TB SR Implementation Guideline-Clean-Final

/fli6«o Ifo/f]u sfo{qmd
Unf]an km08 ;xfotf cGt{ut

;fem]bf/ ;+:yf åf/f sfof{lGjt
sfo{qm|d ;+rfng lgb]{lzsf
rf}yf] ;+:s/0f
cf. j. @)&*÷)&(
g]kfn ;/sf/
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List of Abbreviation
ANC : Antenatal Care
CMAM : Community Based Management of Acute Malnutrition
DR : Drug Resistant
DM : Diabetes Mallitus
EP : Extra Pulmonary
EQA : External Quality Assurance
FAST : Finding, Actively, Separating, and Treating
IDP : Internally Displaced Population
IMCI : Integrated Management of Childhood Illness
IPT : Isoniazid Preventive Therapy
TBPT : Tuberculosis Preventaive Therapy
IMAM : Integrated Management of Acute Malnutrition
IEC : Information, Education Communication
LFA : Local Fund Agent
MCH : Maternal and Child Health
MAM : Moderate Acute Malnutrition
MTB : Mycobacterium Tuberculosis
MOU : Memorandum of Understanding
NRH : Nutrition Rehabilitation Home
NTP : National Tuberculosis Program
OTC : Outpatient Therapeautic Centre
OPD : Outpatient Department
ORW : Outreach Worker
PR : Principal Recipient
PBC : Pulmonary Bacteriogically Confirmed
PCD : Pulmonary Clinically Diagnosed
PPM : Public Private Mix
SAM : Severe Acute Malnutrition
SOP : Standard Operating Procedure
SR : Sub Recipient
RRMTB : Rifampicin Resistant Mycobacterium Tuberculosis
ljifo ;"rL
sfo{qmd ;+rfngsf nflu ;fem]bf/ संस्था (SR), k|b]z/ :jf:Yo sfof{no, :yfgLo tx Pj+ cGo ;/f]sf/jfnf lgsfox?n]
kfngf गर्नुपर्े j'Fbfx? M .......................................................................................................................... 1
Ifo/f]u lgbfgsf nflu vsf/ ;+sng tyf 9'jfgL ;]jf - Sputum collection and transportation).................. 3
PBC / !% jif{ eGbf d'lgsf la/fdLx?sf] 3/kl/jf/sf ;b:ox?nfO{ Ifo/f]usf] :s[lgª (Contact Tracing) ug]{ ........ 7
;Defljt cf}ifwL k|lt/f]lw Ifo/f]u (Drug Resistant TB) sf la/fdLsf] l/kmflDkl;g ;]lG;l6lel6 k/LIf0f .................. 9
Drug Resistant (DR) Ifo/f]u la/fdLsf] 3/kl/jf/sf ;b:ox?sf] ;Dks{ k/LIf0f (Contact Tracing) ............. 11
c:ktfndf s'kf]lift tyf :jf;–k|:jf; ;+s|d0f ePsf afnaflnsfx?df Ifo/f]u lgbfg ......................................... 14
Tuberculosis Preventive Therapy (TPT) sfo{qmdsf] ;'?jft tyf lg/Gt/tf ....................................... 16
c:ktfnx?df Ifo/f]u ;+s|d0f /f]syfd tyf lgbfgsf] nflu FAST gLlt cjnDag ............................................. 17
sfo{s|d zLif{s Mcf}ifwL k;ndf la/fdL /]km/n k|0ffnL :yfkgf u/L Ifo/f]u lgbfg ................................................ 19
k|jf;L tyf df};dL sfdbf/df Ifo/f]usf] l:s[lgª tyf lgbfg ......................................................................... 21
Ifo/f]u lgbfg, pkrf/ tyf s]; gf]l6lkms]zgdf lghL :jf:Yo ;+:yfnfO{ d'n k|jfxLs/0fdf Nofpg] (Pay for Perfornace
to Private Doctors) ................................................................................................................... 24
lghL :jf:Yo ;]jf k|bfosx?;Fu /fli6«o Ifo/f]u sfo{qmd ;DaGwL hfgsf/L d"ns cGt/lqmof sfo{qmd ........................ 26
sfo{s|dsf] k|efjsfl/tf dfkgsf nflu k|b]z, lhNnf, ;lxt Plss[t cg'udg d'Nof+sgsf tyf ;'kl/j]If0f .................. 27
SR b\jf/f ;+rflnt sfo{s|dsf] :yflgo txdf ;ldIff uf]li7 ......................................................................... 28
Nepal Chemist and Drug Association (NCDA) ;+u Ifo/f]u sfo{s|d ;DjGwL uf]i7L . ......................... 29
Cg;"'rL !: :jf:Yo ;+:yf Pj+ Ifo/f]u lgbfg ;]jf DoflkË km/d]6 .................................................................... 27
cg';'rL @: TB screening Consent Form ...................................................................................... 28
cg';"rL #: .................................................................................................................................... 29
cg';'rL $: dfOqmf]:sf]kL s]Gb|sf] nflu Assessment checklist ................................................................ 32
cg';'rL %: Fast Stratergy Framework ......................................................................................... 33
cg';'rL ^: afnaflnsfdf Ifo/f]u lgbfg :sf]/ sf8{ .................................................................................... 34
cg';'rL &: /]sl8{ª tyf l/kf]l6{ª kmf/fd ................................................................................................. 35
cg';'rL *: TB Preventive Therapy Letter .................................................................................. 53
sfo{qmd ;+rfngsf nflu ;fem]bf/ संस्था (SR), k|b]z/ :jf:Yo sfof{no, :yfgLo tx Pj+
cGo ;/f]sf/jfnf lgsfox?n] kfngf गर्ुपन र्े j'Fbfx? M
/fli6«o Ifo/f]u sfo{qmdsf] kGrjlif{o gLlt -@)@! b]lv @)@^_ df tf]lsPsf nIo k|flKtsf nflu g]kfn ;/sf/, Unf]an
km08 / ;]e b lrN8«]g O{G6/g]zgn ljr lqklIfo ;Demf}tfsf] cfwf/df SR (Sub Recepient) cyf{t ;fem]bf/ ;+:yf
dfkm{t ljleGg lhNnf tyf :yfgLo lgsfodf ljleGg sfo{qmd÷ls|ofsnfkx? sfof{Gjog ug{ nfluPsf] 5 . oL
sfo{qmd÷ls|ofsnfkx? ;kmntfk"j{s sfof{Gjog u/L tf]lsPsf nIo k|fKt ug{ :jf:Yo lgb]{zgfno, :jf:Yo sfof{no
/ :yfgLo tx nufot ;Dk'0f{ ;/f]sf/jfnf ;dfg lhDd]jf/ ePsfn] o;sf] sfof{Gjog Pj+ cg'udg k|s[ofdf ;a}
lgsfon] cf–cfkm\g]f e"ldsf Pj+ lhDd]jf/L jxg u/L sfo{qmd ;+rfng ug{÷u/fpg' kb{5 .
sfo{qmd sfof{Gjog ubf{ ;dGjo ul/g' kg]{ lgsfo÷JolQm;

• /fli6«o Ifo/f]u lgoGq0f s]Gb|, :jf:Yo lgb]{zgfno, :jf:Yo sfof{no, :yfgLo tx, sfo{qmd sfo{fGjog x'g]
:jf:Yo ;+:yf / ;]e b lrN8]«g cGt{utsf sfo{qmd;Fu ;DjlGwt÷tf]lsPsf clwsf/L÷sd{rf/xLx? .
• SR n] :jf:Yo lgb]{zgfno Pj+ :jf:Yo sfof{no;Fusf] ;dGjo, / :yfgLo txsf] ;xsfo{df sfo{qmd ;+rfngsf]
of]hgf sfo{tflnsf lgdf{0f u/L sfof{Gjog ug]{ .
• :jf:Yo lgb]{zgfno, :jf:Yo sfof{no Pj+ :yfgLo tx;Fusf] ;dGjodf PsLs[t cg'udgsf] tflnsf lgdf{0f ug]{
/ ;f]lx cg';f/ lgoldt ?kdf :jf:Yo ;+:yf Pj+ Ifo/f]u lgbfg s]Gb|df PsLs[t cg'udg u/L sfo{qmdsf]
lg/Gt/tf / k|efjsfl/tf ;'lglZrt ug]{ / ;f]sf] k|ltj]bg tof/ u/L k]z ug]{ .
• SR n] sfo{qmd ;DaGwL vr{ ubf{ u/fpFbf :jLs[t ah]6 leq /xL, g]kfn ;/sf/sf] b}lgs e|d0f vr{ lgodfjnL
@)^$ -;+zf]wg @)&@_, cy{ dGqfnosf] sfo{ ;Grfng lgb]{lzsf @)&% tyf ;DalGwt k|b]z cGtu{tsf] vr{
;DaGwL xfn nfu" ePsf] dfkb08 cg';f/ sfo{qmd;Fu ;DjlGwt b}=e| eQf Pj+ cGo eQf pknJw u/fpg] .
• SR dfkm{t lhNnfdf ;+rfng ePsf sfo{qmdsf] cg'udg tyf d"Nof+sgsf nflu /fli6«o Ifo/f]u lgoGq0f s]Gb|,
;fdflhs ljsf; dGqfno cGt{ut sfo{qmd;Fu ;DjlGwt ;/f]sf/jfnf ;/sf/L lgsfo, / ;]e b lrN8«]gaf6
tf]lsPsf JolQmn] sfo{qmdsf] k|efjsfl/tfsf ;DjGwdf cg'udg tyf d"Nof+sg ug]{5g\ .
• SR n] :jf:Yo ;+:yfdf ;+rfng÷sfof{Gjog ug]{ ;Dk"0f{ ls|ofsnfksf nflu cfjZos hfgsf/L, k|s[of, /]sl8{ª
l/kf]{l6ª nufotsf ljifodf cfjZostf cg';f/ :jf:Yo ;+:yfsf sd{rf/Lx?nfO{ tfnLd tyf :ynut
cg'lzIf0fsf dfWodaf6 Ifdtf clej[l4 ug]{ .
• sfo{qmd ;+rfngsf nflu cfjZos ;fdfuL| Pj+ /]sl8{ª l/kf]{l6ª ;DjGwL kmd{, km/d]6 :jf:Yo sfof{no tyf
:yfgLo txsf] ;dGjodf ;DjlGwt :jf:Yo ;+:yfdf SR n] cfjZostf / cf}lrTosf cfwf/df pknJw u/fpg] .
• lgbfg e} pkrf/df cfPsf ;a} Ifo/f]usf la/fdLx?nfO{ Ifo/f]u pkrf/ /lhi6/df btf{ ePsf] Pj+ HMIS/DHIS2
df k|ltj]bg ePsf] ;fem]bf/L ;+:yf (SR) n] ;'lglZrt ug'{kg]{ .
• :jf:Yo ;+:yf Pj+ Ifo/f]u lgbfg s]Gb|n] SR dfkm{t ;+rfng x'g] sfo{qmdsf /]sl8{ª tyf l/kf]{l6ª pknJw
u/fOPsf] kmd{, km/d]6 cg';f/ ug]{ Joj:yfsf ;fy} SR nfO{ pQm sf{os|d;+u ;DjlGwt cfjZos
tYof+s÷k|ltj]bg pknAw u/fpg] s'/f sf] Joj:yf :yfgLo txn] ug'k{ 5{ .
• ;fdflhs kl/rfns (Social Mobilizer) nfO{ kfos kg]{ s'g} Ps :yfgLo txdf sfo{:yn tf]ls pQm :yflgo
txdf ;fdflhs kl/rfnsf al; sfd ] sfo{If]q leq kg]{ cGo :yfgLo txsf ;a} :jf:Yo ;+:yfx? ;d]6L sfo{s|d
;+rfng ug]{ .
• ls|ofsnfksf ljleGg zLif{sdf ljlgof]hg ePsf kfl/>lds tyf k|f]T;fxg afktsf] /sd tf]lsPsf cflwsf/Ls
sd{rf/LnfO{ SR n] cfjZos sfuhkq k|fKt u/L e'QmfgL ug{] u/fpg] .
1
• Ifo/f]u lgbfgsf nflu ul/g] kl/If0f afkt pknJw u/fOg] /sd g]kfn ;/sf/ jf cGo ;|f]t af6 bf]xf]/f] e'Qmflg
gePsf] lglZrt ul/ k|lt ;kmn kl/If0f afkt k|lt dlxgf e'Qmflg ug]{ . error, invalid h:tf c;kmn
glthfsf] e'Qmflg gx'g] .
• SR n] o; sfo{s|dsf] k|To]s å}dfl;s k|ult tyf sfo{s|dsf r'gf}tLx? t];|f] dlxgfsf] bf];|f] xKtf;Dddf ;DjlGwt
:yfgLo txdf k|:t'lts/0f åf/f 5nkmn ug]{ ;fy} jif{{sf] b'O{ k6s ;fdflhs ljsf; dGqfno Pj+ :jf:Yo
lgb]{zgfno ;+u ;+o'Qm ?kdf ;dLIff ug]{ . klxrfg ul/Psf r'gf}tL tyf ;d:ofsf] Joj:yfkg sf nflu lhDd]jf/
JolQm, ;do ;Ldf ;lxtsf] sfo{of]hgf agfO{ nfu" ug]{ .
• sfo{qmd;+u k|ToIf ;DjGw gePsf Pj+ sfo{s|ddf pNn]v gePsf] :yfg, JolQm tyf ;d'bfodf ;+rfng ePsf
ls|ofsnfksf vr{ a]?h' x'g]5 .
• sfo{s|d ;+rfngsf nflu of] lgb]{lzsf jfx]s Ifo/f]u;+u ;DjlGwt /fli6«o /0fgLlt, lgb]{lzsf, Standard
Operating Procedure (SOP), / sfo{qmd;Fu ;DalGwt ;Demf}tfnfO{ dfu{ lgb]{zgsf ?kdf lnO{ sfo{qmd
;+rfng ug]{ .
• o; lgb]{lzsfdf tf]lsPsf] afx]s cGo sfo{s|d ;+rfng Pj+ o;sf] df]8flnl6 kl/jt{g ug'{kg]{ ePdf SR n]
/fli6«o Ifo/f]u lgoGq0f s]Gb| Pj+ PR ;Fu clgjfo{ ?kdf k"j{ :jLs[lt lng' kg]{5 .
• :jf:yo ;]jf ljefusf dxflgb]{zssf] cbIftfdf sf{os|dsf] d'Nof+sgsf nflu Pp6f adhoc committee
u7g x'g] 5 / pQm sld6Ln] Unf]an km08 sf] ;xof]udf ;+rfng ePsf Ifo/f]u sfo{s|dn] pb]Zo cg'?k ;kmntf
xfl;n eP gePsf] ;DjGwdf k|To]s ltg dlxgfdf :ynut e|d0f ul/ ;ldIff ug]{ 5 / ;f] cg';f/ cfjZos
dfu{ lgb]{zg ug]{ 5 . k|fKt dfu{ lgb]{zg cg';f/ sfo{s|ddf ck]lIft ;'wf/ eP gePsf] ljj/0f SR n] pknJw
u/fpg] 5 .
• :jf:Yo ;+:yfdf ;+rfng ePsf sfo{s|dx?sf] clen]v HMIS tool cg';f/ ug]{ / pknJw u/fOPsf] km/d]6df
k|ltj]bg tof/ ug]{ . :jf:Yo ;+:yfdf ;djlGwt :jf:YosdL{ ;+u ;fdflhs kl/rfns a;L pknJw u/fOPsf]
km/d]6df dfl;s k|ltj]bg tof/ ug]{ / Ps k|lt k|dfl0ft k|ltlnlk lnO{ :yflgo tx af6 NTPMIS df k|ltj]bg
ug]{ .
2
sfo{sd
| zLif{s
Ifo/f]u lgbfgsf nflu vsf/ ;+sng tyf 9'jfgL ;]jf - Sputum collection and
transportation)
p2]Zo Ifo/f]u lgbfg x'g af6 5'6]sf la/fdL kQf nufO{ pkrf/df Nofpg] .
nlIft ;d'x alx/+u÷cGt/+u -cf]=kL=8L=÷cfO{=lk=8L_ ;]jfdf cfPsf ;Defljt Ifo/f]usf la/fdLx?,
P=Pg=l;= ;]jf lng cfPsf ue{jlt cfdf, tyf afnaflnsf ;d]t
sfo{sd| • lhNnfsf s'n :jf:Yo ;+:yfsf] *) k|ltzt :jf:Yo ;+:yfdf s'l/o/ ;]jf nfu' ug{'kg]{
sfof{Gjogsf ePsfn] { tn pNn]lvt dfkb08sf cfwf/df ;DjlGwt :jf:Yo sfof{no tyf :yfgLo
cTofjZos dfkb08 txsf] ;dGjodf :jf:yo ;+:yf 5gf}6 .
• lhNnfnfO{ $ efudf af8g] $)

k|ltzt clt b'/ud (Hard to
Reach), @) k|ltzt dWod b'/ud
(Moderate to Reach), @)
k|ltzt b'/ud / afFsL @) k|ltztnfO{
;'ud If]q -lhNnfsf] ;b/d'sfdsf] sf]/
Pl/of_ dflg ;fdflhs kl/rfnssf] af8kmfF8
ug]{ .
• :jf:Yo ;+:yf 5gf}6 ubf{ clt b'/ud Pl/ofnfO{ -$) k|ltzt_ klxnf se/ ub}{
s|d; lelq efudf k|j]; ug]{ .
• ;'ud If]qdf s|; /]km/n k|0fnL ;'b[9 ug{] cyf{t vsf/ ;+sng tyf 9'jfgLsf
nflu o; If]qsf :jf:yo ;+:yf Go'g k|fyldstfdf /fvL 5gf]6 ug]{ jf clt
b'u{d af6 5gf]6 ub}{ leq k:bf nIo cg';f/ :jf:Yo ;+:yf 5gf]6 ug{ afFls
ePdf ;'ud -sf]/ efu_ If]qdf ePsf t/ Ifo/f]u lgbfgsf] ;]jfgePsf
:jf:yo ;+:yf 5gf]6 ug]{ . /fli6«o Ifo/f]u sfo{s|d cGt{utsf lhgPS;k6{
;]jf ePsf Ifo/f]u lgbfg s]Gb|df vsf/ 9'jflg ;]jf dfkm{t vsf/ hfFr ug]{ .
olb s'g} sf/0fn] lhgPS;k6{ hfFr ul/ lgbfg ug{ ;Dej gePdf Ifo/f]u
sfo{s|dsf] EQA k|0ffnLdf u'0f:t/ ;'lglZrt x'g] / jflif{s #)) eGbf al9
hfFr x'g] dfOs|f];sf]kLs s]Gb|df hfFr u/fpg] . hfFrdf g]u]l6e glthf ePsf
;a} lj/fdLsf] Pp6f gd'gf lhgPS;k6{ ;]G6/x?df 9'jfgL u/fO{ k'Mg kl/If0f
ug{] .
• Ifo/f]u lgbfg ;]jf gePsf ;a} :jf:Yo ;+:yfx? / jflif{s #)) eGbf sd
vsf/ hfFr x'g] ;a} dfO{s|f];sf]kL ;]G6/x?af6 vsf/ ;+sng / 9'jfgL ug]{ .
• pNn]lvt dfkb08sf cfwf/df nIo cg';f/ lhNnfsf :jf:Yo ;+:yfsf] ;"rL tof/ ug]{
. pQm ;"rLaf6 w]/} cf]=lk=l8 lelh6 ePsf :jf:Yo ;+:yfx?nfO{ klxnf] k|fyldstf lbb}
s|dzM cGo :jf:Yo ;+:yfx?nfO{ s|dfut ?kdf vsf/ ;+sng tyf 9'jfgL sfo{s|d
;+rfng ug]{ .
gf]6M -k|fyldlss/0f ubf{ kxfl8 lhNnfsf xsdf :jf:Yo ;+:yfdf Go'gtd cf};tdf b}lgs !) hgf /
t/fO{sf lhNnfsf xsdf !% hgf gofF cf]=lk=8L= la/fdL ePsf :jf:Yo ;+:yf_.
• vsf/ 9'jfgL ug{ kfos kg]{ Ifo/f]u lgbfg s]Gb| cGo lhNnfdf kg]{ eP klg ;f]lx
;]G6/df vsf/ 9'jfgL u/L hfFr u/fpg] . olb lgbfg s]Gb| SR sf] sfo{If]q eGbf
3
aflx/sf lhNnfdf /x]df cfjZos sfuhft ;+sng u/L sfo{s|ddf Joj:yf eP

