Hindi Translation of Lancet Articles :: PFI Publication :: KNOWLEDGE MANAGEMENT CENTRE PORTAL, POPULATION FOUNDATION OF INDIA

Expand document

Collapse document

Hindi Translation of Lancet Articles

1 Pages 1-10

1.1 Page 1

1.2 Page 2

1.3 Page 3

1.4 Page 4

1.5 Page 5

1.6 Page 6

1.7 Page 7

1.8 Page 8

1.9 Page 9

1.10 Page 10

2 Pages 11-20

2.1 Page 11

2.2 Page 12

2.3 Page 13

2.4 Page 14

2.5 Page 15

2.6 Page 16

2.7 Page 17

2.8 Page 18

2.9 Page 19

2.10 Page 20

3 Pages 21-30

3.1 Page 21

3.2 Page 22

3.3 Page 23

3.4 Page 24

3.5 Page 25

3.6 Page 26

3.7 Page 27

3.8 Page 28

3.9 Page 29

3.10 Page 30

4 Pages 31-40

4.1 Page 31

4.2 Page 32

4.3 Page 33

4.4 Page 34

4.5 Page 35

4.6 Page 36

4.7 Page 37

4.8 Page 38

4.9 Page 39

4.10 Page 40

5 Pages 41-50

5.1 Page 41

5.2 Page 42

5.3 Page 43

5.4 Page 44

5.5 Page 45

5.6 Page 46

5.7 Page 47

5.8 Page 48

5.9 Page 49

5.10 Page 50

6 Pages 51-60

6.1 Page 51

6.2 Page 52

6.3 Page 53

6.4 Page 54

6.5 Page 55

6.6 Page 56

6.7 Page 57

6.8 Page 58

6.9 Page 59

6.10 Page 60

7 Pages 61-70

7.1 Page 61

7.2 Page 62

7.3 Page 63

7.4 Page 64

Hindi Translation of Lancet Articles

1 Pages 1-10

▲back to top

1.1 Page 1

▲back to top

1.2 Page 2

▲back to top

1.3 Page 3

▲back to top

1.4 Page 4

▲back to top

xHkZ fujk/s kdkas ds mi;ksx ls jkds h xbZ ekr` eR` ;q %

172 ns'kksa dk v/;;u

lSQÌq hu ,gen] fdaxQSax yh] yh fy;]q ,eh vks lbq Z

lkjka'k

i"` BHkwfe ifjokj fu;kstu lqjf{kr ekr`Ro i;z kl ds pkj LraHkksa esa ls ,d gSA bl i;z kl dk mÌs'; gS

fodkl'khy ns'kksa esa ekr` e`R;q de djukA gekjk mÌs'; Fkk ekr` e`R;q ij xHkZ fujks/kdksa ds mi;ksx ds

izHkkoksa dk vuqeku yxkukA blds vfrfjDr] ;g vueq ku yxkuk fd ;fn fofHkUu ns'kks]a {ks=h; o fo'o

Lrj ij xHkZ fujks/ku dh viw.kZ vko';drkvksa dks iwjk dj fn;k tk,] rks ekr` e`R;q esa fdruh deh vkus

dh laHkkouk gSA

dk;iZ z.kkyh geus esVjuy ekjS VfS yVh ,sfLVes'ku baVj ,tsalh xqiz ¼MMEIG½] ;w,u oYMZ dkSUVªklfS IVo

;wt+ 2010 vkjS ;w,u oYMZ ikSiyq 's ku ikz SLisDVl~ 2010 vkadM+ksa ds ladyu esa ls mfpr vkadM+s fudkys

vkSj dkmaVjQSDP;vq y ekSMfyxa rjhds ¼ekWMy 1½ dk mi;ksx fd;kA geus MMEIG }kjk mi;ksx fd,

x, ekrR` o e`R;q vueq ku LFkkfir djus ds rjhds dks nksgjkrs gq,] bldk vueq ku yxk;k fd 172 ns'kksa esa

xHkZ fujks/kdksa ds mi;ksx ds dkj.k fdruh ekrkvksa dh tku cpkbZ tk ldhA blds vfrfjDr] geus ,d

nwljs ekWMy ¼ekWMy 2½ dk mi;ksx fd;k] ftlds vk/kkj ij 167 ns'kksa ds fy, blh idz kj ds vuqeku

yxk, vkjS xHkZ fujks/ku dh viw.kZ vko';drk iwjh djus ls gksus okys iHz kkoksa dk vkadyu fd;kA geus

laosnu'khyrk fo'ys"k.k o nksuksa ekWMy ds chp rkyesy dh Hkh ryq uk dhA

fu"d"kZ ekWMy 1 ds mi;ksx ds vk/kkj ij gekjk vuqeku gS fd o"kZ 2008 esa 3]42]203 efgykvksa dh eR` ;]q

ekr`Ro ds dkj.k gbq Z] yfs du xHkZ fujks/kdksa ds mi;ksx ls 2]72]040 ¼vfuf'prrk varjky 127937 &

407134½ ekr` e`R;q jksdh tk ldh ¼44 ifz r'kr½A vr% ;fn xHkZ fujks/kdksa dk mi;ksx u fd;k tkrk] rks

2008 esa gbq Z dqy e`R;q ls 1-8 xq.kk vf/kd ekr` e`R;q gksus dh laHkkouk FkhA xHkZ fujks/ku dh viw.kZ

vko';drkvksa dks iwjk djus ls izfr o"kZ 1]04]000 vfrfjDr ekrkvksa dh tku cpkbZ tk ldrh gS ¼29

ifz r'kr deh½A

foospuk dbZ fodkl'khy ns'kksa esa vokafNr xHkZ /kkj.k vkjS xHkZ fujks/kdksa dh vko';drk dkQh vf/kd gSA

ge iez k.k is'k djrs gaS fd fodkl'khy ns'kksa esa ekr` eqR;q de djus esa xHkZ fujks/kdksa dk mi;ksx ,d

vko';d vkSj izHkkodkjh izkFkfed lqj{kkRed mik; gSA

vkuS ykbu idz k'ku

tqykbZ 10] 2012

http://dx.doi.org/10.1016/S014

0-6736(12)60478-4

vkuS ykbuZ ns[kus ;k fVIi.kh djus

ds fy, ns[ks

http://dx.doi.org/10.1016/S014

0-6736(12)60982-9

fMikVZeSaV vkWQ ikiS qys'ku] QfS eyh

,Msa jhikz Ms fDVo gYS Fk ¼,l vgen

ih,pMh] D;w yh ,e-,-] izkQs Slj

,-vks- lqbZ ih,pMh½] vkjS

fMikVZeaSV vkWQ baVju'S kuy

gYS Fk¼,y fy;q ih,pMh½] fcy ,sMa

fefyUMk xsV~l bafLVV;~ wV QkWj

ikiS qys'ku ,Msa jhizkMs fDVo gYS Fk]

CywecxZ Ldwy vkWQ ifCyd gYS Fk]

tkuS gkiS fdUl ;wfuoflVZ h]

ckYVheksj] ,eMh] ;w,l,

i=kpkj ds fy, laidZ djsa %

Mk-lSQíq hu vgen] fMikVeZ SaV

vkWQ ikiS qys'ku] QSfeyh ,sMa

jhizkMs fDVo gYS Fk] CywecxZ Ldwy

vkWQ ifCyd gYS Fk] tkSu

gkSifdUl ;wfuoflVZ h] ckYVheksj]

,eMh 21205] ;w ,l ,

sahmed@jhsph.edu

ifjf'k"V ds fy, vkSuykbZu ns[ksa

vkfFkdZ lg;ksx fcy ,Msa fefyUMk xsV~l QkmUMs'kuA

iLz rkouk

xHkZ fujks/kdksa ds mi;ksx ls ifz r o"kZ

yxHkx 23 djksM+ tUe jksds tk ldrs gSaA

vkjS vokafNr xHkZ /kkj.k jksdus esa ifjokj

fu;kstu ,d ikz Fkfed mik; ds :i esa

mi;ksx fd;k tkrk gAS 1]2 1970 ds n'kd

esa dyq iztuu'khyrk nj 4-7 tUe ifz r

efgyk dh nj ls 2000 ds n'kd esa 2-6

tUe ifz r efgyk rd fxjh & fo'o Lrj

ij efgykvksa dh itz uu'khyrk nj esa vkbZ

bl Hkkjh fxjkoV ds fy,] xHkZ fujks/kdksa ds

c<+rs mi;ksx dks gh Js; tkrk gSA

gkykafd rsth+ ls c<+rh tul[a ;k ij jksd

yxkus ds fy,] fodkl'khy ns'kksa esa 1950

ds n'kd ls gh ifjokj fu;kstu dh

'k#q vkr dh xbZ] ;g ekrkvksa vkSj f'k'kvq ksa

ds LokLF; esa l/q kkj ykus ds fy, ,d

egRoiw.kZ lkotZ fud LokLF; mik; ds :i

esa mHkj dj vk;k gSA3

xHkZ fujks/ku vkSj cPpksa ds tUe ds chp

varj j[kus ls efgykvksa ds fy, vU;

LokLF; ykHk Hkh gksrs gSaA4&7 xHkZ fujks/kdksa

1.5 Page 5

▲back to top

ds mi;ksx ls cPpksa ds tUe ds chp

varjky c<+us ds dkj.k cPpksa ds thfor

jgus dh njksa esa Hkh c<+ksrjh gqbZ gS vkSj

blls nyq ZHk ikfjokfjd lla k/kuksa ds fy,

cPpksa ds chp ifz r;ksfxrk Hkh de gksrh

gAS 8&11

ljq f{kr ekr`Ro iz;kl ¼n lsQ enjgqM

bfuf'k,fVo½] ekr`Ro eRq ;q dks de djus

dk ,d fo'o Lrjh; vfHk;ku] ftls 1987

esa 'k#q fd;k x;k] ds varxZr fodkl'khy

ns'kksa esa ekr` eR` ;q dks de djus ds pkj

egRoiw.kZ mik;ksa esa ls ifjokj fu;kstu dks

Hkh ,d mik; ds :i esa fpfàr fd;k x;k

& blesa vU; gSa] izlo iwoZ ns[kjs[k]

ljq f{kr ilz o vkSj izlo i'pkr~ ns[kHkkyA

xkjS ryc gS] fd dqy ekr` eR` ;q ds ekeyksa

esa ls 99 izfr'kr fodkl'khy ns'kksa esa gksrh

gaSA12 1994 es]a dk;jks esa vk;ksftr

tul[a ;k ,oa fodkl fo"k; ij varjkZ"Vªh;

lxa ks"Bh esa efgykvksa ds LokLF; esa l/q kkj

ds fy, xHkZ fujks/kdksa ds egRo ij t+ksj

fn;k x;kA13 rc ls ifjokj fu;kstu dks

ekr` eR` ;q ij gksus okys mlds izR;{k o

vizR;{k iHz kkoksa ds fy, dkQh ekU;rk nh

tk jgh gAS 14]15

ifjokj fu;kstu ls ekr` e`R;q la[;k de

gksus ij lh/kk izHkko iM+rk gS D;ksfa d blls

xHkZ /kkj.k vkSj mlls tqM+h leL;kvksa dh

lHa kkouk ¼tksf[ke esa deh½] vlqjf{kr xHkZ

lekiu ds [krjs ¼tksf[ke esa deh½ de gks

tkrs gSaA ;oq k efgykvksa] ftuesa Jks.kh

fodkl iwjk u gksus dh lHa kkouk jgrh gS]

esa iFz ke xHkZ /kkj.k esa foyac djus esa Hkh

lg;ksx feyrk gS vkSj cgqr tYnh tYnh

xHkZ /kkj.k ds dkj.k vk tkus okyh

det+ksjh ls Hkh cpko gksrk gAS izfr o"kZ]

xHkoZ rh gksus okyh dqy 19 djksM+ efgykvksa

esa ls yxHkx 5 djksM+ efgyk,a vokafNr

xHkZ ds lekiu ds fy, xHkiZ kr djokrh gaS]

vkjS yxHkx 13 izfr'kr tufu;ksa dh eR` ;q

xHkiZ kr ls tqM+h leL;kvksa ds dkj.k gksrh

gSA16 cpk, ;k jksds x, cPpksa ds tUe ;k

xHkZ lekiu ds ekeyksa dk Hkh lh/kk iHz kko

ekr` e`R;q nj ij iM+rk gS] ftls ekr` eR` ;q

tksf[ke ¼ifz r efgyk½ ds :i esa ekik tkrk

gS & ftldh ifjHkk"kk g]S ifz r o"kZ izfr

100]000 iztuu vk;q dh efgykvksa esa gksus

okyh ek¡vksa dh eR` ;q dh la[;kA

xHkZ fujks/kdksa ds mi;ksx ls ifz r tUe ij

ekr` e`R;q dk tksf[ke Hkh de gksrk gS]

ftls ekr` eR` ;q vuiq kr ¼izfr o"kZ 100]000

thfor tUeksa esa gbq Z ek¡vksa dh eR` ;q l[a ;k½

ds :i esa ekik tkrk gSA blls **cgqr

tYnh] cgqr nsj l]s cgqr vf/kd ;k tYnh

tYnh gksus okys** xHkZ /kkj.k ds [krjs de

fd, tk ldrs gaSA17]18 ;qok efgykvksa ¼18

o"kZ ls de vk;q½ esa ekr` e`R;q laHkkouk

vU; efgykvksa dh vkSlr ds eqdkcys

vf/kd gksrh g]S D;ksfa d mudh Jks.kh dk

fodkl iwjh rjg ls ugha gqvk gksrkA blh

rjg] vf/kd mez dh efgykvksa ¼40 o"kZ ls

vf/kd vk;q½ vkjS vf/kd la[;k ds cPpksa

okyh efgykvksa esa Hkh xHkZ ds dkj.k gksus

okyh e`R;q dh lHa kkouk vf/kd gksrh gS]

D;ksfa d vU; efgykvksa ds edq kcys mudk

LokLF; det+ksj gks ldrk gSA eryc]

caXykns'k esa fd, x, iz;ksxkRed v/;;u

n'kkrZ s gaS fd ;fn 20 o"kZ ls de o 39 o"kZ

ls vf/kd vk;q dh efgyk,a cPps iSnk ugha

djrha] rks ekr` eR` ;q esa 34 izfr'kr dh

deh vk ldrh gSA blh idz kj ikap ;k

mlls vf/kd cPpksa okyh efgyk,a ;fn

vkjS cPps inS k u djsa rks ;gh la[;k 58

ifz r'kr de gks ldrh gSA19 1970 ds

n'kd es]a ikiS yq s'ku dkmafly ds

'kks/kdrkZvksa us vueq ku yxk;k fd

fodkl'khy ns'kksa esa **iztuu'khyrk

viHz kkoh vk;*q * ¼;kfu] xHkZ /kkj.k dks

18&35 o"kZ rd dh efgykvksa rd gh

lhfer dj nsuk½ okyh efgykvksa }kjk ;fn

cPps inS k u fd, tk,a] rks ekr` e`R;q esa 20

izfr'kr rd deh vk ldrh gSA20 blh

1.6 Page 6

▲back to top

izdkj xHkZ fujks/kdksa ds mi;ksx ls nks

cPpksa ds chp le;kof/k c<+k nsus ls ek¡vksa

ds thfor jgus dh lHa kkouk c<+kbZ tk

ldrh gS D;ksafd blls nks xHkZ ds chp

LokLF; lq/kkjus ds fy, vf/kd le;

feyrk g]S ftlls ek¡vksa dks vius iks"k.k

dh fLFkfr dks csgrj djus ds fy, vkSj

vf/kd le; fey tkrk gSA

ysfdu] 1980 ds n'kd ds e/; esa] fpark

O;Dr dh xbZ fd ifjokj fu;kstu dk ekr`

eR` ;q vuiq kr ij lHa kor% cgrq de iHz kko

gAS 21]22 ysfdu ml le; laHkor% ifjokj

fu;kstu ds iHz kkoksa dk vkadyu djus esa

FkksM+h tYnh dh xbZ] D;ksfa d efgykvksa dh

iztuu'khyrk ds njksa esa cnykoksa ds vkadM+s

vHkh vkuk 'kq# gh g,q FksA

fiNys 2&3 o"kkasZ esa fd, x, 3

v/;;uks1a 4]15]23 esa 1990 vkSj 2008 ds chp

itz uu'khyrk esa vkbZ deh ds ekr` e`R;q

ij iHz kko dk v/;;u fd;k x;k] ysfdu

mUgkusa s ifjokj fu;kstu ds ekr` eR` ;q ij

gksus okys dyq iHz kkoksa dk v/;;u ugha

fd;kA mu v/;;uksa esa izeq[k rkjS ij dgk

x;k gS fd itz uu'khyrk njksa esa deh vkus

ds ihNs] xHkZ fujks/kdksa ds mi;ksx dh

egRoiw.kZ Hkwfedk jghA

gkykafd 1990 esa 5]46]000 ls 2008 esa

3]58]000 dh l[a ;k rd fo'o Lrj ij

ekr` e`R;q esa dkQh deh vkbZ gS] fQj Hkh

,slk yxrk gS fd lglzkCnh fodkl y{;

5, ds vu:q i 1990 ls 2015 ds chp ekr`

e`R;q dks rhu&pkFS kkbZ vuiq kr ls de djus

dk y{; dbZ ns'k ikz Ir ugha dj ik,axsA24

,d ,sls ,tsUMk dh vko';drk gS] ftlds

varxrZ 2015 ds ckn Hkh ekr` e`R;q dks de

djus ds fy, ifjokj fu;kstu dks egRo

fn;k tk,A

gekjk mÌs'; Fkk fd ge mUgha 172 ns'kksa esa

ekr` eR` ;q dks de djus esa xHkZ fujks/kdksa

ds mi;ksx ds iHz kkoksa dk vuqeku yxk,a]

ftuesa MMEIG] ftlds fo'o LokLF;

lLa Fkku] UNICEF] l;a qDr jk"Vª tula[;k

dks"k vkjS fo'o cSad lnL; gaS] us v/;;u

fd;k FkkA geus flE;qys'ku vuyS sfll ds

vk/kkj ij ;g Hkh vueq ku yxk;k fd ;fn

xHkZ fujks/kdksa dh viw.kZ vko';drkvksa dks

iwjk dj fn;k tk, rks ekr` eR` ;q esa fdruh

deh dh vis{kk dh tk ldrh gAS

dk;iZ z.kkyh

vkadM+ksa ds lkz sr

geus rhu iez [q k lkz srksa ls vkadM+ksa dk

mi;ksx fd;kA igyk Fkk MMEIG

¼WHO½ }kjk 2008 dh ekr` eR` ;q Lrj dk

vueq ku yxkus ds fy, mi;ksx fd, ekr`

e`R;q vkadM+ksa dk lda yuA24 geus ek¡vksa dh

eR` ;q] iztuu'khyrk] ldy ?kjsyw mRikn]

vkSj tUe nsrs le; dq'kyrkikz Ir lgk;d

dh ekStwnxh dh tkudkjh izkIr dhA geus

xHkZ fujks/kdksa ds mi;ksx o ifjokj

fu;kstu dh viw.kZ vko';drkvksa lca a/kh

tkudkjh l;a qDr jk"Vª xHkZ fujks/kd

mi;ksx 2010 vkadM+ksa25 ds lda yu ls izkIr

dh] ftlesa 193 ns'kksa o {ks=ksa ds 1950 ls

2010 ds chp ds vkadM+s miyC/k gaS] ftUgsa

eq[;r% tul[a ;k Lrjh; v/;;uksa ds

ek/;e ls ladfyr fd;k x;k gAS blh ls

geus fookfgr efgykvksa ;k ;kuS :i ls

lfØ; efgykvksa dh l[a ;k Hkh fudkyhA

varr%] geus tUeksa dh l[a ;k] 15&49 o"kZ

vk;q dh efgykvksa dh tula[;k vkSj

lk/kkj.k Lrj ij itz uu'khyrk njksa ds

vkadM+s la;qDr jk"Vª fo'o tul[a ;k

iwokuZ eq ku 2010 vkadM+ksa ds lda yu ls

izkIr fd,A26

xHkZ fujks/kd mi;ksx nj

xHkZ fujks/kdksa ds mi;ksx lca a/kh vkadM+ksa dk

e[q ;r% tul[a ;k los{Z k.kksa ls vuqeku

yxk;k x;k] blhfy, ;g vkadM+s dsoy

los{Z k.k o"kksaZ ds fy, gh miyC/k FksA dbZ

ns'kksa ds fy,] xHkZ fujks/kd mi;ksx nj o"kZ

1.7 Page 7

▲back to top

2008 ¼bl v/;;u dk lna HkZ o"kZ½ ls igys

ds gSa ¼ifjf'k"V½A bu vkadM+ksa dks miyC/k

ekr` eR` ;q vkadM+ksa ds le;kuq:i cukus ds

fy, geus LiykbZu jSUMe bQSDV~l ekSMy

ij vk/kkfjr MSeksxfSz Qd izkstDS 'ku eFS kM ds

mi;ksx ls xHkZ fujks/kdksa ds mi;ksx dk

vueq ku ¼,DLVªkiksyVs ½ yxk;kA blls izkIr

g,q xHkZ fujks/kd mi;ksx nj ds izR;{k o

iwokZueq kfur vkadM+s ifjf'k"V esa n'kk,Z x,

gSaA iRz ;{k vkjS iwokZuqekfur xHkZ fujks/kd

mi;ksx njksa ds chp lglca a/k x.q kkad 0-993

gSA o"kZ 2008 esa xHkZ fujks/kd mi;ksx njsa

15 ns'kksa esa fjdkMZ dh xbZa] vkjS bu

vkadM+ksa dk iwokuZ qekfur vkadM+ksa ls

ut+nhdh lglca a/k xq.kkad ik;k x;k

¼lglca a/k xq.kkad 0-998( ifjf'k"V½A

lkaf[;dh; fo'ys"k.k % ekWMy 1

xHkZ fujks/kdksa ds mi;ksx ls cpkbZ xbZ

ekrkvksa dh tkuksa dh la[;k dk vuqeku

yxkus ds fy, geus nks fo'ys"k.k izk:iksa

dk iz;ksx fd;kA ekWMy 1 esa] geus

MMEIG }kjk mi;ksx fd, x, ekr` e`R;q

vueq ku iz.kkyh dks nksgjkrs gq,

dkmUVjQDS P;qvy ekWMfyax vikz sp dk

i;z ksx fd;kA24]27 geus cgqLrjh; ijkorZu

ekWMy (multilevel regression) ds

mi;ksx ls ekr` e`R;q vuiq kr dk vuqeku

LFkkfir fd;kA

log(PMDFi) = β0 + β1log(GDPi) +

β2log(GFRi) + β3SABi + αcj[i]+ αRk[i] +

log(1 – ai) + Ɛi

xHkZ fujks/kd mi;ksx nj ¼izfr'kr½

fp= 1 & 15&49 o"kZ vk;q dh efgykvksa esa gqbZ dqy e`R;qvkas esa ekr` eqR;q vuqikr ds lanHkZ esa xHkZ fujks/kd

mi;ksx nj ¼ykxS PMDF½

xHkZ fujks/kd mi;ksx nj ¼izfr'kr½

fp= 2 & xHkZ fujks/kd mi;ksx nj vkjS lk/kkj.k iztuu'khyrk nj

lk/kkj.k iztuu'khyrk nj & ifz r 1000 itz uu'khy vk;q ¼15&49 o"kZ½ dh efgykvkas }kjk okf"kdZ Lrj ij

fn, tkus okys tUeksa dh la[;k

PMDF o"kZ i ] j ns'k vkjS k HkkSxksfyd {ks=

esa iztuu'khy vk;q ¼15 ls 49 o"kZ vk;q½

dh efgykvksa dh dqy e`R;q l[a ;k esa ls

ekr` eR` ;q dk vuqikr FkkA ifz r O;fDr dqy

?kjsyq mRikn ¼GDP½ dks o"kZ 2005 esa

ipsfZ t+xa ikWoj ifS jVh ds vk/kkj ij Bhd

fd;k x;kA GFR vke iztuu'khyrk nj

gksrh g]S ftls iztuu'khy vk;q dh izfr

1000 efgykvksa esa izfro"kZ g,q tUeksa dh

l[a ;k ds :i esa ifjHkkf"kr fd;k tkrk gAS

SAB vuqikr mu ek¡vksa dk gS] ftuds

ikl tUe nsrs le; izf'kf{kr lg;ksxh

miyC/k Fks] vkSj αR vkjS αc k HkkSxksfyd

{ks= ds j ns'k ds fy, jSUMe baVjlIS Vl~ gSaA

ai itz uu'khy vk;q dh efgykvksa dh dqy

e`R;q esa ls ,Ml~ ds dkj.k gqbZ e`R;q dk

vuiq kr gS vkSj Ɛi xfYr;ksa ds fy, mi;ksx

fd;k x;k gAS

geus bl ekWMy dks nksckjk fufnZ"V djrs

g,q blesa xHkZ fujks/kd mi;ksx nj ds fy,

,d fu;e Hkh 'kkfey fd;k %

1.8 Page 8

▲back to top

log(PMDFi) = β0 + β1log(GDPi) +

β2log(GFRi) + β3SABi + β4CPRi +

αcj[i]+ αRk[i] + log(1 – ai) + Ɛi

gekjs izkFkfed v/;;u ls gesa xHkZ fujks/kd

mi;ksx nj vkjS ykSx PMDF ds chp

ekr` e`R;q xHkZ fujks/kd ekr` e`R;q xHkZ fujks/kd iz;ksx ls jksdh xbZ ekr` xHkZ fujks/kd iz;ksx ls

vuiq kr* mi;ksx nj

e`R;q ¼vfuf'prrk nj †½

jksdh xbZ ekr` e`R;q dk

¼izfr'kr½

vuiq kr ¼ifz r'kr½

fo'o

252

64-2

342203 272040 ¼127937&407134½

44-3

fodflr {ks=

75-0

1038 1578 ¼661&2502½

60-3

fodkl'khy {ks=

273

62-9

341165 270461 ¼127249&404629½

44-2

vÝhdk

542

29-1

191207 92652 ¼45668&133675½

32-7

mÙkjh vÝhdk

61-6

3145 4426 ¼2005&6819½

58-5

mi lgkjk vÝhdk 596

22-1

188062 88277 ¼43663&126856½

31-9

,f'k;k

187

67-7

139369 162636 ¼74860&247736½

53-9

iwoZ ,f'k;k

85-3

6941 10732 ¼4531&16928½

60-7

nf{k.k ,f'k;k

279

55-2

109969 124314 ¼57729&187801½

53-1

nf{k.kiwoZ ,f'k;k 170

61-4

19277 24629 ¼11143&38700½

56-1

if'peh ,f'k;k 65

56-7

3182 2961 ¼1457&4308½

48-2

yfS Vu vejhdk

75-3

7505 11251 ¼5093&17092½

60-0

Lora= la;qDr jk"Vª 49

71-7

1798 2583 ¼1017&4089½

59-0

dSfjfc;u

155

62-4

1157 1153 ¼547&1709½

49-9

nf{k.k iwohZ ;wjksi ds 26

63-7

129 186 ¼64&327½

59-0

ifjoruZ dkfyd ns'k

lHkh vkadM+s la[;k esa gaS] dsoy xHkZ fujks/kd mi;ksx nj vkSj jksdh xbZ ekr` eR` ;q vuiq kr ¼ifz r'kr½ dks NksM+djA iRz ;sd {ks=h; Js.kh

esa 'kkfey ns'kksa dh lwfp rkfydk 2 esa nh xbZ gSA esVjuy ekSjVfS yfV ,sfLVes'ku baVj & ,tlsa h xqzi dh esVjuy ekjS VfS yVh fjiksVZ ds

vk/kkj ij ns'kksa dks fodflr vkjS fodkl'khy ns'kksa ds :i esa Js.khc) fd;k x;kA24 *ekWMy 1 ij vk/kkfjr o"kZ 2008 esa 100]000

thfor tUeksa esa ekr` eR` ;q dh la[;k ds vuqekuA †2-5 vkjS 97-5 ilZUVkby ds vueq kuA

rkfydk 1 % o"kZ 2008 esa xHkZ fujks/kdksa ds mi;ksx ls jksdh xbZ ekr` eR` ;vq ksa dh {ks=h; leh{kk] ekWMy 1 ij vk/kkfjr

lh/kk lca a/k u gksus ds lda sr feys ¼fp=

1½] vr% geus bl ekWMy esa xHkZ fujks/kd

mi;ksx nj ds fy, ,d DokMªfS Vd VeZ dks

'kkfey fd;kA pwfa d ykSx GDP] vke

itz uu'kkhyrk nj ykSx] izf'kf{kr

lg;ksfx;ksa ds lkFk tUe nsus okyksa dk

vuqikr vkjS xHkZ fujks/kd mi;ksx nj dk

lHa kor% vkil esa lca a/k ns[kk tkrk] geus

osfj;US l c<+kus okys rRoksa ds lkFk

eYVhdksyhfu;fS jVh dk v/;;u fd;k &

;g lHkh 5-0 ls dkQh de Fks] ftldk

eryc gS fd mPp eYVhdksyhfu;fS jVh gksus

dh lHa kkouk de gSA HkkxS ksfyd {ks=ksa dh

l[a ;k de Fkh vkjS geus lHkh {ks=ksa dks

fQDLM bQSDV~l ds :i esa mi;ksx fd;k

ftlls fd] jSUMe VeZ osfj;SUl ds fy,

vke rkjS ij vko';d] ukjS efS yVh

vt+Ei'ku ls cp ldsAa

MMEIG dk PMDF ds mi;ksx ls ekr`

e`R;q dk vuqeku yxkus dh vksj T+;knk

#>ku Fkk] uk fd ekr` e`R;q vuiq kr

vk/kkfjr ekr` e`R;q izk:i cukus ij]

D;ksfa d PMDF dks ekr` e`R;q vuiq kr ds

edq kcys] T+;knk fLFkj vkSj fo'oluh; ekuk

tkrk FkkA vr%] geus ekr` e`R;q vuiq kr

dk vuqeku fudkyus ds fy, PMDF dks]

15&49 o"kZ mez dh efgykvksa dh eR` ;q

l[a ;k ls x.q kk dj] mls dqy thfor tUeksa

dh l[a ;k ls Hkkx dj fn;k] tks gesa l;a Dq r

jk"Vª tula[;k bdkbZ ls izkIr gq, FksA

MMEIG us bl rjhds dk mi;ksx mu

ns'kksa esa ekr` e`R;q vuiq kr fudkyus ds fy,

fd;k tgka ls tufu;ksa dh gksus okyh eR` ;q

ds fo'oluh; vkadM+s izkIr ugha FksA ftu

ns'kksa esa lpq k# :i ls ukxfjd iathdj.k

i.z kkyh pykbZ tkrh gS] mu ns'kksa ds fy,

1.9 Page 9

▲back to top

mUgksua s de fjiksVZ ntZ+ djkus dh laHkkouk

dk l/q kkj ekud yxk dj] ogka ls izkIr

izR;{k ekr` eR` ;q vuiq krksa ds vueq kuksa dk

mi;ksx fd;kA pfwa d geus ewy ekWMy esa

FkksM+h Qsjcny dh Fkh] geus lHkh ns'kksa ds

fy, vius gh] fizfMD'ku ekWMy ls izkIr

fd, x, ifj.kkeksa ds vkadM+ksa dk mi;ksx

fd;k D;ksfa d ge xHkZ fujks/kdksa ds mi;ksx

ls ekr` e`R;q ij gksus okys izfrrF;kRed

iHz kkoksa dh tkap djuk pkgrs FksA

ifj.kkeLo:i] gekjs ekr` e`R;q vuiq kr ds

vuqeku MMEIG }kjk vueq kfur vkadM+ksa

ls FkksM+k vyx gaSA

geus ;g Hkh vuqeku yxk;k fd vkadM+ksa

;k ekWMy vuqekuksa dh xyrh ds dkj.k

fdruh ek¡vksa dh e`R;q dks cpk;k tk ldk]

