DMO
DMO
EXECUTIVE SUMMARY
The report consists of 7 chapters which have been subdivided into appropriate topics.
The First Chapter of the report is for introduction of the District Government
Rahimyarkhan.
This Chapter of the report explains the Organizational structure of the District
Government, Rahim Yar Khan. In this chapter, the structure of the District Government
and functions of District Government are discussed.
The third Chapter constitutes the introduction, mission, vision, objectives, thrust areas
under ESR, key features, achievements and working of the Punjab Education Sector
Reforms Program, especially it contains the information about pillars of Punjab
Education Sector Reforms Program on which basis this program based.
In the fourth chapter, the Monitoring & Evaluation of PESRP is explained in detail. It
contain the methods / process, how to do on going monitoring by the PMIU, Field
Monitoring, how to do computerization of monitoring data on specific software,
transmission of inspection data to PMIU/CMMF and detail about District Review
Committee.
The fifth chapter constitutes the introduction, vision, objectives, Broad ingredients of
reform, and outcomes of the Punjab Health Sector Reforms Program.
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This chapter also has complete information about the BHUs (Basic Health Units), its
working, strength of staff, role and functioning of the BHUs, its community support
(school and community session), information about RD (Rural Dispensaries), curative
services at BHUs and RDs and Evaluation by World Bank. Sixth chapter covers the
Monitoring & Evaluation of Punjab Health Sector Reform Program and contain detail
about field monitoring at District level, how to do follow up of monitoring reports.
In the seventh chapter, my achievements during this six months internship in the District
Monitoring Office such as new knowledge, problems encountered, and impacts of
experience on career are summarized.
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Chapter: 1
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The District Government Rahim Yar Khan, like all other District Governments of the
Country, came into being under the devolution system in 2001 and Punjab Program
Monitoring and Implementation Unit is an autonomous body of the Provincial
Government of Punjab work under the supervision of District Coordination Officer,
Rahimyarkhan.
The District Government Rahim Yar Khan is constituted by the 140 Union Councils of
the district. Each U.C consists of One Nazim and One Naib Nazim and 14 other
members called Councilors. All these are directly elected by the public in the Local
Government Elections held after 4 years. The U.C Nazim is also a member of the Zila
Assembly.
Zila Nazim who is elected by the majority votes of the members of the District Assembly
is the head of the District Government. He is responsible to look after all the matters of
the District with the help of District Coordination Officer and The District Police Officer
like development programs, law and order etc.
The Naib Zila Nazim is the speaker and head of the Zila Assembly secretariat. He is
responsible to conduct the Ijlas of the assembly and assist the Zila Nazim in his
functions.
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The District Coordination Officer is the head of District Coordination Office and all the
District Government Departments. The District Coordination Officer Coordinates
between the Provincial Government and the District Government and deal the
correspondence of these Governments.
The head of remaining all departments is called the Executive District Office rand the
heads their sub-departments is called District Officer/ Deputy District Officer.
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The organization hierarchy chart shown on next page explains the hierarchy of the
District Government functionaries.
ORGANIZATIONAL HIERARCHY:
ZILA NAZIM
DO (Coordination)
DDO (Coord)
Council Zila Council District
Officer Monitoring
Secretariat DO
Officer
(Civil Defense)
DO (HRM)
DDO (HRM)
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SNA DO
Literacy
CHAPTER NO. 2
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MY PLACEMENT:
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The Chief Minister Punjab approved Poverty Focused Investment Strategy (PFIS) as a
guiding frame work for the future development planning and strategic programming of
investments in the Education Sector. PFIS articulates Punjab Government’s commitment
and strategy to achieve the development targets to set forth by Chief Minister’s vision
2020, Punjab Poverty Reduction Strategy Paper and Millennium Development Goals
(MDGs). It identifies the issues and gaps that need to be addressed to fully exploit the
potential of education and health sector for pro-poor impact.