cg';f/sf] e'QmfgL ug]{ .
• :jf:Yo ;+:yfsf] ;+Vof lbOPsf] dfkb08 cg';f/ 5gf}6 ubf{ nIo eGbf tn dfly x'g]
ePdf SR n] sf/0f ;lxtsf] ljj/0f k]z u/L k|fKt ;xdlt cg';f/ ug]{ .
• ;fdflhs kl/rfnssf dfWodaf6 vsf/ 9"jfgL ug]{ .
• vsf/ ;+sng tyf 9'jfgLsf nflu xKtfsf] s'g} Ps af/ tf]ls ;f]lx cg';f/ tf]lsPsf]
lgbfg s]Gb|df vsf/ 9'jfgL ug]{ . olb xKtfdf Ps k6s eGbf al9 vsf/ 9'jfgL ug{
k|To]s k6s Py]i6 gd"gf -kfFr eGbf al9_ ePdf ;f]sf] ljj/0f SR n] k]z u/L k|fKt
;xdlt cg';f/ ug]{ .
• cf]=lk=l8=df cfPsf ;Defljt Ifo/f]usf la/fdLsf] vsf/ gd"gf ;+sng tyf 9'jfgL
ubf{ lgDg k|lqmofx? ckgfpg]:
✓ vsf/ ;+sng ul/Psf ;Dk"0f{ la/fdLx?sf] gfd, cf]=lk=l8= btf{ g+ / vsf/ k7fPsf]
ldlt ;lxtsf] ;"rL agfO{ lgbfg s]Gb|df k7fpg] .
✓ kmfNsf]g 6\o'adf la/fdLsf] gfd, cf]=lk=l8= btf{ g+ pNn]v ug]{
✓ ;+sng ePsf] vsf/nfO{ lgDg cg';f/ tLg lno/ KoflsË ug{] ।
➢ vsf/ /fv]sf] kmfNsf]g 6\o'asf] lasf]{ /fd|f];Fu s:g]
➢ kmfNsf]g 6\o'asf] lasf]{nfO{ b'O{-ltg /fp08 kf/flkmg l;n 6]kn] tfGb} a]g]{
➢ kmfNsf]g 6\o'anfO{ Knfli6ssf] lhkns Aofudf /fVg]
➢ lhknu Aofudf /flvPsf] 6\o'anfO{ vfd jf sf]Nr]g aS;df /fd|f];Fu /flv
aflx/ af6 6]kn] a]/]/ 9'jfgL ug]{ .
sfof{Gjog k|s[of • 5gf}6 u/LPsf :jf:Yo ;+:yfx? tyf Ifo/f]u lgbfg s]Gb|x?sf] ljj/0f cg';"rL ! cg';f/
tof/ u/L kxF'r / b"/Lsf cfwf/df vsf/ ;+sng Pj+ hfFrsf nflu ljleGg ;d"x agfpg]
/ ;DalGwt :jf:Yo ;+:yf / lgbfg s]Gb|x?nfO{ ;f] ;d"xsf af/]df hfgsf/L u/fpg] .
• :jf:Yo ;+:yfx?df vsf/ ;+sng tyf 9'jfgL ug]{ lbgsf] hfgsf/L OPD df ;a}n]
b]lvg] u/L /fVg] / pQm lbgdf ;d'bfo kl/rfns b\jf/f Ifo/f]u lgbfg s]Gb|df vsf/
9'jfgL u/fpg] .
• :jf:Yo ;+:yf Pj+ lgbfg s]Gb|nfO{ SR n] jlx/+u ;]jf lng cfPsf ;Defljt Ifo/f]usf
la/fdLsf] vsf/ ;+sng, Kofs]lhª / 9'9’jfgL ubf{{ Ifo/f]usf] ;+s|d0faf6 ;'/lIft x'g
ckgfpg' kg]{ ljlw h:t} tLg lno/ Kofs]lhª / 9'jfgL ug]{ ljlw, 9'jfgL tflnsf,
sfo{qmd;Fu ;DjlGwt clen]v tyf k|ltj]bg ;fy} pQm lqmofsnfk;+u ;DalGwt ah]6
Joj:yfkg, e'QmfgL k|s[of, / ;+:yfn] vsf/ 9'jfgLsf] dfl;s nIo h:tf ljifo–j:t'sf]
af/]df cled'lvs/0f ug]{ .
• lk=cf/= n] pknJw u/fPsf] ;fdflhs kl/rfns ljt/0f 6]an cg';f/ x'g] u/L t/fO{df
clwstd # j6f / kxf8df @ j6f :jf:Yo ;+:yfx? se/ ug]{ u/L ;fdflhs
kl/rfnssf] ljt/0f ug]{ / ;f] cg';f/ vsf/ 9'jfgL u/fpg] .
• :jf:Yo ;+:yfn] OPD df klxrfg ePsf ;Defljt Ifo/f]usf la/fdLnfO{ vsf/ hfFrsf]
ljsNk lbg]Ù klxnf] ljsNk– la/fdLn] vsf/ ;DjlGwt :jf:Yo ;+:yfdf lbg O{R5's
ePdf ;f]lx lbg jf vsf/ 9'jfgLsf nflu tf]sLPsf] lbgdf :jf:YosdL{sf] k|ToIf
lgu/fgLdf la/fdLsf] vsf/sf] gd"gf ;+sng ug]{ / bf];|f] ljsNk– dfOs|f];sf]lks
;]G6/df la/fdL cfkm} uO{ vsf/ hfFr u/fpg rfx]df vsf/ hfFr Nofj cg'/f]w kmf/d
el/ k7fpg] / pQm la/fdLsf] ljj/0f vsf/ 9'jfgL /lhi6/df cWwfjlw ug'{sf ;fy}
pQm lj/flddf Ifo/f]usf] lgbfg tyf pkrf/sf] ;'lglZrttf ug]{ .
4
• lhgPS;k6{df k/LIf0fug'{kg]{ ePdf vsf/sf] Pp6f u'0f:tl/o :ynut gd"gf /

dfO{s|f];sf]lks ;]G6/df k/LIf0f u/fpg' kg]{ ePdf b'O{ j6f :ynut vsf/ gd"gf lng]
-bf];|f] gd"gf Ps 306fsf] km/sdf_
• vsf/ gd"gf e08f/0f ug{ /]lkm|h]/]6/sf] Joj:yf ePsf] :jf:Yo ;+:yfn] xKtf leqdf
;+sng ePsf] vsf/sf] gd"gf plrt tfks|ddf /]lkm|h]/]6/ df ;'/lIft tj/n] /fvL
tf]lsPsf] lbgdf ;fdflhs kl/rfnssf dfWodaf6 Ifo/f]u lgbfg s]Gb|df vsf/ 9'jfgL
ug]{ .
• vsf/ gd"gf e08f/0f ug{ /]lkm|h]/]6/sf] Joj:yf gePsf :jf:Yo ;+:yfaf6 vsf/
;+sng tyf 9'jfgLsf nflu tf]lsPsf] lbgsf] !@ ah] leq vsf/ ;+sng u/L ;f]xL
lbg tf]lsPsf] lgbfg s]Gb|df vsf/ 9'jfgL u/fpg] / Ifo/f]u lgbfg s]Gb|n] ;Dej eP
;Dd ;f]xL lbg vsf/sf] hfFr ug]{, olb ;Dej gePdf k|fKt vsf/sf] gd"gf ;'/lIft
/fvL kl/If0fsf] k|s[ofdf n}hfg] .
• u'0f:t/ gePsf vsf/sf] gd"gf afktsf] /sdsf] e'QmfgL :jf:Yo ;+:yfnfO{ pknJw
gx'g] af/]df ;DjlGwt ;a} :jf:Yo ;+:yfnfO{ hfgsf/L u/fpg]
• ;fdflhs kl/rfnsn] :jf:Yo ;+:yfaf6 vsf/ ;+sng ubf{ vsf/sf] gd"gf x]/]/
u'0f:t/ gb]lvPsf vsf/sf gd"gf la/fdLaf6 k'Mg ;+sng u/fpg :jf:Yo ;+:yfnfO{
cg'/f]w ug]{ . u'0f:t/Lo vsf/ eGgfn] afSnf] kx]nf]÷v}/f] l9Ssf k/]sf] / /ut jf
vfgfsf 6's|fx? gePsf] vsf/ xf] .
• vsf/ hfFrdf kf]lhl6e glthf b]lvPdf ;DjlGwt :jf:Yo ;+:yfnfO{ kmf]g tyf O{d]n
dfkm{t lgbfg s]Gb|n] t'?Gt hfgsf/L u/fpg] / Nofj l/kf]{6 ;fdflhs kl/rfnssf
dfWod af6 ;DjlGwt :jf:Yo ;+:yfdf pknJw u/fpg] .
• lgbfg ePsf la/fdL pkrf/df gcfPdf ;DjlGwt :yfgsf ;d'bfo kl/rfns, dlxnf
:jf:Yo :jo+;]ljsf tyf cGo ;d'bfo dfkm{t kmnf]ck u/fO{ pkrf/df Nofpg] .
• k|To]s dlxgfdf :jf:Yo ;+:yfx?n] 9'jfgL u/]sf vsf/ / ;f] af6 lgbfg ePsf] Ifo/f]u
la/fdL ;+Vof dfl;s nIo cg'?k eP gePsf] ljZn]if0f ug]{ / la/fdL pkrf/ /lhi6/df
btf{ e} pkrf/ lnPsf] ;'lglZrt ug]{ .
• nuftf/ @ dlxgf;Dd ljleGg sf/0fn] vsf/ ;+sng gePsf jf ;+sng ePsf gd"gf
af6 klg nuftf/ # dlxgf ;Dd Ifo/f]u lgbfg gePsf ;+:yfx?nfO{ vsf/ ;+sng
tyf 9'jfgL k|0ffnLaf6 cnu ug]{ / cGo :jf:Yo ;+:yf 5gf]6 ug]{ .
• SR n] k|To]s dlxgf :jf:Yo ;+:yf Pj+ dfO{s|f];sf]lk ;]G6/n] tof/ u/]sf] dfl;s
k|ltj]bg / cfjZos cGo sfuhftx? ?h' u/L oL sfo{;Fu ;DjlGwt /sd e'QmfgL ug]{
.
ck]lIft pknAwL Ifo/f]usf] s]; gf]l6lkms]zgdf j[l4 x'g]5 .
cfly{s afF8kFmf8
l;=g+= ljj/0f PsfO{ b/ k6s hDdf
-g]kfn ;/sf/sf] ;Defljt la/fdL klxrfg÷/]km/÷ vsf/ !)) ! !))
k|lt ;Defljt
k|rlnt cfly{s P]g ! ;+sng÷ tLg lno/ Kofls+u÷/]sl8{ª tyf
Ifo/f]u la/fdL
lgodsf] clwgdf /xL l/kf]l6{ª tyf sDo'lgs];g
s/ s§L nufotsf Ifo/f]u lgbfg ePsf] la/fdL kmnf]ck tyf k|lt Ifo/f]u
@ %)) ! %))
sfo{ ;d]t ug]{ _ pkrf/df btf{ la/fdL
# vsf/ hfFr k|lt la/fdL %) ! %)
!= ;Defljt la/fdLsf] /]s8{ gePsf] Pj+ ;+sng u/]sf] vsf/sf] gd"gf Nofj jlu{s/0f cg';f/ u'0f:t/ gePdf
pQm gd"gf jfktsf] /sd pknJw gx'g] t/ ;f] JolQmsf] csf]{ u'0f:t/Lo gd"gf lnO{ pQm gd"gfsf] /sd
pknJw u/fpg] .
5
@+= ;+sng tyf 9'jfgL ePsf] vsf/sf] gd"gfsf] ljj/0f :jf:Yo ;+:yfdf ePsf] HMIS 6.1 /lhi6/df ePsf] ljj/0fsf
cfwf/df vsf/ ;+sng, tlLg lno/ KoflsË / /]sl8{Ë tyf l/kf]l6{Ë jfkt ? !)) / Ifo/f]u lgbfg e} pkrf/df
btf{ jfkt ? %)) :jf:Yo ;+:yfnfO{ pknJw u/fpg] , / NofjnfO{ lhgPS;k{6 b\jf/f vsf/ hfFr jfkt ? %)
/ :k'6d dfO{s|f];sf]kL b\jf/f vsf/ kl/If0f eP ? #% sf b/n] k|lt la/fdL pknJw u/fpg] .
#== vsf/sf] gd"gf Ifo/f]usf] lrGx tyf nIf0f gePsf] la/fdLaf6 ;+sngePsf] e]l6Pdf pQm gd"gfsf] jfktsf]
/sd e'QmfgL gx'g] .
$= ;=g+= # sf] /sd g]kfn ;/sf/ jf cGo ;|f]t af6 bf]xf]/f] e'QmfgL gePsf] lglZrt u/L k|lt ;kmn k/LIf0f afkt
e'QmfgL ug]{ . error, invalid h:tf c;kmn glthfsf] e'QmfgL gx'g] . x/]s dlxgfsf] cGtdf cfjZos sfuhft
?h' u/L :jf:Yo lgb]{zgfno÷k|b]z hg:jf:Yo k|of]uzfnf;+u ;dGjo u/L bf]xf]/f] e'QmgL gePsf] ;'lglZrt ug]{
.
6
sfo{s|d zLif{s
PBC / !% jif{ eGbf d'lgsf la/fdLx?sf] 3/w'/Lsf ;b:ox?nfO{ Ifo/f]usf] :s[lgª (Contact
Tracing) ug]{
p2]Zo Ifo/f]usf la/fdLx?sf] 3/kl/jf/sf ;b:ox?df Ifo/f]u lgbfg u/L pkrf/df Nofpg] .
nlIft ;d"x • Rffn' tyf clwNnf] cfly{s jif{df pkrf/df /x]sf ;a} PBC / s'g} klg k|sf/sf]] (PBC,
PCD, EP) Ifo/f]u ePsf !% jif{ d'lgsf afnaflnsfsf]] 3/kl/jf/sf ;b:ox?
sfo{qmd ;Dks{ k/LIf0fstf{ (contact tracer) :jf:Yo ;+:yfsf] cu'jfO{df 5gf}6 ug]{ .
sfof{Gjogsf • ;Dks{ k/LIf0fstf{ 5gf}6 ubf{ n]vk9 ug{ ;Sg] lgDg JolQmdWo]af6 lgDg k|fyfldstf
cTofjZos cg';f/ 5gf}]6 ug]{ :
dfkb08 !. dlxnf :jf:Yo :jo+ ;]ljsf (FCHVs),
@. cfdf ;d"xsf] ;b:o (Mother’s Group),
#. ;fd'bflos 86\; ;]jf k|bfos (CB DOTS Provider) jf
$. Ifo/f]u lgsf] ePsf] la/fdL
olb oL JolQmx? gePdf Ifo/f]u sfo{s|djf/]df cled'lvs/0f lnPsf jf Ifo/f]u sfo{qmd
a'em]sf ;d'bfosf JolQm h:t}M lzIfs, ;fdflhs kl/rfns, :yfgLo;+:yf jf Snjsf ;b:o
tyf :jf:Yo ;DjlGw tfnLd, cWoog ePsf h:t} CMA, ANM, HA cflb cWoog u/]sf
JolQm klg 5gf}6 ug{ ;lsg]5 .
• Ifo/f]u lgbfg ePsf] Ps aif{sf] cjlwdf lj/fdLsf] lgoldt ;Dks{df /x]sf 3/kl/jf/sf
;b:ox?nfO{ 3/ e]6 ul/ Ifo/f]usf] lrGx tyf nIf0fsf cfwf/df b"O{ k6s l:s|lgË ug]{ . klxnf]
;Dks{ kl/If0f Ifo/f]u lgbfg x'g;fy / bf];|f] slDtdf rf/ dlxgfsf] cGt/fndf ug]{ . ;fy}
pkrf/ k'/fePsf] Ps ji{f kl5 clGtd k6ssf] ;Dks{ kl/If0f af6 slDtdf ^ dlxgfsf]
cGt/fndf Ps k6s ug]{ .
• ;Dks{ k/LIf0faf6 klxrfg ePsf ;Defljt Ifo/f]usf la/fdLnfO{ lhgPS;k6{af6 k/LIf0f
u/fpg], olb s'g} sf/0fj; lhgPS;k6{ af6 k/LIf0f u/fpg] cj:yf gePdf vsf/ 9'jfgL
k|0ffnLdf cfj4 Quality assured dfOs|f];sf]lks ;]G6/df k/LIf0f ug]{ .
• dfO{s|f];sf]kL kl/If0fdf g]u]l6e glhtf cfPsf ;a} gd"gf x?sf] lhgPS;k6{ k/LIf0f ug]{
. o;sf nflu :jf:Yo ;+:yfn] la/fdLnfO{ ;Dks{ u/L k'gM vsf/} gd"gf ;+sng u/L
lhgPS;k6{ ;]G6/df k7fpg] .
• ;Dks{ k/LIf0fdf klxrfg ePsf ;Defljt Ifo/f]u la/fdLnfO{ :jf:Yo ;+:yfdf /]km/ ug]{
;fy} :k6df vsf/sf b'O{ gd'gf Ps w06fsf] km/sdf ;+sng u/L ltg lno/ KoflsË u/]/
glhssf] lhgPS;k6{ ;]G6/ jf 9'jfgL k|0ffnLdf cfj¢ :jf:Yo ;+:yf df{kmt vsf/ hfFr
u/fpg] .
• Ifo/f]u la/fdLsf] 3/kl/jf/sf ;b:o eGgfn] p;sf] cfkm\gf] kl/jf/sf ;fy} pQm 3/df
j;f]jf; ug]{ cGo kl/jf/sf ;b:o ;d]tnfO{ j'emg' k5{ . ;fy} la/fdLsf] 3/ eGgfn] p
xfn a;f]jf; u/L/x]sf] lghL jf ef8fsf] 3/ jf cGo JolQm h:t} ;fyL jf gft]bf/sf] 3/
eGg] klg j'em\g' kb{5 .
• ;Dks{ k/LIf0fdf Ifo/f]usf la/fdLsf] lgoldt ;Dks{df ePsf kfFr jif{ d'lgsf
afnaflnsfdf Ifo/f]usf] s'g} lrGx tyf nIf0f gePsf] kfOPdf TB Preventive Therapy
(TPT) ;'? ug{ ;DjlGwt :jf:Yo ;+:yfdf n}hfg] .
• Ifo/f]usf] l:s|lgª ubf{ Ifo/f]usf] la/fdL k|lt x'g] e]befj Go'lgs0f ug{ lgDg ls|ofsnfk
ug]{ M
o ;Dks{ k/LIf0f ug'{ k'j{ Ifo/f]usf] la/fdLsf] df}lvs :jLs[lt lng] .
7
o pkrf/t{ la/fdL af6 cGo JolQmdf Ifo/f]usf] ;+qmd0f x'g] ;Defjgf Go"g x'g] s'/fsf]
hfgsf/L pQm 3/kl/jf/ ;b:ox? Pj+ l5d]sLsf JolQmx?nfO{ hfgsf/L u/fpg] .
• ;Dks{ k/LIf0fubf{ HMIS 6.6 ;Dks{ k/LIf0f kmf/d k|of]u ug]{ / ;a} laj/0f -HMIS 6.7_
;Dks{ k/LIf0f tyf Ifo/f]u k|lt/f]wfTds pkrf/ /lh:6/_ df cWofjlw ug]{ .
sfof{Gjog k|s[of • :jf:Yo ;+:yfx?nfO{ pkrf/t{ la/fdLsf] ;+Vofsf cfwf/Dff ;"rLs[t ug]{ . ;"rLs[t dWo]
t'ngfTds?kdf w]/} la/fdL ePsf :jf:Yo ;+:yfx?af6 ;Dks{ k/LIf0f z'? ub{} s|dzM cGo
;a} la/fdL ePsf :jf:Yo ;+:yfx?df hfg] . ;'?df Rffn' cfly{s jif{{df pkrf/t{ Ifo/f]usf
la/fdLsf 3/kl/jf/sf ;b:ox?nfO{ ;Dks{ k/LIf0f u/]kl5 clwNnf] cfly{s jif{{df pkrf/
u/]sf la/fdLsf 3/kl/jf/sf ;b:ox?nfO{ ;Dks{ k/LIf0f ug]{ .
• SR n] :jf:Yo/ sfof{no tyf :yfgLo txsf] ;dGjodf 5gf}6df k/]sf :jf:Yo ;+:yfsf
:jf:YosdL{nfO{ sfo{qmd ;DaGwL hfgsf/L tyf cfjZos logistics pknAw u/fpg] .
• ;Dks{ kl/If0fstf{nfO{ sfo{qmd ;DaGwL Ifdtf clej[l4 ug]{ .
• :jf:Yo ;+:yfdf rfn' tyf clwNnf] cf=j= df btf{ e} Ifo/f]usf] pkrf/ lnPsf ;a} PBC
/ s'g} klg k|sf/sf]] (PBC, PCD, EP) Ifo/f]u ePsf !% jif{ d'lgsf afnaflnsfx?sf]
7]ufgf ;lxtsf] ljj/0f agfO{ :jf:Yo ;+:yfn] ;Dks{ k/LIf0fstf{ nfO{ pknJw u/fpg] .
• pknAw ljj/0fsf] cfwf/df ;DalGwt ;Dks{ k/LIf0fstf{n] Ifo/f]u la/fdLsf] 3/kl/jf/sf
;b:osf] pNn]lvt dfkb08 cg';f/ :s[lgª ug]{ .
• :s[lgª ubf{ Ifo/f]usf] nIf0f ePsf] kfO{Pdf vsf/ kl/If0fsf] nflu Ps w06fsf] km/sdf
vsf/sf] b'O{ gd'gf ;+sng ug]{ / Ifo/f]u lgbfg s]Gb|df hfFr u/fpg] jf vsf/ 9'jfgL
k|0ffnLdf cfj4 :jf:Yo ;+:yfdf ;+sng u/]sf] vsf/ k/LIf0fsf nflu a'emfpg] . ;fy}
:jf:Yo ;+:yfdf yk hfFrsf nflu /]km/ ug]{ .
• vsf/ ;+sng ubf{ ;Defljt Ifo/f]usf] la/fdLsf] pxL lbgsf] @ j6f vsf/sf] :k6 gd"gf
lnO{ :jf:Yo ;+:yfdf tLg n]o/ Kofls+u u/L n}hfg] .
• :jf:Yo ;+:yfn] ;Dks{ k/LIf0faf6 ;+sng ePsf] vsf/sf] j6\6fdf …;Dks{ k/LIf0fÚ hgfO{
Ifo/f]u lgbfg s]Gb|df vsf/ 9'jfgL k|0ffnL dfkm{t k7fpg] .
• ;Dks{ k/LIf0faf6 Ifo/f]u lgbfg ePdf 6L=jL= /lhi6/sf] k|]if0f/lgbfg dxndf ;Dks{
k/LIf0f egL pNn]v ug]{] .
• Ifo/f]u lgbfg e} pkrf/df gcfPsf] la/fdLnfO{ pkrf/df Nofpg :jf:Yo ;+:yfn] ;Dks{
k/LIf0fstf{ kl/rfng u/L pkrf/df Nofpg] .
ck]lIft pknAwL la/fdLsf] ;Dks{df ePsf 3/ kl/jf/sf ;b:odf Ifo/f]u lgbfg eO{ pkrf/ x'g]5 / Ifo/f]usf]
s]; gf]l6lkms];gdf j[l4 x'g]5 .
cfly{s afF8kFmf8 l;=g+= ljj/0f PsfO{ b/ k6s hDdf

