:yfnfO{ ;]jfsf] k|s[lt ;fj{hlgs ePsf] af]w u/fpg s]xL gLltut Joj:yf ug]{, lghL ;+:yfnfO{ 6«:6sf ablng k|f]T;fxg ug]{, lghL nufgLsf ;+:yfnfO{ nufgL :yfgfGt/0fsf] df}sf lbg], ;fj{hlgs lghL ;fem]bf/Lsf] cjwf/0ff sfof{Gjogdf Nofpg], 6«:6sf] cjwf/0ff sfof{Gjogdf Nofpg] h:tf ljsNkx¿

tof/ u/L sfof{Gjogdf Nofpg ;lsG5 . oL afx]s cGo yk ljsNk klg x'g ;S5g\ h;sf] vf]hL ug{' cfjZos 5 . dWosfn / bL3{sfnsf ;fjh{lgs ;+:yf lgdf{0fdf hf]8 lbg] / :jf:Yo ;]jfnfO{ k"0f{t ;fj{hlgsLs/0f agfpg] tkm{ nfUg'kg]{ b]lvG5 . oLdWo] b]xfodf s]xL ljsNksf af/]df dfq rrf{ ul/Psf] 5 .

!= cg'udg / lgodg a9fpg]

cfhsf] ef]ln d'n'ssf] :jf:Yo ;]jfsf] ;fj{hlgsLs/0f ;Dej 5}g . olb xfdLn] cfhsf lbgb]lv g} ;'wf/sf sfd ;'? u/\of}+ eg] klg o;sf] glthf b]lvg klg s]xL ;do nfU5 . cleefjssf] ljZjf; lhTgsf nflu klxnf ;'wf/ u/]/ b]vfpg ;Sg'k5{ . sfd / glthfaf6 ljZjf; cfh{g x'g] xf] . oL ;a} sfdsf nflu s]xL ;do rflxG5 . ;a}eGbf klxnf ePsf lgod sfg'gleq} /xL ;fj{hlgs ;+:yfsf] ;'wf/ / lghL ;+:yfsf] lgodg k|efjsf/L agfpg'k5{ . ;fj{hlgs ;+:yf k"/f ;do ;~rfng ug]{, hgzlQmnfO{ k"/f ;do sfddf nufpg], lghL ;+:yfnfO{ lgodadf]lhd dfq ;]jf z'Ns lng lbg], hgzlQm / ;]jfu|fxLsf] ;]jf ;'ljwfdf Wofg lbg], sfo{k|lqmofnfO{ kf/bzL{ agfpg] h:tf sfdx¿ tTsfn ;'? ug{'k5{ . lghL ;+:yfx¿ dfkb08adf]lhd ;~rfng ug{ u/fpg :jod lghL ;+:yfx¿ g} cu|;/ x'g'k5{ . o;af6 uf]8d]n u/]sf] km"naf/L em}F lghL ;+:yfx¿ yk ;fOhdf cfpg] x'G5g\ . s]xL ;+:yfx¿ Pscfk;df dh{ x'g klg ;S5g\ . To;}u/L dfkb08 gk'u]sf sltko lghL ;+:yfx¿ l/ªaf6 aflxl/g klg ;S5g\ . clxn] s} sfg'gleq /xL tTsfndf ug{ ;lsg] pkfodWo] oL pkfox¿ sd hf]lvdk"0f{ 5g\ . ;a}sf nflu pkof]uL klg 5g\ .

@= gofF df]8n ljsf; u/L sfof{Gjogdf Nofpg]

cWoog / ljZn]if0fsf cfwf/df g]kfnsf] :jf:Yo ;]jfdf nufgLsf b[li6sf]0fn] gofF df]8n ljsf; u/L sfof{Gjogdf Nofpg' cfjZos b]lvG5 . ;fj{hlgs / lghLsf] laraf6 csf]{ gofF df]8n agfpg cfjZos 5 h;af6 ;'wf/df sd hf]lvd cfcf];\ / cleefjssf] u'd]sf] ljZjf; lkmtf{ lng ;lhnf] xf]cf];\ . oL df]8ndWo] s] slt ;dodf k"0f{ ;fj{hlgsLs/0fdf k'Ug ;lsG5 eg]/ :ki6 u/L ;f]xLadf]lhd ;/sf/sf gLlt tyf sfo{qmd lgwf{/0f / sfof{Gjog ug{'k5{ .

s= df]8n Ps:jf:Yo ;]jfsf] k"0f{ ;fj{hlgsLs/0f, hxfF /fHos} ;+:yfn]

df]8n PsM :jf:Yo ;]jfsf] ;fj{hlgsLs/0f

df]8n b'O{M :jf:Yo ;]jfsf] cfFlzs lghLs/0f

df]8n tLgM:jf:Yo ;]jfsf] clws lghLs/0f

df]8n rf/M :jf:Yo ;]jfsf] lghLs/0f

:jf:Yo ;]jfdf lghLs/0f

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/fHos} nufgLdf :jf:Yo ;]jf lng]lbg] sfd u5{g\ . ;+:yfsf] ;j} ;DklQ ;/sf/L jf ;fj{hlgs x'G5 . ;+:yf ;~rfngsf nflu cfjZos /sd ;fj{hlgs x'G5 cyf{t ;/sf/n] g} Joxf]5{ . o;df cleefjsnfO{ ;+:yf 5gf]6sf] cj;/ gx'g klg ;S5 . of] t Ps cfbz{ cj:yf xf] . olb d'n'sdf /x]sf ;+:yfn] cleefjsx¿;Fu s'g} z'Ns jf /sd lnPsf] 5}g / :t/Lo :jf:Yo ;]jf k|bfg u/]sf 5g\ eg] To; lsl;dsf ;+:yfnfO{ o; ;d"xdf /fVg ;lsG5 . o:tf ;+:yf agfpgsf nflu ;do / ;|f]t cfjZos x'G5 . casf lbgdf ug}{ sfd rfFlx oxL xf] .

v= df]8n b'O{;fj{hlgs ;DklQ jf ;+:yfdf ;Lldt dfqfdf lghL nufgL lelqg lbO{ ;+:yf ;~rfng ug]{ gLlt o;df k5{ . o:tf] lghL nufgL ;/sf/n] cg'bfg lbP/ klg x'g;S5, ;]jfu|fxL;Fu z'Ns lnP/ klg x'g ;S5, lghL nufgLstf{x¿nfO{ g} nufgL ug{ lbP/ klg x'g;S5 . o;df jhf/sf] dfu jf pbf/ ahf/ gLltsf] cjwf/0ff cg';f/ ;]jf z'Ns nufpg kfOFb}g\, a? o;sf] ;§fdf z'Ns sd agfpg' kg]{ x'G5 . ;+:yfn] ;fj{hlgs ;DklQ k|of]u ug]{ x'gfn] ;]jf z'Ns ;lA;8fOH8 cjwf/0ffjdf]lhd to x'g] ub{5 . clxn]sf ;fj{hlgs ;+:yfx¿ h;n] gful/s;Fu ;]jf z'Ns lnPsf 5g\ tL klg oxL df]8ndf k5{g\ . pQm ;]jf z'Ns lng' x'GYof] jf x'Gy]g jf ;f] s] slt cf}lrTok"0f{ lyof] eGg] ljifodf jx; x'g ;Snf . t/ ;]jf z'Ns lnPsfx¿ o;} df]8ndf k5{g\ . :jf:Yo ;]jfsf] clws lghLs/0feGbf t of] 9fFrf pkof]uL x'G5 . o;af6 ;/sf/sf] vr{ ef/ sd t x'G5 t/ ljkGg / ul/anfO{ yk ef/ kg]{ lglZrt 5 . tTsfnsf nflu of] 9fFrf pkof]uL x'g] blvG5 lsgls o;df ;fj{hlgs lghL ;fem]bf/Lsf] cjwf/0ff k|of]u ug{ ;lsG5 . o;sf] sfof{Gjogdf hf]lvd / cj/f]w sd 5 .

u= df]8n tLgo;df ;+:yf :yfkgf / ;~rfng ug{sf nflu lghL nufgLnfO{ v'nf ul/G5 . ;+:yf ;~rfng / z'Nsdf ;/sf/sf] k|ToIf lgu/fgL sfod x'gsf nflu ;/sf/n] s]xL cg'bfg klg lbg ;S5 . cg'bfg glbO{sg klg ;~rfng x'g;S5 . t/ ;+:yfn] lglZrt dfkb08sf cfwf/df ;]jfu|fxLnfO{ lgz'Ns jf ;lA;8fOH8 nfutdf ;]jf lbg'k5{ . ;+:yf :yfkgf / ;~rfngdf gS;fª\sgsf] cjwf/0ff nfu' x'G5 . of] cj:yf :jf:Yo ;]jfdf clws lghLs/0fsf] cj:yf xf] . o;df sdhf]/ / lakGgn] ;]jf kfpg sl7g x'G5 lsgls o;df ;]jf z'Ns a9L x'g;S5 .

3= df]8n rf/v'nf ahf/ jf pbf/ cy{tGq Pjd\ ahf/Ls/0fsf] cjwf/0ffadf]lhd ;+:yf :yfkgf / ;~rfng ug{ lbg] cjwf/0ff o;cGtu{t k5{ . o;n] ljb]zaf6 la/fdL Nofpg]

dfq dfq geO{ :jb]zLnfO{ aflx/ hfgaf6 klg /f]s]/ d'n'sleq /f]uhfuL l;h{gf/ art klg u5{ eGg] ul/G5 . ;fy} ;/sf/n] s/ klg ;ª\sng ug{ ;S5 . o;df k"0f{t lghLs/0fsf] cjwf/0ff nfu' x'g ;S5 . k'hLFjfbL d'n'sdf ;d]t :jf:Yo ;]jfdf o; lsl;dsf] cjwf/0ff sfof{Gjogdf 5}g .

#= ljlzi6 vfnsf ;+:yf rnfpg cg'dlt lbg]

:jf:Yo ;]jfdf cWoog cg';Gwfg;lxtsf sfo{sf nflu s]xL ljlzi6Ls[t lgsfo ;~rfng ug]{ cjwf/0ff o; cGtu{t k5{ . o;df :jf:Yo ;]jf pBf]usf] ¿kdf ;~rfng ug{ kfpg] cjwf/0ff x'G5 . /fHosf] sfd wf/fdf ;kmf / lkpgof]Uo kfgL cfk"lt{ ug]{ xf] olt ubf{ klg s;}n] af]6nsf] kfgL lsg]/ vfG5' eG5 eg] cltl/Qm z'Ns lt/ / ;f] ;'ljwf pkef]u klg u/ eGg] cfF6 rflxG5 eGg]x¿n] o;nfO{ ;lhnf] dfG5g\ .

/ cGtdf,;dfhdf lje]bn] c;dfgtf 5 h'g jiff}{b]lv rNb} cfof], sltko cj:yfdf t ;+:sf/ g} al;;Sof] . ca clxn]sf] ;dfhdf To;nfO{ s/]S;g ug]{ ;fwgdWo]sf] k|d'v ;fwg :t/Lo :jf:Yo ;]jfsf] ;fj{hlgsLs/0f g} xf] . ef]lnsf] ;dfhdf :yfloTj / d}qLkgsf nflu klg :jf:Yo ;]jfnfO{ /fHon] k"0f{ ;fj{hlgs j:t' / ;]jf ;'ljwfsf] ¿kdf lng} k5{ . o;nfO{ k"0f{ ;fj{hlgs j:t' jf ;]jf ;'ljwfsf] ;"rLdf /fVbf ca hGdg] x/]s afns jf aflnsfn] cfˆgf] hLjgsf] ;'?jftb]lv g} pko'Qm -;dfgdfq xf]Og_ jftfj/0f kfpg ;S5g\ . Gofok"0f{ cj;/ kfpF5g\ hxfF sdhf]/nfO{ cem a9L ;]jf ;'ljwf pknAw x'G5 . ;dfhdf Gofo Tolt a]nfdfq x'G5 hlt a]nf hGdg] ;a}sf nflu :jf:Yo ;]jfsf] cj;/ Gofok"0f{ aGg ;S5 / x/]s JolQmn] cfˆgf] efjL ofqf cfˆgf] cGt/lglxt Ifdtf / k|ltefsf cfwf/df to ug{ ;S5 . ;dfhdf oxL lgod jf k4lt sfod ug{ ;s] ;d'Ggt ;dfh lgdf{0f ug{ ;lsG5 . of] sfo{ c;Dej 5}g . cem} klg s]xL lau|]sf] 5}g .

/fHon] gful/saf6 s/ ;ª\sng u/L pQm /sd tLg d'Vo sfo{df vr{ ub{5 . klxnf] /fHodf cdgrog / zflGt ;'/Iff sfod ug{' xf] . bf];|f]df gful/ssf nflu cfjZos sfo{qmd ;~rfng ug{' xf] eg] t];|f] sfo{ Go"g cfo ePsf / sdhf]/nfO{ ljz]if ;xof]u pknAw u/fpg' xf] . of] ljz]if ;xof]u eg]sf] klg :jf:Yo ;]jfnfO{ k"0f{ ;fj{hlgsLs/0f ¿kdf :jLsf/ u/L ul/a, sdhf]/ / c;xfosf nflu pko'Qm jftfj/0f l;h{gf ug]{ kIf;Fu ;DalGwt 5 . ;a}sf nflu Gofok"0f{ cj;/;lxtsf] pko'Qm jftfj/0f s;}sf] lgufx geP/ clwsf/ xf] eg]/ a'‰of} eg] ;d:of ;dfwfg x'g ;do nfUb}g .

- 50 -

/fHosf] Wofg :jf:Yo ;]jfsf] ;fj{hlgsLs/0f ug{df g} x'g'k5{ . Pnf]6L / ;fyLx¿ -@)!@_ n] eg]em} clxn] g} of] sfd ;Dej gx'g klg ;S5, o;sf nflu ;do klg nfUg ;S5 . t/ ;/sf/sf sbd o;tkm{ nlIft x'g}k5{ . o;}u/L :jf:Yo ;]jfsf] lghLs/0ftkm{ t hfg} x'Fb}g . clxn]sf nflu :jf:Yo ;]jfsf] ;fj{hlgsLs/0f / :jf:Yo ;]jfdf lghLs/0f eGg] cjwf/0ffnfO{ ldnfP/ larsf] af6f] agfO{ ;f]nfO{ cjnDjg ug{' g} plrt x'g;S5 . d'n'ssf] ult a9LeGbf a9L ;fj{hlgsLs/0fsf] 5]pdf k'Ug] x'g'k5{, h'g cfbz{ cj:yf xf] . cfbz{ cj:yf xfl;n ug{ s]xL ;do nfUnf t/ klg o;nfO{ 5f]8g' x'Fb}g .

olb d'n'ssf] :jf:Yo ;]jfnfO{ ;fFlRrs} ;'wf/ ug]{ xf] eg] of] d'n'sdf /x]sf ;+:yfx¿nfO{ dflysf df]8ndWo] s'gdf slxn] / s;/L jbNg] eGg] b[li6sf]0f /fv]/ cl3 j9\g'k5{ . s'g 36fpg] / s'g j9fpg] eg]/ olsg ug{'k5{ . clxn] rflxg] eg]sf] ljg ljg df]8n xf] . o; ;Gbe{df O6flnog dfS;{jfbL lrGts PG6f]lgof] u|fD;Lsf] ;+s6 ;DaGwL egfO pkof]uL x'G5 . pgn] s'g} k|;ª\udf k'/fgf d"No dfGotf eTsg] t/ gofF d"No dfGotf galg;s]sf] larsf] cj:yf g} ;+s6 xf] eg]sf 5g\ . pgsf] o; egfO cfhsf lbgdf klg :jf:Yo ;]jfsf] ;Gbe{df plQs} ;fGble{s b]lvG5 . gofF gaGbf;Dd k'/fgfnfO{ geTsfpmF . gofF klg agfpb}F hfpF ha aG5, clg k/fgfsf af/]df ;f]rf}Fnf . clxn]sf] nflu cfjZos / pko'Qm dfu{ oxL x'g;S5 .

;Gbe{ ;fdu|Lx¿

g]kfnsf] ;+ljwfg, @)&@ .

;+o'Qm /fi6« ;ª\3sf] dfgjclwsf/ 3f]if0ff kq ;g\ !($* .

Allotey, P. ; Yasin, S. ; Tang, S. ; Chong, S. L. ; Chee Ho Cheah, J. & Reidpath, D. D. (2012). Universal coverage in an era of privatisation: can we guarantee health for all? BMC Public Health volume 12, Article number: S1. https://bmcpublichealth. biomedcentral. com/articles/10. 1186/1471-2458-12-S1-S1

Daviet, B. (2016). Revisiting the Principle of Education as a Public Good. Education Research and Foresight Series, No. 17. Paris: UNESCO. Available at: http://www. unesco. org/new/en/education/themes/leading- theinternational- agenda/rethinking-education/erf-papers/

Depersio, G. (2020). What Are Arguments in Favor of Privatizing Public Goods? Feb 24, 2020. https://www. investopedia. com/ask/answers/040615/what-are-main-arguments-favor-privatization-public-goods. asp

Dourado, C. (2019). Privatization and public health: a question of Human Rights. https://europeansting. com/2019/10/28/privatization-and-public-health-a-question-of-human-rights/

Gollust, S. E. and Jacobson, P. D. (2006). Privatization of Public Services: Organizational Reform Efforts in Public Education and Public Health. Am J Public Health. 2006 October; 96(10): 1733–1739. https://www. ncbi. nlm. nih. gov/pmc/articles/PMC1586133/

Horne, L. C. (2019). "Public Health, Public Goods, and Market Failure". In Public Health Ethics, Volume 12, Issue 3, November 2019, Pages 287–292, https://doi. org/10. 1093/phe/phz004

https://classroom. synonym. com/what-are-the-duties-of-state-government-12082173. html

https://www. khanacademy. org/economics-finance-domain/microeconomics/market-failure-and-the-role-of-government/externalities-topic/a/public-goods-cnx

https://www. who.int/news-room/fact-sheets/detail/human-rights-and-health

Kaul, I. and Mendoza, R. (). Advancing the concept of public goods.

Locke, John. Second Treaties on Government 1689. In https://en. wikipedia. org/wiki/Social_contract

Minnesota Department of Health. Government's Responsibility for Public Health. https://www. health.state.m.us/communities/practice/resources/chsadmin/mnsystem-responsibility. html

Rousseau, Jean-Jacques. The Social Contract, or Principles of Political Right (1762). In https://en. wikipedia. org/wiki/Social_contract

Smith, R (). Global public goods and health. Editorial. https://www.who.int/bulletin/volumes/81/7/en/Smith0703. pdf

World Health Organization. Universal health coverage (UHC). 24 January 2019. https://www. who. int/news-room/fact-sheets/detail/universal-health-coverage-(uhc).

- 51 -

/fli6«o lrlsT;f P]g, @)&% sfof{Gjogsf] ;Gbe{

l8NnL/fd n'O6]n

!= k[i7e"ld

dfgj hLjgdf :jf:Yo lzIff / :jf:Yo ;]jf k|flKt ckl/xfo{ ljifo xf] . ;':jf:Yo gful/ssf] sNkgf ubf{ dfgj :jf:Yosf] ;d'lrt ljsf;;Fu} hf]l8P/ cfpF5 . h'g;'s} /fi6«sf] ljsf;sf] dxTjk"0f{ ;"rs dfgj :jf:Yosf] cj:yf xf] . dfgj :jf:Yo / lrlsT;f lzIff ljifodf cGof]Gofl>t ;DaGw 5 . h'g b]zsf] lrlsT;f lzIff k|0ffnL Jojl:yt / :t/Lo 5 ;f]xL cg';f/ To; b]zsf] dfgj :jf:Yo cj:yfdf k|ToIf k|efj /xG5 . u'0f:t/Lo lrlsT;f lzIffsf] k|Tofe"ltn] lrlsT;f If]qdf ;Ifd hgzlQm pTkfbg x'g] / ;Ifd hgzlQmn] :t/Lo :jf:Yo ;]jf k|bfg ug{ ;Sg] / kl/0ffdt dfgj :jf:Yodf ;'wf/ cfpg] ljifo cGof]Gofl>t 5 .

k|To]s gful/snfO{ /fHoaf6 cfwf/e"t :jf:Yo ;]jf lgz'Ns k|fKt ug]{ xs x'g], cfsl:ds :jf:Yo ;]jfaf6 al~rt x'g gkg]{ / :jf:Yo ;]jfdf ;dfg kx'Frsf] xs /xg] ;+j}wflgs Joj:yfnfO{ sfof{Gjog ug{ lrlsT;f lzIff / :jf:Yo ;]jf lj:tf/df w]/} sfo{ ug{ afFsL /x]sf] cj:yf 5 . :jf:Yosf If]qdf cfTdlge{/tf k|fKt ug{ ;Ifd / Gofok"0f{ :jf:Yo ;]jf k|0ffnL :yfkgf ug{ h?/L 5 . ;du| gful/ssf] hLjg;Fu hf]l8Psf] ljifonfO{ lghL If]q / clgolGqt v'nf ahf/df 5f]8]/ ;d:of ;dfwfg gx'g] x'Fbf :jf:Yo ;]jf lj:tf/sf] of]hgf tyf lgodgsf] clGtd / lhDd]jf/Lk"0f{ bfloTj ;/sf/df /xg'kg]{ x'G5 . lrlsT;f lzIffnfO{ cfly{s pkfh{gsf ¿kdf kl/eflift x'g nfu]sf] jt{dfg cj:yfaf6 g]kfnL ;dfhdf ;]jfd"ns / lg:jfy{ ;dlk{t x'g] ljifosf ¿kdf ¿kfGt/0f ug{ o; If]qdf ;/sf/sf] lgodgsf/L / lhDd]jf/k"0f{ ;]jf k|bfos e"ldsfdf a9f]Q/L ug{ h?/L ePsf] 5 .

g]kfndf lrlsT;f lzIff lj:tf/sf] qmddf ;/sf/L tyf u}/;/sf/L If]qaf6 ljljw k|of; ePsf 5g\ . ljleGg ljwf / ljifo If]qsf cfjZos hgzlQm pTkfbg ug{ ul/Psf] k|of;df lgodgsf/L lgsfosf] blj{nf] / lhDd]jf/ k"0f{ e"ldsf kl/eflift x'g g;Sbf bzsf}+b]lv lrlsT;f lzIff If]qdf ljljw ;d:of / lj;ª\ult ;d]t df}nfpg] cj;/df dnhn ePsf] cj:yf /Xof] . Psflt/ lrlsT;f lzIff k|bfos ;+:yfx¿sf] lgodgsf/L lgsfo u7g u/L u'0f:t/ k]zfwld{tf / Joj;flostfsf] clej[l4 ug{ h?/L b]lvof] eg] csf]{lt/ lrlsT;f lzIffdf ;dfg kx'Fr sfod ub}{ ef}uf]lns ;Gt'ng / ;fdflhs Gofo sfod ug]{ dxTjk"0f{

lhDd]jf/L /fHoaf6 lgjf{x ug{'kg]{ cj:yf /Xof] . lrlsT;f lzIffsf] ;Ifd k|0ffnL / lgodgsf/L lgsfosf] cefjdf o; If]qdf b]lvPsf ljBdfg r'gf}tL, ljs[lt lj;ª\ult / lje]bsf] ljifodf b]lvPsf] hgrf;f] /fli6«o cfjZostf tyf lzIff ljsf;sf] ;Gbe{df ;do;dodf u7g ePsf cfof]u tyf sfo{bnsf] ;'emfj;d]tsf cfwf/df u'0f:t/Lo lrlsT;f lzIffdf ;j{;fwf/0fsf] kx'Fr a9fO u'0f:t/ / k];fwld{tf;lxtsf] :j:y / bIf hgzlQm ljsf; ub}{ ;+:yfut hjfkmb]lxtf, ef}uf]lns ;Gt'ng, ;fdflhs Gofo sfod u/L ;a}sf] ;dfg kx'Fr ;'lglZrttfsf nflu lrlsT;f lzIff cfof]usf] :yfkgf / ;~rfng ug]{ ;DaGwdf Joj:yf ug{ @)&$ sflt{s @$ df /fli6«o lrlsT;f lzIff ;DaGwdf Joj:yf ug{ cWofb]z hf/L eO{ ;f]xLcg';f/ lrlsT;f lzIff cfof]u :yfkgf ePsf] / @)&% kmfNu'0f !) ut] /fli6«o lrlsT;f P]g, @)&% hf/L ePsf] 5 .

@= /fli6«o lrlsT;f P]g, @)&% n] u/]sf Joj:yf

lrlsT;f lzIffsf] If]qdf /fHosf] nufgL clej[l4 ub}{ lrlsT;f lzIffnfO{ g]kfnsf] /fli6«o cfjZostf cg'¿k ljsf; ug]{, lrlsT;f lzIffsf] lgodgnfO{ PsLs[t / r':t agfpg], lrlsT;f lzIff k|bfos ;+:yfsf] :yfkgf / ;~rfng ;DaGwL sfo{nfO{ Jojl:yt agfpg], lrlsT;f lzIffdf u'0f:t/, k];fwld{tf, ;+:yfut hjfkmb]xL, ef}uf]lns ;Gt'ng / ;fdflhs Gofo sfod u/L ljkGgnufot ;j} ljBfyL{x¿sf] ;dfg kx'Fr ;'lglZrt ug]{ u/L ;DdfggLo k|wfgdGqLHo"sf] cWoIftfdf @( ;b:oLo lrlsT;f lzIff cfof]u u7gsf] Joj:yfsf ;fy cfof]usf sfd, st{Jo / clwsf/nfO{ kl/eflift u/]sf] 5 . cfof]usf] sfo{sf/L lgsfosf] sfd ug{ cfof]usf pkfWoIfsf] cWoIftfdf lgb]{zsx¿, cfof]usf ;b:ox¿dWo]af6 cfof]usf cWoIfn] dgf]lgt u/]sf sDtLdf Ps dlxnf;lxt @ hgf / ;b:o ;lrj /xg] u/L * ;b:oLo lrlsT;f lzIff cfof]u sfo{sf/L ;ldlt u7g u/L ;ldltsf] sfd st{Jo / clwsf/ tf]lsPsf] 5 . lrlsT;f lzIff If]qdf lzIf0f ;+:yf :yfkgf ug{ rfxg]n] cfzo kq lng'kg]{nufot lzIf0f ;+:yfsf] ;DaGwg ;DaGwL Joj:yf / lrlsT;f lzIff;DaGwL ;j} sfo{qmdsf] k|Tofog lng] ;DaGwL Joj:yf ul/Psf] klg P]gdf ul/Psf] 5 . ljBfyL{ egf{ / PsLs[t k|j]z k/LIff ;DaGwL Joj:yf, z}lIfs Sofn]G8/, lzIf0f z'Ns tyf 5fqj[lQ ;DaGwL :ki6 Joj:yf klg P]gdf g} ul/Psf] 5 .

;b:o ;lrj, lrlsT;f lzIff cfof]u, ;fgf]l7dL

- 52 -

ljZjljBfno, k|lti7fg jf cGo lzIf0f ;+:yfsf] kf7\oqmd lzIf0f ljlw / pkflwsf] dfkb08 lgwf{/0f;DaGwL clwsf/ cfof]udf /x]g'sf ;fy} ;+:yfut hjfkmb]lxtf tyf pkflwsf] dfkb08 ;DaGwL Joj:yf klg ul/Psf] 5 . lrlsT;f lzIff cfof]udf dfkb08 tyf k|Tofog lgb]{zgfno, of]hgf ;dGjo tyf k|fl1s pGgog lgb]{zgfno, k/LIff lgb]{zgfno / g];gn af]8{ ckm d]l8sn :k]l;oflnl6h u/L # cf]6f lgb]{zgfno / Pp6f af]8{sf] ;+/rgf :yfkgf u/L $ hgf lgb]{zs /xg] Joj:yf ul/Psf] 5 . cfof]usf pkfWoIf / lgb]{zsx¿ cfof]usf] k"/f ;do sfd ug]{ kbflwsf/Lsf ¿kdf /xg] Joj:yf ul/g'sf ;fy} cfof]usf pkfWoIf / lgb]{zsx¿sf] lgo'lQm ;DaGwL Joj:yf klg P]gdf pNn]v ul/Psf] 5 . cfof]usf] jl/i6 sd{rf/Ln] cfof]usf] ;b:o ;lrjsf ¿kdf sfd ug]{ Joj:yf /x]sf] t/ cfof]udf sd{rf/Lsf] Joj:yfkg geP;Dd g]kfn ;/sf/sf] /fhkqfª\lst k|yd >]0fLsf] sd{rf/Ln] ;b:o ;lrjsf] ¿kdf sfd ug]{ tyf cfof]udf sd{rf/L lgo'lQm geP;Dd g]kfn ;/sf/n] sd{rf/L pknAw u/fpg] Joj:yf /x]sf] 5 .

P]gdf cfof]usf] cfˆg} sf]if /xg] Joj:yf ul/Psf] / cfGtl/s n]vf k/LIf0f cfof]uaf6 lgo'Qm n]vf k/LIfs / clGtd n]vf k/LIf0f dxfn]vf k/LIfsaf6 x'g] Joj:yf /x]sf] 5 . lrlsT;f lzIff cfof]un] cfjZostfcg';f/ lrlsT;f lzIff;Fu ;DalGwt ljZjljBfno, k|lti7fg, sfplG;n / lzIf0f ;+:yfsf] lg/LIf0f ug{ ;Sg], gofF z}lIfs sfo{qmd ;~rfng ug{ k|f]T;fxg ug]{, lrlsT;f lzIffsf ljleGg ljwfdf l;6 cf/If0f ug{' kg]{, ljZjljBfno jf k|lti7fgn] of] P]g k|f/De ePkl5 s'g} klg lzIf0f ;+:yfnfO{ lrlsT;f lzIfftkm{ k|df0fkq jf ;f]eGbf tNnf] txdf sIff ;~rfng ug{ cg'dlt lbg g;Sg] ;fy} ;~rfng ePsfsf] xsdf % jif{leqdf km]hcfp6 ug{' kg]{, lrlsT;f lzIff ;DaGwL lzIf0f ;+:yfnfO{ P]g k|f/De ePsf] ldltn] !) jif{kl5 g]kfn /fHoleq ;~rflnt lrlsT;f ;DaGwL lzIf0f ;+:yf qmdz u}/gfkmfd"ns / ;]jfd"ns ;+:yfsf ¿kdf /xg] Joj:yf klg P]gdf ul/Psf] 5 . cfof]un] g]kfn ;/sf/;Fu ;Dks{ /fVg' kbf{ lzIff ;DaGwL ljifo x]g]{ g]kfn ;/sf/sf] dGqfnodfkm{t /fVg'kg]{ cflb Joj:yf klg P]gdf /x]sf] 5 .

#= P]g sfof{Gjogsf] ;Gbe{

/fli6«o lrlsT;f P]g @)&% df Joj:yf ePadf]lhd P]gsf] sfof{Gjogsf] ;Gbe{df tkl;n adf]lhdsf sfo{x¿ ePsf 5g\ M

!= lrlsT;f lzIff cfof]usf] u7g ;DaGwL Joj:yf adf]lhd @( ;b:oLo cfof]u u7g eO{ xfn;Dd cfof]usf # j6f a}7s a;L lrlsT;f lzIff;Fu ;DalGwt dxTjk"0f{ ljifodf lg0f{o eO{ sfof{Gjogdf uPsf] 5 . lrlsT;f

lzIfftkm{ :gfts tx / :gftsf]Q/ txsf] z'Nsdf Ps¿ktf Nofpg z'Ns lgwf{/0f u/L nfu' ul/Psf] 5 .

@= lrlsT;f lzIff cfof]usf pkfWoIf / lgb]{zsx¿sf] lgo'lQm eO{ @)&% ef›b]lv g} sfo{ k|f/De ePsf] 5 / sfo{ ;ldltn] sfo{ ul//x]sf] 5 .

#= cfof]udf s]xL sd{rf/Lx¿sf] c:yfoL kb l;h{gf u/L cfof]usf sfdnfO{ lgoldttf k|bfg ul/Psf] 5 . cfjZos sd{rf/L Joj:yfkgsf nflu ;ª\u7g ;+/rgf tof/ u/L :jLs[ltsf nflu g]kfn ;/sf/ cy{ dGqfnodf k7fOPsf] 5 .

$= cfˆgf] ejg gePsf] sf/0f lzIff tyf dfgj ;|f]t ljsf; s]G›sf] ;fljs z}lIfs hgzlQm ljsf; s]G› /x]sf] @ g+ ejgsf] s]xL efu / z}lIfs k/LIf0f s]G› /x]sf] ejg lzIff lj1fg tyf k|ljlw dGqfnon] pknAw u/fO{ ;f] :yfgdf cfof]usf] sfof{no :yfkgf ul/Psf] 5 .

%= lrlsT;f lzIff ;~rfngsf nflu PsLs[t z}lIfs Sofn]G8/ th{'df u/L sfof{Gjogdf NofOPsf]df sf]le8 !( sf/0f lgwf{l/t sfo{qmd ;~rfngdf s]xL afwf pTkGg ePsf] cj:yf 5 .

^= :gftsf]Q/ txsf] PsLs[t k|j]z k/LIffsf nflu kf7\oqmd th{'df eO;s]sf] 5 / ;f]xL kf7\oqmdcg';f/ k/LIff ;~rfng ug{ cfjZos tof/L sfo{ eO/x]sf] 5 .

&= lrlsT;f lzIffsf ljleGg lzIf0f ;+:yfsf] ljleGg k|of]hgsf nflu ug]{ cg'udg ;DaGwL dfkb08 tyf sfo{ljlwx¿ th{'df eO{ sfof{Gjogdf 5g\ .

*= k|Tofog tyf dfkb08 lgb]{zgfnoaf6 l;6 lgwf{/0f k|of]hgsf nflu cg'udg ug]{ sfo{ eO/x]sf] 5 .

(= /fli6«o lrlsT;f lzIff P]g, @)&% sf] bkmf %$ lbPsf] clwsf/ cGtu{t /fli6«o lrlsT;f lzIff lgodfjnLsf] th{'df u/L :jLs[ltsf nflu g]kfn ;/sf/ dlGqkl/ifbdf k]; ul/Psf] 5 .

!)= cfof]un] tf]s]sf z'Ns sfof{Gjogsf nflu lgoldt cg'udg / lgb]{zg lbO{ lg0f{o sfof{Gjo ul/Psf] 5 .

!!= /fli6«o lrlsT;f lzIff P]g @)&% n] tf]s]adf]lhd ;j} lgb]{zgfno / af]8{ :yfkgf eO{ sfo{ cufl8 al9/x]sf] 5 .

!@= lrlsT;f lzIff If]qsf ;d;fdlos ljifo / d'2fx¿sf af/]df ;/f]sf/jfnf lj1x¿;Fu cfjZostf cg';f/ cGt/lqmof / 5nkmn u/L sfof{Gjogdf NofOPsf] 5 .