bu l[a ;kvksa esa fdruh vfuf'prrk gks

ldrh gSA geus forj.k ¼fMLVªhC;w'ku½ dk

nksckjk uewuk ¼lES iy½ cukus ds fy,

cwV&LVªfS iax rduhd dk i;z ksx fd;kA

blds ek/;e ls] geus 95 izfr'kr

vfuf'prrk nj n'kkZus ds fy,] jksdh xbZ

ekr` eR` ;q l[a ;kvksa dk vuqeku 2-5oha vkSj

97-5oha ilZUVkbyZ ij yxk;kA geus

fifz MD'ku ekWMy esa lna HkZ ns'kksa ij

Lrjhd`r 100 cwV&LViSª jSfIyds'kUl28 dk

mi;ksx fd;kA

fodflr {ks=

vkWLVsªfy;k

vkWfLVª;k

cSfYt;e

dSusMk

Øks,f'k;k

pdS fjifCyd

MSuekdZ

,LVksfu;k

fQuyaSM

Ýkal

teuZ h

xhz l

gaxjh

vkblZ yaSM

vk;jyaMS

bVyh

tkiku

yVS fo;k

fyFkq,fu;k

yDt+ecxZ

ekYVk

usnjyaSMt~ +

U;w t+hyaMS

ukSjos

iksySaM

ikSpxwZ y

Lyksosfd;k

Lyksosfu;k

ekr` eR` ;q xHkZ

ekr`

vuqikr* fujks/kd e`R;q

mi;ksx nj

¼izfr'kr½

xHkZ fujks/kd i;z ksx ls

jksdh xbZ ekr` eR` ;q

¼vfuf'prrk nj †½

xHkZ fujks/kd iz;ksx

ls jksdh xbZ ekr`

eR` ;q dk vuiq kr

¼ifz r'kr½

8 73-5

5 59-8

5 76-5

7 77-5

8 86-0

7 75-3

5 87-1

20 78-1

5 86-6

8 78-5

7 80-1

3 75-3

11 87-0

5 78-0

4 69-1

4 70-4

8 54-1

29 75-2

18 60-7

7 78-0

8 90-5

8 69-3

11 81-1

6 89-0

8 82-6

7 87-1

8 83-9

8 84-9

21 32 ¼15&48½

60-4

4 6 ¼3&8½

58-0

7 10 ¼3&18½

60-6

24 36 ¼13&60½

60-7

4 6 ¼2&10½

60-8

8 12 ¼6&18½

60-6

4 5 ¼3&8½

60-7

4 5 ¼3&8½

60-7

3 5 ¼3&7½

60-7

62 96 ¼45&143½

60-7

44 68 ¼29&106½

60-8

4 6 ¼2&9½

60-6

11 17 ¼7&26½

60-7

1 1 ¼1&1½

60-7

3 4 ¼2&7½

59-9

23 34 ¼13&53½

60-0

83 107 ¼49&162½

56-3

7 11 ¼5&17½

60-5

6 8 ¼4&12½

58-2

1 1 ¼1&2½

60-7

1 1 ¼1&1½

60-5

16 24 ¼11&36½

59-9

7 10 ¼5&15½

60-8

4 6 ¼2&9½

60-6

29 44 ¼16&69½

60-8

8 12 ¼6&19½

60-7

5 7 ¼3&11½

60-8

2 3 ¼1&4½

60-8

1.10 Page 10

▲back to top

Lisu

LohMu

fLoV~t+jyaMS

;-w ds-

;w-,l-,-

mÙkjh vÝhdk

,sYthfj;k

bftIV

fyC;k

eksjDdks

V;~ wfuf'k;k

mi lgkjk vÝhdk

vaxksyk

cfS uu

cksVL~ okuk

cqjdhuk Qklks

cq#UMh

dSe:u

dsi oMsZ

lUS Vªy vÝhdu

fjifCyd

pMS

dkseksjksl

dkUS xks ¼czkt+kfoy½

dksVs Mh vkbZok;S sj

thcwVh

Mh vkj dkSUxks

bDosVksfj;y fxuh

,fjfVª;k

bfFk;ksfi;k

xcS kSu

?kkuk

fxuh

fxuh fcLlkS

dsU;k

fylksFkks

ykbchfj;k

eSMkxLS dj

ekykoh

ekyh

ekjS hVsfu;k

ekfS jf'k;l

ekst+kEchd

ukehfc;k

ukbtZ j

ukbtZ hfj;k

j~okaMk

lsusxy

ekr` eR` ;q

vuiq kr*

xHkZ

fujks/kd

mi;ksx nj

¼ifz r'kr½

68-4

80-6

87-3

83-6

78-2

ekr`

e`R;q

574

xHkZ fujks/kd iz;ksx ls

jksdh xbZ ekr` e`R;q

¼vfuf'prrk nj †½

30 ¼14&45½

8 ¼4&11½

6 ¼3&9½

86 ¼42&128½

887 ¼362&1438½

128 61-5

61 60-8

78 54-5

123 65-0

65 62-0

616 7-8

407 18-0

82 48-7

494 17-1

878 11-7

721 29-2

44 62-2

1044 20-5

1465 3-3

207 28-0

497 45-4

532 13-8

340 16-1

541 22-9

324 11-8

381 9-1

413 14-2

382 35-5

374 22-3

706 9-2

852 10-4

377 44-4

745 43-9

972 11-6

340 36-0

593 39-3

869 8-6

607 9-3

34 78-3

716 16-4

183 54-8

770 11-7

812 14-6

330 28-2

417 12-5

914 1283 ¼621&2011½

1218 1697 ¼723&2534½

114 148 ¼67&229½

794 1150 ¼526&1818½

107 151 ¼70&229½

4778 879 ¼420&1281½

1389 613 ¼242&966½

39 46 ¼1&135½

3540 1476 ¼723&2082½

2436 684 ¼343&949½

5064 3682 ¼1978&5231½

6 8 ¼5&11½

1609 813 ¼445&1149½

7296 560 ¼294&794½

45 31 ¼17&44½

622 693 ¼369&1063½

3837 1283 ¼547&1942½

83 33 ¼16&46½

15606 8825 ¼4221&12637½

82 23 ¼10&37½

692 150 ¼78&221½

12748 4383 ¼2421&5785½

151 134 ¼71&211½

2824 1554 ¼763&2293½

2767 607 ¼318&867½

554 138 ¼69&194½

5659 6172 ¼2355&9702½

443 479 ¼238&672½

1414 394 ¼212&570½

2337 2094 ¼1147&2889½

3553 3467 ¼1957&4675½

4705 959 ¼506&1355½

655 145 ¼79&221½

7 10 ¼4&16½

6270 2499 ¼1231&3440½

108 140 ¼68&206½

6070 1707 ¼892&2375½

48872 17227 ¼9014&24743½

1329 933 ¼492&1307½

1956 589 ¼313&846½

xHkZ fujks/kd iz;ksx

ls jksdh xbZ ekr`

e`R;q dk vuqikr

¼izfr'kr½

59-7

60-8

60-7

60-8

60-7

58-4

58-2

56-4

59-2

58-5

15-5

30-6

54-2

29-4

21-9

42-1

58-6

33-6

07-1

41-1

52-7

25-0

28-1

36-1

22-0

17-8

25-6

46-9

35-5

18-0

19-9

52-2

52-0

21-8

47-3

49-4

16-9

18-1

60-7

28-5

56-5

21-9

26-1

41-2

23-1

2 Pages 11-20

▲back to top

2.1 Page 11

▲back to top

fl;sjk fy;ksu

lksekfy;k

nf{k.k vÝhdk

lwnku

Lokt+hyaSM

rut+kfu;k

n xkfEc;k

Vksxks

;xq kUMk

t+kfEc;k

ft+EckCos

iwohZ ,f'k;k

phu

eUxksfy;k

mÙkj dksfj;k

nf{k.k dksfj;k

nf{k.k ,f'k;k

vQxkfuLrku

caXykns'k

HkwVku

Hkkjr

bZjku

ekynhOt+

usiky

ikfdLrku

Jh yda k

nf{k.k iwohZ ,f'k;k

cwzusbZ

cjek

dSEcksfM;k

fQth

baMksusf'k;k

yvs ksl

eyfs 'k;k

ikiqvk U;w fxuh

fQyhihUl

flaxkiksj

lksykseu vkbZyaSMt~ +

FkkbZyaSM

freksj&yLS V

fo;ruke

if'pe ,f'k;k

ckgjsu

flijl

bjkd

bt+jk;y

tkMS uZ

dqoSr

ycS uu

ekr` eR` ;q xHkZ

ekr`

vuiq kr* fujks/kd e`R;q

mi;ksx nj

¼ifz r'kr½

xHkZ fujks/kd i;z ksx ls

jksdh xbZ ekr` e`R;q

¼vfuf'prrk nj †½

959 7-0

808 14-7

221 62-1

670 8-0

207 49-9

679 31-4

328 16-4

498 18-6

278 22-9

290 39-9

828 61-2

2138 350 ¼188&495½

3194 1138 ¼606&1550½

2409 3402 ¼614&6224½

8677 1645 ¼687&2444½

73 88 ¼42&111½

12010 9389 ¼5504&12462½

201 81 ¼41&114½

1061 484 ¼221&740½

4074 2308 ¼1205&3072½

1571 1553 ¼745&2113½

3131 4382 ¼1996&6597½

xHkZ fujks/kd iz;ksx

ls jksdh xbZ ekr`

eR` ;q dk vuiq kr

¼izfr'kr½

14-1

26-3

58-5

15-9

54-7

43-9

28-6

31-3

36-2

49-7

58-3

35 85-7

82 68-7

123 71-3

12 80-8

6440 9974 ¼4193&15853½ 60-8

41 61 ¼27&97½

59-8

405 612 ¼276&844½

60-2

57 88 ¼37&136½

60-8

1365 20-5

319 57-6

232 31-7

239 57-6

40 76-6

41 37-2

393 46-7

259 29-3

35 69-4

17342 8749 ¼4710&12001½ 33-5

10973 14752 ¼4337&25922½ 57-3

35 28 ¼13&43½

44-1

64240 86366 ¼42037&128629½ 57-3

554 854 ¼395&1335½

60-6

3 3 ¼1&4½

48-0

2883 3293 ¼1531&4780½

53-3

13814 10080 ¼4619&14803½ 42-2

130 194 ¼88&288½

59-9

21 52-3

230 41-1

254 39-4

23 71-3

272 60-2

312 38-7

29 64-4

239 36-2

100 50-7

8 68-6

98 35-7

22 76-7

381 18-5

47 79-2

2 3 ¼1&4½

55-6

2348 2390 ¼905&3883½

50-4

918 897 ¼384&1464½

49-4

5 7 ¼3&8½

60-2

11491 15917 ¼7454&25188½ 58-1

530 509 ¼240&712½

49-0

158 228 ¼101&347½

59-0

495 446 ¼205&643½

47-4

2235 2730 ¼1191&4199½

55-0

3 5 ¼2&8½

59-8

16 14 ¼6&21½

47-0

219 338 ¼122&527½

60-7

168 76 ¼33&109½

31-1

696 1079 ¼501&1595½

60-8

18 70-2

13 54-5

59 49-8

7 81-0

57 58-4

7 58-4

25 60-6

3 4 ¼2&6½

60-0

2 2 ¼1&3½

56-4

557 671 ¼316&951½

54-6

11 16 ¼8&23½

60-8

89 121 ¼60&187½

57-6

4 5 ¼3&8½

57-6

17 23 ¼11&34½

58-2

2.2 Page 12

▲back to top

vkseku

dVkj

lknS h vjsfc;k

flfj;k

VdhZ

;qukbVsM vjc

,sfejsV~l

;eu

yfS Vu vejhdk

vtSaUVhuk

fcyht+

cksfyfo;k

czkt+hy

fpfy

dksyfEc;k

dkSLVk jhdk

bDosMkSj

,y lSYosMkjS

xvq kVsekyk

fx;kuk

gksUMwjkl

efS Dldks

fudkjkxqvk

iukek

ijS kx,q

is#

lwjhuke

m#x,q

osusT+;w,yk

Lora= la;qDr jk"Vª

vkjehfu;k

vt+jcst+ku

csyk:l

tkSftZ;k

dt+kDLrku

fdfxZLrku

ekYS Mksok

rthfdLrku

rdq ZesfuLrku

;wdjsu

mt+csfdLrku

dSfjfc;u

cgkekt+

ckjcsMkSl

D;wck

MkSfeuhdu fjifCyd

gSrh

tekbdk

ekr` eR` ;q xHkZ

vuqikr* fujks/kd

mi;ksx nj

¼izfr'kr½

25 34-1

13 49-0

25 24-9

42 57-7

23 72-8

14 35-3

211 27-4

49 68-1

73 38-0

159 60-4

74 81-0

27 64-8

76 79-4

35 83-0

130 73-8

119 71-5

84 45-4

227 38-4

87 66-3

62 73-1

102 72-8

68 73-0

109 77-4

90 72-8

117 46-8

31 78-8

60 73-7

29 55-5

38 53-2

23 72-9

46 48-4

76 54-0

80 50-6

39 69-3

54 81-8

40 38-2

52 64-3

42 67-0

31 66-8

37 75-4

65 69-9

43 73-8

85 68-8

312 32-9

80 71-5

ekr` xHkZ fujks/kd i;z ksx ls

eR` ;q jksdh xbZ ekr` e`R;q

¼vfuf'prrk nj †½

16 14 ¼6&21½

2 3 ¼1&5½

146 90 ¼40&125½

246 332 ¼163&483½

306 466 ¼217&697½

9 8 ¼4&12½

1780 1211 ¼631&1759½

336 498 ¼235&750½

6 6 ¼2&8½

419 582 ¼286&837½

2303 3574 ¼1544&5497½

69 99 ¼48&143½

698 1081 ¼511&1658½

27 41 ¼19&64½

366 559 ¼262&850½

148 224 ¼108&327½

379 422 ¼183&597½

31 30 ¼13&44½

176 258 ¼106&397½

1262 1921 ¼899&2935½

143 217 ¼89&341½

48 74 ¼34&112½

169 260 ¼121&396½

546 829 ¼369&1270½

12 14 ¼4&22½

16 25 ¼11&36½

360 549 ¼259&819½

14 19 ¼8&29½

64 81 ¼31&124½

23 34 ¼15&52½

24 29 ¼14&45½

231 296 ¼128&471½

97 118 ¼53&179½

18 27 ¼11&39½

832 1291 ¼474&2132½

79 75 ¼30&111½

58 84 ¼29&134½

195 286 ¼118&421½

171 250 ¼111&359½

3 4 ¼1&6½

2 3 ¼1&5½

51 78 ¼37&121½

192 285 ¼131&434½

851 698 ¼340&1014½

42 64 ¼29&95½

xHkZ fujks/kd iz;ksx

ls jksdh xbZ ekr`

e`R;q dk vuqikr

¼izfr'kr½

45-9

54-3

38-2

57-4

60-3

46-8

40-5

59-7

48-6

58-1

60-8

59-1

60-8

60-4

60-2

52-7

48-8

59-4

60-4

60-3

60-7

60-3

53-3

60-8

60-4

56-7

55-9

60-3

54-1

56-2

55-0

59-9

60-8

48-7

59-0

59-5

60-6

60-0

60-4

59-8

45-0

60-2

2.3 Page 13

▲back to top

ekr` e`R;q xHkZ

ekr`

vuqikr* fujks/kd eR` ;q

mi;ksx nj

¼ifz r'kr½

xHkZ fujks/kd iz;ksx ls

jksdh xbZ ekr` eR` ;q

¼vfuf'prrk nj †½

xHkZ fujks/kd i;z ksx

ls jksdh xbZ ekr`

e`R;q dk vuiq kr

¼ifz r'kr½

iksrksZ jhdks

16 85-3

9 14 ¼6&20½

60-8

f=funkn ,sMa VkscSxks

51 43-6

11 11 ¼5&17½

51-8

nf{k.k iwohZ ;wjksi ds ifjoruZ dkfyd ns'k

,sYcsfu;k

31 68-0

15 21 ¼8&37½

59-7

ckfS Lu;k ,sMa

10 38-4

4 4 ¼0&8½

48-8

gt+sxZ ksfouk

cYxsfj;k

19 77-8

14 21 ¼9&33½

60-7

elS sMksfu;k

14 57-1

4 5 ¼2&7½

57-2

ekSUVsuhxzks

16 42-3

2 2 ¼1&3½

51-1

jksesfu;k

37 71-5

80 121 ¼41&219½

60-2

lfc;Z k

12 44-5

14 16 ¼6&24½

52-2

lHkh vkadM+s la[;k esa gaS] dsoy xHkZ fujks/kd mi;ksx nj vkSj jksdh xbZ ekr` e`R;q vuqikr ¼izfr'kr½ dks

NksM+djA *ekWMy 1 ij vk/kkfjr o"kZ 2008 esa 100]000 thfor tUeksa esa ekr` eR` ;q la[;k ds vueq kuA

† 2-5 vkjS 97-5 ilZUVkby ds vuqekuA

rkfydk 2 % 172 ns'kksa esa xHkZ fujks/kd i;z ksx ls o"kZ 2008 esa jksdh xbZ ekr` e`R;q la[;k ds ekWMy 1 ij

vk/kkfjr vueq ku

lkaf[;dh; fo'ys"k.k % ekWMy 2

gekjk nwljk rjhdk fy;q vkjS muds

lgHkkfx;ksa2 }kjk mi;ksx fd, xHkZ

fujks/kdksa ds mi;ksx ls jksds x, tUeksa dh

l[a ;k ds fu/kkjZ .k ds rjhds ij vk/kkfjr

FkkA iwoZ rjhds ls lgt bl rjhds esa]

igys geus jksds x, tUeksa dh l[a ;k dk

vuqeku yxk;k vkjS fQj MMEIG ds ekr`

eR` ;q vuqikr vuqekuksa dk mi;ksx djrs

gq, geus lh/kk vueq ku yxk;k fd fdruh

ek¡vksa dh tku cpkbZ tk ldhA bl rjhds

ds mi;ksx ls geus tula[;k Lrj ij

itz uu'khyrk vkSj xHkZ fujks/kdksa ds

mi;ksx ds chp lca a/k dk fo'ys"k.k fd;kA

xHkZ fujks/kdksa dk mi;ksx vkSj lk/kkj.k

itz uu'khyrk nj ds chp ds mYVs lca a/k

¼buolZ ½ dks fp= 2 esa n'kkZ;k x;k gSA

fy;q vkSj muds lg;ksfx;ks2a us bl lca a/k

dh ek=k LFkkfir djus ds fy,] uhps nh

xbZ bDos'ku esa CPR ds fy, DokMªSfVd

VeZ ds lkFk yhfu;j fjxS'z ku ekWMy dk

mi;ksx fd;k %

GFRi = β0 + β1CPRi + β3CPR2i + Ɛi

mUgksua s lk/kkj.k iztuu'khyrk nj dk

vuqeku bl izdkj yxk;k %

GFRi potential = GFRi observed - (β1CPRi

+ β3CPR2i )

gkykafd gekjk ekuuk gS fd lk/kkj.k

itz uu'khyrk vkSj xHkZ fujks/kdksa dk

mi;ksx fdlh ns'k ;k lekt ds lna HkZ ij

vk/kkfjr gSA fdlh ns'k dh lk/kkj.k

iztuu'khyrk nj ogka ds yksxksa ds chp

;kuS lca a/kksa] itz uu'khyrk vkjS xHkZ lekiu

los kvksa dh miyC/krk ij fuHkZj djrh gSA

blds vfrfjDr] xHkZ fujks/kdksa dh lQyrk

mi;ksx dh xbZ xHkZ fujks/ku iz.kkyh ij

vk/kkfjr gS & mnkgj.k ds fy,] ulcanh]

xHkZ fujks/kd lqbZ vkSj xHkk'Z k; ds vUnj

yxk, tkus okys xHkZ fujks/kd vU; xHkZ

fujks/kdksa ds eqdkcys vf/kd izHkkodkjh

gksrs gSaA fofHkUu ns'kksa] i] esa fdlh fof'k"V

o"kZ] t ] ds nkjS ku vkus okys bl izdkj ds

varj dks feVkus ds fy, geus jSMUMe

dks,sfQ';SUV ekWMy dk bl izdkj mi;ksx

fd;k %

2.4 Page 14

▲back to top

GFRit = β0 + β1CPRit + β3CPR2it +

טiCPRit +vi Ɛit

jUS Me baVjlIS V osfj;US l v~N(0,σ²V) vkjS

jUS Me Lyksi ט~N(0,σ² )טdks vkSlr 0

vkjS osfj;US l σ² ds lkFk lk/kkj.k :i ls

forfjr fd;k x;kA fQj geus ,d ns'k] i

esa jksds x, tUeksa (BA) dh l[a ;k dk

vuqeku yxk;k %

BAi = GFRi potential - GFRi observed

1000 x W15-49

vkjS jksdh xbZ ekr` e`R;q ¼MDA½ l[a ;kvksa

dk vuqeku yxk;k %

MDAi = BAi x MMRi

----------

100000

ekWMy 2 ds mi;ksx ls geus xHkZ fujks/kdksa

dh vko';drk iwjh gksus ds ekr` eR` ;q ij

gksus okys iHz kkoksa ¼lglzkCnh fodkl mÌs';ksa

5ch ds ekudksa esa ls ,d½ dk Hkh vuqeku

yxk;kA geus xHkZ fujks/kdksa dh

vko';drk iwjh u gksus dh ifjHkk"kk bl

izdkj dh & itz uu'khy vk;q ¼15 & 49

o"k½Z okyh os efgyk,a] tks fookfgr gaS ;k

;kfS ud :i ls lfØ; gSa vkSj nks cPpksa ds

chp varj j[kuk pkgrh gaS] ;k cPpk ugha

pkgrha ijarq xHkZ fujks/kdksa dk mi;ksx ugha

djrhaA pfwa d ekWMy 1 vkSj 2 ds ifj.kke

,d nwljs ds dkQh ut+nhd Fks] vkSj

D;kfsa d geus ekWMy 2 esa MMEIG ds ekr`

eR` ;q vuqikr vuqekuksa dk mi;ksx fd;k

Fkk] geus bl vueq ku ds fy, Hkh ekWMy 2

ds ifj.kke dk gh mi;ksx fd;k] ftlls

fd] vk/kkjHkwr ekr` e`R;q l[a ;k MMEIG

dh fjiksVZ ds cjkcj jgsA geus bu nksuksa

ekWMyksa dh et+cwrh o fo'oluh;rk tkapus

ds fy, loa snu'khyrk fo'ys"k.k fd;kA

lkFk gh] bu nksuksa ekWMy ds chp dh

xHkZ fujks/kd mi;ksx nj ¼izfr'kr½

fp= 3 % xHkZ fujks/kd mi;ksx nj vkjS ekr` e`R;q esa vueq kfur deh

ut+nhdh dh rqyuk djus ds fy, CySUM

vkWYVeSu iz.kkyh i;z ksx esa ykbZ xbAZ lHkh

vkadM+ksa dk fo'ys"k.k LVVS k ¼ot+uZ 2½ ds

}kjk fd;k x;kA29

vkfFkZd lg;ksx lzksr dh Hkwfedk

bl v/;;u dks foÙkh; lg;ksx nsus okyksa

dh v/;;u dh :ijs[kk] vkadM+s ,df=r

djus] vkadM+ksa ds fo'ys"k.k o O;k[;k ;k

fjiksVZ ys[ku esa dksbZ Hkwfedk ugha FkhA

ys[kd dks lHkh vkadM+s miyC/k Fks vkSj

lHkh ys[kdksa us feydj bls izdkf'kr fd,

tkus dk fu.kZ; fy;kA

ifj.kke

rkfydk 1 esa ekWMy 1 ds vk/kkj ij

fudkyh xbZ fo'o o {ks=h; Lrj ij ekr`

e`R;q vuiq kr] ekr` eR` ;q l[a ;k vkSj xHkZ

fujks/kdksa ds mi;ksx ls jksdh xbZ ekr` e`R;q

l[a ;k o vuqikr] ftlesa vfuf'prrk

vuqeku 'kkfey g]S lfa {kIr esa n'kkZ;k x;k

gSA gekjs vuqeku vuqlkj] 2008 esa dqy

ekr` e`R;q la[;k 342]203 Fkh] ekWMy ds

ifz rrF;kRed fofuns'k ij vk/kkfjr ¼ekWMy

1½] tks fo'o LokLF; lLa Fkku }kjk mlh

o"kZ ds fy, nh xbZ l[a ;k 358]000 ls dNq

de gS vkSj bafLVV~;wV vkWQ gSYFk esfVªDl

2.5 Page 15

▲back to top

,sMa boSyq,'ku }kjk vueq kfur l[a ;k

342]900 ds ut+nhd gSA30

gekjs fo'ys"k.k ds vuqlkj] 120 djksM+

iztuu'khy vk;q dh fookfgr ;k ;kSu :i

ls lfØ; efgykvksa] esa ls 72-2 djksM+

efgyk,a xHkZ fujks/kdksa dk mi;ksx dj jgh

FkhaA gekjk ekuuk gS fd fo'o Hkj esa] o"kZ

2008 e]sa xHkZ fujks/kdksa ds mi;ksx ls

272]040 ek¡vksa dh tku cpkbZ tk ldh

¼vfuf'prrk nj 127]937 & 407]134½A

xHkZ fujks/kdksa ds mi;ksx ds fcuk] ekr`

e`R;q la[;k blls 1-8 x.q kk vf/kd gksus dh

lHa kkouk Fkh ¼tks 614]000 dh la[;k

gksrh½A bldk eryc gS fd xHkZ fujks/kdksa

ds mi;ksx ds dkj.k 44-3 ifz r'kr ek¡vksa

dh tku cpkbZ tk ldh ¼614]000 esa ls

272]040½ ;k fQj izfr o"kZ xHkZ fujks/kd

iz;ksx dj jgh izfr 100]000 itz uu'khy

efgykvksa esa 38 ekr` eR` ;q jksdh tk ldhA

ftu {ks=ksa esa xHkZ fujks/kd mi;ksx njsa

vf/kd gSa ¼65 izfr'kr ls vf/kd½] ogka

yxHkx 60 izfr'kr ek¡vksa dh tku cpkbZ

tk ldhaA blds eqdkcys] mi&lgkjk

vÝhdk esa dsoy 22 izfr'kr fookfgr ;k

;kSu :i ls lfØ; efgyk,a xHkZ fujks/kdksa

dk mi;ksx dj jgh Fkha vkSj dsoy 32

ifz r'kr ekr` eR` ;q xHkZ fujks/kd ds iz;ksx

ls jksdh tk ldhaA

Dqy †

fodflr {ks=

vkWLVªsfy;k

vkWfLVª;k

cSfYt;e

dSusMk

Øks,f'k;k

pdS fjifCyd

MuS ekdZ

,LVksfu;k

fQuyaSM

Ýkal

ekr` eR` ;q

vuqikr*

260

xHkZ fujks/kd

i;z ksx ls jksds

x, tUe

¼×1000½

251708

924

369

442

1550

242

437

259

226

2542

rkfydk 2 esa iRz ;sd ns'k ds ekWMy 1 ij

vk/kkfjr vuqeku n'kk,Z x, gSaA xHkZ

fujks/kdksa ds mi;ksx ds dkj.k jksdh xbZ

ekr` eR` ;q dh l[a ;k vyx vyx ns'kksa esa 7

ls 61 izfr'kr ds chp gSA vQx+kfuLrku]

MeS ksxzkfQd fjifCyd vkWQ n dkUS xks]

bfFk;ksfi;k] ukbthfj;k] ikfdLrku] lnw ku

vkjS rut+kfu;k eq[;r% ,sls ns'k gaS tgka

ekr` e`R;q l[a ;k,a cgrq vf/kd gaS vkSj ;gka

xHkZ fujks/kdksa dk mi;ksx Hkh cgqr de

gksrk gS ¼30 izfr'kr ls de½A blds

eqdkcys] czkt+hy] phu] Hkkjr] baMksusf'k;k

vkjS nf{k.k vÝhdk esa vf/kd ¼60 ifz r'kr

ls vf/kd½ xHkZ fujks/kdkas ds mi;ksx ds

dkj.k cM+h la[;k esa ek¡vksa dh tkusa cpkbZ

tk ldh gSaA xHkZ fujks/kd mi;ksx nj o

ekr` e`R;q esa vuqekfur fxjkoV ds chp

lca a/k ds gekjs fo'ys"k.k ds vulq kj ¼fp=

3½] tc xHkZ fujks/kd mi;ksx 65 izfr'kr

rd igaqprk gS] rks ekr` eR` ;q esa deh 60

izfr'kr rd igaqprh gSA ij mlds ckn

ekr` eR` ;q esa deh 60 izfr'kr ij gh #d

tkrh gS] pkgsa xHkZ fujks/kdksa dk mi;ksx 65

izfr'kr ls vf/kd gh D;ksa u gksA

ekr` eR` ;q xHkZ fujks/kd

iz;ksx ls jksdh

xbZ ekr` e`R;q

358591

299430

186

203

xHkZ fujks/kd iz;ksx

ls jksdh xbZ ekr`

e`R;q dk vuiq kr

¼ifz r'kr½

45-5

77-6

82-9

78-8

81-4

85-2

80-1

80-6

81-1

79-3

77-2

2.6 Page 16

▲back to top

ekr` e`R;q

vuqikr*

teZuh

xzhl

gaxjh

vkblZ yaMS

vk;jyaSM

bVyh

tkiku

yVS fo;k

fyFkq,fu;k

yDt+ecxZ

ekYVk

usnjySaM~t+

U;w t+hyaMS

ukjS os

iksyaSM

ikSpxwZ y

Lyksosfd;k

Lyksosfu;k

Lisu

LohMu

fLoV~t+jyaSM

;-w ds-

;w-,l-,-

mÙkjh vÝhdk

,sYthfj;k

120

bftIV

fyC;k

eksjDdks

110

V~;wfuf'k;k

mi lgkjk vÝhdk

vaxksyk

610

cSfuu

410

cksVL~ okuk

190

cqjdhuk Qklks 560

cq#UMh

970

dSe:u

600

dsi oMsZ

lUS Vªy vÝhdu 850

fjifCyd

pMS

1200

dkseksjksl

340

dkSUxks ¼ckz t+kfoy½ 580

dksVs Mh vkbZokS;sj 470

thcwVh

300

Mh vkj dkSUxks 670

bDosVksfj;y fxuh 280

,fjfVª;k

280

bfFk;ksfi;k

470

xSckuS

260

xHkZ fujks/kd

i;z ksx ls jksds

x, tUe

¼×1000½

3795

510

485

187

2507

4734

119

154

667

192

215

1820

503

281

2037

395

372

2747

13574

1458

2859

246

1479

451

163

348

100

181

876

727

ekr` e`R;q xHkZ fujks/kd

iz;ksx ls jksdh

xbZ ekr` eR` ;q

266

125

284

109

122

330

1054

3258

856

1749

1650

2345

158

710

1626

271

4730

556

1400

394

120

4013

913

2690

657

4215

2087

1309

489

5976

274

724

577

3392

852

19343 5871

508

141522 3416

103

xHkZ fujks/kd i;z ksx

ls jksdh xbZ ekr`

e`R;q dk vuiq kr

¼ifz r'kr½

85-0

82-7

83-1

73-1

82-2

82-1

83-7

83-1

82-6

78-3

76-8

78-8

83-1

82-8

83-7

83-5

80-6

78-7

83-7

78-8

75-6

67-1

58-7

62-7

69-6

73-4

10-5

22-0

57-2

18-5

19-6

33-1

60-0

27-2

4-4

36-8

44-4

20-1

28-6

23-3

17-1

14-8

19-1

46-4

2.7 Page 17

▲back to top

ekr` eR` ;q

vuqikr*

?kkuk

350

fxuh

680

fxuh fcLlkS

1000

dsU;k

530

fylksFkks

530

ykbchfj;k

990

eMS kxLS dj

440

ekykoh

510

ekyh

830

ekjS hVsfu;k

550

ekSfjf'k;l

ekst+kEchd

550

ukehfc;k

180

ukbZtj

820

ukbZthfj;k

840

jo~ kaMk

540

lsusxy

410

fl;sjk fy;ksu 970

lksekfy;k

1200

nf{k.k vÝhdk 410

lwMku

750

Lokt+hyaMS

420

rut+kfu;k

790

n xkfEc;k

400

Vksxks

350

;xq kUMk

430

t+kfEc;k

470

ft+EckCos

790

iwohZ ,f'k;k

phu

eUxksfy;k

mÙkj dksfj;k

250

nf{k.k dksfj;k 18

nf{k.k ,f'k;k

vQxkfuLrku

1400

caXykns'k

340

HkwVku

200

Hkkjr

230

bZjku

ekynhOt+

usiky

380

ikfdLrku

260

Jh yda k

nf{k.k iwohZ ,f'k;k

czwusbZ

cjek

240

dSEcksfM;k

290

fQth

baMksusf'k;k

240

yvs ksl

580

xHkZ fujks/kd

i;z ksx ls jksds

x, tUe

¼×1000½

351

795

397

273

238

102

1414

181

102

1957

225

723

392

234

321

62755

130

1056

2537

324

5525

41248

3210

902

3575

878

1844

441

10084

156

ekr` e`R;q xHkZ fujks/kd

i;z ksx ls jksdh

xbZ ekr` eR` ;q

2645

1230

2667

391

649

104

7958

4212

315

337

1439

284

3023

1748

3056

1392

4495

608

593

113

4818

1310

106

119

6465

838

50528 11874

2176

977

1923

418

2161

261

4745

991

4477

8025

9717

1685

147

158

13978 5710

244

745

270

6299

1684

2547

1100

2988

2536

6898

23847

820

2641

457

17789 4538

11697 18786

61911 94871

416

963

2779

3429

13871 9296

142

342

2445

4426

1048

1279

10121 24201

985

904

xHkZ fujks/kd i;z ksx

ls jksdh xbZ ekr`

e`R;q dk vuqikr

¼ifz r'kr½

31-7

12-8

13-8

34-6

51-7

16-5

36-6

31-3

11-9

16-0

76-4

21-4

52-9

11-5

19-0

31-0

17-9

10-8

17-3

64-2

14-8

51-7

29-0

22-4

26-6

21-1

30-2

45-9

77-6

72-5

76-3

84-9

20-3

61-6

50-5

60-5

69-8

63-1

55-2

40-1

70-6

64-4

55-0

65-2

70-5

47-9

2.8 Page 18

▲back to top

eyfs 'k;k

ikiqvk U;w fxuh

fQyhihUl

flaxkiksj

lksykseu

vkbyZ aSMt~ +

FkkbZyaSM

freksj&yLS V

fo;ruke

if'pe ,f'k;k

ckgjsu

flijl

bjkd

bt+jk;y

tkSMZu

dqorS

ycS uu

vkseku

dVkj

lknS h vjsfc;k

flfj;k

VdhZ

;qukbVsM vjc

,sfejsVl~

;eu

yfS Vu vejhdk

vtSaUVhuk

fcyht+

cksfyfo;k

ckz t+hy

fpfy

dksyfEc;k

dkLS Vk jhdk

bDosMkjS

,y lYS osMkSj

xvq kVsekyk

fx;kuk

gksUMwjkl

eSfDldks

fudkjkxqvk

iukek

iSjkxq,

is#

lwjhuke

m#x,q

osusT+;w,yk

Lora= la;Dq r

jk"Vª

ekr` eR` ;q

vuqikr*

250

100

370

210

180

140

110

270

110

100

xHkZ fujks/kd

i;z ksx ls jksds

x, tUe

¼×1000½

1031

154

2690

205

3333

4268

757

262

160

113

168

418

715

2904

374

1617

280

8229

769

1779

157

497

234

309

171

4245

187

105

187

1077

130

975

ekr` eR` ;q xHkZ fujks/kd

iz;ksx ls jksdh

xbZ ekr` e`R;q

171

320

517

385

2099

2529

469

1600

162

837

2390

708

568

142

100

270

329

310

668

1774

785

482

1132

473

503

1805

4773

200

780

1512

393

695

137

258

498

340

222

188

1741

3609

140

187

146

178

596

1055

407

663

xHkZ fujks/kd i;z ksx

ls jksdh xbZ ekr`

e`R;q dk vuiq kr

¼ifz r'kr½

65-2

42-7

54-6

84-6

42-4

77-3

20-8

74-1

66-6

44-5

65-2

50-6

68-7

71-8

50-2

61-5

41-4

54-9

68-3

59-1

30-7

70-1

47-5

51-6

72-6

75-4

66-0

67-5

63-9

65-3

40-6

61-7

45-9

67-5

57-2

59-9

55-0

63-9

64-6

72-1

62-0

2.9 Page 19

▲back to top

ekr` eR` ;q

vuqikr*

vkjehfu;k

vt+jcst+ku

csyk:l

tkfS tZ;k

dt+kDLrku

fdfxLZ rku

ekYS Mksok

rthfdLrku

rqdZesfuLrku

;wdjsu

mt+csfdLrku

dSfjfc;u

cgkekt+

ckjcsMkSl

D;wck

MkfS euhdu

100

fjifCyd

grS h

300

tekbdk

iksrksZ jhdks

f=funkn ,Msa

VkscSxks

nf{k.k iwohZ ;wjksi

ds ifjoruZ dkfyd

ns'k

,sYcsfu;k

ckfLu;k ,sMa

gt+sxZ ksfouk

cYxsfj;k

eSlsMksfu;k

ekSUVsuhxzks

jksesfu;k

lfcZ;k

xHkZ fujks/kd

iz;ksx ls jksds

x, tUe

¼×1000½

136

391

592

169

632

184

183

8471

183

213

2214

1140

539

345

230

107

173

144

119

343

1107

305

ekr` eR` ;q xHkZ fujks/kd

iz;ksx ls jksdh

xbZ ekr` eR` ;q

149

136

284

149

601

3304

124

117

164

119

576

166

342

286

224

345

819

690

xHkZ fujks/kd iz;ksx

ls jksdh xbZ ekr`

e`R;q dk vuqikr

¼ifz r'kr½

74-3

70-3

86-0

76-4

67-7

60-6

80-3

84-6

48-7

65-8

82-9

67-3

73-5

83-3

82-0

60-6

45-8

67-1

76-8

69-3

75-7

77-6

82-6

72-8

299

83-9

72-7

lHkh vkadM+s la[;k esa gSa] dsoy dqy ekr` eR` ;q vuqikr ¼vklS r½ vkSj jksdh xbZ ekr` e`R;q vuqikr

¼ifz r'kr½ dks NksM+djA *esVjuy ekjS VSfyfV ,sfLVes'ku baVj & ,tsalh xzqi }kjk yxk, x, o"kZ 2008 esa

100]000 thfor tUeksa esa ekr` e`R;q la[;k ds vuqekuA24 † czwusb]Z flijl] vkbZlyaSM] yDt+ecxZ vkjS

elS sMksfu;k dks NksM+dj( bu ns'kksa ds fy, xHkZ fujks/kd iz;ksx ds vkadM+s miyC/k ugha Fks] vkSj budh de

tula[;k o de ekr` eR` ;q la[;k gksus ds dkj.k bUgsa bl fo'y"s k.k ls ckgj j[kk x;k ¼ekWMy 1 es]a bu

ns'kksa ds fy, xHkZ fujks/kd mi;ksx ds vkadM+s {ks=h; vkadM+ksa ds vk/kkj ij fudkys x,½A

rkfydk 3 % 167 ns'kksa esa xHkZ fujks/kd iz;ksx ls o"kZ 2008 esa jksdh xbZ ekr` e`R;q la[;k ds ekWMy 2 ij

vk/kkfjr vueq ku

2.10 Page 20

▲back to top

rkfydk 3 esa ekWMy 2 ds ifj.kke n'kk,Z

x, gSa] ftlesa geus MMEIG ds vueq kfur

ekr` e`R;q vuqikr dk lh/kk mi;ksx fd;k

FkkA ekWMy 2 ds vk/kkj ij ekr` eR` ;q

l[a ;k dk gekjk vuqeku 358]591 Fkk] tks

fd MMEIG ds vuqeku 358]000 ds

ut+nhd gh gS ¼1000 dh jkmUM vkWQ

l[a ;k vuqlkj½A24 ekWMy 2 ds gekjs

fo'ys"k.k vulq kj] xHkZ fujks/kdksa ds mi;ksx

ls o"kZ 2008 esa 299]430 ¼45-5 ifz r'kr½

ekr` e`R;q cpkbZ tk ldhA

dqy feykdj] vkadM+ksa ds loa snu'khyrk

fo'ys"k.k n'kkZrs gaS] fd ekWMy 1 ds

ifj.kke dkQh et+cwr vkjS fo'oluh; gSaA

nksuksa ekWMy ds vk/kkj ij jksdh xbZ ekr`

e`R;q vueq kuksa dh ryq uk n'kkrZ h gS] fd ns'k

Lrjh; vuqekuksa ds chp 0-98 dk lglca a/k

gS ¼ifjf'k"V½A bu ifj.kkeksa ds lca a/k ekius

ds fy, mi;ksx dh xbZ CySUM & vkSYVeuS

i.z kkyh n'kkrZ h gS fd dsoy 6 ns'k ¼3-6

izfr'kr½ & dSusMk] Øks,f'k;k] ekykoh]

Lyksosfu;k] nf{k.k dksfj;k vkSj fLoVt~ +jySaM

& laca/k lhek ls ckgj Fks ¼ifjf'k"V½A

fp= 4 esa xHkZ fujks/kdksa dh vko';drk

iwjh dj fn, tkus ij lHa kkfor ekr` e`R;q

l[a ;k n'kkZbZ xbZ gSA xHkZ fujks/kdksa dh

vko';drk iwjh dj fn, tkus ls 104]000

vfrfjDr ek¡vksa dh tku cpkbZ tk ldrh

Fkh ¼29 ifz r'kr rd dh deh½A ;g la[;k

fo'o Lrj ij xHkZ fujks/kdks ds mi;ksx esa

64 izfr'kr ls 75 izfr'kr gbq Z c<+ksrjh ds

cjkcj gSA ;g c<+ksrjh T+;knkrj mi

lgkjk vÝhdk vkSj nf{k.k ,f'k;k esa gksxh]

tgka ekr` e`R;q lcls vf/kd gSaA 2008 dh

ekr` e`R;q la[;k vkjS xHkZ fujks/kdksa ds

mi;ksx ls laHkor% cpkbZ tkus okyh ekr`

eR` ;q la[;k ds chp] mi lgkjk vÝhdk esa

59]000 dk varj gS vkSj nf{k.k ,f'k;k esa

32]000 ls vf/kd ¼fp= 4½ & ftldk

eryc gS fd dsoy bu nks {ks=ksa dh xHkZ

fujks/kdksa dh vko';drk,a iwjh dj fn,

ekr` e`R;q

CIS

dSfjfc;u

fodflr {ks=

iwohZ ,f'k;k

yfS Vu vejhdk

mÙkjh vÝhdk

nf{k.k iwohZ ,f'k;k

nf{k.k ,f'k;k

mi lgkjk vÝhdk

ifjorZudkfyd ;wjksi*

if'peh ,f'k;k

dyq

xHkZ fujks/ku dh viw.kZ vko';drkvksa

dh iwfrZ ds ckn ekr` e`R;q

ekr` e`R;q

fp= 4- xHkZ fujks/ku dh viw.kZ vo';drkvksa dh iwfrZ ls gksus okyh ekr` e`R;q esa laHkkfor dehA

izfr o"kZ ekr` e`R;q la[;k ds vuqdj.k fd, x, ifj.kke] ftUgsa ldy Lrj ij izLrrq fd;k x;k g]S ;fn

visf{kr xHkZ fujks/ku ekxa dks iwjk dj fn;k tk, ¼yky iafDr½] ;k uk fd;k tk, ¼uhyh iafDr½A izR;sd {k=s

Js.kh esa 'kkfey fd, x, ns'kksa dh lwfp rkfydk 2 esa nh xbZ gSA CIS ¾ Lora= jk"VªeaMyA *nf{k.k iwohZ ;wjksi

ds ifjorZudkfyd ns'kA

tkus ls 91]000 ek¡vksa dh tku cpkbZ tk

ldrh gSA gkykafd ;g vuqeku ifjdfYir

g]S D;ksfa d xHkZ fujks/kdksa dh vko';drk

dks iw.kZr;k iwjk djuk lHa ko ugha gS]

ysfdu fQj Hkh xHkZ fujks/kdksa ds mi;ksx ls

jksdh xbZ 272]000 ekr` eR` ;q ¼tlS k fd

ekWMy 1 esa fn[kk;k x;k gS½ vkjS mlds

vfrfjDr 104]000 ekrkvksa dh tku cpk,

tkus dh lHa kkouk ¼;fn mudh xHkZ

fujks/kd dh viw.kZ vko';drk,a rjq ar iwjh

dj nh tk,a½ n'kkrZ k gS fd fo'o Lrj ij

xHkZ fujks/kdksa ds mi;ksx ls ifz r o"kZ

376]000 ekr` eR` ;q jksdh tk ldrh gSA

ppkZ

gekjs v/;;u ds ifj.kke n'kkrZ s gSa fd

ifjokj fu;kstu fo'o Hkj es]a izfr o"kZ

lHa kor% 272]000 ek¡vksa dh tku cpkus esa

enn djrk gSA blls igys flga o

lgHkkfx;ksa1 }kjk fd;s x, v/;;u esa Hkh

dgk x;k gS fd vk/kqfud xHkZ fujks/kdksa ds

mi;ksx ls izfr o"kZ 260]000 ek¡vksa dh

tku cprh gAS

3 Pages 21-30

▲back to top

3.1 Page 21

▲back to top

iuS y % v/;;u dk lanHkZ

O;ofLFkr leh{kk

geus mu lHkh lgdfeZ;ksa }kjk lehf{kr idz k'kuksa dh O;ofLFkr :i ls [kkst dh ftuesa **ifjokj fu;kstu**] **xHkZ fujks/kd mi;ksx**

vkjS **ekr` e`R;q** 'kCnksa dk mi;ksx fd;k x;k Fkk vkSj ik;k fd 1980 ds n'kd esa ekr` e`R;q ij ifjokj fu;kstu ds izHkkoksa dh

Hkwfedk dk v/;;u djus ds iz;kl fd, x, FksA19]21]22 yfs du ml le; dbZ fodkl'khy ns'kksa ds ns'k Lrjh; ekr` eR` ;q vueq ku

miyC/k u gksus ds dkj.k] ;g v/;;u NksVs {ks=ksa ;k fujh{k.k vkadM+ksa ij vk/kkfjr Fks] vr% mUgsa vke Lrj ij mi;ksx ugha fd;k tk

ldrk FkkA fiNys 2&3 o"kkasZ esa rhu v/;;uksa esa14]15]23 1990 ls 2008 ds chp iztuu'khyrk njksa esa deh ds ekr` eR` ;q ij izHkkoksa dk

v/;;u fd;k x;k] ijarq ifjokj fu;kstu ds dqy izHkkoksa dk ughaA xqVekdj bfULVV~;wV1 dh ,d vkSipkfjd fjiksVZ es]a Hkwe.Myh;

Lrj ij ekr` e`R;q dh deh ij] ifjokj fu;kstu ds gksus okys iHz kkoksa dk vuqeku yxk;k x;k] yfs du mlesa mi;ksx fd, x, rjhdksa

dks is'k ugha fd;k x;kA buesa ls fdlh Hkh v/;;u esa ns'k Lrjh; fo'o O;kih iHz kkoksa dk v/;;u ugha fd;k x;kA

O;k[;k

fodkl'khy ns'kksa esa ekr` eR` ;q de djus ds fy, xHkZ fujks/kdksa ds mi;ksx dks c<+kok nsuk] ,d iHz kkodkjh ikz Fkfed lqj{kkRed mik;

gAS gekjs ifj.kke iqu% LFkkfir djrs gSa] fd ftu ns'kksa esa xHkZ fujks/kdksa ds mi;ksx dh nj de g]S ogka xHkZ fujks/kdksa rd igqap c<+kuk

vko';d gS] ftlls fd ekr` e`R;q de djus esa lcls vf/kd lQyrk ikz Ir dh tk ldrh gAS

gkykafd geus fu;ekulq kj v/;;u fd;k

fd fofHkUu ns'kksa o {ks=ksa esa fdruh ek¡vksa

dh tku xHkZ fujks/kdksa ds mi;ksx ls jksds

x, tUeksa ds dkj.k cpkbZ xb]Z fQj Hkh

bl v/;;u esa dfe;ka gSaA igyk] gekjs

lHkh vuqeku vkadM+ksa dh xq.koÙkk]

fo'ks"kdj MMEIG ds] ekr` eR` ;q vuqikr

ds vkadM+ksa dh xq.koÙkk ij fuHkjZ gaSA

fodkl'khy ns'kksa esa det+ksj iathdj.k

izfØ;kvksa vkjS xHkZ /kkj.k lca a/kh eR` ;q vU;

dkj.kksa esa iathd`r fd, tkus ds dkj.k]

ogka ls ikz Ir ekr` e`R;q lca af/kr vkadM+s

dkQh [kjkc gksrs gSaA nwljk] MMEIG ds

ekr` e`R;q vuiq kr lca a/kh vkadM+s ekWMy

vk/kkfjr vueq ku gksrs gSa] tks /kkj.kkvksa]

tSls vkadM+ksa ds forj.k] [kks;s gq, vkadM+s

vkSj izklfa xd dksosfj;sV~l] ij vk/kkfjr gSA

fo'o Hkj esa egRoiw.kZ vkadM+ksa ds fjdkMZ

j[kus ds rjhdksa dks et+cwr djuk gksxk]

ftlls fd xHkZ lekiu vkjS ekr` eR` ;q

l[a ;k tSls vkadM+ksa ds fy, ekWMy

vk/kkfjr itz uu'khyrk vkSj eR` ;q laHkkouk

ds vuqekuksa ij fuHkZj u gksuk iM+As

vueq kuksa ds laca/k esa bl vfuf'prrk dks

udkjk ugha tk ldrkA rhljk] ge xHkZ

fujks/kd mi;ksx ds nks eq[; ra=ksa ij gksus

okys iHz kkoksa dk fo'ys"k.k ugha dj ik,15]32

& tUeksa dh la[;k esa deh vkSj mPp

ilz fw r tksf[ke Js.kh esa vkus okyh xHkoZ rh

efgykvksa dh l[a ;k esa cnyko] ftlds

dkj.k Hkh ekr` e`R;` dh lHa kkouk esa deh

vkrh gSA ge mu dj.kh; ra=ksa dks] ftuds

}kjk xHkZ fujks/ku i;z ksx ekr` eR` ;q esa deh

ykrk gS] mUgsa ifjHkkf"kr ugha dj ik,A

blds fy, gesa vkjS v/;;u djuk gksxk]