-g]kfn ;/sf/sf] ! ;Dks{ k/LIf0fstf{ nfO{ oftfoft vr{ k6s $)) @ *))
k|rlnt cfly{s P]g pkrf/df gcfPsf] la/fdLnfO{ pkrf/df Nofpg
lgodsf] clwgdf /xL @ ;Dks{ kl/If0fstf{ nfO{ oftfoft/kmnf]ck vr{
k6s $)) ! $))
s/ s§L nufotsf :jf:Yo ;+:yfnfO{ ;Defljt la/fdL klxrfg÷ vsf/
sfo{ ;d]t ug]{ _ # ;+sng÷ tLg lno/ Kofls+u÷/]sl8{ª tyf l/kf]l6{ª k6s !)) ! !))
tyf sDo'lgs];g
$ k|lt ;kmn vsfF/ hfFr k|lt la/fdL %) ! %)
% Ifo/f]u la/fdL kmnf]ck tyf pkrf/df egf{ k|lt la/fdL %)) ! %))
• :jf:Yo ;+:yfdf ePsf] HMIS 6.1 /lhi6/df ePsf] ljj/0fsf cfwf/df vsf/ ;+sng, tlLg lno/ KoflsË / /]sl8{Ë
tyf l/kf]l6{Ë jfkt ? !)) :jf:Yo ;+:yfnfO{, vsf/ hfFr jfkt ? %) NofjnfO{, / Ifo/f]u lgbfg e} pkrf/df btf{
jfkt ? %)) ;Dks{ k/LIf0fug]{ JolQmnfO{ HMIS 6.7 ljj/0fsf cfwf/df e'QmfgL ug]{ .
8
• l;=g+ @ sf] /sd ;Dks{ kl/If0f stf{n] lgbfg e} pkrf/df gcfPsf lj/fdLnfO{ w/e]6 ul/ pkrf/df NofP jfkt
oftfoft vr{ .
• o; ls|ofsnfkdf vsf/ hfFrsf nflu Nofj sd{rf/LnfO{ lbO{g] /sd :jf:Yo ;+:yfaf6 vsf/ 9'jfgL u/L Nofjdf
k/LIf0fubf{ lbOg] vr{ zLif{saf6 e'Qmflg lbg] .
• :jf:Yo ;+:yfn]] Ifo/f]u :s[lgª kmf/d HMIS 6.6 lj/fldsf]] ;lx5fk ;lxtsf] slk lnO{ ;Dks{ kl/If0fstf{ nfO{
oftfoft vr{ lbg] .
•
sfo{qmd zLif{s M
;Defljt cf}ifwL k|lt/f]lw Ifo/f]u (Drug Resistant TB) sf la/fdLsf] l/kmflDkl;g ;]lG;l6lel6 k/LIf0f
p2]Zo DR Ifo/f]u la/fdL kQf nufO{ pkrf/df Nofpg] .
nlIft ;d"x • lhgPS;k6{af6 lgbfg gul/Psf xfn pkrf/ft{ Ifo/f]usf ;a} PBC / PCD la/fdLx?
.
• pkrf/sf] @, % dlxgf / pkrf/sf] cGtdf vsf/ kmnf]ck hfFrdf glthf kf]h]l6e ePsf
/ Ifo/f]usf] pkrf/df ;Gtf]ifhgs ;'wf/ gePsf la/fdLx? .
• ljutdf Ifo/f]u ePsf / xfn k'gM Ifo/f]usf] lrGx tyf nIf0f lno/ cfPsf Ifo/f]usf
;Defljt la/fdLx? .
sfo{qmd • vsf/ 9'jfgL ;fdflhs kl/rfns (Social mobilizer) dfkm{t ug]{ .
sfof{Gjogsf • :jf:Yo ;+:yf Pj+ lgbfg s]Gb|sf :jf:YosdL{x?nfO{ ;+efljt DR Ifo/f]usf
cTofjZos dfkb08 la/fdLx?sf] vsf/ ;+sng, Kofs]lhË / 9'jfgL ubf{{ Ifo/f]usf] ;+s|d0faf6 ;'/lIft
x'g ckgfpg' kg]{ ljlw h:t} tLg lno/ Kofs]lhËdf k|of]u x'g] :k'6d sG6]g/ nfO{
lgoldt lgd{'lns/0f (disinfection) ug]{ tl/sf, vsf/ 9'jfgL tflnsf Pj+
sfo{qmd;Fu ;DjlGwt /]sl8{ª tyf l/kf]{l6ªsf ;fy} pQm lqmofsnfk;+u ;DalGwt
ah]6 Joj:yfkg / e'QmfgL k|lqmof h:tf ljifo–j:t' af/] SR n] :ynut (onsite)
cled'lvs/0f ug]{ .
• lhgPS;k6{ af6 lgbfg ge} pkrf/df /x]sf Ifo/f]usf la/fdLsf] l/kmflDkl;g
;]lG;l6le6L k/LIf0fsf ug]{ .
• cf}ifwL ;+j]glzn Ifo/f]u (DS TB) Pj+ cf}ifwL k|lt/f]lw Ifo/f]u (DR TB) lgbfg
sfo{s|d b'a} nfu' ePsf :jf:Yo ;+:yfdf vsf/ ;+sng tyf 9'jfgL Ps} lbgdf ug]{
. olb cf}ifwL k|lt/f]lw Ifo/f]u (DR TB) lgbfg sfo{s|d dfq nfu' ePsf] :jf:Yo
;+:yf ePdf sfo{s|d ;+rfng k'j{ ;DjlGwt :jf:Yo ;+:yf / lhgPS;k6{ ;+usf]
;dGjodf vsf/ ;+sng, 9'jfgL Pj+ hfFrsf] lbg lglZrt ug]{ .
• lhgPS;k6{ kl/If0fdf RR-MTB lgbfg ePdf ;DalGwt :jf:Yo ;+:yf;+usf]
;dGjodf l8=cf/=pkrf/ s]Gb|df la/fdL /]km/ u/L pkrf/ lnPsf] ;'lglZrttf ug]{
.
sfof{Gjog k|s[of • ;DalGwt :jf:Yo ;+:yfn] ;+efljt DR Ifo/f]usf la/fdLx?sf] ljj/0f lbOPsf] /lhi6/df
cWofjlws ug]{ / tf]lsPsf] lbgdf tL la/fdLx?sf] vsf/sf] Pp6f gd"gf ;+sng, tLg
lno/ Kofls+u u/L ;fdflhs kl/rfns dfkm{t lhgPS;k6{ ;]G6/df k7fpg]] .
• vsf/ 9'jfgL ug{ kfos kg]{ lhgPS;k6{ ;]G6/ cGo lhNnfdf kg]{ eP ;f]xL ;]G6/df k7fpg]
/ pQm gd"gfsf] k/LIf0f z'Ns bf]xf]/f] e'QmfgL gePsf] lglZrt u/L k/LIf0fsf nflu k7fPsf]
SR n] k/LIf0f z'Ns pknJw u/fpg] .
9
• pkrf/fy{ Ifo/f]usf la/fdLsf] lgbfg lhgPS;k6{af6 gePsf] eP dfq pQm la/fdLsf]

vsf/sf] Pp6f gd"gf lnO{ l/kmflDkl;g ;]lG;l6le6L k/LIf0fsf nflu lhgPS:k6{ ;]G6/df
k7fpg] .
• :jf:Yo ;+:yfsf ;Defljt l8=cf/= Ifo/f]usf la/fdLsf] vsf/ 9'jfgL ubf{ lgDg k|lqmof
ckgfpg]:
• vsf/ ;+sng u/LPsf ;Dk'0f{ la/fdLx?sf] gfd, cf]=lk=l8= btf{ g+ / vsf/ k7fPsf]
ldlt pNn]v ;"rL agfO{ k7fpg] .
• kmfNsf]g 6\o'adf klg la/fdLsf] gfd, cf]=lk=l8= btf{ g+ pNn]v ug]{
• ;+sng ePsf] vsf/nfO{ ltg lno/ lgDg cg';f/ tLg lno/ KoflsË ug{] ।
1. vsf/ /fv]sf] kmfNsf]g 6\o'asf] lasf]{ /fd|f];Fu s:g]
2. kmfNsf]g 6\o'asf] lasf]{nfO{ b'O{-ltg /fp08 kf/flkmg l;n 6]kn] tfGb} a]g]{
3. kmfNsf]g 6\o'anfO{ Knfli6ssf] lhknu Aofudf /fVg]
4. lhknu Aofudf /flvPsf] 6\o'anfO{ vsf/ 9'jfgL ug]{ ef8f]df /flv 6]kn] a]/]/ 9'jfgLsf]
nflu tof/ ug]{ .
• lhgPS;k6{ ;]G6/df ;+sng ePsf] vsf/ gd"gf ;f]xL lbgdf hfFr ug{ g;s]sf] xsdf ;f]
gd"gf sf] plrt e08f/0f u/L csf]{ lbgdf hfFr ug]{ .
• vsf/ hfFrsf nflu k7fpg] :jf:Yo ;+:yfn] la/fdLsf] vsf/ hfFrsf] glthf lhg‐PS;k6{
;]G6/sf sd{rf/L];uF ;Dks{ u/L ;'lglZrt ug{] / kl5 vsf/ 9'jfgL k|0ffln dfkm{t Nofjsf]
glthf k|fKt u/L /lhi6«/df cWofjlws ug]{ . lhg PS;k6{ hfFraf6 Rifampicin resistant
lgbfg ePdf Ifo/f]usf] /lhi6/df moved to second line treatment elg hgfpg] / t'?Gt
DR Ifo/f]u pkrf/sf nflu ;DjlGwt DR Ifo/f]u pkrf/ s]Gb|df k7fO{ la/fdLn] pkrf/
lnPsf] ;'lglZrt ug]{ .
• lhg‐PS;k6{ ;]G6/df vsf/ hfFr u/] jfkt sd{rf/LnfO{ lbOg] z'Ns g]kfn ;/sf/sf] ;|f]t
cGt{ut k|b]z ;/sf/ / :jf:Yo lgb]{zgfno dfkm{t pknJw gePsf] lglZrt u/L ;kmn
pknJw u/fpg] .
Ifo/f]u pkrf/ /lhi6/ HMIS 6.5A / ;Defljt If/f]usf /lhi6/ HMIS 6.1 df ljj/0f
cWofjlw ug]{
• SR n] ;DalGwt :jf:Yo ;+:yf / lhg PS;k6{ ;]G6/af6 cfjZos sfuhftx? ;+sng ug]{
/ ;f] sf] ?h' u/L /sd e'StfgL ug]{ .
ck]lIft pknAwL ;+efljt DR Ifo/f]u la/fdLx?df DR Ifo/f]u kQf nflu pkrf/df cfpg] .
cfly{s afF8kFmf8
-g]kfn ;/sf/sf] l;=g+= ljj/0f PsfO{ b/ k6s hDdf
k|rlnt cfly{s P]g ;Defljt la/fdL klxrfg÷ vsf/ ;+sng÷ tLg lno/ k|lt
lgodsf] clwgdf /xL !)) ! !))
1 Kofls+u÷/]sl8{ª tyf l/kf]l6{ª tyf sDo'lgs];g la/fdL
s/ s§L nufotsf
lgbfg ePsf l8=cf/= la/fdLnfO{ kmnf]ck tyf k|lt
sfo{ ;d]t ug]{ _ %)) ! %))
2= pkrf/df egf{ la/fdL
k|lt
lhgPS;k6{ k/LIf0f z'Ns %) ! %)
3= la/fdL
• :jf:Yo ;+:yfdf ePsf] HMIS 6.1 -ljutdf pkrf/ history ePsf, l8=cf/= Ifo/f]usf ;Dk{s sf ;Defljt la/fdLsf nflu_ /
HMIS 6.5A -pkrf/f{y la/fdL, kmnf]ck kl/If0f– @÷#, % / pkrf/sf cGtdf vsf/ kf]h]l6e la/fdL / pkfrf/df ;+tf]ifhgs ;'wf/
gePsf la/fdLsf nfuL_/lhi6/df ePsf] ljj/0fsf cfwf/df vsf/ ;+sng, tlLg lno/ KoflsË / /]sl8{Ë tyf
l/kf]l6{Ë jfkt ? !)) / Ifo/f]u lgbfg e} pkrf/df btf{ jfkt ? %)) :jf:Yo ;+:yfnfO{, vsf/ hfFr jfkt ?
%) NofjnfO{ e'QmfgL ug]{ .
10
• olb Psf 3/kl/jf/df Ps eGbf al9 Ifo/f]u la/fdL ePdf, 3/w'/Lsf ;b:ox?nfO{ Ifo/f]u :s[lgËsf nflu lbOg]
oftfoft vr{ k|lt la/fdL sf cfwf/df ge} k|lt w/w'/Lsf cfwf/df lbg] . t/ olb Ifo/f]usf la/fdL km/s km/s
3/w'/Ldf a:g] ePdf k|lt la/fdLs} cfwf/df lbg] .
• l;=g+= # sf] /sd g]kfn ;/sf/ jf cGo ;|f]t af6 bf]xf]/f] e'QmfgL gePsf] lglZrt u/L k|lt ;kmn k/LIf0f
afkt e'QmfgL ug]{ . error, invalid h:tf c;kmn glthfsf] e'QmfgL gx'g] .
sfo{qmd zLif{s M
Drug Resistant (DR) Ifo/f]u la/fdLsf] 3/kl/jf/sf ;b:ox?sf] ;Dks{ k/LIf0f (Contact
Tracing)
p2]Zo Ifo/f]usf la/fdLx?sf] 3/kl/jf/sf ;b:ox?df Ifo/f]u lgbfg u/L pkrf/df Nofpg] .
nlIft ;d'x • xfn DR Ifo/f]u pkrf/df /x]sf la/fdLsf 3/kl/jf/sf ;b:ox?
• vsf/ 9'jfgL sfo{s|daf6 RR-MTB lgbfg ePsf la/fdLsf 3/kl/jf/sf ;b:ox?
• clwNnf] cfly{s jif{{df pkrf/ k'/f u/]sf DR Ifo/f]u la/fdLx?
sfo{qmd • ;Dks{ k/LIf0f ;fdflhs kl/rfns÷l8kmN6/ 6«];/÷:jf:YosdL{ dWo] pknJw s'g} ! hgfn]
sfof{Gjogsf ug]{ .
cTofjZos • :jf:YosdL{n] ;Dks{ kl/If0f ug{ g;Sg] cj:yfdf dfq ;fdflhs kl/rfns jf l8kmN6/
dfkb08
6«];/n] ;Dks{ kl/If0f ug]{ .
• vsf/ 9'jfgL k|0ffln dfkm{t vsf/ k7fpg g;lsg] :yfgsf ;Defljt Ifo/f]usf la/fdLsf]
vsf/ ;+sng tyf k/LIf0f ;fdflhs kl/rfns dfkm{t ug]{ .
• pkrf/t DR Ifo/f]u la/fdLsf] 3/kl/jf/sf ;b:ox?nfO{ pkrf/ cjlwdf slDtdf ^
dlxgfsf] cGt/fndf @ k6s l:s[lgª ug]{ / pkrf/ k'/f u/]sf] Ps jif{ cjlw kl5 clGtd
k6ssf] ;Dks{ kl/If0f af6 ^ dlxgfsf] cjlwdf km]/L ! k6s ;Dks{ k/LIf0f ug]{ .
• DR Ifo/f]u la/fdLsf] 3/ kl/jf/sf ;b:o eGgfn] p:sf] cfkm\gf] kl/jf/sf ;fy} pQm 3/df
j;f]jf; ug]{ kl/jf/ eGbf aflx/sf ;b:o ;d]t x'g / tL ;a}sf] ;Dks{ k/LIf0f ug]{ . ;fy}
la/fdLsf] 3/ eGgfn] p xfn a;f]jf; u/L/x]sf] lghL jf ef8fsf] 3/ jf cGo JolQm h:t}
;fyL jf gft]bf/sf] 3/ x'g ;S5 .
sfof{Gjog k|s[of • ;fdflhs kl/rfnsn] :jf:Yo ;+:yfsf] ;dGjodf 3/kl/jf/sf ;b:ox?sf] ;Dks{ k/LIf0fsf
nflu ;DjlGwt l8=cf/= la/fdLsf]] 7]ufgf ;lxtsf] ljj/0f pknJw /lhi6/df cWofjlws ug{]
/ ;f] cg';f/ 3/e]6 of]hgf agfpg] .
• :jf:Yo sdL{ pknJw gePdf ;fdflhs kl/rfns jf l8kmN6/ 6«];/ kl/rfng ul/ lj/dfLsf]
3/b}nf]df ;Dks{ kl/If0f ug]{ .
•
• DR Ifo/f]u la/fdLsf] 3/kl/jf/sf ;b:ox?sf] :s|lgª ubf{ la/fdLk|lt ;d'bfosf JolQm,
3/wgL Pj+ kl/jf/sf ;b:oaf6 x'g ;Sg] e]befjdf ;Dj]bgzLn e} pkrf/ lnPsf JolQm
af6 cGo JolQmdf Ifo/f]u ;+s|d0f x'g] ;Defjgf Go'g x'g] s'/fsf] hfgsf/L pQm 3/kl/jf/
Pj+ ;d'bfosf dflg; nfO{ k/fdz{ (counselling) ug'{sf ;fy}} la/fdLsf] df}lvs dGh'/L klg
lng' kb{5 .
• ;Dks{ k/LIf0fdf Ifo/f]usf] lrGx tyf nIf0f b]lvPsf 3/kl/jf/sf ;b:ox?sf] vsf/ ;+sng
u/L lhg PS;k6{ ;]G6/df vsf/ 9'jfgL k|0ffnL dfkm{t k7fpg] jf lhgPS;k6{ ;]G6/ glhs
eP ;Dks{ k/LIf0fstf{n] vsf/sf] gd"gf ;+sng u/L k/LIf0f u/fpg] .
11
• lhg‐PS;k6{ kl/If0fdf la/fdL lgbfg ePdf ;f] sf] hfgsf/L 6]lnkmf]g jf Od]n dfkm{t t'?GTf
;DjlGwt :jf:Yo ;+:yf, la/fdL / ;fdflhs kl/rfnsnfO{ u/fpg] / l/kf]6{ ;fdflhs
kl/rfns dfkm{t :jf:Yo ;+:yfnfO{ pknJw u/fpg] . RR-MTB lgbfg ePdf t'?Gt ;fdflhs
kl/rfns jf l8kmN6/ 6«];/n] la/fdLnfO{ DR Ifo/f]u pkrf/ s]Gb|df nu]/ pkrf/ ;'?
u/fpg] tyf RR – sensitive TB lgbfg ePdf ;DjlGwt :jf:Yo ;+:yfdf g} DS TB sf] pkrf/
u/fpg] .
• SR n] lhgPS;k6{ ;]G6/, pkrf/ s]Gb| jf pks]Gb|df uO{ sfo{qmd;Fu ;DjlGwt cfjZos
sfuhft ?h' u/L /sd e'QmfgL ug]{ .
• ;Dks{ k/LIf0fubf{ HMIS 6.6 ;Dks{ k/LIf0f kmf/d k|of]u ug]{ / ;a} laj/0f HMIS 6.7 -
;Dks{ k/LIf0f tyf Ifo/f]u k|lt/f]wfTds pkrf/ /lh:6/_ df cWofjlw ug]{ .
ck]lIft pknAwL DR Ifo/f]u la/fdLsf] ;Dks{df ePsf 3/kl/jf/sf ;b:ox?df Ifo/f]u lgbfg eO{ pkrf/df
cfpg] .
cfly{s afF8kFmf8
-g]kfn ;/sf/sf]
l;=g+= ljj/0f PsfO{ b/ k6s hDdf
k|rlnt cfly{s P]g
lgodsf] clwgdf /xL ;Dks{ k/LIf0fstf{ -;fdflhs kl/rfns ;d]t_ nfO{ k|lt
!))) @ @)))
s/ s§L nufotsf ! Ifo/f]usf] l:s|lgª ug{ oftfoft vr{ - clwstd_ lj/fld
sfo{ ;d]t ug]{ _ vsf/ ;+sng÷ tLg lno/ Kofls+u÷/]sl8{ª tyf l/kf]l6{ª tyf k|lt !)) ! !))
@= sDo'lgs];g la/fdL
k|lt
%)) ! %))
#= Ifo/f]u la/fdL kmnf]ck tyf pkrf/df egf{ la/fdL
k|lt
%) ! %)
$= Ifo/f]u k/LIf0f z'Ns -k|lt ;kmn k/LIf0f_ la/fdL
• HMIS 6.1 /lhi6/df ePsf] ljj/0fsf cfwf/df vsf/ ;+sng, ltg lno/ KoflsË / /]sl8{Ë tyf l/kf]l6{Ë jfkt ? !)),
Ifo/f]u lgbfg e} pkrf/df btf{ jfkt ? %)) :jf:Yo ;+:yfnfO{ / NofjnfO{ vsf/ hfFr jfkt ? %) e'QmfgL ug]{ .
HMIS 6.6 sf] ljj/0fsf cfwf/df :jf:YosdL{ jf ;fdflhs kl/rfns÷l8kmN6/ 6«];/ nfO{ ;Dks{ k/LIf0fsf afkt ?
!))) k|lt 3/ e]6 oftfot vr{ e'QmfgL ug]{ . ;Dks{ k/LIf0f ubf{ HMIS 6.6 df k|To]s 3/kl/jf/sf ;b:osf] ;xL 5fk
u/fpg] .
• l;=g+= $ sf] /sd g]kfn ;/sf/ jf cGo ;|f]t af6 bf]xf]/f] e'QmfgL gePsf] ;'lglZrt u/L pknJw u/fpg] . error,
invalid and indeterminate glthf ePsf hfFrsf] /sd e'QmfgL gx'g] .
sfo{qmd zLif{s :jf:Yo ;+:yfdf afnaflnsfdf Ifo/f]u lgbfg sfo{s|d

p2]Zo s'kf]lift tyf :jf;–k|:jf; ;+s|d0f ePsf afnaflnsfdf Ifo/f]usf] lgbfg u/L pkrf/df
Nofpg]
nlIft ;d'x :jf:Yo ;+:yfdf cfPsf s'kf]lift Pj+ :jf; k|:jf; ;+s|d0f ePsf % jif{{ d'lgsf afnaflnsf
.
sfo{qmd • tn pNn]v ePsf] dfkb08sf cfwf/df :jf:Yo ;+:yf 5gf}6 / k|fylds/0f ug]{ .
sfof{Gjogsf 1. t'ngfTds?kdf sd lgbfgfTds ;'ljwf ePsf :jf:Yo ;+:yfdf of] sfo{s|d
cTofjZos dfkb08 ;+rfng ug'{kg]{ ePsfn] lhNnf ;b/d'sfdaf6 6f9f -slDtdf !% ls=ld=_ ePsf
/ t'ngfTds?kdf a9L cf]lkl8 df rfk ePsf :jf:Yo ;+:yfx?
2. s'kf]lift tyf :jf;k|:jf; ;+s|d0f ePsf afnaflnsf a9L ePsf :yfgsf :jf:Yo
;+:yfx? -;b/d'sfdaf6 !% ls=ld= eGbf sd eP klg_
3. ;]jfsf] kx'Fraf6 6f9f ePsf, l;dfGts[t, clt ljkGg tyf lk5l8Psf hg;d'bfo
a;f]af; u/]sf :yfgsf :jf:Yo ;+:yfx? -;b/d'sfdaf6 !% ls=ld= eGbf sd eP
klg_
12
4. kf]if0fsf] sfo{s|d -IMAM/CMAM_ ;+rfng ePsf] lhNnfdf Outpatient