!#= P]gsf] Joj:yf cg';f/ ;/sf/L lzIf0f ;+:yfn] g]kfn ;/sf/nfO{ pknAw u/fpg] &% k|ltzt l;6df ljBfyL{ 5gf]6 eO{ ;DalGwt lzIf0f ;+:yfn] lgz'Ns cWoog u/fP afkt pknAw u/fpg' kg]{ Psd'i6 cg'bfgsf] klxnf] ls:tf /sd ;DalGwt lzIf0f ;+:yfdf pknAw

- 53 -

u/fOPsf] 5 .!$= P]gdf Joj:yf ePadf]lhd cfof]un] ug{'kg]{ sfdx¿

qmdz cufl8 a9fOPsf] 5

$= sfof{Gjogsf hl6ntfx¿

/fli6«o lrlsT;f lzIff P]g, @)&% n] Joj:yf u/]sf P]gsf bkmfx¿nfO{ sfof{Gjog ug]{ qmddf s]xL c:ki6tf / s]xL hl6ntfx¿ klg b]lvPsf 5g\ . P]gdf b]lvPsf s]xL c:ki6tf / sfof{Gjogsf hl6ntf tkl;ncg';f/ /x]sf 5g\ M

! P]gsf] kl/efiff v08sf] ÚyÚ df lzIf0f z'Nssf] kl/efiffdf lzIf0f ;+:yfn] lrlsT;f lzIffsf] cWoog cjlw e/df lng] egf{, lzIf0f, Nofa, k':tsfno, ;fd'bflos tflnd jf k/LIff z'Ns ;Demg'k5{ / ;f] zAbn] cfof]usf] :jLs[ltdf lzIf0f ;+:yfn] lng] cGo z'NsnfO{ ;d]t hgfpF5 elgPsf]df cfof]un] lzIf0f z'Nssf gfddf Psd'i7 /sd tf]s]sf]df lzIf0f ;+:yfn] o; zLif{sdf g;ldl6Psf] egL sfplG;n z'Ns, ljZjljBfno /lhi6«];g z'Ns, cfjf; z'Ns, oftfoft z'Ns, v]ns'b z'Ns, ljdf z'Nsnufotsf gfddf yk /sd dfu ug]{ cj:yf /x]sf] x'Fbf o; ljifodf yk JofVof x'g'kg]{ cj:yf 5 . of] c:ki6tfsf sf/0f ljBfyL{ df/df kg]{ / cfof]unfO{ z'Ns sfof{Gjogdf ;d]t hl6ntf b]lvPsf] .

@ P]gsf] kl/efiff v08sf] ÚkÚ df ;fj{hlgs lzIf0f ;+:yf eGgfn] ;/sf/L ;fd'bflos jf ;fj{hlgs ;DklQsf] k|of]u u/L :yfkgf ePsf ;/sf/L ;fj{hlgs u'7L jf cGo lzIf0f ;+:yf ;Demg'k5{ elgPsf]df of] kl/efiffn] ;fj{hlgs lzIf0f ;+:yfsf] Plsg ug{ sl7gfO pTkGg ePsf] .

# P]gsf] kl/R5]b % df lrlsT;f lzIfftkm{sf] lzIf0f ;+:yf :yfkgf ug{ cfzo kq lng'kg]{ Joj:yf ul/Psf] / cfzo kq nflu lgj]bg ;fy ;DaGwg lng rfx]sf] ljZjljBfnosf] ;xdlt kq ;+nUg x'g'kg]{ Joj:yf /x]sf] / cfkm\gf] cf+lus sfo{qmd ePsf ljifodf ljZjljBfnon] % eGbf a9L lzIf0f ;+:yfnfO{ ;DaGwg lbg gkfpg] sfg'gL k|fjwfgn] gofF ;+:yfn] df}h'bf ljZjljBfnoaf6 ;xdltkq lng hl6ntf /x]sf] .

$ P]gsf] bkmf !@ df ljBfyL{sf] k9fO / cEof;sf nflu d]l8sntkm{ slDtdf tLg ;o tyf 8]G6n / gl;{ª tkm{ Ps;o z}øofsf] c:ktfn ;~rfng geP;Dd cfzokq k|bfg ug{ g;lsg] pNn]v ePsfn] gofF ;+:yf ;~rfngsf] cfzo kq lng / klxn] ;DaGwg lnO{ ;s]sfnfO{ of] bkmf adf]lhdsf] k"jf{wf/ ljsf; ug{ ;do nfUg] / yk nufgL ug{'kg]{ cj:yf b]lvPsf] .

% P]gsf] bkmf !% df k|Tofog ;DaGwL sfo{ ug{ sfg'g adf]lhd 5'§} lgsfo u7g x'g] elgPsf]df 5'§} lgsfo u7g geP;Dd sfo{ ;~rfngdf hl6ntf b]lvPsfn] 5'§} lgsfo u7g ug]{ sfo{ rfF8f] x'g' kg]{ b]lvG5 .

^ P]gsf] !% -$_ df sfg'gdf h'g;'s} s'/f n]lvPsf] ePtf klg of] P]g k|f/De ePkl5 kl/ifb\n] k|df0fkq txeGbf d'lgsf :jf:Yo lzIff ;DaGwL s'g} klg k|fljlws sfo{qmd ;~rfng ug{ gkfpg] Joj:yfn] Ps} k6s k|fljlws If]qdf ;~rflnt cgdL, cx]j, 6]lSgsn P;Pn;L h:tf kl/ifbaf6 ;~rflnt sfo{qmddf hl6ntf cfPsf] 5 . tf]lsPadf]lhd cku|]8 ug]{ cj;/ k|bfg ug]{ elgP klg cku|]8sf nflu tf]lsPsf k|fjwfg k"/f u/L cku|]8 ug{ ;d:ofk"0f{ b]lvPsf] 5 .

& P]gsf] bkmf !& -&_ df ;fj{hlgs lzIf0f ;+:yfn] :gfts txsf] sfo{qmddf pknAw l;6 ;+Vofsf] krxQ/ k|ltzt lgz'Ns 5fqj[lQsf nflu Joj:yf ug{'kg]{ Joj:yf u/]sf] / cfof]usf] k/fdz{df To:tf] l;6 qmdz j[l4 ub}{ n}hfg ;lsg] /xg'sf ;fy} !& -*_ df pkbkmf & adf]lhd lgz'Ns 5fqj[lQ pknAw u/fPjfkt g]kfn ;/sf/n] ;fj{hlgs lzIf0f ;+:yfnfO{ Psd'i7 cg'bfg k|bfg ug]{ 5 elgPsf] 5 . lgz'Nssf] l;6 &% k|ltztn] ;+VofTds ¿kdf w]/} x'g] / Psd'i6 cg'bfgsf] /sd;d]t gtf]lsPsf] l:yltdf z'NsnfO{ cfwf/ dfgL cg'bfg lbFbf ;/sf/sf] nufgLdf cToflws j[l4 x'g] cj:yf 5 . ;fj{hlgs lzIf0f ;+:yfn] ljZjljBfno cg'bfg cfof]uaf6 cGo cg'bfg ;d]t kfpg] x'Fbf of] cg'bfgnfO{ ;/sf/n] pknAw u/fpg] cGo cg'bfg;Fu ldnfg ug{ h?/L b]lvPsf] 5 .

* P]gsf] !* -@_ ÚvÚ df ;fj{hlgs lzIf0f ;+:yfdf cfwf/e"t lrlsT;f lj1fg jf lSnlgsn ljwf -d]l8sn tyf 8]G6n_ cWoog ubf{ g]kfnL ljBfyL{nfO{ lzIf0f z'Ns lng gkfpg] / To:tf ljBfyL{nfO{ ;d'lrt lgjf{x eQf ;DalGwt lzIf0f ;+:yfn] pknAw u/fpg] Joj:yf ul/Psf]df z'Ns klg lng gkfpg] cg'bfgsf] Joj:yf klg gx'g] / lgaf{x eQf klg lbg'kg]{ x'Fbf lzIf0f ;+:yfdf cfly{s ;d:of eO{ ;+:yf rNg ufx|f] x'g] xf] ls eGg] sf]0faf6 ;d]t ljifo p7fg ePsf] 5 .

( P]gsf] bkmf $& df of] P]g k|f/De ePsf] ldltn] bz jif{kl5 g]kfn /fHoleq ;~rflnt lrlsT;f lzIff ;DaGwL lzIf0f ;+:yf qmdz u}/gfkmfd"ns / ;]jfd"ns ;+:yfsf ¿kdf /xg] 5g\ eGg] Joj:yfn] lrlsT;f lzIff If]qdf ;/sf/n] nufgL a9fpg'kg]{ afWofTds Joj:yf l;h{gf ug{'sf ;fy} lghL¿kdf ;~rflnt lzIf0f ;+:yfdf ;d]t cg'bfg k|jfx ug{'kg]{ cj:yf b]lvPsf] 5 .

- 54 -

%= lgisif{

lrlsT;f lzIffnfO{ g]kfnsf] /fli6«o cfjZostf cg'¿k ljsf; ug{ o; If]qdf /fHosf] nfufgL clej[l4 ub}{ lrsfT;f lzIff If]qsf] lgodgnfO{ PsLs[t tyf r':t agfpg, lrlsT;f lzIff ;DaGwL lzIf0f ;+:yfsf] :yfkgf / ;~rfng ;DaGwL sfo{nfO{ Jojl:yt ug{ lrlsT;f lzIffnfO{ ;]jfd"ns tyf u}/gfkmfd"ns agfpg u'0f:t/Lo, ljj]szLn tyf ;fdflhs bfloTjaf]w ePsf lrlsT;fsdL{x¿sf] pTkfbg sfo{sf nflu lrlsT;f lzIff cfof]unfO{ ;'b[9Ls/0f ug{ h?/L 5 . lrlsT;f lzIff If]qsf] ;a} tx / ljifox¿ ;~rfng / Joj:yfkg ;DaGwL gLltut Joj:yf cfof]uaf6 ub}{ gLltadf]lhd cg'udg tyf lgodg ug{'kg]{ 5 . lrlsT;f lzIff ;~rfngsf nflu cfzokq k|bfg ug]{, ;DaGwg / ;DaGwg vf/]hLsf] l;kmfl/; ug]{, lrlsT;f lzIffsf ;a} tx / ljifosf l;6 lgwf{/0f ug]{, PsLs[t k|j]z k/LIff ;~rfng ug]{, z'Ns lgwf{/0f ug]{, lrlsT;f lzIffsf ;a} If]qsf] dfkb08 tof/ ug]{ h:tf P]gdf Joj:yf ePsf sfo{

cfof]uaf6 lg/Gt/ eO/xg] 5 . /fli6«o lrlsT;f lzIff P]g, @)&% sf] sfof{Gjon] lrlsT;f lzIffsf If]qdf b]lvPsf lj;ª\ultx¿sf] cGTo u/L ;dfg kx'Frsf] k|Tofe"t ub}{ :t/Lo lzIff k|bfg ug{ dxTjk"0f{ e"ldsf lgjf{x ug]{ s'/fdf ljZjf; lng ;lsG5 .

;Gbe{ ;fdu|L

lrlsT;f lzIff ;DaGwL ;|f]t ;fdu|L, @)&^, lrlsT;f lzIff cfof]u, ;fgf]l7dLlrlsT;f lzIff ;DaGwL ljleGg cfof]u / sfo{bnsf] k|ltj]bgx¿lrlsT;f lzIff cfof]u tyf sfo{sf/L ;ldltsf j}7ssf lg0f{ox¿g]kfnsf] ;ljwfg, @)&@, sfg'g cfof]u/fli6«o lrlsT;f lzIff P]g, @)&%, g]kfn /fhkq, kmfu'g !), @)&%

- 55 -

lrlsT;f lzIffdf PsLs[t k|j]z k/LIff ;~rfngsf nflu ug'{kg]{ sfo{ / ljBdfg r'gf}tLx¿

tLy{/fh e6\6/fO{

!= k[i7d"ld

lrlsT;f lzIff If]qdf nfdf] ;do;Dd /x]sf] cGof}n / cJoj:yfnfO{ Jojl:yt ug{ g]kfn ;/sf/n] ;DalGwt ljifo lj1x¿ ;+nUg u/fO{ l;kmfl/;x¿ lng] sfo{ cufl8 a9fO/x]sf] lyof] . o;} ;Gbe{df ljz]ifu/L @)$^ ;fnsf] P]ltxfl;s cfGbf]ngkZrft\ g]kfnsf] cy{Joj:yfn] pbf/jfbL gLlt cjnDag u¥of] . o;}sf] kmn:j¿k g]kfndf lzIff / :jf:Yo If]qdf lghL If]qsf] k|j]z eof] . lghL ljBfno tyf sn]hx¿, lghL :jf:Yo ;+:yf tyf d]l8sn sn]hx¿ v'Ng nfu], h;sf] kmn:j¿k ;/sf/n] d]l8sn lzIffdf dxTjk"0f{ x:tIf]q gug]{ xf] eg] tNnf] ju{ tyf ;LdfGts[t ;d"xn] ;f] lzIffdf s'g} ;+nUgtf g} gkfpg] cj:yf;d]t b]vf kg]{ l:ylt b]lvFb} cfof] .

nf]s sNof0fsf/L sfo{ u/L u0ftGqfTds zf;g Joj:yfnfO{ bl/nf] agfpg' /fi6«sf] k|d'v sfo{ef/ xf] . o;} ;Gbe{df g]kfnsf] ;+ljwfgsf] wf/f #! sf] lzIff ;DaGwL xs / wf/f #% sf] :jf:Yo ;DaGwL xssf] Joj:yfaf6 cfwf/e"t lzIff tyf :jf:Yo ;]jf ;j{JofkL / u'0f:t/Lo x'g] dfGotfnfO{ :jLsf/ u/L ;xh kx'Frsf] ;'lglZrttf u/]s]f 5 .

lrlsT;f lzIff If]qdf b]lvPsf ljs[lt tyf lj;ª\ultx¿nfO{ x6fpg / cWoog tyf cWofkgnfO{ u'0f:t/Lo, ;fGble{s / cfjZos agfpgsf nflu ljleGg ;dodf sfo{bn, ;ldlt tyf sfo{;d"xx¿ lgdf{0f eP . pQm sfo{;d"xx¿n] cfkm\gf] ;do cg's'n l;kmfl/;x¿ tyf cjnDag ug'{ kg]{ pkfox¿ ;'emfpFb} cfPsf] b]lvG5 . o; qmddf dfy]df cfof]un] k]; u/]sf] k|ltj]bg tyf l;kmfl/; eg] d]l8sn lzIffsf] ;'wf/sf] nflu d]?b08s} ¿kdf /x]sf] eGg] ul/G5 . ;f]xL cfof]usf] k|ltj]bg / l;kmfl/;nfO{ sfof{Gjog gu/]sf] / lrlsT;f lzIff If]qdf ljsl;t lj;ª\ultx¿nfO{ ;dodf ;dfwfg ug{ g;Sbf lrlsT;f lzIffdf Jofkf/Ls/0f ePsf] / ;LdfGts[t ;d"xsf ljBfyL{x¿n] o; lzIffdf kx'Fr gk'u]sf] ;d]t b]lvof] . cem egf}F Pp6f PdlalaP; egf{ eP/ ljBfyL{x¿n] s/f]8f}+ /sd;Dd ltg'{ k/]s]f egL ljleGg ;~rf/ dfWoddf k|sflzt ;dfrf/n] cf}+NofPsf] b]lvof] . o;} ;Gbe{df 8fS6/ uf]ljGb s]=;L= n] k6s k6s u/]s]f ef]s x8tfn;lxtsf] cfGbf]ng / Tof] cfGbf]ng ;Gbe{df ;/sf/n] u/]sf] ;Demf}tfadf]lhd ;du| lrlsT;f lzIff

;GalGwt sfo{qmdx¿sf] z'Ns lgwf{/0f ug]{, cg'udg ug]{, PsLs[t k|j]z k/LIff ;~rfng ug]{, glthf k|sfzg ug]{ nufotsf sfo{x¿ Pp6} 5ftf ;ª\u7gaf6 ug'{kg]{ cfjZostf 7flgof] . o;}sf] kmn:j¿k @)&$ ;fn sflt{s @$ ut] cWofb]zdfkm{t\ lrlsT;f lzIff cfof]u :yfkgfsf] uf]/]6f] sf]l/of] .

cWofb]zaf6 ;'? ePsf] lrlsG;f lzIff cfof]usf] ofqf /fli6«o lrlsT;f lzIff P]g, @)&% ;+3Lo ;+;baf6 :jLs[t eO{ ldlt @)&% kmfNu'0f !) ut]sf] /fhkqdf k|sfzg ePkZrft\ ;f]xL P]gsf] kl/R5]b @ bkmf # sf] k|fjwfg adf]lhd :yfkgf eO{ sfo{ ul/cfPsf] 5 .

lrlsT;f lzIff cfof]usf] ljleGg sfo{dWo] lrlsT;f lzIff k|bfg ug]{ ljleGg z}lIfs ;+:yfsf] cg'udg tyf lg/LIf0f u/L l;6 lgwf{/0f ug]{ / PsLs[t k|j]z k/LIff ;~rfng /x]sf] b]lvG5 . P]gsf] bkmf ^ n] cfof]usf] oxL sfd, st{Jo / clwsf/nfO{ lgb]{lzt u/]sf] 5 . h;cg';f/ lrlsT;f lzIffsf] If]qdf cjnDag ug'{kg]{ /fli6«o gLlt to ug'{, ;+3 tyf k|b]z txsf lrlsT;f lzIffsf] ;a} tx tyf ljwfsf] dfkb08 / :t/;DaGwL gLlt tyf dfkb08 lgwf{/0f ug]{, PsLs[t k|j]z k/LIff -sdg OG6«fG;_ ;~rfngsf nflu gLlt tyf dfkb08 lgwf{/0f ug]{, k|Tofog ;DaGwL gLlt, cfwf/ tyf dfkb08 lgwf{/0f ug]{, lrlsT;f lzIffsf] ljifodf ljZjljBfno, k|lti7fg / kl/ifb\nfO{ cfjZostfcg';f/ lgb]{zg lbg] nufotsf /x]sf 5g\ .

/fli6«o lrlsT;f lzIff P]g, @)&% adf]lhd e/v/} :yfkgf ePsf] cfof]unfO{ k|efjsf/L agfO{ cufl8 agfpg cfjZos ;ª\Vofdf sd{rf/L tyf ef}lts k"jf{wf/sf] h?/t kb{5 . t/ nfdf] ;do;Dd Go"gtd sfo{ ;Dkfbg ug]{ cfjZos hgzlQmsf] k"lt{ gePsf sf/0f P]gn] lnPsf ;a} sfo{x¿nfO{ d"t{ ¿k lbg s]xL ;d:of /x]sf] 5 . o;} ;Gbe{df ljZjJofkL ¿kdf sf]/f]gfsf] ;ª\j|md0f km}lnPsf] / @)&^ r}q !! ut]b]lv d'n's ns8fpgsf] cj:yfdf /x]sf] 5 . ;'?df ! xKtf 3f]if0ff ePsf ns8fpg cfjZostf / cj:yf x]/]/ ;/sf/n] kl5Nnf] ;dodf lg/Gt/ cufl8 al9/x]s]f 5 . o;} qmddf sf]/f]gf kf]h]l6e ;ª\j|md0fsf] b/ lbgfg'lbg cfsfl;Fb} uPsf] b]lvG5 . o;} ;Gbe{df cfof]un] kf]i6 u|fh'P;g cGtu{tsf ljleGg lrlsT;f ;]jf k|bfg

;x;lrj, g]kfn ;/sf/

- 56 -

ug]{ z}lIfs ;+:yfdf ;~rflnt sfo{qmdx¿sf] cg'udg tyf lg/LIf0fkZrft l;6 lgwf{/0f u/L PsLs[t k|j]z k/LIff ;~rfng ug'{ kg]{ cfjZstf 5 . h'g sfo{ ug{ g;Sg] xf] eg] ljz]if1 lrlsT;ssf] ckof{Kttf x'g] / sf]le8 !( tyf o:t} cGo /f]ux¿sf] ;ª\j|md0f km}lnPdf ljz]if1tf ePsf hgzlQm ahf/df Go"g eO{ ;]jf k|jfxdf g} gsf/fTds c;/ kg{ ;Sb5 . o;sf ;fy} cfof]u :yfkgfsf] cf}lrTo / sfg'gn] tf]s]sf] lhDd]jf/L axg u/] gu/]sf] ;Gbe{df k|ZglrGx ;d]t p7fg x'g;Sg] b]lvG5 .

@= lrlsT;f lzIfftkm{sf] jt{dfg cj:yf

g]kfn d]l8sn sfplG;nsf] btf{ clen]v cg';f/ g]kfndf kf]:6 Uo|fh'o;g ug]{ lrlsT;f hgzlQm sl/j & xhf/ & ;o tyf PdlalaP;÷lal8P; u/]sf hgzlQm @^ xhf/ # ;o /x]sf] b]lvG5 . g]kfndf clxn] kf]:6 u|fh'P;g ug{ rfxg] lrlsT;s hgzlQmsf] ;ª\Vof !) xhf/eGbf a9L /x]sf] b]lvG5 . t/ g]kfndf k|To]s jif{ sl/j &)) sf xf/fxf/Ldfq} l;6 ePsf] x'Fbf k|j]z k/LIffaf6 k|lt:kwf{df pTs[i6 x'g]x¿nfO{ tf]lsPsf] l;6df egf{ ug'{ h?/L /xG5 .

kf]:6 Uo|fh'P;g ug]{ ;ª\Vof Pd8L÷PdP; / Pdl8P; u/L & xhf/ & ;o %* dWo] dlxnfsf] ;ª\Vof ;ª\Vof @ xhf/ @ ;o @* /x]sf] 5 eg] k'?ifsf] ;ª\Vof % xhf/ % ;o #) hgf /x]s]f 5 . k|ltztsf] lx;fjn] of] dlxnfsf] k|ltzt @*=&@ / k'?ifsf] k|ltzt &!=@* k|ltzt /x]sf] b]lvG5 . o;}u/L PdlalaP; / lal8P; u/L @^ xhf/ # ;o $^ /x]sf]df dlxnf tyf k'?ifsf] k|ltzt qmdzM #^=(* k|ltzt / ^#=)@ k|ltzt /x]sf] 5 . o; lx;fan] s'n hDdfdf kf]:6 u|fh'o6 / u|fh'o6 u/L s'n lrlsT;sdf dlxnfsf] k|ltzt #@=*% k|ltzt / k'?ifsf] k|ltzt ^&=!% k|ltzt /x]s]f b]lvG5 .

kf]:6 u|fh'o;gsf l;6 ljt/0f d'Vo u/L g]kfnL ljBfyL{ nlIft u/L x'g] u/]sf] 5 . z}lIfs ;q @)@) sf] l;6 lgwf{/0f ljt/0f / ;~rfng ug{sf nflu PsLs[t k|j]z k/LIff cfof]un] ;~rfng ug'{kg]{ 5 . To;sf nflu cfof]un] cgnfOg k|0ffnLaf6 k|j]z k/LIff lng] sfo{ ug{ ;km\6j]o/ ;d]t lgdf{0f u/L clGtd r/0fdf k'/\ofO;s]s]f 5 . t/ nlDaFbf] ns8fpg / To;kl5sf] cj:yf ;d]tnfO{ dWo]gh/ u/L l;6 lgwf{/0f cufl8 ug'{kg]{ ;3g cg'udg tyf lg/LIf0f, k|j]z k/LIff / ;DalGwt sfo{ ug{ cfof]uaf6 ;a} 7fpFdf ljz]if1 6f]nL k7fpg ;lsg] cj:yf b]lvFb}g .

#= cj cjnDag ug]{ pkfo

pNn]lvt cj:yfnfO{ ljZn]if0f ubf{ k|To]s jif{ kf]:6 u|fh'P;gsf ljleGg sfo{qmdx¿df egf{ ul/g], Tof] egf{ cufl8 l;6 lgwf{/0f / ljt/0f Pj+ ef}lts k"jf{wf/;d]tsf]

:ynut cWoog u/L lj1af6 k|ltj]bg lng' kg]{ b]lvG5 . t/ jt{dfg sf]le8–!( sf] 8/nfUbf] cj:yfnfO{ x]bf{ cfof]un] l;6 lgwf{/0f / ljt/0f ug'{ k"j{ lgDgfg';f/sf @ j6f df]8]n ckgfP/ k"jf{wf/ tyf cGo tof/Lsf ;DaGwdf ljj/0f, k|ltj]bg - xf8{k|lt, ;km\6k|lt, cl8of], lel8of], h'd nufot_ lng ;lsG5 . oL b'O{j6f lasNknfO{ k|of]u u/L cfof]un] lg0f{onfO{ j:t'k/s / oyfy{k/s agfpg ;lsG5 .

s= sf7df8f}+ pkTosfleqsf ljZjljBfno, k|lti7fg / d]l8sn sn]hx¿df M

!= gofF sfo{qmd nfu' x'g]sf] xsdf!= cfof]usf] cu'jfOdf ljz]if1 6f]nL u7g ug]{ .@= ljz]if1 6f]nLnfO{ cg'udg ug{ lhDd]jf/L lbO{

v6fpg] .#= k|To]s 6f]nLdf !÷! hgf cfof]usf pk;lrj

:t/sf sd{rf/L ;fd]n u/fO{ ;xhLs/0fdf ;xof]u k'/\ofpg] .

$= cg'udg 6f]nLn] :ynut ¿kdf ef}lts tyf cGo z}lIfs k"jf{wf/ eP gePsf] k|ltj]bg k]; ug]{ .

$= cg'udg 6f]nLn] cfkm"n] u/]s]f cg'udg, lg/LIf0f tyf ljleGg sfo{sf] d'Vo d'Vo ljifoj:t'sf] lel8of];d]t lnO{ cfof]u ;dIf k]; ug]{ .

%= ljleGg c:ktfn tyf d]l8sn sn]hdf xfndf lj/fdLsf] ;ª\Vof Go"g x'g] x'Fbf ns8fpg eGbf cufl8sf dlxgfsf] cf};t lnO{ cg'dfg / k|If]k0f ug]{ k|0ffnL cjnDag ug]{ .

^= ;fljsadf]lhdsf sfo{qmdsf l;6 ljt/0fdf ;fljss} k"jf{wf/sf] lgoldttf / gofF sfo{qmdsf] xsdf cfjZos kg]{ Nofa nufotsf cfjZos k"jf{wf/ eP gePsf] Plsg u/L x]g]{ .

&= ljz]if1 6f]nLaf6 k|fKt ePsf] k|ltj]bg pk/ cfof]u :jod\n] cgnfOg tyf ckmnfOg dfWodaf6 k'gM hfFr ug{] u/fpg] .

*= ;DalGwt ljZjljBfno, cWoog ;+:yfg, k|lti7fg, kl/ifb\ / sn]hnfO{ cf–cfkm\gf ;a} sfuhftx¿nfO{ k|dfl0ft u/L kl5;Dd km/s gkg]{ u/L k7fpg nufpg] .

(= cfof]uaf6 v6fOg] ljz]if1 6f]nL tyf sd{rf/LnfO{ tf]lsPsf] ;]jf ;'ljwf pknAw u/fpg] .

@= ;fljsadf]lhdsf sfo{qmd nfu' eO/x]sf ;+:yfsf] xsdf M!= lgj]bg, k|:tfjgfsf ;fy :jd"Nofª\sg k|ltj]bg

k]; ug{ nufpg] .@= cgnfOg k|0ffnL -h'd OG:k]S;g, lel8of] sGkm/]G;

jf pko'Qm k4lt_ af6 ljB'tLo dlg6l/ª cfof]usf]

- 57 -

;DalGwt lgb]{zgfnon] lng] / k'i6\ofO;lxt k]; ug]{ .

#= /fd|f] Voflt tyf k|lti7fdf /x]sf, ljutdf unt cEof; gu/]sf ;+:yfx¿sf] ;fljssf tYo, tYof+s, sfuhkq / :jd"Nofª\sgsf] cfwf/df l;6 lgwf{/0f ug{ ;Sg] .

$= ;/sf/L ljZjljBfno, sn]h, k|lti7fgsf] xsdf ;fljs adf]lhds} cfwf/ / dfkb08 adf]lhd l;6 lgwf{/0f ug]{ .

v= sf7df8f}+ pkTosf jflx/sf ljZjljBfno, k|lti7fg / d]l8sn sn]hx¿sf] xsdf M

!= ;fljs adf]lhds} sfo{qmd nfu' eO/x]sf ;+:yfsf] xsdf!= lgj]bg, k|:tfjgfsf ;fy :jd"Nofª\sg k|ltj]bg

k]; ug{ nufpg] .@= cgnfOg k|0ffnL -h'd OG:k]S;g, lel8of] sGkm/]G;

jf pko'Qm k4lt_ af6 ljB'tLo dlg6l/ª cfof]usf] ;DalGwt lgb]{zgfnon] lng] / k'i6\ofO;lxt k]; ug]{ .

#= /fd|f] Voflt tyf k|lti7fdf /x]sf, ljutdf unt cEof; gu/]sf ;+:yfx¿sf] ;fljssf tYo, tYof+s, sfuhkq / :jd"Nofª\sgsf] cfwf/df cfof]un] l;6 lgwf{/0f ug{ ;Sg] .

$= yk sfo{qmd ;~rfng ug'{ kg]{ ePdf jf To;sf] dfu ePdf ;f]sf nflu cfjZos kg]{ k"jf{wf/, hgzlQm, ljz]if1tf nufotsf ljifoj:t'sf] cfjZostf / cf}lrTotfnfO{ k'i\6\ofOF;lxt k]; ug'{kg]{ .

%= l;6 lgwf{/0f tyf gofF ljifosf] cWofkg sf]6f -l;6_ pknAw u/fpg] ;DaGwdf cfof]un] u/]s]f lg0f{o clGtd x'g] .

@= gofF sfo{qmd ;'? ug]{ ;+:yfsf] xsdfM!= cfof]u ljz]if1 6f]nL tf]Sg] .@= jt{dfg cfjfudg ;xhtf ePsf] x'gfn] glhssf]

csf]{ s]Gb| jf kfos kg]{ :yfgdf sfo{/t ljz]if1 jf kbflwsf/LnfO{ cfof]un] cg'udg tyf lg/LIf0f ug]{ lhDd]jf/L tf]Sg] .

#= o;k|sf/ lhDd]jf/L tf]Sbf :yfgLo ljz]if1 6f]nL v6fpg k|fyldstf lbg] . To;sf] pbfx/0fsf] ¿kdf w/fgdf lg/LIf0f tyf cg'udg / k|ltj]bg ug{ lj/f6gu/sf] lj1tf k|of]u ug]{, lj/f6gu/sf] nflu w/fgsf] k|of]u ug]{, o;}u/L ;Defjgfsf] cfwf/df cfof]un] lgwf{/0f ug]{ .

$= cg'udgstf{ 6f]nLn] :ynut ¿kdf cg'udg tyf lg/LIf0f u/L ;du| ef}lts tyf cGo z}lIfs k"jf{wf/ eP gePsf] k|ltj]bg tof/ u/L cgnfOgdfkm{taf6 k]; ug{ nufO{ ;Ssn k|ltj]bg x'nfs jf s'l/o/dfkm{t k]; ug{ nufpg] .

%= cg'udg 6f]nLn] cfkm"n] u/]s]f cg'udg, lg/LIf0f tyf ljleGg sfo{sf] d'Vo d'Vo ljifoj:t'sf] lel8of];d]t lnO{ cfof]u ;dIf k|]lift ug]{ .

^= ljleGg c:ktfn tyf d]l8sn sn]hdf xfndf lj/fdLsf] ;ª\Vof Go"g x'g] x'Fbf cufl8sf] dlxgfsf] cf};t lnO{ cg'dfg ug]{ k|0ffnL cjnDag ug]{ .

&= ;fljsadf]lhdsf sfo{qmdsf l;6 ljt/0fdf ;fljss} k"jf{wf/sf] lgoldttf / gofF sfo{qmdsf] xsdf cfjZos kg]{ Nofa nufotsf cfjZos k"jf{wf/ eP gePsf] Plsg u/L x]g]{ .

*= ljz]if1 6f]nLaf6 k|fKt ePsf] k|ltj]bg pk/ cfof]u :jod\n] cgnfOg tyf ckmnfOg dfWodaf6 k'gM hfFr ug]{ u/fpg] .

&= cf–cfkm\gf ;a} sfuhftx¿nfO{ ;DalGwt ljZjljBfno, cWoog ;+:yfg, k|lti7fg, kl/ifb\ / sn]hnfO{ k|dfl0ft u/L kl5;Dd km/s gkg]{ u/L k7fpg nufpg]

!)= ljz]if1 6f]nLnfO{ lbg] ;'ljwf, oftfoft cGo cGo nlhl:6s ;xof]usf] cfof]un] Plsg u/L lg0f{o u/L pknAw u/fpg] .

o; sfo{af6 cfpg] ck]lIft glthf M

sf]le8 – !( sf] ;ª\j|md0f nfdf] ;do /x]/ cfjfudg c;xhtf eP klg of] sfo{ h?/L ePsf] x'Fbf ;~rfng ug'{ ckl/xfo{ b]lvG5 . plNnlvt pkfoaf6 sfo{ ;~rfng ug{ ;lsPdf ;dodf g} kf]:6 u|fh'o;gsf l;6 lgwf{/0f eO{ PsLs[t k|j]z k/LIff ;~rfng x'g], tf]lsPsf ;+:yf tyf sn]hdf cWoog lgoldt eO{ ljz]if1 lrlsT;f hgzlQmsf] pTkfbg x'g] b]lvG5 . km]l/ jt{dfg ;dodf g]kfnL lrlsT;sx¿n] ljb]zdf uO{ kf]:6 u|fh'P;g ug{ ;d]t ;Defjgf Go"g /x]sf] x'Fbf ;fljssf] l;6df k'glj{rf/ u/L s]xL k|ltzt l;6 a9fpg'kg]{ ;d]t cfjZostf 5 . o;n] ubf{ g]kfndf g} kf]:6 u|fh'P;g ug]{ x'Fbf g]kfnL /sd ljb]z hfg /f]lsg] ;d]t b]lvG5 . h;af6 cfof]u u7gsf] cf}lrTo k'li6 x'g], cfkm\gf] ;dIfdtfdf pTs[i7tf x'g] / cfd hgdfg;df ljZjf; hfu[t x'G5 .