District Monitoring Office, Rahim Yar Khan works under the control of Programme
Monitoring and Implementation Unit (PMIU), Govt. of the Punjab. The District
Monitoring Office monitors and reports on the following Programmes at District level:
The District Monitoring Officer, Rahimyarkhan is the Head of District Monitoring Office
and he is responsible for daily correspondence and monitoring, complaints and
submission of reports to the Higher Authorities within the stipulated time. He also
coordinate with the District Coordination Officer Rahimyarkhan in case of disposal of
cases, complaints, reports and arrangement of committees at District level in Committee
Room of DCO, Rahimyarkhan.
Strength of the department comprises of the office staff and field / front line Monitoring
& Evaluation Assistants (MEAs) of Chief Minister’s Monitoring Force.
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ORAGANIZATIONAL HIERARCHY:
District
Monitoring
Officer
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The District Monitoring Office works under the control of Programme Monitoring &
Implementation Unit (PMIU) of the Govt. of Punjab.
Top-Down:
From the higher authorities/ Department to the Subordinates/
Departments i.e. letters/Circulars received from the PMIU/CMMF/DCO/Secretary
(Education/Health) etc.
Bottom-Up:
From the lower level to the higher level i.e. DMO communicating
to the Deputy Director (M&E)/DCO/ Secretary/Higher Authorities etc.
Parallel:
Between the two Officers/Departments of parallel ranks i.e.
District Monitoring Officer communicating with the District Officer (Education)/ DO
(Planning & Development).
Telephone
Fax
Internet (E-mail)
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CHAPTER: 3
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Mission Statement
Developing human resources in Pakistan as a pre-requisite for global peace, progress and
prosperity.
Vision
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Objectives
Government of Pakistan
Ministry of Education
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INTRODUCTION:
Punjab Education Sector Reform Programme (PESRP) was started under the frame work
of Poverty focused investment strategy (PFIS) by the approval of Chief Minister Punjab.
Govt. of Punjab initiative PESRP in 2004 for future development planning and strategic
programming of investment in education sector in Punjab. It identifies the issues and
gaps that need to be addressed to fully exploit the potential of education sector for pro-
poor impact.
The education department has formulated the mid-term development frame work and its
annual development program based on the vision and strategies given by Punjab
Education Sector Reform Programme for education.
Following are the three pillars of the Punjab Education Sector Reform Program:
(A) Improve fiscal sustainability and improve the fiduciary environment to:
(i) Ensure that public expenditure continues to be increased and effectively used for
education at both provincial and district levels.
(ii) Strengthen the districts’ financing capacity and ensure that adequate resources are
transferred to districts to meet education needs.
(iii) Increase transparency of financial management and procurement processes and
practices.
(iv) Strengthen provincial and district capacities to monitor financial flows.
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(B) Increase equitable access to education and improve quality and relevance of
education. This forms the core reform agenda. Access agenda will focus on
programs to:
(i) Reduce the high drop outs at pre-primary and primary level, especially for girls.
(ii) Strengthen the elementary and secondary sector levels.
(iii) Encourage the participation of private sector.
(i) Strengthen the sector planning and policy development capacity of the provincial
education department.
(ii) Strengthen capacity of district education departments to improve service delivery.
(iii) Strengthen monitoring and evaluation
(iv) Enhance school based management and monitoring of school performance by
communities.
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Discouraging drop outs in schools by provision of a child-friendly environment
through banning corporal punishment.
Improving the skills of teachers away from rote learning to student centered
learning and adopting a system of continuous professional developing teachers
reinvigorating Punjab Education Foundation to encourage greater participation of
private sector in provision of education to populace, and to explore and
encourage public private partnerships.
Instituting advance HRM system for effective utilization of public sector human
resource across the different tires of education managements throughout the
province.
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CHAPTER: 4
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PESRP has an inbuilt component of Monitoring & Evaluation. All the data is fully
computerized and the datasets are professionally analyzed and then used for decision
making. This monitoring system is based on the programme’s ongoing monitoring,
supplemented by a strong field monitoring component also in the shape of the District
Monitoring Team, and a robust third party validation system.