Therapeutic Center (OTC) ;]G6/x? ePsf] :jf:Yo ;+:yfx? .
• Ifo/f]u lgbfgsf nflu /]km/ eO{ hfg] s'kf]lift afnaflnsf / p;Fu ;fydf hfg] cleefasn]
k|fKt ug]{ oftfoft tyf a;f]af; /sd Ifo/f]u lgbfg /]km/n ;]G6/ -c:ktfn_ af6} pknAw
u/fpg' kb{5 .
• afnaflnsfdf Ifo/f]usf lgbfg ubf{ cg';"rL–& sf] :sf]/ rf6{sf] klg k|of]u ug{sf nflu
lrlsT;snfO{ hfgsf/L u/fpg] .
• aRrfnfO{ /]km/ ubf{ pknJw x'g] oftfoft tyf a;f]af; vr{ b"/Lsf cfwf/df s"n ah]6sf]
l;df leq /xL jlu{s/0f ug]{ h:t}M sGrgk'/ af6 ;]tL k|fb]lzs c:ktfndf cfpbf x'g] vr{
/ c5fd af6 ;]tL k|fb]lzs c:ktfndf cfpbf x'g] vr{nfO{ cfjZostfsf cg';f/ km/s
km/s b/ agfpg' kg]{ .
• s'kf]lift afnaflnsfdf Ifo/f]u :s[lg+u ;DaGwL ljifoa:t', Ifo/f]u lgbfgsf nflu /]km/
sfof{Gjog k|s[of u/L k7fpg' kg]{ c:ktfn, ToxfF la/fdLn] kfpg] ;'lawf / sfo{qmd;Fu ;DjlGwt /]sl8{ª Pj+
l/kf]{l6ª h:tf ljifox?sf ;fy} :jf:Yo ;+:yfn] :s[lgª ug]{ cg'dflgt dfl;s nIosf af/]df
cled'lvs/0f ug]{ / cfjZo logistics x? pknAw u/fpg] .
• afnaflnsf Ifo/f]u lgbfgsf nflu /]km/ ug{sf nflu b'O{ k|sf/sf c:ktfn 5gf}6 ug]{M
klxnf] sfo{s|d nfu" ePsf lhNnfsf lhNnf c:ktfn jf t'ngfTds?kdf /fd|f] lgbfgfTds
;]jf / lrlsT;s ePsf c:ktfn / bf];f|] lhNnf aflx/sf t'ngfTds?kdf u'0f:t/
lgbfgfTds ;]jf sf ;fy} afn/f]u ljz]if1 lrlsT;s ePsf] c:ktfn .
• :jf:Yo ;+:yfx?n] /]km/ ubf{ klxnf lhNnfdf tf]lsPsf] /]km/n c:ktfndf k7fpg] . olb
lhNnf /]km/n c:ktfn af6 dflyNnf] c:ktfndf /]km/ u/L k7fpg k/]df lhNnf c:ktfn]
cfjZos sfuhft tof/ u/L /]km/ ug]{ .
• afnaflnsf /]km/ u/L k7fpg] c:ktfnsf] Plsg u/L pQm c:ktfnsf] lrlsT;snfO{ afn
Ifo/f]u ;DaGwL Ifdtf clej[l¢ tfnLd ug]{/u/fpg] jf tfnLd k|fKt lrlsT;ssf] k"0f{
ljj/0f -;Dks{ JolSt, ;Dks{ g+=, /]km/ ug]{ lbg cflb_ hfgsf/L ;DalGwt :jf:Yo ;+:yfnfO{
SR n] pknAw u/fpg] . ;fy} /]km/n c:ktfndf tf]lsPsf kmf]sn JolQmsf] gfd / ;Dks{
gDj/ :jf:Yo ;+:yfnfO{ pknJw u/fpg] .
• /]km/n c:ktfnsf sfo{s|d kmf]sn JolQmn] :jf:Yo ;+:yfaf6 /]km/ e} cfPsf afnaflnsfdf
Ifo/f]u lgbfg ug{ ;xof]lu e"ldsf lgefpg] / ;xhLs/0f ug]{ .
• :jf:Yo ;+:yfdf cfPsf SAM aRrfnfO{ Ifo/f]u lgbfgsf nflu l;w} /]km/n c:ktfndf
k7fpg] / MAM cGtu{t juL{s[t ePsf aRrfx? Pj+ :jf;k|:jf; ;+s|d0f ePsf
aRrfx?df Ifo/f]usf] lrGx tyf nIf0f tyf Ifo/f]u la/fdL;+usf] ;Dks{ lxl:6«sf cfwf/df
l:qmlg+u u/L ;Defljt Ifo/f]usf aRrfx?nfO{ /]km/n c:ktfndf lgbfgsf nflu k7fpg] .
• /]km/n c:ktfndf k7fO{Psf ;a} aRrfx?sf] ug'{ kg]{ k/LIf0fM PS;/], df]G6' / lhg PS;k6{
af6 vsf/ k/LIf0f u/fpg] . vsf/ lgsfNg g;Sg] aRrfx?sf] tfnLd k|fKt lrlsT;sn]
Uofl:6«s nfefh lgsfnL lhg PS:k6{af6 Ifo/f]usf] lgbfg ug]{ .
• Uofl:6«s nfefh lgsfNg ;Dea gePdf PS;–/], df]G6' 6]:6, Pkm=Pg=l; -cfjZosdf dfq_
/ clinical lg0f{osf cfwf/df Ifo/f]u lgbfg ug]{ . ;Defljt EP Ifo/f]usf xsdf
cfjZostf cg';f/ FNAC, CSF (Cerebro spinal fluid) sf] u/L lgbfg ug]{ . yk
hfgsf/Lsf nflu aRrfdf Ifo/f]u diagnosis algorithm x]g]{ .
• ;Defljt If/f]usf /lhi6/ HMIS 6.1 df ljj/0f cWofjlw ug]{
ck]lIft pknAwL afnaflnsfdf Ifo/f]u lgbfg e} pkrf/df Nofpg] .
13

-g]kfn ;/sf/sf] ;Defljt la/fdL klxrfg÷vsf/ ;+sng÷
k|rlnt cfly{s P]g tLg lno/ Kofls+u÷/]sl8{ª, l/kf]l6{ª tyf
lgodsf] clwgdf /xL != k|lt la/fdL !)) ! !))
sDo'lgs];g
s/ s§L nufotsf
sfo{ ;d]t ug]{ _ :jf:Yo ;+:yf af6 ;DjlGwt lhNnfsf]
/]km/n c:ktfndf cfpbfsf] oftfoft, k|lt afns cf};t !))) ! !)))
vfgf tyf af; vr{
@=
lhNnfsf] /]km/n c:ktfn af6 dflyNnf]
/]km/n c:ktfndf cfpFbfsf] oftfoft, k|lt afns cf};t @))) ! @)))
vfgf tyf af; vr{
k|lt la/fdL pknJw ah]6 leq /xL
afnaflnsdf Ifo/f]usf] lgbfg Pj+ lrlsT;s z'Ns, PS;/],
cfjZos k/LIf0f vr{ df]G6', Uof;l6«s nfefh
#= jf:tljs vr{sf cfwf/df
/ k|lt ;kmn k/LIf0fjfkt
lhgPS;k6{ ? %) pknJw
u/fpg] .
Ifo/f]u lgbfg ePsf aRrfx?sf] pkrf/
$= tyf Joj:yfkg -la/fdL /]km/ ug]{ :jf:Yo k|lt la/fdL %))
;+:yf_
• HMIS 6.1 /lhi6/df ePsf] ljj/0fsf cfwf/df vsf/ ;+sng, ltg lno/ KoflsË / /]sl8{Ë tyf l/kf]l6{Ë jfkt ? !)), Ifo/f]u
lgbfg e} pkrf/df btf{ jfkt ? %)) :jf:Yo ;+:yfnfO{ / NofjnfO{ vsf/ hfFr jfkt ? %) e'QmfgL ug]{ .
• :jf:Yo ;+:yfaf6 lhNnf:t/df ePsf] c:ktfndf /]km/n u/]sf afnaflnsfnfO{ lbOg] oftfoft tyf a;f]af; vr{ /]km/ ug]{
:jf:Yo ;+:yfsf] HMIS 6.1 df ePsf] ljj/0f cg';f/ ug]{ / lhNnf:t/sf c:ktfn af6 afnaflnsf /]km/n c:ktfndf ePsf]
oftfoft tyf a;f]af; vr{ /]km/ ug]{ c:ktfnsf] HMIS 6.1 ljj/0f cg';f/ ug]{ .
• EP Ifo/f]u lgbfgsf nflu pknJw /sdaf6 FNAC, CSF nufot cfjZos k/LIf0f-cfjZos afnaflnsfnfO{ dfq_
sfo{qmd zLif{sM
c:ktfndf s'kf]lift tyf :jf;–k|:jf; ;+s|d0f ePsf afnaflnsfx?df Ifo/f]u lgbfg

p2]Zo s'kf]lift tyf :jf;–k|:jf; ;+s|d0f ePsf afnaflnsfdf Ifo/f]u lgbfg u/L pkrf/df
Nofpg]
nlIft ;d'x • c:ktfnsf] jlx/+Ë tyf Og8f]/df cfPsf % jif{ d'lgsf s'kf]lift Pj+ !% jif{ d'lgsf :jf;
k|:jf; ;+s|d0f ePsf afnaflnsf .
• Nutrition Rehabilitation Home -kf]if0f k'g{:yfkg s]Gb|÷u[xdf_ egf{ ePsf afnaflnsf
sfo{qmd • o; sfo{s|ddf t'ngfTds?kdf w]/} afnaflnsf sf] /f]u lgbfg tyf pkrf/ Joj:yfkg x'g]
sfof{Gjogsf ;/sf/L tyf u}x| ;/sf/L 7'nf c:ktfn 5gf}6 ug]{ .
cTofjZos dfkb08 • afnaflnsfdf Ifo/f]u lgbfgsf nflu tfnLd k|fKt lrlsT;s, afn/f]u laz]if1 lrlsT;s
klxrfg ug]{ .
• sfo{qmd kmf]sn JolQm -;Dej eP;Dd c:ktfns} s'g} :jf:YosdL{ dWo]af6_ 5gf}6 ug{]
jf 5gf}6 eO;s]sf] xsdf pgLx?nfO{ g} lg/Gt/tf lbO{ sfo{qmd ;+rfng ug{ ;lsg]5 .
5gf}6 ePsf] sfo{s|d kmf]s JolQmsf] lhDd]jf/L cg'rL # tf]lso adf]lhd ug]{ .
• c:ktfndf k|To]s lbg lgoldt?kdf Ifo/f]u lgbfg sfo{ ug{'kg]{5 .
14
• c:ktfnsf lrlsT;s tyf cGo :jf:YosdL{nfO{ sfo{qmdsf] cf}lrTo, ljwL, /]sl8{ª tyf
sfof{Gjog k|s[of l/kf]{l6ª, ck]lIft ;xof]u cflb h:tf ljifodf SR n] cled'lvs/0f ug]{ .
• c:ktfnsf] ;dGjodf sfo{qmd kmf]sn JolQmsf] 5gf}6 ug]{ . c:ktfndf pkrf/sf nflu
cfPsf, ljz]ift s'kf]if0f Pj+ s8f :jf;–k|:jf; ;+s|d0f ePsf afnaflnsfdf Ifo/f]usf]
l:s|lgª u/L ;Defljt Ifo/f]u e]l6Pdf yk lgbfg sfo{ ug]{ .
• klxrfg u/LPsf ;a} ;Defljt Ifo/f]usf afnnflnsf] X-Ray Pj+ Mantoux k/LIf0f ug]{
• aRrfn] vsf/ lgsfNg g;Sg] ePdf Uof;l6«s nfefh lgsfln lhg PS;k6{df k/LIf0fu/fO{
Ifo/f]us lgbfg ug]{ .
• Ifo/f]usf] lgbfgsf nflu lrlsT;sn] cfjZostf 7fg] cg';f/sf :k'6d dfO{s|f];sf]kL,
FNAC, CSF nufoft cGo dfWodaf6 Ifo/f]ussf] lgbfg u/fpg] .
• SR n] s'kf]lift afnaflnsfdf Ifo/f]u lgbfg cGt{ut cGo :jf:Yo ;+:yfaf6 /]km/ e}
cfPsf la/fdLnfO{ lbOg] oftfoft vr{ c:ktfndf tf]lsPsf] sfo{qmd kmf]sn JolQmnfO{
k]ZsL :j?k pknAw u/fpg] / dfl;s ?kdf cfjZos sfuhftx? ;+sng u/L k]ZsL
/sd km/5\of}6 ug]{ .
• ;Defljt If/f]usf /lhi6/ HMIS 6.1 df ljj/0f cWofjlw ug]{
ck]lIft pknAwL ;Defljt afnaflnsfdf Ifo/f]usf] lgbfg eO{ pkrf/df cfpg] .

-g]kfn ;/sf/sf] ;Defljt la/fdL klxrfg÷vsf/ ;+sng÷
k|rlnt cfly{s P]g tLg lno/ Kofls+u÷/]sl8{ª, l/kf]l6{ª tyf
lgodsf] clwgdf /xL != k|lt la/fdL !)) ! !))
sDo'lgs];g
s/ s§L nufotsf
sfo{ ;d]t ug]{ _ afnaflnsdf Ifo/f]usf] lgbfg tyf
k|lt dlxgf $))) !@ !@,)))
Joj:yfkg kmf]sn JolStm
k|lt la/fdL pknJw ah]6 leq /xL
afnaflnsdf Ifo/f]usf] lgbfg Pj+ lrlsT;s z'Ns, PS;/],
cfjZos k/LIf0fvr{ df]G6', Uof;l6s nfefh
@= jf:tljs vr{sf cfwf/df
/ k|lt ;kmn k/LIf0f jfkt
lhgPS;k6{ ? %) pknJw
u/fpg] .
Ifo/f]u lgbfg ePsf aRrfx?sf] pkrf/
#= tyf Joj:yfkg -la/fdL /]km/ ug]{ :jf:Yo k|lt la/fdL %))
;+:yf_
• HMIS 6.1 /lhi6/df ePsf] ljj/0fsf cfwf/df vsf/ ;+sng, ltg lno/ KoflsË / /]sl8{Ë tyf l/kf]l6{Ë jfkt ? !)), Ifo/f]u
lgbfg e} pkrf/df btf{ jfkt ? %)) c:ktfnn] o; sfo{sf] ;+rfngsf nflu tf]s]sf] JolQmnfO{, / NofjnfO{ vsf/ hfFr jfkt
? %) e'QmfgL ug]{ .
• o; sfo{s|d cGt{ut :jf:Yo ;+:yf jf lhNnf c:ktfnaf6 /]km/ e} cfPsf afnaflnsfdf Ifo/f]u lgbfg ePdf pQm s]; jfkt
kfpg] /sd ;'?df /]km/ ug]{ :jf:Yo ;+:yfnfO{ dfq pknJw u/fpg] . c:ktfnsf] OPD cyjf Indoor jf afnaflnsf df
Ifo/f]u lgbfg sfo{s|d nfu' gePsf :jf:Yo ;+:yfaf6 cfPsf afnaflnsf df Ifo/f]u :s[lgË u/L lgbfg u/]sf s];nfO{ dfq
/]km/n c:ktfnnfO{ pknJw u/fpg] .
• EP Ifo/f]u lgbfgsf nflu pknJw /sdaf6 FNAC, CSF nufot cfjZos k/LIf0f-cfjZos afnaflnsfnfO{ dfq_
15
sfo{qmd zLif{s M
Tuberculosis Preventive Therapy (TPT) sfo{qmdsf] ;'?jft tyf lg/Gt/tf

p2]Zo kfFr jif{ eGbf d'lgsf afnaflnsfx?nfO{ ;s[o Ifo/f]u (Active TB) x'gaf6 arfpg] .
nlIft ;d'bfo pkrf/t PBC Ifo/f]usf la/fdLsf] lgoldt ;Dks{df /x]sf kfFr jif{ eGbf d'lgsf
afnaflnsfx?
sfo{qmd sfof{Gjogsf • of] sfo{qmd ;Dks{ k/LIf0f sfo{s|d nfu" ePsf ;a} :jf:Yo ;+:yfdf nfu" ug]{ .
dfkb08 • :jf:Yo ;+:yfsf :jf:YosdL x?nfO{ ul/g] cled'lvs/0f sfo{s|d tyf lgoldt
:ynut cg'lzIf0f÷cg'udg e|d0fdf of] ;DjlGw ljifo–a:t' df cfjZos hfgsf/L
lbO{ Ifdtf clej[l4 ug]{] .
• ;Dks{ k/LIf0f sfo{s|d cGt{ut pkrf/t Ifo/f]u lj/fldsf 3/kl/jf/sf ;b:odf
Ifo/f]u l:s|lgªdf e]l6Psf kfFr jif{ d'lgsf, Ifo/f]usf] s'g} lrGx tyf nIf0f
gePsf ;a} aRrfdf TB preventive therapy (TBPT) nfu' ug]{ .
• ;a} gofF btf{ x'g] afnaflnsfnfO{ # dlxgf rfO{N8 /]lhd]g cGt{utsf] HR v'jfpg]
yk hfgsf/Lsf nflu TB preventive therapy sf] kl/dflh{t ufO{8nfO{g @)!( cWoog
ug]{ / ;f]lx adf]lhd ug]{ .
• ;Dks{ k/LIf0fdf 3/kl/jf/df e]l6Psf afnaflnsfdf ;s[o Ifo/f]u gePsf] Plsg
:jf:Yo ;+:yfsf lrlsT;s jf Ifo/f]u ;DjlGw tfnLd lnPsf :jf:YosdL{n] ug]{
.
• cf}ifwL ;]jg ug]{ aRrfnfO{ Ps dlxgfsf nflu :jf:Yo ;+:yfn] cf}ifwL pknAw
u/fpg] / aRrfn] 3/df lgoldt cf}ifwL vfP gvfPsf] ;'lglZrt ug]{ .
• SR n] TPT sf nflu cfjZos cf}ifwL ;DjlGwt :jf:Yo ;+:yfnfO{ lhNnf jf
kflnsf;+u dfu ug{ nufO{ aRrfnfO{ ljt/0f ug]{ Joj:yf ldnfpg] .
sfof{Gjog k|s[of • ;Dks{ k/LIf0fubf{ s'g} kl/jf/df kfFr jif{{ d'lgsf aRrfx? e]l6Pdf TPT sf nflu
contact tracer n] ;DjlGwt :jf:Yo ;+:yfdf k7fpg] .
• pQm :jf:Yo ;+:yfsf lrlsT;s jf :jf:YosdL{n] ;f] aRrfdf Ifo/f]usf] lrGx / nIf0fx?
eP gePsf] Plsg ug]{, olb Ifo/f]usf] nIf0f gb]lvPdf pQm aRrfnfO{ TPT z'? ug{
u/fpg] .
• TPT ;'? ug{' k'j{ jRrfsf] cfdf afa' tyf cleefjsnfO{ TPT af6 jRrfnfO{ x'g]
kmfO{bf Pj+ o;sf] k|lts'n c;/, Ifo/f]usf lrGx tyf nIf0fsf jf/]df clgjfo{ ?kdf
hfgsf/L u/fpg] .
• pQm aRrfsf] :jf:Yo l:ylt, pkrf/ cg'udgsf nflu pkrf/ cjlwdf Ps k6s
aRrfsf] 3/df hfg] . cg'udg ubf{pknJw r]slni6sf] k|of]u clgjfo{ ug]{ . -gf]6M
kmnf]ck r]slni6 SR n] agfO{ :jf:Yo ;+:yfnfO{ lbg]_
• jRrfx?df TPT lnbf lnb} Ifo/f]usf] lrGx tyf nIf0f jf cGo :jf:Yo ;d:of b]vf
k/]df t'?Gt :jf:Yo ;+:yfdf k7fpg] .
• :jf:Yo ;+:yfn] olb TPT lnPsf] aRrfdf Ifo/f]usf] lrGx ,nIf0f tyf cGo :jf:Yo
;d:of ePsf] 5 eg] pQm s'/fsf] lgbfg u/L plrt pkrf/ Joj:yfkg ug]{ . olb
:jf:Yo ;+:yfn] aRrfsf] :jf:Yodf ;d:of jf Ifo/f]u lgbfg ug{ g;Sg] ePdf
dflyNnf]txjf lgbfg ;'ljwf ePsf] :jf:Yo ;+:yfdf t'?Gt /]km/ u/L k7fpg] .
16
• ;DalGwt :jf:Yo ;+:yfn] TPT df btf{ ePsf aRrfx?sf] cfjZos /]s{l8ª tyf l/kf]{l6ª
:jf:Yo ;+:yfn] HMIS 6.7 -;Dks{ k/LIf0f tyf Ifo/f]u k|lt/f]wfTds pkrf/ /lh:6/_
df cWofjlws ug]{ .
• SR n] aRrfx?nfO{ lbOg] oftfoft vr{ ;DalGwt :jf:Yo ;+:yfsf] kmf]sn JolQmnfO{
k]ZsL lbO{ aRrfx?n] oftfoft vr{ kfP gkfPsf] ;'lglZrt ug]{ / dfl;s ?kdf cfjZos
sfuhftx? ;+sng u/L km/\5of}6 ug]{ .
ck]lIft pknAwL Ifo/f]usf la/fdLsf] ;Dks{df ePsf afnaflnsfdf Ifo/f]usf]] ;+s|d0f x'g af6 arfO{ Ifo/f]u
;+s|d0fsf] >[ªvnf cGt x'g] .