D;ksfa d muls ge irk yxk ldrs gaS fd

vk;q] iztuu'khyrk] cPpksa ds tUe ds chp

varj vkfn dk ekr` e`R;q ij D;k iHz kko

gksrk g]S bl iHz kko ij xHkZ fujks/kd iz;ksx

dk D;k ;ksxnku gS o mldh fn'kk o

ifj.kke D;k gSaA

fodflr vkjS fodkl'khy ns'kksa dh

efgykvksa ds iztuu LokLF; ds chp varj

dks dbZ yksx vLohdk;Z ekurs gSa] vr% bls

lglzkCnh fodkl mÌs'; l[a ;k 5 esa

lca ksf/kr fd;k x;k gAS xHkkoZ LFkk vkjS

ilz o ls tqM+h leL;kvksa ds dkj.k fo'o

Hkj esa ifz r o"kZ yxHkx 358]000 efgykvksa

vkjS 30 yk[k uotkr f'k'kqvksa dh eR` ;q

gksrh g]S 24]33 buesa ls yxHkx lHkh eR` ;q

fodkl'khy ns'kksa esa gksrh gaS] vkSj lHa kor%

T+;knkrj eR` ;q gksus ls cpkbZ Hkh tk ldrh

3.2 Page 22

▲back to top

gaSA gkykafd ekr` e`R;q la[;k esa lcls

vf/kd deh mUgha ns'kksa esa ikz Ir dh tk,xh

tgka oreZ ku esa xHkZ fujks/kdksa dk dkQh

de mi;ksx gksrk gS ¼vf/kdrj mi&lgkjk

vÝhdk es½a ] vkSj tc bldk iz;ksx c<+

tk,A

gkykafd ekr` eR` ;q nj ds iez q[k dkj.k

jDrlkz o] mDr jDrpki lca a/kh fodkj]

iwfrrk] ckf/kr izlo] vkjS vljq f{kr xHkZ

lekiu gaS] ekr` e`R;q jksdus ds fy, ifjokj

fu;kstu izkFkfed rjhdk gSA ilz o lca a/kh

leL;kvksa ls gksus okyh e`R;q jksdus ds

fy, ewyHkwr vkSj vkikrdkyhu fpfdRlk

dh vko';drk gS34] vkjS xHkkZoLFkk ls

tqM+h tkuysok leL;kvksa dk igys ls

vueq ku ugha yxk;k tk ldrkA ljq f{kr

ekr`Ro iz;kl ds varxZr] O;kid mPp

Lrjh; ifjokj fu;kstu o ekr` LokLF;

los kvksa rd O;kid igqap vkSj ilz o ds

le; izf'kf{kr O;fDr;ksa }kjk ns[kjs[k

miyC/k gksuk egRoiw.kZ gAS ilz o ds le;

inS k gksus okyh leL;kvksa dk fujkdj.k

djus ds fy,] i;kIZ r {kerkvksa dh

vko';drk gksrh gS]35 ysfdu bl {ks= esa

cgqr /kheh xfr ls fodkl gks jgk gS]

ftlls ekr` eR` ;q esa deh ykus esa ck/kk vk

jgh gSA nks&frgkbZ ls vf/kd efgyk,a vkt

Hkh ?kj ij gh cPpksa dks tUe nsrh gaS]

ysfdu mlesa ls dsoy dqN efgykvksa dks

gh izf'kf{kr LokLF; dfeZ;ksa ls lg;ksx

fey ikrk gAS tks efgyk,a ifz 'kf{kr

LokLF; dfe;Z ksa ds fcuk gh cPpksa dks tUe

nsrh gSa] os c<+rs ekr` e`R;q dks vkjS c<+k

ldrh gSa] gkykafd dNq vU; {ks=ksa esa

efgykvksa ds fy, vPNh izlo los k,a

miyC/k gks ldasxhA ekrR` o ns[kjs[k dh

lfq o/kkvksa esa fofHkUu ns'kksa ds chp

vlekurk,a vkSj c<+us dh lHa kkouk gS] vkSj

ftu {ks=ksa esa ifz 'kf{kr LokLF; dfeZ;ksa ds

fcuk gh cPpksa dk tUe gksrk gS] ogka ekr`

e`R;q l[a ;k,a vf/kd gkxsa hA lHkh fo'ys"k.kksa

esa ekr` eR` ;q ds tksf[ke esa deh ykus esa

iztuu'khyrk esa deh dh Hkwfedk ij t+ksj

fn;k x;k gAS 14]36 vr% ekr` eR` ;q de djus

ds fy,] xHkZ /kkj.k iwoZ vkjS cPps ds tUe

ls igys] nkSjku vkSj ckn ds lHkh pj.kksa

e]sa mPp Lrjh; ns[kjs[k los kvksa dh

miyC/krk vR;ar vko';d gSA37

dbZ ns'kksa esa] lk/kkj.k iztuu'khyrk nj o

vokafNr xHkZ/kkj.k nj vHkh Hkh cgrq T+;knk

gaSA efgyk,a ckj ckj thou dks [krjk iSnk

djus okyh xHkZ /kkj.k lca a/kh leL;kvksa dk

lkeuk djrh gaS vkSj muds thou ds

iztuu'khy o"kksaZ esa] eR` ;q o vLoLFkrk ds

ifz r mudk tksf[ke cuk jgrk gSA dqN

efgyk,a vljq f{kr xHkZ lekiu ifz Ø;kvksa

dk mi;ksx djds bu [krjksa dks vkjS c<+k

ysrh gaSA ckj ckj vljq f{kr xHkZ lekiuksa

dks izHkkodkjh xHkZ fujks/kdksa dh miyC/krk

ls jksdk tk ldrk gSA xHkZ fujks/kdksa dh

vko';drk dks iwjk djuk lglkz Cnh

fodkl mís'; 5ch ds 4 y{;ksa esa ls ,d

gSA lokZf/kd ekr` eR` ;q vuiq kr okys ns'kksa

esa xHkZ fujks/kd mi;ksx nj Hkh de gksrh

gSA buesa ls dbZ ns'kksa es]a xHkZ fujks/kdksa dh

viw.kZ vko';drk dk nj xHkZ fujks/kdksa dh

mi;ksx nj ls Hkh T+;knk gAS ysfdu xHkZ

fujks/kdksa dh viw.kZ vko';drk dks iwjk

djus ls gksus okyh ekr` e`R;q esa deh ds

Qk;ns mu Qk;nksa ds vfrfjDr gSa] tks mu

efgykvksa dks feyrs gSa] ftudh xHkZ

fujks/kdksa dh vko';drk iwjh dh tk pqdh

gAS vr% xHkZ fujks/kdksa ds ekr` eR` ;q ij

gksus okys dqy izHkkoksa ds eqdkcys] xHkZ

fujks/kdksa dh vko';drk dks iwjh djus ls

cpkbZ tkus okyh ek¡vksa dh tku ds gekjs

vueq ku de gks ldrs gSaA

ge lkfcr djrs gSa fd fodkl'khy ns'kksa esa

ekr` e`R;q de djus ds fy, xHkZ fujks/kdksa

dk mi;ksx ,d iHz kko'kkyh] ikz Fkfed

ljq {kkRed mik; gAS gekjs v/;;u ds

ifj.kke lkfcr djrs gaS] fd ftu ns'kksa esa

3.3 Page 23

▲back to top

xHkZ fujks/kdksa dk de mi;ksx fd;k tkrk

gS] ogka xHkZ fujks/kdksa rd csgrj igqap

LFkkfir djus ls ekr` e`R;q jksdus esa lcls

vf/kd lQyrk izkIr dh tk ldrh gS

¼iSuy½A Hkwe.Myh; Lrj ij LokLF; dh

ppkZvksa vkjS izR;sd ns'k esa efgykvksa ds

LokLF; ds fy, fd, tk jgs i;z klksa esa]

xHkZ fujks/kdksa dh viw.kZ vko';drk dks

iwjk djus ds y{; dks 'kkfey fd;k tkuk

pkfg,A

y[s kd

,l, vkSj ,vksVh us v/;;u dh :ijs[kk r;S kj

dh vkSj ;g y[s k fy[kkA ,l, us lkaf[;dh;

ekWMy rS;kj djus vkjS fo'ys"k.k dh ifz Ø;k dk

usr`Ro fd;kA D;w,y us vkadM+s ,df=r djds

mudk fo'ys"k.k fd;kA ,y,y us idz kf'kr dk;Z

ds iuq koZ yksdu] ifj.kkeksa dh O;k[;k vkSj fjiksVZ

ds la'kks/ku esa enn dhA

erHksn

ge ?kks"k.kk djrs gSa fd gekjs chp dksbZ erHksn

ugha gAS

lanHkZ

1 Singh S, Darroch JE, Ashford LS, Vlassoff M. Adding it up: the costs and

benefits of investing in family planning and maternal and newborn health.

New York: Guttmacher Institute and United Nations Population Fund, 2009.

2 Liu L, Becker S, Tsui A, Ahmed S. Three methods of estimating births

averted nationally by contraception. Popul Stud (Camb) 2008; 62: 191–210.

3 Seltzer JR. The origins and evolution of family planning programs in

developing countries. Santa Monica, CA: RAND Corporation, 2002.

4 Ory HW. The noncontraceptive health benefits from oral contraceptive use.

Fam Plann Perspect 1982; 14: 182–84.

5 Jensen JT, Speroff L. Health benefits of oral contraceptives. Obstet

Gynecol Clin North Am 2000; 27: 705–21.

6 Dayal M, Barnhart KT. Noncontraceptive benefits and therapeutic uses of

the oral contraceptive pill. Semin Reprod Med 2001; 19: 295–303.

7 Maguire K, Westhoff C. The state of hormonal contraception today:

established and emerging noncontraceptive health benefits. Am J Obstet

Gynecol 2011; 205 (suppl 4): S4–8.

8 Potts M. Family planning is crucial to child survival. Network 1990; 11: 2.

9 DaVanzo J, Hale L, Razzaque A, Rahman M. Effects of interpregnancy

interval and outcome of the preceding pregnancy on pregnancy outcomes

in Matlab, Bangladesh. BJOG 2007; 114: 1079–87.

10 DaVanzo J, Hale L, Razzaque A, Rahman M. The effects of pregnancy

spacing on infant and child mortality in Matlab, Bangladesh: how they vary

by the type of pregnancy outcome that began the interval. Popul Stud

(Camb) 2008; 62: 131–54.

11 Yeakey MP, Muntifering CJ, Ramachandran DV, Myint Y, Creanga AA, Tsui

AO. How contraceptive use affects birth intervals: results of a literature

review. Stud Fam Plann 2009; 40: 205–14.

12 WHO. Mother–baby package: implementing safe motherhood in countries.

Geneva: World Health Organization, 1996.

http://whqlibdoc.who.int/hq/1994/W HO_FHE_MSM_94.11_Rev.1.pdf

(accessed Feb 6, 2012).

13 AbouZahr C. Some thoughts on ICPD+5. Bull World Health Organ 1999;

77: 767–70.

14 Stover J, Ross J. How increased contraceptive use has reduced maternal

mortality. Matern Child Health J 2010; 14: 687–95.

15 Ross JA, Blanc AK. Why aren’t there more maternal deaths? A

decomposition analysis. Matern Child Health J 2012; 16: 456–63.

16 WHO. Unsafe abortion: global and regional estimates of the incidence of

unsafe abortion and associated mortality in 2008. Geneva: World Health

Organization, 2011.

17 UNICEF. Plan of action for implementing the world declaration on the

survival, protection and development of children in the 1990s.

http://www.unicef.org/wsc/plan.htm (accessed Feb 6, 2012).

18 O’Loughlin J. Safe motherhood: impossible dream or achievable reality?

Med J Aust 1997; 167: 622–5.

19 Fortney JA. The importance of family planning in reducing maternal

mortality. Stud Fam Plann 1987; 18: 109–14.

20 Berelson B. 18–35 in place of 15–45? Population Council Annual Report

1971. New York: Population Council, 1972.

21 Trussell J, Pebley AR. The potential impact of changes in fertility on infant,

child, and maternal mortality. Stud Fam Plann 1984; 15: 267–80.

22 Winikoff B, Sullivan M. Assessing the role of family planning in reducing

maternal mortality. Stud Fam Plann 1987; 18: 128–43.

23 Jain AK. Measuring the effect of fertility decline on the maternal mortality

ratio. Stud Fam Plann 2011; 42: 247–60.

24 WHO, UNICEF, UNFPA, The World Bank. Trends in maternal mortality:

1990 to 2008. Geneva: World Health Organization, 2010.

25 UN. World contraceptive use 2010. New York: United Nations, Department

of Economic and Social Affairs, Population Division, 2011.

26 UN, Department of Economic and Social Affairs. World Population

Prospects, the 2010 Revision. http://esa.un.org/unpd/wpp/index.htm

(accessed Feb 6, 2012).

27 Wilmoth J, Zureick S, Mizoguchi N, Inoue M, Ostergaard M. Levels and

trends of maternal mortality in the world: the development of new estimates

by United Nations. Geneva: World Health Organization, 2010.

28 Efron B. Better bootstrap confidence intervals. J Am Stat Assoc 1987; 82:

171–85.

29 Stata Corporation. Stata statistical software: release 11. College Station,

TX: Stata Press, 2009.

30 Hogan MC, Foreman KJ, Naghavi M, et al. Maternal mortality for 181

countries, 1980–2008: a systematic analysis of progress towards

Millennium Development Goal 5. Lancet 2010; 375: 1609–23.

31 Bland JM, Altman DG. Statistical methods for assessing agreement

between two methods of clinical measurement. Lancet 1986; 1: 307–10.

32 Stover J, Ross J. How contraceptive use affects maternal mortality.

Washington, DC: US Agency for International Development, 2008.

33 Lawn JE, Cousens S, Zupan J, for the Lancet Neonatal Survival Steering

Team. 4 million neonatal deaths: When? Where? Why? Lancet 2005; 365:

891–900.

34 WHO, United Nations Population Fund, UNICEF, Mailman School of Public

Health Averting Maternal Death and Disability programme. Monitoring

emergency obstetric care: a handbook. Geneva: World Health

Organization, 2009.

35 Prata N, Passano P, Sreenivas A, Gerdts CE. Maternal mortality in

developing countries: challenges in scaling-up priority interventions.

Womens Health (Lond Engl) 2010; 6: 311–27.

36 Diamond-Smith N, Potts M. A woman cannot die from a pregnancy she

does not have. Int Perspect Sex Reprod Health 2011; 37: 155–58.

37 Prata N, Sreenivas A, Greig F, Walsh J, Potts M. Setting priorities for safe

motherhood interventions in resource-scarce settings. Health Policy 2010;

94: 1–13.

3.4 Page 24

▲back to top

ifjokj fu;kts u & 2

xHkZ fujk/s ku vkjS LokLF;

tkSu DyhyaMS ] vxLVhu dkSUMs&,sX;wMSyks] gcZV ihVjlu] tkuS jkSl] ,eh lqbZ

fodkl'khy ns'kksa e]sa fiNys 20 o"kksaZ esa xHkZ fujks/kdksa ds mi;ksx ds dkj.k] dsoy vupkgs xHkZ /kkj.k dks

jksdus ls] ekr` eR` ;q dh la[;k esa 40 ifz r'kr dh deh vkbZ gSA vR;f/kd tksf[ke Hkjs xHkZ /kkj.k dks

jksdus esa enn djds] fo'ks"kdj mu efgykvksa esa tks igys gh dkQh cPpksa dks tUe ns pqdh gSa] vkSj

ftudk laHkor% vljq f{kr xHkZ lekiu gks tkrk] xHkZ fujks/kdksa ds mi;ksx us ekr` e`R;q vuqikr de djus

esa egRoiw.kZ Hkwfedk fuHkkbZ gS & fiNys n'kd esa ekr` e`R;q vuqikr ¼izfr 100]000 thfor tUeksa esa ekr`

eR` ;q dk tksf[ke½ esa yxHkx 26 izfr'kr dh deh vkbZ gSA vkSj xHkZ fujks/kdksa dh viw.kZ vko';drk dks

iwjk djds 30 izfr'kr vfrfjDr ek¡vksa dh e`R;q dks jksdk tk ldrk FkkA vk/kqfud xHkZ fujks/kdksa ds

efgykvksa ds LokLF; ij gksus okys Qk;ns] ftuesa xjS xHkZ fujks/kd Qk;ns Hkh 'kkfey gSa] muds mi;ksx ls

inS k gksus okys [krjksa ls dgha T+;knk gaSA xHkZ fujks/ku ds mi;ksx ds dkj.k nks cPpksa ds chp varj c<+

tkus ls] csgrj ilz odkyhu ifj.kke o f'k'kq mÙkjthfork dh laHkkouk c<+ tkrh gSA fodkl'khy ns'kksa es]a

;fn nwljs cPps dk tUe igys cPps ds tUe ds 6 ekg ds vanj gh gks tkrk g]S rks vlkef;d tUe vkjS

tUe ds le; de ot+u tSlh leL;kvksa esa nks x.q kk c<+ksrjh gksus dh laHkkouk jgrh gAS blds

vfrfjDr] igys cPps ds tUe ds 2 o"kZ ds vanj nwljk cPpk gksus ls] nwljs cPps dh f'k'kqdky esa gh

eR` ;q dh laHkkouk mu cPpksa ls 60 ifz r'kr c<+ tkrh gS ftudk tUe muds cM+s HkkbZ&cguksa ds tUe ds

nks lky ckn gvq k gksA

iLz rkouk

efgykvksa vkSj cPpksa ds LokLF; vkjS

mÙkjthfork ds fy, xHkZ fujks/kd ds

mi;ksx ls gksus okys lcls egRoiw.kZ

ykHk] xHkZ /kkj.k dh l[a ;k esa deh gksus

ls gh izkIr gksrs gSa] fo'ks"kdj muesa tgka

ekrR` o] izlodky vkSj f'k'kq mÙkjthfork

ds lca a/k esa vklS r ls T+;knk tksf[ke dh

lHa kkouk gksA bu tksf[keksa dk tqM+ko

cgqr de mez ¼18 o"kZ vk;q ls de½ vkjS

T+;knk mez ¼34 o"kZ vk;q ls vf/kd½ esa

xHkZ /kkj.k djus] vf/kd l[a ;k esa cPpksa

dks tUe nsus] vkSj nks cPpksa ds tUe ds

chp de varj gksus] vkjS mu xHkZ /kkj.kksa

ls gS] ftudk vljq f{kr xHkZ lekiu esa

var gksus dh lHa kkouk gAS ge itz uu ds

xHkZ fujks/kd mi;ksx ds bu

tulkaf[;dh; igyqvksa ij gksus okys

izHkkoksa dk fo'ys"k.k dj jgs gSa

¼ifjf'k"V½A gekjk vueq ku gS fd xHkZ

fujks/kd iz;ksx esa 10 ifz r'kr c<+ksrjh

gksus l]s iztuu'khyrk esa izfr efgyk 0-6

tUe dh deh vkrh g]S pkj ;k mlls

vf/kd cPpksa okyh efgykvksa esa vkxs gksus

okys tUeksa ds vuqikr esa 5 izfr'kr dh

deh vkrh gS] 35 o"kZ vk;q ;k mlls

vf/kd mez dh efgykvksa ds tUe nsus esa

1-5 ifz r'kr dh deh vkjS nks cPpksa ds

tUe esa 2 o"kZ ls de varj gksus dh

lHa kkouk esa 3-5 izfr'kr dh deh vkrh

gSA ge bu igyqvksa ds ekr`Ro]

izlodkyhu vkSj f'k'kq LokLF; ij gksus

okys iHz kkoksa ij /;ku ns jgs gSaA bl iwjs

v/;;u esa de ;k e/;e Lrj dh

vkenuh okys ns'kksa ij t+ksj fn;k x;k

gSA geus vPNh rjg ls LFkkfir xjS &xHkZ

fujks/kd ykHkksa vkjS dqN fof'k"V xHkZ

fujks/ku i.z kkfy;ksa ds efgyk LokLF; ls

tqM+s tksf[ke ds lcwrksa dh leh{kk dh gSA

;Fkksfpr] geus LFkkfir leh{kkvksa ds

uohuhdj.k ds fy, mu v/;;uksa esa

mi;ksx fd, x, 'kCnksa dk iuq % iz;ksx

djrs g,q ] muesa vius u, 'kCn tksM+dj

,d ckj vkSj [kkst dh vkjS xk.S k vkadM+ksa

dk Hkh fo'ys"k.k fd;k gSA

vkuS ykbuZ idz k'ku

tyq kbZ 10] 2012

http://dx.doi.org/10.1016/S014

0-6736(12)60609-6

vkuS ykbuZ ns[kus o fVIi.kh ds

fy,

http://dx.doi.org/10.1016/S014

0-6736(12)60904-0

ifjokj fu;kstu ij fy[ks x,

ikap ys[kkas dh Ja`[kyk dk nwljk

ys[k

yaMu Ldwy vkWQ gkbtZ hu ,sMa

VªkfS idy efS Mflu] yaMu] ;wds

¼ikz QS ts DysySaM] ,e ,½(

isjhusVkys ktS h fjlpZ ckz ap] gVt~ +y

foeSUl gkfS LiVy] ;wful duS sMh

f'koz j u'S kuy bafLVV;~ wV vkQS

pkbZYM gSYFk ,sMa áweu

MSoyieaSV] uS'kuy bafLVV;~ wV~l

vkQS gYS Fk] cSFksLMk] ,eMh] ,sMa

MhVªkbS VZ ] ,evkbZ] ;,w l,

¼, dksUMs&,X;wMsyk]s ,eMh½

fMikVZeaSV vkWQ esVjuy ,sMa

pkbYZ M gYS Fk] fxfyaXl Ldwy vkSQ

Xykcs y ifCyd gSYFk

¼ikz QS ,p ihVjlu] ,eMh½ vkjS

fMikVZeSaV vkQS vkCS LVSfVDª l ,sMa

xkbusdkSykts h] Ldwy vkQS

efS Mflu

¼izkQS ,p ihVjlu½]

;wfuoflVZ h vkQS ukFS kZ djS kys kbuk]

psiy fgy] ,ulh] ;,w l,( ¶;wplZ

xzqi] okfS 'kaxVu] Mhlh] ;w,l,

¼ts jkSl] ih,pMh½( vkSj

fMikVeZ SaV vkQS ikiS qys'ku] QfS eyh

,Msa jhizkMs fDVo gYS Fk] tkUS l

gkSifdUl CywecxZ Ldwy vkQS

ifCyd gYS Fk] ckYVheksj] ,eMh]

;w,l,

¼izkQS , lbq Z] ih,pMh½

laidZ ds fy, %

izkQS - ts DysySaM] yaMu Ldwy

vkQS gkbtZ hu ,sMa VªkSfidy

efS Mflu] yaMu] WC1E 7HT] ;wds

john.cleland@lshtm.ac.uk

ifjf'k"V ds fy, vkSuykbuZ ns[ksa

3.5 Page 25

▲back to top

[kkst j.kuhfr ,oa p;u ds ekinaM

geus eSMykbu] ,Ecsl] ikiS ykbu] n D;wE;yw fs Vo

baMSDl Vq uflaZx ,Msa vykbMZ gYS Fk fyVjspj]

(CINAHL) vkjS fyVjspjq k yVS huks&vefS jdkuk ,

Mks dSfjcs ,e fl;fS Ul;kt+ Mk lkMS s (LILACS) ds

lkFk xHkZ fujks/ku ;k ifjokj fu;kstu] tUe nsus

;k nks tUeksa ds chp varj j[kus] itz uu'khyrk]

vuk;kl xHk]Z fd'kksj mez esa xHkZ /kkj.k] mPp

tksf[ke xHkZ /kkj.k] xHkZ lekiu] ekr`Ro LokLF;]

ekr` e`R;q] ilz odkfyd LokLF;] f'k'kq LokLF;]

f'k'kq eR` ;q] cky LokLF; vkjS cky e`R;q dh]

fcuk fdlh Hkk"kk ifz rca/k ds] [kkst dhA blds

lkFk lkFk] geus ifjokj fu;kstu ;k xHkZ

fujks/ku ds fo"k;ksa ij gqbZ varjk"Z Vªh; cBS dksa dh

dk;Zokgh] LFkkfir v/;;uksa dh lanHkZ lwfp]

ikB~;iLq rdk]sa igys izdkf'kr i.z kkyhc) v/;;uksa

vkjS ys[kksa dh Hkh [kkst dhA geus bl dk;{Z ks=

ds fo'ks"kKksa ls Hkh laidZ fd;kA

caXykns'k ¼2001½10

dsU;k ¼1993½*11

eryc] caXykns'k ¼1976&85½1

U;w ;kSdZ] ;w,l, ¼1936&38½12

ukbtZ hfj;k ¼1985&2001½*13

VdhZ ¼1992½*14

t+kfEc;k ¼1982½*15

tUekas dh la[;k

fp= 1 % vf/kd@T+;knk tUe nsus vkjS ekr` e`R;q vuqikr ds chp laca/k ds p;fur v/;;uA

*vLirky vk/kkfjr ;k laLFkkxr vkadM+s

iez q[k lans'k

 fodkl'khy ns'kksa es]a fiNys N% n'kdksa es]a

xHkZ fujks/kd iz;ksx esa c<+ksrjh ds dkj.k

itz uu'khyrk esa yxHkx 75 izfr'kr dh

deh vkbZ gS vkSj mu efgykvksa esa Hkh xHkZ

/kkj.k ds vuiq kr esa deh vkbZ gS] ftuds

vf/kd cPps gSa] ftlds dkj.k ekrR` o

mÙkjthfork ds fy, vklS r ls vf/kd

[krjk gksrk gAS

 o"kZ 2008 e]sa xHkZ fujks/kd mi;ksx ls

vuk;kl xHkZ /kkj.k esa deh ds dkj.k] fo'o

Hkj esa 250]000 ekr` eR` ;qvksa dks jksdk tk

ldkA ;g la[;k ml o"kZ esa 355]000 gqbZ

ekr` e`R;qvksa dk 40 izfr'kr gSA

 ;fn fodkl'khy ns'kksa es]a xHkZ /kkj.k ls

cpus dh bPNk j[kus okyh lHkh efgyk,a

izHkkodkjh xHkZ fujks/kdksa dk iz;ksx dj]sa rks

ekr` eR` ;q dh la[;k esa 30 ifz r'kr

vfrfjDr deh ykbZ tk ldrh gAS

 vf/kd cPpksa okyh efgykvksa esa gksus okys

tUe vkSj vljq f{kr xHkZ lekiu iz.kkfy;ksa

dk mi;ksx djus ds fy, etcjw djus okys

igyvq ksa ij gksus okys izHkkoksa ds dkj.k] xHkZ

fujks/ku ifz r xHkZ /kkj.k] ekr` eR` ;q tksf[ke

de djus esa Hkh enn djrk g(S xHkZ

fujks/kd iz;ksx esa ifz r 1 ifz r'kr c<+ksrjh ls

ekr` e`R;q vuiq kr esa izfr 100]000 thfor

tUeksa ij 4-8 eR` ;vq ksa dh deh vkrh gAS

 xHkZ fujks/kd mi;ksx] nks xHkZ /kkj.kksa ds

chp dk le; c<+k dj] ilz odkfyd

ifj.kkeksa vkSj f'k'kq mÙkjthfork c<+kus dh

{kerk j[krk gS( le`) vkSj xjhc ns'kksa es]a

nks tUeksa ds chp de varj gksus ds dkj.k]

vlkef;d tUe ;k tUe ds le; de

ot+u gksus tSls tksf[ke dkQh c<+ tkrs gaSA

fodkl'khy ns'kksa e]sa ;fn lHkh cPpksa ds

tUeksa ds chp nks lky dk varj j[kk tk,

rk f'k'kdq ky ¼1 o"kZ ls de me½z esa eR` ;q

gkus s dh laHkkouk esa 10 izfr'kr dh deh

vk ldrh gS vkSj 1&4 o"kZ mez ds chp

eR` ;q gksus dh laHkkouk esa 21 izfr'kr dhA

 fof'k"V xHkZ fujks/ku i.z kkfy;ksa ds LokLF;

ykHk] muds mi;ksx ls gksus okys [krjksa ls

dgha T+;knk gaS] gkykafd dqN y?kq nq"iHz kkoksa

ds dkj.k mudk mi;ksx #d tkus dh

laHkkouk dkQh c<+ tkrh g]S fo'ks"kdj

gkeksuZ y izfØ;kvksa okys xHkZ fujks/kdksa ds

mi;ksx dhA

3.6 Page 26

▲back to top

ekr` mÙkjthfork vkSj LokLF;

ekr` e`R;q ekinaM vkjS itz uu'khyrk

efgyk ds iztuudky ds nkjS ku g,q xHkZ

/kkj.kksa dh l[a ;k o le;] vLoLFkrk dh

ekStwnxh vkjS izlfw r ns[kHkky dk] ekr`

eR` ;q tksf[ke ij dkQh izHkko gksrk gSA bu

iHz kkoksa dks ekius ds fy, pkj eki gSa %

ekr` eR` ;q l[a ;k] ekr` e`R;q nj] ekr` eR` ;q

vuqikr vkjS iwjs thoudky esa ekr` e`R;q

tksf[keA

ekr` e`R;q nj izfr 1000 itz uu'khy vk;q

¼15 & 49 o"kZ½ dh efgykvksa esa ekr` eR` ;q

dh l[a ;k gksrh gSA ekr` eR` ;q vuqikr esa

Hkh ogh va'k x.kd gksrk gS] ysfdu mldh

vfHkO;fdr izfr 100]000 thfor tUeksa ij

dh tkrh gSA thoudky esa ekr` e`R;q

tksf[ke dks efgyk ds itz uudky esa

ekrR` o lca a/kh dkj.kksa ls gksus okyh e`R;q dh

lpa ;h lHa kkouk ds :i esa ifjHkkf"kr fd;k

tkrk gS vkSj ;g efgykvksa esa xHkZ /kkj.k

lca a/kh e`R;q dk eki gSA ekr` e`R;q nj vkSj

thoudky esa ekr` e`R;q tksf[ke] nksuksa dk

gh itz uu'khyrk nj ls lh/kk

ifz rfØ;kRed laca/k gS] vr% ;g ifz r

efgyk ekr` eR` ;q tksf[ke dk eki gAS

tcfd ekr` eR` ;q vuiq kr izlfw r los kvksa

rd [kjkc igaqp vkSj los kvksa dh voekud

x.q koÙkk ds dkj.k ifz r xHkZ /kkj.k tksf[ke

dks n'kkrZ k gSA xHkZ /kkj.kksa esa deh ds

dkj.k ekr` e`R;q la[;k esa Hkh deh vkrh

g]S D;ksafd ;g Lor% fl) gS fd tc xHkZ

/kkj.k gh ugha gksxk rks ekr` eR` ;q dk

[krjk gh ugha jgsxkA

mPp tksf[ke vkjS vuk;kl xHkZ /kkj.k vkjS

ekr` eR` ;q ls cpko

gkykafd ekr` eR` ;q vuiq kr dk lh/kk lca a/k

ekrR` o ns[kjs[k dh csgrjh ls gS] bl ij

iztuu'khyrk nj dk Hkh izHkko gksrk gS]

ftlls mPp ilz wfr tksf[ke okyh efgykvksa

esa tUeksa dk vuqikr izHkkfor gksrk gS &

eryc fd os efgyk,a tks 18 o"kZ vk;q ls

de gSa ;k 34 o"kZ vk;q ls T+;knk gaS]

ftudk dsoy ,d cPpk gS ;k 3 ls vf/kd

cPps gaS] vkSj ftUgksua s cgrq T+;knk cPpksa

dks tUe fn;k gSA1&6 bu igyqvksa dk

izlfw r tksf[ke ij fdruk iHz kko gksrk gS]

bl ij fookn gSA7&9

tSlk fd ifjf'k"V esa fn[kk;k x;k gS] xHkZ

fujks/kd mi;ksx esa c<+ksrjh vkSj mlds

dkj.k itz uu'khyrk esa deh dh otg ls

izlfw r tksf[ke esa Hkh deh vkrh gS] tks

eq[;r% ftu efgykvksa ds vf/kd cPps gaS

muesa vokafNr xHkZ /kkj.k esa deh ds dkj.k

gksrk gSA A T+;knk cPpksa dks tUe nsus ls

tqM+s tksf[ke tUeksa dh l[a ;k lca a/kh ekr`

e`R;q vuiq kr esa fn[kkbZ nsrs gSa] tks

fodkl'khy ns'kksa esa T+;knkrj vLirky ds

fjdkMZ ls fudkys x, gaS ¼fp= 1½A ekr`

eR` ;q vuiq kr igys cPps okyh efgykvksa esa

T+;knk gksrk g]S nwljs ;k rhljs cPpksa ds

fy, fxj tkrk g]S pkFS ks vkjS ikapos cPpksa

ij fQj ls c<+ tkrk gS vkjS 6 cPpksa ij

lcls vf/kd gksrk gSA T+;knk cPpksa ds

dkj.k c<+k gqvk ekr` e`R;q tksf[ke fp= 1

esa n'kk,Z x, ns'kksa ds vfrfjDr] ikfdLrku]

lus sxy vkjS if'peh vÝhdk esa ns[kk x;k

gSA16&18

tUeksa ds chp varj ds lna HkZ es]a 1985 vkjS

1997 ds chp fd, x,] ySfVu vejhdk

vkjS dSfjfc;u esa 450]000 tUeksa ds ,d

fo'ys"k.k esa ekr` e`R;q ds fy, 2-5 ¼95

izfr'kr lhvkbZ 1-2 & 5-4½ dk ,MtLVsM

vkWM jsf'k;ks ns[kk x;k] tc nks xHkZ /kkj.kksa

ds chp 6 eghus ls de varj FkkA19 ysfdu

22 v/;;uksa dh ,d iz.kkyhc) leh{kk]

ftlesa ls ,d&frgkbZ fodkl'khy ns'kksa esa

fd, x, Fks] esa tUe varjky vkjS ekrR` o

ifj.kkeksa dh tkap dh ftlesa de xHk/Z kkj.k

varjky ds ekr` eR` ;q ij vlxa r iHz kko

mHkj dj vk,A20 'kks/kdrkvZ ksa us tUeksa ds

3.7 Page 27

▲back to top

chp de varj dk xHkkZoLFkk ifj.kkeksa rFkk

ekr` vLoLFkrk ds lkFk xgjk lca a/k]

ysfdu ekr` eR` ;q ds lkFk det+ksj lca a/k

crk;k & bl fojks/kkHkkl dk vkSj v/;;u

djuk gksxkA

mPp tksf[ke xHkkZoLFkk dh ,d vkjS Js.kh

mudh gS ftudk var vljq f{kr xHkZ

lekiu esa gksrk gAS flag vkjS lg;ksfx;ksa21

us n'kkZ;k fd o"kZ 2008 esa fo'o Hkj esa

dqy 20-82 djksM+ xHkZ /kkj.k g,q A muesa ls

18-54 djksM+ fodkl'khy {ks=ksa esa g,q ]

ftuds 40 ifz r'kr vuk;kl xHk/Z kkj.k FksA

muesa ls 16 izfr'kr us ¼thfor½ tUe

fn;k] 19 ifz r'kr esa xHkZ lekiu gqvk vkSj

5 ifz r'kr dk xHkiZ kr gks x;kA lS?k vkSj

lg;ksfx;ksa22 ds vuqeku ds vuqlkj] o"kZ

2003 esa fo'o Hkj esa 4-2 djksM+ xHkZ

lekiu g,q ] ftuesa ls 1-97 djksM+ ¼48

ifz r'kr½ vljq f{kr fLFkfr;ksa esa gq,A 97

ifz r'kr vljq f{kr xHkZ lekiu fodkl'khy

ns'kksa esa gksrs gSa vkjS 2006 ds vkadM+ksa ds

vuqlkj] ;g l[a ;k 2-16 djksM+ g]S ftlesa

mi&lgkjk vÝhdk vkSj ySfVu vejhdk esa

2003 ds ckn ls c<+ksrjh gbq AZ 23

fookfgr efgykvkas esa xHkZ fujks/kd mi;ksx ¼izfr'kr½

fp= 2 % 40 ns'kksa esa le; ds lkFk lkFk ekr` e`R;q vuqikr vkjS fookfgr efgykvksa esa xHkZ fujks/kd mi;ksx

o"kZ 1986 ls 2009 ds chp] 40 fodkl'khy ns'kksa ¼ns'kksa ds uke o frfFk;ksa dh lwfp ifjf'k"V esa nh xbZ g½S

esa fd, x, tulkaf[;dh; o LokLF; lo{sZ k.kksa ls xHkZ fujks/kd mi;ksx ds vuqeku fy, x,A xHkZ fujks/kd

mi;ksx vuqekuksa dh frfFk;ksa ls esy [kkrs g,q ekr` e`R;q vuiq kr ikz Ir djus ds fy, fo'o LokLF; laLFkku