- 58 -

$= lrlsT;f lzIff cfof]usf jt{dfg ;d:of tyf r'gf}tLx¿

s= ejg tyf lgb]{zgfno Joj:yfkgtkm{

cfof]usf] cfkm\gf ejg ePsf], ;fljssf] lzIff ljefu / dGqfno dftxtsf @ j6f ejgaf6 sfo{ ;Dkfbg ug'{ k/]s]f 5 . cfGtl/s ¿kdf Joj:yfkg ug'{kg]{ ;a} lgb]{zgfnox¿ 5l/P/ /x]af6 ;]jf k|jfxdf c;xhtf /x]s]f b]lvG5 . To;}n] tTsfn ejg lgdf{0f x'g' h?/L 5 . To;sf] nflu e/v/} l8hfOg :jLs[t eO{ 7]Ssf k|lqmofaf6 lk|km\ofasf] Pp6} ;lrjfno ejg lgdf{0fsf] kl/sNkgf cufl8 a9]sf] 5 . o;af6 pkfWoIf tyf lgb]{zsx¿sf] a;fO{ P/]Ghd]G6 ldn]/ 8]lne/L k|efjsf/L aGg] 5 .

v= ;"rgf k|ljlw, sDKo'6/ tyf cGo nlhl:6s ;kf]6{tkm{

e/v/ :yflkt ePsf] cfof]udf hgzlQm Go"g /x]sf], ;"rgf k|ljlw ;~rfng gePsf], cfjZos kg]{ ;km\6j]o/x¿ lgdf{0f x'Fb} u/]sf] cj:yfn] klg ;"rgf k|ljlwd}qL x'g ;ls/x]s]f 5}g . o;} u/L sfof{nonfO{ cfjZos kg]{ sDKo'6/, lk|G6/, Nofk6k nufotsf] Joj:yfkg ug{ sf]le8sf] sf/0fn] ah]6 oy]i6 5}g . o;sf ;fy ;fy} cfjZos dfqfdf 6]an, s';L{, kmlg{r/;d]t gePsf] x'Fbf ;]jf k|jfxdf ;xhtf ePsf] 5}g . o;sf ;fy} ;jf/L ;fwgsf]] Joj:yfkg yk ug'{kg]{ b]lvG5 .

u= hgzlQmtkm{

cfof]u Pp6f cljl5Gg pQ/flwsf/jfnf :jzfl;t ;+:yf /xg] u/L :jtGq x}l;ot sfg'gn] lbPsf] 5 . t/ xfn;Dd g]kfn ;/sf/n] sfhdf v6fPsf] ;b:o ;lrj tyf cGo sd{rf/L / s]xL s/f/ tyf k/fdz{sf sd{rf/Lx¿af6 cfof]usf] sfo{ cufl8 al9/x]sf] 5 . cfof]usf] :yfoL b/aGbL :jLs[t eO;s]s]f 5}g, k|To]s jif{ c:yfoL b/aGbL :jLs[t eO{ ;f]xLadf]lhd vl6Psf sd{rf/Lx¿af6 sfo{ x'g] u/]s]f 5 . t/ cfof]u :yfkgfsf] nIo / p2]Zo x]bf{ Jofj;flos k|s[ltsf sd{rf/L cfjZos kg]{ b]lvG5 . o;tkm{ cfufdL lbgdf cfof]usf] k|oTg x'g'kg]{ b]lvG5 .

3= jfXotkm{

cfof]usf] cWoIf k|wfgdGqL :jo+ x'g], :jf:Yo dGqL / lzIff dGqL ;xcWoIf x'g], ljleGg ljZjljBfno, k|lti7fg, kl/ifb tyf lrlsT;f lzIff If]qdf sfo{/t ;+:yf tyf JolQmx¿ To;sf] ;b:o x'g], sfo{sf/L pkfWoIfn] b}lgs sfo{sf/L sfo{ ug]{, ;b:o ;lrjn] cfof]usf] ;b:o ;lrj ;d]t eO{ sfo{ ul/cfPsf] cj:yf 5 . lrlsT;f lzIff;Fu ;DalGwt jflx/L w]/} ;+3;+:yf tyf kbflwsf/L / JolQmx¿;Fu sfo{ ug'{kg]{ x'Fbf o;sf] jfx\o ;~rf/ ;xh x'g'kg]{ b]lvG5 . To;sf] nflu cfof]un] ;"rgf k|ljlw zfvf tyf k|jQmfnfO{ k|efjsf/L agfpg' kg]{ b]lvG5 .

ª= ah]6/L Joj:yfkg

P]gsf] cfzonfO{ x]g]{ xf] eg] cfof]usf] cfkm\g} vftf x'g'kb{5 . g]kfn ;/sf/n] lbg] cg'bfgnfO{ cfof]un] afF8kmfF8 u/L ;~rfng ug{ kfpg];Ddsf] :jfoQtf cfjZos b]lvG5 . lsgls of] cfof]u Pp6f :jtGq sfo{ ug]{, lj1 ;]jf cfjZos kg]{ / tTsfn} s]xL ug'{kbf{ dGqfnodfkm{t cy{ dGqfnodfkm{t ah]6 lgsf;f lng' kg]{ k4ltn] ubf{ l9nf] sfo{ ;Dkfbg x'g] u/]sf] 5 . t;y{ cfGtl/s cfDbfgL ;d]t x'g] x'Fbf vr{ ug]{ df]8fln6L :jLs[t u/L u/fO{, cy{ dGqfnoaf6 Psd'i6 ah]6 NofO{ cfkm\gf] of]hgfcg';f/ /sd ljlgof]hg / vr{ ug]{ ;Ddsf] :jfoQtf cfjZos b]lvG5 .

%= pk;+xf/

jf:tjdf lrlsT;f lzIff If]qdf ul7t o; cfof]un] v]Ng] e"ldsfaf6 g]kfndf ;dGoflos / Gofok"0f{ lrlsT;f lzIff k|0ffnLsf] ljsf; x'g] b]lvG5 . To;sf] nflu cfof]unfO{ k|efjsf/L ¿kdf cufl8 a9fpg' kb{5 . sfo{ :jfoQtf, :jtGqtf, plrt hgzlQm Joj:yfkg, ;|f]]tsf] ;d'lrt kl/rfng, cg'udg lgl/If0f k|0ffnLsf] bl/nf]kgfaf6 dfq} of] ;Defjgf 5 .

-lgh e§/fO{ lrlsT;f lzIff cfof]usf] pk;lrjdf /xFbf u/]s]f cg'ej;d]tsf] cfwf/df tof/ ePsf] n]v_

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g]kfnsf] lrlsT;f lzIffM ljut, jt{dfg\ / eljio

t'n;Lk|;fb cfrfo{

ljifo k|j]z

:j:y hLjg lhpg' cfd gful/ssf] clei6 ePsfn] k/fk"j{sfnb]lv g} dfgj hfltn] uef{j:yfb]lv d[To'k"j{;Dd :jf:Yo ;]jfsf] pkof]u s'g} g s'g} ¿kdf ug]{ u/]sf] s'/f k|frLg wd{ u|Gyx¿df kfOG5 . o;af6 k|:6 x'G5 ls dfgj :jf:Yosf] dxTj ljutb]lv g} ;jf{lws ePsf] / ;f]xLcg';f/ lrlsT;f lj1fgsf] cEof; x'Fb} cfPsf] b]lvG5 . ;do kl/jt{g;Fu} lrlsT;f lzIffsf] ljwfx¿ ljlzi6Ls[t, cfw'lgs / ljsl;t x'Fb} uPsf] ;d]t kfOG5 . dfgj :jf:Yosf ;DaGwdf cflbd sfnb]lv g} wd{zf:q, gLltzf:q / cfrf/ ;+lxtfdfkm{t dfgjlxtsf nflu ;r]t u/fPsf] b]lvG5 . cf}ifwL tof/L / pkrf/sf ljleGg k4ltsf] ljsf; cflbd sfnb]lv g} x'Fb} cfPsf] / cfhsf] ;do;Dd cfOk'Ubf kl/dflh{t Pjd\ cfw'lgs lrlsT;f lj1fgsf] dfgj hfltn] e/k'/ pkof]u ul//x]sf] cj:yf 5 .

t;y{ dfgj :jf:Yo ;a}sf] klxnf] k|flydstf ePsfn] lrlsT;f lzIff cWoog ug]{ rfxgf k|foh;f] ;a}sf]] ePsf] b]lvG5 . ljZjsf k|foh;f] b]zx¿sf] k|fyldstf klg u'0f:t/Lo lrlsT;f lzIffaf6 bIf :jf:YosdL{ pTkfbg ug]{ / u'0f:t/Lo lrlsT;f ;]jf k|bfg ug]{ /x]sf] b]lvG5 . o; ;Gbe{df xfd|f] b]zdf klg lrlsT;f lzIff k|bfg ug]{ lzIf0f ;+:yfx¿sf] :yfkgf ;fj{hlgs / lghL If]qaf6 ug]{ gLlt ;/sf/n] lnPsf] x'gfn] lzIf0f ;+:yfx¿sf] ;ª\Vof pNn]Vo j[l4 eO/x]s]f 5 . ltgLx¿sf] lgodg ug,{ u'0f:t/ sfod ug{, k];fwld{tf / Jofj;flostfsf] clej[l4 ug{ h?/L 5 . b'u{ddf /x]sf h]x]gbf/ tyf ljkGg ;d'bfosf ljBfyL{x¿sf] ;dfg kx'Fr ;'lglZrt u/L lrlsT;f lzIffnfO{ hftLo, juL{o, If]qLo, eflifs, n}ª\ lus / ef}uf]lns ¿kdf ;dfj]zL agfpg ljutb]lv g} oyfzSo k|of; ePsf] ;d]t b]lvG5 .

lrlsT;f lzIffnfO{ u'0f:t/Lo agfpg ;j{k|yd d]l/6df cfwfl/t ljBfyL{ 5gf]6 k|0ffnL ckgfpg' kg]{ / bIf k|lzIfs lgo'St u/L cEof;o'St k7gkf7g ug{ h?/L 5 . of]Uo lrlsT;s pTkfbgsf nflu k"jf{wf/o'Qm lzIf0f ;+:yf x'g' clgjfo{ ;t{ xf] . k"jf{wf/ eGgfn] pko'Qm z}lIfs ;fdu|L, ljBfyL{d}qL l;sfO jftfj/0f / ef}lts k"jf{wf/, cfjZos oGq pks/0f, c:ktfn / lj/fdLx¿sf] kof{Kt ;ª\Vof;d]tnfO{ hgfpF5 . :jf:Yo If]qsf ljBfyL{n] Jofjxfl/s ¿kdf l;Sg] dx jk"0f{ ;|f]t la/fdLx¿ g} x'g\ . :jf:YosdL{x¿sf] l;k ljsf; ug{] :yfg c:ktfn xf] eg] lzIf0f ;|:yfx¿

;}4flGts l;sfO ug]{ lzIffnox¿ ePsfn] lzIf0f ;+:yf / c:ktfnlar ;Gt'ng x'g clgjfo{ b]lvG5 .

lrlslT;f lzIf0f ;+:yfsf] cfˆg} c:ktfn dfq eP/ klg k'Ub}g, ToxfF w]/} k|sf/sf lj/fdLx¿ kof{Kt dfqfdf pknAw x'g;s] dfq ljBfyL{x¿n] l;Sg] df}sf kfpg ;S5g\ . :jf:YosdL{ cWoog ug]{ ;+:yfdf la/fdLx¿nfO{ ;'ne z'Ns / ;xh kx'Fr x'g cfjZos b]lvG5 . o; afx]s k':tsfno, ;"rgfk|ljlw, Od]n, OG6/g]6, k|of]uzfnf ;]jf h:tf ;'ljwfx¿ kof{Kt dfqfdf pknJw x'g h?/L 5 . Ps hgf k|l;4 Canedian Physian, William Osler n] lrlsT;f lzIffsf] u'0f:t/ ;DaGwdf eg]sf 5g\ æWho studies medicine without books sails an uncharted sea, but who studies medicine without patient does not to go to sea at all. Æ cyf{t\ k':ts cWoog gu/L lrlsT;s aGg' eg]sf] ljgf tof/L ;d'›df hfg' h:t} xf] eg] la/fdL ljgf lrlsT;f lzIff l;Sg' eg]sf] ;d'›d} ghfg' h:t} xf] eg]sf 5g\ .

lrlsT;f lzIffsf] u'0f:t/ / ;fdflhs pQ/bfloTj ;DaGwdf ljZjsf ljleGg ;+3 ;+:yfx¿n] cfcfkm\gf cjwf/0ff / ljrf/x¿ o;k|sf/ k|:t't u/]sf 5g\ M

WHO, 2013 n] ælrlsT;f lzIffdf ;/sf/sf] cleefjsLo lhDd]jf/L x'g'k5{Æ / ælrlsT;f lzIff clgolGqt v'nf ahf/nfO{ 5f]8\g ldNb}gÆ eGg] dfGotf k|:t't u/]sf] 5 . To;}u/L Government of Canada n] æ:jf:Yo lzIf0f ;+:yfx¿ ;dfhk|lt pQ/bfoL x'g'k5{ . Æ eGg] cjwf/0ff cl3 ;f/]sf] 5 . American College of Physician n] æ:jf:YosdL{sf] k];fwld{tf eg]sf] la/fdLsf] enfO g} ;jf]{kl/ dfGg' xf] . Æ eg]sf] 5 . Global Independent Commission 2010 n] ælzIffsf] d"n dfGotf la/fdL tyf ;j{;fw/0fsf] cfjZostfnfO{ ;dtf / bIftfk"j{s k"/f ug{' xf] .Æ eGg] cjwf/0ff k|:t't u/]sf] 5 . To;}u/L Global Consensus 2010 n] ælrlsT;f lzIffsf ;+:yfx¿n] ;dfhsf] :jf:Yo;DaGwL cfjZostf ;dtf, u'0f:t/, ;fGble{stfsf ;fy} pko'Qm 9ª\un] k"/f ug{'k5{ .Æ eGg] dfGotf /fv]sf] 5 .

o;/L lrlsT;f lzIff dfgj :jf:Yo;F+u k|ToIf ;/f]sf/ /fVg] If]q ePsfn] o;sf] lgu/fgL /fHon] ug{'kg]{ dfGotf ljZjdf /x]sf] 5 . o;nfO{ :jtGq¿kn] lghL If]qnfO{ 5f]8\g ldNb}g eGg] dfGotf /x]sf] b]lvG5 . o;sf] u'0f:t/df ;Demf}tf ug{ g;lsg] dfGotf /x]sf] 5 . s'g} klg :jf:YosdL{df

lgj[Q pk;lrj, lrlsT;f lzIff cfof]u

- 60 -

u'0f:t/sf] sdL ePdf pSt JolStn] xhf/fF} ;j{;fwf/0fsf] hLjg hf]lvddf kfg{ ;Sg] b]lvG5 . t;y{ lrlsT;f zIff / :jf:YosdL{x¿sf] k];fwld{tf eg]s} gful/ssf nflu u'0f:t/Lo :jf:Yo ;]jf pknJw u/fpg' / lrlsT;f lzIf0f ;+:yfx¿ ;dfhk|lt pQ/bfoL x'g' Pjd\ u}/gfkmfd'vL / hg;]jfsf] efjgfaf6 ;~rfng x'g'kg]{ dfGotf /x]sf] 5 .

g]kfndf lrlsT;f lzIffsf] ljut cj:yf

g]kfndf lrlsT;f lzIffsf] k|f/De ;g\ !(## -!(()_ df g]kfn /fhsLo cfo'j]{b ljBfno :yfkgf u/]/ ePsf] kfOG5 . o;kl5 qmda4¿kdf l;len d]l8sn :s'n ;g\ !(#$-!((!_ v'n] . ;g\ !(%^ -@)!#_ df gl;{ª / x]Ny cl;:6]G6 :s'n ;~rfngdf cfP . To;}u/L ;g\ !(^@ -@)!(_ df cx]j :s'n v'n]/ k9fO ;'? eof] . ;g\ !(^# -@)@)_ df cgld :s'nx¿ :yflkt ePsf b]lvG5g\ . tTkZrft\ ;g\ !(&@ df lrlsT;f zf:q cWoog ;+:yfg :yfkgf eO{ ;fdfGo lrlsT;f, kmfd]{;L, /]l8of]u|fkmL, x]NyNofa, gl;{ª, cfo'j]{b ljifodf k|df0fkq txsf sfo{qmd ;~rfng eP . ;g\ !(&^ df lqlj, lrlsT;f zf:q cWoog ;+:yfgaf6 laPg gl;{ªsf] cWofkg ;'? eof] . To;sf] @ jif{kl5 cyf{t\ ;g\ !(&* df lqlj, lrlsT;f zf:q cWoog ;+:yfgaf6 PdlalaP:fsf] cWofkg ;'? ePsf] kfOG5 .

;g\ !((# df ljlk sf]O/fnf :jf:Yo lj1fg k|lti7fg ;~rfngdf cfP/ lqe'jg ljZj ljBfnoafx]s k|lti7fgdfkm{t klg lrlsT;f lzIffsf] k7gkf7g ;'? ePaf6 o; If]qsf] yk lj:tf/ ePsf] 5 . lghL nufgLdf lrlsT;f lzIffsf] ljsf;sf] ;Gbe{nfO{ x]bf{ ;j{k|yd ;g\ !(($ df kf]v/f sf:sLdf dl0fkfn sn]hckm d]l8sn ;fOG;]hsf] :yfkgfaf6 ;'? ePsf] dfGg ;lsG5 . To;kl5 ;g\ @))@ df lrlsT;f lj1fg /fli6«o k|lti7fg, jL/ c:ktfnsf] :yfkgf eof] . ;g\ @))* df kf6g :jf:Yo lj1fg k|lti7fg :yfkgf eof] . To;kl5 qmdz s0f{fnL k|b]zsf] h'Dnfdf s0ff{nL :jf:Yo lj1fg k|lti7fg / kfFr g+ k|b]zsf] bfªdf /fKtL :jf:Yo lj1fg k|lti7fg :yflkt eP eg] ;'b"/klZrd k|b]zsf] s}nfnLsf] u]6fdf ;fj{hlgs d]l8sn sn]hsf] lgdf{0f ;'? eO{ xfn;Dd hf/L /x]sf] cj:yf 5 .

g]kfndf lrlsT;f lzIffsf] jt{dfg\ cj:yf

xfn xfd|f] b]zdf PdlalaP; / ;f]eGbf dflysf] lrlsT;f lzIff If]qsf] k7gkf7gsf nflu lqe'jg ljZjljBfnocGtu{t cfª\lus– !, ;DaGwg–& u/L hDdf * cf]6f lzIf0f ;+:yfx¿ ;~rfngdf /x]sf 5g\ . To;}u/L sf7df8f} ljZjljBfno cGtu{t cfª\lus– !, ;DaGwg–& / lj:tfl/t– @ cf]6f u/L hDdf !) cf]6f ;~rfng eO/x]sf 5g\ . To;}u/L k|lti7fgx¿– & cf]6f / lqljaf6 ;DaGwg k|fKt 8]G6n sn]hx¿ –@ cf]6f / sf7df8fF} ljZjljBfnoaf6 ;DaGwg

k|fKt 8]G6n sn]h ! u/L hDdf # cf]6f ;~rfngdf 5g\ . o;/L lqe'jg ljZjljBfno, sf7df8f+} ljZjljBfnosf cfª\lus / ;DaGwg;lxt !* cf]6f lzIf0f ;+:yfx¿, k|lti7fgx¿ & cf]6f / 8]G6n sn]h # cf]6f u/L hDdf @* cf]6f lal8P; Pjd\ PdlalaP; tx / ;f]eGbf dfly cWoog cWofkg ug]{ lzIf0f ;+:yf ;~rfngdf /x]sf b]lvG5g\ .

To;}u/L dxf]Q/Lsf] alb{af;, ¿kGb]xLsf] a'6jn / ;'v]{tdf ;fj{hlgs d]l8sn sn]h :yfkgfsf nflu k"jf{wf/ lgdf{0f sfof{nox¿ :yfkgf eO{ ;~rfngdf cfPsf 5g\ . kl5Nnf] ;dodf k|b]z g+ @ sf] ;Kt/Ldf /fd/fhf k|;fbl;+x lrlsT;f lj1fg k|lti7fg :yfkgfsf nflu k"jf{wf/ lgdf{0f sfo{no :yfkgf ePsf] 5 . o;/L /fli6«o lrlsT;f lzIff P]g, @)&% sf] k|fjwfgcg';f/ k|To]s k|b]zdf sDtLdf Ps cf]6f d]l8sn sn]h vf]Ng] gLlt cg';f/ sfo{ eO/x]sf] b]lvG5 .

PdlalaP; txsf] @)&! ;fnsf] hDdf l;6 ;ª\Vof !(*! /x]sf]df To;kl5sf ji{fx¿df k|lt lzIf0f ;+:yf a9Ldf !)) l;6 dfq x'g] u/L l;6 lgwf{/0f ePsfn] of] ;ª\Vof ;fnfvfnf !%)) df ;Lldt x'g k'u]sf] b]lvG5 . :gftsf]Q/ txsf] l;6 ;fnfvfnf ^)) eGbf a9L 5}g . xfn 8]G6ncGtu{t :gfts txsf nflu ;fnfvfnf %))÷^)) l;6 /x]sf] b]lvG5 .

ljZj :jf:Yo ;ª\u7gsf cg';f/ x/]s !),))) hg;ª\Vofsf nflu sDtLdf @# hgf :jf:YosdL{ -lrlsT;s, g;{ / ld8jfOkm_ x'g'k5{ eGg] dfkb08 /x]sf] 5 . ;g\ @)!# sf] tYofª\scg';f/ xfd|f] b]zdf k|lt !),))) hg;ª\Vofsf nflu ^=* dfq :jf:YosdL{ /x]sf 5g\ . ljZjsf ^* eGbf a9L b]zdf k|lt !),))) df #$=% eGbf a9L /x]sf] kfOG5 . g]kfndf ;x/L / ;'ud If]qdf eGbf u|fdL0f / b'u{d If]qdf :jf:YosdL{sf] pkl:ylt Hofb} Go"g 5 . ;g\ @)!* sf] g;{ / ld8jfOkmsf] ;ª\Vof Pjd\ lrlsT;ssf] cg'kft lgDgfg';f/ /x]sf] b]lvG5 M

Nursing and midwifery personnel(Per 10,000 population)

sn Countries Personnel year1 Nepal 31.084 20182 India 17.271 20183 Pakistan 6.683 20184 Bangladesh 4.124 20185 Sri Lanka 21.803 20186 Bhutan 18.518 20187 Maldives 64.282 20188 China 26.621 20189 Belgium 194.614 201810 Norway 182.248 201811 USA 145.480 2018

Global Health Observatory Data, 2018

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Medical Doctors (Per 10,000 population)sn Countries Personnel year1 Nepal 7.487 20182 India 8.571 20183 Pakistan 9.801 20184 Bangladesh 5.809 20185 Sri Lanka 10.041 20186 Bhutan 4.242 20187 Maldives 45.627 20188 USA 26.120 2018

Global Health Observatory Data, 2018

o;/L x]bf{ xfd|f] b]zdf gl;{ª / ld8jfOkm/Lsf] ;ª\Vof ;Gtf]ifhgs b]lvPklg ljsl;t b]zsf] t'ngfdf sd g} 5 eg] lrlsT;ssf] ;ª\Vof Go"g /x]sf] b]lvG5 . b]zsf] cfjZostfg';f/ :jf:YosdL{x¿sf] ;ª\Vof a9fpg tyf ef}uf]lns ;Gt'ng sfod ug{ cem} h?/L b]lvG5 .

g]kfn d]l8sn sfplG;nsf] tYofª\scg';f/ lrlsT;f lzIff xfl;n ug{ ljb]l;g] g]kfnL ljBfly{x¿sf] ;ª\Vof pNn]Vo /xg] u/]sf] 5 . g]kfnL ljBfyL{x¿ lrlsT;f lzIff cWoogsf nflu ljz]iftM ef/t, aª\unfb]z, rLg, /l;ofnufotsf d'n'sx¿df hfg] u/]sf 5g\ . Tof] ;ª\Vof o; k|sf/ 5 M

S|m=;= ;g\ ;ª\Vof

! @)!# %^%

@ @)!% !$^!

# @)!^ $&*

$ @)!& $(%

% @)!* %*^

;|f]tMM g]kfn d]l8sn sfplG;n

o;/L 7'nf] ;ª\Vofdf g]kfnL ljBfy{Lx¿ lrlsT;f lzIff cWoogsf nflu ljb]z hfFbf k|fljlws hgzlQm ljb]z knfog x'g] ;Defjgf cTolws /xg'sf] ;fy} 7'nf] wg/flz ;d]t ljb]l;g] ub{5 . csf]{lt/ cGo d'n'sx¿df lrlsT;f lzIff cWoog ug]{ g]kfnL ljBfyL{x¿n] cWoog k"/f u/]/ :jb]z kmls{Pkl5 g]kfn d]l8snsf sfplG;njf6 lnOg] nfO;]G;sf] k/LIffdf ^) k|ltzteGbf a9L cg'QL0f{ x'g] tYofª\s b]lvPsf] s'/f g]kfnsf d]l8sn sn]hx¿sf] z'Ns, ;DaGwg / u'0f:t/sf ;DaGwdf ;dLIff / k'g/fjnf]sg ug{ ul7t ;ldltsf] k|ltj]bg, @)^* df pNn]v 5 . g]kfn d]l8sn sfplG;nsf] kl5Nnf] tYofª\scg';f/ pSt sfplG;naf6 lnOg] of]Uotf k/LIffdf a9L dfqfdf cg'QL0f{ ePsf] tYofª\s 5 .

g]kfndf lrlsT;f lzIffsf] eljio cj:yf

g]kfndf :jf:Yo hgzlQmsf] pknJwtf / ljt/0fdf ;d:of

/x]sf] b]lvG5 . ;'ud / b'u{d ;a}If]qdf hgzlQmsf] ;d'lrt kl/rfng ug{ hgzlQmsf] pTkfbgdf j[l4 / ljt/0fdf ;dtf sfod ug{ h?/L 5 . lrlsT;f lzIffdf ljkGg ju{ / lk5l8Psf] If]qsf] kx'Fr ;'lglZrt ug{ clgjfo{ 5 . xfd|f] b]zsf c:ktfnx¿df xfn @$,))) sf] xf/fxf/Ldf z}of /x]sf 5g\ . ljZj :jf:Yo ;ª\u7gsf] dfkb08cg';f/ k|ltxhf/ hg;ª\VofnfO{ !=( z}øof cfjZos kb{5 . o; lx;fan] g]kfndf %),#$) eGbf a9L z}o\ofsf] cfjZostf kg]{ b]lvG5 . eljiosf nflu lrlsT;sx¿sf] cfjZostfnfO{ dgg ubf{ yk lrlsT;s pTkfbg ug'{kg]{ b]lvG5 t/ cfjZostf eGbf a9L pTkfbg ePdf 7'nf] wg/flz nufgL u/L pTkflbt hgzlSt a]/f]huf/ x'g' / sd pTkfbg eO{ ;j{;fw/0fnfO{ :jf:Yo ;]jfsf] kx'Fr k'/\ofpg g;Sg] cj:yf cfpg' /fi6«sf nflu 3ftsl;4 x'g ;Sg]tkm{ ljz]if Wofg hfg'kg]{ x'G5 .

lrlsT;sx¿sf] cfjZostf k|If]k0f k|lt !),))) hg;ª\Vofcg';f/M

S|m=;= ;g\ ;ª\Vof

! @)!! @^$($

@ @)!^ @*$(@

# @)@! #)^%^

$ @)@^ #@(((

% @)#! #%%#*

;|f]tM lrlsT;f lzIff;DaGwL gLlt th{'df pRr:t/Lo sfo{bnsf] k|ltj]bg

ljZj :jf:Yo ;ª\u7gn] l;kmfl/; u/]sf] dfkb08cg';f/ rlsT;s / hg;ª\Vofsf] cg'kft !M!))) x'g'kg]{ 5 . xfn g]kfndf lrlsT;ssf] s'n ;ª\Vof ;g\ @)!( sf] cGTo;Dd PdlalaP; /lh:68{ ePsf] ;ª\Vof @#,!$^ / Pd8L÷Pd\P;\ &!*% /x]sf] 5 (NMC, 2019) . g]kfnsf] hgu0fgf @)^* cg';f/ g]kfnsf] hg;ª\Vof j[l4b/ jflif{s !=#% sf] b/df ;g\ @)@) df g]kfnsf] hg;ª\Vof @,(!,#^,*)* k'u]sf] cg'dfg ug{ ;lsG5 . o;/L x]bf{ clxn]sf] ;dodf g]kfndf PdlalaP; lrlsT;s / hg;ª\Vofsf] cg'kft !M!@%( /x]sf] / ljZj :jf:Yo ;ª\u7gn] l;kmfl/; u/]sf] dfkb08 cg';f/ sfod x'gsf nflu ;g\ @)@! sf] cGt ;Dddf lrlsT;ssf] ;ª\Vof #)^%^ k'lu;s]sf] x'g'k5{ .

casf] lhDd]jf/L

pko{'St cj:yfnfO{ x[boª\ud ubf{ ;a}sf nflu ;j{;'ne lrlsT;f lzIff / lgMz'Ns :jf:Yo ;]jfsf uGtJodf k'Ug' g} cfhsf] d'Vo r'gf}tL xf] . o;sf nflu lrlsT;f lzIffsf] If]qdf /fHosf] nufgL clej[l4 ug]{, lrlsT;f lzIffnfO{

- 62 -

g]kfnsf] /fli6«o cfjZostfcg'¿k ljsf; ug]{, lrlsT;f lzIffsf] lgodgnfO{ PsLs[t tyf r':t agfpg], lrlsT;f lzIf0f ;+:yfx¿sf] :yfkgf / ;~rfng;DaGwL sfo{nfO{ Jojl:yt ug]{, lrlsT;f lzIffdf u'0f:t/ sfod ug]{, lzIf0f ;+:yf / lrlsT;sx¿sf k];fwld{tf sfod ug]{, ;+:yfut hjfkmb]lxtf jxg u/fpg], ef}uf]lns ;Gt'ng / ;fdflhs Gofo sfod ug]{, ljkGg ju{sf ljBfyL{sf] ;dfg kx'Fr ;'lglZrt ug]{, :jf:Yo / lzIffnfO{ gful/ssf] cfwf/e"t df}lns xssf] ¿kdf k|Tofe"t ul/Psf] ;+j}wflgs efjgfnfO{ Jojxf/df ptfg]{, ;a} lzIf0f ;+:yfx¿sf nflu kf7\oqmd, lzIf0f ljlw, d"Nofª\sg k4ltsf nflu Go"gtd\ ;femf dfkb08 to ug]{, lzIf0f ;+:yfx¿sf] Jojl:yt¿kdf lgodg ug]{, /fli6«o lrlsT;f lzIff P]gsf k|fjwfgx¿nfO ;fdlos ¿kdf sfof{Gjog ug]{, lzIf0f ;+:yfx¿nfO{ ;]jfd"ns agfpg], lrlsT;f lzIffsf] u'0f:t/nfO{ ;du| ;dfhsf] j[xQ/ lxt;Fu hf]8\g], g]kfnsf] :jf:Yo hgzlQmnfO{ 1fg, l;k / k|fljlws¿kn] ;Ifd agfpg], dfgjLo ¿kdf ;+j]bgzLn x'g pTk|]l/t ug]{, ;fdflhs ;]jfsf] efjgf ljsf; u/fpg] h:tf uxg lhDd]jf/L xfd|f ;fd' /x]sf 5g\ .

lgrf]8

/fli6«o lrlsT;f lzIff P]g, @)&% nfO{ sfof{Gjogdf Nofpg /fli6«o lrlsT;f lzIff lgodfjnL oyfzSo rfF8f] nfu' ug{'k5{ . lrlsT;f lzIf0f ;+:yfx¿sf] lgodg sfo{nfO{ k|efjsf/L agfO{ u'0f:t/ sfod ug{ Go"gtd\ ;femf dfkb08 to u/L nfu' ug'{k5{ . af}l4s Ifdtf ePsfx¿nfO{ o; If]qdf cWoogsf nflu cfsif{0f ug{ dfkgLo / e/kbf]{ 5gf]6 k|0ffnL ljsf; ug'{k5{ . lrlsT;f ;]jf dfgjLo :jf:Yo;Fu

;DalGwt ljifo ePsfn] o;df k];fwld{tfk|lt ;+j]bgzLn x'g h?/L 5 . lrlsT;f k];fsf] pGgog, lgu/fgL / lgoGq0fsf] lhDd]jf/L kfPsf] lgsfo g]kfn d]l8sn sfplG;n;Fu lrlsT;f lzIff cfof]usf] ;xsfo{ / ;dGjo /fd|f] x'g'k5{ . lzIf0f ;+:yfx¿sf] Jofjxfl/s sfo{;Dkfbgsf ;a} kIfsf] cg'udg tyf d"Nofª\sg ug{ klg plQs} cfjZos 5 . k];fut sfg'gL Joj:yf / k];fwld{tfsf] ljifo ;DalGwt kf7\oqmdsf] cleGg cª\u agfO{ sfof{Gjogdf Nofpg'k5{ . lrlsT;f lzIff ;Da4 j}b]lzs lgsfox¿;Fu ;fem]bf/L / ;dGjo u/L z}lIfs u'0f:t/ / Joj:yfkgdf ;'wf/ Nofpg ;do;dodf Practice Exchange Visit ug]{ cjwf/0f kq tof/ u/L sfof{Gjogdf Nofpg'k5{ . ;fy} cfjlws ¿kdf lzIfs / ljBfyL{x¿sf] clej[lQ hfFr ug]{ k|fjwfg /fvL k[i7kf]if0f lng]lbg] sfo{n] ;du|df lrlsT;f lzIffsf] u'0f:t/ pGgog ug{ 6]jf k'Ug ;S5 .