At the onset of the programme, the Govt. of Punjab established Programme Monitoring
& Implementation Unit (PMIU) to oversee the monitoring & evaluation systems for the
education sector in Punjab. In a remarkably short time the PMIU developed a robust
monitoring system that is independently scrutinized by periodic third party validations,
and continuous to monitor, analyze and report progress on the various inputs of the
reform programme. The PMIU continues to undertake robust analysis to identify needs
and help inform policy decisions (such as prioritizing missing facilities and teacher
vacancies on an actual need basis). In addition to monitoring of programme inputs,
PMIU conducts school census twice during the academic year (in May and October).
FIELD MONITORING:
To complement the process monitoring setup for various activities of the reform
initiative of the Govt. of the Punjab, an elaborate field monitoring mechanism has been
established in the province. The purpose is to bring about real improvement in policy
implementation through results based management and outcome monitoring.
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The field monitoring system comprises of District Monitoring Officers posted in every
district of the province. The DMOs are assisted by the Monitoring & Evaluation
Assistants. The monitoring establishment has been well-equipped in terms of transport
and modern IT tools such as computers, cameras among other items to perform the
assign tasks and to provide real time monitoring reports. Under this monitoring
arrangement each school in Punjab is being visited, at least once in a month by the
MEAs. Data collected by the MEAs is properly digitized in the office of DMO and
analyzed by the PMIU to see districts’ performance vis-à-vis key indicators.
The field monitors keep a close watch on various development initiatives of the
provincial government in the districts, keep and facilitate the information flow lines with
the administrative departments and PMIUs intact and also to keep a constant liaison been
provided with the database of those sectors in which they have been engaged, they
constantly analyzed the latest developments, and apprise the District Government of the
emerging trends. The database created by the PMIU is placed with the DMO to make
information and analysis available to district officials. This field monitoring system is
already beginning to show results, as useful information from the field especially relating
to quality of civil works (development initiatives) and on teacher attendance is being
provided to the Education Department.
The monitoring process at district level is commenced by the District Monitoring Office.
The MEAs assist and report to the District Monitoring Officer regarding field monitoring
of schools and ongoing development schemes there at under different phases of
Education Sector Reforms (ESR).
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Each school of the district has been assigned a unique EMIS Code. Each of the MEAs is
assigned to visit the schools situated in one union council. The MEAs have been
provided state of the art proforma for school inspection (copy attached as appendix)
which contains the following information:
Illegal Fee/Funds.
Staff (Teaching & Non-Teaching).
• No. of sanctioned and filled posts.
• Physically present
• On sanctioned leave
• On official duty
• Un-authorized absent
• Late Comer
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The observations and data collected through the above mentioned inspection form is
submitted by the MEAs to the District Monitoring Office. Each inspection form, then, is
computerized on Inspection database software.
This inspection database software contains the same inspection form as detailed above
and other processing tools for analysis and converting the data into information.
The function of District Monitoring Office is only to assist the Education Department
and not to take any action against any irregularity. Soft copy of the monitoring data is
created through database software and then forwarded to Dy. Director (M & E) of PMIU
and Dy. Director (Monitoring) of CMMF for onward processing and necessary action. A
hard copy of the same is sent to the District Coordination Officer and Executive District
Officer (Edu).
At the PMIU, this inspection data is further processed and then the reports are forwarded
to the education department for further necessary action accordingly. The Dy. Director
(Monitoring) forwards his report to the Secretary (Education), District Coordination
Officer, Executive District Officer (Edu) for further necessary action.
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The meeting of District Review Committee is held at end of each month under the
Chairmanship of District Coordination Officer to review all the matters regarding Punjab
Education Sector Reforms Programme (PESRP). The implementation of decisions taken
in the meeting are further reviewed in the next DRC meeting.
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CHAPTER: 5
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The HSRP envisions a healthy population with a sound health care system practicing
healthy life style, in partnership with private sector including civil society, which is
effective, efficient and responsive to the health needs of low socio-economic groups
especially women in the eproductive age.