(WHO) le; J`a[kyk ds vuqeku27 dk mi;ksx fd;k x;kA igyk MsVkIokbaV ml ns'k ds fy, miyC/k

loZizFke tulkaf[;dh; o LokLF; los{Z k.k vkda M+ksa ds vuq:i g]S vkjS nwljk MVs kIokbaV lcls gky ds

los{Z k.k vkadM+ksa ds vu:q i gSA los{Z k.kksa ds chp dh vkSlr le;kof/k 12 o"kZ Fkh ¼4 ls 12 o"kZ ds chp½A

vklS r Lyksi & 8-5 ¼IQR & 22-2 ls & 2-3½

fodkl'khy ns'kksa esa gksus okyh yxHkx

47000 ekr` e`R;q ¼dyq ekr` e`R;q dk 13

ifz r'kr½ vljq f{kr xHkZ lekiu ds dkj.k

gksrh gaSA24 xHkZ fujks/kd mi;ksx ls xHkZ

lekiu djokus dh et+cwjh ls cpk tk

ldrk gS vkSj bu esa ls T+;knkrj e`R;qvksa

dks jksdk tk ldrk gAS

xHkZ fujks/kd iz;ksx ds dkj.k

itz uu'khyrk esa vkbZ deh ds dkj.k ekr`

eR` ;q esa vkbZ deh dk vuqeku

jkSl vkjS CySUd25 dk vueq ku gS fd 1990

vkSj 2008 ds chp fodkl'khy ns'kksa esa]

itz uu'khyrk esa deh ds dkj.k] 17 yk[k

ekr` e`R;q jksdh tk ldha] tks fd ekr` e`R;q

nj esa 54 izfr'kr deh ds vuq:i gSA

pwfa d xHkZ fujks/kd ds c<+rs iz;ksx ds

dkj.k iztuu'khyrk esa 73 izfr'kr deh

vkbZ gS ¼ifjf'k"V½] bu 18 o"kkasZ esa] ekr`

e`R;q nj esa vkbZ 40 ifz r'kr deh dk Js;

xHkZ fujks/ku dks fn;k tk ldrk gAS

nkjksp vkjS flga 26 dk vuqeku gS fd izfr

100]000 vk/kfq ud xHkZ fujks/kd

mi;ksxdrkZvksa ds dkj.k] yxHkx 43-8 ekr`

eR` ;q #drh gSaA bl vuqikr dk eryc gS

fd] xHkZ fujks/ku dh vuqifLFkfr esa] o"kZ

2008 es]a dqy ekr` eR` ;q dh l[a ;k ¼yxHkx

355]00027½ 74 ifz r'kr vf/kd gks ldrh

Fkh] ;kfu fd 619]114A blds ckn ,d

vyx rjhds ls fd, x, fo'ys"k.k ls Hkh]

o"kZ 2008 es]a fodkl'khy ns'kksa esa xHkZ

fujks/kd i;z ksx ls jksdh xbZ ekr` eR` ;q ds

vuiq kr ds fcYdqy ;gh vuqeku izkIr g,q

gaSA28

jklS vkjS CySUd25 vkjS nkjksp vkSj flag26 us

ekuk gS fd jksds x, o vU; tUeksa ds fy,

izlfw r tksf[ke cjkcj gSA izlfw r tksf[ke

¼ekr` eR` ;q vuiq kr½ dh deh dh vksj xHkZ

fujks/ku ds vfrfjDr ;ksxnkuksa dk

vkdyu djus ds fy,] geus 40

fodkl'khy ns'kksa esa muds lgizlj.k dh

3.8 Page 28

▲back to top

tkap dh ¼fp= 2½A lk/kkj.k lca a/k fn[kkrk

gS] fd xHkZ fujks/kd iz;ksx esa izR;sd

ifz r'kr dh c<+ksrjh dk lca a/k ifz r 100]000

tUeksa esa 8-5 ekr` e`R;qvksa esa deh ls gSA

ifj.kkeksa dks my>kus okys ?kVdksa dks

fu;af=r djus ds fy,] geus bu 40

fodkl'khy ns'kksa ds fy, fiNys 12 o"kksaZ esa

ekr` e`R;q vuiq kr esa cnyko vkSj xHkZ

fujks/kd i;z ksx dk iSuy fjxSz'ku

vuyS sfll fd;k ¼ifjf'k"V½A ekWMy

fn[kkrk gS fd xHkZ fujks/kd iz;ksx esa

iRz ;sd izfr'kr c<+ksrjh ds lkFk ekr` e`R;q

vuiq kr esa deh izfr 100]000 tUeksa esa 4-3

eR` ;q ds fglkc ls vkrh gAS gekjk vuqeku

gS fd xHkZ fujks/kd i;z ksx ds

ifj.kkeLo:i] v/;;u ds 12 o"kksaZ dh

le;kof/k es]a ekr` e`R;q vuqikr esa dqy 26

izfr'kr dh deh vkbZA jksdh xbZ ekr` eR` ;q

l[a ;k ds lna HkZ esa xHkZ fujks/kd iz;ksx

djus ls izfr o"kZ 3-7 ifz r'kr vfrfjDr

deh vkrh gAS

ifjokj fu;kstu dh viw.kZ vko';drkvksa

dks iwjk djus ds ifj.kkeksa dk v/;;u

djus l]s 'kks/kdrkZ vuqeku yxk ldrs gSa

fd] xHkZ fujks/kd mi;ksx ekr` e`R;q esa vkSj

fdruh deh yk ldrk gAS tulkaf[;dh;

vkjS LokLF; losZ{k.k vkadM+ksa ¼1985 &

2000½ ls dksyfEc;u vkjS lg;ksfx;ksa29 us

vueq ku yxk;k] fd izfr o"kZ xHkZ lekiu

e`R;vq ksa esa ls 90 ifz r'kr vkjS ilz o lca a/kh

eR` ;vq ksa esa ls 23-6 ifz r'kr ¼dqy ekr`

eR` ;qvksa dk 32 ifz r'kr½ dks jksdk tk

ldrk g]S ;fn os efgyk,a tks xHkZ /kkj.k

djuk ugha pkgrha] izHkkodkjh xHkZ fujks/kdksa

dk mi;ksx djsAa blds ckn fd, x, ,d

fo'ys"k.k esa Hkh ;gh fu"d"kZ fudyk & fd

xHkZ fujks/kdksa dh viw.kZ vko';drk dks

iwjk djus l]s 28 izfr'kr ekr` eR` ;q jksdh

tk ldrh gSaA30

pfwa d xHkZ fujks/kd mi;ksx ds dkj.k] o"kZ

2008 esa vueq kfur] 43&44 izfr'kr ekr`

eR` ;q jksdh tk ldha]27]28 vkSj blds ilz fw r

tksf[ke ij vizR;{k izHkkoksa ds dkj.k] 3-7

izfr'kr vfrfjDr jksdh xbZ ekr` eR` ;q dks

;fn tksM+k tk, rks xHkZ fujks/kd mi;ksx

l]s fodkl'khy ns'kksa esa ifz r o"kZ 47&48

izfr'kr ekr` e`R;q jksdh tkrh gaSA ;g

l[a ;k vkjS Hkh c<+ tkrh gS] ;fn ekr` eR` ;q

ds lkFk ,sls ekeyksa dks Hkh 'kkfey fd;k

tk,] tgka eka dh tku vR;ar tksf[ke esa

gksus ds ckotwn cp xbZ ¼,sls ekeys tgka

eka ds LokLF; ij xaHkhj izHkko gqvk gks ij

mldh tku cp xbZ gks½A

ilz odkyhu LokLF;

dkSUMs ,sX;wMyS ks vkSj lg;ksfx;ksa31 }kjk nks

xHkZ /kkj.k ds chp dh le;kof/k vkSj

izfrdwy izlfw r ifj.kkeksa ds chp lca a/k ij

dh xbZ foLrr` iz.kkyhc) leh{kk vkSj

voyksdukRed v/;;uksa ds eVS k fo'ys"k.k

dh fjiksVZ nh xbAZ 67 v/;;u] ftuds

ifj.kkeksa dks ekr` vk;q vkSj lkekftd &

vkfFkZd Lrj ds fy, fu;fer fd;k x;k]

ftlesa 1-1 djksM+ xHkZ /kkj.k 'kkfey Fks]

'kkfey fd, tkus ds l[+r ekinaMksa ds

vu:q i FksA buesa ls 26 v/;;uksa ls eSVk

fo'ys"k.k ds fy, vkadM+s fy, x,] 16 ls

vlkef;d tUe ds] nl ls tUe ds le;

de ot+u ds] 13 ls xHkkoZ f/k vu:q i

vi;kIZ r Hkwz.k fodkl ds] lkr ls Hkzw.k eR` ;q

ds] vkSj pkj ls uotkr f'k'kq dh 'kh?kz

eR` ;q dsA

bu ikap ifz rdwy izlwfr ifj.kkeksa ds

tksf[ke vkjS xHkZ /kkj.k varjky ds chp

lca a/k n'kkZus okys eSVk fjx'zS ku doZ buds

chp ts vkdkj lca a/k fn[kkrs gSa ¼fp= 3½A

vlkef;d tUe] tUe ds le; de ot+u]

vkSj xHkkZof/k vuq:i vi;kZIr Hkzw.k fodkl

ds fy, lcls vf/kd tksf[ke] 20 ekg ls

de vkSj 60 ekg ls vf/kd le;kof/k ds

3.9 Page 29

▲back to top

fy, gh FksA Hkzw.k e`R;q vkSj uotkr f'k'kq

dh 'kh?kz e`R;q] nksuksa ds fy, lcls vf/kd

tksf[ke 6 ekg ls de vkSj 50 ekg ls

vf/kd varjky esa ik;k x;kA ftu f'k'kqvksa

dk xHkZ /kkj.k fiNys cPps ds tUe ds 18

& 23 ekg ds ckn gqvk Fkk] muesa ifz rdwy

ilz fw r ifj.kkeksa dk lcls de tksf[ke

ns[kk x;k vkjS bl Js.kh dks lna HkZ Js.kh

ds :i esa mi;ksx fd;k x;kA xHkksaZ ds

chp 6 ekg ls de vof/k okyh ekavksa }kjk

tUes uotkr f'k'kqvksa esa] vlkef;d tUe

ds fy, 1-4 ¼95 ifz r'kr lhñvkñbZ 1-2 &

1-6½] tUe ds le; de ot+u ds fy, 1-6

¼1-4 & 1-9½] vkSj xHkkZof/k vuq:i vi;kIZ r

Hkzw.k fodkl ds fy, 1-3 ¼1-2 & 1-3½ iwy

,sMtSLVeaV fd;k x;k] ftudh ryq uk mu

uotkr f'k'kqvksa ls dh xbZ] ftudh ekavksa

ds xHkksaZ ds chp 18 & 23 ekg dk varj

FkkA blh rjg] 6 &17 ekg ds varj ds

ckn inS k g,q uotkr f'k'kqvksa es]a lna HkZ

lewg ds eqdkcys bu izfrdwy ifj.kkeksa dh

lHa kkouk 5 & 14 izfr'kr vf/kd FkhA xHkksaZ

esa 59 ekg ls vf/kd le;kof/k dk Hkh bu

rhu ifz rdwy izlfw r ifj.kke ls tqM+s gq,

tksf[keksa ls xgjk lca a/k ik;k x;k &

vlkef;d tUe

tUe ds le; de ot+u

xHkkoZ f/k vu:q i vi;kZIr Hkwz.k fodkl

Hkzw.k eR` ;

uotkr f'k'kqvksa dh 'kh?kz eR` ;

xHkZ /kkj.k ds chp dh le;kof/k ¼ekg½

fp= 3 % xHkZ /kkj.kksa ds chp le;kof/k ds vk/kkj ij izfrdwy izlwfr ifj.kkeksa dk ykxS vkMS t~ + jsf'k;ks

xHkZ /kkj.k ds chp dh le;kof/k ds vk/kkj ij izfrdwy ilz wfr ifj.kkeksa ds eVS k fjx'Sz ku doZA ;g ifj.kke

dkSUMs & ,sX;qMyS ks vkjS lg;ksfx;ksa }kjk fd, x, eVS k fo'ys"k.k ls :ikUrfjr fd, x, gSaA31

vlkef;d tUe ds fy, ¼OR 1-20 [95

ifz r'kr lhvkbZ 1-17&1-24]½( tUe ds le;

de ot+u ds fy, 1-43 [1-27&1-62](

xHkkZof/k vuq:i vi;kZIr Hkzw.k fodkl ds

fy, 1-29 [1-20&1-39]A v/;;u vuq:i

milewg fo'ys"k.k ls irk pyk] fd xHkksZa

ds chp 6 ekg ls de vof/k ds]

vlkef;d tUe vkSj tUe ds le; de

ot+u ds tksf[keksa ij udkjkRed iHz kko

fodflr ns'kksa ¼lek;ksftr OR 1-3 [1-2&1-

3] vkjS 1-5 [1-4&1-6]½ ds eqdkcys

fodkl'khy ns'kksa esa ¼lek;ksftr OR 2-3

[95 izfr'kr lhñvkñbZ 2-2&2-4] vkSj 2-1 [2-

0&2-3]½ dkQh vf/kd gSaA ;g ifj.kke

n'kkZrs gSa fd xHkZ /kkj.k ds chp 18 ekg ls

de vkSj 59 ekg ls vf/kd le;kof/k dk

vlkef;d tUe] tUe ds le; de ot+u

vkSj xHkkZof/k vuq:i vi;kZIr Hkwz.k fodkl

tSls tksf[keksa ls xgjk lca a/k gAS

fodflr vkSj fodkl'khy ns'kksa esa blds

ckn fd, x, v/;;uksa us bu ifj.kkeksa dh

ifq "V dh gSA32&39 bt+jk;y esa fd, x,

440]838 thfor tUeksa ds ,d ns'k Lrjh;

dksgkVS Z v/;;u esa ik;k x;k fd xHkksZa ds

chp 6 ekg ls de le;kof/k dk uotkr

f'k'kq e`R;q tksf[ke esa lkaf[;dh; :i ls

egRoiw.kZ c<+ksrjh ds lkFk xgjk lca a/k gS

lek;ksftr OR 1-64 [95 ifz r'kr lhvkbZ

1-22&2-19]½A36

xHkkasZ ds chp de le;kof/k ds ilz fw r

LokLF; ij izHkkoksa dh ifz Ø;k ds fo"k; ij

dkQh fookn gAS blesa ls lcls egRoiw.kZ

vo/kkj.kk gS fd] xHkksaZ vkSj nks cPpksa ds

Lruiku ds chp de le; gksus ds dkj.k]

eka dks feyus okys iks"k.k esa deh vk tkrh

gSA fLeVl~ vkSj ,slsM40 dk lq>ko Fkk fd

xHkkasZ ds chp de le;kof/k ds dkj.k

izfrdwy izlfw r ifj.kkeksa ds vfrfjDr

tksf[ke ds ihNs vi;kIZ r ekr` lalk/ku]

tSls QksysV ds dkj.k gks ldrk gAS tks

xHkoZ rh efgyk,a QkfS yd ,flM dh

3.10 Page 30

▲back to top

xksfy;ka ugha ysrha muesa esVjuy ljs e vkSj

QksyVs ds ,fjFkzkslkbZV dkUS luVªs'kUl

xHkkoZLFkk ds ikapos ekg esa de gksus yxrs

gaS vkSj cPps ds tUe ds dbZ ekg ckn rd

Hkh de gh jgrs gaSA ;fn og efgyk

QksyVs dh iwfrZ gksus ls igys gh nksckjk

xHkoZ rh gks tkrh gS rks mlesa QksysV dh

deh gksus dh lHa kkouk c<+ tkrh gS] vkSj

mlds ifj.kkeLo:i ifz rdwy ilz fw r

ifj.kkeksa ds tksf[ke Hkh c<+ tkrs gaSA xHkZ

/kkj.k ds chp yach le;kof/k ds ifz rdwy

iHz kkoksa ds lca a/k esa t+w vkjS lg;ksfx;ksa41 dk

dguk gS fd xHkkZoLFkk ds nkjS ku izkIr dh

xbZ 'kkjhfjd itz uu {kerk,a cPps ds tUe

ds ckn /khjs /khjs de gksus yxrh gaSA

mudk dguk gS fd] xHkksaZ ds chp 60 ekg

ls vf/kd le;kof/k ds dkj.k gksus okys

izlfw r ifj.kke mu efgykvksa ds leku gh

gksrs gaS] ftUgksaus igyh ckj xHk/Z kkj.k fd;k

gAS 41

uotkr f'k'kq ,oa cky eR` ;q vkjS LokLF;

cky LokLF; ij lHa kkfor tulkaf[dh;

iHz kkoksa esa ls tUeksa ds chp varj ij lcls

T+;knk /;ku fn;k x;k gAS jVL~ Vsu }kjk

fd, x, ,d foLrr` fo'ys"k.k es]a fiNys

cPps vkSj lpw d cPps ds xHkkZ/kku ds chp

dh le;kof/k ds izHkkoksa dk v/;;u fd;k

x;kA bl v/;;u esa 52 tulkaf[;dh;

,oa LokLF; losZ{k.kksa ls ,df=r 10 yk[k

tUeksa ds lfEefyr vkadM+ksa dk mi;ksx

fd;k x;kA

cM+h l[a ;k esa tulkaf[;dh; vkjS

lkekftd & vkfFkZd igyqvksa dks fjxS'z ku

ds iz;ksx ls fu;af=r fd;k x;kA fp= 4

esa ize[q k lek;ksftr ifj.kke n'kkZ, x, gaSA

uotkr f'k'kvq ksa ¼1 o"kZ mez ls de½ esa]

le;kof/k ftruh de Fkh ¼18 ekg ;k

mlls de½ mruk gh eR` ;q tksf[ke vf/kd

FkkA 60 ekg ;k mlls vf/kd le;kof/k

dk lca a/k vf/kd tksf[ke ls ik;k x;kA 52

los{Z k.kksa esa] nwljs tUe ds yxHkx 50

ifz r'kr vkSj rhljs tUe ¼;k mlds ckn½

ds 70 izfr'kr tUeksa dk xHkkZ/kku] 24 vkSj

36 ekg ls de le;kof/k esa gqvk Fkk] vkSj

tul[a ;k lca a/kh tksf[ke ls irk pyrk gS

fd uotkr f'k'kvq ksa dh eR` ;q esa 7-5

ifz r'kr dh deh ykbZ tk ldrh g]S ;fn

efgyk,a fiNys tUe ds ckn 24 ekg rd

xHkkZ/kku u djsa ¼tks fd nksuksa cPpksa ds

tUe ds chp 33 ekg ds varj ds cjkcj

gksxk½A ;g ifj.kke eksVs rkSj ij

iz.kkyhc) leh{kk43 vkSj blls igys

fofHkUu ns'kksa esa fd;s x, v/;;uksa ds

cjkcj gh gSaA44&48 tUe varjky ds :i esa

O;Dr fd;k tk, rks] 3 o"kZ ;k mlls

vf/kd varj ds ckn tUes cPpksa ds

edq kcys] ftu cPpksa dk vius ls cM+s HkkbZ

& cguksa ds tUe ds 2 o"kZ ds vanj tUe

gksrk gS] mudh uotkr f'k'kq voLFkk esa

e`R;q gksus dh 60 ifz r'kr vf/kd laHkkouk

gksrh gS vkSj tks 2&3 o"kZ ds vanj tUe

ysrs gaS mudh 10 izfr'kr vf/kdA geus

eki =qfV;ksa] ifj.kkeksa dks my>kus okys

dkjdksa vkSj dj.kh; lca a/kksa dh ppkZ

ifjf'k"V esa dh gAS

jVL~ Vsu ds fo'ys"k.k42 ds vuqlkj] uotkr

f'k'kqvksa ds edq kcys f'k'kq voLFkk ¼1&4 o"kZ

vk;½q esa NksVh le;kof/k ls tMq +s tksf[ke

T+;knk gksrs gaS] vkSj varj dh le;kof/k

c<+us ds lkFk lkFk yxkrkj de gksrs tkrs

gaSA ysfdu] vU; yxHkx lHkh v/;;uksa ds

vuqlkj uotkr f'k'kqvksa ds edq kcys] 1 o"kZ

ls vf/kd mez ds cPpksa esa NksVh le;kof/k

ds dkj.k e`R;q gksus dh lHa kkouk de gksrh

gAS 43&45]48 lHkh ize[q k v/;;uksa dh ;fn

:f<+oknh O;k[;k dh tk,] rks irk pyrk

gS fd 2 o"kZ ls de le;kof/k ds ckn

tUe gksus ij ls] 1&4 o"kZ vk;q ds cPpksa

dh e`R;q gksus dk tksf[ke] yxHkx 40

4 Pages 31-40

▲back to top

4.1 Page 31

▲back to top

izfr'kr c<+ tkrk gAS varr%] jVL~ Vsu dk

fo'ys"k.k lda sr nsrk gS fd] NksVh

le;kof/k ds ckn tUes cPpksa esa ckf/kr

fodkl dk tksf[ke dkQh c<+ tkrk gS

¼fp= 4½] ,d ,slk ifj.kke tks iz.kkyhc)

leh{kk ds ifj.kkeksa ds cjkcj gAS 49

blls igys fofHkUu ns'kksa esa fd, x,

v/;;uksa dh fjiksVZ crkrh gSa fd] lwpd

cPps ds tUe ds nks o"kZ ds vanj nwljk

cPpk gksus ij] lwpd cPps dh 1&2 o"kZ

vk;q esa e`R;q dk tksf[ke nksxq.kk gks tkrk

gS] vkjS 2&4 o"kZ vk;q ds fy, bu izfrdwy

izHkkoksa dk tksf[ke de gks tkrk gAS 43&45

vr%] ;fn lHkh cPpksa esa de ls de 2 o"kZ

dk varj j[kk tk,] rks vuqeku dgrs gSa

fd uotkr f'k'kqvksa dh e`R;q nj esa 10

izfr'kr rd deh vk ldrh gS vkjS 1&4

o"kZ vk;q ds cPpksa dh eR` ;q nj esa 21

ifz r'kr dhA8

cky mÙkjthfork ds fy, vU;

tulkaf[;dh; tksf[ke] ftuls cpk tk

ldrk gS] esa 'kkfey gS] itz uu'khyrk vk;q

dh lhek okyh ;k mls ikj dj pdq h mez

dh efgykvksa }kjk fn, tkus okys tUeA

tks cPps] 18 o"kZ vk;q ls de mez dh

uotkr f'k'kq ¼,d o"kZ vk;q ls de½ eR` ;q

cky ¼1&4 o"kZ vk;q½ eR` ;q

ckf/kr fodkl

fiNys tUe vkSj vxys xHkZ /kkj.k ds chp le;kof/k ¼ekg½

fp= 4 % uotkr f'k'kqvkas dh e`R;]q cky e`R;q vkjS ckf/kr fodkl dk lek;ksftr lkisf{kr tksf[ke] fiNys

tUe o vxys xHkZ/kkj.k ds chp dh le;kof/k ij vk/kkfjr

52 tulkaf[;dh; ,oa LokLF; lo{sZ k.kksa ls izkIr vkda M+ksa dk ladyu] jV~LVsu ds fo'ys"k.k ifj.kkekas ls

vuqdwfyr42

efgykvksa }kjk tUe fn, tkrs gaS] muesa 18

o"kZ vk;q ls vf/kd mez dh efgykvksa }kjk

tUe fn, x, cPpksa ds eqdkcys] e`R;q

tksf[ke 40 izfr'kr vf/kd gksrk gS vkjS

muesa ckf/kr fodkl o [kwu dh deh gksus

dh lHa kkouk vf/kd gksrh gAS 50 ysfdu]

tUeksa ds chp varj dks lek;ksftr dj

fn, tkus ij] 35 o"kh;Z ;k mlls vf/kd

mez dh efgykvksa }kjk tUes cPpksa esa ;g

ifz rdwy izHkko ugha ns[ks x,A tUe Øe ds

dkj.k 20 ifz r'kr vf/kd cky eR` ;q] nks ;k

rhu tUe Øe ds eqdkcys ] 7 ;k mlls

vf/kd la[;k rd lhfer gS 51 pfwa d cgqr

de mez dh efgykvksa }kjk tUe fn, tkus

dh la[;k dkQh de gS vkjS vf/kd la[;k

esa cPps gksus dk izpyu Hkh de gS] bu

fLFkfr;ksa ls cpko djus ij Hkh] cky e`R;q

esa cgrq T+;knk deh ikz Ir ugha dh tk

ldrhA

xSj xHkZ fujks/kd mi;ksx lca a/kh LokLF;

ykHk vkSj dqN fof'k"V iz.kkfy;ksa ls tMq +s

tksf[ke

vk/kfq ud xHkZ fujks/kdksa ds dqy LokLF;

ykHk] muls gksus okys LokLF; tksf[keksa ds

eqdkcys dgha T+;knk gSa vkjS muds mi;ksx

ls gksus okys tksf[ke] xHkZ fujks/kdksa dk

mi;ksx u djus ls dkQh de gSa & blds

vdkV~; izek.k miyC/k gSaA52 gkykafd

vk/kqfud iz.kkfy;ksa ds xHkZ fujks/kd ykHk

yxHkx ,d tlS s gh gaS] muls gksus okys

xjS xHkZ fujks/kd ykHk o tksf[ke gj

iz.kkyh ds fy, foy{k.k gaSA

fo'o Hkj esa lcls ipz fyr xHkZ fujks/ku

i.z kkyh gS 'kY; ulcanhA efgyk ulcanh

¼fMEch; ulcanh½ vkjS iq#"k ulcanh

¼oSlDS Veh & 'kqØokfgdk ulcanh½ esa rjq ar

gksus okys 'kY; lca a/kh tksf[keksa dh laHkkouk

jgrh gS] ysfdu eR` ;q ;k xaHkhj :i ls

4.2 Page 32

▲back to top

vLoLFkrk ds tksf[ke dh lHa kkouk fMEch;

ulcanh esa cgqr de gS vkjS 'kqØokfgdk

ulcanh esa vkjS Hkh deA53 dbZ v/;;uksa

}kjk n'kk;Z k x;k gS] fd vke rkSj ij]

xHk/Z kkj.k dks jksdus ds ykHk ds vfrfjDr]

efgyk vkSj iq#"k ulcanh ds nh?kdZ kfyd

LokLF; izHkko dkQh de gSa & ldkjkRed

;k udkjkRedA efgyk ulcanh dk

vaMk'k; ds dSalj dks jksdus ij izHkko

ekuk tkrk gSA53 gkykafd efgyk ulcanh

ds ckn xHkZ /kkj.k lHa kkouk cgqr de gksrh

g]S ysfdu ;fn xHkkZ/kku gks tk,] rks

ufy;ksa esa Hkzw.k Bgjus dh lHa kkouk vf/kd

gksrh g(S ysfdu xHkZ fujks/kd mi;ksx u

fd, tkus ds edq kcys] ufy;ksa esa xHkZ

Bgjus dk tksf[ke de gksrk gAS 53

fo'o Hkj esa mi;ksx fd, tkus okys

vk/kfq ud izfrorhZ xHkZ fujks/kd ds :i esa]

varZxHkkZ'k;h midj.kksa ¼vkbZ;wMh½ dk

mi;ksx lcls T+;knk ipz fyr g]S vkjS

v/;;uksa ds ifj.kke] blds efgykvksa ds

LokLF; ij gksus okys ykHk blls tqM+s

nh?kZdkfyd tksf[keksa ds edq kcys T+;knk

crkrs gaSA tks efgyk,a vkb;Z wMh dk mi;ksx

dj jgh gaS] vkSj ftuesa ;kSu lpa kfjr

chekfj;ksa dh vk'kadk de gS ¼ifz r 1000

efgykvksa esa yxHkx 1-6½ muesa Jks.kh dh

lwtu dh leL;k vkus dh lHa kkouk cgqr

de gksrh gAS ysfdu ftu efgykvksa dks

lokbZ dy DySfeMk;y ;k xksuksdkdS y

bUQSD'ku gS] muds fy, vkbZ;wMh yxkus ls

Jks.kh dh lwtu dk [krjk vkSj c<+ tkrk

gAS 54 vkb;Z wMh mi;ksx ls xHkkZ'k;h dSUlj

dk [krjk Hkh de gksrk gS]55 vkSj ,d

lda fyr fo'ys"k.k ds vuqlkj] xHkkZ'k;

xzhok dSalj dk tksf[ke Hkh de gksrk gAS 56

tks vkbZ;wMh ySosykSjtSLVªSy lzko djrs gaS]

muds mi;ksx ls ekfld /keZ ds le; [kwu

dk cgko de gksrk gAS tSlk fd efgyk

ulcanh ds lkFk gksrk gS] vkbZ;wMh ds

mi;ksx ds nkSjku xHkk/Z kku dh lHa kkouk Hkh

de jgrh gS] ysfdu ;fn xHkZ Bgj tk,

rks mlds vLFkkfud gksus dk tksf[ke

T+;knk gSA ysfdu fQj Hkh] bldk tksf[ke

dksbZ Hkh xHkZ fujks/kd mi;ksx u djus ds

edq kcys dkQh de jgrk gSA57

vk/kqfud xHkZ fujks/kdksa esa ls] dbZ ns'kksa esa

,LVªkstu & izkstLS Vkstu fefJr vksjy xHkZ

fujks/kd ¼vkslhih½ dk mi;ksx dkQh

ipz fyr gS] vkjS bu ij ,sfrgkfld :i ls

lokZf/kd v/;;u Hkh fd;k x;k gSA ;wds esa

yacs le; rd mi;ksxdrkZvksa ls lia dZ

cuk dj fd, x, ,d fo'kky dksgkVS Z

v/;;u ls ikz Ir vkadM+ksa ds fo'ys"k.k ds

ifj.kke crkrs gSa] fd vkslhih mi;ksx ls

gj izdkj ds dkj.kksa ls gksus okyh eR` ;q

lHa kkouk esa deh vkrh gAS 58 ;qok LoLFk

efgyk,a tks /kweiz ku ugha djrha] muesa

vkslhih mi;ksx ls ân; jksx ds lkis{k

vkSj fujis{k tksf[ke de gks tkrs gaS]

ysfdu 35 o"kZ mez ls cM+h /kweziku djus

okyh efgykvksa esa] ;g tksf[ke c<+ tkrk

gSA59 buds mi;ksx ls [kwu dh deh dk

ilz kj de gksrk gS59 vkjS xHkkZ'k;h o

fMEck'k; ds dSalj dk tksf[ke Hkh de

gksrk g]S vkjS ;g izHkko budk yacs le;

rd mi;ksx djus ls c<+rs tkrs gSa rFkk

mi;ksx jksd nsus ij Hkh dkQh le; rd

dk;e jgrs gaSA60]61 Lru dSalj ds tksf[ke

ij vkslhih mi;ksx ds izHkko Li"V ugha

gaSA 54 v/;;uksa ds ,d lfEefyr

fo'ys"k.k dh fjiksVZ ds vulq kj] vkslhih

mi;ksxdrkZvksa esa Lru dSalj dh laHkkouk

esa FkksM+h c<+ksrjh crkbZ xb]Z tks igys ds

mi;ksxdrkZvksa esa ugha Fkh]62 ysfdu blds

ckn vejhdk esa fd, x, ,d fo'kky

v/;;u esa ,slh fdlh c<+ksrjh dh fjiksVZ

ugha feyhA63 dqN v/;;uksa esa áweu

iSfiyksekokbjl ¼,pihoh½ Mh,u, ikfS t+fVo

vkslhih mi;ksxdrkvZ ksa esa xHkk'Z k; xzhok

dSalj dk tksf[ke c<+us dh fjiksVZ nh gS]

ysfdu tks ,pihoh Mhu, uSxsfVo gSa] muesa

4.3 Page 33

▲back to top

;g tksf[ke ugha gSA59 ,d lfEefyr

fo'ys"k.k us n'kkZ;k fd] vkslhih

mi;ksxdrkZvksa esa xHkk'Z k; xzhok dSalj

tksf[ke c<+ tkrk gS vkjS blds mi;ksx

dh c<+rh le;kof/k ds lkFk lkFk ;g

tksf[ke Hkh c<+rk g]S ysfdu mi;skx NksM+

nsus ls tksf[ke de gks tkrk gSA ;g

tksf[ke 10 lky ckn mu yksxksa ds cjkcj

gks tkrh g]S ftUgksua s bldk mi;ksx dHkh

u fd;k gksA64dsoy izkstLS Vkstu okys

iRz ;kjksi.k ,oa batSD'ku Hkh dbZ ns'kksa esa

ipz fyr gaSA fMiks eSMªkDS lhizkstLS Vªksu ,sflVsV

batDS 'ku ds yacs le; rd mi;ksx dk

lca a/k gfÏ;ksa dh det+ksjh ls gS] ysfdu

blds iHz kkoksa dks] ;fn iw.krZ ;k ugha rks

dkQh gn rd] mi;ksx jksdus ij gVk;k

tk ldrk gSA fd'kksj mez ds

mi;ksxdrkZvksa esa mudh gfÏ;ksa ds nzO;eku

;k cM+s gksus ij gÏh VwVus ds tksf[ke ij

blds izHkko vKkr gaSA65

,pvkboZ h@,M~l ds lkFk th jgh

efgykvksa es]a gkeksuZ lca a/kh xHkZ fujks/kdksa

vkjS vkbZ;wMh ds [krjksa ds lcwr de gSa]

ysfdu miyC/k v/;;uksa ds vuqlkj buds

ifz rdwy LokLF; izHkko de gh gaS] ftlesa

,pvkboZ h laØfer efgykvksa esa chekfj;ksa

ds c<+us ;k vlaØfer lgHkkfx;ksa esa

,pvkboZ h laØe.k QyS us tSls tksf[keksa esa

c<+ksrjh dh lHa kkouk Hkh de gh gAS 66

ysfdu ,d Øe jfgr ijh{k.k67 ds vuqlkj]

vkbZ;wMh mi;ksxdrkZvksa ds edq kcys gkeksuZ

lca a/kh xHkZ fujks/kd mi;ksxrkZvksa esa

,pvkboZ h lca af/kr chekjh c<+us vkSj e`R;q

dk tksf[ke c<+ tkrk gAS vÝhdk ds lkr

ns'kksa esa ,pvkboZ h&1 ljS ksfMLdkjS MUS V

nEifÙk;ksa ¼tgka naifÙk esa ,d lgHkkxh

,pvkbZoh laØfer gS½ ds lkFk fd, x,

,d izR;kf'kr dksgkVS Z v/;;u ds vulq kj]

gkeksZu lca a/kh xHkZ fujks/kdksa ds mi;ksx ls]

i#q "k ls efgyk dks vkSj efgyk ls iq#"k

dks] nksuksa fLFkfr;ksa esa vlaØfer lgHkkxh

dks ,pvkboZ h laØe.k dk tksf[ke c<+

tkrk gSA gkeksuZ lca a/kh xHkZ fujks/kdksa ds

,pvkbZoh laØe.k tksf[ke c<+kus ds fo"k;

ij fd, x, v/;;uksa ds ifj.kkeksa dh

O;k[;k djuk eqf'dy jgk gS] D;kfsa d

buds ifj.kkeksa dks my>kus okys igyqvksa

dks fu;af=r djus esa dkQh puq kfS r;ksa dk

lkeuk djuk iM+rk gSA o"kZ 2012 esa

vk;ksftr ,d fo'o LokLF; lLa Fkku

rduhdh lxa ks"Bh us fu"d"kZ fn;k fd]

,pvkboZ h laØfer ;k ,pvkbZoh laØe.k

dk mPp tksf[ke j[kus okyh efgykvksa esa

gkeksuZ lca a/kh xHkZ fujks/kdksa ds mi;ksx ij

jksd ugha yxkuh pkfg,] ysfdu mlus

dsoy izktSLVkstu batSD'ku yxokus okyh

efgykvksa ds fy, foLrr` Li"Vhdj.k tkjh

fd;k] D;ksfa d blds ,pvkbZoh laØe.k ij

izHkko Li"V ugha gaSA69

gkykafd xHkZ fujks/kd mi;ksx ds dkj.k

xaHkhj LokLF; tksf[ke c<+us dh lHa kkouk

vlkekU; gS] blls gksus okys l{w e izHkko

lk/kkj.k :i ls ns[ks x, gaS] fo'ks"kdj

lcls iHz kkoh xHkZ fujks/ku iz.kkfy;ksa eAsa

mnkgj.k ds fy,] gkekusZ lca a/kh xHkZ

fujks/kdksa vkSj vkbZ;wMh ds mi;ksx ls

ekfld /keZ jDrlzko vfu;ferrk,a vDlj

ns[kh tkrh gSa] vkSj ekfld /keZ esa

vfu;ferrk ds dkj.k dqN {ks=ksa esa bu

i.z kkfy;ksa ds mi;ksx dks Lohd`fr ugha

feyrhA70 vke rkSj ij] gkykafd l{w e

izHkko NksVs gh gksrs gSa] muds dkj.k yksx

bu i.z kkfy;ksa dk mi;ksx ugha djuk pkgrs

vkSj ;gh budk mi;ksx NksM+ fn, tkus

dk dkj.k cu tkrs gSaA felky ds rkjS ij]

30&50 ifz r'kr efgyk,a buds l{w e izHkkoksa

;k LokLF; fparkvksa ds dkj.k] mi;ksx ls

12 ekg ds vanj gh] vkslhih ;k xHkZ

fujks/kd lbq Za dk mi;ksx NksM+ nsrh gaS]

gkykafd buesa ls dkQh efgyk,a tYn gh]

fdlh vU; idz kj ds xHkZ fujks/kd dk

mi;ksx djuk 'kq# dj nsrh gSaA71

4.4 Page 34

▲back to top

ppkZ

fpfdRlh; O;o/kkuksa esa] vius vusd

ldkjkRed ifj.kkeksa ds dkj.k xHkZ fujks/ku

vf}rh; gSA itz uu fodYi puq ko ,d

ewyHkwr ekuo vf/kdkj gS] vkjS efgykvksa

dks ckj ckj xHkZ /kkj.k] Lru iku djkus]

cPpksa dh ns[kjs[k djus ls eqfDr ns dj]

xHkZ fujks/kd tSaMj lekurk dh vksj ,d

fo'kky dne dk lwpd gSA blh idz kj]

de cPpksa okys ifjokj] tgka gj cPps ds

fy, mi;qDr lla k/ku miyC/k gksa]

ykHknk;d g]S rFkk lekt esa iztuu'khyrk

nj esa deh vkSj /kheh tula[;k c<+ksrjh ls

lkekftd vkjS vkfFkdZ mUufr rFkk

LFkkuh; i;kZoj.k ds lja {k.k ij gksus okys

iHz kko Hkh egRoiw.kZ gaSA

efgykvksa ds LokLF; vkSj mÙkjthfork ij

xHkZ fujks/kd mi;ksx ds iHz kkoksa ds lcwr

fof'k"V :i ls egRoiw.kZ gaSA gekjk vuqeku

gS fd xHkZ fujks/kd mi;ksx ds dkj.k

vuk;kl xHkkZ/kku dks jksd dj] mlds

dkj.k efgykvksa dks ckj ckj] xHkkZoLFkk ds

[krjksa dk lkeuk djus ls cpkdj] fiNys

20 o"kksaZ es]a fodkl'khy ns'kksa esa ekr` e`R;q

l[a ;k esa yxHkx 40 izfr'kr dh fxjkoV

vkbZ gAS blds vfrfjDr] vf/kd cPpksa

okyh efgykvksa esa] ftuesa de cPpksa okyh

efgykvksa ds edq kcys ilz fw r lca a/kh tksf[ke

dh lHa kkouk vf/kd gksrh gS] esa tUekas dh

l[a ;k dks jksd dj vkjS vljq f{kr xHkZ

lekiu esa deh ykdj Hkh] ekr` eR` ;q la[;k

de djus esa enn feyh gAS 12 o"kksaZ dh

vkSlr le;kof/k es]a gekjk vuqeku gS fd

fodkl'khy ns'kksa esa xHkZ fujks/kdksa dk

mi;ksx c<+us ls izfr 100]000 thfor

tUeksa ij] ekr` eR` ;q ds tksf[ke esa 28

ifz r'kr dh deh vkbAZ

fodflr ns'kksa esa xHkZ fujks/kd mi;ksx ds

dkj.k thou j{kk ds izHkko iwjs gks pqds gaS

vkjS Hkfo"; esa ekr` e`R;q jksdus vkSj ekr`Ro

lca a/kh vLoLFkrk de djus ds izHkko mUgha

ns'kksa rd lhfer gSa tgka itz uu'khyrk njsa

vf/kd gSa] tgka ifjokj fu;kstu dh viw.kZ

vko';drk,a vf/kd gaS vkSj tgka xHkZ

lekiu xSj dkuwuh rFkk vDlj vljq f{kr

gksrk gSA ,sls vf/kdka'k ns'k mi&lgkjk

vÝhdk esa fLFkr gaS] vkjS ;g vk'p;Ztud

ugha gS fd fo'o Hkj esa gksus okyh ekr`

e`R;qvksa esa bl {ks= dk va'k] o"kZ 1980 ls

2008 ds chp 23 izfr'kr ls c<+dj 52

ifz r'kr gks x;kA72 nks Lora= fo'ys"k.kksa29]30]

ftuesa vyx vyx i.z kkfy;ksa dk mi;ksx

fd;k x;k] dk ,d gh fu"d"kZ fudyk %

fodkl'khy ns'kksa esa ifjokj fu;kstu viw.kZ

vko';drkvksa ds lekiu ls ekr` e`R;q esa

30 izfr'kr dh deh ykbZ tk ldrh gSA

;g vuqeku xHkZ fujks/kdksa ds lHa kkfor

vYikof/k ;ksxnku dks c<+k&p<+k dj O;Dr

djrk gS D;ksfa d viw.kZ vko';drkvksa dks

dHkh Hkh iwjk ugha fd;k tk ldrkA ysfdu

;g xHkZ fujks/kdksa ds nh?kZdkfyd ;ksxnku

ij [kkeks'k g]S D;ksfa d mPp iztuu'khyrk

ns'kksa esa xHkZ fujks/kdksa dh vo';drk le;

ds lkFk c<+xs hA fo'ks"kdj xzkeh.k {ks=ksa esa

tgka LokLF; los kvksa dk cqfu;knh <kapk

i;kZIr ugha gSa] ogka ekr` e`R;q jksdus ds

fy, ifjokj fu;kstu ,d lLrk ,oa

izHkkodkjh mik; gS D;ksfa d dqN oSdfYid

O;o/kkuksa dh rjg] blds fy, tfVy

rduhdksa ds mi;ksx dh vko';drk ugha

gksrhA73

izlodky] uotkr f'k'kvq ksa vkSj cky

LokLF; ds lna HkZ esa xHkZ fujks/ku ds ykHk

nks xHkZ /kkj.kksa ds chp varj c<+kus ls izkIr

gksrs gaSA izek.k n'kkrZ s gSa fd] fodkl'khy

ns'kksa es]a fiNys tUe ds 6 ekg ds vanj gh

nwljs xHkk/Z kku ds dkj.k] vlkef;d tUe

vkjS tUe ds le; de ot+u ds tksf[ke

nks xq.kk c<+ tkrs gSaA tc ge Hkwz.k fodkl

vkjS o;Ld thou esa ân; jksx vkSj fny

ds nkSjs dh O;kidrk ds chp lca a/k dks

4.5 Page 35

▲back to top

ns[krs gSa rc bl tqM+ko dk egRo vkSj

vf/kd c<+ tkrk gSA74

fiNys cPps ds tUe vkjS vxys xHkkZ/kku

ds chp varj j[kus dk uotkr f'k'kq dh

mÙkjthfork ls lca a/k fo[;kr gS vkSj bls

vDlj ifjokj fu;kstu esa fuos'k djus ds

ihN]s egRoiw.kZ dkj.k ds :i esa iz;ksx

fd;k tkrk gSA blds eqdkcys] NksVs varj

ds ckn cPpksa ij ¼1&4 o"kZ vk;q½ gksus okys

iHz kkoksa ds fo"k; esa de tkudkjh gAS blds

vfrfjDr] f'k'kq dky esa mÙkjthfork dh

lHa kkouk vkjS Hkh de gks tkrh g]S ;fn

nwljk cPpk igys cPps ds tUe ds 2 o"kZ

ds vanj gh tUe ys ysrk gAS ;g nksgjs

iHz kko mi&lgkjk vÝhdk ds mPp

itz uu'khyrk okys ns'kksa esa cky LokLF;

dk;ZØeksa ds fy, vR;ar egRoiw.kZ gSa] tgka

yxHkx 60 izfr'kr cPpksa ds cM+s vkSj NksVs

HkkbZ&cgu gksrs gSa vkSj tgka 1 o"kZ vk;q ls

vf/kd ds cPpksa dh eR` ;q] 5 o"kZ ls de

vk;q ds cPpksa dh gksus okyh e`R;q dk 30

ls 50 izfr'kr fgLlk gSA

izlodkfyd] uotkr f'k'kqvksa vkSj cky

LokLF; ds lca a/k esa xHkZ fujks/kdksa ds

mi;ksx dk ize[q k ;ksxnku] xHkZ /kkj.kksa dh

l[a ;k dks fu;af=r djus ds :i esa gqvk gS

ftll]s igys ¼ftu ds igys dksbZ tUe

ugha gvq k½ vkSj vkf[kj ¼ftu ds ckn dksbZ

tUe ugha gqvk½ esa tUe ysus okys cPpksa ds

vuqikr esa c<+ksrjh gqbZ gSA ysfdu nks tUeksa

ds chp ds varj ij xHkZ fujks/kdksa ds iHz kko

fujk'kktud jgs gSaA bldk ,d dkj.k gS]

dqN ns'kksa esa ifjokj dks lhfer j[kus ds

fy, ulcanh ij t+ksj nsuk] ftlds dkj.k

nks tUeksa ds chp varj djus okyh

iz.kkfy;ksa dk mi;ksx lhfer gks x;kA

izloksÙkj ifjokj fu;kstu los kvksa ij

vR;f/kd t+ksj nsus dh vko';drk gS vkjS

nks tUeksa ds chp varj dks c<+kok fn,

tkus ds ;w,l,M (USAID) vkjS

MCY;w,pvks (WHO) }kjk mBk, x, dne

dk ge Lokxr djrs gaSA75 ;g i;z kl

fo'ks"kdj vÝhdk ds fy, dkQh ykHknk;d

gks ldrk gS] tgka nks tUeksa ds chp i;kIZ r

varj j[kus dks cgrq egRo fn;k tkrk gSA

fpfdRlh; fo'ks"kKksa }kjk vDlj xHkZ

fujks/kdksa ds LokLF; ij gksus okys Bksl

ykHk vuns[ks dj fn, tkrs gaS] 'kk;n

blfy, D;ksfa d blds izek.k] dqN fof'k"V

i.z kkfy;ksa ds xjS &xHkZ fujks/ku LokLF;

ykHkksa dks NksM+dj] tulkaf[;dh; fo'ks"kKksa

}kjk] xjS &fpfdRlh; if=dkvksa esa izdkf'kr

fd, x, gaSA vuns[kk djus ds ihNs ,d

vkjS dkj.k ;g gks ldrk g]S fd xHkZ

fujks/kd ikz |S ksfxdh vPNh rjg ls LFkkfir

gS vkjS ;g dk;Z{ks= vc jkspd ugha jgkA

blds vfrfjDr] ifjokj fu;kstu dh

t+ksjnkj iSjoh djus dk laca/k tula[;k

fu;a=.k ls gS] tks vc yksdkpkj ds vu:q i

ugha le>k tkrkA bl fo"k; ij yacs

le; ls pqIih ds ifj.kkeLo:i] ifjokj

fu;kstu dk;ZØeksa ds fy, varjk"Z Vªh;

vkfFkZd lg;ksx vkjS leFkZu esa Hkkjh deh

vkbZ gAS bl vuns[kh ds dkj.k] ekr` ,oa

cky LokLF; ds lna HkZ esa cgrq cM+h dher

pdq kuh iM+h gS] fo'ks"kdj vÝhdk eAsa

gekjk ekuuk gS] fd bl vlra qyu dks

lca ksf/kr djus dk le; vk pdq k gAS

y[s kd

tslh us y[s k dh ;kstuk cukbAZ lHkh y[s kdksa us

y[s k ds vyx vyx va'kksa ij dke fd;kA

erHksn

ge ?kks"k.kk djrs gaS fd gekjs chp dksbZ erHksn

ugha gSA

vkHkkj

ge vU;syh jkslkl&cewMZ st+ dks ilz odkfyd

LokLF; ds va'k esa lg;ksx nsus ds fy, /kU;okn

nsrs gaSA ,Vh dh lgHkkfxrk fcy ,Msa fefyUMk

xsVl~ }kjk tkSu gkiS fdUl Cyew cxZ Ldwy vkWQ

ifCyd gYS Fk dks fn, x, vkfFkZd lg;ksx ds

dkj.k laHko gks ikbZA

4.6 Page 36

▲back to top

lanHkZ

1 Koenig MA, Fauveau V, Chowdhury AI, Chakraborty J,

Khan MA. Maternal mortality in Matlab, Bangladesh,

1976–85. Stud Fam Plann1988; 19: 69–80.