;Gbe{ ;fdu|L

!= g]kfnsf] ;+ljwfg, @)&@, g]kfn sfg'g lstfa Joj:yf ;ldlt

@= /fli6«o lrlsT;f lzIff P]g, @)&%#= lrlsT;f lzIff;DaGwL /fli6«o gLlt th{'df pRr:t/Lo

sfo{bnsf] k|ltj]bg, @)&@$= kG„fF} of]hgf, -@)&^–@)*!_%= lrlsT;f lzIff z'Ns lgwf{/0f ;'emfj l;kmfl/;sf nflu

ul7t pk;ldltsf] k|ltj]bg, @)&^^= g]kfn d]l8sn sfplG;nsf] j]a;fO6

- 63 -

lrlsT;f lzIffdf ;'wf/sf] yfngL

;Ltf/fd sf]O/fnf♦

!= g]kfndf lrlsT;f lzIffsf] ;'?jft

g]kfndf lrlsT;f lzIffsf] ljsf;j|mdnfO{ x]bf{ k|fljlws lzIffsf] of]hgfa4 ljsf;j|md /fli6«o lzIff k4ltsf] of]hgf, @)@* nfu' ePkl5 b]lvG5 . :Jff:Yo If]qdf lj=;+= !(*( df g]kfn /fhsLo cfo'j]{b ljBfnosf] :yfkgf;Fu} :jf:Yo ;]jf k|bfgfy{ cfjZos hgzlStsf] pTkfbg ;'? ePsf] xf] . To;sf] Ps jif{kl5 g} lj=;+= !(() ;fndf l;len d]l8sn :s'n vf]lnof], h;n] 8«];/ / sDkfpG8/ h:tf :jf:Yo;]jLsf] pTkfbg ;'? u¥of] . :jf:Yo dGqfno dftxt ;~rfng x'g] u/L ;g\ !(%^ df gl;{Ë / x]Ny cl;:6]G6 :s'nx¿, ;g\ !(^@ df cx]j :s'n / ;g\ !(^# df cgdL :s'n v'n]sf lyP .

gl;{ª, x]Ny cl;:6]G6, cgdL / cx]j sfo{j|mdx¿ ;~rfng ug]{ ;a} :s'nx¿nfO{ ufe]/ ;g\ !(&@ df lrlsT;f zf:q cWoog ;+:yfgsf] :yfkgf ul/Psf] lyof] eg] ;g\ !(&@ b]lv !(&* ;Dd lrlsT;fzf:q cWoog ;+:yfgn] cfwf/e"t / dWod:t/sf :jf:Yo hgzlSt pTkfbg ug]{ sfo{sf] yfngL ePsf] b]lvG5 . To:t} ;fdfGo lrlsT;f, kmfd]{;L, /]l8of]u|fkmL, x]NyNofa, gl;{ª / cfo'j]{b ljifodf k|df0fkq txsf sfo{j|mdx¿ ;~rflnt lyP . ;g\ !(&^ df o; ;+:yfgdf ;'? ul/Psf] klxnf] :gfts :t/sf] sfo{j|md la=Pg=/x]sf] lyof] . To;} u/L lrlsT;f zf:q cWoog ;+:yfgn] :gfts:t/Lo lrlsT;s pTkfbg ug]{ z}lIfs sfo{j|md -PdaLaLP;_ yfngL ug{sf nflu cfjZos tof/L klg ul//x]sf] lyof] .

klxnf] k6s g]kfndf k|df0fkq tx pQL0f{ :jf:Yo ;xfos, g;{, kmfd]{l;:6, Nofa ;xfos, /]l8of]u|fkm/x¿ nufotsf :jf:YosdL{dWo]af6 @@ hgfnfO{ 5gf]6 u/L ;g\ !(&* df lqe'jg ljZjljBfno lrlsT;f zf:q cWoog ;+:yfgn] :gfts -PdlalaP;_ :t/sf] sfo{j|md ;'? u¥of] . ljBfyL{ egf{ ;ª\Vofdf lj:tf/} a9f]Q/L ub}{ ;g\ !((# df egf{ ;ª\VofnfO{ k|ltjif{ $) hgf k'¥ofOof] . o;}lar ;g\ !(*& ;fnb]lv o; sfo{j|mddf egf{ x'g] ljBfyL{dWo] %) k|ltzt lj1fgdf k|df0f kq tx pQL0f{x¿dWo]af6 egf{ lng] k|fjwfg ;'? ul/of] . ;g\ @))) b]lv o;df kl/jt{g u/L k'/} ljBfyL{x¿ lj1fgdf k|df0fkq tx pQL0f{ u/]sf dWo]af6 dfq k|lt:kwf{ u/fO{ of]Uotfj|mdsf cfwf/df egf{ lng] k4lt nfu' ul/of] .

lrlsT;f lzIffnfO{ k|f]T;fxg ug{ / b]zsf nflu cfjZos

hgzlSt pTkfbg ug{sf nflu ljZjljBfnox¿n] ljleGg d]l8sn sn]hnfO{ ;DaGwg lbPsf 5g\ / tL sn]hdf d]l8sn lzIff cWofkg x'G5 . lqe'jg ljZjljBfnocGtu{t !) cf]6f, sf7df8f}+ ljZjljBfnocGtu{t !! j6f / & j6f k|lti7fgdf d]l8sn lzIff cWofkgsf] k"jf{wf/ k"/f eO{ cWofkg eO/x]sf] 5 . k"jf{wf/ ljsf; ;ldlt u7g cfb]z, @)&@ cg';f/ u]6f d]l8sn sn]h, s}nfnL / ldlt @)&% kmfu'g # ut]sf] lg0ff{ofg';f/ ;'v]{t, a'6jn / alb{jf;df ;/sf/L nufgLdf g} d]l8sn sn]h vf]Ngsf nflu k"jf{wf/ ljsf; cfof]hgfn] sfo{ ul//x]sf] 5 .

@= /fli6«o gLlt tyf dfkb08sf nflu ePsf ljleGg k|of;

hg:t/, JolSt / ;/f]sf/jfnfn] lrlsT;f lzIffdf clgoldtf eof], tf]lsPsf] eGbf a9L z'Ns d]l8sn sn]hn] lnP, u'0f:t/sf] kf/bzL{ dfkb08 ePg, egf{ k|lj|mofdf clgoldttf eof] eGg] u'gf;f] JofKt ePkl5 ljleGg cfof]u, sfo{bn tyf ;ldltx¿ u7g u/L hfFra'em ul/of] . ;+;bLo ;ldltb]lv Goflos cfof]u;Ddn] o; k|sf/sf ljifodf lgisif{;lxt ;/sf/nfO{ cfkm\gf] k|ltj]bg a'emfPsf 5g\ . pSt k|ltj]bgn] lrlsT;f lzIffsf nflu ;'emfPsf d'Vo d'Vo ljifox¿ o; n]vdf ;dfj]z ug]{ k|of; ul/Psf] 5 .

@=! d]l8sn sn]h tyf pRr:t/Lo /fli6«o dfkb08 l;kmfl/; ;ldltsf] k|ltj]bg, @)&!

k"j{ ;lrj >L ho/fd lu/L ;+of]hs /x]sf] * ;b:oLo ;ldltn] d]l8sn sn]h tyf pRr:t/Lo /fli6«o dfkb08 tof/ u/L ldlt @)&! ;fn efb| $ ut] tTsfnLg dfggLo lzIff dGqL lrqn]vf ofbj ;dIf k|ltj]bg k]; u/]sf] lyof] . o; ;ldltn] lrlsT;f lzIffsf ljleGg ljwfdf b]lvPsf ;d:of / ltgsf] ;dfwfgsf nflu ;'emfj k]; u/]sf] lyof] . o;n] u/]sf d'Vo l;kmfl/;x¿ b]xfoadf]lhd /x]sf 5g\ M

@=!=! /fli6«o gLlt tyf dfkb08 ;DaGwL l;kmfl/;x¿-!_ ;/sf/n] nufgL d}qL jftfj/0f l;h{gf ug{'kg]{, -@_ ;/sf/n] g} ;DaGwg k|bfos lgsfox¿sf] ;d]t ;+nUgtf /x]sf] ;+oGqåf/f k"jf{wf/ ljsf; ug{ dg;fokq k|bfg u/L tf]lsPsf k"jf{wf/ k"/f u/]sf] cj:yfdf ;DaGwg kfpg] ;'lglZrttf u/L :jb]zL nufgLstf{ k|f]T;flxt ug]{ gLlt cjnDjg ug{'kg]{, -#_ lrlsT;f lzIffsf nflu hg;ª\Vof, ef}uf]lns cjl:ylt / ;Gt'lnt ljsf;nfO{ ;d]t dWogh/

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u/L lgwf{/0f ul/Psf] /fli6«o gLlt tyf dfkb08 / gS;fª\sgdf plNnlvt If]qdf dfq gFof d]l8sn sn]h :yfkgf÷;~rfngsf] :jLs[lt lbg] -$_ sn]h :yfkgfsf nflu lzIff dGqfno, :jf:Yo tyf hg;ª\Vof dGqfno, ljZjljBfnox¿ / g]kfn d]l8sn sfplG;n nufotsf ;a} ;/f]sf/jfnfsf] ;+nUgtfdf PsLs[t dfkb08 lgwf{/0f u/L ;f]sf] sfof{Gjgo ug{'kg]{, -%_ d]l8sn sn]hsf] :yfkgf tyf ;';~rfngsf nflu lzIff dGqfno, :jf:Yo tyf hg;ª\Vof dGqfno, ljZjljBfnox¿ / g]kfn d]l8sn sfplG;n;d]tsf] k|ltlglwTj /xg] u/L ;dGjotTds ;+oGqsf] Joj:yf ug]{, -^_ g]kfn ;/sf/n] gLltut Joj:yf u/L d]l8sn lzIffdf ;j{;'ne tyf ;dtfd"ns kx'Fr lj:tf/sf] k|Tofe"t ug{'kg]{, .

To;} u/L -&_ lrlsT;f lzIffsf] ljsf; tyf lj:tf/df ;fj{hlgs lghL ;fem]bf/L, ;xsf/L, u}/ ;/sf/L If]q tyf lghL If]qsf] ;xeflutfnfO{ ;d]6\g] u/L :ki6 gLltut Joj:yf ug{'kg]{, -*_ /fli6«o d]l8sn af]8{ u7g u/L ljifout ¿kdf PsLs[t k|j]z k/LIff ;~rfng ug]{ ;d]t Joj:yf u/L ;f]sf cfwf/df :jb]z tyf ljb]zdf lrlsT;f lzIff cWoog ug{ kfpg] Joj:yf ug{'kg]{, -(_ /fli6«o d]l8sn af]8{åf/f ;~rflnt k/LIffsf] of]Uotfj|mddf pkNnf] :yfgdf /xL pQL0f{ u/]sf dWo] cfly{s ljkGgtfsf sf/0f lrlsT;f lzIff cWoog ug{ c;dy{ ljBfyL{nfO{ g]kfn ;/sf/n] cf+lzs cg'bfg jf ;x'lnot Jofhdf C0f lbO{ :jb]z d} lrlsT;f lzIff k|fKt ug{ ;Sg] u/L kx'Fr lj:tf/ ug{'kg]{, -!)_ 5fqj[lQdf ul/Psf] cf/If0fsf] Joj:yfdf tf]lsPsf] ;d'bfosf] ljkGg tyf ;LdfGts[t ju{nfO{ klxnf] k|fyldstf lbg'kg]{, -!!_ ljb]zL ljBfyL{x¿nfO{ cfslif{t u/L g]kfnnfO{ z}lIfs pGgogsf] s]G› ljGb'sf ¿kdf ljsf; ug]{, -!@_ ;~rfng cj:yfdf /x]sf jf /xg] lzIf0f ;+:yfx¿nfO{ dflgt ljZjljBfnosf] ¿kdf ;~rfng ug{ kfpg] u/L sfo{ ljlwsf] ljsf; ug]{, -!#_ d]l8sn sn]hx¿n] lzIf0f l;sfOsf ;fy;fy} tf]lsPsf ;]jf If]qleq :jf:Yo ;]jf -ljz]if1 ;]jf;d]t_ pknAw u/fpg] sfg'gL Joj:yf x'g'kg]{, -!$_ ljZjljBfnosf] yk ef}lts tyf k|fl1s k"jf{wf/ ljsf; u/L ;DaGwg k|bfg ug]{ Ifdtf lj:tf/df g]kfn ;/sf/n] ;d]t ;xof]u ug{'kg]{, -!& lrlsT;f lzIffdf tNnf] txsf] cWoog k"/f u/L b'u{d If]qdf lglZrt cjlw sfo{ u/]sf cfwf/df pkNnf] txsf] lzIffdf lglZrt k|ltzt l;6df egf{ kfpg] Joj:yf u/L b'u{d tyf ;/sf/n] h?/L 7x/ u/]sf If]qdf ljz]if1 lrlsT;ssf] pknAwtfnfO{ ;'lglZrt ul/g'kg]{ h:tf l;kmfl/; /x]sf lyP .

@=!=@= ;DaGwg ;DaGwL l;kmfl/;x¿-!_ xfn;Dd ;DaGwg k|bfg ul//x]sf lqe'jg ljZjljBfno / sf7df8f} ljZjljBfnox¿sf] ef}lts tyf k|fl1s k"jf{wf/

lj:tf/ u/L ;DaGwg k|bfg ug]{ tyf ;f]sf] Joj:yfkg ug{ Ifdtf clej[l4 ul/g' plrt x'g] x'Fbf ;f]sf] nflu g]kfn ;/sf/n] lgb]{zg lbg], -@_ xfn;Dd lrlsT;f lj1fg;DaGwL sfo{j|md ;~rfng gu/]sf ljZjljBfnox¿n] klg lrlsT;f lzIffsf nflu cfjZos k"jf{wf/ ljsf; u/L ;DaGwg k|bfg ug{'kg]{, -#_ jL=kL= sf]O/fnf :jf:Yo lj1fg k|lti7fg, w/fgsf] P]gdf Joj:yf geO{ lgodfjnLdf ;DaGwg k|bfg ug{ ;Sg] Joj:yf /x]sf]n] P]gaf6 g} pko'Qm Joj:yf x'g'kg]{, -$_ k"jf{wf/ tof/Lsf j|mddf /x]sf ;+:yfx¿n] tf]lsPsf] dfkb08 k"/f u/]df dfq ;DaGwg lbg] Joj:yf ldnfO{ afFsLsf xsdf gS;fª\sgsf cfwf/df ;DaGwg lbg] Joj:yf ug{'kg]{, -%_ ;DaGwgsf nflu k"jf{wf/ k"/f u/] gu/]sf] ;DaGwdf j:t'ut cj:yf dfkg ug{ PsLs[t ;fwgsf] ljsf; u/L jf:tljs cj:yf lrq0f x'g] Joj:yf ug{'kg]{, -^_ ;/f]sf/jnfx¿sf] ;d]t ;+nUgtfdf dfkb08 lgwf{/0f u/L ;f]sf] s8fOsf ;fy kfngf ug{'÷u/fpg' kg]{, -&_ cj pk|fGt dg;fo kq k|fKt u/L ;DaGwg k|fKt ug{ k"jf{wf/ k"/f u/]sf ;+:yfx¿sf] k|f/lDes k/fdz{ adf]lhdsf] Joj:yf cjnDjg ug{'kg]{ h:tf l;kmfl/; /x]sf lyP .

@=!=# u'0f:t/ ;DaGwL l;kmfl/;x¿-!_ g]kfnL ljBfyL{sf nflu æ/fli6«o d]l8sn af]8{Æ u7g u/L PsLs[t k|j]z k/LIff ;~rfng ug]{ Joj:yf clgjfo{ ug{'kg]{, -@_ ljb]zL ljBfyL{x¿sf] egf{sf] nflu ljZjljBfnon] pk'oQm 5gf]6 k|lqmof cjnDag ug]{, -#_æ/fli6«o d]l8sn af]8{Æ åf/f ;~rflnt k/LIffsf] of]Uotfj|mddf /x]sfdWo] ˆofsN6L ljsf; tyf 5fqj[lQsf nflu lglZrt k|ltztdf l;6 ;'/lIft ub}{ afFsL /xg] l;6x¿df of]Uotfj|mdsf cfwf/df dfq ljBfyL{ egf{ ug{'kg]{, -$_ j:t'lgi6, kf/bzL{ Pj+ ljZj;gLo cg'udgsf nflu PsLs[t cg'udg k|0ffnLsf] ljsf; ug]{, -$_ ˆofsN6Lsf] Ifdtf ljsf;sf nflu lzIf0f ;+:yfn] k|To]s jif{ oy]i6 nufgLsf] Joj:yf ug{'kg]{, -%_ ljZjljBfnoaf6 ;~rfng x'g] k/LIff :t/Lo / ljZj;gLo agfpg] / ko{j]Ifsx¿n] OdfGbfl/tfsf ;fy sfo{ ug{'kg]{ Joj:yf ug]{, -^_ ljZjljBfnon] pQ/k'l:tsf k/LIf0f ubf{ sf]l8ª÷l8sf]l8ªsf] Joj:yf clgjfo{ ug]{, -&_ g]kfn ;/sf/, lzIff dGqfno / g]kfn d]l8sn sfplG;naf6 ;d]t k/LIffsf] lg/LIf0f u/L dof{lbt jgfpg ;dGjofTds ;+oGq lgdf{0f ug]{, -*_ d]l8sn lzIffsf] d'Vo efu j]8 ;fO8 l6lrª ePsfn] ;f]sf] clgjfo{ kfngf ug{' kg]{ Joj:yf ug]{, -(_ g]kfn d]l8sn sfplG;nn] lng] nfO;]G;sf] k/LIffnfO{ lnlvtdf dfq ;Lldt gu/L l;k k/LIf0f ug]{ Joj:yf ldnfpg], -!)_ ;~rflnt sn]hx¿sf] ;j{kIfLo ljifodf x/]s kfFr jif{df ef}lts, z}lIfs, dfgjLo tyf cfly{s nufot kIfdf d"NofÍg ug{'kg]{ / ;f]xL cfwf/df dfq sn]hx¿sf] :t/ j[l4 ul/g' kg]{, -!!_ ljZjljBfnox¿n] dftxtsf d]l8sn sn]hdf k|fWofkg/t hgzlStnfO{ of]Uotf / bIftfsf

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cfwf/df juL{s/0f, kb ldnfg / ;dfof]hg ug]{ Joj:yfnfO{ nfu' ug{'kg]{, -!@_ lzIf0f c:ktfnsf ;DaGwdf :jf:Yo tyf hg;ª\Vof dGqfnoaf6 nfu' ul/Psf] dfkb08sf ;fy ;fy} g]kfn d]l8sn sfplG;nåf/f lgwf{l/t cGo dfkb08sf] clgjfo{ sfof{Gjog ug]{ u/fpg] Joj:yf ldnfpg'kg]{ nufotsf ljleGg ;'emfj k]; u/]sf] lyof] .

@=@ g]kfnsf d]l8sn sn]hx¿sf] z'Ns, ;DaGwg / u'0f:t/sf ;DaGwdf ;dLIff / k'g/fjnf]sg ug{ ul7t ;ldltsf] k|ltj]bg, @)^*

ldlt @)^& ;fn cflZjg !@ ut]/fli6«o of]hgf cfof]usf ;b:o dfggLo >L k|]djxfb'/ s'Fj/sf] ;+of]hsTjdf ul7t !) ;b:oLo ;ldltn] ljleGg pk;ldlt u7g u/L lrlsT;f lzIffdf b]lvPsf ;d:of ;dfwfgsf nflu ;'emfj k]; u/]sf] lyof] . pk;ldltdf z'Ns;DaGwL 8f= ;f]dgfy cof{n, ;DaGwg;DaGwL dfggLo 8f= r]t/fh kGt / kl/df0fTds tyf u'0ffTds lrlsT;s pTkfbg ug]{ tyf g]kfnL ?k}of ljbl;g glbg];DaGwL of]hgf cfof]usf dfggLo ;b:o k|f= 8f= tLy{/fh vlgofF ;+of]hs /x]sf] tLg ;b:o pk;ldlt u7g ul/Psf] lyof] . o; ;ldltn] k]; u/]sf d'Vod'Vo l;kmfl/; b]xfoadf]lhd /x]sf 5g\ M

@=@=! ;DaGwg ;DaGwL l;kmfl/;x¿xfn;Dd lqe'jg ljZjljBfno / sf7df8f} ljZjljBfnoaf6 dfq d]l8sn sfo{j|md ;~rfngsf nflu ;DaGwg k|bfg ug]{ sfo{ ePsf] 5 . ;f]jfx]s cGo ljZjljBfnosf] cfkm\gf] sfo{j|md gePsf] sf/0f ;DaGwg lbg gkfPsf] cj:yf 5 . ctM cGo ljZjljBfnox¿n] klg cfkm\gf] k"jf{wf/ tof/ u/L cfkm\gf] sfo{If]qdf ;DaGwg k|bfg u/fpg] Joj:yf x'g cfjZos b]lvPsf] 5 . sltko ljZjljBfnon] km\ofsN6L;Dd lgdf{0f u/]sf] cj:yf eP tfklg cfkm\g} sfo{j|md ;~rfng geP;Dd ;DaGwg k|bfg ug{ gldNg] eGg] sf/0f g]kfn d]l8sn sfplG;naf6 To:tf] ljZjljBfnoaf6 ;DaGwg lbPsf sfo{j|md ;~rfng ug]{ lgsfonfO{ cg'dlt k|bfg ug{ gldNg] hgfPsf] cj:yfdf tf]lsPsf] dfkb08 k"/f ug{ nufpg' kg]{ b]lvG5 . goFf :yfkgf x'g nufgL u/]sf d]l8sn sn]hx¿ ;~rfngdf cfpg ;xh kl/l:ylt gb]lvPsf] x'Fbf o;nfO{ s]xL ;/nLs/0f u/L dfkb08 k'u]sf ljZjljBfnon] km\ofsN6L / k"jf{wf/ lgdf{0f u/L ;DaGwg lbg] sfo{ ug{ kfpg] Joj:yf ug{' kg]{ b]lvG5 . cj pk|fGt d]l8sn sn]h gePsf] If]q jf c~rndf dfq dg;fo kq lbg pko'Qm x'g] / d]l8sn sn]hx¿ kof{Kt ePsf] If]qdf yk d]l8sn sn]hnfO{ dg;fo kq lbg'eGbf ePsf d]l8sn sn]hx¿sf] plrt Joj:yfkgdf Wofg lbg pko'Qm x'g] b]lvG5 . ljZjljBfnoaf6 ;DaGwg k|fKt u/L ;~rflnt k|fOe]6 d]l8sn sn]hx¿n] ljZjljBfno, g]kfn d]l8sn

sfplG;n / g]kfn ;/sf/n] tf]s]sf] dfkb08 k"/f gePsf] cj:yf b]lvPdf ;DaGwg vf/]h;Ddsf] sf/jfxL x'g ;Sg] ePdf ;f] sfo{ ljZjljBfno ;efaf6 dfq ug{ ;lsg] Joj:yf ldnfpg'kg]{ b]lvG5 .

@=@=@ z'Ns Joj:yfkg ;DaGwL l;kmfl/;x¿g]kfndf ;~rfng ePsf d]l8sn sn]hx¿sf] z'Ns lgwf{/0f ubf{ cjpk|fGt d]l8sn sn]hx¿sf] xsdf ljZjljBfnon] / ljZjljBfnosf] xsdf ljZjljBfnosf] l;g]6af6 lg0f{o u/L g]kfn ;/sf/af6 ;xdlt ePkl5 dfq nfu' ug]{{ . o; k|ltj]bgdf k|:t't ul/Psf] z'Ns lgwf{/0fsf cfwf/nfO{ sfod u/L To:tf sfo{j|md ;~rfng ug]{ sn]hx¿n] lng kfpg] z'Ns lglZrt ug]{ . sn]hx¿n] lng] hDdf z'NsnfO{ klxnf] jif{÷;]ld:6/df a9Ldf cfwf / afFsL z'Ns ;dfg'kflts¿kdf k|To]s jif{÷;]ld:6/df lng÷ltg{ kfpg] Joj:yf ldnfpg] . k/LIffnufotsf ljleGg gfdsf cGo z'Nsx¿ leGgleGg ¿kdf cfkm'v';L lgwf{/0f ePsf] b]lv+Fbf o;nfO{ ljZjljBfnon] cWoog z'Ns;Fu} ls6fg u/L tf]lslbPsf] xb;Dd dfq sn]hx¿n] lng kfpg] Joj:yf ug{] . tf]lslbPsf] xbeGbf a9L z'Ns c;'n u/]df To:tf] ;+:yf jf sn]h pk/ sf/jfxL rnfpg] . ;DaGwg k|bfg ug]{ ljZjljBfnon] z'Ns Aoj:yfkg ljifodf lgoldt cg'udg u/L clgjfo{¿kdf kl/kfng ug]{ Joj:yf ldnfpg] .

@=@=# z}lIfs u'0f:t/sf ;DaGwL l;kmfl/;x¿sfo{j|md ;~rfng ug]{ sn]hn] g]kfn ;/sf/;Fu ePsf] ;Demf}tf, ;DaGwg lbg] ljZjljBfno / g]kfn d]l8sn sfplG;nn] tf]s]sf ;t{x¿ clgjfo{ kfngf ug{'kg]{ . To:tf sn]hn] ;~rfng ug]{ sIffx¿ kf7\oj|mdcg';f/ clgjfo{ k7gkf7gsf] Joj:yf ug{'kg]{ . km\ofsN6Lsf] u'0f:t/nfO{ Wofgdf /fvL ;Ifd, of]Uo / pko'Qm JolQmnfO{ dfq 5gf]6 ug]{ Joj:yf ldnfpg] . ljZjljBfnoaf6 ;~rfng x'g] k/LIff :t/Lo / ljZj;gLo agfpg] / :jtGq ko{j]Ifsx¿n] OdfGbf/Ltfsf ;fy sfo{ ug{'kg]{ Joj:yf ug]{ . g]kfn ;/sf/, lzIff dGqfno / g]kfn d]l8sn sfplG;naf6 ;d]t k/LIffsf] lg/LIf0f u/L dof{lbt agfpg ;dGjfofTds ;+oGq lgdf{0f ug]{ . ljZjljBfnon] pQ/k'l:tsf k/LIf0f ubf{ sf]l8ª÷l8sf]l8ªsf] Joj:yf clgjfo{ ug]{ . d]l8sn lzIffsf] d'Vo efu j]8 ;fO8 l6lrË ePsfn] ;f] clgjfo{ kfngf ug{'kg]{ Joj:yf ug]{, g]kfn d]l8sn sfplG;nn] lng] nfO;]G;sf] k/LIffdf l;k k/LIf0f clgjfo{ nfu' ug]{ Joj:yf ldnfpg] . ;~rflnt sn]hx¿sf] ;j{kIfLo ljifodf jif{sf] Psk6s lzIff dGqfno, ;DaGwg lbg] ljZjljBfno / g]kfn d]l8sn sfplG;nsf] ;+o'Qm lg/LIf0f ug]{ sfo{nfO{ k|efjsf/L¿kdf sfof{Gjog ug]{ Joj:yf ldnfpg] . g]kfn d]l8sn sfplG;n] tf]s]sf dfkb08 sfof{Gjog u/L lgodfg';f/ sn]h ;~rfng ug]{ clgjfo{ Joj:yf ldnfpg] .

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k|To]s d]l8sn sn]hn] u7g ug]{ Governing Body df lzIff dGqfno, ljZjljBfno / g]kfn d]l8sn sfplG;nsf] k|ltlglw /xg] clgjfo{ Joj:yf ug]{ . km\ofsN6L nufot u'0f:t/Lo JolQm 5gf]6 k|lj|mofnfO{ kf/bzL{ / ljZj;gLo jgfpg] cfjZos ;+oGq lgdf{0f ug]{ . d]l8sn sn]hdf cWoog/t ljBfyL{n] s'g} sf/0fj; cWoog k"/f ug{ g;sL lard} k9fO 5f8\g kg]{ cj:yfdf To:tf] ljBfyL{n] lt/]sf] z'Nssf] k|ltjif{ !) k|ltztsf b/n] s6\6f u/L afFsL /sd ljBfyL{nfO{ lkmtf{ ug]{ .

@=@=# z'Ns ;DaGwL l;kmfl/;x¿;Dk"0f{ d]l8sn sn]hx¿n] g]kfn d]l8sn sfplG;nn] tf]s]sf] dfkb08 k"/f u/]sf] x''g'kg]{, Go"gtd dfkb08;DdnfO{ cfwf/ lnO{ vr{ lgsfNbf clwstd z'NseGbf sd cfPdf ;f]xL z'Ns lng' kg]{ . s'g} d]l8sn sn]hn] To:tf] z'NseGbf sd x'g] u/L z'Ns lng jfwf gkg]{, $=% jif]{ d]l8sn :gfts lzIff PdlalaP;sf] nflu 5fqfj[lQ ;d]t ;dfof]hg ubf{ x'g] hDdf z'Ns ? #),$^,()% . @% -tL; nfv 5of;nL; xhf/ gf} ;o kfFr ?k}of / k};f klRr; dfq_ tf]Sg] . g]kfn /fi6« j}+sn] jflif{s ¿kdf tf]s]sf] d'b|fl:kmlt b/sf] cfwf/df dflyNnf] lgsfoaf6 cg'dlt lnP/ dfq z'Ns ;dfof]hg ug{ ;lsg] . sn]hx¿n] lng] hDdf z'NsnfO{ klxnf] jif{÷;]ld:6/df a9Ldf rfln; k|ltzt / jfFsL z'Ns ;dfg'kflts¿kdf k|To]s jif{÷;]ld:6/df lng÷ltg{ kfpg] Joj:yf ug]{ . cfufdL z}lIfs ;q b]lv d]l8sn sn]hx¿n] z'Ns lgwf{/0f ubf{ ;~rfns ;ldltsf] l;kmfl/;df ;DaGwg lbg] ljZjljBfnoaf6 lg0f{o u/]/ dfq nfu' ug]{ . d]l8sn sn]hn] z}lIfs ;q @)^* sf nflu tf]lsPsf dfkb08 / cfwf/sf] cwLgdf /xL a9Ldf ? #),$^,()% . @% lng], d]l8sn sn]hdf cWoog/t ljBfyL{n] s'g} sf/0fj; cWoog k"/f ug{ g;sL lar}df k9fO 5f8\g kg]{ cj:yfdf To:tf] ljBfyL{n] lt/]sf] z'Nssf] k|lt jif{ !) k|ltztsf b/n] s6\6f u/L afFsL /sd ljBfyL{nfO{ lkmtf{ ug]{ . o;/L egf{ l/Qm ePsf] l;6 csf{] jif{sf nflu ljZjljBfno / g]kfn d]l8sn sfplG;nn] yk u/L :jLs[t ug]{ Joj:yf ldnfpg] .

@=@=$ ;DaGwg ;DaGwL l;kmfl/;x¿ljZjljBfnon] cfkm\gf] km\ofsN6L ePsf] ljifodf dfq ;DaGwg lbg kfpg], yk d]l8sn sn]hx¿ :yfkgf ug]{ ;DaGwdf d]l8sn sn]h gePsf] If]q, c~rn / lhNnfnfO{ k|fyldstf lbO{ d]l8sn sn]h vf]Ng];DaGwL dfkb08 jgfO{ :jLs[ltsf nflu lzIff dGqfnon] dlGqkl/ifbdf k]; ug]{, lzIff dGqfno, g]kfn d]l8sn sfplG;n / ;DjlGwt ljZjljBfnosf] ;t{ / dfkb08adf]lhd ;~rfng gx'g] d]l8sn sn]hx¿sf] ;DaGwg vf/]h ug]{ ;DaGwdf lzIff dGqfnon] ;DjlGwt ljZjljBfno / g]kfn d]l8sn sfplG;n;Fu ;DjGjo u/L cfjZos sf/jfxL ug]{ .

@=@=% u'0f:t/ ;DaGwL l;kmfl/;x¿ljZjljBfnon] pQ/k'l:tsf k/LIf0f ubf{ sf]l8ª÷l8sf]l8ªsf] Joj:yf clgjfo{ ug]{, g]kfn d]l8sn sfplG;nn] lng] nfO;]G;sf] k/LIffdf l;k k/LIf0f clgjfo{ nfu' ug]{, k|To]s jif{ lzIff dGqfno, /fli6«o of]hgf cfof]u, ;DaGwg lbg] ljZjljBfno / g]kfn d]l8sn sfplG;nn] ;+o'Qm lg/LIf0f u/L d]l8sn sn]hsf] k|efjsf/L ;~rfngsf] Joj:yf ldnfpg], :jb]z jf ljb]zdf PdlalaP; tyf lal8P; cWoog ug]{ ;DaGwdf egf{ k/LIff g]kfn d]l8sn sfplG;nn], ljZjljBfno / lzIff dGqfno;Fu ;dGjo u/L ;~rfng ug]{ u/fpg], cflb .

@=# lrlsT;f lzIff;DaGwL /fli6«o gLlt th'{df pRr:t/Lo sfo{bnsf] k|ltj]bg, @)&@

g]kfndf lrlsT;f lzIff;DaGwL /x]sf ;d:of / r'gf}tLx¿sf] klxrfg, ljZn]if0f / k|efjx¿sf] tYok/s ljj]rgf u/L lrlsT;f lzIffsf] /fli6«o gLlt th'{df u/L l;kmfl/; ug{ tTsfnLg k|wfgdGqL :t/Lo ldlt @)&!÷)(÷!* ut]sf] lg0f{ofg';f/ lqe'jg ljZjljBfnosf k"j{pks'nklt tyf lzIffljb\ k|f= s]bf/eQm dfy]dfHo"sf] ;+of]hsTjdf lrlsT;f lzIff;DaGwL /fli6«o gLlt th'{df u/L l;kmfl/; ug{ sfo{If]qut ;t{x¿;d]t tf]sL pRr:t/Lo sfo{bn u7g ePsf] lyof] . o; sfo{bnnfO{ g]kfn ;/sf/, dlGqkl/ifb\sf] ldlt @)&!÷!@÷@) sf] lg0f{ofg';f/ lrlsT;fzf:q nufotsf ljifosf ;a} txdf a}1flgs z'Ns lgwf{/0f / ;DaGwg vf/]hL ;DaGwL gLltut Joj:yf l;kmfl/;sf nflu ;d]t sfof{b]z yk ePsf] lyof] . o; sfo{bnn] l;kmfl/; u/]sf d'Vod'Vo ljifoj:t' b]xfoadf]lhd 5g\ M

lrlsT;f lzIffsf] bfloTj :jf:Yosf] If]qdf /fli6«o cfTdlge{/tf k|fKt ug]{ / Pp6f ;'ne, ;jn / Gofok"0f{ :jf:Yo ;]jf k|0ffnLsf] :yfkgf ug]{ x'g'kb{5 . hgtfsf] hLjg d/0f;Fu k|ToIf ;/f]sf/ /fVg] lrlsT;f lzIff h:tf] uDeL/ ljifo clgolGqt v'nf ahf/nfO{ a]nufd 5f]8\g ldNb}g . o;sf] lj:tf/sf] of]hgf tyf lgodgsf] clGtd lhDd]jf/L ;/sf/sf] g} x'g'kb{5 . lrlsT;f lzIff cfly{s cfocfh{gsf] ;|f]t dfq geO{ g]kfnL ;dfhsf] ;]jfdf lgM:Jffy{ 9ª\un] ;dlk{t /xg' xf] . of] ;dk{0f bIf / dfgjLo ljj]so'Qm lrlsT;fsdL{x¿sf] pTkfbg, ;dtfd"ns tyf u'0f:t/Lo :jf:Yo ;]jfsf] k|jfx tyf :jf:Yo If]q;Fu ;DjlGwt ljifoj:t'df pTs[i6:t/sf] cg';Gwfg sfo{åf/f cleJoQm x'g'kb{5 . sf7df8f}+, nlntk'/ / eQmk'/ lhNnfdf d]l8sn, 8]G6n / gl;{Ë ljifodf :gfts sfo{j|md ;~rfng ug{ casf] bz jif{;Dd s'g} klg ;+:yfnfO{ cfzo kq (LOI) k|bfg gug]{ . d]l8sn, 8]G6n tyf gl;{Ë ljifosf] :gfts sfo{j|md ;~rfng ug{sf nflu j|mdzM tLg ;o / Ps ;o a]8sf] c:ktfn k"0f{ ¿kdf ;~rfng ul/g;s]sf

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s'g} klg ;+:yfnfO{ pQm sfo{j|md ;~rfng ug{ cf;o kq k|bfg gug]{ / klxn] g} cf;o kq kfO;s]sf] cj:yf eP To:tf ;+:yfx¿sf] cf;o kq gjLs/0f gug]{ h:tf l;kmfl/; u/]sf] lyof] .