-g]kfn ;/sf/sf] k|rlnt k|lt
cfly{s P]g lgodsf] aRrfnfO{ TPT ;+sngsf nflu oftfoft
! afnaflnsf÷k|lt $)) # !@))
clwgdf /xL s/ s§L vr{
dlxgf
nufotsf sfo{ ;d]t ug]{ _ :jf:YosdL{nfO{ TPT Joj:yfkg vr{ - # k|lt afnaflnsf
@ ^)) ! ^))
dlxgf cjlw ;Dd_
• HMIS6.7 ePsf] ljj/0fsf cfwf/df afnaflnsfnfO{ oftfoft vr{ pknJw u/fpg] .
• TPT Joj:yfkg eGgfn] cfjZostf cg';f/ aRrfsf] w/e]6, 6]lnkmf]g, /]sl8{Ë tyf l/kf]l6{Ë afkt lbOg] /sd xf] .
TB Preventive Weight bands Number of Tablets RH (75/50)
Therapy Medicine
4-7.9kg 1
Dosage
8-11.9kg 2
12-15.9kg 3
16-24.9kg 4
Use adult dosages and
25kg+ preparations
sfo{qmd zLif{s M
c:ktfnx?df Ifo/f]u ;+s|d0f /f]syfd tyf lgbfgsf] nflu FAST gLlt cjnDag
p2]Zo • c:ktfndf Ifo/f]usf] ;+qmd0f /f]syfd ug{] .
• Ifo/f]usf la/fdLsf] lgbfg u/L pkrf/df Nofpg]
nlIft ;d'bfo c:ktfnsf] OPD tyf In patient department (Indoor) df cfPsf ;a} la/fdLx?
sfo{qmd sfof{Gjogsf • t'ngfTds?kdf w]/} OPD visit x'g] c:ktfn 5gf}6 ug]{ .
dfkb08 • o; gLlt cGt{ut Ifo/f]usf] lrGx tyf nIf0fsf cfwf/df / PS;/]sf dfWod :s[lgª
ug]{ .
• Ifo/f]usf] ;Defljt la/fdLsf] lgbfg lhgPS;k6{ - lhgPS:k6{ pknJw gePdf dfq
:k'6d dfO{s|f];sf]kL_ jf lrlsT;ssf] clinical judgement sf cfwf/df ug]{ . o;
sfo{s|dsf] lj:t[t hfgsf/Lsf nflu Fast approach / tn lbOPsf] cg;"'rL % sf]
flow chart cWoog ug]{ .
• o; sfo{s|d cGt{ut c:ktfndf lgo'Qm ul/Psf sd{rf/Ln] cg';"'rL $ cg';f/sf] sfo{
ug]{ .
sfof{Gjog k|s[of • sfo{s|daf6 tf]lsPsf c:ktfnx?df FAST gLlt cjnDjg ug]{ . olb tf]lsPsf] eGbf
km/s c:ktfn 5gf}6 ug{'k/]df k'j{ :jLs[lt lnO{ ug]{ .
17
• ;j{k|yd c:ktfnsf] Joj:yfkg;+u a}7s a;L FAST sf] cf}lrTo, cfjZostf tyf
o;sf] ;+rfng ljlwsf jf/]df 5nkmn u/L sfo{s|dsf] k|efjsf/L ;+rfngsf] jftfj/0f
;'lglZrt ug]{ .
• SR n] c:ktfnsf] ;dGjodf sfo{s|d ;+rfng tyf Joj:yfkgsf nflu b'O{ hgf kmf:6
df]lanfO{h/ 5gf}6 ug]{ .
• 5gf}6 ePsf df]lanfO{h/x? ;lxt c:ktfndf FAST gLlt cGt{ut sfo{ ug]{ ;a}
lrlsT;s, :jf:ysld{, Nofj tyf g/l;Ë sd{rf/LnfO{ Ps lbg] cled'lvs/0f ug]{] .
• of sfo{s|d df]lanfO{h/n] c:ktfn ;+rfng ePsf] x/]s lbgdf la/fdL btf{ kmfF6;Fu
;dGjo u/L k|To]s la/fdLnfO{ vf]sL nfu] gnfu]sf] :s[lgª ug]{ u/fpg] .
• c:ktfnsf] Joj:yfkg;Fu ;dGjo u/L ;Defljt Ifo/f]usf la/fdLnfO{ 5'6\6} :yfgdf
-Separation) /fVg] Joj:yf ug]{ .
• :s[lgª ubf{ vf]sL nfu]sf] la/fdLsf] OPD card df FAST sf] stamp nufO{ c:ktfndf
Joj:yf u/LPsf] 5'§} -Separation) :yfgdf k7fpg] . pSt :yfgdf ;Dk"0f{ la/fdLx?nfO{
cg';r " L @ df /flvPsf] screening questionnaire cg';f/ Ifo/f]usf] ;Defljt
la/fdLsf] klxrfg ug]{ ;fy} c:ktfndf PS;/] ;]jf pknJw ePdf pQm la/fdLsf] PS;–
/] af6 klg Ifo/f]usf] l:s[lgª u/fpg] .
• vf]sL nfUbf ;+qmd0f /f]syfdsf nflu d'v 5f]Kg] tyf cGo pkfo ckgfpg' kg]{ ljifosf
af/]df hfgsf/L u/fpg] .
• lhg PS;k6{ ;]G6/ ePsf] c:ktfndf Ifo/f]usf] ;Defljt la/fdLsf]] vsf/sf] :k6
gd"gf ;+sng ug]{ / vsf/ hfFr cg'/f]w kmf/fd e/L lhg PS;k6{df hfFrsf] nflu
k7fpg] .
• lhg PS;k6{ ;]G6/ gePsf] c:ktfnsf] xsdf vsf/sf] b'O{ j6f gd"gf lnO{ sputum
microscopy sf nflu :nfO8 tof/ u/L hfFr ug]{ / Pp6f /fd|f] gd"gf lhgPS;k6{
hfFrsf] nflu k7fpg] .
• dflysf] k|s[of k'/f eO{;s]kl5 ;f] la/fdLx?nfO{ hfFr ug{ cfPsf] k|d'v :jf:Yo
;d:ofsf nflu ;DalGwt lrlsT;ssf] df nfO{gdf ga;fO{ ;f]em} ;]jf lng] Joj:yf
ldnfpg] .
• Ifo/f]u lgbfg s]Gb|df vsf/sf] hfFr ;f]xL lbgdf u/fpg] / olb hfFr ug{ g;lsPsf]
cj:yfdf plrt e08f/0f u/L csf]{ lbgdf hfFr u/L l/kf]{6 lbg] .
• vsf/ hfFraf6 k|fKt glthfsf cfwf/df /fli6«o Ifo/f]u sfo{qmdsf] pkrf/ lgb]{lzsf
cg';f/ pkrf/ u/fpg] . -gf]6M ;xhstf{n] la/fdLnfO{ vsf/ hfFrsf] l/kf]{6 lng] lbg
tyf ;dosf] hfgsf/L u/fpg'kb{5 tyf cfjZostf cg';f/ l/kf]{6 lnP glnPsf]
kmnf]ck ug'{ kb{5 ._
• gf]6M Indoor df egf{ ePsf la/fdLx?sf] klg dfly pNn]lvt k|s[of cg'?k FAST gLlt
cg';f/ l:s[lgª ug]{ .
• sfo{s|dsf] rf}dfl;s ;dLIffubf{ c:ktfn df FAST sfo{s|ddf k|ToIf ;+nUg lrlsT;s,
:jf:Yo sld{, Nofj tyf g;/l;Ë sd{rf/LnfO{ ;dfj]z u/L ah]6sf] kl/lwleq /xL
;+rfng ug]{] .
• o; sfo{s|dsf] /]s{l8ª tyf l/kf]{l6ª ;Defljt Ifo/f]u la/fdLsf] /lhi6/ HMIS 6.1
df cWofjlws ug]{ .
ck]lIft pknAwL c:ktfnx?df Ifo/f]usf] ;+qmd0f /f]syfd x'g]5 / ;+efljt Ifo/f]u la/fdLsf] lgbfg tyf
pkrf/ eO{ s]z gf]l6lkms];gdf j[l¢ x'g]5 .
18
cfly{s afF8kFmf8 != pknJw ah]6 cg';f/ sfo{s|d ;'k/efO{h/ lgo'Qm u/L sfo{s|d ;+rfng ug]{ .
-g]kfn ;/sf/sf] k|rlnt @=k|lt ;kmn lhgPS:k6{ hfFrsf] ? %) pknJw u/fpg] . HMIS 6.1 /lhi6/df ePsf] ljj/0fsf cfwf/df e'QmfgL
cfly{s P]g lgodsf] ug]{ .
clwgdf /xL s/ s§L
nufotsf sfo{ ;d]t ug]{ _
sfo{s|d zLif{s Mcf}ifwL k;ndf la/fdL /]km/n k|0ffnL :yfkgf u/L Ifo/f]u lgbfg .
औषधि पसलको सम्पकु मा आएका सम्भाधित क्षयरोगका धिरामीहरुलाइ धिधकत्सकको मा रेफरल
उद्देश्य
गरी क्षयरोग धर्दार् गर्े ।
लक्षित समहू औषधि पसलमा उपिारका लाधग आएका सिै धिरामीहरु
▪ यो कायुक्रम महार्गर तथा उपमहार्गर पाधलका क्षेत्र धभत्र गर्नु पर्े भएता पधर् यसको पररधि
िररपरर रहेका अन्य औषिी पसललाई पधर् समािेश गर्े ।
▪ यो कायुक्रम औषधि पसल र धिधकत्सक िीि रेफरल प्रणाली धिकास गरी संिालर् गर्े ।
▪ धिरामी रेफरल गर्े स्थार्मा धिधकत्सक सधहत एक्स–रे सेिा भएको सस्ं थालाई पधहलो
प्राथधमकता मा राखी रेफरल के न्र छर्ोट गर्े । यधद रेफरल धिधकत्सक को मा एक्स रे सेिा
र्भएमा एक्स-रे सेिा भएको र्धिकै को सस्ं थामा धिरामी प्रेषण गरी एक्स-रे गराउर्े ।
▪ धिधकत्सक र औषिी पसल को अर्नपात िढीमा १:१० िर्ाइ रेफरल प्रणाली धिकास गर्े ।
अथाुत् एक धिधकत्सकको मा िढीमा १० िटा सम्म औषधि पसलले धिरामी रेफर गर्े व्यिस्था
धमलाउर्े ।
▪ हरे क सम्भाधित क्षयरोगको धिरामीको खकार परीक्षण धिर्एक्सपटु िाट गर्े ।
कायुक्रम कायाुन्वयर् ▪ क्षयरोग धर्दार्का लागी धिर्एक्सपटु, स्पटन म माइक्रोसकोपी, एक्स-रे, मोन्टन, एफएर्एसी
अत्यावश्यक मापदण्ड कायुक्रमले व्यहोर्े छ भर्े धिधकत्सक शल्न क लगायत अन्य थप परीक्षण शल्न क धिरामी स्ियल ं े
ब्यहोर्े छ ।
▪ क्षयरोग धर्दार्का लाधग गररर्े खकार परीक्षण ल्याि राधरिय क्षयरोग कायुक्रम अन्तगुत आिद्ध
भएको हुर्न पर्ेछ र धर्यधमत रूपमा गणन स्तर परीक्षणका लागी EQC प्रणालीमा आिद्ध भएको
हुर्नपर्े छ ।
▪ रे फरल प्रणालीमा P4P, FAST कायुक्रम अन्तगुत समािेश भएका अस्पताल एिं
धिधकत्सकलाई समािेश गर्े र आिश्यकता अर्नसार अन्य धिधकत्सकलाई पधर् समािेश गर्े ।
▪ धिगतमा यस कायुक्रममा आिद्ध भएका औषिी पसल र धिधकत्सक को कायु मल्ू याक ं र् गर्े र
सतं ोषिर्क र्धतिा भएका औषिी पसल र धिधकत्सकहरूलाई कायुक्रममा सिन ारु गर्े
▪ यो कायुक्रम को ररकधडिंङ्ग तथा ररपोधटिंग e-TB PPM र eTB P4P माफु त गर्े . िसको लाधग
ntpmis.gov.np/ मा लगइर् गर्े .
▪ कायुक्रममा औषिी पसलहरू छर्ोट गर्ु प्रदेश/धिल्ला औषधि व्यिसायी संघ (NCDA) को
समन्ियमा धर्म्र् कनराहरूलाई आिार िर्ाइ म्याधपङ गर्े ।
कायाुन्वयर् प्रक्षक्रया - दैधर्क ग्राहक को संख्या
- कफ़ धसरप/ एक्स्पेक्टोरे न्ट को धिधक्र को पररमाण
- एन्टीिायोधटक को धिधक्र को पररमाण
- क्षयरोग को उपिार मा प्रयोग हुर्े औषधिको धिधक्रको पररमाण
19
▪ धिधकत्सकको म्याधपङ धर्म्र् कनराहरूका आिारमा गर्े ।

o औषिी पसल र धिधकत्सक िीिको दरू ी १ धक.मी धभत्र हुर्पन र्े ।
o क्षयरोग धर्दार्मा सक्षम तथा अर्नभिी धिधकत्सक हुर्नपर्े ।
o एक्स-रे सेिा उपलब्ि भएका धक्लधर्क तथा अस्पतालमा कायुरत धिधकत्सकलाई
पधहलो प्राथधमकता धदर्े ।
o कायुक्रमको रे कधडुङ तथा ररपोधटुङ online reporting गर्ु सक्र्े हुर्न पर्े ।
▪ छर्ौट भएका औषिी पसल, धिधकत्सकहरू र सहयोगी संस्था िीि कायुधिधि सधहतको MoU
गराउर्े ।
▪ छर्ोट भएका धिधकत्सक िा तोधकएका फोकल व्यधिलाई क्षयरोग धर्दार् एिं उपिार, रे कधडुङ
तथा ररपोधटुङ सम्िन्िी अधभमख न ीकरण गर्े ।
▪ छर्ोट भएका औषधि पसलमा फोकल पसुर् छर्ोट गर्े र उि व्यधिलाई क्षयरोगको धस्क्रधर्गं
तथा प्रेषण एिं रे कधडुङ तथा ररपोधटुङ सम्िन्िी अधभमख न ीकरण ug]{ ।
▪ औषिी पसलमा आएका सम्भाधित क्षयरोगका धिरामी लाई उधित परामशु गरर धर्दार् को लाधग
तोधकएको धिधकत्सक को मा पठाउर्े र क्षयरोग धर्दार् भए र्भएको यधकर् गरर अधभलेख
अद्यािधिक गर्े ।
▪ धिधकत्सक िा संस्थामा तोधकएको फोकल व्यधिलाई धर्दार् भएका सिै धिरामीहरूको eTB
PPM मा अधभलेख अद्यािधिक गर्ु लगाउर्े साथै उपिारका लागी धिरामीलाई पाइक पर्े
उपिार के न्रमा रे फर गर्े । धिधकत्सकले यधद धिरामीलाई उपिारका लाधग आफूसँग राखेमा उि
धिरामीको सफल उपिार भएको प्रधतिेदर् गर्ु लगाइ कायुक्रममा तोके को रकम उपलब्ि गराउर्े ।
▪ PPM Mobilizer हरू लाई कायुक्रम र online R&R सम्िन्िी अधभमख न ीकरण गर्े ।
▪ एउटा PPM Mobilizer लाइ एक हप्तामा १५ िटा औषिी पसल पर्े गरी धिम्मेिारी कायु
धिभािर् गर्े र सो अर्सन ार प्रत्येक धदर् कम्तीमा ३ िटा औषिी पसल र ती पसलले रेफर गर्े
धिधकत्सकको मा भेट गरर धिरामीको क्षयरोग रे फरल तथा धर्दार् एिं यी सिै धक्रयाकलापहरूको
उधित अधभलेख भए र्भएको सधन र्धित गर्े ।
▪ PPM Mobilizer ले धिधकत्सकले धर्दार् गरे का धिरामीहरू उपिारमा आए र्आएको यधकर्
गर्े र उपिारमा र्आएका सिै क्षयरोगका धिरामहरूलाई उपिारमा ल्याउर्े ।
▪ धिर्एक्सपटु र्भएको संस्थामा रेफर भइ आएका धिरामीको खकार िाँि का लाधग खकार
धिधकत्सकको मा खकार संकलर् र ३ धलयर प्याधकङ गर्े व्यिस्था धमलाउर्े । संकलर् भएको
खकारलाइ PPM Mobilizer ले धिर्एक्सपटु के न्रमा ढनिार्ी गरर परीक्षण गराउर्े र सो को
र्धतिा सम्िधन्ित धिधकत्सकलाई उपलब्ि गराउर्े । खकार संकलर्, धतर् धलयर प्याधकङ
िापतको रकम स्वास््य संस्थाबाट खकार ढुवानी काययक्रम धशषुक अन्तगुत सम्िन्िीत धशषुक
िाट भि न ार्ी गर्े ।
▪ PPM मोधिलाईिरले धर्रन्तर धिधकत्सक/तोधकएका फोकल व्यधि तथा औषिी पसलको
फोकल पसुर्लाई भेट गरी व्यिहार पररितुर् का लाधग धर्रन्तर पहल गर्े साथै लक्ष्य अर्रुन प काम
भए र्भए को छलफल गर्े। त्यस्तै, धर्िाुररत फारम मा ररकधडिंग तथा ररपोधटिंग भए र्भएको र
क्षयरोग सम्िर्ि् ी िर्िेतर्ा मल ू क IEC तथा BCC Material प्रदशुर् गरे र्गरे को सधन र्धित गर्े
▪ कायुक्रम संयोिकले PPM Mobilizer ले गरे का हरे क धक्रयाकलापहरूको सक्ष्ू म अर्गन मर् गर्े
एिं औषिी पसल र धिधकत्सकको मा धर्यधमत रूपमा भेटघाट गरी कायुक्रमको सफल
कायाुन्ियर् को सधन र्धित गर्े ।
▪ PPM- Pharmacy / P4P /lhi6/df sfo{s|dsf] ljj/0f cWofjlws ug]{ .
20
अपेक्षित परिणाम/ औषिी पसल को सम्पकु मा आएका सम्भाधित क्षयरोगका धिरामी हरुमा क्षयरोग धर्दार् भई
उपलक्षधि उपिारमा दताु हुर्ेछ र क्षयरोगको के स र्ोधटधफके सर्मा िृधद्ध हुर्ेछ
धस.र्ं. धििरण एकाई दर पटक िम्मा
धिधकत्सकको मा धिरामी रे फरल, रे कधडुङ तथा ररपोटुङ
गरे िापत औषधि पसललाई धदइर्े रकम
प्रधत
१ ५० १ ५०
धिरामी
(नोट: प्रेषण गररएका बबरामी सम्बबधित बिबकत्सकको मा
दताय भएको हुनु पनेछ)
प्रेषण गररएका सम्भाधित क्षयरोग का धिरामी क्षयरोग प्रधत
२ ५०० १ ५००
धर्दार् भए िापत औषधि पसल लाई धदइर्े रकम धिरामी
आक्षथुक बााँडफााँड प्रधत
३ धिरामी को X-Ray िापत धदइर्े रकम ४०० १ ४००
र्ेपाल सरकार को धिरामी
क्षयरोग धिरामीको र्ोधटधफके सर् िापत धिधकत्सकलाई प्रधत
प्रिधलत आधथुक ऐर् ४
धदइर्े रकम धिरामी
२०० १ २००
धर्यमको अधिर्मा रधह खकार र्मर्न ाको धतर् धलयर प्याके ि, रे कधडुङ तथा प्रधत
कर कट्टी लगायतका कायु १०० १ १
ररपोटुङ गरे िापत अस्पताल िा धिधकत्सकलाइ रकम धिरामी
समेत गर्े क्षयरोग धिरामीको उपिार र्धतिा सधहत Online प्रधत
५ ४०० १ ४००
reporting गरे िापत, धिधकत्सकलाई धदइर्े रकम । धिरामी
र्ोट:
- खकार र्मनर्ाको धतर् धलयर प्याधकङ िापतको रू १०० स्िास््य संस्थािाट खकार ढनिार्ी कायक्रुम अन्तगुतको सम्िन्िीत धशषुक िाट
खिु गर्े ।
- SR कायुक्रम को Detail budget sheet मा उल्लेख िा िाँडफाँड भए अर्सन ार आिश्यक कागिातहरु तथा प्रकृ या परन ा गरी ििेट को
व्यिस्थापर् गर्े ।
- क्षयरोग धर्दार्का लागी MONTU, FNAC परीक्षण गर्ु आिश्यक भएमा िालिाधलकामा क्षयरोग धर्दार् कायुक्रमको सम्िधन्ित
धशषुक िाट खिु गर्े
- PPM- Pharmacy / P4P /lhi6/df sfo{s|dsf] cWofjlws ljj/0f cg';f/ e'QmfgL ug]{ .
sfo{qmd zLif{s M
k|jf;L tyf df};dL sfdbf/df Ifo/f]usf] l:s[lgª tyf lgbfg