2 Bhatia J. Levels and causes of maternal mortality in

southern India. Stud Fam Plann 1993; 24: 310–18.

3 Wee DW, Mullany LC, Katz J, Khatry SK, LeClerq SC,

Tielsch JM. Pregnancy-related mortality in southern

Nepal between 2001 and 2006: independent estimates

from a prospective, population-based cohort and a

direct sisterhood survey. Am J Epidemiol 2010; 172:

855–60.

4 Atrash HK, Koonin LM, Lawson HWA, Franks AL, Smith

JC. Maternal mortality in the United States, 1979–1986.

Obstet Gynecol 1990; 76: 1055–60.

5 Cecatti J, Correa-Silva EPB, Milanez H, Moraise SS,

Souza JP. The associations between inter-pregnancy

interval and maternal and neonatal outcomes in Brazil.

Matern Child Health J 2008; 12: 275–81.

6 Jain AK. Measuring the effect of fertility decline on the

maternal mortality ratio. Stud Fam Plann 2011; 18:

247–60.

7 Fortney J. The importance of family planning in

reducing maternal mortality. Stud Fam Plann 1987; 18:

109–14.

8 Trussell J, Pebley A. The potential impact of changes in

fertility on infant, child and maternal mortality. Stud Fam

Plann 1984; 15: 267–80.

9 Winikoff B, Sullivan M. Assessing the role of family

planning in reducing maternal mortality. Stud Fam

Plann 1987; 18: 128–43.

10 National Institute of Population Research and Training,

ORC Macro. Bangladesh maternal health services and

maternal mortality survey 2001. Dhaka, Bangladesh,

and Calverton, MD: NIPORT, ORC Macro, 2003.

11 Magadi M, Diamond I, Madise N. Analysis of factors

associated with maternal mortality in Kenyan hospitals.

J Biosoc Sci 2001; 33: 375–89.

12 Yerushalmy J, Palmer C, Kramer M. Studies in

childbirth mortality: age and birth as factors in puerperal

fatality. Public Health Rep 1940; 55: 1195–20.

13 Ujah IAO, Aisien OA, Mutihir JT, Vanderjagt DJ, Glew

RH, Uguru VE. Factors contributing to maternal

mortality in North-central Nigeria: a seventeen-year

review. Afr J Reprod Health 2003; 9: 27–39.

14 Tuncer RA, Erkaya S, Sipahi T, Kutlar I. Maternal

mortality in a maternity hospital in Turkey. Acta Obstet

Gynecol Scand 1995; 74: 604–06.

15 Mhango C, Rochat R, Arkutu A. Reproductive mortality

in Lusaka, Zambia, 1982–83. Stud Fam Plann 1986;

17: 243–51.

16 Fikree F, Midhet F, Sadruddin S, Berendes H. Maternal

mortality in different Pakistani sites: ratios, clinical

causes and determinants. Acta Obstet Gynecol Scand

1997; 16: 637–45.

17 Garenne M, Mbaye K, Bah MD, Correa P. Risk factors

for maternal mortality: a case-control study in Dakar

hospitals (Senegal). Afr J Reprod Health 1997; 1: 14–

24.

18 Bouvier-Colle MH, Ouedraogo C, Dumont A,

Vangeenderhuysen C, Salanave B, Decam C. Maternal

mortality in West Africa: rates, causes and substandard

care from a prospective survey. Acta Obstet Gynecol

Scand 2001; 80: 113–19.

19 Conde-Agudelo A, Belizán JM. Maternal morbidity and

mortality associated with interpregnancy interval: cross

sectional study. BMJ 2000; 321: 1255–59.

20 Conde-Agudelo A, Rosas-Bermudez A, Kafury-Goeta

AC. Effects of birth spacing on maternal health: a

systematic review. Am J Obstet Gynecol 2007; 196:

297–308.

21 Singh S, Sedgh G, Hussain R. Unintended pregnancy:

worldwide levels, trends and outcomes. Stud Fam

Plann 2010; 41: 241–50.

22 Sedgh G, Henshaw S, Singh S, Åhman E, Shah IH.

Induced abortion: estimated rates and trends

worldwide. Lancet 2007; 370: 1338–45.

23 Shah I, Ahman E. New estimates and trends regarding

unsafe abortion mortality. Int J Gynaecol Obstet 2011;

115: 1338–45.

24 WHO. Unsafe abortion. Global and regional estimates

of the incidence of unsafe abortion and associated

mortality in 2008. Geneva: World Health Organization,

2011.

25 Ross J, Blanc AK. Why aren’t there more maternal

deaths? A decomposition analysis. Matern Child Health

J 2012; 16: 456–63.

26 Darroch J, Singh S, for the Guttmacher Institute.

Estimating unintended pregnancies averted from

couple-years of protection (CYP). New York:

Guttmacher Institute, 2011.

27 WHO. Trends in maternal mortality: 1990 to 2008.

Geneva: World Health Organization, 2010.

28 Ahmed S, Li Q, Liu L, Tsui AO. Maternal deaths averted

by contraceptive use: an analysis of 172 countries.

Lancet 2012; published online July 10.

http://dx.doi.org/10.1016/S0140-6736(12)60478-4.

29 Collumbien M, Gerressu M, Cleland J. Non-use and

use of ineffective methods of contraception. In: Ezzati

M, Lopez AD, Rodgers A, Murray CJL, eds.

Comparative quantification of health risks, global and

regional burden of disease attributable to selected

major risk factors. Geneva: World Health Organization,

2004: 1255–320.

30 Singh S, Darroch JE, Ashford LS, Vlassoff M. Adding it

up: the costs and benefits of investing in family planning

and maternal and newborn health. New York:

Guttmacher Institute, 2009.

31 Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta

AC. Birth spacing and risk of adverse perinatal

outcomes: a meta-analysis. JAMA 2006; 295: 1809–23.

32 DeFranco EA, Stamilio DM, Boslaugh SE, Gross GA,

Muglia LJ. A short interpregnancy interval is a risk

factor for preterm birth and its recurrence. Am J Obstet

Gynecol 2007; 197: 264.e1–e6.

33 Rodrigues T, Barros H. Short interpregnancy interval

and risk of spontaneous preterm delivery. Eur J Obstet

Gynecol Reprod Biol 2008; 136: 184–88.

34 Auger N, Daniel M, Platt RW, Luo ZC, Wu Y, Choinière

R. The joint influence of marital status, interpregnancy

interval, and neighborhood on small for gestational age

birth: a retrospective cohort study. BMC Pregnancy

Childbirth 2008; 8: 7.

35 Nabukera SK, Wingate MS, Kirby RS, et al.

Interpregnancy interval and subsequent perinatal

outcomes among women delaying initiation of

childbearing. J Obstet Gynaecol Res 2008; 34: 941–47.

36 Grisaru-Granovsky S, Gordon ES, Haklai Z, Samueloff

A, Schimmel MM. Effect of interpregnancy interval on

adverse perinatal outcomes—a national study.

Contraception 2009; 80: 512–18.

37 Cecatti JG, Correa-Silva EP, Milanez H, Morais SS,

Souza JP. The associations between inter-pregnancy

interval and maternal and neonatal outcomes in Brazil.

Matern Child Health J 2008; 12: 275–81.

38 Williams EK, Hossain MB, Sharma RK, Kumar V,

Pandey CM, Baqui AH. Birth interval and risk of stillbirth

or neonatal death: findings from rural north India. J Trop

Pediatr 2008; 54: 321–27.

39 Adam I, Ismail MH, Nasr AM, Prins MH, Smits LJ. Low

birth weight, preterm birth and short interpregnancy

interval in Sudan. J Matern Fetal Neonatal Med 2009;

22: 1068–71.

40 Smits LJ, Essed GG. Short interpregnancy intervals

and unfavourable pregnancy outcome: role of folate

depletion. Lancet 2001; 358: 2074–77.

41 Zhu BP, Rolfs RT, Nangle BE, Horan JM. Effect of the

interval between pregnancies on perinatal outcomes. N

Engl J Med 1999; 340: 589–94.

42 Rutstein SO. Further evidence of the effects of

preceding intervals on neonatal, infant and under-five-

years mortality and nutritional status in developing

countries: evidence from the Demographic and Health

Surveys. Demographic and Health Surveys working

paper 2008 no. 41. Calverton, MD: Macro International,

2008.

43 Rutstein SO, Johnson K, Conde-Agudelo A, Rosas-

Bermudez A. Effect of birth spacing on infant and child

mortality: a systematic review and meta-analysis. WHO

technical consultation and scientific review of birth

spacing; Geneva; June 13–15, 2005.

44 Hobcraft J, McDonald JW, Rutstein SO. Child spacing

effects on infant and early child mortality. Popul Index

1983; 49: 585–618.

4.7 Page 37

▲back to top

45 Hobcraft J, McDonald JW, Rutstein SO. Demographic

determinants of infant and child mortality. Popul Stud

1985; 39: 363–85.

46 UN Department for Economic and Social Information

Analysis, Population Division. The health rationale for

family planning: timing of births and child survival. New

York: United Nations, 1994.

47 Rutstein SO. Effects of preceding birth intervals on

neonatal, infant and under-five years mortality and

nutritional status: evidence from demographic and

health surveys. Int J Gynaecol Obstet 2005; 89 (suppl

1): S7–24.

48 Mahy M. Childhood mortality in the developing world: a

review of evidence from the Demographic and Health

Surveys. Demographic and Health Surveys

comparative reports no. 4. Caverton, MD: ORC Macro,

2003.

49 Dewey K, Cohen R. Does birth spacing affect maternal

and child nutritional status? A systematic review

literature review. Matern Child Nutrition 2007; 3: 151–

73.

50 Canning D, Ozaltin E, Finlay JE. Association of

maternal health with infant mortality, child

anthropometric failure, diarrhea and anaemia in low and

middle income countries. Boston: Harvard School of

Public Health, 2011.

51 Hobcraft J. Does family planning save children’s lives?

Technical background paper for the International

Conference on Better Health for Women and Children

through Family Planning; Kenya, Nairobi; October 5–9,

1987.

52 Kost K, Forrest JD, Harlap S. Comparing the health

risks and benefits of contraceptive choices. Fam Plann

Perspect 1991; 23: 54–61.

53 Peterson HB. Sterilization. Obstet Gynecol 2008; 111:

189–203.

54 Farley TMM, Rowe PJ, Meirik O, Rosenberg MJ, Chen

J-H. Intrauterine devices and pelvic inflammatory

disease: an international perspective. Lancet 1992;

339: 785–88.

55 Beining RM, Dennis LK, Smith EM, Dokras A. Meta-

analysis of intrauterine device use and risk of

endometrial cancer. Ann Epidemiol 2008; 18: 492–99.

56 Castellsagué X, Diaz M, Vaccarella S, et al. Intrauterine

device use, cervical infection with human

papillomavirus, and risk of cervical cancer: a pooled

analysis of 26 epidemiological studies. Lancet Oncol

2011; 12: 1023–31.

57 Franks AL, Beral V, Cates W Jr, Hogue CJR.

Contraception and ectopic pregnancy risk. Am J Obstet

Gynecol 1990; 163: 1120–23.

58 Vessey M, Yeates D, Flynn S. Factors affecting

mortality in a large cohort study with special reference

to oral contraceptive use. Contraception 2010; 82: 221–

29.

59 Petitti DB. Combination estrogen-progestin oral

contraceptives. N Engl J Med 2003; 349: 1443–50.

60 Cibula D, Gompel A, Mueck AO, et al. Hormonal

contraception and risk of cancer. Hum Reprod Update

2010; 16: 631–50.

61 Collaborative Group on Epidemiological Studies of

Ovarian Cancer. Ovarian cancer and oral

contraceptives: collaborative reanalysis of data from 45

epidemiological studies including 23 257 women with

ovarian cancer and 87 303 controls. Lancet 2008; 371:

303–14.

62 Collaborative Group on Hormonal Factors in Breast

Cancer. Breast cancer and hormonal contraceptives:

collaborative reanalysis of individual data on 53 297

women with breast cancer and 100 239 women without

breast cancer from 54 epidemiological studies. Lancet

1996; 347: 1713–27.

63 Marchbanks PA, McDonald JA, Wilson HG, et al. Oral

contraceptives and the risk of breast cancer. N Engl J

Med 2002; 346: 2025–32.

64 International Collaboration of Epidemiological Studies

of Cervical Cancer. Cervical cancer and hormonal

contraceptives: collaborative reanalysis of individual

data for 16 573 women with cervical cancer and 35 509

women without cervical cancer from 24 epidemiological

studies. Lancet 2007; 370: 1609–21.

65 WHO. WHO statement on hormonal contraception and

bone health. Wkly Epidemiol Rec 2005; 35: 302–04.

66 Curtis KM, Nanda K, Kapp N. Safety of hormonal and

intrauterine methods of contraception for women with

HIV/AIDS: a systematic review. AIDS 2009; 23 (suppl

1): S55–67.

67 Stringer EM, Levy J, Sinkala M, et al. HIV disease

progression by hormonal contraceptive method:

secondary analysis of a randomized trial. AIDS 2009;

23: 1377–82.

68 Heffron R, Donnell D, Rees H, et al. Use of hormonal

contraceptives and risk of HIV-1 transmission: a

prospective cohort study. Lancet Infect Dis 2012; 12:

19–26.

69 WHO. Hormonal contraception and HIV: technical

statement.

http://www.who.int/reproductivehealth/topics/family_pla

nning/Hormonal_contraception_and_HIV.pdf (accessed

Feb 24, 2012).

70 Glasier AF, Smith KB, van der Spuy ZM, et al.

Amenorrhea associated with contraception-an

international study on acceptability. Contraception

2003; 67: 1–8.

71 Ali MM, Cleland J. Contraceptive switching after

method-related discontinuation. Stud Fam Plann 2010;

41: 129–33.

72 Hogan MC, Foreman KJ, Naghavi M, et al. Maternal

mortality for 181 countries, 1980–2008: a systematic

analysis of progress towards Millennium Development

Goal 5. Lancet 2010; 375: 1609–23.

73 Goldie SJ, Sweet S, Carvalho N, Natchu UCM, Hu D.

Alternative strategies to reduce maternal mortality in

India: a cost-effectiveness analysis. PLoS Med 2010; 7:

e1000264.

74 Barker DJ. The origins of the development origins

theory. J Intern Med 2007; 261: 412–17.

75 WHO. Report of a WHO technical consultation on birth

spacing: Geneva, Switzerland, 13–15 June, 2005.

WHO/RHR/07.1. Geneva: World Health Organization,

2007.

4.8 Page 38

▲back to top

ifjokj fu;kts u & 4

itz uu LokLF; ,oa ifjokj fu;kts u ds vkfFkdZ ifj.kke

MsfoM dSfuUx] Vh ikSy 'kYq V~t+

geus bl y[s k e]sa iztuu LokLF; lsokvksa rd igqap ds lglkz Cnh fodkl y{; 1] 2 vkjS 3 ij gksus okys

iHz kkoksa ds iez k.kksa dk v/;;u fd;k gSA bu lglkz Cnh fodkl y{;ksa ds varxZr] vR;ar xjhch o Hkw[k

mUewyu] loOZ ;kih ikz Fkfed f'k{kk vkjS tSaMj lekurk rFkk efgykvksa ds l'kfDrdj.k ds mís'; fufgr

gSaA ikfjokfjd Lrj ij] ckaXykns'k ds *eryc* vkSj ?kkuk ds *uojkaSxks* {ks= esa fd, x, fu;af=r ijh{k.kksa

ds ifj.kke crkrs gaS fd] ifjokj fu;kstu lsokvksa rd c<+rh igaqp ds dkj.k iztuu'khyrk esa deh vkrh

gS vkjS nks tUeksa ds chp varj c<+kus esa Hkh enn feyrh gAS eryc esa fd, x, v/;;u e]sa yca s le;

rd yksxksa ds lkFk laidZ cuk, j[kus ds ckn] irk pyk] fd fu;af=r {ks=ksa ds ifj.kkeksa ds edq kcys] ftu

{ks=ksa esa yksxksa dh ifjokj fu;kstu lsokvksa rd vPNh igaqp gksrh g]S ogka efgykvksa dh vkenuh] laifÙk

vkSj 'kkjhfjd nOz ;eku lwpdkad rFkk cPpksa ds Ldwy tkus vkjS 'kkjhfjd nOz ;eku lwpdkad vkSj csgrj gks

tkrs gSaA o`gr~ vFkZ'kkL= Lrj ij ns[kk tk,] rks itz uu'khyrk esa deh vkus ds dkj.k] ;qok fuHkjZ rk de

gksus vkjS efgykvksa dh orS fud Je esa Hkkxhnkjh ls] vkfFkZd mUufr c<+rh gAS

izLrkouk

o"kZ 2006 es]a 2015 rd iztuu LokLF;

rd loZO;kih igqap LFkkfir djus dks]

lglzkCnh fodkl y{;ksa esa 'kkfey fd;k

x;k] ftlls fd ekr` LokLF; dks csgrj

cuk;k tk ldAs gekjs fo'ys"k.k ds

vuqlkj] itz uu LokLF; vkSj ifjokj

fu;kstu rd igqap LFkkfir djus l]s dqN

vU; lglkz Cnh fodkl y{; izkIr djus esa

Hkh enn fey ldrh gS] tlS s fd vR;ar

xjhch o Hkw[k mUewyu] loZO;kih izkFkfed

f'k{kk izkIr djuk] tSaMj lekurk dks

c<+kok nsuk vkjS efgykvksa dk

l'kfDrdj.k] vkSj i;kZoj.kh; lrrrk

lfq uf'pr djukA

ekYFkwloknh rdZ ds vuqlkj] tul[a ;k

o`f) ds dkj.k vi;kZIr lla k/kuksa ij ncko

vkSj Hkh c<+ tkrk gS] ftlls fd Hkw[k vkSj

eR` ;q dh lHa kkouk,a c<+ tkrh gaSA1 vkfFkdZ

v/;;uksa dk t+ksj bl fo"k; ij jgk gS fd

D;k tulkaf[;dh; cnyko dk dkj.k

dsoy tul[a ;k esa c<+ksrjh gS ;k mlls

vf/kd dqN vkjS HkhA2 LokLF; los kvksa esa

l/q kkj vkSj c<+rs vueq kfur thoudky ds

ifj.kkeLo:i] tul[a ;k esa c<+ksrjh ds

vkfFkZd iHz kko mPp itz uu'khyrk ;k

vkioz klu ds dkj.k tul[a ;k esa o`f) ls

dkQh vyx gaS( vr% tul[a ;k o`f) ds

lkekftd vkjS vkfFkZd izHkkoksa dk vuqeku

yxkus ds fy, mlds lkz sr Kkr gksuk

vko';d gAS 3]

[kkst j.kuhfr vkSj p;u ds ekinaM

geus o"kZ 1980 ls 2012 ds chp gj Hkk"kk esa

izdkf'kr lacaf/kr y[s kksa ds fy,] ocS vkWQ

lkbaZl ,sMa fjlpZ isilZ bu bdukSfeDl

¼RePEc½ dk vUos"k.k fd;kA bl vUos"k.k esa

geus **tula[;k ,oa vkfFkdZ fodkl**]

**tulkaf[;dh; ykHkka'k**] **ifjokj fu;kstu

vkjS vkfFkdZ ifj.kke**] vkSj **itz uu'khyrk

,oa vkfFkdZ ifj.kke** tSls 'kCnksa dk iz;ksx

fd;kA geus bl y[s k esa of.kZr] nks

iz;ksxkRed ifjokj fu;kstu dk;ØZ eksa dks

[kkstus ds fy, **uojkUS xks vkjS ifjokj

fu;kstu** vkSj **eryc vkjS ifjokj fu;kstu**

'kCnksa dh enn yhA geus vius p;u esa

iz;ksxkRed v/;;uksa ij gh t+ksj fn;k] ftuls]

ikfjokfjd ;k o`gr~ vkfFkZd Lrj ij g,q

vkfFkdZ ifj.kkeksa ij iztuu'khyrk ds iHz kko

ds iez k.k ikz Ir gksrs gksAa

vkuS ykbuZ idz k'ku

tqykbZ 10] 2012

http://dx.doi.org/10.1016/S014

0-6736(12)60827-7

;g ifjokj fu;kstu ij fy[ks x,

ikap ys[kkas dh J`a[kyk dk pkFS kk

ys[k gAS

fMikVZeaSV vkWQ Xykcs y gYS Fk ,sMa

ikiS yq s'ku] gkjoMZ Ldwy vkWQ

ifCyd gYS Fk] ckLS Vu] ,e,]

;w,l, ¼ikz Qs - Mh dSfuUx]

ih,pMh½(

vkjS fMikVZeaSV vkWQ bdukfS eDl]

;sy ;wfuoflZVh] U;w gos u] lhVh]

;w,l, ¼izkQs - Vh-ih-'kqYV~t+]

ih,pMh½

i=kpkj ds fy, laidZ%

izkQs - Mh dfS uUx] fMikVZeSaV vkWQ

Xykcs y gYS Fk ,sMa ikiS yq s'ku]

gkjoMZ Ldwy vkWQ ifCyd gYS Fk]

ckLS Vu] ,e, 02115] ;w,l,

dcanning@hsph.harvard.edu

ifjf'k"V ds fy, vkSuykbZu ns[ksa

4.9 Page 39

▲back to top

iez q[k lans'k

 ifjokj fu;kstu dk;ØZ eksa ds dkj.k xzkeh.k

caXykns'k vkjS ?kkuk tSls xjhc {ks=ksa esa

iztuu'khyrk njksa esa deh ykbZ tk ldrh gAS

 itz uu'khyrk esa deh dk tMq +ko efgyk

LokLF;] mudh vkenuh] vkjS oSrfud jkst+xkj

esa mudh Hkkxhnkjh ls gSA

 ftu efgykvksa dks ?kj ij ifjokj fu;kstu ,oa

LokLF; lsok,a miyC/k u jgh gks]a muds

edq kcys] ftUgsa ;g lsok,a miyC/k gaS] muds

cPpksa dk LokLF; csgrj gksrk gS vkSj mUgsa

vPNh f'k{kk izkIr gksrh gSA

 itz uu'khyrk vkjS cky e`R;q esa deh ds

ifj.kkeLo:i orS fud vk;q ds yksxksa dh la[;k

c<+rh g]S ftldk vkfFkdZ fodkl ij

ldkjkRed iHz kko iM+rk gSA

 efgyk dh oSrfud jkst+xkj esa Hkkxhnkjh] cky

LokLF;] vkSj f'k{kk ds {ks= esa ifjokj Lrjh;

O;ogkfjd cnykoksa ds dkj.k og` r~ vkfFkZd vkjS

tulkaf[;dh; ykHk ikz Ir gksrs gaSA

itz uu LokLF; esa l/q kkj vkjS ifjokj

fu;kstu rd igaqp ds dkj.k] vke LokLF;

esa lq/kkj rFkk iztuu'khyrk esa deh ls]

vFkOZ ;oLFkk dks Hkh ykHk gksrk gSA izloiwoZ

vkjS izloksÙkj ns[kjs[k los kvksa ds dkj.k

ek¡vksa vkjS cPpksa ds LokLF; esa Hkh l/q kkj

vkrk gAS ifjokj fu;kstu rd igqap u

dsoy dqy itz uu'khyrk dks de djrh gS

¼eryc] vk;q vk/kkfjr itz uu'khyrk njksa

ds vuq:i ,d efgyk ds thoudky esa

gksus okys cPpksa dh vkSlr l[a ;k½] cfYd

ifjokj fu;kstu ls cgqr de vk;q

¼eryc] 18 o"kZ vk;q ls de mez½ esa ek¡

cuus okyh vkjS cgqr ckj tUe nsus okyh

efgykvksa esa mPp tksf[ke tUe nsus dh

lHa kkouk Hkh de gksrh gAS xHkZ fujks/kdksa dk

iz;ksx nks cPpksa ds chp varj j[kus esa Hkh

enn djrk gS] ftlls ek¡vksa vkSj cPpksa ds

LokLF; esa ykHk gksrk gS] vkjS ekr` o cky

e`R;q de jgrh gSA5 de cPps gksus ij ek¡

& cki gj cPps ds LokLF;] iks"k.k vkjS

f'k{kk ij T+;knk iSlk vkjS le; ns ldrs

gSaA ckykoLFkk e]sa cPpksa ds LokLF; vkSj

f'k{kk ij fd;k x;k fuos'k] cPpksa ds

o;Ld thou esa 'kkjhfjd vkSj lKa kukRed

fodkl rFkk f'k{kk ifj.kkeksa vkjS vkenuh

ds fy, dkQh izHkkodkjh gks ldrk gAS 6&8

gkykafd izeq[k :i ls okafNr iztuu'khyrk

esa deh ds dkj.k itz uu'khyrk esa deh

vkrh gS]9 itz uu LokLF; vkSj ifjokj

fu;kstu dk;ZØe ifjokjksa dks] muds

iztuu'khyrk y{; izkIr djus esa enn

dj ldrs gaSA fu;af=r {ks=ksa ds eqdkcys]

caXykns'k ds eryc vkSj ?kkuk ds uojkSUxks

{ks= esa] ,d tSls iztuu LokLF;] cky

LokLF; vkjS ifjokj fu;kstu dk;ZØeksa ds

dkj.k] nksuksa {ks=ksa esa dqy iztuu'khyrk esa

yxHkx ifz r efgyk ,d cPps dh deh

vkbZA10]11 vr% iztuu LokLF; ,oa ifjokj

fu;kstu dk;ZØe xjhc {ks=ksa esa Hkh

iHz kkodkjh gks ldrs gSaA

ifjokj fu;kstu rd igaqp vkSj ekr` ,oa

cky LokLF; los kvksa ds dkj.k] ifjokjksa ds

fy, dbZ idz kj ds vkfFkZd ykHk gksrs gSa]

tks dsoy iztuu'khyrk vkSj LokLF; esa

l/q kkj rd gh lhfer ugha gaSA mnkgj.k ds

fy,] iztuu'khyrk rFkk efgykvksa vkSj

cPpksa ds LokLF; ij csgrj fu;a=.k ds

dkj.k efgykvksa dks viuh dq'kyrk,a c<+kus

ds volj feysxa s ftlls fd os thouHkj esa

gksus okyh viuh vkenuh c<+k ldrh gaSA

blds vfrfjDr] dqy itz uu'khyrk esa

deh ls lHa kor% ek¡ & cki vkjS vf/kd

lia fÙk tksM+ ldrs gaS tks os vU;Fkk ugha

dj ikrs] fo'ks"kdj ;fn ;g lia fÙk fdlh

cPps ls visf{kr lg;ksx vkjS ns[kjs[k ds

cnys muds thou esa lg;ksx ns ldAs

vius izR;sd cPps ds LokLF; vkjS f'k{kk esa]

ek¡ & cki tks ekuoh; iwfa t fuos'k djrs

gaS] mlesa Hkh ifjokj fu;kstu lca af/kr

tkudkjh o lsok,a miyC/k djkus okys

iztuu LokLF; dk;ZØeksa ds dkj.k c<+ksrjh

4.10 Page 40

▲back to top

gks ldrh gSA12&14 varr%] ;fn

iztuu'khyrk esa deh] cky mÙkjthfork esa

of` ) ls T+;knk gks tk,] rks lkenq kf;d ;k

lexz Lrj ij lkekU; lra yq u izHkko vk

ldrs gSa] ftlds ifj.kkeLo:i] fiNyh

ihf<+ ds edq kcys] oreZ ku lenq k; esa] ;oq k

yksxksa dh l[a ;k esa deh vk tk,xhA

itz uu'khyrk esa deh vkus ds nks n'kdksa

ds vanj] igys ls de ;qok dke dh mez

esa igqapsaxsA blds dkj.k dke djus okys

;oq kvksa dh l[a ;k esa deh vk,xh] ftlls

lHa kor%] osru esa c<+ksrjh gksxh ¼;g ekurs

gq, fd vU; mRiknd igyw vkSj rduhdksa

esa dksbZ cnyko ugha gksrk½A

vkenuh c<+kus ds fy, dq'kyrk,a c<+kuk]

HkkSfrd lia fÙk ,df=r djuk] vkjS cPpksa

ds LokLF; vkSj f'k{kk esa fuos'k djuk rHkh

gks ik,xk tc ikfjokfjd Lrj ij ,d

lla k/ku dh txg nwljs lalk/ku ,df=r

fd, tk,a] tks fd lHa ko gAS ysfdu bl

izdkj ds dkjf.kd tqM+koksa dks dsoy

voyksfdr vkadM+ksa ds vk/kkj ij ekiuk

efq 'dy gSA lhfer l[a ;k esa ;qokvksa ds

orS fud dk;Z esa tqM+us ds ckt+kj ij gksus

okys iHz kko lexz Lrj ij gh ns[ks tk

ldrs gSa] gkykafd bu iHz kkoksa dk vk|S ksfxd

Økafr ds ckn ds ;qx esa egRo gS fd ugha]

bl fo"k; ij loky gSA15

ftu {ks=ksa esa lkekftd iz;ksx ds :i esa

ifjokj fu;kstu vkjS iztuu LokLF;

dk;ZØe ykxw fd, tk pqds gSa] ogka ds

ikfjokfjd Lrj lo{sZ k.k vkSj tulkaf[;dh;

vkadM+ksa ls izkIr lw{e vFkZ'kkL= izek.k bu

dk;ZØeksa ds visf{kr izHkkoksa dk vkdyu

djus esa enn djrs gSaA bu {ks=ksa esa

efgykvksa ds lna HkZ esa] o;Ld ekuoh;