;DjlGwt lzIf0f ;+:yfn] ;/sf/nfO{ ;Dklt x:tfGt/0f ug{ rfx]df ;/sf/n] lgodfg';f/sf] plrt d'cfAhf lbO{ ;/sf/n] :jfldTj u|x0f ug{ ;Sg] jf, o:tf lzIf0f ;+:yfn] ;/sf/n] k|fyldstf tf]s]sf] If]qdf :yfgfGt/0f ug{ rfx]df ;/sf/n] k|f]T;fxg ;'ljwf -hUUff lnh, s/ 5'6, cflb_ pknJw u/fpg], lg/LIf0fsf] ;dodf k"0f{ ¿kdf lzIf0f c:ktfn ;~rfngdf gcfO{;s]sf] xsdf To:tf ;+:yfx¿nfO{ sf7df8f}+ aflx/ sfo{j|md ;~rfng ug]{ tyf cGo k|rlnt lgodx¿ k"/f ug]{ ;t{df dfq LoI gjLs/0f ug{ ;lsg], sf7df8f}+ aflx/ hfg rfxg] ;+:yfx¿sf] xsdf ;/sf/n] ;xhLs/0f ug]{, ;/sf/n] k|fyldstf tf]s]sf If]q / :yfgdf ;~rfng x'g rfxg] :jf:Yo lzIf0f ;+:yfx¿nfO{ ;/sf/n] k|f]T;fxg ;'ljwf -hUUff lnh, s/ 5'6, cflb_ pknJw u/fpg ;Sg] l;kmfl/; klg u/]sf] lyof] .

Pp6f lhNnfdf Pp6f dfq d]l8sn, 8]G6n sn]h :yfkgf ug{ kfpg], o;eGbf klxnf :yfkgf eO;s]sf] xsdf of] k|fjwfg nfu' gx'g], :yfkgf eO;s]sf sn]h tyf :s'nx¿ ;dfof]hg -dh{/_ ug{ :ki6 dfkb08 to u/L sfof{Gjogdf Nofpg], ljleGg ljsf; If]qdf /x]sf ljZjljBfnox¿ -k"jf{~rn, kf]v/f, dWoklZrdf~rn, ;'b"/ klZrdf~rn / kl5 vf]lng]_ n] ;DaGwg lb+bf cfkm\gf] ef}uf]ns If]qleq dfq sfo{j|md ;~rfng ug]{ u/L lbg] g]kfn d]l8sn sfplG;nn] to u/]sf] d"Nof+sg k|ltj]bg (Yardsticks) sf cfwf/df Go"gtd l;6 ;ª\Vof %) sf nflu nuftf/ @ jif{;Dd &% k|ltzteGbf sd cª\s k|fKt ug]{ sn]hx¿sf] ;DaGwg vf/]hLsf] Joj:yf ug]{ l;kmfl/; u/]sf] lyof] . o;/L ;DaGwg vf/]h ubf{sf ;dodf egf{ eO;s]sf ljBfyL{sf] xsdf pgLx¿sf] cWoogsf] ;'lglZrttf ljZjljBfnosf] bfloTj x'g]5 . o:tf ljBfyL{x¿nfO{ ;DjlGwt ljZjljBfno cGtu{tsf] cGo sn]hx¿df tTkZrftsf] z}lIfs ;qsf] ;ª\Vofdf ;dfof]hg ug]{ u/L ldnfpg] elgPsf] lyof] .

k|To]s d]l8sn jf 8]G6n sn]hx¿n] gofF z}lIfs ;qdf jflif{s ¿kdf PdlalaP; sfo{j|mddf a9Ldf !)) hgf tyf 8]G6n sfo{j|mddf a9Ldf %) hgf dfq ljBfyL{ egf{ ug{ ;lsg] . ;fj{hlgs sn]hdf :gfts:t/sf] sfo{j|mddf pknJw l;6 ;ª\Vofsf] %) k|ltzt l;6 lgz'Ns x'g'kg]{ / lzIff dGqfnoaf6 xfn sfof{Gjogdf /x]sf] of]Uotd ljBfyL{sf nflu 5fqj[lQ sfo{j|mdnfO{ lg/Gt/tf lbg'kg]{ h:tf l;kmfl/; u/]sf] lyof] .

kfFr jif{eGbf a9L ;do;Dd u'0f:t/Lo :gftsf]Q/ txsf] sfo{j|md ;~rfng u/]sf sn]hx¿nfO{ ljlzi6Ls[t :gftsf]Q/

sfo{j|md ;~rfng ug{ kfpg, k|To]s ljZjljBfnon] b'u{d If]qdf ;]jf u/]sf lrlsT;snfO{ :gftsf]Q/ txdf k|j]z ;xh ug{ k|j]z k/LIff k"0ff{ª\ssf] !) k|ltzt;Dd cª\s k|bfg ug]{ Joj:yf ug]{, o;sf] ef}uf]lns If]q ljefhg / ;f]jfktsf] cª\s ef/ k|rlnt lgoddf Joj:yf u/]adf]lhd x'g], d]l8sn tyf 8]G6n ljifosf] :gfts txdf egf{ x'g rfxg] ljBfyL{x¿df kl/kSjtf tyf lrlsT;f k];fsf nflu cfjZos kg]{ u'0fx¿;d]t ;'lglZrt ug{sf] nflu pko'Qm kmfpG8];g sf];{sf] Joj:yf ug{], PdlalaP; txsf] sfo{j|mdsf] z'Ns clwstd ?= #% nfv tf]Sg], o;nfO{ bfdf;fxLn] jflif{s ¿kdf lng] Joj:yf ug]{, o;afx]s cGo z'Ns -h:t}M k/LIff, sfplG;n, egf{, k':tsfno, k|of]uzfnf cflb lng] gkfOg] . -lzjs'df/ /fO{ k|ltj]bgdf d"ntM cfwfl/t_ lal8P; sfo{j|mdsf] :gfts txsf] z'Ns clwstd ?= !* nfv eGbf a9L lng gkfOg], o;df ;d]t dfly PdlalaP; h:t} cGo yk z'Ns lng gkfOg] tyf bfdf;fxLn] jflif{s ¿kdf lng] Joj:yf ug]{, egf{ ;"rgfdf g} z'Nssf] ljj/0f / ljifout ¿kdf pknJw l;6 ;ª\Vof clgjfo{ ¿kdf v'nfpg' kg]{, ;a} txsf ;Mz'Ns k9fOg] sfo{j|mdx¿df lnOg] z'Nsx¿ jflif{s ¿kdf dfq ljBfyL{x¿af6 lnOg] Joj:yf ug]{ l;kmfl/; klg u/]sf] lyof] .

:jf:Yo hgzlSt ;DaGwL lzIffsf] ;jf{ª\uL0f ljsf; Pjd\ k|j4{gsf nflu xfd|f] df}h'bf ;+/rgfut Joj:yf, sfg'gL Joj:yfx¿ / cEof;x¿ ck|efjsf/L /x]sf sf/0f ;du| lrlsT;f lzIff If]q cGof}nk"0f{ /x]sf] s'/f ;j{ljlbt g} 5 . o:tf] cj:yfdf lrlsT;f lzIffsf If]qdf ljZj kl/j]zdf cfpg] kl/jt{g / ;d:of tyf r'gf}tLx¿nfO{ ;dfof]hg Pjd\ ;fdgf ug{ ;Sg] ;+/rgfut / sfg'gL Joj:yf ug'{ cfjZos b]lvG5 . o;} ;Gbe{df lzIf0f ;+:yfsf] :yfkgf, lzIf0f c:ktfn, PsLs[t k|j]z k/LIff, lzIf0f ;+:yf ;~rfng, cg'udg, u'0f:t/ ;'lglZrttf, k|Tofofg, cfwf/e"t kf7\oj|md k|f¿k, :gftsf]Q/ txsf] j}slNks tflnd Joj:yf, OG6g{l;k, ;+:yfut tyf lgsfout ;dGjonufotsf If]qsf] sfo{If]qut lhDd]jf/L tf]sL k|wfgdGqLsf] cWoIftfdf Ps clwsf/ ;DkGg :jfoQ lrlsT;f lzIff cfof]u u7g ug'{k5{ . ;fy} g]kfn d]l8sn sfplG;nsf] k'g;{+/rgf;d]t ug'{ h?/L 5 .

@=$ lrlsT;f lzIff ;DaGwL 5fgljg cfof]usf] k|ltj]bg, @)&@

g]kfn ;/sf/, dlGqkl/ifb\sf] ldlt @)&!÷!@÷@^ sf] lg0f{ofg';f/ lrlsT;f lzIff ;DaGwL cfzokq, lj:tfl/t sfo{j|md, of]Uotfj|mdsf cfwf/df ljBfyL{ egf{, l;6 yk36 / z'Ns ;DaGwdf lqe'jg ljZjljBfno, sf7df8f}+ ljZjljBfno / g]kfn d]l8sn sfplG;naf6 eP u/]sf sfdsf] ljifodf 5fgljg ug]{ sfo{If]q tf]lsPadf]lhd sfo{

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;DkGg ug{ k'g/fj]bg cbfnt, kf6gsf k"j{ d'VoGofofwLz >L xl/jfj' e6\6/fO{sf] cWoIftfdf 8f= xl/k|;fb nD;fn, ;x;lrj, lzIff dGqfno / 8f= u'0f/fh nf]xgL, ;x;lrj, :jf:Yo dGqfno /x]sf] tLg ;b:oLo 5fglag cfof]u ul/Psf] lyof] . o; cfof]un] lbPsf d'Vod'Vo l;kmfl/; b]xfadf]lhd 5g\ M

@=$=! cf;okq;DaGwLsn]h tyf sfo{j|md ;~rfngsf nflu k|f/lDes Pj+ dxTjk"0f{ r/0f ePsfn] cfzokq ;DaGwL Joj:yf P]gåf/f lglb{i6 ul/g'kg]{, g]kfnsf] ef}uf]lns ;Gt'ng tyf If]qut ljsf;sf] cjwf/0ffnfO{ cfTd;ft\ ug{ tyf hgzlSt k|If]k0fsf cfwf/df ljleGg ljwfsf hgzlStsf] pko'Qm ;Gt'ng /fVg lglZrt gS;fª\sgsf cfwf/df dfq cfzokq k|bfg ug]{ Joj:yf x'g'kg]{, cfzokq k|bfg ug'{ cufj} tf]lsPsf dfkb08 / cfjZos k|lqmof k"/f u/] gu/]sf] Plsg u/]/ dfq cfzokq k|bfg ul/g'kg]{ / cfzokq ;DaGwL lg0f{o eO;s]kl5 ;DaGwg kfpg] cj:yf ;d]t ;'lglZrt x'g'kg]{, d]l8sn sn]hx¿nfO{ dg;fokqsf] cjlw yk ug]{ lg0f{o ubf{ tL ;t{x¿df s] s:tf ;t{x¿ s] slt k"/f u/] gu/]sf] eGg] ;DaGwdf ljZn]if0f u/]/ dfq cf;okqsf] cjlw yk x'g] Joj:yf ul/g'kg]{ l;kmfl/; /x]sf lyP .

@=$=@ ;DaGwg ;DaGwdf;DaGwg ;DaGwL :ki6 / j:t'lgi7 Joj:yf ljZjljBfnox¿sf] P]gdf g} /flvg'kb{5 . cfjZostf ljZn]if0f, eljiosf nflu k|If]k0f / ef}uf]lns ;Gt'ngnfO{ ;d]t cfwf/ agfO{ gS;fª\sgsf cfwf/df dfq ;DaGwg lbg] Joj:yf ug'{kg]{, tf]lsPsf] k|lqmof k'¥ofO{ cfzokq kfP/ cfjZos k"jf{wf/ k"/f ul/;s]sf sn]hx¿nfO{ ;DaGwg k|bfg ug{ pko'Qm x'g], k|To]s ljZjljBfnon] ;DaGwg lbPsf sn]h / sfo{j|mdx¿sf] cfjlws cg'udg u/L ;f]sf] k|ltj]bg ;fj{hlgs ug]{ / sfof{Gjog ug]{, g]kfn d]l8sn sfplG;nn] to u/]sf] d"Nofª\sg k|ltj]bgsf cfwf/df tf]lsPsf] eGbf sd l;sfO pknlAw k|fKt ug]{ sn]hx¿sf] ;DaGwg vf/]hLsf] :ki6 Joj:yf ug'{kg]{ h:tf l;kmfl/; /x]sf lyP .

@=$=# lj:tfl/t sfo{j|md ;DaGwdfsfg'gdf tf]lsPeGbf afx]ssf] k|lqmofaf6 sfo{j|md lj:tf/ ug]{ kl/kf6LnfO{ lgoGq0f ul/g'kg]{, sfg'gdf g} ;DaGwg / lj:tfl/t sfo{j|mdsf ;DaGwdf :ki6 JofVof u/L s:tf] cj:yfdf ;DaGwg / s:tf] cj:yfdf sfo{j|md lj:tf/sf nflu cg'dlt lbg] eGg] v'nfOg' kg]{ / sf7df8f}+ ljZjljBfno ;DaGwg tyf lj:tfl/t sfo{j|md ;DaGwL lgod, @)&! df k'g/fjnf]sg ul/g'kg]{ h:tf l;kmfl/; /x]sf lyP .

@=$=$ ljBfyL{ egf{ / l;6 lgwf{/0f ;DaGwdfpknAw k"jf{wf/sf cfwf/df l;6 lgwf{/0f ug'kg]{ / l;6 lgwf{/0fsf ;Dk"0f{ k|lqmof j}1flgs tyf ljlwx¿ kf/bzL{ x'g'kg]{, lrlsT;f lzIffdf /fli6«o:t/df ;femf k|j]z k/LIffsf] Joj:yf x'g'kg]{, ljBfyL{ egf{df d]l/6 ln:6 -of]Uotfj|md_ nfO{ k|d'v cfwf/ agfO{g'kg]{, ljZjljBfnon] g} d]l/6sf cfwf/df ljBfyL{ egf{ u/]/ dftxtsf sn]hdf ljBfyL{ k7fpg] Joj:yf ug'{ pko'Qm x'g] l;kmfl/; /x]sf lyP .

@=$=% z'Ns ;DaGwdfj}1flgs dfkb08sf cfwf/df k|To]s ljZjljBfnon] g} z'Ns lgwf{/0f u/L egf{ cufj} ;f]sf] ;fj{hlgsLs/0f ug'{kg]{, ;a} txsf ;Mz'Ns k9fOg] sfo{j|mdx¿df lnOg] z'Nsx¿ jflif{s ¿kdf dfq ljBfyL{x¿af6 lnOg] Joj:yf ug]{, ljZjljBfnon] tf]lslbPsf] z'NseGbf a9L / cltl/Qm zLif{s yk]/ ;d]t z'Ns c;"n ug]{ sn]hx¿sf] k|j[lQnfO{ sf/jfxLsf] bfo/fdf Nofpg] l;kmfl/; /x]sf lyP .

@=$=^ ;+:yfut Ifdtf ljsf; / hjfkmb]lxtf k|j4{g;DaGwLljZjljBfnox¿, k|lti7fg, g]kfn d]l8sn sfplG;n / cGo ljifout sfplG;nx¿ nufotsf lgofds lgsfox¿sf] lgodg / cg'udg ug]{ Ifdtf ljsf; ug'{kg]{, cg'udg / lgodgsf ;"rs tyf dfkb08x¿ j}1flgs, :ki6, dfkgof]Uo / t'ngfof]Uo x'g'kg]{, cg'udgaf6 k|fKt k|ltj]bg tyf ;"rgfnfO{ dfq k|zf;lgs lg0f{o -cfzokq, ;DaGwg k|bfg÷yk, gjLs/0f, vf/]hL, sfo{j|md lj:tf/ cflb_ sf] cfwf/ agfOg'kg]{, k|To]s :jf:Yo lzIf0f ;+:yfn] kf/bzL{ 9ª\un] n]vfk/LIf0f tyf ;fdflhs k/LIf0f k|ltj]bg lgodgsf/L lgsfodf k]; ug'{sf] ;fy} ;DalGwt ;+:yfsf] j]a;fO6df klg lgoldt ¿kdf cBfjlws ug]{ l;kmfl/; /x]sf lyP . .

@=%= PdlalaP; / lal8P; z'Ns k'g/fjnf]sg ;ldltsf] k|ltj]bg, @)&#

PdlalaP; / lal8P; z}lIfs sfo{j|mdsf] ;Djt\ @)&# b]lv d]l8sn sn]h÷lzIf0f ;+:yfx¿n] lng kfpg] z'Ns k'g/fjnf]sg u/L /fo ;'emfj ;lxtsf] k|ltj]bg k]; ug{ g]kfn ;/sf/ dlGqkl/ifb\af6 ldlt @)&# . )# . @^ df k|f=8f= lzjs'df/ /fO{sf] ;+of]hTjdf * ;b:oLo ;ldlt u7g ul/Psf] lyof] h;n] lgDgfg';f/sf ;'emfj k]; u/]sf] lyof] M

d]l8sn sn]h÷lzIf0f ;+:yfsf lzIf0f c:ktfn sn]hsf km\ofsN6L -ljBfyL{ z'Nsaf6 tna÷eQf vfg] lSnlgsn km\ofsN6L_ x¿;d]t c:ktfn ;]jf k|bfgdf ;+nUg x'Fbf klg cfly{s ¿kdf :jlge{/ geO/x]sf] b]lvPsf] x'Fbf lzIf0f c:ktfn :jlge{/ agfpg'kg]{ -nfut k|efjsfl/tf xfl;n ug]{ p2]Zosf ;fy Joj:yfkgsf x/]s kIfdf s'zntf

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k|bz{g ug'{ h?/L x'G5 . o;f] ugf{n] Joj:yfksLo s'zntfsf] sdLsf] af]em ljBfyL{df kg]{ hf]lvdaf6 d'Qm x'g ;lsG5_ . ;fy}, d]l8sn jf 8]G6n sn]h÷k|lti7fgx¿n] ;fljssf] ef}lts ;+/rgf tyf dfgj ;+zfwgsf] clwstd\ pkof]u u/L :jf:Yo tyf lrlsT;f lzIffsf ljwfsf cGo z}lIfs sfo{j|md ;~rfngsf nflu kxn ug]{÷;~rfng ug]{ / o;sf nflu ;DaGwg lbg] ljZjljBfno tyf ;DalGwt ljifout sfplG;nx¿n] ;xof]u ug'{kg]{, ljBfyL{sf] z'Ns ef/df Go"gLs/0f ug{ tf]lsPsf] ljBfyL{ ;ª\Vofsf cfwf/df ljZjljBfno tyf g]kfn d]l8sn sfplG;naf6 lgwf{l/t dfkb08eGbf a9L /x]sf km\ofsN6L tyf cGo dfgj ;+zfwgsf] ;ª\VofnfO{ kb;f]kfg cg'¿ksf] ¿kdf sfod x'g] u/L j|mdzM Jojl:yt ug]{ .

sIff 5f]8\g] ;ª\Vofsf ljBfyL{sf] afFsL cjlwsf] /sd bfdf;fxLn] ljBfyL{nfO{ lkmtf{ ug'{kg]{ Joj:yf ;'lglZrt ug]{, z'Ns lgwf{/0fdf cGo z}lIfs sfo{j|mdx¿sf] ;d]t k|efj /xg] ePsfn] Pd=8L=, Pd=P;= h:tf z}lIfs sfo{j|mdx¿df ljBfyL{ 5gf}6, egf{ tyf z'Ns ljZjljBfno jf k|lti7fgaf6} lgwf{/0f u/L ;f] txsf] cWoogsf nflu lzIf0f ;+:yf tf]sL lbg] Joj:yf ug]{, g]kfn ;/sf/ dlGqkl/ifb\sf] @)&@ . % . #! sf] lg0f{ofg';f/ b]zsf ;a} lghL sn]hdf :gftsf]Q/ txdf xfn sf7df8f}+ ljZjljBfnon] lng] u/]sf] z'Ns ?= @# nfv tf]Sg] / ;f]jfkt ;DalGwt sn]hn] ;d'lrt lgjf{x eQf lbg'kg]{ Joj:yf u/]sf] x'Fbf :gftsf]Q/ txdf sf7df8f}+ ljZjljBfnon] cª\uLsf/ u/]sf] Joj:yf cg'¿k g} cGo ljZjljBfno tyf k|lti7fgx¿n] ug'{ u/fpg' plrt x'g] l;kmfl/; /x]sf lyP .

;Dk"0f{ d]l8sn sn]hx¿n] g]kfn ;/sf/, ljZjljBfno tyf g]kfn d]l8sn sfplG;nn] tf]s]sf] dfkb08 k"/f u/]sf] x''g'kg]{, cfufdL jif{sf] nflu g]kfn /fi6« j}+sn] jflif{s¿kdf tf]s]sf] d'b|fl:kmlt b/sf] cfwf/df z'Ns ;dfof]hg ug]{, lrlsT;f lzIff tyf ;]jf u'0f:t/Lo agfpg tf]lsPsf] z'Nsaf6 k|fKt s'n /sdsf] sDtLdf Ps k|ltzt sn]hsf km\ofsN6L tyf cg';Gwfgstf{x¿nfO{ k|lqmof k"/f u/L cg';Gwfg cg'bfg pknAw u/fpg] h:tf l;kmfl/; u/]sf] lyof] .

@=^ /fli6«o :jf:Yo gLlt, @)&!

b]xfosf :jf:Yo gLltsf d'Vo lgb]{zs l;4fGt sfod /fvL :jf:Yo If]qnfO{ Jojl:yt ug]{ k|of; ul/Psf] 5 M

gLlt !M df}lns xssf ¿kdf /x]sf] u'0f:t/Lo :jf:Yo ;]jf ;a} gful/sx¿sf] ;xh kx'Frdf k'Ug] u/L k|efjsf/L ¿kdf pknJw u/fpg] Pj+ cfwf/e"t :jf:Yo ;]jf lgz'Ns ¿kdf pknAw u/fpg] .

gLlt @M :jf:Yo ;]jfx¿ ;j{;'ne Pj+ k||efjsf/L ¿kdf

k||jfx ug{ cfjZos bIf hgzlStsf] of]hgf, pTkfbg, k||flKt, ljsf; tyf pkof]]u ug{ k|lt !) xhf/ hg;ª\Vofsf nflu Pp6f lrlsT;s;lxt @# hgf :jf:YosdL{ pknJw x'g] Joj:yf j|mdzM ;'lglZrt ul/g], b"u{d / lxdfnL If]qsf] nflu ljz]if Joj:yf ul/g] /0fgLltx¿ ckgfOg] Joj:yf /x]sf] 5 .

log} of]hgf / k|If]k0fsf cfwf/df xfd|f] :jf:Yo hgzlStsf] cfFsng ug{ ;lsG5 . ;du|df hgzlStsf] k|If]k0f d"ntM dfgj ;+;fwgsf] cfk"lt{, gjk|j]zL / ;]jfaf6 alxu{dg x'g]x¿sf] ;ª\Vofdf lge{/ x'G5 .

ljBdfg hgzlStsf] cfk"lt{ Pj+ eljiosf] cfjZostflarsf] leGgtfsf] ljZn]if0fsf cfwf/df sdLsdhf]/Lx¿nfO{ ;Daf]wg u/L ;du| :jf:Yo If]qsf nflu hgzlStsf] k|If]k0fsf] pko'Qm ;dfwfg xfl;n ug{' cfhsf] cfjZostf xf] . hgzlStsf] k|If]k0f Psftkm{ b]zsf] :jf:Yo ;]jfsf] efjL of]hgfdf e/ kb{5 eg] csf]{tkm{ oxL hgzlStsf] j}1flgs k|If]k0fkZrft\ dfq :jf:Yo ;]jfsf ljleGg cjojdf ljleGg lg0f{ox¿ lng ;lsG5, .

@= &= lrlsT;f lzIff;DaGwL hfFra'em cfof]u, @)&$

lrlsT;f lzIffsf If]qdf ljleGg clgoldtf ePsf], ljz]if u/L ;DaGwg, k|j]z k/LIff, egf{, z'Ns / u'0f:t/sf If]qdf o; k|sf/sf ;d:of /x]sf] hgu'gf;f] dWogh/ /fVb} o;sf] lg/fs/0fsf nflu g]kfn ;/sf/n] ldlt @)&$ . ! . $ df /fhkqdf ;"rgf k|sflzt u/L ljz]if cbfntsf k"j{ cWoIf >L uf}/Laxfb'/ sfsL{sf] cWoIftfdf 8f= pk]Gb| b]jsf]6f ;b:o / lzIff dGqfnosf ;x;lrj >L ;"o{k|;fb uf}td ;b:o ;lrj /x]sf] tLg ;b:oLo lrlsT;f lzIff;DaGwL hfFra'em cfof]u, @)&$ u7g u/]sf] lyof] .

o; cfof]un] ldlt @)&$ ;fn h]7 !^ ut]af6 sfo{ k|f/De u/L ldlt @)&$ ;fn df3 !( ut] tTsfnLg ;DdfggLo k|wfgdGqL >L z]/axfb'/ b]pjf ;dIf k]; u/]sf] lyof] t/ o; cfof]usf] k|ltj]bgnfO{ ;fj{hlgs ul/Pg / pSt Goflos cfof]usf nflu ePsf] vr{ / cfof]un] u/]sf] sfo{ ;b'kof]u x'g ;s]g . k|ltj]bg ;fj{hlgs gePsfn] o; cfof]un] sf/jfxL ug{sf nflu l;kmfl/; u/]sf JolStnfO{ sf/jfxL ePg . t/ o; hfFra'em cfof]un] lbPsf] sltko l;kmfl/;;d]tsf cfwf/df /fli6«o lrlsT;f lzIff;DaGwL P]g, @)&% hf/L eof] / o;} P]gsf cfwf/df lrlsT;f lzIff cfof]u u7g eO sfo{ ul//x]sf] 5 .

#= lrlsT;f lzIff ;'wf/sf nflu efjL lbzf

lrlsT;f lzIff If]qdf xfn;Dd ePsf k|of;, b]lvPsf ;d:of / ef]lug] r'gf}tL Pjd\ ;fdlos cj:yfsf] ljZn]if0f

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ubf{ ;'wf/sf nflu b]xfoadf]lhdsf ;'emfj k]; ul/Psf] 5 M

!= k|To]s jif{ d]l8sn lzIff cWofkgsf nflu ljb]l;g] ljBfyL{ ;ª\Vof / /sd, cWofkgkZrft\sf] u'0f:t/ ;'lglZrtf u/L k|To]s k|b]z ;/sf/cGtu{t /xg] d]l8sn sn]hsf] :yfkgf ug]{ . k"jf{wf/, km\ofsN6L / ;]jf If]qsf] gS;fª\sg u/]/ dfq o; k|sf/sf d]l8sn sn]h vf]Ng] .

@= d]l8sn sn]hsf] cg'udg ubf{ ljZjljBfno, :jf:Yo dGqfno, lzIff dGqfno / g]kfn d]l8sn sfplG;nsf] k|ltlglwTj x'g] u/L lj1 ;ldlt tof/ ug]{ / ;+o'St cg'udg ug]{ . cg'udgsf j|mddf d]l8sn sn]hdf kg]{ Jooef/sf af/]df k|:6 vfsf tof/ ug]{ . cg'udgstf{nfO{ s]Gb|af6} cg'udg eQf lbg] . sn]hdf s'g} cfly{s ef/ gkfg]{ .

$= ef}lts kIfdfq ;j} s'/f geO{ u'0f:t/Lo lzIff / ;]jf dxTTjk"0f{ ePsfn] xf8{j]o/eGbf ;km\6j]o/df a9L hf]8 lbg] k/Dk/fsf] yfngL h?/L 5 . o;sf nflu xfn cfwf/e"t lj1fgsf nflu tof/ ul/Psf] dfkb08 tTsfn ;+zf]wg u/L ;do;fk]If agfpg' kg]{ .

%= cg'ej / of]Uotfsf cfwf/dfq km\ofsN6L lng] ug'{k5{ . g]kfn d]l8sn sfplG;nsf] k/LIff pQL0f{ u/]sf] jf cGo s'g} k/LIff pQL0f{ u/L /lh:68{ ePsf] lrlsT;s jf JolStnfO{ km\ofsN6Ldf lng ;lsG5 t/ o;sf] cGo cfwf/ ljZjljBfnonoaf6 g} lgwf{/0f ul/g'k5{ . ;Dej eP;Dd g]kfnL km\ofsN6Laf6 g} sn]h ;~rfngsf nflu k|fyldstf lbg'kg]{{ .

^= d]l8sn sn]hn] lgo'St u/]sf pk k|wfWofks jf ;xk|Wofksdf lgo'lSt u/L :jLs[ltsf nflu ljZjljBfno jf g]kfn d]l8sn sfplG;n jf lrlsT;f lzIff cfof]udf k7fPkl5 tTsfn o;sf] lg0f{o lng'kg]{, h;n] ubf{ km\ofsN6Lsf] ;ª\Vof sd b]lvg] / sn]hnfO{ k|fKt x'g] cWofkg sf]6f 36\g] ;Defjgf sd /xG5 .

&= g]kfn d]l8sn sfplG;nn] d]l8sn sn]hsf] cg'udgsf nflu tof/ u/]sf] lgb]{lzsf jf dfkb08 ;fdlos ¿kdf lj1;Fusf] 5nkmn tyf k/fdz{af6 /fli6«o lrlsT;f lzIff cfof]un] cBfjlws ub}{ n}hfg'k5{ jf ;do;fk]If gofF lgb]{lzsf tof/ ug'{k5{ . g]kfn d]l8sn sfplG;n, ljZjljBfno, :jf:Yo dGqfno / lzIff dGqfnodf ePsf ljleGg dfkb08nfO{ PsLs[t u/L /fli6«o lrlsT;f lzIff cfof]un] Pp6} dfkb08 nfu' ug'{kg]{ .

*= o;/L k"jf{wf/ k"/f ug{ g;s]sf], cg'udgsf j|mddf lbOPsf] ;'emfj sfof{Gjogdf gNofPsf, k6sk6s u'0f:t/ / ef}lts cj:YffnfO{ lnP/ ljjfbdf k/]sf, nfdf] ;do;Dd ;~rfng x'g lbO/xFbf yk gf]S;fgL x'g] ;Defjgf /x]sf, ;fdfGo ;'wf/df ;d]t Wofg

glbPsfh:tf d]l8sn sn]h / c:ktfnnfO{ glhs}sf] d]l8sn sn]h;Fu dh{ ug{ pko'St x'g] .

(= k|efjsf/L ¿kdf rnfpg g;Sg] d]l8sn sn]h ;/sf/n] g} lsg]/ rnfpg' pko'St b]lvG5 . o;/L ;/sf/n] lsGg] ePdf k|b]z:t/df e"uf]n / hg;ª\VofnfO{ ;d]t dWogh/ /fvL ;dfg'kflts ¿kdf ;]jf k|jfx x'g] s'/fdf ljz]if ;r]ttf ckgfpg' pko'St x'g] . /fHon] tf]s]sf] lhDd]af/Laf6 klG5g] sn]h / c:ktfnnfO{ tTsfn ;/sf/Ls/0f ug'{kg]{ .

!)= k|ljlw, cf}ifwL / lj/fdL :jod\sf sf/0f c:ktfndf egf{ eO/xg] lj/fdLsf] ;ª\Vof sd x'g] ePsfn] c:ktfndf /x]sf z}øofsf] sDtLdf ^) k|ltzt pkef]u x'g'kg]{ dfkb08 Jofjxfl/s b]lvFb}g . o;nfO{ %) k|ltztdf emfg]{ jf ;fdlos agfpg' kg]{ .

!!= u|fdL0f If]qsf hgtfnfO{ ;]jf k|jfx ug{ / pTkflbt hgzlStnfO{ OG6{gl;k ug{sf nflu d]l8sn sn]hn] u|fdL0f If]qdf 7fpF7fpFdf c:ktfn vf]Ng'kg]{ k|fjwfg /fVg] tyf l;lgo/ / h'lgo/ d]l8sn clkm;/ ;Fu;Fu} /x]/ sfo{ ug]{ / l;Sg] cj;/sf] ;'lglZrtfsf nflu ;+oGq tof/ ug'{kg]{ .

!@= Pp6f sn]h jf c:ktfndf lgodfg';f/sf] ;Demf}tf u/L sfo{ ul//x]sf] JolSt jf ;+:yfn] ;Demf}tfadf]lhd ;]jf k|bfg gu/L cGo ;+:yf;Fu cfj4tf lnO sfo{ ug{ gkfOg] Joj:yf ug'{kg]{ . ;Demf}tf eª\u ePdf dfq cGoq sfd ug{ / lhDd]af/L axg ug{ kfOg] Joj:yf ug'{ pko'St x'g] .

!#= lhNnf ;b/d'sfd, ;x/el/sf jf glhs ePsf ;a} d]l8sn c:ktfnn] sDtLdf jif{sf] ! k6s ljkb\ Joj:yfkg cEof; u/L ;fdflhs bfloTj / u'0f:t/Lo ;]jf k|jfxsf] ;'lglZrtf lbg] Joj:yf ug'{kg]{ .

!$= d]l8sn sn]hn] Ps} :yfgdf dfq &)) z}ofsf] c:ktfn ;~rfng ug{'eGbf b'u{d If]qdf jf lxdfnL tyf kxf8L lhNnfdf ;d]t u'0f:t/Lo :jf:Yo ;]jfsf] ;'lglZrtfsf nflu k|To]s d]l8sn sn]hnfO{ ljBfyL{ ;ª\Vof, ef}uf]lns ;xhtf, ef}lts ;'ljwf, km\ofsN6L h:tf cfwf/ tof/ u/L sDtL # b]lv % lhNnfdf lj:tfl/t c:ktfn ;~rfng ug}{kg]{ k|fjwfg /flvg' pko'St b]lvG5 . o;sf] df]8fln6L / nfeflGjt ;/f]sf/jfnfsf] ljZn]if0f u/]/ of] k|lj|mof ;~rfng ug'{ pko'St x'g] .

!%= ;dfj]zLs/0fn] u'0f:t/Lotf dfly k|Zg lrGx v8f ug]{ ePsfn] k|fljlws lzIff, d'VotM d]l8sn lzIffdf tTsfn ;dfj]zLs/0fsf cfwf/df sf]6f lgwf{/0f k|lj|mof aGb ug'{kg]{ .