p2]Zo • k|jf;L tyf df};dL sfdbf/df Ifo/f]usf] lgbfg Pj+ pkrf/ ug]{ .
nlIft ;d'bfo • Jf}b]lzs /f]huf/ af6 kmls{g] df};dL tyf k|jf;L sfdbf/x?
sfo{qmd sfof{Gjogsf • sfo{s|ddf tf]lsP adf]lhd g]kfn–ef/t gfsfdf of] sfo{s|d ;+rfng ug'{ kb{5 .
dfkb08 • sfo{s|d ;+rfng k'j{ ;DjlGwt k|b]z :jf:y lgb]{zgfno, lhNnf k|;f;g sf{ofno, :jf:Yo
sfof{no, :yflgo tx, lhNnf k|;f;g sfof{no, lhNnf k|x/L sfo{fno, 6«flkms sfo{fno
tyf cGo ;/f]sf/jfnfx?nfO{ sfo{qmdsf] p2]Zo tyf cf}lrTo jf/]df Ps lbg]
cled'lvs/0f sfo{s|d ug]{ .
• ;DjlGwt gfsfdf sfd ug]{ lgsfox? h:t} k|x/L, e+;f/ sd{rf/Lx?, u}x| ;/sf/L
;+:yfx?, :jf:Yo sd{rf/L Pj+ cGo ;/f]sf/jfnfx?;+u sfo{sdsf af/]df Ps lbg]
cled'lvs/0f ug]{ .
• Gffsfdf x'g] dn]l/of, Pr=cfO{=eL, sf]le8 !( h:tf cGo :jf:Yo sfo{s|dx? ;+u
;dGjo tyf ;xsfo{ ul/ sfo{s|dnfO{ yk k|efjsf/L agfO{ ;+rfng ug]{ .
• k|To]s gfsfdf Ifo/f]usf] :s[lgª ug{ b'O{ hgf ;fdflhs kl/rfns lgo'Qm ug]{ .
21
• Gfsfdf Ifo/f]u :s[lgË sfo{sf nflu Pp6f lk|km]a sf]7f lgdf{0f ug{ :yfgLo tx, e+;f/
tyf cGo ;/f]sf/ jfnf ;+u a}7s u/L cfjZos Joj:yf ug]{ ;fy} cGo cfjZos
;fdfuL|x? h:t} vsf/ e08f/0fsf nflu /lkm|h]/]6/, km\ofg, kmlg{r/ cflbsf] Joj:yf ug]{
.
• Ifo/f]usf] :s[lgªdf e]l6Psf ;Defljt Ifo/f]usf la/fdLaf6 Pp6f vsf/sf] gd"gf lnO{
lhg PS;k6{ ;]G6/df ;fdflhs kl/rfns b\jf/f vsf/ 9'jfgL u/fO{ k/LIf0f u/fpg] .
• ptm screening desk df Ifo/f]usf] hfgsf/L d"ns ;+b]zx? ;lxtsf] jf]8{ /fVg] tyf
Ifo/f]usf] cGo IEC ;fdfu|Lx? /fVg] .
sfof{Gjog k|s[of • ;fdflhs kl/rfnsnfO{ sfo{qmd ;DaGwL cfjZos cled'lvs/0f u/L u/fO{ cfjZos
logistics k|bfg ug]{ .
• ;DjlGwt gfsfdf dflg;x?sf] a9L cfjthfjt x'g] ;do Plsg u/L ljz]iftM pQm
;dodf Ifo/f]usf] :s[lgË nfO{ kmf]s; ug]{ .
• b'j} ;fdflhs kl/rfnsn] k|To]s lbg lgoldt ?kdf gfsfdf j;L ef/taf6 g]kfn k|j]z
ug]{ Joltmx?sf] cjnf]sg ug{] . olb pQm Joltm df};dL jf k|jf;L sfdbf/ ePsf]] z+sf
nfu]df lgh Joltm sxfF uO{ clejfbg ug]{, cfkm\gf] kl/ro lbg] / lgh Joltm ef/tdf
sfdbf/sf] ?kdf j;]/ kms]{sf] s'/f Plsg ug]{ .
• olb ;f] JolQm ef/tdf sfdbf/sf] ?kdf j;]/ kms]{sf] eP, lghnfO{ ;DalGwt sfo{qmdsf
af/]df hfgsf/L u/fpg] / Ifo/f]usf] :s[lgªsf] nflu cg'dlt lnO{ screening
questionnaire sf] k|of]u u/L Ifo/f]usf] lrGx nIf0fx?af/] ;f]Wg] .
• olb Ifo/f]usf] lrGx tyf nIf0f gb]lvPdf Ifo/f]u af/] :jf:Yo lzIff lbO{ wGojfb ;lxt
labf ug{] .
• olb lgh Joltm ef/taf6} Ifo/f]u lgbfg eP/ kms]{sf] eP g]kfndf sxfF btf{ eO{ cf}ifwL
;]jg ug]{ eGg] s'/fsf] hfgsf/L lbg]] .
• olb Ifo/f]usf] ;Defljt la/fdL ePdf, lghnfO{ vsf/ hfFrsf] dxTjjf/] hfgsf/L u/fpb}]
:k6df vsf/sf] gd"gf ;+sng ug]{ / pQm gd"gf k/LIf0fsf] nflu lhgPS;k6{ ;]G6/df
hfFrsf] u/fpg] . olb vsf/ kl/If0faf6 Ifo/f]u lgbfg ePdf ;fdflhs kl/rfnsn]
lhNnf sfo{s|d ;+of]hsnfO{ t'?Gt kmf]g u/L hfgsf/L u/fpg] .
• lhNnf sfo{s|d ;+of]hsn] ;DjlGwt la/fdLnfO{ kmf]g dfkm{t lghsf] l/kf]6{sf] jf/]df
j'emfO{ glhssf] :jf:Yo ;+:yfdf pkrf/sf ]nflu hfg cg'/f]w ug]{] . csf]{ ljsNk h:t},
olb ;f] la/fdL ;DalGwt lhNnf s} xf] eg] la/fdLsf] 7]ufgf ePsf] :jf:Yo ;+:yfsf]
:jf:YosdL{ jf d=:jf=:jo+=;]ljsf kl/rfng u/L pkrf/df Nofpg] Joj:yf ldnfpg] .
olb ;f] la/fdL cGo lhNnfsf] ePdf ;f] lhNnfsf] SR sf] lhNnf sfo{s|d ;+of]hs jf
:jf:Yo sfof{no tyf :yfgLotxdfkm{t ;DalGwt :jf:Yo ;+:yfsf] :jf:YosdL{nfO{
hfgsf/L u/fO{ lghnfO{ pkrf/df Nofpg] .
• k|To]s ltg ltg dlxgfdf sfo{s|dsf] Ps lbg] ;dLIff ug]{ . ;dLIffdf :jf:Yo sfof{no,
:yflgo tx Pj+ o; sfo{df k|tIo ;/f]sf/ ePsf u}x|;/sf/L ;+:yf, eG;f/ sfof{nosf
k|ltlglw, eG;f/ k|xl/sf k|ltlglw cflbnfO{ ;lDdlnt u/fO{ ug]{ .
• HMIS 6.1 /lhi6/df sfo{s|dsf] ljj/0f cWofjlw ug]{ .
ck]lIft pknAwL Ifo/f]usf ;Defljt Seasonal labor migrants x?df Ifo/f]u lgbfg eO{ s]z
gf]l6lkms]zgdf j[4L x'g]5 .
22
cfly{s afF8kFmf8 pknJw ah]6 cg';f/ sfo{s|d ;+rfng ug]{ .

k|lt ;kmn lhgPS:k6{ hfFrsf] ? %) pknJw u/fpg] . HMIS 6.1 /lhi6/df ePsf] ljj/0fsf cfwf/df e'QmfgL ug]{ .
-g]kfn ;/sf/sf] k|rlnt
cfly{s P]g lgodsf]
clwgdf /xL s/ s§L
nufotsf sfo{ ;d]t ug]{
_
sfo{qmd lzif{s
sf/fuf/ (Prison) df Ifo/f]usf] ;s[o vf]hk8tfn
p2]Zo • s}lb alGbdf Ifo/f]u lgbfg Pj+ pkrf/df ug]{ .
nlIft ;d'bfo • sf/fuf/df /x]sf s}bLx? jf y'g'jfx?
sfo{qmd sfof{Gjogsf • sf/fuf/x?sf] ljj/0f tyf , d'Vo ;/f]sf/ JolQmx?, ;Dks{ gDa/, s}bLx?sf] ;+Vof,
dfkb08 pknAw >f]t ;fwg cflb sf] af/]df hfgsf/L lng' kb{5 .
• ;DalGwt sf/fuf/sf] cflwsfl/s lgsfonfO{ SofDksf] ;+rfng af/]df, SofDksf] cf}lrTo,
dxTj tyf cfjZos ;xof]usf] af/]df cled'vLs/0f ug]{ .
• lrlsT;s, :jf:YosdL{, /]l8of]u|fkm/ ;lxtsf] 6f]nL kl/rfng ul/ sf/fuf/df Ifo/f]u
lgbfg SofDk ;+rfng ug]{ . / of] sfo{s|d aif{sf] @ k6s, ^÷^ dlxgfsf] cjlwdf ug]{ .
• x/]s JolQmx?sf] b'a} PS;–/] Pj+ Ifo/f]usf] lrGx tyf nIf0fsf cfwf/df l:s|lgË ug]{ .
• x/]s Ifo/f]usf ;Defjljt lj/fdLsf] lhgPS;k6{ b\jf/f kl/If0f ug]{ .
• 86\; ;]jf gePsf x/]s sf/fuf/df 86\; ;]G6/ :yfkgf ul/ pkrf/sf] Joj:yf ug]{ .
• sf/fuf/df s}lb klxnf] k6s k|j]z / s}b e'Qmfg ul/ 3/ hfg nfUbf Ifo/f]usf] clgjfo{
l:s|lgË sf nflu sf/fuf/ ;+u ;dGjo tyf cfjZos ;xof]u pknJw u/fO{ ;f] Joj:yf
nfu' u/fpg] .
• /fli6«o Ifo/f]u lgoGq0f s]Gb| ;+u ;dGjo ul/ tFxf ePsf] PS;–/] ;lxtsf] ;jf/L ;fwgsf
k|of]u ul/ SofDk ;+rfng ug]{ .
sfof{Gjog k|s[of • SofDk ;+rfng k'j{ sf/fuf/ tyf c–Go ;/f]sf/jfnf JolQmx? ;+u ;dGjo a}7s ug]{ /
cfjZos ;xof]u Pj+ SofDk ;+rfngsf ljlw tyf ks[ofsf jf/]df hfgsf/L u/fO{ SofDk
;+rfngsf] ldlt, sf/fuf/af6 k|fKt ug'{kg]{ ;xof]usf] ;'lglZrttf ug]{ .
• SofDk ;+rfng ug'{k'j{ sf/fuf/sf gfOs] tyf efOgfOs]x?nfO{ Ifo/f]usf] lrGx tyf
nIf0fsf] klxrfg, lgbfg tyf pkrf/sf af/]df Ps lbg] cled'lvs/0f ug]{ .
• afUdtL Pj+ u08sL k|b]zsf nflu 5gf}6 ePsf} SR ;+u ;dGjo ul/ k|To]s sf/fuf/df
@ hgfsf b/n] :yflgo ?kdf lrlsT;s 5gf}6 ul/ tflnd u/fpg] . ;fy} sfo{s|d ePsf
SR n] :yflgo :jf:YosdL{ @ hgf / ;DjlGwt sf/fuf/sf @ hgf :jf:Yosld{nfO{
Ifo/f]u lgbfg tyf Joj:yfkg ;djlGw tflnd u/fpg] .
• Digital Radiography (DR) tyf Computed Radiography (CR) PS;–
/] ;+rfng ug{ tflnd k|fKt Pj+ cg'elj /]l8of]u|fkm k|lt SR Ps hgfsf b/n]
:yflgo?kdf 5gf}6 ul/ kl/rfng ug]{ . DR PS;–/] ;+rfngsf nflu pQm JolQmnfO{
/fli6«o Ifo/f]u lgoGq0f s]Gb|df k7fO{ tflnd u/fpg] .
• ;Defljt Ifo/f]u lj/fdLsf] lrGx tyf nIf0fsf cfwf/df x'g] l:s|lgËdf gfOs] tyf efO{
gfO{s] sf] k|of]u ug]{ .
23
• /fli6«o Ifo/f]u lgoGq0f s]Gb| ;+u ;dGjo ul/ tFxf ePsf] PS;/] ;lxtsf] ;jf/L ;fwg
k|fKt ul/ SofDkdf ;+rfng ug]{ . ;jf/L ;fwfg Pj+ k|of]u ePsf pks/0fsf] ;+rfng
tyf dd{t o;} sfo{s|daf6 ug]{ .
• ;jf/L rfns pknJw gePdf sfo{s|daf6} Joj:yf ug]{ .
• Ifo/f]u lgbfgsf nflu sf/fuf/d} DR tyf CR PS;–/] pknJw ePdf ;DjlGwt
sf/fuf/s} k|of]u ug]{ .
• SofDk ;+rfngsf] nflu cfjZosLo ;fdfu|Lx?, pks/0f, kmd{ km/Dof6 cfbL sf] Joj:yf
ug]{ .
• tf]lsPsf] lbgdf SofDk ;+rfng ug]{ .
• Ifo/f]u klxrfgsf nfuL pkl:yt ;]jfu|fxLnfO{ PS;–/] Pj+ lrGx nIf0fsf
cfwf/df l:s[lgª u/L ;+efljt Ifo/f]usf] la/fdLx?sf] lhg PS;k6{df vsf/
hfFrsf nflu Pp6f gd'gf ;+sng ug]{] .
• ;+sng u/]sf] vsf/ plrt tl/sfn] glhssf] lhg PS:k6{ ;]G6/df nlu kl/If0f
u/fpg] .
• lhgPS;k6{ af6 lgbfg gePsf JolQmx?nfO{ PS;–/] tyf lrGx nIf0fsf
cfwf/df lrlsT;sn] lgbfg ug]{ .
• Ifo/f]u lgbfg ePdf ;DjlGwt Ifo/f]usf] k|sf/ cg';f/ JolQmnfO{ Ifo/f]u
;DalGw :jf:Yo lzIff lbO{ pkrf/sf] nflu sf/fuf/d} 86\; ;]G6/ :yfkgf ul/
pkrf/ u/fpg] Joj:yf ldnfpg] .
• HMIS 6.1 /lhi6/df sfo{s|dsf] ljj/0f cWofjlws ug]{ .
ck]lIft pknlAw sf/fuf/df /x]sf ;Defljt Ifo/f]u la/fdLdf Ifo/f]u lgbfg ug]{ .
cfly{s afF8kFmf8 SR sfo{s|dsf] detail budget sheet df pNn]v jf afF8kmfF8 eP cg';f/ cfjZos sfuhftx? tyf k|s[of
-g]kfn ;/sf/sf] k|rlnt k'/f u/L ah]6sf] Joj:yfkg ug]{ .
cfly{s P]g lgodsf]
clwgdf /lx s/ s§L
nufotsf sfo{ ;d]t ug]{
_
sfo{qmd lzif{s
Ifo/f]u lgbfg, pkrf/ tyf s]; gf]l6lkms]zgdf lghL :jf:Yo ;+:yfnfO{ d'n k|jfxLs/0fdf
Nofpg] (Pay for Performance to Private Doctors)
p2]Zo • lghL :jf:Yo ;+:yf tyf lSnlgsdf df lgbfg tyf pkrf/df /x]sf Ifo/f]u lj/fdLx?nfO{
d'n k|jfxLs/0f u/L Ifo/f]usf] s]z gf]l6lkms];gdf yk ug]{ .
nlIft ;d'bfo • lglh :jf:Yo ;+:yf tyf lSnlgsdf sfd ug]{ / t'ngfTds?kdf Ifo/f]usf] w]/} lgbfg
ug]{ lrlsT;sx?
sfo{qmd sfof{Gjogsf • of] sfo{s|d dxfgu/kflnsf tyf pkdxfgu/kflnsfdf jf SR nfO{ tf]lsPsf lhNnfdf
dfkb08 ug'{ kb{5 .
• o; sfo{s|dsf nflu 5gf}6 x'g] lrlsT;sx? cf};tdf k|lt dlxgf $÷% hgf Ifo/f]u
lgbfg ug]{nfO{ pRr k|fyldstf lbb} o; sfo{s|ddf cfj4 ug]{ .
24
• o; sfo{s|ddf cfj¢ x'g] lrlsT;snfO{ lgbfg tyf pkrf/df /x]sf x/]s Ifo/f]usf
lj/fldnfO{ o; sfo{sf nflu lasf; ul/Psf] online software dfkm{t notification
ug'kg]{ s'/fsf] hfgsf/L lbg] .
• ;DalGwt lrlsT;s jf p:n] tf]s]sf] JolQmn] lgoldt online reporting ug'{kb{5 /
;f] sf] lgoldt kmnf]ck SR sf] kmf]sn Joltmn] ug]{ .
sfof{Gjog k|s[of • dxfgu/kflnsfdf !) hgf / pkdxfgu/kflnsf tyf tf]lsPsf cGo gu/kflnsfdf %

hgf lrlsT;s 5gf}6 ug]{ .
• pk{o'St lrlsT;sx?sf] klxrfg ;DjlGwt lhNnfsf Ifos'i7 kmf]sn k;{g, hfgsf/
JolQm jf ;+:yfx?, dxfgu/kflnsf tyf pkdxfgu/kflnsfsf :jf:Yo ;+of]hs cflbsf]
;dGjodf ug]{ .
• klxrfg ePsf lrlsT;x?nfO{ SR n] Ifos'i7 kmf]sn k;{g jf :yflgo lgsfosf :jf:Yo
;+of]hs ;lxt ;DjlGwt lrlsT;ssf]df u} o; sfo{sf nflu pknAw u/fOPsf] ;]jf
;'ljwfsf] ;fy} sfo{sf] cf}lrTo, dxTj tyf cfjZostfsf] jf/]df hfgsf/L u/fpg] .
• o; sfo{s|ddf cfj¢ x'g rfxg] lrlsT;s / p;sf] ;xof]lu 5gf}6 ul/ online
software ;DjlGw tflnd lbg] / oL lrlsT;s af6 Ifo/f]usf] lgbfg tyf pkrf/sf]
ljj/0f o;} software dfkm{t u/fpg] .
• SR n] k|lt dlxgf lrlsT;sx?nfO{ e]6 ul/ nIo cg'?k sfo{ eP gePsf] 5nkmn ug]{
. lrlsT;sx?n] u/]sf] Ifo/f]usf] gf]l6lkms];g tyf pkrf/ u/]sf] Plsg ul/ k|dfl0ft
x'g] cfjZos 8s'd]G6 ;+sng ul/ sfo{s|dn] tf]s] cg';f/sf] /sd pknJw u/fpg] .
• lrlsT;sn] Ifo/f]u lgbfg ePsf] JolQmnfO{ cfkm\g} lgu/flgdf pkrf/ u/fPdf pQm
lj/fldnfO{ /fli6«o Ifo/f]us sfo{s|d cGt{ut lglZrt ul/Psf] pkrf/sf] dfkb08
cg';f/ pkrf/ k'/fu/fPdf dfq sfo{s|ddf tf]lsPsf] /sd pknJw u/fpg] .
• eTB P4P df sfo{s|dsf] ljj/0f cWofjlw ug]{ .
ck]lIft pknlAw lglh lrlsT;sx?df lgbfg tyf pkrf/df /x]sf t/ s]; gf]l6lkms];g x'g af6 5'6]sf
lj/fdLsf] hfgsf/L /fli6«o Ifo/f]u sfo{s|d cfpg] / Ifo/f]u lj/fdLsf] gf]l6lkms]zgdf
a[l4 x'g] .