INTRODUCTION:
The Punjab Health Sector Reform Programme (PHSRP) was launched in with block
allocations of Rs. 700 million and Rs. 500 million during ADP 2004-05 and ADP 2005-
06, respectively. The scope of the PHSRP broadly includes provision of missing human
and physical facilities at the Basic Health Units (BHUs) and Rural Health Centers
(RHCs), improvement in health service delivery, human resource development, timely
supply of essential medicines and health awareness / health education. Civil works
constituted about 70% of the programme, while the remaining 30% of it is concerned
with provision of equipments.
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The programme envisaged the signing of terms of partnership between the District
Governments and the Provincial Government, whereby the Provincial Government has
been committed to provide the District Government with the missing infrastructure to
strengthen the existing medical facilities at the BHU and RHC level. The HSRP provides
for a comprehensive needs analysis of the missing facilities (physical & manpower) at
the BHU and RHC level with the assistance of District Governments.
VISION
Healthy population with a sound health care system practicing healthy life style, in
partnership with private sector including civil society, which is effective, efficient and
responsive to the health needs of low socio-economic groups especially women in the
reproductive age.
In order to concretize the above vision, 10 specific areas have been identified. These
are:
OBJECTIVES
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The PHSRP covers many areas. However, there are some basic common areas and
convergences of actions, some of which are listed below:
OUTCOMES:
The HSR has been developed after careful mapping of reforms initiative being
implemented in the Punjab under various programmes and projects. The program has far
reaching outcomes for Punjab and Pakistan. Some of these are briefly listed below:
Integration of all Primary Health Care Services including preventive health care,
school health andnutrition services at the BHU level.
Provision of missing facilities in RHCs / BHUs, adequate medicines and ensuring
availability of staff.
Upgradation of facilities in DHQ/THQ Hospitals.
Upgradation of training facilities for nurse / paramedics.
Introduction of a new cadre of health professionals with specialization in
community medicine for working in PHC facilities.
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District Rahimyarkhan having 104 BHUs. BHUs were established as the “First Level
Healthcare Facilities” (FLHFs) in the rural areas under the Health Policy of the 1970s
and early 1980s. A BHU was designated to be the FLHF for the area of a Union Council
which, in the Punjab, means an average of 11 “revenue estates”, commonly referred to as
“villages”.
Each BHU is established upon approximately 2 to 3 acres of land and comprises the
Healthcare block, an MO’s residence and, ordinarily, 5 other residences for the staff. The
total constructed area of a BHU exceeds 9,000 sft with its own water supply and rainage
facilities.
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A proposal was made to the Chief Minister, Punjab, in January 2003. In it, he was
apprised of:
(i) The proposition developed by the Zila Nazim of RYK for the PRSP to take over
the management of all the 104 BHUs in that District.
(ii) The broad features of how these health facilities (HFs) were proposed to be
managed by the PRSP.
The newly established District Governments (DG) had, since August 2001, inherited
authority from the Provincial Government in many sectors of which the Primary
Healthcare sector was one. In March 2003, two months after the approval of the Chief
Minister, an Agreement was signed between the District Government of RYK (DGRYK)
and the PRSP. The essential framework of the Agreement was crafted with much care in
the absence of precedents that could serve as models. It was thoroughly vetted by the
Health, Finance, Local Government and the Law Departments of the Provincial
Government for the comfort of the nascent District Government. And finally, it was the
un-flinching support of the then Zila Nazim, RYK * that over-rode the reservations
persisting within the DGRYK.
The plans for the management of the Initiative had to suffer a fundamental review soon
after the Agreement was concluded. Contrary to expectations, PRSP could not be
provided the services of key management personnel by the Government. As a result, the
“Project Management Unit” (PMU) had to be created within the DOH of the GoPb and
not in the PRSP. As an administrative arrangement, this was seriously flawed, to say the
least. But this is how the work had to commence. PRSP’s association with the operation,
though intimate from the start, remained indirect in some ways until the end of June
2004.