!^= ljZjljBfno tyf ;/sf/n] tf]s]sf] ;j} Kf|sf/sf] z'Ns a}+sdfkm{t dfq a'emfpg] / a'em\g] Joj:yf ug'{ pko'St

- 71 -

x'g] .!&= ljb]zL km\ofsN6Lx¿nfO{ g]kfnsf d]l8sn sn]hdf

sfo{ lhDd]af/L lbFbf k|To]s jif{ km\ofsN6L gjLs/0f ug'{kg]{ k|fjwfg Jofjxfl/s gx'g] x'Fbf k|To]s tLg tLg jif{df lrlsT;f lzIff cfof]udfkm{t km\ofsN6Lsf] gjLs/0f ug{] k|fjwfg /fVg' pko'St x'g] .

!*= d]l8sn sn]h jf ljZjljBfnonfO{ lgb]{zg lbg;Sg] Psdfq ;+:yf lhDd]af/ x'g'kg]{ . ljleGg txaf6 x'g] lgb]{zgn] sn]h jf ljZjljBfnonfO{ cGof}ntf l;h{gf ug]{ u/]sf] 5 . ca pk|fGt lrlsT;f lzIff cfof]unfO{ dfq lhDd]af/ agfOg' pko'St x'g] .

!(= d]l8sn sn]hx¿nfO{ ;;t{ l;6 lgwf{/0f / sfo{j|md yk ug{ cg'dlt lbg] k/Dk/fsf] cGTo ul/g'kg]{ . d]l8sn sn]hdf sf]6f lgwf{/0fsf nflu cfjZos dfkb08 tof/ u/L nfu' ug'{kg]{ . dfkb08 cf}ifwL / k|ljlwsf] ljsf;;Fu d]n vfg] u/L k|To]s jif{ kl/jt{g ug{ ;lsg] x'g'kg]{ .

@)= d]l8sn sn]hx¿n] cfkm\gf] k|b]zleqsf kfos kg]{ lhNnfsf dfkb08 k"/f u/]sf ;/sf/L c:ktfn tyf k|fOe]6 c:ktfn;Fu ;xsfo{ u/L lnh, kf6g{l;k jf s/f/ ;Demf}tfdfkm{t bIf hgzlStaf6 :jf:Yo ;]jf k|jfx ug'{sf ;fy} d]l8sn lzIffsf nflu OG6g{l;k ug]{ Joj:yf ldnfpg pko'St x'g] . o;sf nflu d'VotM u|fdL0f e]unfO{ ;Daf]wg ug]{ u/L k|fyldstfdf lng'kg]{ .

@!= d]l8sn sn]h / o;sf] s]Gb|Lo c:ktfnlarsf] b"/L a9Ldf & ls=ld= jf cg';Gwfg u/L pko'Sttfsf cfwf/df ;~rfng ug{ kfpg] u/L dfkb08df ;'wf/ ul/g'kg]{ . sn]h / ljBfyL{ cfjf; larsf] b'/L a9Ldf @ ls=ld= eGbf a9L x'g gx'g] .

@@= PdlalaP; / lal8P; -:gfts_ txsf] k|j]z k/LIffsf nflu PsLs[t k|j]z k/LIffsf] Joj:yf ug'{kg]{ / sDtLdf pQL0ffª\s ̂ ) k|ltzt tf]Sg pko'St x'g] . o;sf nflu PsLs[t z}lIfs Sofn]G8/ tof/ u/L nfu' ug'{ pko'St x'g] .

@#= k"FhL ljb]lzPsf] tYonfO{ dWogh/ u/L km\ofsN6L, ef}lts k"jf{wf/ nufotsf tf]lsPsf dfkb08adf]lhd ;~rfngdf /x]sf d]l8sn sn]hx¿df k"jf{wf/sf] pRrtd k|of]u u/L bIf hgzlSt pTkfbg ug]{ clek|fon] x/]s ljZjljBfnon] k|To]s jif{ b'O{ ;];gdf sIff ;~rfng ug]{ Joj:yf ug]{ / To;/L ;~rffng ubf{ k|To]s ;];gdf a9Ldf &%÷&% ljBfyL{ egf{ ug{ ;Sg] u/L k|aGw ug'{ pko'St x'g] . o;sf nflu ef}lts k"jf{wf/, km\ofsN6L, nfOj|]/L, l;k k/LIf0f Nofah:tf If]qdf ljz]if ;ts{tf ckgfpg' pko'St x'g] .

@$= ;/sf/, lrlsT;f lzIff cfof]u / ljZjljBfnosf]

lgb]{zg cj1f u/L a9L l;6df egf{ ug]{, a9L z'Ns lng] / u'0f:t/df Wofg glbg] d]l8sn sn]hx¿nfO{ ljZjljBfnon] klxnf] jif{ eP egf{ :yug ug]{, bf];|f] jif{;d]t c6]/ u/] ;DaGwg lgnDag ug]{ / t];|f] jif{ cj1f u/] ;DaGwg vf/]h ug]{ ;Ddsf] sfg'gL Joj:yf u/L sf/jfxL ug{ pko'St x'g] .

@%= lrlsT;f lzIff cfof]un] ;d;fdlos dfkb08 agfO{ ;f]sf cfwf/df ;j} d]l8sn sn]hsf] l;6 lgwf{/0f ug]{ / PsLs[t k|j]z k/LIffsf cfwf/df egf{ ug]{ k|lj|mof cjnDag ug'{kg]{ .

@^= ;do;fk]If l;k l;sfpgsf nflu d]l8sn sn]hsf NofanfO{ k|To]s jif{ :t/f]Gglt ug'{k5{ . k|flS6snsf nflu nf;sf] Joj:yfkg ug{sf nflu k|b]z:t/sf ;/sf/L c:ktfnaf6} d]l8sn sn]hn] n}hfg ;Sg] Joj:yf ug'{kg]{ . j]jfl/;] / :j]R5fn] bfg lbPsf nf;nfO{ ;'ky d"Nodf k|fKt x'g] Joj:yf x''g'k5{ / ;Dej eP;Dd w]/} nf;df ljBfyL{n] k|flS6sn ug{ kfpg] Joj:yf x'g'kg]{ .

@&= xfn ;~rfngdf /x]sf d]l8sn sn]h / :jf:Yo k|lti7fgnfO{ k|b]z ljZjljBfnodf ¿kfGt/0f ug{sf nflu cfjZos cg';Gwfg u/L k|lj|mof cufl8 a9fpg'k5{ . o;/L k|b]z :t/df ljZjljBfno vf]Ngsf nflu ;DalGwt k|b]z ;/sf/n] g} lhDd]jf/L lng] Joj:yf ug'{k5{ . ;~rflnt d]l8sn sn]hnfO{ ljZjljBfnodf :t/f]Gglt ug{;Sg] ;Defjgf /x]df To:tf sn]hnfO{ k|b]z ;/sf/n] lsGg] jf ;xsfo{df ;~rfng ug{ ;Sg] df]8fln6L tof/ ug'{kg]{ .

@*= ev{/} :yfkgf ePsf] lrlsT;f lzIff cfof]unfO{ k"0f{tf lbg' h?/L x'g] . kbflwsf/Lsf] k"0f{tf;Fu} cfof]unfO{ cfjZos kg]{ sd{rf/Lsf] b/aGbLsf] :jLs[lt, sfo{ ljj/0f, sd{rf/Lsf] Ifdtf ljsf;, cfjZos ef}lts ;'wf/ tTsfn ug'{kg]{ b]lvg] . csf]{ Joj:yf gePsf;Ddsf nflu c:yfoL b/aGbL l;h{gf u/L sd{rf/L Joj:yfkg u/] tfklg o;nfO{ nfdf];do;Dd /fVg' pko'St x'Fb}g .

;Gbe{ ;fdu|L

lr=lz=cf= -@)&^_, lrlsT;f lzIff;DaGwL ;|f]t ;fdu|L, ;fgf]l7dL, eStk'/ M lrlsT;f lzIff cfof]ulr=lz=cf= -@)&^_, lrlsT;f lzIff cfof]usf] jflif{s k|ltj]bg, @)&% . @)&^, ;fgf]l7dL, eStk'/ M lrlsT;f lzIff cfof]ug]kfn ;/sf/ -@)^*_ g]kfnsf d]l8sn sn]hx¿sf] z'Ns, ;DaGwg / u'0f:t/sf ;DaGwdf ;dLIff / k'g/fjnf]sg ug{ ul7t ;ldltsf] k|ltj]bg, @)^* M lzIff dGqfnog]kfn ;/sf/ -@)&!_, d]l8sn sn]h tyf pRr:t/Lo

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/fli6«o dfkb08 l;kmfl/; ;ldltsf] k|ltj]bg, @)&! M lzIff dGqfnog]kfn ;sf/ -@)&!_, /fli6«o :jf:Yo gLlt, @)&!M :jf:Yo dGqfnog]kfn ;/sf/ -@)&@_, lrlsT;f lzIff;DaGwL /fli6«o gLlt th'{df pRr:t/Lo sfo{bnsf] k|ltj]bg, @)&@ M lzIff dGqfno

g]kfn ;/sf/ -@)&@_, lrlsT;f lzIff ;DaGwL 5fgljg cfof]usf] k|ltj]bg, @)&@ M lzIff dGqfnog]kfn ;/sf/ -@)&!_, PdlalaP; / lal8P; z'Ns k'g/fjnf]sg ;ldltsf] k|ltj]bg, @)&# M lzIff dGqfnog]kfn ;/sf/ -@)&$_, lrlsT;f lzIff;DaGwL hfFra'em cfof]u, @)&$ -k|]; aStJosf cfwf/df_-ck|sflzt_

-n]vs sf7df8f}+ dxfgu/kflnsfsf lzIff clwsf/L x'g\ . o; n]vdf k|:t't ljrf/ n]vssf lghL x'g\, o;n] n]vs sfo{/t ;+:yfsf] cflwsfl/s k|ltlglwTj ub}{g ._

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u'0f:t/Lo lrlsT;f lzIffsf s]xL cEof; / casf] uGtJo

lji0f'k|;fb clwsf/L

!= u'0f:t/sf] kl/ro

u'0f:t/nfO{ ;fdfGotof u'0fsf] ;"rs jf dfkb08sf] cj:yf jf u'0fsf] :t/sf ¿kdf lng] ul/G5 . s'g} j:t' jf ;]jfdf ck]lIft u'0fsf] dfqf jf kl/df0fnfO{ u'0f:t/ eGg ;lsG5 . o;n] j:t' jf ;]jfdf tf]lsPsf] dfkb08 jf :t/nfO{ ;ª\s]t ub{5 . h:t} pkef]Stfsf b[li6n] o;nfO{ j:t' jf ;]jf k|bfosn] cfk"lt{ u/]sf] j:t' jf ;]jfsf] k|ToIf / ck|ToIf d"Nok|lt ;]jfu|fxL jf pkef]Qmfsf] ;Gt'li6sf] cj:yfsf ¿kdf klg lng ;lsG5 . cem csf]{ zAbdf eGg'kbf{ 3f]lift jf cGt/lglxt cfjZostf k"/f ug]{ OR5f, OR5fsf] kl/k"lt{ / ;Gt'li6sf] dfqfsf] n]vfhf]vf ug]{ lg/Gt/ k|lqmofsf ¿kdf u'0f:t/nfO{ lng] ul/G5 . o;/L u'0f:t/n] s'g} j:t' jf ;]jfn] ;]jfu|fxL jf pkef]Stfsf] cfjZostf k"/f ug]{ Ifdtf jf u'0fsf] cj:yfnfO{ klg a'emfpF5 .

;fdfGotof u'0f:t/nfO{ lglZrt cfwf/, dfk808, ;"rs cflbsf dfWodaf6 JoSt ug]{ u/]sf] kfOG5 . h:t} cª\u]hLsf criteria, standard, indicator, yardsticks cflb zAbåf/f klg u'0f:t/nfO{ JoSt ug]{ u/]sf] kfOG5 . cfwf/ (criteria) sf] zflAbs cy{ s'g} j:t' /xg] jf c8\g] 7fpF, hu, 6]sf] jf s'g} s'/fnfO{ cWoog ug]{ b[li6sf]0f, l;4fGt jf dfkb08 pNn]v u/]sf] kfOG5 . dfkb08 (standard) sf] zflAbs cy{ gfks, gfKg] sfd, gfkf] jf gfKg] tf}ng] ;fwg, u'0f:t/ lgwf{/0f ug]{ ;fwg, lgwf{/s, t'ngf cfwf/ eGg] pNn]v kfOG5 . To:t} ;"rs (indicator) sf] zlAbs cy{ ;"rgf lbg], ;ª\s]t ug]{ ;"rs, ;ª\s]ts eGg] pNn]v u/]sf] kfOG5 . dfks (yardsticks) n] klg s'g} j:t' gfKg] Ps k|sf/sf] dfkb08, lkmtf jf 6]k eGg] a'emfpF5 .

s:tf] lrlsT;f lzIffnfO{ u'0f:t/Lo lrlsT;f lzIff eGg] s'/f lglZrt ug{ lglZrt dfkb08 / ;"rsnfO{ cfwf/ dfGg] ul/G5 . cyf{t\ u'0f:t/Lo lrlsT;f lzIff eGgsf nflu s]]s] dfgs, cfwf/ jf dfkb08 k"/f x'g'k5{ eGg] s'/f olsg ePkl5 dfq u'0f:t/Lo lrlsT;f lzIffnfO{ kl/eflift ug{ ;lsg] x'G5 .

:jf:Yo If]qdf u'0f:t/n] :jf:Yo ;]jf k|jfx ug]{ hgzlQm, pks/0f, cf}ifwL tyf :j:y jftfj/0f nufot :jf:Yo ;]jf k|jfxdf u'0f:t/LotfnfO{ ;ª\s]]t u5{ . bIf / k];fut ¿kdf OdfGbf/ lrlsT;s / :jf:YosdL{, u'0f:t/Lo :jf:Yo pks/0f / cf}ifwLsf ;fy} ;]jfsf] ;xh / ;j{;'ne pknAwtf h:tf kIf cfslif{t x'G5g\ . lrlsT;f lzIff k|bfg ug]{ ;+:yf /

hgzlQm u'0f:t/Lo ePdf dfq pTkflbt hgzlQm u'0f:t/Lo x'g], u'0f:t/Lo nufgL tyf u'0f:t/Lo z}lIfs k|lqmof cflb o; u'0f:t/Lo :jf:Yo lzIff;Fu ;DjlGwt kIf x'g\ eGg ;lsg] eP klg logsf] u'0f:t/Lotfsf] Plsg dfkb08 jf ;"rs s] x'g] eGg] :ki6 x'g h?/L x'G5 .

o;/L x]bf{ u'0f:t/ eg]sf] ax'kIfLo / d"No (Value) df cfwfl/t ;fk]lIft cjwf/0ff xf] . j:t' jf ;]jfdf x'g] ;jf]{Rrtf (Excellence) / pRr :t/Lotf (High standard) nfO{ u'0f:t/ dflgG5 . To:t} nfut k|ltkmnsf b[li6n] u'0f:t/ pTkfbgsf] cfGtl/s k|efjsfl/tf / pknlAwsf] ;dli6¿k xf] . cyf{t\ nufgL, k|lqmof, pTkfbg tyf k|ltkmnsf] ;dli6 ¿k u'0f:t/ xf] . ;f/f+zdf eGg' kbf{ u'0f:t/ eg]sf] ck]Iff / ;Gt'li6larsf] b'/L gfKg] cfwf/ klg xf] . j:t' jf ;]jf hlt u'0f:t/Lo x'G5, Tolt g} ck]Iff / ;Gt'li6larsf] b'/L sd x'Fb} hfG5 . To;}n] pkef]Stf / ;Gt'li6 tyf ;]jf jf j:t'sf] u'0f:t/lar cGof]Gofl>t ;DaGw /x]sf] x'G5 .

@= lrlsT;f lzIff / u'0f:t/

u'0f:t/Lo lrlsT;f lzIff s] xf] eGg] ;DaGwdf dfly plNNflvt u'0f:t/sf] cjwf/0ffn] klg s]xL cfwf/ k|bfg ub{5 . lrlsT;f lzIffsf] u'0fsf] ;"rs jf dfkb08sf] cj:yf jf :t/ klg lrlsT;f lzIffsf] u'0f:t/ gfKg] cfwf/ x'g ;S5 . cyf{t\ lrlsT;f lzIffaf6 ck]lIft u'0fsf] dfqf jf kl/df0fnfO{ lrlsT;f lzIffsf] u'0f:t/ dflgG5 . To:t} JolSt, ;d'bfo / /fi6«sf] :jf:Yo cfjZostf k"\/f ug]{ Ifdtf jf u'0fsf] cj:yf lrlsT;f lzIffsf] Ps dxTjk"0f{ kIf x'g ;S5 . o;sf nflu lrlsT;f lzIffdf ul/Psf] nufgL / pTkfbg Pjd\ k|ltkmn k|flKtsf] cj:yf / ;Gt'li6sf] txnfO{ klg u'0f:t/Lo lrlsT;f lzIffsf] Ps cfwf/sf ¿kdf lng ;lsG5 . o; ;Gbe{df lrlsT;f lzIffsf] cfGtl/s ;Ifdtf, nfut k|efjsfl/tf / pknlAwsf] :t/n] lrlsT;f lzIffsf] u'0fsf] cj:yfnfO{ k|ltlglwTj ub{{5 .

lrlsT;f lzIffsf] u'0fsf] ;"rs jf dfkb08sf] cj:yf jf :t/ lrlsT;f lzIffsf] u'0f:t/ gfKg] cfwf/ s] x'g\ eGg] af/]df g]kfnL kl/j]zdf lglZrt dfkb08 tf]lsPsf] kfOFb}g . cyf{t\ lrlsT;f lzIffaf6 ck]lIft u'0fsf] dfqf jf kl/df0f Pjd\ JolSt, ;d'bfo / /fi6«sf] cfjZostf k"\/f ug]{ Ifdtf jf u'0fsf] cj:yf jf lrlsT;f lzIffdf ul/Psf] nufgL / pTkfbg Pjd\ k|ltkmn k|flKtsf] cj:yf / ;Gt'li6sf]

pk;lrj, lrlsT;f lzIff cfof]u

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tx, lrlsT;f lzIffsf] cfGtl/s ;Ifdtf, k|efjsfl/tf / pknlAwsf] :t/ cflb dWo] s]sf cfwf/df lrlsT;f lzIffsf] u'0fsf] cj:yf s:tf] x'g] cyf{t\ ;du|df s:tf] lrlsT;f lzIffnfO{ u'0f:t/Lo eGg] af/]df ljleGg ljåfg\ tyf ljZn]ifssf dtdf ljljwtf kfOG5 .

g]kfndf xfn;Dd u'0f:t/Lo lrlsT;f lzIffsf] :ki6 kl/efiff x'g ;s]sf]] kfOFb}g . lrlsT;f lzIff ;DaGwL s]xL gLlt tyf sfo{qmdx¿n] lglb{i6 u/]sf lrlsT;f lzIffsf s]xL dfksnfO{ cfwf/ dfGg ;lsG5 . o:tf ;"rsn] lrlsT;f lzIff k|0ffnLsf] cfGtl/s / jfx\o ;Ifdtf, kx'Fr, ;dtf / ;dfgtf ;+:yfut Ifdtf cflbnfO{ lglb{i6 ug{ ;S5g\ . ljBfyL{sf] ;du| l;sfO pknlJwsf] cj:yf / sfo{If]qdf To;nfO{ ?kfGt/0f h:tf cfwf/nfO{ klg lrlsT;f lzIffsf] u'0f:t/sf ;"rssf ¿kdf lng ;lsG5 . t/ ;fwf/0f lzIffsf] z}lIfs u'0f:t/ / k|fljlws :j:Yo lzIffsf] u'0f:t/lar kSs} km/s dfkb08 cjnlDat x'G5g\ . h:tf] ;fwf/0f lzIffdf pQL0f{ cg'QL0f{ / k|fKtfª\s jf k|fKt u|]8nfO{ klg pknlJwsf ¿kdf lng ;lsPnf t/ :jf:Yo h:tf] If]qdf l8lehg jf u|]8eGbf klg ;Ifdtf jf 1fg l;knfO{ Jojxf/df ptfg]{ ;Ifdtf s:tf] 5 eGg] s'/fn] :jf:Yo lzIffsf] u'0f:t/ k|efljt ug]{ x'G5 . 7'nf ck/];g jf lr/kmf/ h:tf ;Ifddtfsf ljifo k/LIffsf] cª\sg jf k|fKtfª\s;Fu t'ngf ug{ ldNb}g . h:tf] kfOn6n] &).*) k|ltzt hfg]/ geP h:t} lrlsT;s h:tf k|fljlwsn] klg ;t k|ltzt g} hfGg'kg]{ x'G5 ls x'Fb}g . gq dfgjLo hLjgdf To;sf] s:tf] c;/ k|efj k5{ eGg] dt klg plQs} dxTjk"0f{ 5 .

o; ;Gbe{df u'0f:t/Lo lrlsT;f lzIffsf lglZrt cfwf/, dfkb08 / ;"rs lglbi6 x'g g;Sbf;Dd s:tf] lrlsT;f lzIff jf s'g k|sf/sf] lrlsT;f lzIff, s'g z}lIfs ;+:yfsf] lrlsT;f lzIff u'0f:t/Lo xf] eGg ;lsg] Plsg cj:yf /xGg xf]nf . t;y{ lrlsT;f lzIff u'0f:t/Lo dfGg] cfwf/x¿ s]s] x'g ;S5g\ < u'0f:t/Lo lrlsT;f lzIff eGgsf nflu s]]s] cfwf/ jf dfkb08 k"/f x'g'k5{ eGg] s'/f Plsg ug'{ cfhsf] Ps dxTjk"0f{ / h?/L cfjZostf x'g uPsf] 5 .

#= u'0f:t/Lo lzIffsf ;DaGwdf k|rlnt s]xL cfwf/x¿

;fwf/0f lzIff / lrlsT;f lzIffsf 1fg l;k k|bfg ug]{ dfWod jf k|lqmofsf b[li6n] s]xL Go"gtd xb;Dd p:t} s'/fx¿ ldNg] ePsfn] ;fwf/0f lzIffsf ;Gbe{df lbOPsf u'0f:t/Lo lzIffsf dfkb08 jf cfwf/ pNn]v ug{ ;fGble{s x'Fbf oxfF k|rlnt ;fwf/0f lzIffsf s]xL dfgs jf cfwf/ k|:t't ul/Psf] 5 . oL cfwf/n] lrlsT;f lzIffsf dfkb08 jf cfwf/ vf]hLdf s]xL k[i7e"ld k|bfg ug]{ ePsfn] ;f] ;DaGwdf k|:t't ug]{ hdsf]{ ul/Psf] 5 .

s:tf] lzIffnfO{ u'0f:t/Lo lzIff eGg] af/]df ljleGg ;ª\3 ;+:yf, ljåfg\ tyf ljZn]ifssf dtdf ljljwtf kfOg] ub{5 . lrlsT;f lzIff klg Ps k|sf/sf] lzIff g} ePsfn] o; ;Gbe{df ljleGg ;ª\3 ;+:yf tyf ljåfg\x¿n] u'0f:t/Lo lzIffsf ljleGg dfkb08 / ;"rs pNn]v u/]sf] ;Gbe{df s]xL xb;Dd oL cfwf/n] lrlsT;f lzIff;Fu ;DaGw /fVg] x'gfn] oxfF pNn]v ug]{ k|of; ul/Psf] 5 .

#=! cGt/f{li6«o cEof;x¿

-s_ o'lg;]kmn] lzIffsf] u'0f:t/ lgwf{/0f ug]{ ^ cf]6f cfofd k|:t't u/]sf] 5 M!= u'0f:t/Lo ljBfyL{ (Quality Learner)@= u'0f:t/Lo jftfj/0f (Quality Environment)#= u'0f:t/Lo ljifoj:t' (Quality Content)$= u'0f:t/Lo k|lqmof (Quality Process)%= u'0f:t/Lo k|ltkmn (Quality Outcomes)^= u'0f:t/Lotf / pQ/bfloTjk"0f{ (Quality and

Responsiveness)

-v_ ;a}sf nflu lzIff (EFA) 8sf/ sfo{9fFrf / ;x;|fAbL ljsf; nIon] klg u'0f:t/Lo lzIffsf af/]df pNn]v u/]sf] kfOG5 . ;a}sf nflu lzIff (EFA) sf] b:tfj]hn] lgDg lnlvt cj:yfsf] k|Tofe"lt ePdf u'0f:t/Lo lzIff x'g] s'/f pNn]v u/]sf] 5 M

� lzIffsf lglb{i6 nIo, p2]Zo tyf l;sfO pknlAw xfl;n ePsf] x'g'kg]{

� ljBfyL{n] ck]lIft l;sfO pknlAw / bIftf k|fKt u/]sf] x'g'kg]{

� xfl;n ul/Psf l;sfO pknlAwx¿ dfkgof]Uo x'g'kg]{

-u_ UNESCO (1996) sf cg';f/ u'0f:t/Lo lzIff x'gsf nflu lgDg cjwf/0ff cufl8 ;f/]sf] 5 M � Learning to know -hfGgsf nflu l;sfO_ � Learning to do -ug{sf nflu l;sfO_ � Learning to be -JolStsf] ;du| ;Ifdtf ljsf;sf

nflu l;sfO_ � Learning to live together -;Fu} a:g ÷ afFRgsf

nflu l;sfO_

-3_ Morgan and Murgatrayd (1997) n] u'0f:t/ lgwf{/0fsf nflu lgDg tTjx¿nfO{ cfwf/ dfg]sf 5g\ M!= pTkfbgdf cfwfl/t tTj (Product based)M

lzIffsf] pTkfbg s:tf] /xof] eg]/ x]g]{ . lzIffn] /fd|f] pTkfbg u¥of] eg] Tof] u'0f:t/Lo xf] .

@= k|ltkmndf cfwfl/t tTj (Manufacture based)M tf]lsPsf] l;sfO pknlAw jf :t/ / dfqf k|fKt ePdf u'0f:t/Lo x'g] .

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#= ;]jfu|fxLdf cfwfl/t tTj (Customer/ User based)M lzIffsf] pTkfbgaf6 u|fxs ;Gt'i6 x'g'k5{ . ljBfyL{, cleefjs / ahf/sf] dfu k"/f x'g'k5{ .

$= d"Nodf cfwfl/t tTj (Value based)M nIo / p2]Zo kl/k"lt{ ug{ ;Sg' u'0f:t/Lo lzIffsf] Pp6f cfwf/ xf] .

o;/L ;fdfGotof sfd nfUg], hLjgf]kof]uL, JolSt, ;dfh / /fi6«sf ck]Iff k"/f ug]{, dfgj hLjgnfO{ u'0f:t/Lo agfpg] lzIffnfO{ u'0f:t/Lo lzIff dfGg] u/]sf] kfOG5 . ;+;f/e/ ljSg ;Sg], dfgjLo d"No, dfGotf / g}ltstf, dfgj clwsf/k|lt ;r]t, ;dfnf]rgfTds lrGtg / ;f]rfO ePsf], cfw'lgs k|ljlwo'St k|fljlws tyf Jofj;flos vfnsf] lzIffnfO{ u'0f:t/Lo lrlsT;f lzIff dfGg] u/]sf] kfOG5 .

#=@ g]kfnsf /fli6«o cEof;x¿

-s_ ljleGg cfof]u, ;ldltsf k|ltj]bgx¿df ePsf] Joj:yf/fli6«o lzIff cfof]usf] k|ltj]bg, @)$( n] lzIffsf] u'0f:t/sf] ljsf; x'g g;Sg'sf sf/0fx¿sf] ljZn]if0f ub}{ lzIff ljsf;sf nflu lzIffsf] u'0f:t/ ;+jw{g ug]{ !* cf]6f gLlt ;d]t l;kmfl/; u/]sf] 5 . k|ltj]bgn] lzIffsf] u'0f:t/ x]g]{ s]xL d'Vo cfwf/nfO{ lgDgfg';f/ lnPsf] b]lvG5 M

� lzIffdf cj;/ / ;xeflutf � z}lIfs k|0ffnLsf] cfGtl/s Ifdtf � lzIffsf] ;fGble{stf / u'0f:t/ � kf7\oqmd, kf7\ok':ts / kf7\o;fdu|L � lzIfssf] tof/L / tflnd � lzIf0f l;sfOsf] cj:yf � z}lIfs Joj:yfkg � cfly{s Ifdtf

-v_ ;a}sf nflu lzIff sfo{qmd (EFA) / ljBfno If]q ;'wf/ sfo{qmd (SSRP)u'0f:t/Lo lzIffsf s]xL ;"rsx¿!= lzIffsf] ;/b/ / v'b egf{ b/@= lzIffdf ;/b/ /fli6«o pTkfbg (GNP) sf] vr{

k|ltzt#= ah]6df lzIffsf] vr{ k|ltzt$= tflnd / of]Uotf k'u]sf lzIfssf] k|ltzt%= lzIfs–ljBfyL{ cg'kft^= sIff bf]xf]¥ofpg] b/ / l6sfp b/&= ;Ifdtf (coefficient of efficiency)*= l;sfO pknlAw k|ltzt(= ;fIf/tf n}+lus ;dtf ;"rsfª\s cflb

-u_ dfWolds lzIff ;xof]u sfo{qmd (SESP)!= /fli6«o, If]qLo Pjd\ :yfgLo cfjZostf cg's"nsf]

kf7\oqmd@= of]Uo lzIfs / ltgsf] k|efjsf/L pkof]u#= u'0f:t/Lo kf7\o;fdu|Lx¿sf] pknAwtf$= k|efjsf/L ljBfno Joj:yfkg

-3_ /fli6«o kf7\oj|md k|f¿kljBfno lzIffsf nflu /fli6«o kf7\oj|md k|f¿k -;+zf]wg @)&! ;lxt_, @)^# n] z}lIfs u'0f:t/ ck]lIft ¿kdf sfod x'g g;Sg'sf k5fl8 d'n'ssf] /fhgLlts, cfly{s jf ;fdflhs, ;f+:s[lts cflb w]/} kIf lhDd]jf/ eP klg d"ntM z}lIfs kIfsf ¿kdf kf7\oj|md, lzIfs ljsf; / Joj:yfkg, lzIf0f l;sfO lj|mofsnfk / d"Nofª\sg h:tf kIfnfO{ lhDd]jf/ b]vfPsf] 5 . lzIffsf cGo kIf / txdf u'0f:t/ / ;fGble{stf ljsf; ug{ kf7\oj|md, d"Nofª\sg, lghL If]q;Fu k|lt:kwf{, lzIfs Joj:yfkg, ljBfno jftfj/0f ;'wf/, cg'udg, d"Nofª\sg tyf ;'kl/j]If0fsf kIfx¿nfO{ cGt/ ;DalGwt d'2fsf ¿kdf cª\uLsf/ u/L ;Daf]wg ug'{kg]{ s'/fdf hf]8 lbPsf] 5 . pko'{St ;d:ofnfO{ b[li6ut ub}{ ljBfno lzIffsf] u'0f:t/ / dfgs lgwf{/0fsf nflu b]xfosf gLltut Joj:yf u/]sf] 5 M

� ljBfno lzIffsf] u'0f:t/ sfod u/L :t/Lo hgzlSt pTkfbg ug{ ljBfno lzIffsf] /fli6«o u'0f:t/ dfgs (quality standard) tof/ ug]{

� /fli6«o u'0f:t/ dfgssf cfwf/df If]q, lhNnf tyf ljBfnosf] cf–cfˆgf] u'0f:t/ dfks (quality benchmark) to u/L ;Da4 ultljlw :jtGq ¿kdf ;~rfng ug]{

� kf7\oj|md / kf7\o;fdu|Lsf] u'0f:t/ dfkb08 tof/L ug]{, cflb .

/fli6«o kf7\oj|md k|f¿k, @)&^ n] z}lIfs u'0f:t/ ;DaGwdf u/]sf] Joj:yf � /fli6«o tyf cGt/f{li6«o cg'ej tyf cEof;;d]tsf cfwf/df ljBfno lzIff;DaGwL /fli6«o u'0f:t/ dfgs tyf dfkb08 lgwf{/0f ul/g] 5 . /fli6«o kf7\oj|md vfsfadf]lhd kf7\oj|md tyf kf7\o;fdu|L, l;sfO ;xhLs/0f, lzIfssf] of]Uotf tyf ;Ifdtf, sIffsf]7f Joj:yfkg / d"Nofª\sg;DaGwL dfkb08 ljsf; u/L sfof{Gjogdf NofOg] 5 .

� ljBfno lzIffsf] u'0f:t/ sfod u/L ;Ifd hgzlSt pTkfbg ug{ ljBfno lzIffsf] /fli6«o u'0f:t/ dfgs (quality standard) tof/ ul/g] 5 .

� ljBfno lzIffsf] u'0f:t/ lgwf{/0f ug{ sIff * df :yfgLo tx:t/Lo, !) df k|b]z:t/Lo / !! tyf !@ df /fli6«o:t/df ;fj{hlgs k/LIff ;~rfng u/L k|fKt

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glthfsf cfwf/df lzIfs / ljBfnonfO{ k|f]T;fxg ug]{ Joj:yf ul/g] 5 .

� /fli6«o u'0f:t/ dfgssf cfwf/df k|b]z, :yfgLo tx tyf ljBfnon] cfcfkm\gf] z}lIfs u'0f:t/ dfgs (quality benchmark) to u/L kf7\oj|md tyf kf7\oj|md;Da4 ultljlwx¿ :jtGq ¿kdf ;~rfng ug{ ;Sg] 5g\ . u'0f:t/ dfgssf cfwf/df ljBfnonfO{ yk ;xof]u sfo{j|md ;~rfng ul/g] 5 . ;fy} ljBfno :jod\nfO{ klg o;sf nflu a9L lhDd]jf/ agfOg] 5 .

o;} u/L ljBfno If]q ljsf; of]hgf (SSDP) sf] s]Gb|Lotf Quality environment, Quality learning & Quality teaching df /x]sf] b]lvG5 . dfly plNnlvt ljleGg b:tfa]h;d]tsf cfwf/df x]bf{ ;du|df g]kfnsf] lzIffsf] u'0f:t/ x]g]{ dfkb08 / ;"rsnfO{ PsLs[t ubf{ cj;/ / kx'Fr, ;dtf÷;dfgtf / clwsf/df cfwfl/t lzIff, ;fGble{stf / hLjgf]kof]uL lzIff, :yfgLo 1fg, l;k, d"No dfGotfsf] k|j{wg, cfGtl/s / jfx\o ;Ifdtf, k|efjsfl/tfsf ;fy cGt//fli6«o kl/j]zdf k|lt:kwf{ ug{ ;Sg] hgzlSt pTkfbg h:tf kIfdf hf]8 lbPsf] b]lvG5 . To:t} u'0f:t/Lo pTkfbg, nufgL, k|lqmof, pTkfbg / k|ltkmnsf ;fy} ;fdflhs, cfly{s ¿kfGt/0f, ;dfj]zLs/0f ÷ ;fdflhs ;dfxLs/0f, ;/f]sf/jfnfsf] pRr ;Gt'li6, s'n ah]6 / k|ltJolSt u|fx{:y pTkfbgsf] lzIffdf nufgL k|ltzt Pjd\ cGt/fli6«os/0f, /fli6«os/0f / :yfgLos/0fsf] ldngljGb'nfO{ klg lzIffsf] u'0f:t/ x]g]{ dfkb08 / ;"rssf ¿kdf lnPsf] b]lvG5 .