-g]kfn ;/sf/sf] k|rlnt Ifo/f]u lj/fdL lgbfg u/L pkrf/ u/]sf] online k|lt
cfly{s Pg lgodsf] ! @)) ! @))
reporting df l/kf]{6 -gf]l6lkms];g_ u/] jfkt lj/fdL
clwgdf /lx s/ s§L
pkrf/ u/]sf] Ifo/f]u lj/fdLsf] pkrf/ glthf
nufotsf sfo{ ;d]t ug]{ k|lt
@ ;xLt online reporting df kmnf]ck l/kf]{6 - $)) ! $))
_ lj/fdL
gf]l6lkms];g_ u/] jfkt
• eTB P4P df ePsf] lj/fdLsf] ljj/0fsf cfwf/df e'Qmflg ug]{ .
25
sfo{qmd zLif{s M
lghL :jf:Yo ;]jf k|bfosx?;Fu /fli6«o Ifo/f]u sfo{qmd ;DaGwL hfgsf/L d"ns cGt/lqmof
sfo{qmd
p2]Zo lghL :jf:Yo ;]jf k|bfosx?nfO{ /fli6«o Ifo/f]u sfo{qmdsf] lgbfg tyf pkrf/ protocol
;DaGwL hfgsf/L u/fO{ k|efjsf/L ;/sf/L lghL ;fem]bf/L sf] partnership modality
(PPM) sf] af/]df hfgsf/L lbg]
nlIft ;d'bfo • Ifo/f]usf] lgbfg tyf pkrf/df k|ToIf ;+nUg lghL :jf:Yo ;+:yf h:t} c:ktfn,
lSnlgs cflbdf sfo{/t lrlsT;s .
sfo{qmd sfof{Gjogsf • SR n] ;DaGwLt lhNNffsf] :jf:Yo sfof{no Pj+ :yfgLo tx;Fusf] ;dGjodf lhNnfsf
dfkb08 gu/kflnsf, dxfgu/kflnsf, Pj+ pkdxfgu/kflnsf df /x]sf ;]jf k|bfos Pj+
lrlsT;sx?sf] ljj/0f tof/ kfg]{ .
• tof/ u/LPsf] ljj/0f af6 cGt{s[of uf]li7df ;xefuLtfsf] nflu lrlsT;sx? 5gf}6
ug]{ .
• a}7sdf p7]sf ljifoj:t'x?sf] tyf partnership modality (PPM) sf] ;'emfjx?
;+sng u/L SR n] /fli6«o Ifo/f]u s]Gb| nfO{ PR dfkm{t l/kf]{6 pknAw u/fpg] .
sfof{Gjog k|s[of • 5gf}6 ePsf ;]jf k|bfosx?nfO{ ;xefuLtfsf] nflu lhNnfsf] :jf:Yo sfof{no tyf
:yfgLo tx dfkm{t kqfrf/ ug]{ .
• a}7s ;+rfngsf] nflu cfjZosLo sfo{of]hgf tof/ ug]{ ;fy} cfjZos ;fdfu|Lx?sf]
klg pknAwtf ;'lgZrt ug]{ .
• ;DalGwt lhNnfsf] ::jf:Yo sfof{no tyf :yfgLo lgsfosf] g]t[Tjdf a}7s ;+rfng
ug]{ .
• lgDg ljifo a:t' ;dfj]z u/L cGt{s[of uf]li7 ;+rfng ug]{ M
• Ifo/f]usf] /fli6«o tyf cGt/fli6«o morbidity ljZn]if0f, ISTC/PPM sf
l;4fGtx?
• Ifo/f]u sfo{s|dsf] xfnsf pknJwL, r'gf}tLx?
• Ifo/f]u sfo{s|dsf] pb]Zo, nIo tyf gLltx? tyf eflj of]hgf
• Ifo/f]usf] lgbfg tyf pkrf/df /fli6«o Ifo/f]u sfo{s|dsf] gLlt,
• Ifo/f]u cGt ug{ lghL :jf:Yo ;]jf k|bfosx?sf] st{Jo tyf e"ldsf cflb
ljifo ;dfj]z u/L sfo{s|d ;+rfng ug]{ .
• /fli6«o Ifo/f]u sfo{qmddf ;+nUg eO{ ;xof]u ug{ OR5's ;]jf k|bfosx?sf] ;"rL a}7s
kZrft tof/ u/L ;DalGwt lgsfo;Fu link u/fO{ ;+nUg u/fpg cfjZos kxn ug]{ .
ck]lIft pknAwL lghL ;]jf k|bfosx? /fli6«o Ifo/f]u sfo{qmddf ;+nUg eO{ Ifo/f]u cGTosf] nIo k|flKtsf]
nflu ;xof]u ug]{5g .
cfly{s afF8kFmf8 SR sfo{s|dsf] detail budget sheet df pNn]v jf afF8kmfF8 eP cg';f/ cfjZos
-g]kfn ;/sf/sf] k|rlnt sfuhftx? tyf k|s[of k'/f u/L ah]6sf] Joj:yfkg ug]{ .
cfly{s P]g lgodsf]
clwgdf /xL s/ s§L
nufotsf sfo{ ;d]t ug]{ _
26
sfo{qmd lzif{s
sfo{s|dsf] k|efjsfl/tf dfkgsf nflu k|b]z, lhNnf, ;lxt Plss[t cg'udg d'Nof+sgs tyf
;'kl/j]If0f
p2]Zo • ls|ofsnfk sfof{Gjog cg'udg, u'0f:t/ dfkg tyf :jf:YosdL{sf] Ifdtf clej[l4 x'g]
nlIft sd{rf/L • sfof{qmd;+u k|ToIf ;+nUg SR, k|b]z, lhNnf tyf :yflgo txsf ;DaGwLt sd{rf/Lx?
sfo{qmd sfof{Gjogsf • sfo{sd | ;Fu ;DjlGwt e|d0fsf] k|s[lt cg';f/ k|b]z tyf lhNnf ;+usf] ;dGjodf
dfkb08 e|d0fsf] ;'kl/j]If0f of]hgf agfO{ cfkm\g] ;+:yfaf6 k|dfl0ft ug]{ / ;f] Ps k|ltlnlk
PR nfO{ pknJw u/fpg] .
• ;'k/lj]If0f of]hgf agfpbf :jf:Yo sf{ofno jf :yflgo lgsfo ;xtsf] ;+o'St of]hgf
/ csf]{ SR sf] cfkm\gf] lgodlt cg'udgsf] agfpg] .
• e|d0f kZrft tf]lsPsf] 9fFrfdf e|d0f k|ltj]bg agfpg] .
• cg'udg tyf d'Nof+sgsf nflu r]s lni6sf] clgjfo{ k|of]u ePsf] x'g'kg]{ .
• :ynut cg'lzIf0f sf dfWodaf6 :jf:Yo ;+:yfx?sf] sfo{s|d ;+rfngsf ljlw tyf
k|s[of, ;f] sf] clen]v tyf k|ltj]bgsf ;fy} HMIS Pjd NTPMIS df lgoldt
k|ltj]bg eP gePsf] ;'lglZrt ug]{ ;fy} cfjZostf cg';f ;f] ;DjGwdf Ifdtf
clej[l4 ug]{ .
sfof{Gjog k|s[of • sfo{s|d ;+of]hs tyf cGo cfjZos sd{rf/Lx?sf] lgoldt cg'udg e|d0fsf nflu
ldlt, :yfg, p2]Zo ;lxtsf] of]hgf agfpg] / ;f] cg';f/ :jf:Yo ;+:yfdf cg'udg
ug]{ .
• sfo{s|dsf] k|efjsfl/ ;+rfng tyf ;f] sf] d'Nofªsgsf nflu cfjZostf cg';f/
:jf:Yo lgb]{zgfno, :jf:Yo sfof{no tyf :yflgo lgsfo ;lDdlnt al9df ltg hgfsf]
;+o'Qm cg'udg 6f]nL agfO{ ;d:of klxrfg ePsf :jf:y ;+:yfx?df k|To]s dlxgf Ps
k6s x'g] ul/ e|d0f tflnsf lgdf{0f ul/ ;'k]l/j]If0f ug]{ / pQm ;d:ofx?sf] lg/fs/0f
ug]{ .
• cg'udg kZrft tTsfn} :jf:Yo ;+:yfnfO{ /fd|f kIf ;lxt ;'wf/ ug'{kg]{ kIfx/?sf
af/]df 5nkmn ug]{ / ;'wf/sf nflu ug'{kg]{ ls|ofsnfk, ;f] sf] ;do l;df / lhDd]jf/
JolQm ;lxtsf] sfo{ of]hgf agfpg] .
• cfjZostf cg';f/ cg'udgdf klxrfg ePsf ljifox?nfO{ ;DjGwLt :yflgo tx nfO{
klg hfgsf/L u/fpg] / ;d:of ;dfwfgsf nflu :yflgo txsf] lhDd]jf/L ;lxtsf]
sfo{ of]hgf agfO{ sfof{Gjog ug]{ u/fpg] .
• csf]{ k6ssf] e|d0fdf :jf:Yo ;+:yfnfO{ clwNnf] e|d0fdf lbOPsf] ;'emfj sfo{Gjog
eP gePsf] lglZrt ug]{ .
• cg'udg e|d0fdf sfo{s|dsf] sfof{Gjog tf]lsPsf] dfu{ lgb]{zg cg';f/ eP gePsf]
Pj+ sfo{s|d tf]lsPsf] :yfg, JolQm tyf ;d'bfodf eP gePsf], sfo{s|dsf] u'0f:tl/o
sfof{Gjog Pj+ cfjZos clen]v tyf k|ltj]bg eP gePsf] ;'lglZrt ug]{ .
• ;d'bfodf ;+rfng ePsf Ifo/f]u klxrfg tyf /]km/n sfo{s|dsf] k|efjsf/Ltf Pj+
;DjGwLt ;]jfu|fxL df sfo{s|d k'u] gk'u]sf] ;'lglZr ug]{ . o;sf nfly ;]jfu|fxLsf]
ljj/0f :jf:yo ;+:yf af6 lnO{ gd'gf 5gf]6df k/]sf ;]jfu|fxLsf] 3/b}nf]df uO{ ;]jf
kfPsf] ;'lglZrt ug]{ .
27
• ;DjGwLt sd{rf/Ln] cg'udg Ef|d0f kZrft standard format df k|ltj]bg agfO{

cfkm\gf] ;+:yfnfO{ pknJw u/fpg] / cfjZos k/]sf j]nfdf ;/f]sf/jfnfx?nfO{ pkJw
u/fpg] .
ck]lIft pknlAw • sfo{s|dn] tf]s]sf nIox? pb]Zo cg'?k k|fKt ug{ ;lsg] .
• sfo{s|dsf] u'0f:tl/otf ;'lglZrt x'g] .
-g]kfn ;/sf/sf] sfuhftx? tyf k|s[of k'/f u/L ah]6sf] Joj:yfkg ug]{ .
k|rlnt cfly{s P]g
lgodsf] clwgdf /lx
s/ s§L nufotsf
sfo{ ;d]t ug]{ _
sfo{qmd lzif{s
SR b\jf/f ;+rflnt sfo{s|dsf] :yflgo txdf ;ldIff uf]li7

p2]Zo • sfo{s|dsf] k|efjsf/Ltf Pj+ u'0f:tl/otfsf] ;'lglZrttf Pj+ r'gf}lt tyf ;d:ofx?sf] klxrfg
tyf lg/fs/0f x'g] .
;xeflu • kflnsf :t/df x'g] Ifo/f]usf] lgoldt ;ldIf uf]li7df ;xeflu ;a}
sfo{qmd sfof{Gjogsf • kflnsf :t/df x'g] rf}dfl;s uf]li7sf] nuQ} bf];|f] lbg SR af6 ;+rflnt Ifo/f]u
dfkb08 sfo{s|dsf] ;ldIff ug]{ .
• ;xeflunfO{ SR n] Ps lbgsf] lgodn] kfpg] eQf, :6]zg/L, vfhf nufotsf] vr{
pknJw u/fpg] eg] ;xeflusf] cft]hft] b}=e|= eQf tyf oftfoft vr{ kflnsfdf
pknJw Ifo/f]u lgoldt ;ldIff uf]li7 sfo{s|d af6 x'g] .
• ;ldIff kflnsf sf d]o/, k|d'v k|zf;lso clws[t Pj+ :jf:Yo ;+of]hssf] pkl:yltdf
;+rfng ug]{ .
• ;ldIffdf klxrfg ePsf r'gf}lt tyf ;d:ofx?sf] ;dfwfgsf nflu ;do l;df Pj+
lhDd]jf/ JolQm ;lxtsf] sfo{ of]hgf lgdf0f ug]{ / pQm of]hgf cg';f/ sfo{s|d ;'wf/
ug]{ .
• ;d:of ;dfwfgsf nflu :jf:Yo ;+:yf Pj+ :yflgo tx eGbf dfly k|b]z, ;+3df n}hfg'
kg]{ ljifo a:t' ePdf l6kf]6 ul/ lhNnf, k|b]z Pj+ ;+3 :t/df x'[g]' sfo{s|d ;ldIffdf
5nkmn rnfO{ ;dfwfg u/fpg] .
• ;xeflunfO{ :jf:yo ;+:yfdf ;+rfng ePsf sfo{s|dsf] ;+rfng tyf Joj:yfkg
nufot tyf lo ;+u ;djlGwt /]sl8{Ë tyf l/kf]l6{Ë sf af/]df cfjZostf cg';f/
Ifdtf clej[l4 ug]{ .
• :yflgo tx Pj+ SR af6 ;+rfng x'g] Ifo/f]u sfo{s|dx?sf =lar tfbDotf sfod
ug{ lhDd]jf/L ;lxtsf] sfo{of]hgf agfpg] .
sfof{Gjog k|s[of • :yflgo lgsfosf :jf:Yo zfvf k|d'v ;+u ;dGjo ul/ Ifo/f]u sfo{s|dsf] ;ldIffsf]
ldlt to ug]{ .
• :yflgo lgsfo dfkm{t yk Ps lbg SR dfkm{t ;+rfng ePsf sfo{s|dsf] 5'66} ;ldIff
x'g] s'/fsf] ;DjGwLt ;a} :jf:yo ;+:yfx/nfO{ hfgsf/L u/fpg] .
28
• sfo{s|d ;ldIffsf nflu tf]lsPsf] ;dofjlwsf] sfo{ k|ult, sfo{s|dsf ;d:of tyf
r'gf}lt / ;dfwfgsf pkfo ;lxtsf] k|:t'lts/0f 9fFrf agfO{ :jf:Yo ;+:yfnfO{ pknJw
u/fpg] / ;f] cg';f/ ;DjlGwt :jf:Yo ;+:yfnfO{ k|:t'lts/0f ug{ nufpg] .
• SR n] klg :yflgo txsf] ;dGjodf sfo{ k|ult, sfo{s|dsf ;d:of tyf r'gf}lt /
;dfwfgsf pkfo ;lxtsf] k|:t'lts/0f ug]{ .
• ;fy} :jf:Yo ;+:yfx?nfO{ sfo{s|dsf] ;kmn sfof{Gjogsf nflu cfjZos 1fg tyf
l;ksf af/]df cled'lvs/0f ug]{ ;fy} pQm ;+rfng ePsf sfo{s|dsf] clen]v tyf
k|ltj]bgsf nflu Ifdtf clej[l4 ug]{ .
• SR dfkm{t lgbfg ePsf / :jf:yo ;+:yfdf btf{ e} pkrf/ lnPsf lj/fdLsf] ;ªVof
ldnfg ug]{ / ;f] cg';f/ HMIS/DHIS2 df cWofjlw u/fpg] .
• sfo{s|dsf] k|efjsf/L Pj+ u'0f:tl/o sfof{Gjogdf b]lvPsf ;d:of tyf ltgsf
;dfwfgsf pkfosf nflu ;do l;df Pj+ lhDd]jf/ JolQm ;xltsf] sfo{ of]hgf agfO{
nfu' ug]{ / ;f]sf] k|ultsf af/]df csf]{ k6ssf] ;ldIffdf k|:t'lt ug]{ .
• Ifo/f]u lgjf/0fsf nflu :yflgo txaf6 lgdf{0f ug{ ;lsg] ls|ofsnfkx?sf af/]df
5nkmn rnfO{ klxrfg ug]{ / lt ls|ofsnfkx?sf] ah]6sf nflu :yflgo txnfO{ pknJw
u/fpg] / of]hgfdf k/] gk/]sf] klg cfufdL lbgsf uf]li7df ;ldIff ug]{ .
ck]lIft pknlAw • sfo{s|dn] tf]s]sf nIox? pb]Zo cg'?k k|fKt ug{ ;lsg] .
• sfo{s|dsf] u'0f:tl/otf lglZrt x'g] .
-g]kfn ;/sf/sf] sfuhftx? tyf k|s[of k'/f u/L ah]6sf] Joj:yfkg ug]{ .
k|rlnt cfly{s P]g
lgodsf] clwgdf /lx
s/ s§L nufotsf
sfo{ ;d]t ug]{ _
sfo{qmd zLif{s
Nepal Chemist and Drugist Association (NCDA) ;+u Ifo/f]u sfo{s|d ;DjGwL
uf]i7L .
p2]Zo kmfd]{l; tyf lghL :jf:Yo ;+:yfdf lgbfg tyf pkrf/df /x]sf Ifo/f]u la/fdLx?nfO{ Ifo/f]u
sfo{s|dsf] l/kf]l6{ªsf] d"n k|jfxLs/0fdf NofO{ s]; gf]l6lkms];g j[l4 ug]{ .
;xefuL NCDA ;+u cfa4 ;b:ox¿ .
sfo{qmd sfof{Gjogsf • NCDA sf ;b:ox?nfO{ Ifo/f]usf] lgbfg, /]km/n ;DjGwdf cf}lrTo, dxTj tyf
dfkb08 cfjZostfsf] af/]df hfgsf/L u/fpg] .
• Ifo/f]usf] lgbfg, pkrf/ tyf /]km/n sf nflu ;xeflux?sf] NCDA sf] lhDd]jf/L
tyf st{Josf af/]df 5nkmn u/fO{ plgx? Aff6 x'g ;Sg] of]ubfgsf] ;'rL tof/
ug]{ .
• plgx?n] k'of{pg ;Sg] of]ubfgnfO{ ;'lglZrt ug{ Ifo/f]u sfo{s|d af6 s] s:tf
;xof]u cfjZos 5g\ ;f] sf] ljj/0f tof/ ug]{ / ;f]sf] hfgsf/L /f=If=s] tyf PR
lbg] .
29
• ;xdlt ePsf ljifoa:t' tyf Ifo/f]u lgbfg tyf pkrf/df cf}ifwL k;nx?n]
Ifo/f]u Joj:yfkgsf nflu ug'{ kg]{ sfdst{Jo sf af/]df ljleGg lhNnfsf cf}ifwL
k;nx?nfO{ NCDA dfkm{t kqfrf/ ug{ nufpg] .
• ;fy} cf}ifwL k;nx?n] Ifo/f]usf ;Defljt lj/fldx?sf] lgbfg tyf pkrf/sf
nflu /]km/ u/LPsf tyf pkrf/df /flvPsf la/fdLsf]/]sl8{ª tyf l/kf]{l6ª sf
nflu km/d]6sf] lasf; Pj+ ;f] cg';f/ la/fdLsf]ljj/0f cWofjlws u/fpg NCDA
dfkm{t kqfrf/ ug{ nufpg] .
sfof{Gjog k|s[of • s]G›df /x]sf ;/f]sf/jfnf;Fu ;dGjo u/L cfjZo\s tof/L u/L ;xeflutfsf
nflu kqfrf/ ug]{ .
• dfly pNn]lvt dfkb08 cg';f/ p2]Zo kl/k'lt{sf nflu uf]i7Ldf 5nkmn ul/g]
ljifo tof/ u/L ;f] cg';f/ uf]i7L ;+rfng ug]{ .
• lgdf{0f ePsf] sfo{of]hgf cg';f/ sfd eP gePsf] cg'udg ug]{ k|0fnLsf]
ljsf; ug]{ / ;f]sf] ljj/0f cWofjlws u/L PR nfO{ hfgsf/L u/fpg] .
ck]lIft pknAwL cf}ifwL k;nx?af6 Ifo/f]u la/fdLsf] /]km/n tyf s]; gf]l6lkms];g eO{ s]; gf]l6lkms];gdf
a[l4 x'g] .
sfuhftx? tyf k|s[of k'/f u/L ah]6sf] Joj:yfkg ug]{ .
30
Cg;"'rL !: :jf:Yo ;+:yf Pj+ Ifo/f]u lgbfg ;]jf DoflkË km/d]6
/fli6«o Ifo/f]u sfo{s|d

Ifo/f]u lgbfg ;]jf Pj+ :jf:Yo ;+:yfx?sf] ljj/0f
जिल्लाः मित ाः
of] ljj/0f cWofjlws u/L /f=If=s] tyf ;]e b lrN8«]gnfO{ pknJw u/fpg]
27
cg';'rL @: TB screening Consent Form
/fli6«o Ifo/f]u sfo{s|d

Ifo/f]u la/fdLsf] ;Dks{df /x]sf JolQmdf Ifo/f]usf] screen sf nflu ul/g] k|ZgfjnLx?
d ===========-gfd_======================== x'F . d /fli6«o Ifo/f]]u sfo{s|d cGt/ut Ifo/f]u la/fdLsf]

3/kl/jf/df ;Defljt Ifo/f]usf la/fdL kTtf nufpg v6]sf] :jo+d ;]js÷;]ljsf x' . d
tkfO{nfO{ Ifo/f]u eP gePsf] ;'lglZrt ug{ lgDg lnlvt Ifo/f]usf lrGx tyf nIf0fsf af/]df
k|Zg ug]{ 5'' . olb oL k|ZgfjnLx?af6 tkfO{df Ifo/f]u ePsf] ;Defjgf b]lvPdf tkfO{sf] vsf/
;+sng jf tkfO{nfO{ :jf:Yo ;+:yfdf k|]if0f u/L Ifo/f]usf] lgbfgsf nflu tkfO{sf] dGh'/Lsf
nflu cg'/f]w ub{5' .
:jo+d ;]js÷;]ljsfsf] gfd M ldltM