{kerkvksa ds :i esa ikfjokfjd cpr c<+us

dh lHa kkouk gS] ogka cPpksa dh ekuoh;

lia fÙk esa Hkh c<+ksrjh gksxh] vkjS HkkfS rd

ifwa t dks los kfuo`fÙk ds ckn ds mi;ksx ds

fy, ,df=r fd;k tk ldrk gAS ftu

{ks=ksa esa ifjokj fu;kstu vkjS itz uu

LokLF; dk;ZØe ykxw ugha fd, x, gSa]

ogka ds edq kcy]s bu {ks=ksa esa] efgykvksa ds

LokLF; vkjS mRikndrk esa c<+ksrjh ls

ifjokj dks mlds cPpkas ds fy, vkSj

vf/kd lla k/ku izkIr gks ldrs gSaA vkjS

blds ifj.kkeLo:i] cky LokLF; vkSj

f'k{kk ij gksus okys fuos'k esa c<+ksrjh ls

vxyh ih<+h ds fy, lHa kkouk,a Hkh c<+asxh]

ftlls Jfedksa dh mRikndrk vkSj iwfa t

,df=r djus dh {kerkvksa esa fodkl ds

dkj.k xjhch gVsxh] blls lexz vkfFkZd

fodkl gksxkA

ifjokj vkSj lkenq kf;d Lrj ij iHz kko

ifjokj fu;kstu vkjS iztuu LokLF;

lla k/kuksa rd c<+rh igqap ds i;z ksxkRed

egRo dk vuqeku yxkus ds fy,] ,slh

iz.kkyh dh vko';drk gS ftlls fd ek¡ &

cki dh ilna ] vkfFkdZ o lkekftd of` Ùk]

voljksa] ;k ifjokj }kjk oSrfud jkst+xkj

esa Hkkxhnkjh ds vizR;{k fu/kkjZ d rRo]

fuos'k O;ogkj] vkjS mudh ilan ds vU;

ifj.kkeksa ls gVdj] fdlh fof'k"V ifjokj

fu;kstu dk;ZØe ;k uhfr ds dkj.k

itz uu'khyrk vkSj ikfjokfjd LokLF; esa

vkusokys cnykokas dh igpku dh tk ldsA

fu;af=r {ks=ksa ds eqdkcys] ftu {ks=ksa esa

ifjokj fu;kstu dk;ZØe ykxw fd, x, gSa

ogka ds ifj.kke bu dk;ZØekas ds dkj.kh;

iHz kkoksa ds fy, lcls csgrjhu iez k.k nsrs

gaSA

caXykns'k ds eryc ft+ys es]a 1977 ls

1996 ds chp] dqy 141 xkaoksa esa ls 71 esa

ifjokj fu;kstu dk;ZØe ykxw fd, x,A

lkeqnkf;d LokLF; dk;dZ rkZvksa dks bu

xkaoksa es]a 2 lIrkg esa ,d ckj] iRz ;sd ilz o

vk;q dh 'kknh'kqnk efgyk ds ?kj tkdj

mUgsa fofHkUu xHkZ fujks/kd vkjS cky ,oa

5 Pages 41-50

▲back to top

5.1 Page 41

▲back to top

ekr` LokLF; los k,a o lkefx;z ka nsus ds {ks=

esa izf'kf{kr fd;k x;k] ftlesa 1982 ds

ckn dqN vkSj los k,a Hkh tksM+h xbaZA

dk;ZØe 'kq# gksus ls igys] 1974 dh

tux.kuk ds vuqlkj] lHkh 141 xkaoksa esa

,d tSlh mÙkjthfork itz uu'khyrk

¼cky&efgyk vuqikr½] vkSlr f'k{kk Lrj

vkSj vkoklh; fo'ks"krk,a FkhaA dk;ZØe ds

iHz kkoksa ds vkdyu dks igys dsoy tUe

njksa rd gh lhfer j[kk x;k]16 ysfdu

yacs le; rd laidZ cuk, j[kus ds dkj.k

igys ls Hkh vf/kd foLr`r iez k.k izkIr

g,q A ftu xkaoksa esa dsoy ljdkjh ifjokj

fu;kstu los kvksa rd igaqp Fkh muds

eqdkcys ftu xkaoksa esa dk;ZØe ykxw fd;k

x;k] ogka dk;ZØe ykxw djus ds 19 o"kZ

ckn] cky & efgyk vuiq kr esa 16 ifz r'kr

dh deh vkbZ & ;g ifj.kke xkao vkjS

o"kksaZ ds fuf'pr iHz kkoksa ds lek;kstu ds

ckn izkIr gqvkA dk;ZØe ykxw fd, x,

mipkj {ks=ksa esa itz uu'khyrk esa rsth ls

vkbZ deh] dqy itz uu'khyrk esa vkbZ deh

ds lkFk gh izkIr gbq ]Z ftlesa 1974 vkSj

1996 ds chp fu;af=r xkaoksa esa] cky &

efgyk vuqikr ¼thfor ifjokj l[a ;k dk

lpw dkad½ 39 ifz r'kr Fkk tcfd tgka

dk;ZØe ykxw fd;k x;k] mu xkaoksa esa 55

izfr'kr FkkA rqyuk {ks=ksa ds edq kcys tgka

dk;ZØe ykxw fd;k x;k] mu xkaoksa esa

jgus okyh 35&54 o"khZ; efgykvksa us o"kZ

1996 e]sa 23 ifz r'kr de cPpksa dks tUe

fn;k & ;g ifj.kke O;fDrxr] ikfjokfjd

vkSj lkenq kf;d cqfu;knh <kapksa tSls

fu;af=r igyqvksa ds lek;kstu ds ckn

ikz Ir fd, x,A tSlk fd visf{kr Fkk] vkt

rd tUes cPpksa dh la[;k ij dk;ZØe ds

izHkko efgykvksa dh mez c<+us ds lkFk lkFk

¼tSls tSls muds tUe nsus ds o"kksZa ds

dk;ZØe rd igaqp ds vuiq kr esa c<+ksrjh

gbq Z½ c<+rs gaSA gkykafd 55 o"khZ; ;k mlls

vf/kd mez dh efgykvksa }kjk tUe fn,

tkus okys cPpksa dh l[a ;k ij FkksM+k gh

iHz kko gvq k D;ksfa d ;g efgyk,a viuh

izlo vk;q esa bu dk;ZØeksa dk ykHk ugha

¼;k vkaf'kd :i ls½ mBk ikbZ Fkha ¼fp=

1½A o"kZ 1996 esa] fu;af=r {ks=ksa ds

eqdkcys] ifjokj fu;kstu dk;ZØe okys

xkaoksa esa 35&54 o"kh;Z efgykvksa }kjk tUes

5 o"kZ vk;q ls de ds cPpksa dh eR` ;q 30

izfr'kr de Fkh] vkSj bu efgykvksa ds 17

ifz r'kr de thfor cPps Fks18 & tks fd

dk;ZØe lca a/kh iztuu'khyrk esa 23

ifz r'kr deh ls de gAS ;g varj cky

eR` ;q esa vkbZ dqy deh dks iwjk djrk gSA

dk;ZØe dks efgykvksa ds fy, ykHk dh

ut+j ls ns[kk tk, rks] fu;af=r {ks=ksa ds

edq kcys] ftu {ks=ksa esa dk;ZØe ykxw fd;k

x;k] ogka 25&54 o"khZ; efgykvksa esa vkSlr

'kkjhfjd nOz ;eku lwpdkad ¼ch,evkbZ½ 1

fdyks@,e2 ls vf/kd FkkA eryc {ks= esa

fd, x, ,d vkSj iuS y v/;;u ds

ifj.kke crkrs gaS fd efgykvksa ds

ch,evkbZ esa 1 fdyks@,e2 l/q kkj ¼os

ftuds o"kZ 1996 es]a fu;af=r tulewg esa

vkSlr ch,evkbZ 18-4 kg@,e2 Fkk½ dk

tqM+ko e`R;q tksf[ke esa 17 ifz r'kr deh ls

gAS 19 vk;q vkjS f'k{kk dks leku j[krs gq,]

fu;af=r xkaoksa ds edq kcys] ftu xkaoksa esa

dk;ZØe ykxw fd;k x;k] ogka dh

efgykvksa esa o"kZ 1996 esa izfr ekg vkenuh

40 ifz r'kr vf/kd ikbZ xbAZ fu;af=r {ks=

dh efgykvksa ds eqdkcys dk;ZØe {ks= dh

oSrfud jkstx+ kj esa 'kkfey izlo mez dh

efgyk,a T+;knk LoLFk vkSj T+;knk mRiknd

irz hr gqbaZA ;g ykHk oSrfud jkstx+ kj esa

'kkfey efgyk ds fo'ks"krkvksa ds vk/kkj ij

vkadM+ksa esa l/q kkj ds ckn Hkh tkjh jgkA

dk;ZØe xkaoksa dh fookfgr efgykvksa ds

ifjokjksa esa fu;af=r {ks=ksa ds eqdkcys izfr

o;Ld 25 ifz r'kr vf/kd laifÙk Fkh vkSj

mudh lia fÙk esa eosf'k;ksa ds ctk,] tks

cky et+nwjh dh miyC/krk ij fuHkZj djrs

5.2 Page 42

▲back to top

gaS] edku vkSj vU; foÙkh; lia fÙk] fVdkÅ

miHkksDrk oLr,q a vkSj vkHkw"k.k 'kkfey FksA16

ifjokj fu;kstu dk;ZØe okys xkaoksa ds

?kjksa esa ihus vkSj /kksus ds ikuh dh lfq o/kk

vf/kd gS] ftlls efgykvksa vkjS cPpksa ds

le; vkjS Je dh cpr gksrh gSA

efgykvksa dh vkenuh vkSj cPpksa ds

ch,evkbZ vkjS f'k{kk ij gksus okys dk;ØZ e

ds izHkko gekjh vo/kkj.kk dk leFkZu djrs

gSa fd iztuu LokLF; lsokvksa rd igqap ds

dkj.k lglkz Cnh fodkl y{; 1] 2 vkjS 3

ikz Ir djus esa lg;ksx feyk gSA dk;ZØe

xkaoksa ds 7&14 o"kh;Z cPpksa us fu;af=r

xkaoksa ds eqdkcys vf/kd o"kZ f'k{kk izkIr dh

Fkh vkjS bu xkaoksa ds 1&14 o"kh;Z cPpksa dk

vkSlr ch,evkbZ Hkh vf/kd Fkk ¼ftls vU;

igyqvksa dks lek;ksftr fd, fcuk] tSaMj

vk/kkfjr ,t ukSjeykbTZ +M t+MS j Ldksj ds

:i esa O;Dr fd;k tkrk gS½A ysfdu ek¡ &

cki dh f'k{kk] ?kj dh lja puk] vkjS xkao

esa miyC/k vk/kkjHkwr lfq o/kkvksa dk

lek;kstu djus ds ckn] ;g varj dsoy

yM+dksa dh f'k{kk ¼0-5 ,lMh dk varj½

vkSj yM+fd;ksa ds ch,evkbZ ¼0-42 ,lMh

dk varj½ ds fy, egRoiw.kZ FkkA18 vr%]

bl dk;ZØe ds egRoiw.kZ vizR;{k ykHk Fks]

ftuds dkj.k tulkaf[;dh; cnykoksa esa

rsth+ vkbZ vkjS ftudk tqM+ko efgykvksa ds

fy, csgrj LokLF; vkSj mRikndrk] ifz r

o;Ld] ikfjokfjd lia fÙk esa c<+ksrjh] vkjS

o"kZ 1996 esa dk;ZØe xkaoksa esa jgus okyh

efgykvksa ds cPpksa ds fy, csgrj f'k{kk

vkSj LokLF; ls gAS ysfdu iq#"kksa vkjS ;oq k

efgykvksa ¼15&24 o"kZ mez½ ds osru e]sa

dk;ZØe ds dkj.k dksbZ cnyko ugha vk;k]

tks fd bl xzkeh.k {ks= esa ekYFkwloknh

tul[a ;k ncko ds vuq:i visf{kr Fkk]

tgka d`f"k mRikndrk t+ehu ds ,d u,

vkdkj ij fuHkjZ gAS 16

mÙkjh ?kkuk ds uojkUS xks esa fd, x, ,sls

gh ,d v/;;u esa] lenq k;ksa dks fu#ís';

:i ls pkj lewgksa esa ckaV fn;k x;k %

ftu ds ?kj ij efgyk mipkfjdk,a tkdj

fookfgr efgykvksa dks xHkZ fujks/kd vkSj

LokLF; los k,a miyC/k djkrh gSa( ftudh

t+#q xsyq uked usr`Ro uSVodZ ls igpku

djkbZ xbZ ftlls fd iq#"kksa dks lkewfgd

ppkZvksa ds ek/;e ls LokLF; vkSj itz uu

lca a/kh eqíksa ij 'kkfey fd;k tk, vkSj

los k,a iznku djus ds fy, lkeqnkf;d

LokLF; Lo;alsfo;ksa dks HkrhZ fd;k tk

ld(s tgka dk;ZØe ykxw fd, x,( vkjS

tgka dksbZ Hkh dk;ZØe ykxw ugha fd;k

x;k ¼fu;af=r lewg½A11 ikz sxzke ds igys

dqN o"kksaZ esa ¼1993&99½ nksuksa dk;ZØeksa ds

l;a kstu esa vk;&q fof'k"V tUe nj ij

iHz kko MkysA nks cPpksa ds chp varj j[kus

dh pkg dks xHkZ fujks/kd i;z ksx dk ,d

vke dkj.k crk;k tkrk gSA ysfdu nks

tUeksa ds chp varj c<+us ls dsoy xHkkZ/ku

nsjh ls gksrk gS] u fd efgyk }kjk mlds

thoudky esa tUe fn, x, cPpksa dh

l[a ;k esa lekuqikfrd deh vkrh gSA

uojkUS xks es]a fefJr dk;ZØeksa dk xHkZ

fujks/kd mi;ksx ds eqdkcys tUe nj ij

dk;ØZ e ykxw fd, x, {ks=

fu;af=r {ks=

x.q kkad

vk;q lewg ¼o"kZ½

fp= 1 % caXykns'k ds eryc ft+ys esa ifjokj fu;kstu dk;ZØe ykxw fd;s x, xkaoksa vkjS fcuk dk;ØZ e

okys xkaoksa esa o"kZ 1996 rd] fookfgr efgykvkas }kjk tUe fn, x, dqy cPpksa dh la[;k

lHkh xq.kkad 1996 esa ifjokj fu;kstu dk;ZØe ykxw fd, x, xkaoksa ¼ftls o"kZ 1977 esa ykxw fd;k x;k½

vkjS mu xkaoksa esa jgus okyh efgykvk]sa tgka lk/kkj.k ljdkjh ifjokj fu;kstu fDyhfud lsok,a Fkha

¼fu;af=r {ks=½] ds iztuu'khyrk esa varj ds lk/kkj.k U;wure&oxZ vuqeku gSaA =qfV ckj vuqekfur

dk;ZØe izHkkoksa esa 95 izfr'kr lhvkbZ n'kkZrh gS] ftUgsa los{Z k.k :ijs[kk ds vulq kj lES iy ot+u ds fy,

lek;ksftr fd;k x;kA ;g tks'kh vkjS 'kqYV~t+17 ds ,d ys[k ls mudh vueq fr ds ckn fy;k x;kA

5.3 Page 43

▲back to top

T+;knk iHz kko ns[kk x;kA ;g vLi"V

ifj.kke efgykvksa ds thou esa] vYikof/k

xHkZ fujks/kd mi;ksx ls gVdj] ifjokj

fu;kstu vkjS ifjokj LokLF; dk;ZØeksa ds

iztuu'khyrk vkSj ikfjokfjd ifj.kkeksa ijs

nh?kZdkfyd izHkkoksa ds v/;;u dh

vko';drk ij t+ksj nsrs gaSA20 uojkUS xks ls

ikz Ir ckn ds vkadM+ksa ds fo'ys"k.k] fu;af=r

{ks=ksa ds eqdkcys] nksuksa dk;ZØe ykxw fd,

x, xkaoksa esa jgus okyh efgykvksa ds

thoudky esa] cPpksa ds tUe esa 9 ifz r'kr

deh n'kkrZ s gaS] ftldk eryc gS fd tUeksa

ds chp varj c<+kus ls NksVs lia w.kZ ifjokj

gksus dh lHa kkouk gSA ysfdu] t+q#xsyw ds

vf/kdrj iHz kko dsoy f'kf{kr efgykvksa ds

NksVs lewg rd lhfer gaSA21 gkykafd ;g

ifj.kke n'kkrZ s gSa fd ifjokj fu;kstu

dk;ZØe ls vfr&xkz eh.k vkSj xjhc

vÝhdh {ks= esa itz uu'khyrk de gks

ldrh g]S vkjS mipkfjdk }kjk ?kj ?kj

tkus ls uotkr f'k'kq eR` ;q esa deh vkrh

gS]22 vHkh bu dk;ZØeksa ds LokLF; vkjS

vkfFkZd izHkkoksa ds nh?kZdkfyd v/;;u

lekIr ugha g,q gSaA

;g ifj.kke n'kkrZ s gaS fd ifjokj fu;kstu

los k,a iztuu'khyrk] LokLF;] vkjS vkfFkZd

ifj.kkeksa dks izHkkfor dj ldrh gSa( ysfdu

mi&lgkjk vÝhdk

yfS Vu vejhdk vkjS n dSfjfc;u

nf{k.k ,f'k;k

iwohZ ,f'k;k

o"kZ

fp= 2 % pkj fodkl'khy {ks=ksa esa dyq fuHkZjrk vuiq kr] 1950 & 2010

dqy fuHkZjrk vuqikr 15 & 64 o"khZ; tula[;k esa izfr 100 yksxksa esa ls 0 & 14 o"khZ; vkjS 65 o"kZ ;k mlls

vf/kd mez okys yksxksa dh la[;k gAS ;g vkda M+s laHkkfor la;Dq r jk"Vª fo'o tula[;k ¼2010 la'kks/ku½ ls

fy, x, gaSA31

,d Øejfgr fu;af=r dk;ZØe v/;;u]

ftlds varxZr bfFk;ksfi;k esa xHkfZ ujks/kd

xksfy;ka vkSj dUMkse miyC/k djk, x,] ds

vulq kj igaqp LFkkfir djus ds xHkZ

fujks/kd mi;ksx ;k 3 o"khZ; tUe njksa ij

dksbZ iHz kko ugha ns[ks x,A bl ifj.kke dk

,d lHa kkfor dkj.k gks ldrk gS fd ;gka

yksxksa esa xHkZ fujks/kd lbq aZ dk mi;ksx

izpfyr gS] tks dk;ØZ e esa miyC/k ugha

djkbZ xbAZ 23 tks vkykspukRed v/;;u

ifjokj fu;kstu dk;ZØeksa ds izHkkoksa dk

v/;;u djrs gSa vkjS ifj.kkeksa dks my>kus

okys igyvq ksa dks fu;af=r j[krs gSa] mu esa

ykHkdkjh iHz kko fey tkrs gSaA mnkgj.k ds

fy,] dksyfEc;k esa ifjokj fu;kstu los kvksa

ds dkj.k efgyk,a vius igys xHkkZ/kku dks

LFkfxr djus esa lQy jgha] ftlds dkj.k

os orS fud dke esa vkjS vf/kd Hkkxhnkjh dj

ldha]24 vkjS ft+EckCos esa eksckby Dyhfud

vkjS leqnk;ksa ds chp forj.k djus ls xHkZ

fujks/kd mi;ksx esa of` ) gqbZA25

ifjokj fu;kstu dk;ØZ eksa ds izHkkoksa ds

vkjS vf/kd fo'oluh; lw{e vFk'Z kkfL=d

iez k.k ,df=r fd, tk jgs gaSA ifjokj

fu;kstu vkSj ekr` ,oa cky LokLF;

dk;ZØeksa ds xjS &iz;ksxkRed vkjS Øejfgr

iz;ksxkRed vkadM+ksa ds ijh{k.k ls & de

ls de eryc vkjS uojkSUxks esa fd, x,

nh?kZdkfyd lkekftd iz;ksxksa esa & bu

nksuksa dk;ØZ eksa ds ekr` ,o cky dY;k.k ls

tqM+s ykHk Li"V gksrs gSaA de vkenuh okys

ns'kksa esa gksus okys O;kid ikfjokfjd

los{Z k.kksa dh l[a ;k o xq.koÙkk esa Hkh dkQh

c<+ksrjh gqbZ g]S vkSj ;g vkadM+s Hkkoh

dk;ZØeksa dh cslykbu ;kstuk cukus vkjS

ewY;kadu djus esa egRoiw.kZ jgsxa sA26&30 ;g

ikfjokfjd los{Z k.k fofHkUu tul[a ;k lewgksa

¼laiUu o xjhc] 'kgjh o xzkeh.k] vkjS

tutkrh; leqnk;½ ij gksus okys dk;ØZ e

iHz kkoksa ds vkdyu esa enn dj ldrs gaS]

ftlls ,sls dk;ZØe rS;kj fd, tk ldrs

5.4 Page 44

▲back to top

gaS tks budks mu yksxksa rd igqapk, tks

buls ykHk mBk ldrs gSa vkjS bl izdkj

LokLF; ,oa lkekftd dY;k.k ykHk forj.k

esa vlekurkvksa dks de djs]a ;k ifjokj

fu;kstu vkjS iztuu ,oa cky LokLF;

dk;ØZ eksa dh {kerk c<+kus esa enn djsAa

o`gr~ vFkZ'kkL=h; ifj.kke

l)S kafrd :i l]s ikfjokfjd Lrj ij

ifjokj fu;kstu dk;ZØeksa ds ekius ;ksX;

iHz kko jk"Vªh; vk; ds lexz Lrj ij gksus

pkfg,] gkykafd izHkkokas ds chp varfØZ;k ds

dkj.k vafre ifj.kke ij izHkko iM+ ldrk

gS] vkSj dqN iHz kko lHa kor% dsoy lexz

Lrj ij gh ikz Ir gksaxsA mnkgj.k ds fy,]

tul[a ;k of` ) ds dkj.k [kk|kUu vkjS

t+ehu dh dherksa ij ncko cu ldrk gS]

ftldk dsoy T+;knk cPpksa okys ifjokjksa

ij gh ugha] lHkh ij iHz kko gksxkA uojkSUxks

vkSj eryc esa pyk, x, dk;ZØe {ks=h;

Lrj ds dk;ZØe Fks vkjS muesa bu {ks=ksa esa

gksus okys lexz iHz kkoksa dks lfEefyr fd;k

x;k] ysfdu tula[;k esa cnyko ds dkj.k

vU; {ks=ksa esa viRz ;{k izHkko gks ldrs gSa &

tSls fd ioz klh LFkkukarj xeuA

lexz vkfFkdZ izHkkoksa ds ihNs ,d dkj.k

tul[a ;k vk;q <kaps esa iforuZ Hkh gAS

itz uu'khyrk esa fxjkoV ls igys eR` ;q njksa

esa fxjkoV vkrh gS] vr% 'kq#vkr esa cM+h

rsth+ ls tul[a ;k esa o`f) gksrh gSA dqy

tul[a ;k esa bl of` ) ds dkj.k] rst+h ls

'kgjhdj.k gksrk gS D;kfsa d 'kgjh {ks=ksa esa

eR` ;q la[;k ls T+;knk tUeksa dh la[;k c<+

tkrh gS vkjS xzkeh.k {ks=ksa ls yksx 'kgjksa esa

LFkkukarj.k djrs gaS] tgka tula[;k o`f)

vkjS dkexkjksa dh la[;k c<+us ls xzkeh.k

osru esa fxjkoV vk tkrh gAS 2

vf/kdrj fodkl'khy ns'kksa esa] cPpksa dh

l[a ;k cgqr T+;knk gksrh gS vkjS dkexkj

mez ds o;Ldksa dh l[a ;k deA cky eR` ;q

nj de gksus ls ;g fLFkfr vkjS Hkh fcxM+

tkrh gAS itz uu'khyrk esa deh vkus ls

;qok fuHkZjrk vuiq kr ¼16 o"kZ mez ls de

vk;q ds eqdkcys 16&64 o"kh;Z yksxksa dk

vuqikr½ fxj tkrk gS ftlds dkj.k

tul[a ;k esa dke djus dh mez dk fgLlk

c<+ tkrk gS vkSj ifz r O;fDr jk"Vªh;

vkenuh Hkh c<+rh gAS mi&lgkjk vÝhdk

dks NksM+dj] vf/kdrj fodkl'khy ns'kksa esa]

iztuu'khyrk esa fxjkoV vkus ls igys gh

dqy fuHkjZ rk vuiq kr ¼16 o"kZ ls de vkSj

65 o"kZ ls vf/kd mez ds yksxksa ds edq kcys

16&64 o"khZ; yksxksa dk vuqikr½ esa deh

vk pqdh gS ¼fp= 2½A gkykafd] tc

iztuu'khyrk nj izfrLFkkiu nj ¼cPpksa dh

og la[;k tks mudh izfrLFkkiuk ds fy,

vko';d gS] tgka itz uu vk;q esa igqapus

ls igys eR` ;q dh laHkkouk gks( ifz r efgyk

yxHkx nks cPps½ ls de gks tkrh gS rks

;qok fuHkZjrk nj de gks tkrh gS vkSj ;fn

itz uu'khyrk esa vkSj deh vkrh gS rks

mlds dkj.k o)` fuHkjZ rk nj c<+

tk,xhA32

vk;q l;a kstu iHz kkoksa ds vfrfjDr]

itz uu'khyrk esa deh ds dkj.k lexz Lrj

ij efgykvksa dh oSrfud dk;Z esa Hkkxhnkjh

ij Hkh izHkko iM+rk gS] vkSj ;g mPp

vkenuh ns'kksa esa orS fud dk;Z esa efgykvksa

dh Hkkxhnkjh esa c<+ksrjh ds ihNs ,d ize[q k

dkj.k gAS 33&35 rFkkdfFkr ,f'k;kbZ Vkbxj

ns'kksa ¼gkSax dkaSx] flxa kiksj] nf{k.k dksfj;k

vkSj rk;oku½ esa rsth+ ls g,q vkfFkdZ

fodkl ds ihNs orS fud dk;Z esa yksxksa dh

l[a ;k esa c<+ksrjh] ftldk ,d va'k Fkk

tul[a ;k esa dkexkj mez ds yksxksa dh

vuiq kr esa c<+ksrjh] efgykvksa dh Je oxZ

esa Hkkxhnkjh] vkjS f'k{kk izkfIrA36]37 gkykafd

tul[a ;k esa dkexkj mez ds yksxksa dk

vuiq kr vkjS efgykvksa dh Je oxZ esa

Hkkxhnkjh vfuf'pr :i ls c<+rs ugha jg

5.5 Page 45

▲back to top

ldrs vkSj mlds dkj.k vkfFkZd fodkl

Hkh c<+rk ugha jg ldrk] ysfdu fQj Hkh

;g vkfFkZd fodkl esa i;kIZ r mNky ykus

esa l{ke gks ldrk gAS

itz uu'khyrk esa deh ds dkj.k vR;ar

xjhc fodkl'khy ns'kksa esa efgyk dkexkjksa

dh l[a ;k ij de gh izHkko gksrk gS

D;kfsa d bu ns'kksa esa yxHkx lHkh efgyk,a

igys ls gh dke djrh gSaA xzkeh.k {ks=ksa esa

efgyk,a vf/kdrj ?kj ij dke djrh gSa

vkjS vke rkjS ij Lojkstx+ kj pykrh gaS ;k

vius ifjokj ds fy, vorS fud dk;Z

djrh gaSA ,slh fLFkfr esa] ifjokj ,d

mRiknu bdkbZ gksrk gS vkSj cPpksa dh

ns[kjs[k dke ds lkFk lkFk gh dh tkrh gS

& lHa ko gS fd blh dkj.k ls eryc esa

Je oxZ esa efgyk Hkkxhnkjh ij ifjokj

fu;kstu dk;ZØeksa ds lhfer izHkko jgs

¼dk;ZØe ds vf/kdka'k izHkko 25&54 o"khZ;

efgykvksa dh vkenuh ij Fks½A e/;e vkjS

mPp vkenuh Lrj ds ns'kksa esa dke dh

txg vkjS ?kj vke rkjS ij vyx vyx

gksrs gSa] vr% cPpksa dh ns[kjs[k dks dke ds

lkFk tksM+ ikuk lHa ko ugha gksrkA ysfdu]

bu fLFkfr;ksa esa Hkh] orS fud dk;Z esa

Hkkxhnkjh dk puq ko djuk dksbZ lk/kkj.k

fodYi ugha gSA ftu efgykvksa ds cPps

NksVs gksrs gSa] os lHa kor% vukSipkfjd vkSj

yphys le; okys dke djrh gaS] ysfdu

orS fud dke djuk NksM+rh ugha gSa]39]40

ftldk eryc gS fd oSrfud dk;Z esa

efgyk Hkkxhnkjh ij itz uu'khyrk esa

fxjkoV ds iHz kko eq[; rkSj ij 'kgjh {ks=ksa

esa f'kf{kr efgykvksa esa gh ns[ks tk ldrs gaSA

vk;q <kaps vkjS efgyk dkexkjksa ij

itz uu'khyrk esa deh ds izHkko tYn gh

ut+j vkus yxrs gaS vkSj bUgsa dbZ ns'kksa ds

dqy vkadM+ksa esa Hkh Li"V ns[kk tk ldrk

gAS yacs le; esa] csgrj itz uu LokLF;]

iztuu'khyrk esa deh] vkjS nks tUeksa ds

chp c<+s gq, varj ls gksus okys ykHk cPpksa

ds fy, csgrj iks"k.k] LokLF; vkSj f'k{kk

ds :i esa ns[ks tk ldsxa sA iztuu'khyrk

esa deh ds dkj.k iRz ;sd cPps ds fy,

miyC/k lalk/kuksa esa c<+ksrjh gks ldrh gSA

cPpksa dh f'k{kk esa fuos'k ds iHz kko mlds

cM+s gksus ij mldh vkenuh ij ns[ks tk

ldrs gSa] ftlesa Ldwy tkus ds izR;sd o"kZ

ls osru esa 10 izfr'kr rd dh c<+ksrjh

gksrh gSA41 cky LokLF; vkjS iks"k.k &

xHkk'Z k; ds vanj vkSj thou ds igys dqN

o"kkasZ esa & 'kkjhfjd vkjS lKa kukRed

fodkl ij izHkko Mkyrk gS vkjS varr%

o;Ld ds :i esa vkenuh ijA42&45 lexz

Lrj ij] ftu ns'kksa esa yach vk;q lHa kkO;rk

gS muesa NksVh vk;q lHa kkO;rk okys ns'kksa ds

eqdkcys T+;knk vkfFkZd mUufr gksrh gS]46

gkykafd ;g iHz kko blh dkj.k gS fd ugha]

bl ij fookn gAS 15 f'k'kvq ksa ds LokLF; esa

l/q kkj vkjS mlds vkfFkZd izHkkoksa ds chp

yacs varjky vkSj tul[a ;k rFkk dkexkjksa

dh mRikndrk ij iHz kkoksa ds dkj.k] lexz

vkadM+ksa ds vk/kkj ij fu"d"kZ fudkyuk

dfBu gks tkrk gAS

cPpksa vkSj ek¡vksa ds LokLF; esa l/q kkj ds

vkfFkZd izHkko bl ij fuHkZj djrs gSa fd

e`R;q vkjS o;Ld vLoLFkrk esa deh vkbZ gS

fd ugha vkjS thoudky yack gqvk gS fd

ughaA uotkr f'k'kq vkSj cky e`R;q nj esa

fxjkoV ls tul[a ;k vkSj ;oq k fuHkZjrk nj

esa c<+ksrjh gksrh gS] ftlls vYikof/k esa]

vkfFkdZ fodkl esa ck/kk vkrh gAS ysfdu

;fn ek¡,a vkjS cPps LoLFk gSa vkjS

iztuu'khyrk esa fxjkoV vkus ls igys ds

edq kcys muds Hkkoh thoudky yacs g,q gSa

rks vkfFkZd ykHkksa dh vis{kk dh tk ldrh

gSA o;Ld yackbZ ¼tks fd cfq u;knh LokLF;

dk ,d lpw d g½S n'kkrZ h gS fd uotkr

f'k'kq eR` ;q esa deh dk tqM+ko csgrj cky

LokLF; vkSj iks"k.k ls g]S 47 gkykafd

mi&lgkjk vÝhdk ds fy, 'kk;n ;g

tqM+ko ykxw ugha gSA48]49 vYikof/k e]sa cky

5.6 Page 46

▲back to top

LokLF; vkSj mÙkjthfork esa lq/kkj lHa kor%

;oq k fuHkZjrk c<+k ns vkjS izfr O;fDr

vkenuh ?kVk ns] vkSj csgrj LokLF; ds

dkj.k mRikndrk ykHk izkIr gksus esa

lHa kor% T+;knk le; yxsA50 ysfdu] ;gka

egRoiw.kZ eqík ;g gS fd] D;k iztuu

LokLF; vkSj cky mÙkjthfork esa l/q kkj

vius vki esa itz uu'khyrk de djus ds

fy, i;kIZ r gSaA51 cky mÙkjthfork esa

l/q kkj dk eryc gS fd] ifjokj

iztuu'khyrk esa deh ds ckotwn ftrus

cPps inS k djuk pkgrs Fks] os dj ldrs gSaA52

bu iHz kkoksa ds vkdkj ds vuqeku ,d

flE;yq s'ku ekWMy esa mi;ksx fd, x,

ftlesa ukbthfj;k esa ifz r efgyk ,d cPps

dh itz uu'khyrk nj esa deh ds tMq +koksa

dk ijh{k.k fd;k x;kA53 bl deh dk

tqM+ko 20 o"kkasZ ds ckn izfr O;fDr dqy

?kjsyw mRikn esa vk/kkj js[kk iwokuZ qeku ij

13-2 izfr'kr c<+ksrjh djsxh] tks 50 o"kksaZ

ckn nh?kZdkfyd iHz kkoksa ds dkj.k c<+dj

25-4 izfr'kr gks tk,xhA vkfFkZd fodkl

ds i;z ksxkRed v/;;uksa us n'kkZ;k gS fd

;oq k fuHkjZ rk vuiq kr esa deh vkSj

tul[a ;k esa dkexkj mez ds va'k esa

c<+ksrjh dk tqM+ko rst+h ls vkfFkZd fodkl

gksus ls gS]54 tks lHa kor% Hkkjr vkSj phu esa

vkbZ vkfFkdZ mNky ¼vk;&q <kapk iHz kkoksa ds

dkj.k phu esa dqy ?kjsyw mRikn 1-0

ifz r'kr izfr O;fDr izfr o"kZ dh nj ls c<+

jgk gS vkSj Hkkjr esa 0-7 ifz r'kr izfr o"kZ½

dks le>us esa enn dj ldrk gSA55

o`gr~ vFkZ'kkL= vkadM+s iztuu LokLF;]

ifjokj fu;kstu vkSj itz uu'khyrk esa deh

vkjS csgrj lexz vkfFkdZ ifj.kkeksa ds chp

tqM+ko n'kkZrs gSaA ysfdu xjhch mUewyu

vkjS ifjokj fu;kstu ds chp ,d nwljs

dks izHkkfor djus ds lca a/k ds fo"k; esa

ikfjokfjd Lrj ij foLrr` v/;;u djuk

vko';d gSA ifjokj Lrj ds ifj.kke

n'kkrZ s gSa fd vke rkjS ij iztuu LokLF;

,oa ifjokj fu;kstu los kvksa rd igaqp ds

dkj.k xjhc ifjokjksa dks ykHk gksrk gS] vkSj

efgyk l'kfDrdj.k ¼mnkgj.k ds fy,] ftls

iq#"kksa vkjS efgykvksa dh f'k{kk Lrj ds chp

varj ls ekik tk ldrk g½S ls bu lsokvksa

dh lQyrk ij izHkko iM+ ldrk gSA

itz uu LokLF; vkSj ifjokj fu;kstu lsokvksa

rd O;kid igqap ls eq[;r% xjhc ifjokjksa

dks ykHk feyuk pkfg, ftlls fd ih<+h nj

ih<+h xjhch dks c<+us ls jksdk tk lds]

gkykafd mi&tula[;kvksa esa bu dk;ZØeksa

ds iHz kko vyx gksus dh laHkkouk gSA

vc rd rks ge d`f"k mRikndrk esa o`f)

ds dkj.k t+ehu dh deh dh leL;k ls

cps gq, gaSA ysfdu] Hkfo"; esa Hkwe.Myh;

Lrj ij fLFkj lla k/kuksa dh vuiq yC/krk ds

dkj.k dbZ Hkh"k.k ekYFkwloknh puq kfS r;ka

inS k dj ldrh gaSA blesa ls ,d pqukSrh gS

O;kikfjd oLrqvksa] tSls fd thok'e baZ/ku

esa dehA tSls tSls bu O;kikfjd oLrvq ksa

dh miyC/krk esa deh vk,xh olS s oSls

buds nkeksa esa c<+ksrjh ds dkj.k ubZ [kkst

dks c<+kok feysxk ftlls fd blds

fodYiksa ds iHz kkoh mi;ksx vkjS fodkl esa

Hkh c<+ksrjh gksxhA fo'kky Lrj ij ouks]a

eRL; ikyu] ty Lrj vkSj okrkoj.k dk

fouk'k] fo'ks"kdj mRltuZ ds dkj.k

Hkwe.Myh; rkiØe esa o`f)] O;kikfjd

oLrvq ksa dh deh ls dgha T+;knk fparktud

eqís gSa] D;ksfa d bu lla k/kuksa ds lna HkZ esa

dher fu/kkfZ jr djus dh izfØ;k u gksus ds

dkj.k ckt+kj dh izfrfØ;k ds fy, dksbZ

ikz sRlkgu Hkh ugha gSA bl ekeys esa fo'ks"k

:i l]s iztuu'khyrk esa deh vkjS /kheh

tul[a ;k o`f) ds dqy ykHk gks ldrs

gSa]56]57 gkykafd izfr O;fDr c<+rh vkenuh]

tks iztuu'khyrk esa deh ds lkFk gh vkrh

g]S vius gh i;kZoj.kkh; ncko inS k djsxhA

5.7 Page 47

▲back to top

fu"d"kZ

itz uu'khyrk esa fxjkoV vkjS tula[;k

of` ) esa deh us mu ns'kksa esa dsUnhz ; Hkwfedk

fuHkkbZ gS tks ekYFkwloknh f'kdats ls cpus

esa dke;kc jgha vkSj ftudh vFkOZ ;oLFkk

vc fodkl dj jgh gSA58 ,f'k;k vkjS

vÝhdk ls izkIr izek.k n'kkZrs gaS fd

ifjokj fu;kstu rd igaqp ds

itz uu'khyrk ij egRoiw.kZ iHz kko gks ldrs

gaSA ifj.kkeLo:i iztuu'khyrk esa vkbZ

deh vkjS nks tUeksa ds chp csgrj varj ds

dkj.k ekr` vkSj cky LokLF; esa izR;{k

l/q kkj gksrk gS vkSj cPpksa ds 'kkjhfjd o

lKa kukRed fodkl] f'k{kk ifj.kkeksa] vkjS

o;Ld mRikndrk esa HkhA

iztuu'khyrk esa deh ds dkj.k izfr

O;fDr vkenuh esa Hkh c<+ksrjh gksrh gS]

ftlds ihNs dkj.k gS ;oq k fuHkZjrk nj esa

deh vkjS efgykvksa dh lkekftd vkjS

vkfFkdZ fLFkfr esa cnyko] ftlls tSaMj

vlekurk de gksrh gS vkSj efgykvksa dks

iztuu'khyrk esa fxjkoV vkus ls igys ds

edq kcys vkiS pkfjd dk;{Z ks= esa tMq +us ds

T+;knk volj izkIr gksrs gaSA bu rRdky

vkfFkdZ ykHkksa ds vfrfjDr] itz uu'khyrk

esa deh ds vkfFkZd fodkl ij nh?kdZ kfyd

iHz kko gksaxs tc LoLFk vkjS csgrj f'k{kk

izkIr vxyh ih<+h ds cPps Je cy ds :i

esa Hkkx ysaxsA

erHksn

ge ?kks"k.kk djrs gSa fd gekjs chp dksbZ erHksn

ugha gAS

vkHkkj

;g Ja`[kyk y[s k ofdZxa xiqz ehfVax vkWu

ikSiqy's ku] QfS eyh IyfS uax ,sMa vphoeaSV vkWQ n

feyfs u;e MSoyieaSV xksYl] psiy fgy] fnlacj

1&3] 2010 ds fy, rS;kj fd, x, y[s k ls

la'kksf/kr gSA y[s kd ml cSBd esa Hkkx ysus okys

yksxksa dh fVIif.k;ksa ds fy, vkHkkjh gaSA Mh-lh

vkjS Vh-ih-,l nksuksa dks lacaf/kr v/;;u ds fy,

fofy;e ,Msa ¶yksjk áwyVS QkmUMs'ku ls vkfFkZd

lg;ksx feykA

y[s kd

Mh-lh vkSj Vh-ih-,l us lacaf/kr idz kf'kr dk;ksaZ

dh [kkst dh vkjS Mh-lh us iLz rkouk] og` r~

vFk'Z kkL=h; ifj.kkeksa vkjS fu"d"kZ dk igyk ikz :i

fy[kkA Vh-ih-,l us eryc v/;;u ds ifj.kkeksa

dk fo'y"s k.k fd;k vkjS ikfjokfjd rFkk

lkenq kf;d Lrj ij gksus okys iHz kkoksa okys va'k

dk igyk izk:i fy[kkA Mh-lh vkSj Vh-ih-,l

nksuksa us feydj fopkjdrkZvksa dh fVIif.k;ksa ds

vk/kkj ij leh{kk dks vafre :i fn;kA

5.8 Page 48

▲back to top

lanHkZ

1. National Research Council. Population growth and economic development:

policy questions. Washington, DC: National Academy Press, 1986.

2. Dyson T. Population and development: the demographic transition. London:

Zed Books, 2010.

3. Kelley AC, Schmidt RM. Aggregate population and economic growth

correlations: the role of the components of demographic change.

Demography 1995; 32: 543–55.

4. Bloom DE, Freeman RB. Economic development and the timing and

components of population growth. J Policy Model 1988; 10: 57–81.

5. Cleland J, Conde-Agudelo A, Peterson H, Ross J, Tsui A. Contraception

and health. Lancet 2012; published online July 10.

http://dx.doi.org/10.1016/S0140-6736(12)60609-6.

6. Barker DJP. The fetal and infant origins of adult disease. London: BMJ

Books, 1992.

7. Bleakley H. Disease and development: evidence from hookworm

eradication in the American south. Q J Econ 2007; 122: 73–117.

8. Schultz TP. Productive benefits of health: evidence from low income

countries. In: Lopez-Casasnovas G, Riveras B, Currais L, eds. Health and

economic growth: findings and policy implications. Cambridge, MA: MIT

Press, 2005: 257–86.

9. Pritchett L. Desired fertility and the impact of population policies.Popul Dev

Rev 1994; 20: 1–55.

10. Schultz TP. The gender and intergenerational consequences of the

demographic dividend: an assessment of the micro- and macrolinkages

between the demographic transition and economic development. World

Bank Econ Rev 2009; 23: 427–42.

11. Debpuur C, Phillips JF, Jackson EF, Nazzar A, Ngom P, Binka FN. The

impact of the Navrongo project on contraceptive knowledge and use,

reproductive preferences, and fertility. Stud Family Plann 2002; 33: 141–64.

12. Becker GS, Lewis HG. Interactions between quantity and quality of

children. In: Schultz TW, ed. Economics of the family: marriage,children

and human capital. Chicago, IL: University of Chicago Press, 1974: 81–90.

13. Becker GS. A treatise on the family. Cambridge, MA: Harvard University

Press, 1981.

14. Schultz TP. Population policies, fertility, women’s human capital, and child

quality. In: Schultz TP, Strauss J, eds. Handbook of development

economics, vol 4. Amsterdam: Elsevier, 2008: 3249–303.

15. Acemoglu D, Johnson S. Disease and development: the effect of life

expectancy on economic growth. J Polit Econ 2007; 115: 925–85.

16. Schultz TP. How does family planning promote development? Evidence

from a social experiment in Matlab, Bangladesh 1977–1996. Population

Association of America Annual Meeting, Detroit, MI, April 30, 2009.

17. Joshi S, Schultz TP. Family planning and women’s and children’s health:

long term consequences of an outreach program in Matlab, Bangladesh.

IZA discussion paper no. 6551, May, 2012. http://ftp.iza.org/dp6551.pdf

(accessed May 30, 2012).

18. Joshi S, Schultz TP. Family planning as an investment in development:

evaluation of a program’s consequences in Matlab, Bangladesh. Economic

Growth Center discussion paper No. 951. New Haven, CT: Yale University,

2007.

19. Menken J, Duffy L, Kuhn R. Childbearing and women’s survival in rural

Bangladesh. Popul Dev Rev 2003; 29: 405–25.

20. Schultz TP. Assessing family planning cost effectiveness. In: Phillips JF,

Ross JA, eds. Family planning programmes and fertility. New York: Oxford

University Press, 1992: 78–105.

21. Phillips JF, Jackson EF, Bawah AA, et al. The long term fertility impact of

the Navrongo project in Northern Ghana. Population Association of America

Annual Meeting; Detroit, MI; April 30, 2009.

22. Pence BW, Nyarko P, Phillips J, Debpuur C. The effect of community

nurses and health volunteers on child mortality: the Navrongo community

health and family planning project. Scand J Public Health 2007; 35: 599–

608.

23. Desai J, Tarozzi A. Microcredit, family planning programs, and

contraceptive behavior: evidence from a field experiment in Ethiopia.

Demography 2011; 48: 749–82.

24. Miller G. Contraception as development? New evidence from family

planning in Colombia. Econ J 2010; 120: 709–36.

25. Thomas D, Maluccio J. Fertility, contraceptive choice, and public policy in

Zimbabwe. World Bank Econ Rev 2001; 10: 189–222.

26. Miguel E, Kremer M. Worms: identifying impacts on education and health in

the presence of treatment externalities. Econometrica 2004; 72: 159–217.

27. Frankenberg E, Suriatini W, Thomas D. Can expanding access to basic

health care improve children’s outcomes? Popul Stud 2005; 59: 5–19.