;fdfGo r:dfsf] cfFvfn] x]bf{ lrlsT;f If]qsf dfkb08 / ;"rssf ¿kdf d"ntM u'0f:t/Lo ljBfyL{ -:j:y ;lqmo / ultzLn_, u'0f:t/Lo l;sfO jftfj/0f jftfj/0f, u'0f:t/Lo ef}lts ;'ljwf / pks/0f, u'0f:t/Lo lzIfs, u'0f:t/Lo kf7\oqmd tyf kf7\o;fdu|L, u'0f:t/Lo lzIf0f l;sfO k|lj|mof, u'0f:t/Lo d"Nofª\sg k4lt, u'0f:t/Lo Joj:yfkg, u'0f:t/Lo k|ltkmn / To;sf] k|efj h:tf k"jf{wf/ cfjZos kg]{ cfjZos x'G5 . o:t} lrlsT;ssf] dgf]j}1flgs Jojxf/ / dgf]j[lQ, p;df lgxLt ;fwf/0f Jofj;flos l;k -soft skill), k];fut bIftf / ;Ifdtf, k];fk|lt OdfGbfl/tf, g}lts d"No cflb kIfn] klg lrlsT;f If]qnfO{ aflx/af6 x]g]{ ul/G5 .

$= lrlsT;f lzIffsf ;DaGwL s]xL /fli6«o gLlt tyf sfg'gL Joj:yf / cGt/f{li6«o dfkb08x¿

$=!= lrlsT;f lzIff;DaGwL ljBdfg s]xL /fli6«o gLltut tyf sfg'gL Joj:yf

!= ;+j{wflgs Joj:yfg]kfnsf] jt{dfg ;+ljwfgn] k|To]s gful/snfO{ df}lns xssf ¿kdf :jf:Yo;DaGwL xssf] klg ;'lglZrttf

u/]sf] 5 . pSt df}lns xsdf /fHoaf6 cfwf/e"t :jf:Yo ;]jf k|fKt ug]{ xs x'g] / s;}nfO{ klg cfsl:ds :jf:Yo ;]jfaf6 al~rt gul/g] nufut k|To]s gful/snfO{ :jf:Yo ;]jfdf ;dfg kx'Frsf] xssf] ;'lglZrtf u/]sf] 5 . To:t} dlxnfsf] xsdf k|To]s dlxnfnfO{ ;'/lIft dft[Tj / k|hgg :jf:Yo ;DaGwL xssf ;fy} dlxnfnfO{ lrlsT;f lzIff, :jf:Yo nufotsf If]qdf ljz]if cj;/sf] xssf] klg Joj:yf /x]sf] 5 .

gful/ssf cfwf/e"t cfjZostf ;DaGwL ;+j}wflgs gLltdf u'0f:t/Lo :jf:Yo ;]jfdf ;a}sf] ;xh, ;'ne / ;dfg kx'Frsf] ;'lglZrttf ug]{, gful/snfO{ :j:y agfpg /fHon] hg:jf:Yosf If]qdf cfjZos nufgL clej[l4 ub}{ hfg] tyf :jf:Yo If]qdf ePsf] nufgLnfO{ lgodg / Joj:yfkg u/L ;]jfd"ns agfpg] nufot :jf:Yo ;]jfnfO{ ;j{;'ne / u'0f:t/Lo agfpg] gLlt lnPsf] b]lvG5 .

@= sfg'gL Joj:yflrlsT;f lzIff If]qdf ;'wf/sf nflu ljleGg ;dodf gful/s ;dfh, ;Da4 bjfj ;d"x Pjd\ ;/f]sf/jfnfx¿af6 k|:t't dfux¿sf] ;Daf]wg tyf ;fdlos cfjZostf kl/k"lt{sf] k[i7e"lddf ul7t ljleGg cfof]u, sfo{bn / ;ldltsf k|ltj]bgx¿af6 k|fKt ;'emfj tyf /fli6«o cfjZostfsf cfwf/df @)&$ ;fn sflQs @$ ut] /fli6«o lrlsT;f lzIff ;DaGwdf Joj:yf ug{ cWofb]z hf/L ePsf] lyof] .

pQm cWofb]zsf] ;dofjlw ;dfKt x'g} nfUbf ;+3Lo ;/sf/n] k|lt:yfkg ljw]os NofO{ k|lt:yfkg ub}{ lrlsT;f lzIffsf] If]qdf /fHosf] nufgL clej[l4 ub}{ lrlsT;f lzIffnfO{ g]kfnsf] /fli6«o cfjZostfcg'¿k ljsf; u/L lrlsT;f lzIffsf] lgodg / Joj:yfkgnfO{ PsLs[t tyf r':t agfpg, lrlsT;f lzIff;DaGwL lzIf0f ;+:yfsf] :yfkgf / ;~rfng;DaGwL sfo{nfO{ Jojl:yt ug{, lrlsT;f lzIffdf u'0f:t/, k];fwld{tf, ;+:yfut hjfkmb]lxtf, ef}uf]lns ;Gt'ng / ;fdflhs Gofo sfod u/L ljkGg nufot ;a} ju{ / ;d'bfosf ljBfyL{x¿sf] ;dfg kx'Fr ;'lglZrt ug{] p2]Zon] /fli6«o lrlsT;f lzIff P]g, @)&% hf/L eO{ ;f]cg';f/ lrlsT;f lzIff cfof]u u7g eP/ cfof]un] cfkm\gf] sfo{ cufl8 a9fO/x]sf] cj:yf /x]sf] 5 .

#= /fli6«o :jf:Yo gLlt, @)&^gful/s :jf:Yosf nflu :jf:Yo ;]jfx¿ ;j{;'ne Pj+ k|efjsf/L ¿kdf k|jfx ug{ cfjZos bIf hgzlQmsf] of]hgf, pTkfbg, k|flKt, ljsf; tyf pkof]u ug]{ gLlt /x]sf] .

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$= kGw|f}F of]hgf -@)&^–)*!_nIo M ;a} txdf ;an :jf:Yo k|0ffnLsf] ljsf; / lj:tf/ ub}{ hg:t/df u'0f:t/Lo :jf:Yo ;]jfsf] kx'F'Fr ;'lglZrt ug{] .

p2]Zo!= ;+3, k|b]z / :yfgLo txdf ;a} lsl;dsf :jf:Yo

;]jfx¿sf] ;Gt'lnt ljsf; / lj:tf/ ug'{@= ;j{;n'e / u'0f:t/Lo :jf:Yo ;]jfsf] nflu

;/sf/sf] pQ/bfloTj / k|efjsf/L lgodg clej[l4 ub{} gfkmfd"ns :jf:Yo If]qnfO{ ;]jfd"ns If]qsf] ¿kdf qmdzM ¿kfGt/0f ug{' .

#= ax'IfqLo ;dGjo tyf ;fem]bf/L ;lxt :jf:Yo ;]jfdf gful/ssf] kx'Frdfly pkef]u a9fO{ ;]jf k|bfos / ;]jfu|fxLnfO{ yk lhDd]jf/ agfpFb} :j:y hLjgz}nL k|jw{gg ug'{' .

%= /fli6«o lzIff gLlt, @)&^gLlt != lrlsT;f lzIffnfO{ ;]jfd"ns tyf u}/gfkmfd"ns agfpg u'0f:t/Lo, ljj]szLn tyf ;fdflhs bfloTjaf]w ePsf lrlsT;fsdL{x¿sf] pTkfbg ug{ lrlsT;f lzIff cfof]usf] ;'b[9Ls/0f ug]{ / lrlsT;f lzIffdf ;Ifdtfdf cfwfl/t -competency based_ kf7\oj|md nfu" ug]{ .

sfo{gLlt!= lrlsT;f lzIff ;DaGwL ;Dk"0f{ ;+:yf tyf sfo{j|mdx¿

;+3Lo ;/sf/sf] lzIff ;DaGwL ljifo x]g]{ dGqfnosf] ;dGjodf ;~rfng ug]{ Joj:yf ldnfpg'sf ;fy} lrlsT;f lzIff cfof]usf] lgodg, g]t[Tj / lgb]{zgdf u'0f:t/ sfod u/fOg]5 . lrlsT;f lzIff ;DaGwL k|lti7fgx¿nfO{ PsLs[t k|lti7fgsf ¿kdf ;~rfng ug{ cfjZos sfg'gL k|jGw ul/g]5 .

@= lrlsT;f lzIffsf] kf7\oj|md / lzIf0f l;sfO k|lj|mofdf ljBfyL{sf] ;[hgzLntf tyf ;d:ofsf] ljZn]if0f Ifdtf, ;xsfo{ l;k, sfo{ sf}zn, ;d:of ;dfwfg l;k cflbdf hf]8 lbOg]5 . ;f]sf] jf:tljs d"Nof°gsf lglDt d"Nof°g k|0ffnLdf ;'wf/ tyf kl/jt{g ug]{ ;+:sf/sf] ljsf; ul/g]5 .

#= k"jf{wf/ k"/f u/]sf :jf:Yo ;+:yfx¿df g];gn af]8{ ckm d]l8sn :k]l;olN6hsf] tTjfjwfgdf :gftsf]Q/ lrlsT;f lzIffsf sfo{qmdx¿ ;~rfng ug{ cg'dlt lbOg]5 .

$== lrlsT;f lzIffsf] kf7\oqmdn] g}lts d"No dfGotf, ;~rf/ l;k Pj+ ;d'bfok|lt bfloTjaf]w ug]{ vfnsf ljifoj:t' ;d]t ;d]6\g'kg]{ / lzIf0f cEof; tyf OG6g{l;knfO{ j}1flgs Pj+ ;fk]lIfs agfpg :jf:Yo lzIff k|ljlwsf] pRrtd k|of]u ug]{ Joj:yf ldnfOg]5 .

%== lrlsT;f lzIff nufot k|fljlws ljifox¿df ;/sf/n] pknAw u/fPsf] 5fqj[lQdf cWoog u/]sf ljBfyL{x¿n] cWoog k"/f u/] kZrft\ sfg'g adf]lhdsf] cjlwe/ clgjfo{ ;]jf ug{'kg]{ Joj:yf ldnfOg]5 .

^== lrlsT;f lzIff ;DaGwL gofF ;+:yfx¿ :yfkgf Pj+ ;~rfng ubf{ ef}lts k"jf{wf/, hgzlQm tyf cfly{s Joj:yfkgsf ;fy} hg;+Vof / ef}uf]lns ;Gt'ngnfO{ ;d]t cfwf/ agfpg'kg]{ u/L sfg'gL k|jGw ul/g]5 .

gLlt @= cfo'j]{b lrlsT;f If]qdf :jb]zd} ljz]if1 hgzlQmsf] pTkfbg, cf}iflw pTkfbg / u'0f:t/ clej[l4 ug{ cfo'j]{b ljZjljBfno :yfkgf ug]{ .

sfo{gLlt!= cfo'j]{b cWoog cWofkg ug]{ u/L 5'§} ljZjljBfno

:yfkgf u/L o;sf] cf+lus sn]hsf] ¿kdf dfu / cfjZostf cg'¿k k|To]s k|b]zdf cfo'j]{b sn]h :yfkgf ul/g]5 .

@= :jf:Yo;Fu ;DalGwt ;+sfox¿ h:t} M O–d]l8l;g, 8]lG6i6«, gl;{ª, hg:jf:Yo / kmfd]{;L ljifo If]qsf kf7\oqmddf cfo'j]{b ;DaGwL ljifoj:t' ;dfj]z u/L k7g kf7gsf] Joj:yf ul/g]5 .

$=@ lrlsT;f lzIffsf u'0f:t/;DaGwL s]xL cGt/fli6«o dfkb08x¿

lrlsT;f lzIffsf] u'0f:t/ s] s:tf] dfkb08 x'g] eGg] jf/]df ljZjsf b]zx¿df cf–cfˆg} ;fwg, ;|f]t / kl/j]z cg';f/ km/s km/s cEof; ug]{ u/]sf] kfOG5 . oxfF ;a}sf nflu dfu{bz{s ag]sf] ljZj lrlsT;f lzIff dxf;ª\3 -World Federation for Medical education-WFME) n] lgwf{/0f u/]sf] s]xL dfkb08 pNn]v ug]{ k|of; ul/Psf] 5 .

WFME sf] d'Vo p2]Zo g} lrlsT;f lzIffsf] u'0f:t/ clej[l4 ug]{ ;Gbe{df ljleGg dfgssf] lgwf{/0f u/]sf] kfOG5 . o;n] d"ntM cfwf/e"t lrlsT;f lzIff, kf]:6 Uo|fh'P6 tx / lgoldt k];fut ljsf;sf nflu 5'§f5'§} Go"gtd cfwf/e"t dfgs to u/]sf] kfOG5 . o;n] ;g\ @))# df cGt/f{li6«o sfo{bndfkm{t ^) hgf lrlsT;f lzIff lj1 ;dfj]z u/]/ dfgs/dfkb08 tof/ u/]sf] lyof] . tL dfkb08df ljleGg ;dodf k'g/fjnf]sg ul/Fb} cfPsf] kfOG5 . o; WFME n] lgwf{/0f u/]sf dfkb08sf d'Vo If]q o; k|sf/ 5g\M

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World Federation for Medical Education (WFME)Global standards for of Medical and health Profession Education, 2015

Basic Medical Education Master’s degrees in Medical and health Professions Education

Continuing Professional Development -CPD

1. Mission and outcomes 1. Mission and outcomes 1. Mission and outcomes1.1. Mission1.2. Institutional autonomy &

freemdom1.3. Educational outcomes1.4. Paticipation in formulation of

mission and outcomes

1.1. Statements of purpose and outcome

1.2 Participation in the formulation of mission and outcomes

1.3 Autonomy and academic freedom

1.4 Programme title and description

1.1. Misson1.2. Professionalism and

Professional Autonomy1.3. Outcomes of CPD1.4. Participation in formulation

of mission and outcomes

2. Educational Programme 2. Educational Process 2. Educational Programme2.1. Framework of the programme2.2. Scientific method2.3. Basic biomedical science2.4. Behavioural and social

sciences, medical ethics and jurisprudence

2.5. Clinical sciences and skills2.6. Programme structure,

Composition and duration2.7. Programme management2.8. Linkage with medical

practice and the health sectors

2.1 Instructional and learning methods

2.2 Academic skills development2.3 Programme content, scope and

contextualisation2.4 Research and scholarship2.5 Programme structure and

duration2.6 Process of curriculum

development

2.1. Framework of CPD activities2.2. Scientific Method2.3. Cotent of CPD activities2.4. The relation between CPD

and service

3. Assessment of students 3. Assessment of students Learning

3. Assessment and documentation

3.1. Assement methods3.2. Relation between Assessment

and learning

3.1 Assessment methods3.2 The assessment system3.3 Feedback to students3.4 Quality assurance of the

assessment system

3.1. Assessment Methods3.2. Documentation of CPD

activities

4. student 4. students 4. the individual doctor4.1. Admission policy and

sellection4.2. Student intake4.3. Student counselling and

support4.4. Student representation

4.1 Admission policy and selection

4.2 Student intake4.3 Student support and

counselling4.4 Student representation4.5 Graduation requirements4.6 Progress and attrition rates and

reasons

4.1. Motivation4.2. Learning strategies4.3. Influence of individual

doctors on CPD4.4. Working conditions

5. Academic Staff/ Faculty 5. Staffing 5. CPd Provision5.1. Recruitment and sellection

policy5.2. Staff activity and staff

development

5.1 Appointment policy5.2 Obligations and development

of staff5.3 Number and qualifications of

teaching and supervisory staff5.4 Administrative support

5.1. Recognition policy5.2. Provider obligations and

provider development5.3. Role of medical schools

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Basic Medical Education Master’s degrees in Medical and health Professions Education

Continuing Professional Development -CPD

6. Educational resources 6. Educational resources, settings and scholarship

6. Educational resources

6.1. Physical facilities6.2. Clinical training resources6.3. Information technology6.4. Medical research and

scholarship6.5. Educational expertise6.6. Education exchanges

6.1 Educational settings6.2 Information technology

6.1. Physical facilities6.2. Learning settings6.3. Information technology6.4. Interaction with colleagues6.5. Formalised CPD activities6.6. Medical research and

scholarship6.7. Educational expertise6.8. Learning in alternative

settings7. Programme Evaluation 7. Monitoring and Evaluation

of the Educational Process7. Evaluation of CPD

Activities7.1. Mechanisms for programme

monitoring and evalution7.2. Teacher and student feedback7.3. Performance of students and

graduates7.4. Involvement of stakeholders

7.1 Mechanism for Programme Monitoring and Evaluation

7.2 Feedback from Staff and Students

7.3 Performance of Students and Graduates

7.1. Mechanism for programme monitoring and evaluation

7.2. Feedback to providers7.3. Involvement of stakeholders

8. Governance and Administration

8. Governance and Administration

8. organisation

8.1. Governmence8.2. Academic leadership8.3. Educational budget and

resource allocation8.4. Administration and

management8.5. Interaction with health sector

8.1 Programme director8.2 Governance8.3 Academic leadership and

integrity8.4 Programme management8.5 Funding and resource

allocation8.6 Administration8.7 Requirements and regulations8.8 Process for start- up and

approval

8.1. Documentation and needs for planing of CPD

8.2. Academic leadership8.3. Edcational budget and

resource allocation8.4. Administration

8.9 Finance8.10 Financial management and

probity8.11 Programme information

9. Continuous Renewal 9. Continuous Renewal 9. Continuous Renewal

The WFME Global standards for quality medical and health profession refers to the continuing development of the multi- faceted nature of medical practice, covering - in addition to knowledge and skills of medical practice –the wider domains of professionalism (e.g. medical, managerial, social and personal subjects) needed for high quality professional performance. It includes all activities that doctors undertake, formally and informally to maintain, update, develop and enhance their knowledge, skills, and attitudes in response to the needs of their patients.

In the standards document the term medical profession refers to the profession as a group, generally acting through their professional associations, medical scientific societies, medical colleges, medical schools/universities, medical academies and national regulatory authorities overseeing the system.The individual members of the profession, the individual doctors taking care of their own CPD,e.g. by reading of medical journals, studying the internet or participating in their courses.

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o;/L x]bf{ pQm ;+:yfn] lrlsT;f lzIffsf] b"/b[li6;lxt ljleGg lrlsT;f lzIffsf sfo{qmdsf k|s[lt cg';f/sf sfo{ 9fFrf, j}1flgs k4lt, ljBfyL{ 5gf]6sf cfwf/df, lrlsT;f hgzlQmdf k|fl1stf, ef}lts ;'ljwf, lrlsT;f tflndsf ;fwg ;|f]t, d]l8sn cg';Gwfg / lj1tf, z}lIfs cg'ej cfbfgk|bfg nufot sfo{qmdsf] d"NofÍg, lrlsT;f ;'zf;g, k|fl1s g]t[Tj, z}lIfs jh]6 / ;fwg ;|f]t h:tf kIfx¿nfO{ o;df ;dfj]z u/]sf] kfOG5 . dfly pNn]v ul/Psf cfwf/sf af/]df lj:t[t ¿kdf :6fG88{ tf]lsPsf] kfOG5 . pQm ;+:yfaf6 gofF lrlsT;f z}lIfs ;+:yf :yfkgfsf nflu klg :t/Lo dfkb08 tf]lsPsf] kfOG5 . ;+:yf :yfkgf ug{' kgf{sf cf}lrTo k'li6 ug{'kg]{ k|fjwfgb]lv To;/L :yfkgf x'g] gofF lrlsT;f lzIff ;+:yfsf k"jf{wf/ nufot ;Dk"0f{ dfkb08 klg pNn]v ul/Psf] 5 . o;df ;~rfng of]hgf lSnlgsn ;'ljwf, cfly{s ;|f]t;lxtsf] ljlhg]; of]hgf, ef}lts k"jf{wf/, k|fl1s tyf lSnlgsn :6fkm / ljBfyL{ ;xfotf k|0ffnLsf jf/]df lj:t[t :6fG88{ tf]lsPsf] kfOG5 .

o;/L dfly pNn]lvt dfgs jf dfkb08sf k|To]ssf pkdfkb08 / ltgsf ;"rs;d]t agfP/ :t/Ls[t ul/Psf] 5 . ljZjsf ljleGg b]zx¿n] lognfO{ sfof{Gjogdf NofPsf] ;Gbe{df g]kfndf oL / cGo b]zsf cEof;;d]tnfO{ b[li6ut u/L cj d]l8sn lzIffsf] lgodg tyf ;xhLs/0f ug]{ 5ftf ;Ë7gsf ¿kdf lrlsT;f zIff cfof]un] e"ldsf lgjf{x ug{ o;tkm{ tTsfn kfOnf rfNg kg]{ ePsf] 5 .

%= u'0f:t/Lo lrlsT;f lzIffsf nflu efjL uGtJo

ljZjsf b]zx¿sf cf–cfk\mgf] cfjZostf x'g ;Sb5g\ . ljsl;t b]z / ljsf;f]Gd'v b]zsf ck]Iff km/s km/s x'g] kl/k|]Iodf g]kfnsf] lrlsT;f lzIffaf6 JolSt, ;dfh / /fli6«n] c? b]zsf] eGbf km/s ck]Iff /fv]sf] x'g ;S5 . jf:tjdf cem} klg lrlsT;f lzIffdf cj;/ / kx'Frdf 7'nf] c;dfgtf sfod} 5 . ;x/L / u|fdL0f tyf ;fj{hlgs / lghL lzIffnosf] lrlsT;f lzIff larsf] b'/L klg emg km/flsnf] /x]sf] 5 .

lrlsT;f lzIffsf] cfGtl/s / afx\o ;Ifdtf ;Gtf]ifhgs cj:yfdf /x]sf] kfOFb}g . lrlsT;f lzIffn] JolStsf] 1fg, l;k, k];fk|ltsf] Odfgbfl/tfdf cfjZostfcg';f/ kl/jt{g Nofpg ;ls/x]sf] 5}g . Psflt/ pTkflbt hgzlSt vkt x'g ;s]sf] 5}g eg] csf]{lt/ u|fdL0f e]usf hgtfn] bIf :jf:Yo ;]jfaf6 nueu al~rt h:t} 5g\ . lrlsT;f lzIff kfPsf JolSt ;x/s]lGb|t x'g] d"No dfGotfn] k|>o kfO/x]sf] 5 . z}lIfs pTkfbgsf] k|df0fkq / pkflw :jb]z ;]jfeGbf ljb]z ;]jfsf lglDt s]Gb|Ls[t x'g] u/]sf] 5 . ;dfhdf k/Dk/fut d"No dfGotf cf:yf / g}ltstf lj3l6t eO/x]sf] / gofF d"No dfGotf / cf:yf tyf g}ltstfsf] :yfkgf

gePsf] jt{dfg kl/l:yltdf ;a} vfn] lzIffsf dfWodaf6 gofF d"No dfGotf / g}ltstfsf] :yfkgf x'g' kg]{df lbgfg'lbg To:tf d"No dfGotf sdhf]/ aGb} uO/x]sf] 5g\ . kmn:j?k ;fj{hlgs z}lIfs If]qdf lubf]{ ;fdflhs d"No dfGotf / g}ltstf ;a}eGbf 7'nf] ;d:ofsf ¿kdf cufl8 plePsf] 5 eg] o;af6 lrlsT;f lzIff klg c5'tf] /xg ;s]sf] 5}g . ;a} vfn] lzIfs–lzIffyL{df ;fdflhs ;]jfsf] efjgf / /fi6«k|ltsf] hafkmb]lxtfk|lt ;+j]bgzLn t'Nofpg ;lsPsf] cj:yf 5}g .

ljutdf b]zdf /x]sf] /fhgLlts cl:y/tf / nfdf] cGtl/dsfnLg ;dofjlwn] klg ljleGg vfn] lzIff ljsf;sf sfo{qmdn] ;xL ult lng ;s]gg\ . gLlt, sfo{qmd / b:tfj]hx¿df ljleGg k|sf/sf lzIff ljsf;sf /fd|f of]hgf / sfo{qmd ag] klg k|efjsf/L ¿kdf sfof{Gjog x'g ;s]gg\ . o;sf] k|efj lrlsT;f lzIffsf If]qdf klg :jefljs ¿kdf kg{ uof] .

d'n'ssf] lzIff k|0ffnL ;DaGwL gLltsf] ;kmntf k|efjsf/L sfo{fGjogdf lge{/ /xG5 t/ o;sf nflu g]t[Tj lng] lg0ff{os ju{sf] :ki6 ;'ema'em / k|lta4tfsf] sdLn] klg lrlsT;f lzIffsf clwsf+z of]hgf tyf sfo{qmd sfuhL b:tfj]hsf ¿kdf /xg k'u] . g]kfnL hgtfsf] gfddf k|fKt j}b]lzs C0f / ;xof]usf] ;xL ¿kdf vr{ gx'Fbf lrlsT;f lzIffdf klg ck]lIft k|ltkmn k|fKt ug{ g;s]sf] cj:yf 5 . lrlsT;f lzIffnfO{ u'0f:t/Lo, ;fGble{s / ;dfh Pj+ ;do;fk]If agfpgsf nflu gLlt lgdf{tf, of]hgfsf/sf ;fydf ;/f]sf/jfnfx¿sf] Jofks hg;xeflutf / pQ/bfloTj af]w u/fpFb} ;d'bfo / lrlsT;f lzIffnfO{ Psfsf/ agfpg xfdL cem} klg ;Ifd x'g ;ls/x]sf 5}gf}+ .

;du| ah]6sf] ;a}eGbf a9L ah]6 k|ltzt lzIff If]qdf nufgL eP klg o;sf] k|efjsf/L ¿kdf k|of]u x'g ;s]sf] 5}g . o:tf] ah]6 d"ntM k|zf;lgs tnj eQf cflbdf vr{ x'g] / u'0f:t/ ljsf;df cem k|fyldsLs/0f ug{ ;lsPsf] 5}g . lrlsT;f lzIffdf ul/Psf] jx''d'vL nufgLsf] kof{Kt k|ltkmn lng ;lsPsf] 5}g . /fHo ;+oGq sdhf]/ ePsfn] b08lxgtfn] k|>o kfPsf] 5 . o;n] ubf{ /fd|f] sfd ug]{ / gug]{lar lje]b b]lvg ;s]sf] 5}g . kmn:j¿k k];fut cfrf/;+lxtf kfngf gug]{x¿ g} z}lIfs ;dfhdf xfjL x'g k'u]sf 5g\ . ;'wf/sf gfddf x/]s of]hgf tyf sfo{j|md NofOP klg nlIft ju{df s]Gb|Ls[t ug{ g;sL ;x/s]lGb|t / cem ljz]iftM /fhwfgL s]lGb|t x'g hfFbf ck]lIft ju{sf] kx'Frdf To:tf sfo{qmdn] plrt k|efj kfg{ ;s]sf 5}gg\ . ljleGg z}lIfs sfo{j|md cfjZostfd'vL cyf{t\ Demand Driven geO{ Supply Driven ePsfn] klg nufgLaf6 ck]lIft pknlAw xfl;n x'g ;ls/x]s]f 5}g . oL ljljw sf/0f / k|efjn] ;du} lzIffsf ;fy} lrlsT;f lzIffsf]

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u'0f:t/ ljsf;sf sfo{ k|efjsf/L aGg ;s]sf 5}gg\ .

casf] uGtJo

lrlsT;f lzIffnfO{ cfw'lgstf ;lxt g]kfndf cfˆgf] kl/j]z, pknAw ;fwg ;|f]t, hgzlQm, ;fdflhs ;+/rgf / :jf:Yo l:ylt, b]zsf] e"jgf]6 / hg;flVosLo cfjZostf / cf}lrTotfnfO{ ;d]t b[li6ut u/L ljZjsf] cEof;sf ;fk]Iftfdf g]kfnsf] lrlsT;f lzIffnfO{ cfw'lglss/0f, k|fljlwsLs/0f / j}1flgsLs/0f ug{ u'0f:t/Lo lrlsT;f If]qdf b]xfosf sfo{ ug{ pko'Qm b]lvG5 M

!= jf:tljs cj:yf cfsng ug]{Mg]kfnsf] lrlsT;f If]qdf df}h'bf z}lIfs ;+:yf, ltgsf] Ifdtf, ltgsf] u'0f:t/Lotf nufot ;j} kIfsf] cWoog cjnf]sg u/L b]zsf] s'g ef}uf]lns If]qsf] slt hg;ª\VofnfO{ ;]jf k|jfx ug]{ xf] ;f] ;d]tsf cfwf/df cj pTkfbg ug{'kg]{ hgzlQm / cfjZos lrlsT;f lzIffsf ;+:yfsf] kof{jnf]sg ug]{ . o;sf nflu lrlsT;f lzIff;DaGwL o;k"j{ ag]sf ;a} cfof]u, sfo{bn, ;ldlt cflbsf k|ltj]bg / df}h'bf gLltut, :f+/rgfut / sfo{j|mdut cj:yfsf] ;d]t cWoog u/L cBfjlws / ;do ;fGble{s PsLs[t k|ltj]bg tof/ ug]{ .

@= /fli6«o lrlsT;f lzIff k|f?k -National Medical Education Framework -NMEF_ agfpg] M;du| lrlsT;f lzIffsf] dfu{bz{s / gLltut b:tfj]hsf ¿kdf NMEF b:tfj]h ljsf; ug]{ / o;df lrlsT;f lzIffsf dfu{bz{s l;4fGt;lxt lrlsT;f lzIffsf b[li6sf]0f, p2]Zo, lrlsT;f lzIffsf gLlt, kf7\oqmd ;+/rgf, ef}lts k"jf{wf/, z}lIfs k"jf{wf/, ;+:yfut tyf j}olSts ;Ifdtf, ljifo If]q, lzIf0f k|lqmof, lSnlgsn cEof;, ljBfyL{sf] d"NofÍg cflb If]qsf af/]df lj:t[t vfsf tof/ kf/L JolQmlkR5] gLlt, ;+/rgf / sfo{qmd kl/jt{g ug]{ kl/kf6LnfO{ :yfloTj k|bfg ug]{ / efjL sfo{lbzf ;'lglZrt ug]{ .

#= z}lIfs u'0f:t/sf kl/efiff / dfkb08 tf]Sg] Mu'0f:t/Lo lrlsT;f lzIffsf nflu b]zsf] cj:yfcg';f/sf u'0f:t/sf] kl/efiff, dfkb08, ;"rs;lxt z}lIfs u'0f:t/sf dfkb08 lgSof{]n ug]{ / o;}sf cfwf/df lrlsT;f lzIffsf sfo{j|mdx¿sf] cg'udg tyf d"Nofª\sg ug]{ .

$= ljZjJofkLs/0f / :yfgLos/0flar tfbfTDotf sfod u/L :yfgLo df}lns 1fg / l;knfO{ cfw'lgs lzIff;Fu hf]8\g] M;+3Lotfsf] dd{cg';f/ ;a} sfo{j|md s]Gb|Ls[t gu/L k/Dk/fut / :yfgLo:t/df k|rlnt :jf:Yo ;DjGwL df}lns t/ j}1flgs k|rlnt ljlw k4lt cWoog cg';Gwfg u/L ltgsf /fd|f kIfsf] pkof]u ug]{ ;DjGwdf k|fb]lzs tyf :yfgLo tx;F+u ;xsfo{ ug]{ . ;fy} b]zsf] ef}uf]lns,

;fdflhs ;f+:s[lts, cfly{s tyf z}lIfs cj:yf cg';f/ g]kfnL ;dfhsf d"No dfGotf ;d]tnfO{ b[li6ut u/L ljZjJofkLs/0f / :yfgLos/0flar tfbfTDotf sfod ug]{ . g]kfnsf] jf:tljs kl/j]z cg';f/ :yfgLo kl/j]z s]lG›t Jofjxfl/s cg';fGwfg u/L :jf:Yo ;]jfnfO{ Jofjxfl/s / ;fGble{s -Relevent_ agfpg] .

%= sfo{;Dkfbg k/LIf0f -Performance Audit_ ug{] Joj:yf ug]{ MlrlsT;f lzIff ;~rfng ug]{ ;+:yf / sfo{j|mdsf]] lgoldt sfo{;Dkfbg k/LIf0f -performance audit_ ug{ pko'Qm ;"rs;lxt k/LIf0f ;fwg agfpg] / :jd"Nofª\sg tyf :jtGq d"Nofª\sgsf cfwf/df u'0f:t/sf] cj:yf cfsng u/L u'0f:t/ k|jw{gsf lglDt k|f]T;fxg cg'bfg lbg] Joj:yfnfO{ hf]8\g] .

^= g}lts / hLjgf]kof]uL l;k kIfMlrlsT;f k];f d"nt dfgj hLjg;Fu k|ToIf ;DaGw /x]sf] Hofb} ;+j]bgzLn ePsfn] k];fut OdfGbf/Ltf / g}lts d"No dfGotfnfO{ lzIf0f l;sfOsf] cleGg cË agfpg] . ;fy} lrlsT;f lzIffdf soft skill and life skill h:tf kIfx¿ klg PsLs[t ub}{ hLjgf]kof]uL jgfpg o;nfO{ kf7\oj|md tyf lzIf0f l;sfO;Fu hf]8\g] . k];fk|lt k|lta4 / Odfgbf/Ltf k|jw{g ub}{{ k|f]T;fxg ug{ ljleGg k|sf/sf ;"rsdf cfwfl/t ;Ddfg tyf k'/:sf/sf] Joj:yf u/L g}ltstf, bIftf / gofF k|jw{gnfO{ k|f]T;fxg k|bfg ug]{ .

&= k/LIff k4ltdf yk ;'wf/ Mk/LIff k4ltnfO{ cEof;df cfwfl/t agfpg k/LIff k|0ffnLnfO{ Jofxfl/s / sfo{:yndf cfwfl/t agfpg] ;Gbe{df yk cWoog cg';fGwfg u/L ;}4flGts k|0ffnLnfO{ Jofjxfl/s 9fFrfdf n}hfg] jf/]df pko'Qm Joj:yf ug]{ . ;fy} ljZjljBfno / z}lIfs ;+:yfsf k/LIffx¿df 3f]Sg'kg]{ afWotf x6fP/ 1fg,l;k,clej[lQ / pRr bIftf h:tf kIfnfO{ klg hfFRg] kl/kf6LnfO{ cem dha't agfpg ljlzi6Ls/0f tflnsf -specification gird_ sf] k|efjsf/L sfof{Gjogdf hf]8 lbg] Joj:yf ldnfpg] .