Ifo/f]u la/fdLsf] gfdM
hDdf kl/jf/ ;+Vof M
3/ kl/jf/ ;b:osf] gfd M
lnË M pd]/ M
7]ufgf M ufpFkflnsf÷gu/kflnsf M j8f g+= M
ufpF÷6f]n M ;Dks{ g+= M
28
cg';r" L #:
!= lhNnf sfo{cs|d ;+of]hs÷clws[tx?sf] Go'gtd lhDd]jf/Lx? .
• tf]lsPsdf :jf:Yo ;+:yfx?df tf]lsPsf ls|ofsnfkx? lbOPsf] nIo, dfkb08 Pj+ ljlw tyf k|s[of cg';f/
;+rfng ePsf] lglZrt ug]{ .
• ;fdflhs kl/rfns, sf] k|efjsf/L ;+rfng, sfdsf] d'Nof+sg Pj+ cfjZos Ifdtf clej[l4 ug]{ .
• sfo{s|dsf cfjZos tYof+s tyf ljj/0fx? ;dod} ;+sng, ljZn]if0f Pj+ ;DjlGwt lgsfodf k|ltj]bg ug]{
.
• sfo{s|d k|ultsf] ljZn]if0f tyf lgoldt cg'udg e|d0fdf b]lvPsf ;'wf/ ug'{kg]{ ljifo a:t'df ;DjlGwt
:jf:Yo ;+:yf tyf cfp6l/r js{/x?nfO{ ;dod} lnlvt k[i7kf]if0f lbg] .
• lhNnf :jf:Yo sfof{no, :yfgLo lgsfo, :jf:Yo ;+:yf tyf lhNnfsf cGo ;/f]sf/jfnftx;+u k|efjsf/L
;dGjo tyf PsLs[t cg'udg tyf ;'k]l/j]If0fsf dfWodaf6 sfo{s|dx? k|efjsf/L ?kdf ;+rfng ePsf]
;'lglZrt ug]{ .
• sfo{s|dsf] k|To]s å}dfl;s k|ult tyf r’gf}tLsf ljifodf csf]{ dlxgfsf] bf];|f] xKtf leq ;DjlGwt kflnsfdf
;dLIffu/L ;dfwfgsf pkfox? kQfnufpg] .
• :jf:Yo ;+:yf tyf ;d'bfodf lgoldt cg'udg e|d0f u/L sfo{s|dsf] u'0f:tl/otf, k|efjsf/Ltf dfkg ug]{
Pj+ :jf:YosdL tyf ;d'bfosf JolQmsf] cfjZos Ifdtf clej[l4 ug]{ .
• :jf:YosdL{x?nfO{ sfo{s|d ;+rfng ljlw tyf ks[of, Pj+ sfo{s|dsf] /]sl8{ª tyf l/kf]{l6ª ;DjGwL :ynut
cg'lzIf0f sf dfWodaf6 Ifdtf clej[l4 ug]{ .
• SR åf/f ;+rfng ePsf sfo{s|daf6 lgbfg ePsf Ifo/f]usf la/fdLx? g]kfn ;/sf/sf] :jf:Yo ;"rgf
Joj:yfkg k|0ffnLdf (HMIS) cWofjwL ePsf] ;'lglZrt ug]{ .
• cfjZostf cg';f/ Ifo/f]u sfo{s|dsf] rf}dfl;s tYof+s :jf:Yo ;+:yf tyf kflnsfaf6 ;+sng tyf u'0f:t/
dfkg ug]{ .
• sfo{s|d ;+u ;DjlGwt cfly{s sf/f]af/ lbOPsf] lgb]{zg cg';f/ ;DkGg ePsf] tyf pQm sf/f]af/sf cfjZos
sfuhft ;+sng ePsf] ;'lglZrt ug]{ .
@= ;fdflhs kl/rfns (Social Mobilizer)- -vsf/ 9'jfgL_ x?sf] Go'gtd lhDd]jf/Lx? .
• tf]lsPsdf :jf:Yo ;+:yfaf6 ;Defljt Drug Susceptible (DS) Pj+ Drug Resistant (DR)
Ifo/f]usf la/fdLsf] vsf/ ;+sng u/L tf]lsPsf] Ifo/f]u lgbfg s]Gb|df vsf/ 9"jfgL Pj+ hfFrsf] ;'lglZrt
u/L glthf ;DjlGwt :jf:Yo ;+:yfdf pknJw u/fpg] .
• Ifo/f]u la/fdLsf] -b'a} DS tyf DR TB_ 3/kl/jf/sf ;b:osf] ;Dks{ k/LIf0f contact tracer n]
la/fdLsf] 3/df uO pQm 3/df a;f]af; u/]sf kl/jf/sf ;a} ;b:o tyf cGo JolQmx?sf] ;Dks{ k/LIf0f
Pj+ ;Defljt la/fdLsf] vsf/ hfFr ePsf] ;'lglZrt ug]{ .
• :jf:Yo ;+:yfdf cfPsf s'kf]lift tyf Zjf;k|Zjf; k|0ffnLdf ;+s|d0f ePsf afnaflnsfdf Ifo/f]usf] :s[lgª,
/]km/n tyf /f]u lgbfg ePsf] ;'lglZrt ug]{ .
• ;Dks{ k/LIf0f sfo{sf] u'0f:tl/otfsf] ;'lglZrt ;DjlGwt :jf:Yo ;+:yfsf] ;+of]hgdf ;fdflhs kl/rfns
4f/f ug]{ .
• ;Dks{ kl/If0fdf e]l6Psf kfFr jif{{ d'lgsf :j:y afnaflnsfdf TBPT ;'?jft ePsf] Pj+ lgoldt ;]jg
u/]sf] ;'lglZrt ug]{ .
• pk{o'Qm sfo{s|d ;+u ;DjlGwt /]sl8{ª tyf l/kf]{l6ª :jf:Yo ;+:yfn] /fd|f];+u cWofjlws u/]sf] ;'lglZrt
ug]{ .
• pk{o'Qm sfo{s|dx?sf] ;+rfng u'0f:t/ ;'lglZrt ug]{ .
29
• :jf:YosdL{x?nfO{ sfo{s|d ;+rfng ljlw tyf ks[of, Pj+ sfo{s|dsf] /]sl8{ª tyf l/kf]{l6ª ;DjGwL :ynut
cg'lzIf0f sf dfWodaf6 Ifdtf clej[l4 ug]{ .
• SR åf/f ;+rfng ePsf sfo{s|daf6 lgbfg ePsf Ifo/f]usf la/fdLx? g]kfn ;/sf/sf] :jf:Yo ;"rgf
Joj:yfkg k|0flndf (HMIS) cWofjwL ePsf] ;'lglZrt ug]{ .
• cfjZostf cg';f/ Ifo/f]u sfo{s|dsf] :jf:Yo ;+:yf tyf kflnsfaf6 rf}dfl;s tYof+s ;+sng tyf u'0f:t/
dfkg sfo{df ;xof]lu e"ldsf lgjf{x ug]{ .
• sfo{s|d;+u ;DjlGwt lbOPsf cfly{s sf/f]af/ tyf pQm sf/f]af/sf cfjZos sfuhft ;+sng u/L lhNnf
sfo{s|d ;+of]hs tyf clws[tnfO{ pknJw u/fpg] .
#= sfo{qmd ;xhstf{sf] Go'gtd lhDd]jf/Lx? -c:ktfndf s'kf]lift tyf :jf;–k|:jf;
;+s|d0f ePsf afnaflnsf_
• c:ktfnsf] cf]=lk=l8=, O{d/h]G;L, afn lSnlgs, jf8{, kf]if0f k'g{:yfkg s]Gb|÷u[x tyf cGo jf8{df cfPsf
aRrfx? ljz]if u/L s'kf]lift, s8f :jf;–k|:jf; ;+s|d0f ePsf afnaflnsfdf Ifo/f]usf] :s|lgª tyf lgbfg
sfo{ ug]{ s'/fdf ;xof]u / ;xlhs0f ug]{ .
• laleGg :jf:Yo ;+:yf Pj+ s'kf]lift afnaflnsfdf Ifo/f]u lgbfg sfo{s|d cGt{ut cGo :jf:Yo ;+:yfaf6
c:ktfndf l/km/ eO{ cfPsf s'kf]lift Pj+ s8f :jf; k|:jf; ;+s|d0f ePsf afnaflnsf la/fdLx?df Ifo/f]usf]
lgbfg tyf pkrf/ Joj:yfkgdf ;xof]u ug]{
• lrlsT;sn] afnaflnsfdf Ifo/f]u lgbfgsf nflu PS;-/], dG6' 6]i6, Uofli6̭s nfefh nufot cGo klIf0fdf
;xhstf{sf] e"ldsf lgefpg] .
• c:ktfndf x'g] Joj:yfkg ;ldltsf] dfl;s j}7sdf Ifo/f]usf] s]z gf]l6lkms]zg sf] cj:yfjf/] ;dLIff tyf
of]hgf lgdf{0fdf ;xof]u ug]{ .
• c:ktfnsf ;a} sd{rf/xL?, :jf:Yo ;+:yf ;+rfng tyf Joj:yfkg ;ldltsf kbflwsf/Lx?, gu/kflnsfsf
:jf:Yo ;+of]hsx?;+u /fd|f] ;DjGw sfod u/L sfo{sd k|efjsf/L ?kdf ;+rfng ug]{ .
• lrlsT;s, Nofj k|fljlwsx?, la/fdLx? tyf cGo ;/f]sf/jfnfx?n] lgodfg';f/ kfpg'kg]{ /sdx? kfP gkfPsf]
;'lglZrt ug]{ .
• cfkm";Fu ePsf] cfly{s lx;fa lstfa r':t / b'?:t /fVg] / ;dod} ;DaGwLt lgsfodf a'emfpg] .
• dfl;s ?kdf ul/Psf sfo{x?sf] clen]v cWofjlws /fVg] .
• o; sfo{sf] /]sl8{ª l/kf]{l6ª b'?:t /fvL ;/f]sf/jfnftxPj+ lhNnf sfo{s|d ;+of]hs÷clws[tnfO{ dfl;s ?kdf
k|ltj]bg k]z ug]{ .
$= FAST sfo{s|dsf ;xhstf{sf] Go'gtd lhDd]jf/Lx?

• c:ktfnsf] OPD sf8{ jgfpg] zfvf ;Fu ;dGjo u/L cf]=lk=l8df ;]jf lng cfPsf la/fdLx?df vf]sL
nfu]sf] eP lghsf] k"hf{df FAST sf] :6fDk nfufpg ;xof]u ug]{ .
• c:ktfn k|zf;g;Fu ;dGjo u/L FAST gLlt cg';f/ e]l6Psf ;Dd"0f{ vf]ls nfu]sf] la/fdLnfO{ 5'§} sf]7fdf
j:g] Joj:yf ldnfpg] .
• To:tf la/fdLx?df Ifo/f]usf cGo lrGx nIf0fx? :s[lgª ug]{ tyf Ifo/f]usf] ;+efljt la/fdL ePsf]df lghsf]
vsf/ ;+nUg u/L FAST gLlt cg';f/ kl/If0fsf] Joj:yf ldnfpg] .
• d"Vo c:ktfndf x'g] Joj:yfkg ;ldltsf] dfl;s j}7sdf Ifo/f]usf] s]z gf]l6lkms]zg sf] cj:yfjf/]
;dLIfftyf of]hgf lgdf{0fdf ;xof]u ug]{ .
• c:ktfnsf ;a} sd{rf/xL?, :jf:Yo ;+:yf ;+rfng tyf Joj:yfkg ;ldltsf kbflwsf/xL?, kflnsfx?sf
:jf:Yo ;+of]hsx?;+u /fd|f] ;DjGw sfod u/L sfo{sd k|efjsf/L ?kdf ;+rfng ug]{ .
30
• lrlsT;s, Nofj k|fljlwsx?, la/fdLx? tyf cGo ;/f]sf/jfnfx?n] lgodfg';f/ kfpg'kg]{ /sdx? kfP
gkfPsf] ;'lglZrt ug]{ .
• cfkm";Fu ePsf] cfly{s lx;fa lstfa r':t / b'?:t /fVg] / ;dod} ;DalGwt lgsfodf a'emfpg] .
• dfl;s ?kdf u/LPsf sfo{x?sf] clen]v cWofjlws /fVg] .
• o; sfo{sf] /]sl8{ª l/kf]{l6ª b'?:t /flv lhNnf :jf:Yo sfof{no/ :yfgLo tx tyf kl/of]hgf clws[tnfO{
dfl;s ?kdf k|ltj]bg k]z ug]{ .
%= ;fdflhs kl/rfns (Social Mobilizer)- -kmf/d];L /]km/n_ x?sf] Go'gtd lhDd]jf/Lx? .
• x/]s lbg tf]lsPsf cf}ifwL k;ndf e]6 u/L ToxfF ePsf] ;Defljt Ifo/f]u la/fdLx?sf] klxrfg, /]km/n
/]sl8{Ë tyf l/kf]{l6Ësf] ;'lglZrttf ug]{ .
• cf}ifwL k;nsf] ;Defljt Ifo/f]u la/fdLsf] klxrfg, /]km/n Pj+ /]sl8{Ë tyf l/kf]{l6Ë sf af/]df Ifdtf
clej[l4 ug]{ .
• lrlsT;ssf]df ;+sng ePsf] vsf/ tf]lsPsf Ifo/f]u lgbfg s]Gb|df 9'jfgL u/L hfFrsf] ;'lglZrttf ug]{ .
• lgbfg ePsf Ifo/f]usf la/fdLx? pkrf/sf nflu :jf:Yo ;+:yfdf btf{ e} pkrf/ lnPsf] ;'lglZrt ug]{ .
• eTB PPM df cf}ifwL k;n / lrlsT;sx?n] åf/f ul/Psf ls|ofsnfkx?sf] ;dod} /]sl8{Ë ul/Psf]
;'lglZrtf ug]{ .
• sfo{s|ddf tf]lsPsf Ifo/f]u lgbfg tyf /]km/n ;DaGwL vr{x?sf] lx;fa lstfa / e'QmfgL ePsf]
sfuhftx?sf] k|df0fLs/0f / ;+sng sfo{ ug]{ .
31
cg';'rL $: dfOqmf]:sf]kL s]Gb|sf] nflu Assessment checklist
32
cg';'rL %: Fast Stratergy Framework
Yes
33
cg';'rL ^: afnaflnsfdf Ifo/f]u lgbfg :sf]/ sf8{
Feature 0 1 2 3 4 Score
Length of Illness <2 2-4 >4
Nutritional status (weight for age) Above the Between the -2 Less than the -3 SD
-2 lines and -3 SD line line
Recent close contact with an infectious None Verbal history of Proven
TB case (adult PTB or bacteriologically TB contact bacteriologically
conformed) confirmed contact
Lymph nodes: large, painless, firm, soft Yes
sinus in neck/axilla
Night sweats, unexplained fever Yes
Angle deformity of the spine Yes

Malnutrition not improving after 4 weeks Yes
of treatment
Joint swelling, firm, on-fluid, on-traumatic Yes
Unexplained abdominal mass, ascites Yes
Coma for more than 48 hours (with or Yes
without convulsions)
If the child scores 7 or more, and has no other disease more likely to explain the illness, then commence TOTAL
TB treatment
34
cg';'rL &: /]sl8{ª tyf l/kf]l6{ª kmf/fd

1.
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11.
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clen]v tyf k|ltj]]bgsf] k|of]u

SR sfo{s|dsf] clen]v /fVg tkl;n cg';f/sf /]lhi6/ tyf kmf/dx? k|of]u ug{'
kb{5 .
s|=;= sfo{s|d k|of]u u/Lg] kmf/d
! vsf/ ;+sng tyf 9'jfgL • ;Defljt Ifo/f]u btf{ /lhi6/ (HMIS 6.1)-
s}lkmotdf Courier hgfpg]
• vsf/ 9'jfgL kmf/d
@ ;Dks{ k/LIf0f(Drug • Ifo/f]u ;Dks{ k/LIf0fkmf/d (HMIS 6.6)
Sensitive and Drug • ;Dks{ k/LIf0ftyf Ifo/f]u k|lt/f]wfTds pkrf/
Resistance TB) /lhi6/ (HMIS 6.7)
# :jf:Yo ;+:yfdf • k|]if0f k'hf{ (HMIS 6.9)
Afnjflnsfdf Ifo/f]u l:s[lg+u • ;Defljt Ifo/f]u btf{ /lhi6/ (HMIS 6.1) - (of]
/]lhi6/ k|of]u ubf{ SAM/MAM/ARI s] xf]
pNn]v u/L /]km/ u/]sf] ca:yfdf sxfF /]km/ u/]sf]
s}kmLotdf pNn]v ug]{ ._
$ c:ktfndf afnjflnsfdf • ;Defljt Ifo/f]u btf{ /lhi6/ (HMIS 6.1)
Ifo/f]u l:s[lg+u (of] /]lhi6/ k|of]u ubf{ SAM/MAM/ARI s] xf]
pNn]v u/L /]km/ eO{ cfPsf] ca:yfdf sxfFb]lv
cfPsf] xf] pNn]v ug]{ cyjf ;f]lx ;+:yfsf] eP ;f]lx
cg';f/ s}kmLotdf pNn]v ug]{ ._
% cf}ifwL k|lt/f]wfTds Ifo/f]u • Ifo/f]u pkrf/ /lhi6/ (HMIS 6.5 A) - DST
la/fdLsf] l:s[lg+u dxndf glthf cWofjlws ug]{ . s}kmLot dxndf
olb “SR” lqmofsnfk cGtu{t DST u/]sf]
v08df “SR” hgfO{ Gene Xpert site sf] gfd
/ test u/]sf] ldlt pNn]v ug]{ .
^ FAST gLlt • ;Defljt Ifo/f]u btf{ /]lhi6/ (HMIS 6.1) -
FAST lqmofsnfk cGtu{t cfPsf] eP s}lkmotdf
;f] pNn]v ug]{ .
• FAST lqmofsnfk cGtu{t Ifo/f]u symptoms
screening ug'{ k/]df, ;Dks{ k/LIf0fkmf/d
(HMIS 6.6) k|of]u ug{ ;lsg] 5 .
& cf}ifwL k;njf6 ;Defljt • k|]if0f k'hf{ (HMIS 6.9)
Ifo/f]u la/fdLsf] k|]z0f • kmfd]{;L Ifo/f]u k|]if0f /lhi6/ (For Pharmacy)
• Pay for Performance Program Register
(For Hospital/ Doctor)
* g]kfn ef/t gfsfdf • ;Defljt Ifo/f]u btf{ /]lhi6/ (HMIS 6.1)
Ifo/f]usf] l:s[lg+u • vsf/ 9'jfgL kmf/d
( h]ndf Ifo/f]usf] l:s[lgË • ;Defljt Ifo/f]u btf{ /]lhi6/ (HMIS 6.1)
51

!) l6jL lk6L • ;Dks{ k/LIf0ftyf Ifo/f]u k|lt/f]wfTds pkrf/
/lhi6/ (HMIS 6.7)
• Ifo/f]u k|lt/f]wfTds pkrf/ sf8{ (HMIS 6.8)
!! vsf/ kl/If0fsf] nflu • k|of]uzfn cg'/f]w tyf k|ltj]bg kmf/d (HMIS
6.2)
• Ifo/f]u k|of]uzfnf /lhi6/ (dfOs|f]:sf]kL) (HMIS
6.3A) Mark “SR” and Intervention at
last.
• Ifo/f]u k|of]uzfnf /lhi6/ (lhgPS;kf]6{) (HMIS
6.3B) Mark “SR” and Intervention at
last
!@ Ifo/f]usf la/fdL btf{sf] • Ifo/f]u pkrf/ sf8{ -:jf:Yo ;+:yf_– HMIS
nflu 6.4A
• Ifo/f]u pkrf/ sf8{ -la/fdL_–HMIS 6.4B
• cf}ifwL k|tL/f]lw -DRTB) Ifo/f]u pkrf/ sf8{ -
la/fdL_– HMIS 6.4C
• cf}ifwL k|tL/f]lw -DRTB) Ifo/f]u pkrf/ sf8{ -
la/fdL_– HMIS 6.4D
• Ifo/f]u pkrf/ /lhi6/ (HMIS 6.5A)
• cf}ifwL k|tL/f]lw -DRTB) Ifo/f]u pkrf/ /lhi6/
(HMIS 6.5B)
• SR n] dflysf pNn]lvt clen]v /lhi6/x? ;DaGwLt :jf:Yo ;+:yfdf eP gePsf] ;'lgZlrt ug{'
kg]{ 5 .
• NTPMIS df GeneXpert / DR TB sf] tYof° k'0f{?kdf cWofjlws ePsf] ;'lglZrt ug]{ .
• :jf:Yo ;+:yfn] HMIS 9.3 (For Both DS and DR TB)df tof/ kf/]sf] dfl;s
k|ltj]bgsf] cfwf/df tyf sfo{s|dsf]nflu k|of]u u/LPsf /lhi6/sf] cfwf/df dfl;s k|ltj]bg
tof/ kfl/ ;DjGwLt :jf:Yo ;+:yfjf6 k|fdfl0ft u/fO{ lhNnf kl/of]hgf clws[t/;+of]hs nfO{
j'emfpg]
• lhNnf kl/of]hgf clws[t/;+of]hs jf ;fdflhs kl/rfns n] klfnsf cg';f/ dfl;s k|ltj]ng
tof/ kfl/ ;DaGwLt kflnsfnfO{ j'emfpg' kg]{
• lhNnf kl/of]hgf clws[t/;+of]hs n] dfl;s k|ltj]bg ;DaGwLt :jf:Yo sfo{fnodf klg j'emfpg'
kg]{
• Pay for Performance cGt/utsf ;j} la/fdLsf] clgjfo{ ?kdf NTPMIS df k|ltj]bg
ug{' kg]{ .
• cf}ifwL k;ndf ;+rfng ePsf] sfo{s|dsf] k|ltj]bg NTPMIS df ug{' kg]{ .
• For Diagnosed and FU test request, can use HMIS 1.4
• SR sfo{qmd;+u Link ePsf :jf:Yo ;+:yfx?n] pknAw Reporting Form (Form- 1 b]lv
Form 5 ) sf] k|of]u u/L dfl;s ?kdf Report ug'{ kg]{ 5 . ;f] dfl;s Report sf] cfwf/df
DPO/DPC n] e- Reporting (NTPMIS) df /Lkf]{6 ug'{ k5{ .
52
cg';'rL *: TB Preventive Therapy Letter
53

TB SR Implementation Guideline-Clean-Final

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/fli6«o Ifo/f]u sfo{qmd

/fli6«o Ifo/f]u sfo{qmd

Unf]an km08 ;xfotf cGt{ut

sfo{qmd sfof{Gjog ubf{ ;dGjo ul/g' kg]{ lgsfo÷JolQm;

• lhNnfnfO{ $ efudf af8g] $)

aflx/sf lhNnfdf /x]df cfjZos sfuhft ;+sng u/L sfo{s|ddf Joj:yf eP

• lhgPS;k6{df k/LIf0fug'{kg]{ ePdf vsf/sf] Pp6f u'0f:tl/o :ynut gd"gf /

cfly{s afF8kFmf8 l;=g+= ljj/0f PsfO{ b/ k6s hDdf

• pkrf/fy{ Ifo/f]usf la/fdLsf] lgbfg lhgPS;k6{af6 gePsf] eP dfq pQm la/fdLsf]

sfo{qmd zLif{s :jf:Yo ;+:yfdf afnaflnsfdf Ifo/f]u lgbfg sfo{s|d

4. kf]if0fsf] sfo{s|d -IMAM/CMAM_ ;+rfng ePsf] lhNnfdf Outpatient

cfly{s afF8kFmf8 l;=g+= ljj/0f PsfO{ b/ k6s hDdf

c:ktfndf s'kf]lift tyf :jf;–k|:jf; ;+s|d0f ePsf afnaflnsfx?df Ifo/f]u lgbfg

cfly{s afF8kFmf8 l;=g+= ljj/0f PsfO{ b/ k6s hDdf

Tuberculosis Preventive Therapy (TPT) sfo{qmdsf] ;'?jft tyf lg/Gt/tf

cfly{s afF8kFmf8 l;=g+= ljj/0f PsfO{ b/ k6s hDdf

▪ धिधकत्सकको म्याधपङ धर्म्र् कनराहरूका आिारमा गर्े ।

k|jf;L tyf df};dL sfdbf/df Ifo/f]usf] l:s[lgª tyf lgbfg

cfly{s afF8kFmf8 pknJw ah]6 cg';f/ sfo{s|d ;+rfng ug]{ .

sfof{Gjog k|s[of • dxfgu/kflnsfdf !) hgf / pkdxfgu/kflnsf tyf tf]lsPsf cGo gu/kflnsfdf %

cfly{s afF8kFmf8 l;=g+= ljj/0f PsfO{ b/ k6s hDdf

• eTB P4P df ePsf] lj/fdLsf] ljj/0fsf cfwf/df e'Qmflg ug]{ .

• ;DjGwLt sd{rf/Ln] cg'udg Ef|d0f kZrft standard format df k|ltj]bg agfO{

SR b\jf/f ;+rflnt sfo{s|dsf] :yflgo txdf ;ldIff uf]li7

Cg;"'rL !: :jf:Yo ;+:yf Pj+ Ifo/f]u lgbfg ;]jf DoflkË km/d]6

/fli6«o Ifo/f]u sfo{s|d

cg';'rL @: TB screening Consent Form

/fli6«o Ifo/f]u sfo{s|d

d ===========-gfd_======================== x'F . d /fli6«o Ifo/f]]u sfo{s|d cGt/ut Ifo/f]u la/fdLsf]

:jo+d ;]js÷;]ljsfsf] gfd M ldltM

$= FAST sfo{s|dsf ;xhstf{sf] Go'gtd lhDd]jf/Lx?

cg';'rL $: dfOqmf]:sf]kL s]Gb|sf] nflu Assessment checklist

cg';'rL %: Fast Stratergy Framework

cg';'rL ^: afnaflnsfdf Ifo/f]u lgbfg :sf]/ sf8{

Angle deformity of the spine Yes

cg';'rL &: /]sl8{ª tyf l/kf]l6{ª kmf/fd

clen]v tyf k|ltj]]bgsf] k|of]u

• vsf/ 9'jfgL kmf/d

cg';'rL *: TB Preventive Therapy Letter

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