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Given the number of medical professionals in RYK in March 2003, assigning one MO to
a cluster of 3 BHUs. Accordingly, the 104 BHUs in the District, were clustered and
assigned by the first week of July 2003. Had the number of medical professionals been
different in RYK, clustering may also have been otherwise. The next two changes that
the PMU was able to initiate were (i) the staff presence and (ii) the availability of
medicines at the BHUs. Credit for these achievements must go to the small PMU, led by
the first Project Director, all of them driven by an exemplary crusading spirit.
COMMUNITY SUPPORT:
PRSP envisions that the most effective way to ensure that a service delivers the desired
volume and quality is to assign an appropriate role to the beneficiaries. There can be no
greater assurance of the desired volume and quality, on a continuing basis, than this
linkage. The CMIPHC has, therefore, organized a “Support Group” attached to every
BHU. Each Group comprises carefully selected individuals who represent important
interests like elected Councillors, teachers, women, students, professions, minorities, etc,
etc. The Group meets at least once a month and integrates the BHU with the community
that has a stake in the services delivered through the BHU. It is a responsibility of the
Group to see that the BHU is enabled, at all times and on a sustained basis, to provide
larger and better range of services. A member of the DSU staff arranges, attends and
minutes all meetings.
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This is a new activity of PRSP at the BHUs. Every MO (and Paramedic) is now going
out into the villages and getting the community together for interactive sessions on
Healthcare issues. These sessions are expected to create and enhance public awareness
on hygiene, sanitation, nutrition, family health, disease prevention, family planning,
immunization, inoculations, child health, etc, etc.
This too is a new activity. Every MO (and Paramedic) is now going into the schools in
the area of the BHU and holding interactive sessions with the students/teachers in the
relevant fields. School children are also brought to the BHUs for such sessions if the
BHU in not far. Children are screened for some of the common medical problems that
they could be suffering from. Health Cards, which record important data on the child, are
now being provided to students who have been screened.
This is a brand new service at the BHUs and a most significant development in the rural
Punjab. The number of female medical professionals willing to serve in remote rural
areas, in the public and private sectors, has always been small. The rural women are,
therefore, exceptionally disadvantaged in their access to essential medical assistance.
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The CMIPHC has responded with engaging female medical professionals and assigning
clusters of five BHUs to each. She goes around each BHU in the cluster every week. On
the sixth day (a Friday), she holds Health sessions at a Girls college/school in the area of
the five UCs. Time is also taken out on this day for the capacity building of the LHVs
and Midwives. The FMO Days are widely publicised and the schedule is strictly adhered
to so that women know precisely when consultation and medical assistance are possible.
A specialised pharmacy is provided to the FMO. This new window was opened in
November 2004 in RYK.
Now Patient can consult and receive assistance and medicines from for a mere Rs.1
Parchee Fee! FMOs are now regularly assisting with pregnancies and delivering family
planning services. It must be noted that we have arrived at the present strength of FMOs
progressively and that this number is subject to variation from month to month.
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14. It is a focal point, where community and the public sector health functionaries
come together to resolve issues concerning health.
15. BHU provides support; logistics, and management to LHW, TBAs, dispensaries,
MCH centers, sub health centers etc. falling in its assigned geographical limits.
RURAL DISPENSARIES:
The Rural Dispensaries (RDs) or the Mother and Child Health Centers (MCHCs) are in
an even sorrier state than the BHUs. These are often more poorly provisioned than a
BHU. The RDs are commonly housed in inadequate and ancient buildings with few
essential amenities. But RDs can be more centrally located than many BHUs. Given just
a little attention, therefore, many RDs come alive with very large numbers turning up at
these for medical assistance.
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CHAPTER: 6
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Punjab health sector reforms program has been launched to offer the health department
the financial and technical assistance it needs to undertake the challenging task of
introducing comprehensive health sector reforms in the Punjab. The HSRP is an
implementation and monitoring of the health department’s effort to institutionalized
health sector reforms.
Health sector reform framework also proposes to check the problem of absenteeism and
under-utilization of primary health care facilities. In addition to considering institution of
innovative measures to address absenteeism, and enhance the utilization of primary
health services, the Programme Monitoring & Implementation Unit (PMIU) has
developed a comprehensive monitoring & evaluation framework to assess the impact of
these reforms.