%= cGtdf,

:j:y / tGb'?:t hgzlStn] dfq /fd|f];Fu plrt lrlsT;f lzIff k|fKt ub}{ /f]huf/L tyf cfocfh{g ub}{ ;'vL / ;d[4 x'g ;S5 . o;sf nflu u'0f:t/Lo :jf:Yo ;]jfdf ;a}sf] ;xh, ;'ne / ;dfg kx'Frsf] ;'lglZrttf cfjZos x'G5 . u'0f:t/Lo lrlsT;f lzIffn] bIf :jf:Yo hgzlQm pTkfbg ug]{ / bIf hgzlQmn] dfq u'0f:t/Lo lrlsT;f ;]jf k|bfg ub}{ gful/ssf :jf:Yo ;DaGwL xssf] kl/k"lt{df ;3fp k'Ug ;S5 .

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u'0f:t/ eg]sf] d"ntM ;fk]lIft cjwf/0ff xf] . tyflk u'0f:t/Lo ;]jf / pkef]Qmfsf] ;Gt'li6nfO{ :jf:Yo ;]jf k|jfxsf nflu u'0f:t/Lo lrlsT;f lzIff cfhsf] g]kfndf ;a}eGbf j9L rf;f]sf] ljifo xf] . u'0f:t/Lo :jf:Yo ;]jf k|jfx ug{sf nflu s:tf] vfnsf] lrlsT;f lzIff u'0f:t/Lo x'g] xf] eGg] af/]df b]z, sfn / jftfj/0fsf] 7'nf] k|efj /xg ;S5 . cd]l/sf, o'/f]k / Pl;ofsf] u'0f:t/Lo lrlsT;f lzIffsf dfkb08 / ;"rs km/s x'g ;Snfg\ . g]kfndf u'0f:t/Lo dflgPsf dfkb08 o'/f]k cd]l/sfdf u'0f:t/Lo gx'g ;S5g\ . t;y{ g]kfnsf] e"uf]n, hg:jf:Yosf] cj:yf, pknJw ;fwg ;|f]t / hgzlSt, g]kfnL ;fdflhs d"No dfGotf / ljZjf;, g]kfnLsf] dgf]j[lQ, lrlsT;f lzIffdf ul/Psf] nufgL / pTkfbg Pjd\ k|ltkmn k|flKtsf] cj:yf / ;Gt'li6sf] tx, lrlsT;f lzIffsf] cfGtl/s / jfx\o ;Ifdtf, k|efjsfl/tf / pknlAwsf] :t/ tyf lrlsT;f lzIff k|ljlwn] NofPsf gofF l;sfO r'gf}tL / ljZjJofkL ?kdf ug'{kg]{ k|lt:kwf{ nufot sf]le8 !* h:tf dxfdf/Ln] lbPsf] r'gf}tL ;fdgf ug]{ a}slNks l;sfOsf dfWod cflbnfO{ b[li6ut u/L u'0t:t/Lo lrlsT;f lzIffsf nflu casf lbgdf lrlsT;f lzIff cfof]usf cufl8 r'gf}tLsf kxf8 /x]sf] s'/f gsfg{ ;lsFb}g .

o; kl/j]zdf k|rlnt :jf:Yo lzIff ;Da4 gLlt, P]g / sfg'gsf] kl/lwleq /xL lrlsT;f lzIff cfof]un] ljZjljBfno, k|lti7fgnufot cGo ;DalGwt lgsfox¿sf] lglb{i6 :jfoQtf / :jtGqtfnfO{ cfTd;ft u/L /fli6«o:t/df ;Da4 ;a} lgsfox¿;Fu ;dGjo / ;xsfo{ ug]{ Pjd\ cGt/f{li6«o :t/sf lgsfox¿;F+u ;d]t ;dGjo, ;xsfo{ / ;fem]bf/L ub}{ ;dfj]zL / u'0f:t/Lo lrlsT;f lzIffsf] ;'lglZrttf ug]{ sfo{df dfu{ k|z:t ug{ cj l9nf ug'{ x'Fb}g . dflysf sfo{nfO{ k|efjsf/L / ljZj;gLo agfpg ;j{k|yd cfof]un] cfkm" / cfkm\gf sfo{nfO{ u'0f:t/Lo agfP/ ljZjf; lhTg ;Sg'k5{ . ljZjf; lhTg] jftfj/0f

l;h{hf gx'Fbf;Dd c?nfO{ u'0f:t/Lo gePsf] jf dfkb08 gk'u]sf] egL k|Zg ubf{ cfkm"dfly g}lts k|Zg p7\g ;S5 . t;y{ cfuf]un] x/]s sfo{ / k|lj|mofnfO{ gd'gf / u'0f:t/Lo agfpg cfjZos x'G5 .

cGtdf jt{dfg kl/j]zdf la;{g} gx'g] s'/f s] xf] eg] sf]le8 !( n] cd]l/sf jf o'/f]kdf kf/]sf] k|efjem}F olb g]kfnnfO{ cfj|mfGt kf/]sf] eP g]kfn / g]kfnLsf] cj:yf s:tf] x'GYof] xf]nf < o; k|Zgk|lt Psbd} uDeL/ / ;+j]bgzLn eP/ cfh}b]lv o;tkm{ of]hgfa4 9ª\un] ;f]Rg] j]nf cfO;s]sf] 5 eGg] s'/fnfO{ Wofg lbFb} u'0f:t/Lo lrlsT;f lzIffsf nflu ;xhLs/0f lgodg ug{ cfof]usf] casf] uGtJo lglb{i6 u/f}+ .

;Gbe{ ;fdu|L

� lrlsT;f lzIff ;DaGwL ;|f]t ;fdu|L, @)&^, lrlsT;f lzIff cfof]u, ;fgf]l7dL

� g]kfnsf] ;ljwfg, @)&@, sfg'g cfof]u, sf7df8f}+ � /fli6«o lrlsT;f lzIff P]g, @)&%, g]kfn /fhkq, kmfu'g !), @)&%

� kGw|f}F of]hgf -@)&^–)*!_, /fli6«o of]hgf cfof]u, l;+xb/af/

� /fli6«o lzIff gLlt, lzIff, @)&^ lj1fg tyf k|ljlw dGqfno, l;+xb/af/

� /fli6«o kf7\oj|md k|f?k, @)&^, kf7\oj|md ljsf; s]Gb|, ;fgf]l7dL, eStk'/

� lzIff lbj;, :dfl/sf, lzIff ljefu, ;fgf]l7dLsf ljleGg cª\sx¿

� lji0f'k|;fb clwsf/L, lzIffzf:q / g]kfndf lzIff,-@)&%_,cflzif a's xfp;, afuahf/

� World Federation for Medical Education (WFME) Website : http:/www.wfme.org

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æ;'zf;gsf nflu ;fj{hlgs vl/bsf] e"ldsfÆ

/fh]Gb| s'df/ >]i7

!= æ;'zf;gæ

� pQd lsl;dsf] zf;g tyf pQd /fHo Joj:yf,

k|zf;lgs clwsf/sf] ;d'lrt k|of]u g} ;'zf;g xf] .

� zf;g Joj:yfdf /fd|f u'0f ylkP eg] ;'zf;g x'G5 .

;'zf;g s'g} b[Zo j:t' geO{ cd"t{ lrh xf] . o;nfO{

cg'e"ltdf vf]Hg'kb{5 .

� /fHosf] cfly{s, /fhgLlts, k|zf;lgs clwsf/ ltgsf]

;+/rgf / k|lj|mof tyf cfk;sf] aGwgnfO{ Jojl:yt

/ j}1flgs agfpFb} dfgljo ljsf;nfO{ lbuf] agfpg]

/0fgLlt g} ;'zf;g xf] .

� æjx'hg lxtfo, jx'hg ;'vfoæ g} ;'zf;g xf] .

Ö ;'zf;gsf ;Gbe{df # j6f Organs x¿ ;dfj]z

x'G5g\ .

Ö gful/s / ;/sf/lar ;+jfb lxgtfsf] cj:yf 5

eg] Tof] x6fpg' klg ;'zf;g xf] .

@= ;'zf;gsf cfjZos tTjx? -Elements or dimension)1. Legitimacy2. Accountability3. Transparency4. Empowering and Enabling5. Rule of Law6. Human Right

dimension:!= /fh}gLlts cfofd

� hg;xeflutf � jx'njfb / nf]stGq � sfg'gL /fHo � ljs]G›Ls/0f � k|]; :jtGqtf � jx'njfb � :jR5 lgjf{rg k|0ffnL

@= Joj:yfksLo cfofd � 5l/tf] / ;Ifd ;/sf/ � sfo{bIftf � Joj;flostf

#= g}lts cfofd � kf/blz{tf � u|fxssf] ;Gt'li6 � :jR5 k|zf;g � e|i6frf/ lgd{'ntf

$= cfly{s cfod � ljQLo ljs]G›Ls/0f � cfly{s ldtJolotf � v'nf tyf pbf/ cfly{s gLlt � lghL If]qsf] k|efjsf/L ;+nUgtf

%= k|zf;lgs cfofd � ;]jfd'vL sfo{ ;+:sf/ � ;]jf k|jfxdf k|efjsfl/tf � hgd'vL, lhDd]jf/ tyf glthfd"ns k|zf;g

� kf/bzL{ / pQ/bfoL k|zf;g

^= ;fdflhs cfofd � ;fdflhs Gofo / ;'/Iff � lk5l8Psf] ju{sf] k|ltlglwTj � ;fdflhs ;zQmLs/0f

World Bank sf cg';f/ ;'zf;g “Good Governance is the manner in which power is exercised in the management of a country's economic and social resources for development ˮ o;df $ j6f s'/f

pQ/bfloTj, kf/blz{tf, hg;xeflutf / cg'dfg of]Uotf

kb{5 .

UNDP sf cg';f/ ;'zf;g gful/s ;dfh;Fu

;xsfo{tf, /fhg}lts j}wflgstf / pQ/bfloTj, lgikIf / e/kbf]{ Gofo k|0ffnL, r':t, b'?:t / k|efjsf/L ;fj{hlgs Joj:yfkg / ;"rgfsf] xssf] k|Tofe"lt ul/Psf] x'G5 .

;'zf;g -Joj:yfkg tyf ;~rfng_ P]g, @)^$ -bf];|f] ;+zf]wg @)&%.!!.!(_ sf] k|:tfjgfdf d'n'ssf] ;fj{hlgs k|zf;gnfO{ hgd'vL, hjfkmb]xL, kf/bzL{, ;dfj]zL tyf hg;xeflutfd"ns agfO{ To;sf] k|ltkmn ;j{;fwf/0fnfO{

n]vf clws[t, lrlsT;f lzIff cfof]u

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pknAw u/fpg, sfg'gsf] zf;g, e|i6frf/d'Qm / r':t k|zf;g, ljs]G›Ls/0f, cfly{s cg'zf;g tyf ;fj{hlgs sfo{ / ;|f]tsf] s'zn Joj:yfkgh:tf c;n zf;gsf cfwf/e"t dfGotfnfO{ cfTd;ft\ u/L hgtfnfO{ ;]jf k'¥ofO{ d'n'sdf ;'zf;gsf] k|Tofe"lt lbg] ;DaGwdf sfg'gL Joj:yf ug{ of] P]g cfPsf] xf] eGg] /x]sf]5 .

g]kfndf lsg Good Governance ePg t <1. Political Institution Return ePg ;+/If0fjfbL

/fhgLlt cfof],2. Bureaucratic Juggernaut. rn9n gug]{ sd{rf/L

tGq,3. State People Interface: Sate / People ;+jfblxgtfsf]

cj:yf4. over Regulation: grflxFbf] 7fpFdf a9L sfg'g, rflxg]

7fpFdf 5}g .

Governance indicator, World Bank sf cg';f/

!= cfjfh / pQ/bfloTj -Voice & Accountability_ g]kfnsf] Status 0.54 df 5

@= /fhg}lts :yfloTj / lx+;fTds cj:yf#= zf;g / ;/sf/sf] k|efjsfl/tf -Government

Effectiveness_$= lgodsf] u'0ffTds -Regulatory Quality_%= sfg'gsf] zf;g -Rule of Law_^= e|i6frf/ lgoGq0f -Corruption Control_

oL ;a}df cf–cfˆgf] ;"rs (indicator) 5g\ . oL ;a}sf] d"Nofª\sg ubf{ g]kfnsf] governance weak /x]sf] 5 .

#= ;fj{hlgs vl/bsf l;4fGt

;j{dfGo & l;4fGtx?

1. d"No ;fy{stf -Value for Money_2. ldtJolotf -Economy_3. lgi7f -Integrity_4. p2]Zod"nstf -Fit for Purpose_5. sfo{bIftf -Efficiency_6. kf/blz{tf -Transparency_7. :jR5tf -Fairness_

$= ;fj{hlgs vl/bsf dxTj

� ;fj{hlgs k|zf;gsf] cleGg cª\u xf] cfly{s k|zf;g . cfly{s k|zf;g ;/sf/sf] cfly{s hjfkmb]xL jxg ug]{ / cfly{s cg'zf;g s8fOsf;fy nfu" ug]{ pko'Qm dfWod xf] .

� nf]stGqsf] d"n cfwf/ eg]sf] ;'zf;g / gful/ssf] df}lns clwsf/ ;lxtsf] JolQmut :jtGqtf xf] .

� ;fj{hlgs vr{sf] ^)Ü eGbf a9L vr{ /fHosf] ;fj{hlgs vl/bdf x'g] ePsfn] ;fj{hlgs vl/b k|lj|mof / Joj:yfnfO{ kf/bzL{, ;Ifd, ;'b[9 agfpg ;s] d"No ;fy{stf -Value for Money_ ;lxt ;'zf;gk|lt /fHosf] hjfkmb]lxtfdf j[l4 cfpF5 .

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of] cj:yfnfO{ lgodg ug{ -Regulation_

o;/L lgodg u/L ;fj{hlgs vr{ sf] d"No ;fy{stf sfdo /fVg ;s] nf]stGqsf] k|ltkmn hgtf ;dIf k'¥ofpg ;lsG5 .

;'zf;g -Good Governance_ sf] dxTjk"0f{ kIf cfly{s cg'zf;g klg ePsf]n] of] s;/L sfod ug]{ t <

oL kIf 5'6\ofP/ Action df hfg' cfjZos b]lvG5 .

cfly{s cg'zf;gsf] csf]{ kIf a]?h' klg xf] . a]?h'sf ljz]iftfdf s] b]lvG5 t <

!= gLltut a]?h" – -lgoldt ug{'kg]{_@= k]ZsL a]?h"#= k|s[ofut a]?h" – -vl/b P]g + lgod+ cfly{s P]g ;lxt_$= e|i6frf/ hGo a]?h"%= c;"n pk/ ug{'kg]{ a]?h"

%= ljBdfg Joj:yf

!= ;+j}wflgs Joj:yf

� /fHosf] bfloTj – ;'zf;g sfod ug]{ � lgb]{zs l;4fGt – gLlt ;'zf;g d'vL � ;dfj]lztf, sfg'gsf] zf;g, ;Ifd Gofo k|0ffnL � ;+j}wflgs lgsfo, c=b'=c=cf= � ljs]G›Ls/0f � # txsf] ;/sf/ ;+3, k|b]z / :yfgLo

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� sfg'gL Joj:yfdf ;'zf;g -Joj:yfkg tyf ;~rfng_ P]g, @)^$–lgodfjnL, @)^% sf] k|:tfjgfdf k|zf;g ;+oGqnfO{ ;]jf k|bfos / ;xhstf{ agfpFb} ;'zf;gsf] k|Tofe"lt lbg] pNn]v 5 .

#= ;+:yfut Joj:yfM

� dGqfnox? � ;+j}wflgs lgsfox? � ljz]if cbfnt / cbfnt � Civil Society

$= gLltut Joj:yfM

s= !% cf}+ of]hgf, ah]6 aStJo, @)&&v= k|rlnt gLltx¿

� cfly{s pbf/Ls/0f � ul/aL lgjf/0f � ;fdflhs Gofo � dlxnf ;zQmLs/0f / nª\lus Gofo � jftfj/0f ;+/If0f � hghflt blntsf] pTyfg � b'u{d If]qsf] ;Gt'lnt ljsf;

u= gful/s j8fkq÷Nodal Officer/ljB'tLo j8fkq÷3'DtL ;]jf÷ e-GP System/ Online ;]jf/ ;fj{hlgs ;'gjfO{/Audio- Video ;]jf/ T.V.

3= lghfdtL ;]jf P]g, @)$( / lgodfjnL,@)%)

ª= c=b'=c=cf= P]g @)$* / lgodfjnL )$( tyf e|i6frf/ lgjf/0f P]g, lgod, @)%(

r= n]vf k/LIf0f P]g, @)&%5= ;"rgfsf] xs ;DaGwL P]g , @)^$ / lgodfjnL,

@)^%h= ;DklQ ;'4Ls/0f lgjf/0f P]g, @)^$ /

lgodfjnL, @)^^em= /fh:j r'xfj6 cg';Gwfg tyf lgoGq0f P]g,

@)%@ / lgodfjnL, @)&)

`= ;fj{hlgs vl/b P]g, @)^# / lgodfjnL, @)^$

cj s] ubf{ ;'zf;g x'G5 t <

!= ;fj{hlgs hjfkmb]lxxtfsf] kbdf /xg]n]s= hglxtdf sfd u/]/v= lg0f{o k|lj|mofdf kf/blz{tf NofP/u= cfkm"nfO{ ;fwg / zlQm lbg] hgtfk|lt hjfkmb]xL

eP/ .3= -s_ ;/sf/ (Government) = /fHo ;~rfng

ug]{ cª\u/Body -v_ zf;g (Governance) = != ;dfhsf]

lxt ug{ lnPsf] lg0f{o@= lgodaf6 ;~rfng x'g] k|lj|mof

-u_ ;'zf;g (Good Governance) = zf;gsf] ;~rfngdf /fd|f u'0f ylklbP/ plrt glthf k|flKt .

Governance sf Actor / factor Analysis

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ljsf; / ;d[l4

1. Political Reform/ Polices – Lean govt.2. Structural- Result Oriented3. Instrument

Man money method machine information

4. Behavioral / Ethical5. Public Accountability

cfly{s jif{ @)&^.)&& sf] ah]6 jQmJon] ;fj{hlgs ;]jf / ;'zf;g ;DaGwL d"nt lgDg s'/fx?nfO{ hf]8 lbPsf] lyof] M

1. ;'zf;g k|jw{gnfO{ ;jf]{kl/ k|fyldstfdf /fvL ;a} If]qdf ;bfrf/ k4lt cjnDjg ul/g]

2. /fHosf] ;DklQsf] cgflws[t bf]xg /f]Sg]3. e|i6frf/ /f]Sg sfg'gL ;'wf/4. ;fj{hlgs k|zf;gsf] sfo{ ;+:s[ltdf cfd"n kl/jt{g

u/L ;+3Lo 9fFrfdf abNg]5. ;fj{hlgs kbflwsf/Lx?sf] hjfkmb]lxtf ;'lglZrt6. x]nf] ;/sf/sf] kf]6{n :t/Ggf]lt u/L ;a} k|b]z /

:yfgLo tx;Dd sfof{Gjog7. dGqfnosf] k|ult ljB'tLo cg'udg k|0ffnLaf6 ug]{8. k|wfgdGqL tyf dlGqkl/ifb\sf] sfof{non] æPS;g ?dÆ

af6 ljsf; cfof]hgfsf] k|ToIf cg'udg ug]{9. ;/sf/L ;]jfdf glthfdf cfwfl/t sfo{ ;Dkfbg k|0ffnL

cjnDjg ul/g]10. pRr Joj:yfkg txdf sfo{/t sd{rf/Lx¿;Fu sfo{

;Dkfbg s/f/ ;+emf}tf ul/g]11. gful/snfO{ dfgj clwsf/sf cfwf/e"t kIfdf ;hu /

lqmofzLn agfpg hgr]tgf sfo{qmd ;~rfng .12. ;+j}wflgs cfof]ux¿sf] sfo{ k|efjsf/L agfpg Ifdtf

clej[l4 ul/g] .

o;} u/L cfly{s jif{ @)&&.)&* sf] ah]6 jQmJodf ;'zf;g / ;fj{hlgs ;]jf k|jfx ;DaGwL lgDg Joj:yf pNn]v ul/Psf] 5 M

1. ;fj{hlgs lgsfonufot ;a} If]qdf ;bfrf/ ;+:s[ltsf] ljsf; ul/g]5 . d e|i6frf/ ulb{gF, d e|i6«frf/ x'g lbGgF, d b]z / hgtfsf nflu OdfGbf/ eP/ sfd ug]{5' eGg] k|lt1f;lxtsf] ;'zf;g sfo{ ;+:s[lt k|jw{g ul/g]5 . e|i6frf/ /f]syfd / lgoGq0fsf] sfo{nfO{ yk k|efjsf/L agfpg ;DalGwt lgsfosf] Ifdtf clej[l4 ul/g]5 . zf;sLo k|aGwdf sfg'gL /fHosf] cjwf/0ffnfO{ k"0f{ kl/kfngf ul/g]5 .

2. ;DklQ z'4Ls/0f tyf cftª\sjfbL lqmofsnfkdf ljQLo nufgL lgjf/0f ;DaGwL cGt/f{li6«o k|ltj4tfcg'¿k

cfufdL jif{ kf/:kl/s d"Nofª\sg ;'? ul/g]5 . ;DklQ z'4Ls/0f /fli6«o tyf sfo{ of]hgfsf] k|efjsf/L sfof{Gjog ul/g]5 .

3. ;/sf/L ;]jfnfO{ ;xh / k|ljlwd}qL agfOg]5 . x]nf] ;/sf/sf] kf]6{nnfO{ :t/f]Gglt u/L cfd gful/ssf] cfjfh k|ltlalDat ug]{ dfWodsf] ¿kdf ljsf; ul/g]5 .

4. sf]/fgf /f]syfd, lgoGq0f tyf pkrf/sf] sfddf ;a} txaf6 ePsf vr{ nufot cGo ;+3 ;+:yfn] u/]sf] vr{sf] ljj/0f kf/bzL{ agfOg]5 .

5. pRr Joj:yfkg txdf sfo{/t sd{rf/L;Fu sfo{;Dkfbg ;Demf}tf ug]{ sfo{nfO{ glthf;"rsdf cfwfl/t agfO{ ;f]af6 k|fKt pknlAwnfO{ sfo{;Dkfbg d"Nofª\sg;Fu cfa4 ul/g]5 .

6. dfgjclwsf/sf] ;+/If0f / ;+jw{g ub}{ dof{lbt / :jcg'zfl;t ;dfh lgdf{0f ul/g]5 . ;+j}wflgs lgsfosf] sfo{ ;DkfbgnfO{ k|efjsf/L agfpg cfjZos ;fwg, ;|f]t / k|ljlwsf] Joj:yf u/L ;'b[9 ul/g]5 .

;fj{hlgs ;]jf / ;'zf;g;Fu g]kfn sf] ;+ljwfg @)&@ sf] k|:tfjgfdf plNnlvt ePsf cltl/Qm cfly{s ;fdflhs, k|zf;lgs, /fhg}lts Joj:yfsf ;jfnx? k|ToIf / ck|ToIf ?kdf hf]l8G5 . o;} u/L ;+ljwfgsf] wf/f %!-v_ df Joj:yf ePsf /fHosf] gLlt cGtu{t ;fj{hlgs k|zf;gnfO{ :jR5, lgikIf, kf/bzL{, e|i6frf/d'Qm, hgpQ/bfoL / ;xefuL d"ns agfpb} /fHoaf6 k|fKt x'g] ;]jf ;'ljwfdf hgtfsf] ;dfg / ;xh kx'Fr ;'lglZrt u/L ;'zf;gsf] k|Tofe"lt ug]{ Joj:yf pNn]v 5 .

;fj{hlgs vl/b sfo{ ;'Jojl:yt 9ª\uaf6 ;Dkfbg ug{ ;fj{hlgs vl/b P]g, @)^# / lgodfjnL, @)^$ n] ljleGg k|fjwfgx¿sf] Joa:yf ;lxt @)&&÷)!÷!% ;Dd vl/b lgodfjnL @)^$ sf] bzf}+ ;d;fdlos ;+zf]wg ;d]t eO{ sfof{Gjogsf] cj:yfdf cfO;s]sf] 5 . oL P]g, lgodfjnLdf ePsf] k|fjwfgn] lgDg s'/fx¿sf] k|Tofe"t ug]{ hdsf]{ u/]sf] kfOG5 M

� ;fj{hlgs vl/b ;DaGwL sfo{ljlw, k|lj|mof tyf lg0f{onfO{ cem a9L v'nf, kf/bzL{, j:t'lgi7 / ljZj;gLo agfpg] .

� ;fj{hlgs vl/b k|lj|mofdf lgDg s'/f x'g'kg]{ M1. k|lt:kwf{2. :jR5tf3. OdfGbfl/tf4. hjfkmb]lxtf5. ljZj;lgotf6. ;fj{hlgs vr{sf] clwstd k|ltkmn7. lgdf{0f, dfn;fdfg, k/fdz{, cGo ;]jf vl/bsf]

Joj:yfkgsf] Ifdtf clej[l4

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8. lagf e]befj ;fj{hlgs vl/b k|s[ofdf ;xefuL9. ;'zf;gsf] k|Tofe"lt ug]{10. d"No;fy{stf

� vl/b;DaGwL sfo{sf] lhDd]jf/L, af]nkqx¿ cXjfg ug]{ ljlw, nfut cg'dfg tof/ ug]{, :jLs[t ug]{ k|s[of pNn]v 5 .

� vl/b of]hgf tof/ ug{'kg]{ b]lv lhDd]jf/L hjfkmb]lxtf ;lxtsf] Joj:yf /x]sf] 5 .

� vl/b ljlwsf] 5gf}6 ;DalGw bkmf * sf] !–!) ;Dd ljleGg ljlwx¿ pNn]v /x]sf] 5 .

� sf/jfxLsf] k|lj|mof, af]nkq /2 x'g] cfwf/ / sf/jfxLdf ! jif{b]lv # jif{;Dd sfnf];"rLsf nflu l;kmfl/;, hl/jfgf / xh{gfsf] Joj:yf /x]sf] .

� ljefuLo sf/jfxLsf] Joj:yf /x]sf] . � o;}u/L ;fj{hlgs lgsfox¿sf] vl/b sfo{ ;DaGwL cg'udg u/L q'l6 ;Rofpg], Wofgfsif{0f u/fpg], sf/jfxLsf nflu l;kmfl/; ul/g] e"ldsf;lxt PPMO sf] :yfkgf ePsf] pNn]vgLo Joj:yf /x]sf] 5 .

ah]6 lgoGq0f -Budget Control_!= ;+j}wflgs lgoGq0fM– sfg'g adf]lhd afx]s s/ nufpg

p7fpg kfOg] 5}g wf/f -!!% ;+3, @)# k|b]z, @@* :yfgLo

@= cfGtl/s lgoGq0fM– sfof{no k|d'v + n]vfkfn - r]s + ef}r/x? – ;lrj n]vf pQ/bfoL clws[t#= n]vf k/LIf0fMcf=n]=k + d=n]=k=$= :jLs[t kmf/dx?– b'?kof]u /f]Sg ljleGg 9fFrf /

kmf/fdx?

%= afXo Ph]G;LM clVtof/ / ;t{stf/PPMO/ n]vf ;ldlt / ;/f]sf/jfnf

^= cy{ dGqfnoM /sdfGt/ / cGo yk ah]6&= cfly{s P]g lgodx?M vl/b P]g, lgodfjnL, cfly{s

sfo{k|0ffnL, b}=e|=lgodfjnL

pko'{St sfg'gL Joj:yfnfO{ k|efjsf/L ¿kdf Jojxf/df ptfg{ ;lsPdf cfly{s ;'zf;g sfod x'g] b]lvG5 . sfof{Gjog eP gePsf] af/]df ljleGg txaf6 cg'udg / ;xhLs/0f ug]{ Joj:yf ul/g'k5{ .

&= lgisif{

d"ntM nf]stGqsf] kmn ;a} tx / tKsfsf g]kfnLn] ;dfg¿kdf kfpg'kb{5 .

cfly{s lgoGq0fnfO{ k|efjsf/L agfpg sfg'gx¿df ;d;fdlos kl/jt{g ;+zf]wg ug]{ qmddf cfly{s sfo{ljlw P]g,@)%% nfO{ k|lt:yfkg ul/ cfly{s sfo{ljlw tyf ljQLo pQ/bfloTj P]g, @)&^ ldlt @)&^ c;f]h @$ ut]af6 sfof{Gjogdf cfO;s]sf] ca:yf 5 . h;df ;+3Lo ;l~rt sf]if / cGo ;/sf/L sf]ifsf] ;~rfng tyf Aoj:yfkg,ah]6 th{'df, lgsf;f tyf vr{, cfly{s sf/f]af/sf] n]vfª\sg tyf k|ltj]bg, cfGtl/s lgoGq0f, n]vfk/LIf0f tyf cGo cfly{s ultljlwnfO{ Jojl:yt u/L ;8\3Lo ljQLo Joj:yfkg k|0ffnLnfO{ lhDd]jf/, kf/bzL{, glthfd"ns tyf pQ/bfoL agfpg] s'/f pNn]vgLo /x]sf] 5 . oL d"ne"t kIfx¿sf] canDag / pko{'Qm sfof{Gjog g} ;'zf;gsf] P]gf x'g] ePsf]n] Governance sf] nflu ;fj{hlgs vl/bsf] cxd\ e"ldsf /x]sf] x'G5 .

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Journal of Medical Education Commission (JMEC)

About the JournalPublication of JMEC started from July 2020 by Medical Education Commission of Nepal. The aim of JMEC is to promote and provide a common platform to publish the scientific works in the field of medical education as well as to foster the knowledge, disseminate the innovative ideas, technologies, teaching learning techniques in this field.Publication: It is published biannually; in the month of January and July and is peer reviewed internally and externally.Languages: JMEC accepts articles both in English and Nepali languages.

field of Articles:JMEC publishes articles from the field of medical education, medical, ethics, bioethics, teaching–learning methodology, communication skills, student-teacher training methodologies, innovations in medical education, online teaching-learning, telemedicine in medical education, national / international policies in medical education, global standards in medical education and more. Beside this, it also will publish student centered articles in medical ethics and medical education.

Guideline for submission of manuscripts:JMEC requires that the manuscript submitted are the original work of the authors and it is not submitted anywhere else before submission to JMEC. Authors are solely accountable for their works, views and opinions expressed in the submitted manuscript. Manuscript should be submitted duly signed by authors declaring conflict of interest and funding

sources and with a covering letter addressing to the chief editor, JMEC.

The manuscript should mention the corresponding author with full name, designation, corresponding e-mail address and contact number.

Manuscript should be typed in double spaced, only one side A4 size paper, with Times New Roman, font size 12.

JMEC does not charge any fees to the authors.

types of articlesAuthors are required to categorize the articles as original article, review article, case report, short communication, student articles as follows:

• original article - the innovative and scientific works done by medical educators/ researchers /policy makers/administrators/health financers/ education financers.

• review article - on critical analysis of works published in scientific literature and policies related to medical education. The source should be mentioned for data collection, selection of data location methods, extraction and analysis of data if any.

• Case study/report - in ethics, bioethics, clinical ethics and medical education. If any photographs are included, separate informed consent is required.

• short communication - expressing author’s observations, views on the issues which are debatable and controversial or relevant to current issues with their personal view on areas like medical education, ethics, bioethics, clinical ethics etc.

size of articlesCategory of article Abstract Total words (excluding references) references

Original article Up to 250 words Up to 3000 words Up to 50Review article Up to 250 words Up to 4000 words Up to 100

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Category of article Abstract Total words (excluding references) referencesCase study/report Up to 150 words Up to 1000 words Up to 15Short communication Not applicable Up to 1500 words Up to 10

student's forum• Medical education for students / by students -

Articles written by students – medical, dental, nursing, allied science but must comply the terms and conditions as mentioned in general for original article, review article, case report, short communication as well as guideline for manuscript submission and will undergo the peer review process. JMEC encourages student’s articles and publishes with priority.

• Editorials – Editorials are prepared by the editorial board. Guest editorials are sought by invitation to the experts.

referencingAuthors are required to follow Vancouver system of referencing. Here are the examples of citation:

Journal article1. Adhikari B, Mishra SR. Urgent need for

reform in Nepal's medical education. Lancet. 2016;388(10061):2739-2740.

2. Dhakal AK, Shankar PR, Dhakal S, Shrestha D, Piryani RM. Medical Humanities in Nepal: Present Scenario. J Nepal Med Assoc. 2014;52(193):751-754.

3. Dixit H. Development of medical education in Nepal. Kathmandu Univ Med J. 2009;7(25):8-10.

4. Baral N, Paudel BH, Das BK, et al. An evaluation of training of teachers in medical education in four medical schools of Nepal. Nepal Med Coll J. 2007;9(3):157-161.

¾ Journal article published online ahead of printAtreya A, Acharya J. Distant virtual medical education during COVID-19: Half a loaf of bread [published online ahead of print, 2020 Jun 18]. Clin Teach. 2020;10.1111/tct.13185.

¾ Chapter of an edited bookCraven R. Why teach Aboriginal Studies?. In: Craven R, ed. by. Teaching Aboriginal studies. 2nd ed. Crows Nest: Allen & Unwin; 2011. p. 18.

review Process and Publication PolicyAll the manuscript received are duly acknowledged by JMEC Editorial Board. They are preliminarily screened for the requirements as they are not simultaneously submitted elsewhere other than JMEC as declared by authors, duly signed cover letter to the chief editor, preferably categorized article by the authors (original article, review article, case report, short communication) fulfilling the requirement as described in types of students forum manuscript. The articles with flaws in technical, scientific or ethical content will not be considered for publication process.

The screened manuscripts are then proceeded for review by external reviewers other than JMEC as a peer review process. JMEC communicates to the author with the reviewer’s comments for correction if suggested and has the right to accept, to make re-correction and resubmit or reject the manuscript.

Acceptance of manuscript is communicated to the corresponding author in writing and proceeded for publication process.

Accepted articles are submitted for peer review, grammatical editing, formatting in JMEC style. Page proofs are sent to corresponding authors before publication.

Ethical Clearance: Works involving the humans or data collected with direct involvement of participants will need an ethical clearance letter duly signed from ethics committee. All the data involving participants should be anonymized.

Corresponding addressThe Chief EditorJournal of Medical Education Commission (JMEC)Medical Education Commission,Sanothimi, BhaktapurE-mail address: jmec@mec.gov.np

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ISSN : 2717-5073