28. Thomas D, Frankenberg E, Friedman J, et al. Causal effect of health on

labor market outcomes: experimental evidence. California Center for

Population Research on-line working paper series. Los Angeles, CA:

UCLA, 2006.

29. Duflo E, Glennerster R, Kremer M. Using randomization in development

economics research: a toolkit. In: Schultz TP, Strauss J, eds. Handbook of

development economics. Amsterdam: Elsevier, 2008: 3895–962.

30. Todd P. Evaluating social programs with endogenous program placement

and selection of the treated. In: Schultz TP, Strauss J, eds. Handbook of

development economics. Amsterdam: Elsevier, 2008: 3847–94.

31. UN Department of Economic and Social Affairs. UN World Population

Prospects, the 2010 revision. http://esa.un.org/unpd/wpp/ (accessed March

21, 2012).

32. Bloom DE, Canning D, Fink G, Finlay J. The cost of low fertility in Europe.

Eur J Popul 2010; 26: 141–58.

33. Bloom DE, Canning D. Contraception and the Celtic Tiger. Econ Soc Rev

2003; 34: 229–47.

34. Bloom DE, Canning D, Fink G, Finlay JE. Fertility, female labor force

participation, and the demographic dividend. J Econ Growth 2009; 14: 79–

101.

35. Bailey MJ. More power to the pill: The impact of contraceptive freedom on

women’s lifecycle labor supply. Q J Econ 2006; 121: 289–320.

36. Young A. The tyranny of numbers: confronting the statistical realities of the

East Asian growth experience. Q J Econ 1995; 110: 641–80.

37. Bloom DE, Canning D, Malaney P. Demographic change and economic

growth in Asia. Popul Dev Rev 2000; 26: 257–90.

38. Goldin C. The U-shaped female labor force function in economic

development and economic history. In: Schultz TP, ed. Investment in

women’s human capital and economic development. Chicago: University of

Chicago Press, 1995: 61–90.

39. Radhakrishnan U. A dynamic structural model of contraceptive use and

employment sector choice for women in Indonesia. US Census Bureau

Center for Economic Studies Paper No CES-WP-10-28. September 2010.

http://www2.census.gov/ces/wp/2010/CESWP-10-28.pdf (accessed March

21, 2012).

40. Schultz TP. Women’s changing participation in the labor force. Econ Dev

Cult Change 1990; 38: 451–88.

41. Psacharopoulos G. Returns to investment in education: a global update.

World Dev 1994; 22: 1325–43.

42. Bleakley H. Disease and development: evidence from the American south.

J Eur Econ Assoc 2003; 1: 376–86.

43. Bleakley H. Malaria eradication in the Americas: a retrospective analysis of

childhood exposure. Am Econ J Appl Econ 2010; 2: 1–45.

44. Hoddinott J, Maluccio JA, Behrman JR, Flores R, Martorell R. Effect of a

nutrition intervention during early childhood on economic productivity in

Guatemalan adults. Lancet 2008; 371: 411–16.

45. Jukes MCH, Pinder M, Grigorenko EL, et al. Long-term impact of malaria

chemoprophylaxis on cognitive abilities and educational attainment: follow-

up of a controlled trial. PLoS Clin Trials 2006; 1: e19.

46. Bloom DE, Canning D, Sevilla J. The effect of health on economic growth: a

production function approach. World Dev 2004; 32: 1–13.

47. Weil DN. Accounting for the effect of health on economic growth. Q J Econ

2007; 122: 1265–306.

48. Akachi Y, Canning D. The height of women in sub-saharan Africa: the role

of health, nutrition, and income in childhood. Ann Hum Biol 2007; 34: 397–

410.

49. Akachi Y, Canning D. Health trends in sub-saharan Africa: conflicting

evidence from infant mortality rates and adult heights. Econ Hum Bio 2010;

8: 273–88.

50. Ashraf Q, Lester A, Weil DN. When does improving health raise GDP?

National Bureau of Economic Reasearch working paper series no. 14449.

October, 2008. http://www.nber.org/papers/w14449 (accessed March 21,

2012).

51. Schultz TP. Demand for children in low income countries. In: Rosenzweig

MR, Stark O, eds. Handbook of population and family economics.

Amsterdam: Elsevier, 1997: 349–430.

52. Kalemli-Ozcan S. A stochastic model of mortality, fertility, and human

capital investment. J Dev Econ 2003; 70: 103–18.

53. Ashraf QH, Weil DN, Wilde J. The effect of interventions to reduce fertility

on economic growth. National Bureau of Economic Reasearch working

paper series no. 17377. August, 2011. http://www.nber.org/papers/w17377

(accessed March 21, 2012).

54. Kelley A, Schmidt R. Evolution of recent economic-demographic modeling:

a synthesis. J Popul Econ 2005; 18: 275–300.

55. Bloom DE, Canning D, Hu L, Liu Y, Mahal A, Yip W. The contribution of

population health and demographic change to economic growth in China

and India. J Comp Econ 2010; 38: 17–33.

56. O’Neill BC, Dalton M, Fuchs R, Jiang L, Pachauri S, Zigova K. Global

demographic trends and future carbon emissions. Proc Natl Acad Sci USA

2010; 107: 17521–26.

57. Speidel JJ, Weiss DC, Ethelston SA, Gilbert SM. Population policies,

programmes and the environment. Philos Trans R Soc Lond B Biol Sci

2009; 364: 3049–65.

58. Galor O, Weil DN. Population, technology, and growth: from Malthusian

stagnation to the demographic transition and beyond. Am Econ Rev 2000;

90: 806–28.

5.9 Page 49

▲back to top

ifjokj fu;kts u 5

ifjokj fu;kts u dh viw.kZ vko';drkvkas dks iwjk djus ds fy, ekuo

vf/kdkjksa dk i;z ksx

tsu dkfS VaxgeS ] ,fMª;uS teuZS ] ikyS gUV

vkuS ykbuZ idz k'ku

tqykbZ 10] 2012

http://dx.doi.org/10.1016/S014

0-6736(12)60732-6

;g ifjokj fu;kstu ij fy[ks x,

ikap ys[kksa dh Ja`[kyk dk ikapok

ys[k gAS

2 j~;w tSD;qt+ xzkls fyr] d:t]

ftfuok 1227] fLoVt~ +jySaM ¼ts

dkfS VaxgeS ] ,e-,llh½(

baVju'S kuy foeUS l gYS Fk

dkvs fy'ku] U;w ;kdS Z] ,uok;]

;w,l, ¼, teuSZ ] ,e-,½( vkjS

fMikVeZ SaV vkWQ yk]S áweu jkbZV~l

lSUVj] ;wfuoflZVh vkWQ ,slSDl]

dkyS pSLVj] ;wds ¼ih gUV] ,e-

T;wj½

i=kpkj ds fy, %

ts dkfS VaxgeS ] 2 j~;w tSD;qt+

xzkls fyu] d:t] ftfuok 1227]

fLoV~t+jyaSM

cottinghamjc@gmail.com

bl fjiksVZ esa geus crk;k gS fd xHkZ fu;kstu laca/kh tkudkjh vkSj lsokvksa ds lanHkZ e]sa ekuo vf/kdkj

fdl izdkj dkuwu] uhfr;ka] dk;ZØe vkjS ifj;kstuk,a cukus esa enn dj ldrs gaSA ekuo vf/kdkj

nf` "Vdks.k ykxw djrs g,q vkjS tula[;k ,oa fodkl ij varjk"Z Vªh; laxks"Bh rFkk lglkz Cnh fodkl y{;ksa

dh ifz rc)rk,a] ftlesa iztuu LokLF; ¼ifjokj fu;kstu lfgr½ ds ifz r loZO;kih igaqp 'kkfey g]S dks

Lohdkj djrs gq, ge ifjokj fu;kstu dh viw.kZ vko';drk dks ekius dk leFkuZ djrs gaS] ftlds

varxZr igys ls vf/kd lewg 'kkfey fd, tk ldrs gSaA xHkZ fujks/ku dh vko';drkvksa rd igaqp

LFkkfir djus esa vkus okyh ck/kkvksa dh igpku djus] mUgsa de djus vkSj mUgsa feVkus ds fy, fdl

idz kj ekuo vf/kdkjksa dk mi;ksx fd;k tk ldrk g]S mldh ge ;gka :ijs[kk ns jgs gaS( fdl idz kj

ekuo vf/kdkj dkuwu ,oa uhfr;ksa dks l'kDr dj ldrs gSa( vkSj ljdkj dks xHkZ fujks/ku laca/kh

tkudkjh ,oa lsok,a miyC/k djkus dh dkuwuh izfrc)rk iwjh djus esa enn dj ldrs gSaA ge ns'kksa dh

tokcnsgh ds egRo dks js[kkafdr djrs gq,] vkSj ekuo vf/kdkjksa ds varxZr] ifjokj fu;kstu dh i;kZIr

miyC/krk ds fy, izkFkfedrk,a iLz rrq dj jgs gSaA

ia zLrkouk

bl J`a[kyk ds vU; ys[k ifjokj fu;kstu

esa fuos'k djus ds fofHkUu ykHkksa dks

js[kkafdr djrs gSa] ftlesa lglzkCnh fodkl

y{;ksa dh vksj rst+h ls c<+uk Hkh 'kkfey

gAS bl ys[k esa ge crk jgs gSa fd fdl

idz kj ekuo vf/kdkjksa dk lEeku] ljq {kk

vkSj mUgsa iwjk djus ds mik;ksa ls1 yksxksa

dks xHkZ fujks/ku lca a/kh tkudkjh vkjS

los k,a mi;ksx djus ds fy, l{ke cuk;k

tk ldrk gS vkSj bl idz kj ds fuos'k ds

iwjs ykHk mBk, tk ldrs gaSA

vDlj yksx ekuo vf/kdkjksa dks dsoy

muds guu ds lna HkZ esa tkurs gSaA ;g

igyw egRoiw.kZ gS] vkjS ifjokj fu;kstu

dk;ZØeksa o uhfr;ksa ds bfrgkl esa &

fo'ks"kdj tul[a ;k fu;a=.k ds fy, pyk,

x, dk;ØZ eksa ds lna HkZ esa & yksxksa dks

t+cjnLrh xHkZ fujks/kd yxokus ;k

varxHZ kkZ'k;h midj.k ;k iRz ;kjksi.k

yxokus ;k xHkZ lekiu ;k ulcanh djkus

ds fdLls 'kkfey jgs gaSA2&9 ekuo vf/kdkj

i.z kkfy;ka] tSls lfa /k fujh{k.k lLa Fkk,a]

{ks=h; ekuo vf/kdkj U;k;kf/kdj.k] vkjS

jk"Vªh; U;k;ky;ksa ds ek/;e ls yksx o

leqnk; bl idz kj ds ekuo vf/kdkj guu

ls fuokj.k izkIr dj ldrs gSaA6]7 ekuo

vf/kdkj dkuwuksa dk mi;ksx djds muds

guu ij gh jksd yxkbZ tk ldrh gSA

mnkgj.k ds fy,] ekuo vf/kdkj ekudksa

ij t+ksj nsrs g,q ;g lfq uf'pr fd;k tk

ldrk gS fd] LokLF; los kvksa esa fdlh

fof'k"V lewg] tSls 18 o"kZ ls de mez]

tutkrh; vYila[;d] ;k ,pvkbZoh ds

lkFk th jgs yksxksa ds fo#) HksnHkko u

fd;k tk, vkjS los kvksa dh x.q koÙkk esa

l/q kkj dh Hkh ekax dh tk ldrh gAS tc

uhfr fu/kkjZ .k ifz Ø;k ds varxrZ ekuo

vf/kdkjksa dks lfEefyr dj fy;k tkrk gS]

rks os lfq uf'pr djrs gaS fd LokLF;

lfq o/kk,a o los k,a HksnHkko jfgr gksa vkSj

'k#q ls gh mudh x.q koÙkk cuh jgsA ekuo

vf/kdkj dkuwu vkjS ekudksa dks dk;ØZ eksa

dh :ijs[kk o fujh{k.k esa 'kkfey djus]

vkjS ljdkjksa dh tokcnsgh lfq uf'pr djus

ds fy, ekuo vf/kdkj iz.kkfy;ksa dk

mi;ksx djus l]s lHkh ds fy, LokLF;

lfq uf'pr fd;k tk ldrk gAS

5.10 Page 50

▲back to top

[kkst j.kuhfr vkjS p;u ds ekinaM

geus lHkh iez [q k ekuo vf/kdkj lzksrks]a tSls

fd varjk"Z Vªh; vksj {ks=h; laf/ki=ksa vkSj

lafonkvk]sa ifjokj fu;kstu lacaf/kr varjkZ"Vªh;]

{ks=h;] vkjS jk"Vªh; ekuo vf/kdkj dkuwu ds

lkFk lkFk la;qDr jk"Vª (UN) ,tsafl;ks]a

ekuo vf/kdkj fo'ks"kKks]a vkSj xSj ljdkjh

laLFkkvksa }kjk fd, x, dk;ksaZ ¼ftuesa izdkf'kr

o vidz kf'kr lkexzh 'kkfey gS½] tgka ekuo

vf/kdkjksa dk mi;ksx] ;kSu o iztuu LokLF;

dks lg;ksx nsus ds fy, fd;k x;k g]S dh

leh{kk dh gSA pfwa d **ekuo vf/kdkj** vkSj

**ifjokj fu;kstu** ;k **xHkZ fujks/ku** 'kCnksa dh

,d iceMS [kkst ls dNq gh idz kf'kr]

getksyh&leh{kk ys[k izkIr g,q ] vr% geus

la;qDr jk"Vª (UN) o vU; lgdfeZ;ksa ds lkFk

dh xbZ ijke'kZ ds vk/kkj ij ifjokj fu;kstu

dk;ZØeksa ds mnkgj.kksa dh igpku dhA

varjk"Z Vªh; Lrj ij ekU; ekuo vf/kdkj]

tks xHkZ fujks/ku tkudkjh vkjS los kvksa ds

fy, fo'ks"kdj ykxw fd, tk ldrs gaS] os

gaS % HksnHkko u djuk] tkudkjh ,oa f'k{kk]

LokLF; ds mPpre ekudksa dh izkfIr]

,dkarrk] vkjS thouA10&12 bu vf/kdkjksa

dk ,d nwljs ds lkFk xgjk tqM+ko gAS

mnkgj.k ds fy,] LokLF; ds mPpre

ekudksa dks izkIr djus dk vf/kdkj] ftlesa

LokLF; los kvksa rd igaqp vkjS LokLF;

lca a/kh tkudkjh dk vf/kdkj 'kkfey gS]

dks f'k{kk ,oa tkudkjh ds vf/kdkj dks

iwjk fd, fcuk izkIr ugha fd;k tk ldrk]

D;kfsa d yskxksa dks bu los kvksa dk mi;ksx

djus ls igys mudh tkudkjh gksuk

vko';d gSA bl fjiksVZ es]a ge xHkZ

fujks/ku tkudkjh vkSj los kvksa ds vf/kdkj

ij fo'ks"k t+ksj ns jgs gSa] tks fd varjkZ"Vªh;

Lrj ij ekU; bu vf/kdkjksa esa fufgr

g]S 13]14 vkjS gekjk l>q ko gS fd bu

vf/kdkjksa dks c<+kok nsuk o budh ljq {kk

djuk] ifjokj fu;kstu dh viw.kZ

vko';drkvksa dks iwjk djus dh

cg&q vk;keh j.kuhfr dk fgLlk gksuk

pkfg,A

fiNys pkj n'kdksa esa] varjkZ"Vªh; ekuo

vf/kdkj dkuwu ds varxZr ;kSfud ,oa

itz uu LokLF;] ftlesa ifjokj fu;kstu

'kkfey gS] ds ekudksa dks LFkkfir fd,

tkus ds lkFk lkFk dkQh foLrr` Hkh fd;k

x;k gSA mnkgj.k ds fy,] ns'kksa us LokLF;

ds mPpre izkI; ekudksa ds vf/kdkj dk

vuqeksnu fd;k gS]10 ftldh O;k[;k bl

izdkj dh xbZ gS & **;kSfud ,oa itz uu

LokLF; los k,a] ftlesa ifjokj fu;kstu

rd igaqp 'kkfey gks**A15 mUgksua s **LokLF;

los kvksa] ftlesa ifjokj fu;kstu Hkh 'kkfey

g]S rd lc dh igaqp LFkkfir djus ds

mís'; l]s LokLF; los kvksa ds {ks= esa

efgykvksa vkjS i#q "kksa dh lekurk ds

vk/kkj ij] efgykvksa ds fo#) HksnHkko dks

[kRe djus** dk Hkh vueq ksnu fd;k gAS 11

;g vucq a/k mu lHkh ns'kksa ds fy, dkuwuh

:i ls ck/;dkjh gaS ftUgksua s lca af/kr

ifz rKki=ksa vkjS lfa onkvksa dk vuqeksnu

fd;k gS] tSls fd vkfFkdZ ] lkekftd vkjS

lkaLd`frd vf/kdkjksa ij varjkZ"Vªh; lafonk]

cky vf/kdkjksa ij lfa onk (CRC) vkjS

efgykvksa ds fo#) gj idz kj ds HksnHkko

dks feVkus ij lfa onk (CEDAW)A fo'o ds

lHkh ns'kksa us ekuo vf/kdkjksa dh ize[q k

varjkZ"Vªh; lfa /k;ksa esa ls de&l&s de ,d

dk vuqeksnu fd;k gS vkjS dqN us buls

dgha vf/kd lfa /k;ksa dkA16 dbZ ns'kksa us bu

ekudksa dks vius jk"Vªh; dkuwuksa vkSj

fu;eksa esa 'kkfey dj fy;k g]S vkSj dbZ

ns'kksa ds jk"Vªh; lfa o/kku] bu vf/kdkjksa dh

ft+Eesnkjh ysrs gSa] tlS s HksnHkko ds fo#)

vf/kdkjA ;g ekud ljdkjksa ij dkuwuh

:i ls nkf;Ro Mkyrs gaS fd os mPp

xq.koÙkk okys xHkZ fujks/kdksa dh tkudkjh

vkjS los k,a lHkh dks miyC/k djk,a] vkjS

yksxksa dks bu los kvksa dh ekax djus ds

fy, l'kDr djsAa

6 Pages 51-60

▲back to top

6.1 Page 51

▲back to top

ekuo vf/kdkj lfa /k;ksa dks ikz sxSe vkWQ

,sD'ku vkWQ n baVjuS'kuy dkSUÝSal vkWu

ikSiqys'ku ,sMa MoS yieSaV tSls fofHkUu

ljdkjksa ds chp lgefr i=ksa ls lg;ksx

rFkk et+cwrh feyrh gSA17 fofHkUu lewg

bu lfa /k;ksa dks ljdkjksa ls tokcnsgh

ekaxus ds fy, mi;ksx dj ldrs gSa] vkjS

;g la;qDr jk"Vª ,tsfa l;ksa] foÙkiks"kd

ljdkjh ,oa xjS ljdkjh lLa Fkkvksa dh

uhfr;ksa vkSj dk;ZØeksa dk Hkh ekxnZ 'kuZ

djrs gSaA

pfwa d bl J`a[kyk dk izeq[k fo"k; ifjokj

fu;kstu gS] ftldh ifjHkk"kk xHkZ fujks/ku

lca a/kh tkudkjh vkjS los kvksa ds :i esa nh

xbZ gS] ge ;gka vU; egRoiw.kZ ;kfS ud ,oa

itz uu LokLF; los kvksa dh ppkZ ugha dj

jgs gSa] tlS s ;kuS lØa e.kksa dh jksdFkke]

igpku djuk vkjS mudk mipkj djuk

vkjS ljq f{kr xHkZ lekiu los k,a miyC/k

djkuk] gkykafd ljq f{kr xHkZ lekiu

los kvksa rd igqap Hkh efgykvksa dks viuh

itz uu'khyrk fu;fer djus esa l{ke

cukus esa egRoiw.kZ gAS varjkZ"Vªh; ekuo

vf/kdkj dkuwu ds varxrZ ] t+:jh gS] fd

ljdkjsa O;kid dkuwuh vkjS uhfr <kapk

r;S kj dj]sa ftlls fd lfq uf'pr fd;k tk

ld]s fd dkuwuh :i ls ekU;rkizkIr xHkZ

lekiu los k,a ljq f{kr gaS vkjS okLrfod

:i ls miyC/k gSaA18&20 ;g opuc)rk

iwjh djus ds fy, t+:jh gS fd LokLF;

dk;ZdrkZvksa dks izf'kf{kr fd;k tk, o

mUgsa mfpr midj.k miyC/k djk, tk,a]

vkjS efgykvksa ds LokLF; dh ljq {kk ds

fy, blds vfrfjDr dne Hkh mBk,

tk,aA efgykvksa ds LokLF; vkSj ekuo

vf/kdkjksa ds fy, egRoiw.kZ vU; eqís bl

fjiksVZ ds nk;js ls ckgj gaS] tSls fd de

mez esa 'kknh o t+cjnLrh 'kknh dj nsuk

vkjS efgyk tuukaxksa dks fod`r djuk]

nksuksa gh varjkZ"Vªh; ekuo vf/kdkj dkuwu

dks rksM+rs gaSA12]21&23

ldh viw.kZ vko';drk,a\\

HksnHkko u djus ds ekuo vf/kdkj ewY;

gesa ;g tkap djus ds fy, izsfjr djrs gaS

fd viw.kZ vko';drkvksa dh ifjHkk"kk esa

uhfr fuekrZ k] dk;ØZ e izca/kd] lsok inz krk]

vkjS tulkaf[;dh; fo'ks"kK fdls 'kkfey

djrs gaSA viw.kZ vko';drkvksa dk vuqeku

yxkus ds fy, vke rkSj ij ftu lkz srksa dk

mi;ksx fd;k tkrk gS] mlesa dsoy

fookfgr ;k lgokl djus okyh

iztuu'khy vk;q dh efgykvksa dks 'kkfey

fd;k tkrk g]S tks xHkZ /kkj.k ugha djuk

pkgrha] ysfdu orZeku le; esa fdlh

izdkj ds vk/kfq ud xHkZ fujks/kd dk iz;ksx

ugha dj jghaA ysfdu] vc tc dqN ns'kksa

ls vfookfgr ;kSu :i ls lfØ; efgykvksa

ds vkadM+s izkIr gksus yxs gSa] gky ds viw.kZ

vko';drk vuqekuksa esa vfookfgr

efgykvksa dks Hkh 'kkfey fd;k x;k gAS

fodkl'khy ns'kksa es]a laHkor% yxHkx 21-5

djksM+ efgykvksa dh ifjokj fu;kstu

vko';drk,a viw.kZ gaSA24 vHkh Hkh bl

vueq ku esa] mu efgykvksa dks 'kkfey ugha

fd;k x;k gS] tks ,sls vk/kfq ud xHkZ

fujks/kd i;z ksx dj jgh gSa ftlls os larq"V

ugha gSa vkjS ftudk] fdlh mfpr dk;ØZ e

ds lg;ksx ds fcuk] vokafNr xHk/Z kkj.k ;k

xHkZ fujks/kd iz;ksx NksM+us ;k nksuksa dk

[krjk gSA viw.kZ vko';drkvksa ds vuqekuksa

es]a yM+dksa vkjS i#q "kksa dks Li"V :i ls

lca ksf/kr ugha fd;k tkrk] D;kfsa d ftl

efgyk ls xHkZ fujks/kd mi;ksx dh ckr

dh tkrh gS mlls vius ifr ;k lgHkkxh

}kjk xHkZ fujks/kd iz;ksx fd, tkus dks Hkh

'kkfey djus dks dgk tkrk gSA

6.2 Page 52

▲back to top

iez [q k lans'k

 dkuwuh :i ls ck/; ekuo vf/kdkjksa dk izpkj ,oa lqj{kk]

yksxksa dks xHkZ fujks/ku laca/kh tkudkjh vkSj lsokvksa dk

mi;ksx djus ds fy, l'kDr djrh gS vkjS ifjokj

fu;kstu dh viw.kZ vko';drkvksa dks iwjk djus ds fy,

egRoiw.kZ gAS

 HksnHkko u fd, tkus ds fl)kar vkjS LokLF; ds mPpre

ikz I; ekudks]a tkudkjh vkSj f'k{kk] ,dkarrk vkjS thou ds

vf/kdkj] xHkZ fujks/ku laca/kh tkudkjh vkjS lsokvksa ds

vf/kdkj ds fy, vk/kkj gaSA yca s le; ls pyh vk jgh

dk;ØZ e] uhfr vkjS tulkaf[;dh; ifjHkk"kk] fd fdldh

ifjokj fu;kstu dh vko';drk,a viw.kZ gSa] dks vkSj foLrr`

djrs gq, mlesa vfookfgr yksxk]sa fo'ks"kdj fd'kksj mez

oky]s tks efgyk,a iz;ksx fd, tkus okys xHkZ fujks/kd ls

lar"q V ugha gSa] vkSj os vfHkoafpr lewg ftuds fo#)

LokLF; lsok,a ges'kk HksnHkko djrh gaS] dks Hkh 'kkfey djuk

gksxkA

 ljdkjksa ls xHkZ fujks/ku laca/kh tkudkjh vkSj lsokvksa esa

vkus okyh ck/kkvksa dks feVkus ds izfr mudh opuc)rkvksa

dh tokcnsgh ekaxus ds fy,] varjkZ"Vªh; ekuo vf/kdkj

dkuwu vkjS fofHkUu ekuo vf/kdkj iz.kkfy;ksa dk vkSj

vf/kd iHz kkoh rjhds ls mi;ksx fd;k tk ldrk gS & tSls

fd LokLF; lsok iznkrkvksa }kjk lsok inz ku djus esa vkifÙk]

[kjkc lsokvksa ;k midj.kksa dh vuqiyC/krk vkSj lenq k;ksa

dks 'kkfey u fd;k tkukA

 dbZ fofo/k ns'kksa e]sa ekuo vf/kdkjksa ds vk/kkj ij dkuwu]

uhfr;ka vkSj dk;ZØe cuk, x, gaS] ftlls xHkZ fujks/ku

tkudkjh ,oa lsokvksa rd lkoZykSfdd igqap LFkkfir djus]

vkSj O;kid ;kSfudrk f'k{kk dh vksj rst+h ls fodkl gqvk gSA

 ifjokj fu;kstu dh viw.kZ vko';drkvksa dh ikz Fkfedrkvksa

dks iwjk djus ds fu.k;Z ksa ds fy, rhu vk/kkjHkwr fopkj gksus

pkfg, % xHkZ fujks/ku tkudkjh ,oa lsok,a miyC/k djkus

dk lcls vPNk rjhdk gS fd mUgsa ;kfS ud vkSj iztuu

LokLF; lsokvksa ds lkFk miyC/k djk;k tk,( uhfr;ksa vkSj

dk;ØZ eksa dh :ijs[kk ,sls rS;kj dh tk, ftlls fd lHkh

t+:jreanksa dh vko';drk,a fcuk HksnHkko ds iwjh dh tk

ldsa] fo'ks"kdj laosnu'khy vkSj vc rd oafpr j[ks x,

yksxksa dh( vkSj dsoy oKS kfud izek.kksa ds vk/kkj ij gh

ugha] ekuo vf/kdkjksa dks Hkh ikz Fkfedrk,a fu/kkZfjr djus ds

fy, iz;ksx fd;k tkuk pkfg,A

 ekuo vf/kdkj n`f"Vdks.k ls] ifjokj fu;kstu dh viw.kZ

vko';drkvksa dks feVkus vkjS xHkZ fujks/ku tkudkjh vkSj

lsokvksa rd lcdh igqap LFkkfir djus ds fy, dkuwuh

ikz Fkfedrk,a gSa % lkoZykSfdd igqap lfq uf'pr djus ds fy,]

Bksl jk"Vªh; vkSj mijk"Vªh; ;kstuk,a( dkuwuh vkSj fu;a=d

ck/kk,a gVkuk( mPp x.q koÙkk ds itz uu LokLF; midj.kksa

dh fujarj miyC/krk] ftlesa lqjf{kr vkSj iHz kkodkjh xHkZ

fujks/kdksa dh vf/kd ls vf/kd fdLesa 'kkfey gks(a mfpr :i

ls izf'kf{kr vkSj fujhf{kr LokLF; dk;dZ rkZ] tks ,dkarrk

vkSj xksiuh;rk ds ewY;ksa dk lEeku dj]sa iwjh vkSj lgh

tkudkjh nsa vkjS tks Lora= ,oa lwfpr Lohd`fr lfq uf'pr

dj(sa x.q koÙkkiw.kZ lsok,a( igqap LFkkfir djus esa vkus okyh

vkfFkZd ck/kkvksa dks gVkuk( vkjS iHz kkodkjh fujh{k.k o

tokcnsgh ifz Ø;k,a] ftlls fd ekuo vf/kdkj vkjS vU;

opuc)rk,a cukbZ j[kh tk ldAsa

mi lgkjk vÝhdk vkjS ySfVu vejhdk

vkjS dSfjfc;u dh dqy ;kSfud :i ls

lfØ; fd'kksfj;ka ¼15&19 o"kZ mez dh½] tks

xHk/Z kkj.k jksduk pkgrh gSa] esa ls yxHkx

vk/kh vfookfgr gaSA25 muesa l]s dsoy 41

izfr'kr mi&lgkjk vÝhdk esa vkjS 50

izfr'kr ySfVu vejhdk vkSj dSfjfc;u esa]

fdlh vk/kfq ud xHkZ fujks/kd dk iz;ksx dj

jgh gaSA fd'kksj mez ds yM+dksa ds lanHkZ esa

bl idz kj ds vkadM+s miyC/k ugha gaSA

ysfdu fQj Hkh 10 & 19 o"kZ mez ds chp

ds yxHkx 140 djksM+ fd'kksj gSa] ftuesa ls

dkQh ;kSfud :i ls lfØ; gSa ;k tYnh

gh gks tk,axsA buesa ls yxHkx 90 izfr'kr

de ;k e/;e vkenuh okys ns'kksa esa jgrs

gaS] mudh fo|ky;ksa vkjS LokLF; los kvksa

rd igaqp lhfer g]S vkSj mudh fookfgr

fj'rs ls igys ;k ckgj] vkjS fookfgr

fj'rs esa Hkh ;kSu fØ;k esa 'kkfey gksus dh

lHa kkouk gSA

bu ;qokvksa ds ;kuS fØ;k 'kq# djus]

fookg] ;kuS vfHkO;fDr] vkjS xHkZ fujks/kd

mi;ksx djus ¼;k u djus½ ds fu.k;Z ds

muds thou ij cgqr cM+s iHz kko gksaxs vkjS

Hkfo"; esa tula[;k o`f) dks Hkh fu/kkfZ jr

djsxa sA fookfgr gksa ;k u gksa] mudh

ifjokj fu;kstu dh fof'k"V vko';drk,a

gaS] D;ksafd budh vljq f{kr vkjS

6.3 Page 53

▲back to top

vlgefriw.kZ ;kuS lca a/k cukus dh

lHa kkouk,a vf/kd gSa vkjS vDlj buds ikl

viuh ljq {kk ds fy, mfpr tkudkjh ;k

los k,a miyC/k ugha gksrhaA26 u gh ;g ;oq k

mu los kvksa dk mi;ksx djrs gSa] tks

o;Ldksa ds fy, cukbZ xbZ gksaA dbZ ;oq k

yksx vokafNr xHk/Z kkj.k vkSj ;kSu lØa fer

jksxksa ls cpus ds fy, xHkZ fujks/kdksa dk

mi;ksx djus esa #fp ys ldrs gSa] ysfdu

ifjokj fu;kstu lca a/kh ikjaifjd lna s'k

muds fy, dksbZ ek;us ugha j[krsA mudh

vko';drkvksa dks lca ksf/kr djus ds fy,]

izf'kf{kr ,oa lg;ksxh LVkQ] ,dkarrk vkSj

xksiuh;rk] xHkZ fujks/ku vkjS chekfj;ksa ls

cpus] nksuksa ij t+ksj nsus vkSj O;kid

;kSfudrk f'k{kk dh t+:jr g]S tks ekuo

vf/kdkjksa ds ifjizs[; ij vk/kkfjr gks]

ftlesa tSaMj lekurk vkSj xSj&HksnHkko]

;kuS vo/kkj.kk,a vkSj O;ogkj Hkh 'kkfey

gkAsa 27&30

tks vla[; efgyk,a mi;ksx fd, tkus

okys xHkZ fujks/kd ls vlra q"V gSa] mUgsa

viw.kZ vko';drk dh Js.kh esa 'kkfey ugha

fd;k tkrkA dqN ns'kksa es]a nl esa ls

yxHkx pkj efgyk,a] mi;ksx ds igys o"kZ

esa gh xHkZ fujks/kd i;z ksx djuk NksM+ nsrh

gSaA11 rc Hkh] bu efgykvksa dks] iz;ksx

NksM+us ls igys viw.kZ vko';drkvksa ds

vueq ku esa ugha fxuk tkrk] tks n'kkZrk gS

fd dk;ZØe yacs le; esa foQy D;ksa gksrs

gaS & D;ksfa d os xHkZ fujks/ku ds mi;ksx ls

gksus okys y?kq izHkkoksa ds fo"k; esa i;kZIr

tkudkjh nsus ds egRo dks ugha le>rs]

vkjS u gh ftu efgykvksa ij ;g iHz kko gks

jgs gSa mUgsa dksbZ lg;ksx ;k xHkZ fujks/kd

cnyus esa enn djrs gSaA

lHkh {ks=ksa es]a efgykvksa dh dqN Js.kh ds

iwjs lewgksa dh xHkZ fujks/kd lsokvksa rd

dksbZ igaqp ugha gS] ;k gS Hkh rks cgrq de(

bu lewgksa esa] 'kj.kkFkhZ vkSj vkarfjd :i

ls foLFkkfir efgyk,a] dyafdr O;olk;ksa

tSls ;kSu deZ esa 'kkfey efgyk,a] ftUgsa

vU;Fkk dyafdr ekuk tkrk gS] tSls

cykRdkj dh f'kdkj efgyk,a] fodykaxrk

ds lkFk th jgh efgyk,a] ,pvkboZ h

lØa e.k ;k ,Ml~ ds lkFk th jgh efgyk,a

vkSj /kkfeZd ;k tutkrh; vYila[;d]

'kkfey gaSA32&35 xjS HksnHkko ds ekuo

vf/kdkj fl)kar ds vuqlkj] bu lHkh

lewgksa dh xHkZ fujks/ku tkudkjh vkjS

los kvksa rd igqap o miyC/krk gksuh

pkfg,A bu viw.kZ vko';drkvksa dks iwjk

djus ds fy,] bu yksxksa rd igaqpus ds

fy, fof'k"V i;z kl] izf'k{k.k vkjS vU;

idz kj ds fuos'k dh vko';drk gS] ftlls

Hkwe.Myh; o jk"Vªh; Lrjh; lalk/kuksa ij

[kpZ ij iHz kko iM+sxkA dbZ ns'kksa e]sa bu

viw.kZ vko';drkvksa dks iwjk djus ds fy,]

dkuwu] uhfr;ks]a j.kuhfr;ksa vkjS dk;ØZ eksa esa

jk"Vªh; o varjkZ"Vªh; ekuo vf/kdkj ekudksa

ds vuq:i l'a kks/ku djus gksxa sA

igaqp LFkkfir djus esa vkus okyh ck/kkvksa

dks feVkus ds fy, ekuo vf/kdkjksa dk

i;z ksx

LokLF; ds lokPsZ p ekudksa dks izkIr djus

ds vf/kdkj ds fy, t+:jh gS fd LokLF;

tkudkjh ,oa lsokvksa rd lc dh vckf/kr

igqap gks vkSj ;g los k,a lLrh vkjS le;

ij miyC/k gksa]33 ftlesa ifjokj fu;kstu

dh fof'k"V los kvksa rd igqap Hkh 'kkfey

gS15A ysfdu blds ckotwn] xHkZ fujks/ku

rd efgykvksa dh igaqp ds chp dbZ ck/kk,a

gaS] ftlesa 'kkfey gS % ,slh fLFkfr;ka

ftuds dkj.k os Lora= o lfw pr fu.kZ;

ugha ys ikrha ¼tSls fd Li"V tkudkjh ;k

lykg u gksuk½( xksiuh;rk u gksuk( ifr]

ek¡ & cki ;k vLirky dh Lohd`fr dh

vko';drk( vR;f/kd los k 'kYq d( LokLF;

los kvksa ls nwjh vkjS lkotZ fud o lLrs

6.4 Page 54

▲back to top

;krk;kr lk/kuksa dh deh( xHkZ fujks/kd

iz.kkfy;ksa esa foLr`r fodYi miyC/k u

gksuk(36&40 vkSj LokLF; los k inz krkvksa esa

mfpr ifz 'k{k.k] i;kZIr l[a ;k ;k mfpr

fujh{k.k dh dehA17]41 dqN tul[a ;k

lewgksa ds fy, los kvksa dks ckf/kr djus

okys] ;k xHkZ fujks/ku lca a/kh tkudkjh ;k

mudh fcØh ij izfrca/k yxkus okys

dkuwuksa dks efgykvksa }kjk ifjokj fu;kstu

los kvksa rd igqap LFkkfir djus esa ck/kd

ds :i esa fpfàr fd;k x;k gAS 40&44 bl

fjiksVZ esa ge bu lHkh ck/kkvksa ij t+ksj ns

ldrs Fks] ysfdu ge pkj ,sls mnkgj.kksa

dh O;k[;k dj jgs gaS] tgka ekuo vf/kdkj

ekudksa ds iz;ksx ls bu ck/kkvksa dks gVk;k

x;k] ftlls viw.kZ vko';drk,a de djus

esa ;ksxnku feykA

lqjf{kr vkSj iHz kkoh oLrqvksa dh vi;kZIr

vkiwfrZ

fiNys 3 o"kkasZ dh fjiksVZ ds vulq kj] dqN

vÝhdh ns'kksa e]sa xHkZ fujks/kdksa ds LVkSd

[kRe gks tkuk ges'kk ,d leL;k jgh

gAS 45&47 mnkgj.k ds fy,] dsU;k esa 24

izfr'kr efgyk,a ftUgsa vxys 2 o"kksaZ esa

cPps ugha pkfg,] os xHkZ fujks/kd dk iz;ksx

ugha dj jgha D;kfsa d dbZ iz.kkfy;ka] tSls

xHkZ fujks/kd lbq Za] vkjS izR;kjksi.k xHkZ

fujks/kd miyC/k gh ugha gSaA45 bl izdkj

dh vuiq yC/krk ds dkj.k ekr` vLoLFkrk

vkSj e`R;q c<+ ldrh gSA45 dqN ekeyksa esa]

de nkeksa esa [kjkc xHkZ fujks/kd miyC/k

gSa] ysfdu buds dkj.k yksxksa ds LokLF;

vkjS thou ds fy, xaHkhj ifj.kke gks

ldrs gaSA47 ljdkjksa ds ekuo vf/kdkj

vkjS lkotZ fud LokLF; ft+Eesnkfj;ksa ds

varxrZ ] mUgsa xHkZ fujks/kd cukus ;k vk;kr

djus esa x.q koÙkk cuk, j[kus] vkjS baVjuSV

tSls vU; lkz srksa ij fuxjkuh j[kus ds dM+s

fu;e LFkkfir djus gksaxsA

ekuo vf/kdkj ekudksa ds varxrZ ] Lohd`r

xHkZ fujks/kd foLrr` :i l]s yxkrkj

miyC/k jgus pkfg,A11]15]36&39 Lohd`r xHkZ

fujks/kd os gSa] tks de&ls&de fo'o

LokLF; lLa Fkku (WHO) dh ekWMy fyLV

vkWQ blSfU'k;y eSfMflUl48 vkjS mldh

iwjd blfS U'k;y efS MflUl QkWj jhizksMfDVo

gSYFk49 esa 'kkfey gksaA bu lfw p;ksa esa

vkikrdky xHkZ fujks/kd Hkh 'kkfey gSa] tks

vDlj vU; xHkZ fujks/kd miyC/k gksus ij

ekStwn ugha gksrsA lkFk gh] dUMkse o vU;

ck/kd midj.k] gkekusZ xHkZ fujks/kd

¼xksfy;ka] lbq aZ] iRz ;kjksi.k vkjS NYys½

xHkk'Z k; esa yxk, tkus okys midj.k vkSj

ulcanh Hkh 'kkfey gSaA ekuo vf/kdkj

ekudksa ds mi;ksx dk ,d mnkgj.k gS]

dksyfEc;u dkmafly vkWQ LVsV }kjk

fy;k x;k fu.k;Z ] ftlds varxZr mlus

QlS yk fn;k fd vkikrdkyhu xHkZ

fujks/kd rd igqap LFkkfir djuk

dksyfEc;k ds lfa o/kku ds vuqlkj thou

ds vf/kdkj dks cgky djus ds cjkcj gS]