The District Monitoring Office, at district level has been assigned the responsibility to
monitor and collect data for evaluation purpose. The District Monitoring Office executes
its functions regarding the monitoring of HSR through District Monitoring Officer and
Monitoring & Evaluation Assistants (MEAs) who put surprise and periodic visits at the
health care centers to check the compliance of the program. For this purpose different
inspection forms have been developed each for BHUs & RHCs (both forms are attached
under section of appendix).
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The inspection data under the above mentioned heads is collected by the
Monitoring & Evaluation Assistants and the proformas are re-submitted in the District
Monitoring Office for onward transmission to the Deputy Director (Monitoring &
Evaluation), PMIU/PESRP, Lahore, for further necessary action.
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The reports send to the PMIU are further forwarded to the Program Director
(PHSRP) where these reports are analyzed and computerized. The Program Director
(PHSRP) writes the respective District Coordination Officer / Executive District Officer
(Health) to take necessary action regarding the inspection reports of BHUs/RHCs. A
copy of the same is forwarded to the District Monitoring Officer and Secretary Health
for information.
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SWOT ANALYSIS
STRENGTHS
WEAKNESSES
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OPPORTUNITIES
THREATS
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Highly qualified and trained staff should be deputed in field for the effective
monitoring and evaluation.
Try to adopt competitive methods and procedures.
Try to enhance and accuracy, performance and delays in work by setting work in
teams.
Try to adopt one window operation for complaints.
Try to improve your weak areas and as well missing facilities.
With the help of adopting new technology, improve the Monitoring & Evaluation
System Software because now it has been outdated and need to update.
Remove ambiguous management style
Give empower to monitoring employees
Must adopt decenteraliztion
Encourage the privatization
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CHAPTER: 7
LEARNING AS INTERN
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LEARNED:
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PROBLEMS ENCOUNTERED:
Encountering the problems during the routine work is a part of the experience. Problems
are not only the problems but also provide an opportunity to learn. Man learns when he
goes through the solving process of these problems.
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Experience is mandatory for career growth, development and for promotional decisions
both from individual and organizational perspectives.
Skills assessment
recognized.
Problem solving.
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BIBLIOGRAPHY:
• Terms Used
• Abbreviations
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TERMS USED:
DATABASE SYSTEM:
* speed - for fast results in a short time, and for easy maintenance in case of changes in
INTERNSHIP:
MONITORING:
Monitoring is the regular observation and recording of activities taking place in a project
or program. It is a process of routinely gathering information on all aspects of the project
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The Islamia University of Bahawalpur, Rahimyarkhan
Campus
PROGRAMME MONITORING & IMPLEMENTATION UNIT
LOCAL GOVERNMENT:
The elected Government of a town, Tehsil. Or District working under the control of
Provincial government
PROGRAM EVALUATION:
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The Islamia University of Bahawalpur, Rahimyarkhan
Campus
PROGRAMME MONITORING & IMPLEMENTATION UNIT
ABBREVIATIONS:
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The Islamia University of Bahawalpur, Rahimyarkhan
Campus
PROGRAMME MONITORING & IMPLEMENTATION UNIT
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The Islamia University of Bahawalpur, Rahimyarkhan
Campus
PROGRAMME MONITORING & IMPLEMENTATION UNIT
APPENDIX:
ESR School Inspection Form
BHU inspection Form
RHC Inspection Form
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The Islamia University of Bahawalpur, Rahimyarkhan
Campus
PROGRAMME MONITORING & IMPLEMENTATION UNIT
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The Islamia University of Bahawalpur, Rahimyarkhan
Campus
PROGRAMME MONITORING & IMPLEMENTATION UNIT
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The Islamia University of Bahawalpur, Rahimyarkhan
Campus
PROGRAMME MONITORING & IMPLEMENTATION UNIT
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The Islamia University of Bahawalpur, Rahimyarkhan
Campus