ftlds rgr ,sls xHkZ fujks/kdksa ij ifz rca/k

yxk, tkus dh dqN lewgksa dh ekax dks

vLohdkj dj fn;k x;kA44 ,d vkSj

leL;k ;g gS] fd dbZ ns'kksa dks xHkZ

fujks/kdksa dh fujarj vkiwfrZ ds fy,] fiNys

n'kdksa ls de gks jgs foÙk&iks"k.k ij fuHkZj

jguk iM+rk gS] ;k varjkZ"Vªh; ,tsfa l;ksa

}kjk fu%'kYq d vkiwfrZ ij] tks vfuf'pr

jgrh gSA45&46

[kjkc@fuEu xq.koÙkk los k,a

1990 ds n'kd dh 'kq#vkr esa] xHkZ

fujks/kdksa dh fuEu xq.koÙkk los kvksa dks ,d

iez [q k leL;k ekuk x;k vkjS blds

ifj.kkeLo:i mi;ksxdrkZ ij dsfUnzr los k

<kaps dh :ijs[kk r;S kj dh xbZ] tks ekuo

vf/kdkjksa ij varfufZ gr :i ls vk/kkfjr

gAS 50 blds fl)kar gSa % xHkZ fujks/kd

iz.kkfy;ksa ds fodYi] fofHkUu ifz Ø;kvksa ds

6.5 Page 55

▲back to top

iHz kko] tksf[ke vkjS ykHkksa ds fo"k; esa lgh

tkudkjh( inz krkvksa dh rduhdh dq'kyrk(

lfw pr puq ko] fuftrk@,dkarrk vkSj

xksiuh;rk ij vk/kkfjr inz krk &

mi;ksxdrkZ lca a/k( mipkj ds ckn lia dZ

cuk, j[kuk( vkSj fofHkUu idz kj dh

los kvksa dk bdÎk miyC/k gksukA50 bl

<kaps dk vuqdyu fd;k x;k gS] ftlesa

dqN vU; rRo tksM+s x, gSa tSls] dhersa]

los kvksa ls ut+nhdh vkjS tSaMj lca a/kksa dk

/;ku j[kukA caXykns'k] fQyhihUl] lus sxy

vkSj rut+kfu;k esa fd, x, v/;;uksa esa

ns[kk x;k fd bu ekudksa ds vk/kkj ij

ns[ksj[k los kvksa esa l/q kkj vkus l]s efgyk,a

xHkZ fujks/kdksa dk vf/kd mi;ksx djus

yxha( tgka efgykvksa dks vPNh ns[kjs[k

los k,a ikz Ir gks jgh Fkha ogka mu {ks=ksa] tgka

ij LokLF; los k,a vPNh ugha Fkha] ds

edq kcys xHkZ fujks/kd mi;ksx nj T+;knk

FkhA51&54 lkotZ fud LokLF; vko';drkvksa

ds vfrfjDr] LokLF; ds loksPZ p ekudksa

dks izkIr djus ds vf/kdkj ds varxZr]

ljdkjksa dh ft+Eesnkjh curh gS fd os

LokLF; lfq o/kk,a] oLr,q a vkjS los k,a

lfq uf'pr djs]a ftlesa vPNh x.q koÙkkiw.kZ

xHkZ fujks/ku los k,a Hkh 'kkfey gksAa 15 ;g

<kapk bl idz kj dh vko';drkvksa ds fy,

ekxZn'kuZ nsrk gS vkSj vuHq ko n'kkZrs gSa fd

xHkZ fujks/kd mi;ksx ls efgykvksa dh

lra fq "V vkSj mudk iHz kkodkjh mi;ksx c<+us

ls viw.kZ vko';drkvksa dks lca ksf/kr djus

esa enn feyrh gS vkjS bu los kvksa dk

mi;ksx djus okyh efgykvksa vkSj ;oq kvksa

dh la[;k c<+ ldrh gSA

lS)kafrd fojks/k

dbZ los k iznkrk fuft fl)karksa ds vk/kkj

ij fofHkUu idz kj dh ;kuS ,oa itz uu

LokLF; los k,a nsus ls euk dj nsrs gaS]

ftlesa xHkZ fujks/ku Hkh 'kkfey gS] D;ksfa d

os fuft ;k /kkfedZ dkj.kksa ls xHkZ

fujks/kdksa ds mi;ksx ls lger ugha gSaA

ekuo vf/kdkj dkuwu bl fo"k; ij Li"V

gS % iznkrk ds Lora= fopkj] fl)kar vkSj

/keZ ds futh vf/kdkj] muds ejht+ ds

LokLF; dks [krjs esa ugha Mky ldrsA33]55

ekuo vf/kdkjksa ds ;wjksih; U;k;ky; us

bl ekud dks vkSj Li"V djrs gq,] Ýkal

ds nks nokbZ ds ndq kunkjksa ds ,d ekeys

es]a mUgsa /kkfedZ dkj.kksa ls efgykvksa dks

MkWDVj }kjk crk, x, xHkZ fujks/kd nsus ls

badkj djus dk nks"kh Bgjk;kA55 U;k;ky;

us Li"Vhdj.k fn;k fd] tc rd ns'k esa

xHkZ fujks/kdksa dh fcØh dkuwuh gS vkjS

nqdkunkj MkWDVjksa ds fy[ks tkus ij gh

budh fcØh nokbZ dh ndq kuksa esa djrs gaS]

rc rd nqdkunkjksa dks **vU; yksxksa ij

viuh /kkfeZd ekU;rk,a Fkksirs gq, mUgsa ,sls

mRikn cspus ls euk djus dk dksbZ

vf/kdkj ugha gS ¼os½ bu ekU;rkvksa dh

vfHkO;fDr] O;kolkf;d {ks= ds ckgj dj

ldrs gSa**A55 blds ckn ;gh nqdkunkj

Ýkal dh miHkksDrk lfa grk dk mYya?ku

djrs Hkh ik, x,] ftlds varxZr] fdlh

o/S k dkj.k ds fcuk miHkksDrk dks mRikn

cspus ls badkj djus ij ifz rca/k gAS 55]56

;g fu.k;Z bfFkdy xkbMykbUZ l vkWQ n

baVju'S kuy QMS js'ku vkWQ xk;usdkyS ksth

,aM vkSCLVhfVªDl ds vuq:i gSaA57 tks

O;fDr fuft fl)karksa ds vk/kkj ij xHkZ

fujks/kd nsus ls badkj djrs gaS] mUgsa

miHkksDrk dks ,sls inz krk ds ikl Hkstuk

vfuok;Z gS] tks ;g xHkZ fujks/kd mUgsa ns ns

vkSj ;fn os fdlh los k ds ,dek= inz krk

gaS] rks mUgsa os los k,a miyC/k djkuk

vfuok;Z gS] vkSj vkikrdkyhu fLFkfr;ksa esa

Hkh mUgsa ;g lsok,a miyC/k djkuh gkxsa hA

lkeqnkf;d Hkkxhnkjh dh deh

fu.k;Z izfØ;k esa iHz kkfor yksxksa dh

Hkkxhnkjh] ,d ewy ekuo vf/kdkj fl)kar

gSA ifjokj fu;kstu esa] ;fn lenq k;ksa dks

6.6 Page 56

▲back to top

xHkZ fujks/kdksa ls ifjfpr djkus dh izfØ;k

esa 'kkfey ugha fd;k x;k] rks ifj.kke

lHa kor% de izHkkodkjh gkxsa sA58 bl rF;

dh iqf"V djrs gq,] fo'o LokLF; lLa Fkku

(WHO) us xHkZ fujks/kd iLz rkouk ds fy,]

,d Hkkxhnkj izfØ;k dh :ijs[kk rS;kj dh

g]S tks Li"Vr;k ekuo vf/kdkjksa ij

vk/kkfjr gS] vkjS ftls yxHkx 20 ns'k

iHz kkodkjh rjhds ls i;z ksx dj jgs gSaA58 u

dsoy LokLF; ea=ky; dks 'kkfey djrs

gq,] cfYd efgyk LokLF; tuodkyr

izfrfuf/k;ksa o vU; lkenq kf;d lewgksa]

LokLF; los k inz krkvksa vkjS 'kks/kdrkZvksa dks

'kkfey djus okyh ;g ifz Ø;k] xHkZ

fujks/kdksa rd yksxksa dh igaqp c<+kus ds

fy, mfpr cnyko ykus esa l{ke jgh gSA

mnkgj.k ds fy, jksekfu;k esa] bl izfØ;k

us bl vksj /;ku vkdf"krZ fd;k fd] ns'k

ds ,d Hkkx ds yksxksa dks fu%'kqYd ifjokj

fu;kstu los k,a miyC/k Fkha] tcfd ,d

xjhc {ks= esa miHkksDrkvksa ls 'kqYd fy;k

tk jgk Fkk( blds ifj.kkeLo:i] iwjs ns'k

esa xHkZ fujks/kd iz.kkfy;ka fu%'kYq d miyC/k

djkbZ tkus yxhaA

ekuo vf/kdkj izfrc)rkvksa ds vu:q i

dkuwu o uhfr;ka

fdlh ns'k ds dkuwu] uhfr;ksa vkjS dk;ØZ eksa

esa ekuo vf/kdkjksa dks izR;{k :i ls

'kkfey djus l]s lHkh ds fy, ldkjkRed

LokLF; ifj.kke lfq uf'pr fd, tk ldrs

gSaA mnkgj.k ds fy,] ,d n'kd ls Hkh

vf/kd le; ls] czkt+hy esa efgyk LokLF;]

fo'ks"kdj ;kfS ud ,oa iztuu LokLF;] ds

l/q kkj ds fy, mi;Dq r j.kuhfr;ksa esa ekuo

vf/kdkjksa dks vk/kkj cuk;k x;k gSA59

1996 e]sa jk"Vªh; dkaxzsl us ifjokj fu;kstu

ij ,d jk"Vªh; dkuwu ikfjr fd;k ftlds

varxrZ ] ifjokj fu;kstu iRz ;sd ukxfjd

dk vf/kdkj gSA60 blds ckn] yxkrkj nks

jk"Vªh; uhfr;ka ykxw dh xbaZ] ftlls fd

lkoZtfud LokLF; <kaps ds varxrZ ifz rorhZ

xHkZ fujks/kd i.z kkfy;ka miyC/k djk, tkus

vkSj iztuu'khy vk;q dh efgykvksa vkSj

iq#"kksa dks fu%'kYq d xHkZ fujks/kd miyC/k

djk, tkus ds izko/kku FksA czkt+hy esa

;kSfud :i ls lfØ; efgykvksa esa xHkZ

fujks/kdksa dk iz;ksx 1996 esa 55 ifz r'kr ls

c<+ dj 2006 esa 68 izfr'kr rd igqap

x;k] vkSj lkoZtfud LokLF; <kaps ds

ek/;e ls miyC/k djkbZ tkus okyh xHkZ

fujks/kd xksfy;ksa dk mi;ksx bl le;kof/k

esa nks xq.kk ls Hkh vf/kd c<+ x;k] ftlesa

tul[a ;k ds dqN ,sls va'k Hkh 'kkfey gaS

tks igys ls vf/kdkj&foghu jgs gSaA61

ysfdu vf/kdkj&foghu o nwj&njkt+ ds

{ks=ksa esa jgus okys yksxksa rd igqap LFkkfir

djus esa vHkh Hkh leL;k,a dk;e gSaA ij

fQj Hkh] bl {ks= esa dqy miyfC/k;ka

izHkko'kkyh gaS] vkSj gkykafd bu j.kuhfr;ksa

ds fodkl vkjS fØ;kUo;u esa dbZ dkjdksa

dh Hkwfedk jgh] ysfdu uhfr;ksa vkjS

j.kuhfr;ksa dh :ijs[kk r;S kj djus esa

ekuo vf/kdkjksa ds Li"Vr;k iz;ksx dk

budh lQyrk esa dkQh cM+k ;ksxnku

jgkA

o"kZ 1994 l]s dbZ ljdkjksa ds chp py

jgh okrkZvksa esa fd'kksj mez o ;qokvksa ds

xHkZ fujks/ku tkudkjh o los kvksa vkjS

O;kid ;kSfudrk f'k{kk ds vf/kdkj dh

iqf"V dh xbZ gS] tks fd'kksj mez ds

O;fDr;ksa ds lkFk mudh fu.kZ; ysus dh

mn~fodklh {kerkvksa ds vuqlkj crkoZ

djus ds ekuo vf/kdkj ekudksa ds vuq:i

gks] u fd fdlh ,d i{kh; vk;q lhek ds

vk/kkj ijA17]29

dbZ ns'kksa ls izkIr izek.k n'kkrZ s gSa] fd

O;kid ;kSfudrk f'k{kk ls ;kSfud LokLF;

ifj.kke l/q kkjs tk ldrs gaS] ftlesa

vuk;kl xHk/Z kkj.k] ;kuS fØ;k 'kq# djus esa

6.7 Page 57

▲back to top

nsjh] vkjS mPp tksf[ke ;kfS ud O;ogkj dks

de djuk 'kkfey gAS 62&66 o"kZ 2006 vkjS

2008 es]a Øe'k% vÝhdk ds LokLF; ea=h

vkSj ySfVu vejhdk ds LokLF; ,oa f'k{kk

eaf=;ksa us ;kfS udrk f'k{kk miyC/k djkus

dh viuh ljdkjksa dh izfrc)rk dks iwjk

djus ds fy, Bksl dne mBk,] ftlds

varxrZ ekuo vf/kdkjksa ij vk/kkfjr

mn?~ kks"k.kkvksa dks Lohdkj fd;k x;kA dbZ

ns'k bl izdkj ds Bksl dne mBk jgs gaS]

tks bu mn~?kks"k.kkvksa ij vk/kkfjr o buls

iszfjr gaSA O;kid ;kSfudrk f'k{kk]

lkotZ fud LokLF; ds fy, vR;ar

egRoiw.kZ izko/kku gS] ftls varjk"Z Vªh;

ekuo vf/kdkj ekudksa ls lg;ksx izkIr gS]

ftuds varxZr ljdkjksa ij dkuwuh nkf;Ro

gS fd os fd'kksj mez ds O;fDr;ksa dks ,slh

f'k{kk] ftlesa xHkZ fujks/ku tkudkjh Hkh

'kkfey gks] lfq uf'pr djus ds fy, dne

mBk,aA29]30

gkyakfd dbZ fodflr ns'kksa esa fd'kksj mez

ds O;fDr;ksa ds fy, mRd`"V ;kfS udrk

f'k{kk miyC/k gS] vejhdk vHkh Hkh bl

fn'kk esa l?a k"kjZ r gAS 1998 ls 2009 ds

chp] vejhdh ljdkj us dsoy ‘fookg ls

igys rd ;kSu fØ;k ls ijgst dk;ØZ eksa’

esa 150 djksM+ ls vf/kd MkSyj fuos'k fd,]

ftlds varxZr xHkZ fujks/ku tkudkjh

ckaVus ij izfrca/k FkkA jk"Vªifr tktS Z c'q k

ds usr`Ro e]sa ;g dk;ZØe fd'kksj ;kfS udrk

ds lna HkZ esa lcls egRoiw.kZ la?kh; j.kuhfr

Fkk & ns'k ds vanj o varjk"Z Vªh;] nksuksa

Lrjksa ijA o"kZ 2009 es]a jk"Vªifr vksckek

ds i'z kklu esa] bl idz kj ds dk;ØZ eksa ds

fy, ljdkjh lg;ksx lekIr dj fn;k

x;k vkjS foKku&vk/kkfjr iz.kkfy;ksa dks

vkfFkZd lg;ksx fn;k tkus yxk] gkykafd

**dsoy&ijgst** ds dqN dk;ØZ eksa ds fy,

2010 esa fQj ls dkaxzsl }kjk vkfFkZd

lg;ksx fn;k tkus yxkA

vksckek iz'kklu ds fu.kZ;ksa esa ekuo

vf/kdkj vkSj LokLF; rdksaZ dk ;ksxnku

jgkA mnkgj.k ds fy,] 2006 esa tkjh dh

xbZ izHkko'kkyh *vMkSyslSUV efS Mflu fjiksV*Z

dk fu"d"kZ gS % **dsoy& ijgst dk;ØZ eksa

dks vkfFkdZ lg;ksx laca/kh oreZ ku vejhdh

l?a kh; dkuwu vkjS fn'kkfuns'Z k] lS)kafrd

:i ls xyr gSa] vkSj ewyHkwr ekuo

vf/kdkjksa esa ck/kk Mkyrs gaS**A69 *vefS jdu

flfoy fycVhZt+ ;wfu;u* }kjk yk, x,

loa /S kkfud dkuwu }kjk Hkh vejhdh

dsoy&ijgst dk;ØZ eksa dk fojks/k fd;k

x;kA lSUVSyh vkjS lg;ksfx;ksa ds erkuqlkj

%70 **oSKkfud vkjS vf/kdkj vk/kkfjr

leL;kvksa ds nLrkosth+ dj.k ds dkj.k

vejhdk esa ¼fookg rd dsoy&ijgst½ ,-

vk-s ;w-,e- dk;ØZ eksa ds fy, dsUnzh; lg;ksx

esa deh vkb*Z *A

tokcnsgh ds fy, dkuwuh izfrc)rk vkSj

izfØ;k,a

pwfa d varjkZ"Vªh; vkSj jk"Vªh; ekuo

vf/kdkj] ns'kksa ds fy, dkuwuh :i ls

ck/;dkjh mÙkjnkf;Ro dks c<+kok nsrs gSa] os

ns'kksa ls mudh miyfC/k;ksa dh tokcnsgh

Hkh ekaxrs gaSA tokcnsgh izkIr djus ds fy,

dbZ fofHkUu idz kj dh iz.kkfy;ksa vkjS

ifz Ø;kvksa dk iz;ksx fd;k tk ldrk gS]

tks gj ns'k ds fy, vyx gksrh gaS] vkjS

buesa l;a qDr jk"Vª rFkk vU; Hkwe.Myh;

ft+Eesnkjh dh izfØ;k,a Hkh 'kkfey gksrh gaSA

dqN mnkgj.k gSa & jk"Vªh; U;k;ky;]

jk"Vªh; ekuo vf/kdkj laLFkku] varjk"Z Vªh;

ekuo vf/kdkj lfa /k lLa Fkk,a] yksdrkaf=d

:i ls p;fur LFkkuh; LokLF; ifj"kn]

LokLF; miHkksDrkvksa dh dfefV;ka]

O;olkf;d vuq'kklu fØ;kdyki] vkjS

vU; ukxfjd laLFkk,aA71

6.8 Page 58

▲back to top

dqN ns'k vius jk"Vªh; lafo/kku esa gh

ekuo vf/kdkjksa dh LFkkiuk dj nsrs gaS

vkSj bu vf/kdkjksa dk guu gksus ij

iHz kkodkjh dkuwuh mik; miyC/k djkrs gSaA

mnkgj.k ds fy,] nf{k.k vÝhdk ds

loa S/kkfud U;k;ky; us] LokLF; ds loksPZ p

ikz I; ekudksa ds vf/kdkj ds vk/kkj ij

ljdkj dks vkns'k fn;k] fd og

lkoZtfud vLirkyksa esa vkSj Dyhfudksa esa

mu O;fDr;ksa ds fy, ,sUVhjVS ªksok;jy Mªx

uSohjkikbu miyC/k djk,] ftuds fy, ;g

fpfdRlh; :i ls vko';d gksA72

vtsZUVhuk e]sa lhMkS (CEDAW) vkjS

lhvkjlh (CRC) ds vk/kkj ij ,d

U;k;ky; us lHkh iztuu'khy O;fDr;ksa]

ftlesa fd'kksj mez dh yM+fd;ka 'kkfey gaS]

ds fy, ;kfS ud ,oa LokLF; lsok,a miyC/k

djk, tkus laca/kh dkuwu dh laoS/kkfudrk

dk leFkuZ fd;kA73 vkikrdkyhu xHkZ

fujks/kdksa rd igaqp LFkkfir djus ds fy,

jk"Vªh; U;k;ky; vc varjk"Z Vªh; ekuo

vf/kdkj dkuwuksa ij dkQh fuHkjZ dj jgs

gSa]74&77 mlh rjg jk"Vªh; laLFkk,a vkjS O;fDr

varjkZ"Vªh; o {ks=h; ekuo vf/kdkj

vf/kdj.kksa dk i;z ksx] dkuwuh xHkZ lekiu

rd igaqp LFkkfir djus ds fy, dj jgs

gaSA78]79

jk"Vªh; dkuwuksa ds varxrZ LFkkfir fd, x,

jk"Vªh; lLa Fkku] tSls fd dsU;k jk"Vªh;

ekuo vf/kdkj vk;ksx] U;kf;d lLa Fkk,a rks

ugha gSa] ijarq os f'kdk;rksa dh tkap vkSj

lkotZ fud Lrj ij rgdhdkr dj ldrh

gSaA dsU;k vk;ksx dks ukxfjd lLa Fkkvksa ls

,d egRoiw.kZ fjiksV8Z 0 izkIr gqbZ ftlds

ek/;e ls] ns'k ds LokLF; dk;Z{ks= esa

ekStwn leL;kvksa dh vksj /;ku vkdf"kZr

fd;k x;k] ftlesa ifjokj fu;kstu los k,a

Hkh 'kkfey FkhaA blds vk/kkj ij vk;ksx us

efgykvksa ds fy, iztuu LokLF; los kvksa

ds lca a/k esa ,d lkoZtfud tkap 'k#q dhA

bl tkap ds varxrZ ] ns'k Hkj ls lca )

lewgksa ls fyf[kr o ekfS [kd izek.k fy,

x,A bl tkap dh fjiksVZ o lLa rfq r;ka

jk"Vªifr vkSj lla n dks nh tk,axhA81 ,slh

ifz Ø;kvksa ds dkj.k efgykvksa dh itz uu

LokLF; los kvksa] ftlesa ifjokj fu;kstu

'kkfey gS] rd igqap LFkkfir djus esa

lHa kor% dkQh l/q kkj vk,xkA

varjk"Z Vªh; ekuo vf/kdkj tokcnsgh

O;oLFkkvksa] tSls fd lhMkS (CEDAW)

dfefV] dks izHkkodkjh rjhds ls iz;ksx

fd;k tk ldrk gSA ,d jksek efgyk dh

t+cjnLrh ulcanh fd, tkus ds ,d ekeys

e]sa dfefV us vkns'k fn;k fd gaxjh]

ifjokj fu;kstu lca a/kh mfpr tkudkjh

vkjS lykg nsus esa foQy jgk] vkjS

lfq uf'pr ugha dj ik;k fd efgyk viuh

ulcanh ds fy, lfw pr Lohd`fr ns ldAs

mlus vkns'k fn;k fd ljdkj fof'k"V

dne mBk, ftlls fd ,sls ekeys nksckjk

u gksAa 7 lhMkS (CEDAW) dfefV lHa kkfor

xaHkhj ;k i)fr lca a/kh fLFkfr;ksa esa Hkh tkap

dj ldrh gAS o"kZ 2008 vkSj 2009 es]a xjS

ljdkjh lLa Fkkvksa ds ,d xBca/ku us

euhyk ds es;j ds fo#) muds ntZ fd,

x, ekeys ds lg;ksx esa] dfefV ls euhyk

'kgj esa lkotZ fud LokLF; <kaps ds varxrZ

vk/kqfud xHkZ fujks/kdksa dh fcØh ij yxk,

x, ifz rca/k dh tkap djus dk vujq ks/k

fd;kA ;g ys[k fy[krs le; bl ekeys

ij QlS yk vkuk ckdh FkkA82 varjk"Z Vªh;

ekuo vf/kdkj vf/kdj.k dqN fof'k"V

vf/kdkjksa o ewy fl)karksa ij viuh le>

dh fujarj O;k[;k dj jgs gaS] tSls fd

,dkarrk vkjS xksiuh;rk] Lora= vkSj

lfw pr fu.kZ; ysuk] Lok;Rrrk vkSj

vkRefu.kZ;] vkSj tkudkjh nsus vkSj izkIr

djus dh Lora=rk]83&85 tks lHkh xHkZ

fujks/ku tkudkjh vkjS los kvksa rd igaqp

LFkkfir djus ds fy, vko';d gSaA bu

O;k[;kvksa ds dkj.k ifjokj fu;kstu ds

lna HkZ esa bu ekuo vf/kdkjksa o fl)karksa dks

6.9 Page 59

▲back to top

U;kf;d :i esa i;z ksx djus dh lHa kkouk,a

c<+ tkrh gSaA

dqN varjkZ"Vªh; ekuo vf/kdkj rjq ar tokc

dh ekax djrs gSaA mnkgj.k ds fy,]

HksnHkko ds fo#) ljq {kk ds varxZr

vko';d gS fd] ;fn dksbZ uhfr efgykvksa

ds fo#) HksnHkko djrh gS] rks ljdkj dks

rjq ar l/q kkjkRed dk;oZ kgh djuh gksxh]

pkgs mldh lla k/ku {kerk tlS h Hkh gksA

LokLF; ds vf/kdkj ds fofHkUu rRoks]a

ftlesa xHkZ fujks/ku tkudkjh vkjS los k,a

Hkh 'kkfey gS] ds fy, rjq ar dk;oZ kgh

djuk vko';d gS] tSls fd lfq uf'pr

djuk fd los kvksa esa HksnHkko ugha gks jgk]

ewyHkwr nokvksa rd igqap LFkkfir djuk

vkSj egkekfj;ksa ds lcwrksa ij vk/kkfjr

jk"Vªh; LokLF; j.kuhfr ykxw djukA15

ysfdu varjkZ"Vªh; ekuo vf/kdkj] ftlesa

xHkZ fujks/ku tkudkjh ,oa lsok,a 'kkfey gSa]

esa ,sls rRo Hkh gaS ftUgsa /khjs /khjs ;k

lla k/kuksa dh miyC/krk ds vk/kkj ij

ixz fr'khy :i ls ykxw fd;k tk ldrk

gS]10 tSls fd ,d izHkkodkjh LokLF;

iz.kkyh r;S kj djukA izxfr'khy :i ls

ykxw djus dk eryc gS] fd ns'kksa dks

viuh miyfC/k;ka /khjs /khjs vkjS fujarj

c<+kuh gksxa h] tks fd miyC/k lla k/kukas ds

vu:q i gksaA ;fn ladsrdksa vkjS ekudksa ds

vk/kkj ij vufq pr fodkl ik;k x;k] rks

ljdkj dks ,d fu"i{k vkSj rdZlxa r

tokc nsuk gksxk] vU;Fkk tokcnsgh izfØ;k

ds varxrZ ] bls ljdkj ds vius] dkuwuh

:i ls ck/; ekuo vf/kdkj mÙkjnkf;Ro

dk guu ekuk tk,xkA

lglzkCnh fodkl y{; 5ch & 2015 rd

iztuu LokLF; rd loZO;kih igaqp

LFkkfir djuk & dk xHkZ fujks/ku

tkudkjh vkjS los kvksa ds vf/kdkj ls xgjk

lca a/k gAS bl y{; ds ladsrdksa esa ls ,d

gS] ifjokj fu;kstu dh viw.kZ

vko';drk,aA vr%] ;fn fdlh ns'k esa

viw.kZ vko';drkvksa esa deh ugha vk jgh

g]S rks ;g ekuk tk,xk fd ml ns'k dh

ljdkj u rks lglkz Cnh fodkl y{; 5ch

izkIr djus dh dksf'k'k dj jgh gS] vkjS u

gh og xHkZ fujks/ku tkudkjh o los k,a

miyC/k djkus dh viuh opuc)rk dk

ikyu dj jgh gS & ;k rks izkf/kdkjh bl

ds vifz rjks/; dkj.k izLrrq djsAa

lia Uu ns'kksa vkSj varjkZ"Vªh; laLFkkvksa }kjk

xjhc ns'kksa dks fn, tkus okys vkfFkZd

lg;ksx vkSj xHkZ fujks/kd o vU; itz uu

LokLF; midj.k miyC/k djkus dh

opuc)rk,a fof'k"V :i ls egRoiw.kZ gaSA

bu foÙkh; lg;ksxh lLa Fkkvksa dks

opuc)rkvksa ds fy, ft+Eesokj Bgjkus dh

O;oLFkk dkQh det+ksj gaSA86 bl fo"k; esa

,d ubZ fLFkfr lkeus vkbZ gS & lHkh

lk>ns kjksa] ftlesa foÙkh; lg;ksx nsus okys

vkSj O;kikjh Hkh 'kkfey gSa] dks Hkwe.Myh;

Lrj ds fo'ks"kK leh{kk lewg

(Independent Expert Review Group)

jk"Vªh; tokcnsgh O;oLFkk }kjk ft+Eesnkj

Bgjk;k tk ldrk gSA blesa efgyk vkSj

cky LokLF; ¼xHkZ fujks/ku tkudkjh vkjS

los kvksa lfgr½ ds fy, l;a qDr jk"Vª (UN)

egklfpo dh Hkwe.Myh; j.kuhfr dks nh

xbZ opuc)rk 'kkfey gAS 86

fu"d"kZ & dkuwuh rkjS ij vko';d

izkFkfedrk,a

geus n'kkZ;k gS fd ifjokj fu;kstu dh

viw.kZ vko';drkvksa ds lna HkZ esa ekuo

vf/kdkj n`f"Vdks.k] bl :f<+oknh O;k[;k

dks foLrr` djus esa enn djrk gS fd xHkZ

fujks/ku tkudkjh vkjS los kvksa dh

vko';drk o vf/kdkj fdls g]S fdl

idz kj dh vko';drk g]S vkjS fdu

fLFkfr;ksa esa vko';drk gksrh gSA vU;

ekuo vf/kdkjksa dh rjg gh] xHkZ fujks/ku

6.10 Page 60

▲back to top

iuS y % ekuo vf/kdkj ekudksa vkjS fl)karksa ds vk/kkj ij

ljdkjksa }kjk ifjokj fu;kstu dh viw.kZ vko';drkvksa dks

iwjk djus ds fy, ikz Fkfedrk,a

;kSfud ,oa itz uu LokLF; f'k{kk] tkudkjh vkSj lsokvk]sa

ftlesa ifjokj fu;kstu 'kkfey gS] ds fy, jk"Vªh; vkSj

mi&jk"Vªh; ;kstuk,a

;kstukvksa dh :ijs[kk ,d Hkkxhnkj izfØ;k ls r;S kj dh

tk,] ftlls fd loZO;kih igaqp ¼dsoy fookfgrksa ds fy, gh

ugha] cfYd vfookfgr yksxks]a fd'kksjk]sa vU; vkfFkdZ ]

O;kolkf;d o vU; dkj.kksa ls lhekUr yksxksa ds fy, Hkh½

lqfuf'pr dh tk lds( ftlesa lHkh mfpr lkoZtfud] futh]

jk"Vªh; vkjS varjkZ"Vªh; drkZvksa dks 'kkfey fd;k tk,( vkSj

ftlesa dqN fof'k"V igy]w tSls mís'; o mUgsa iwjk djus ds

rjhds] le;kof/k] foLr`r ctV] vkfFkdZ lg;ksx] fjiksVZ]

ladsrd vkjS ekud 'kkfey gksa15

dkuwuh vkjS fofu;eu ck/kkvksa dks gVkuk

;kSfud ,oa iztuu LokLF; f'k{kk] tkudkjh vkjS lsokvks]a

ftlesa ifjokj fu;kstu 'kkfey gS] rd igaqp LFkkfir djus esa

vkus okyh ck/kkvksa dks gVk;k tk,] fo'ks"kdj vf/kdkj&foghu

lewgksa ds fy,42

miHkksDrk oLr,q a

;FkklaHko] vf/kdre izdkj ds ljq f{kr vkSj iHz kkodkjh

vk/kfq ud xHkZ fujks/kd miyC/k djkuk] ftlesa vkikrdkyhu

xHkZ fujks/kd Hkh 'kkfey gSa] tlS k fd fo'o LokLF; laLFkku

(WHO) dh ekWMy lwfp ij vk/kkfjr vfrvko';d nokvksa

dh jk"Vhª ; lwfp esa fn;k x;k gks vkjS tks lHkh mfpr

lkotZ fud vkjS futh lsokvksa esa miyC/k gksa15]49

leqnk; vk/kkfjr vkjS Dyhfud vk/kkfjr LokLF; dk;dZ rkZ

mfpr la[;k esa dq'ky LokLF; dk;ZdrkvZ ksa dks izf'k{k.k nsuk

vkjS fujh{k.k j[kuk] rkfd os vPNh xq.koÙkkiw.kZ ;kfS ud ,oa

itz uu LokLF; lsok,a iznku dj]sa ftlesa xHkZ fujks/ku vkSj

vk/kqfud xHkZ fujks/kdksa ds fo"k; ij] LFkkuh; Hkk"kk esa iwjh

vkjS lgh tkudkjh 'kkfey gks vkjS os ,dkarrk] xksiuh;rk]

fofo/krk] vkjS vU; ewyHkwr lS)kafrd vkjS ekuo vf/kdkj

ewY;ksa dk lEeku djsa15

LokLF; lsok,a

,slh LokLF; lsok,a miyC/k djkbZ tk,a tks lkQ gks]a

miHkksdrk&inz krk ds chp cBS dj ,dkarrk dk;e j[krs gq,

ckrphr djus esa lgk;d gk]sa tgka i;kZIr ek=k esa midj.k

miyC/k gk]sa 15 lsokvksa ds idz kf'kr le; lhek dk ikyu

djrh gk]sa vkSj miHkksDrkvksa dks muds vf/kdkjksa ds fo"k; esa

tkudkjh nsrh gksa

vkfFkdZ igaqp

ljdkj }kjk ikz ;ksftr NwV vkjS lkeqnkf;d chek dk;ØZ e

iznku fd, tk,a] tks mu yksxksa dh lsokvksa rd igqap

lqfuf'pr djrs gSa] tks vU;Fkk bu lsokvksa ds 'kqYd ugha ns

ikrs15]94

fujh{k.k o tokcnsgh

,slh O;oLFkk LFkkfir djuk tks izHkkodkjh] lyq Hk] ikjn'kh]Z

vkSj fujarj :i ls lsokvksa dh x.q koÙkk dh tkap djs(a rqY;

igaqp LFkkfir djus vkSj vU; mís';ksa dh fn'kk esa izxfr dk

vkdyu djs( vkSj ns[ks fd lHkh lk>snkjksa dh opuc)rk,a

iwjh dh tk jgh gSa ;k ugha5]71

tkudkjh vkSj los kvksa ds vf/kdkj dks

O;kogkfjd cukuk gksxk] ftlls fd fofo/k

fLFkfr;ksa esa thou O;rhr djus okys fofo/k

idz kj ds yksxksa dh vko';drk,a iwjh dh

tk ldasA vr% ikz Fkfedrkvksa vkSj;kstukvksa

dks ns'k Lrj ij fu/kkZfjr djuk vko';d

g]S ftudh iqf"V LFkkuh;] jk"Vªh;] vkjS

varjk"Z Vªh; tokcnsgh ifz Ø;kvksa vkjS xjhc

ns'kksa ds fy, vkfFkZd lg;ksx nsus okyh

lLa Fkkvksa }kjk dh tk,A izkFkfedrk,a

fu/kkZj.k djus vkjS fu;kstu ds fy, rhu

egRoiw.kZ eqíksa dk /;ku j[kuk vfuok;Z gAS

igyk] xHkZ fujks/ku tkudkjh vkjS los k,a

vko';d gSa] ij ifjokj fu;kstu dh viw.kZ

vko';drk,a iwjh djus ds fy, i;kZIr

ughaA tlS k fd baVju'S kuy dkUS ÝSUl vkWu

ikSiyq s'ku ,sMa MoS yieSaV ikz sxzke vkWQ

,sD'ku esa Lohdkj fd;k x;k g]S bu

los kvksa dks ,d nwljs ds iwjd] ;kfS ud vkSj

iztuu LokLF; los kvksa ds lfEeJ.k okys

dk;ZØe dk fgLlk cukuk gksxk]17 tks fd

LokLF; i.z kkfy;ksa ds et+cwrhdj.k dh

izkFkfedrk gksuh pkfg,]87 vkjS bUgsa

miHkksDrk ds ekuo vf/kdkjksa ds iwjs lEeku

ds lkFk miyC/k djk;k tkuk pkfg,A

nwljk] ns'kksa dk ekuo vf/kdkj nkf;Ro gS

fd os yksxksa dh HksnHkko ls ljq {kk djsAa

vr%] mUgsa lfq uf'pr djuk gksxk fd xHkZ

7 Pages 61-70

▲back to top

7.1 Page 61

▲back to top

fujks/ku tkudkjh vkjS los kvksa lca a/kh

uhfr;ks]a dk;ØZ eksa vkSj tokcnsgh ifz Ø;kvksa

dh :ijs[kk ,sls rS;kj dh tk, fd lHkh

yksx] fo'ks"kdj loa snu'khy o vc rd

vf/kdkjksa ls oafpr jgs yksxksa ds lewg]

HksnHkko] t+cjnLrh vkjS fgalk ls eqDr

vius tkudkjh vkSj los kvksa ds vf/kdkj

dks iwjk dj ldasA dkuS loa snu'khy ;k

vf/kdkj&foghu g]S ;g gj ns'k o ns'k ds

vyx vyx {ks=ksa dh fLFkfr ds vuqlkj

vyx gksrk gS vkSj gj uhfr vkjS dk;ØZ e

dh jpuk vkjS fuxjkuh ds lna HkZ esa gj

ekeys dk Li"V vkdyu djuk t+:jh gSA

rhljk] ixz fr'khy :i ls ykxw fd;k tkuk

;k lalk/kuksa dh deh dks visf{kr

miyfC/k;ka izkIr u fd, tkus dk dkj.k

ugha cuk;k tk ldrkA88&93 xHkZ fujks/ku

tkudkjh vkSj los kvksa ds vf/kdkj dks ykxw

djus vkSj guu dks jksdus ds fy, ;g

fl)kar o vU; ekuo vf/kdkj eqís] ftlesa

egkekfj;ksa ds izek.k 'kkfey gSa] ds vk/kkj

ij ikz Fkfedrk,a fu/kkfZ jr djuk vko';d

gAS xjhc ns'kksa ds fy, Hkh izkFkfedrkvksa ds

foÙkiks"k.k ds Bksl rjhds miyC/k gaSA94

bu rhu eqíksa dks /;ku esa j[krs gq,] vkSj

;g ekurs gq, fd ns'k viuh ;kSfud o

itz uu LokLF; vf/kdkj opuc)rkvksa dks

iwjk djus ds vyx vyx pj.kksa ij gaS]

ge iuS y (i`‘B la[;k 57) esa lkr ikz Fkfed

mik;ksa ij t+ksj nsrs gSa tks ekuo vf/kdkj

ekudksa vkSj fl)karksa ij vk/kkfjr gSa vkSj

ftuls ljdkjsa ifjokj fu;kstu dh viw.kZ

vko';drkvksa dks iwjk dj ldrh gaS vkSj

xHkZ fujks/ku tkudkjh vkjS los kvksa rd

loZO;kih igaqp LFkkfir dj ldrh gaSA

ljdkjksa dh dkuwuh ft+Eesnkjh gS fd os bu

mik;ksa dks rRdky izkFkfedrk nsrs gq,]

ykxw djus ds fy, ;FkklHa ko iz;kl djsAa

;fn os fcuk fdlh Bksl dkj.k ds ,slk

ugha dj ikrh gaS] rks os LokLF;] xHkZ

fujks/ku tkudkjh vkSj los kvks]a vkjS efgyk

lekurk ds lca a/k esa viuh dkuwuh :i ls

ck/; ekuo vf/kdkj opuc)rkvksa dk

guu djsxa hA bl dkj.k ls] ekuo vf/kdkj

vk/kkfjr O;oLFkk et+cwr jgrh g]S ftlds

mi;ksx ls ljdkjsa iHz kkodkjh o lekos'kh

uhfr;ka cuk ldrh gSa vkSj mlds fy,

lg;ksx izkIr dj ldrh gSaA bu ekuo

vf/kdkjksa dk LokLF; los k iznkrk vkjS

tuodkyr djus okys Hkh i;z ksx dj

ldrs gSa ftlls fd los kvksa dh xq.koÙkk esa

l/q kkj fd;k tk lds vkSj itz uu LokLF;]

ftlesa ifjokj fu;kstu Hkh 'kkfey gS] rd

loZO;kih igaqp LFkkfir dh tk ldAs ns'kksa

}kjk viuh ekuo vf/kdkj opuc)rk,a

iwjh fd, tkus ds fy, ekxnZ 'kZu o vU;

lg;ksx miyC/k gSA mnkgj.k ds fy,]

fo'o LokLF; lLa Fkku (WHO) us ,d

O;oLFkk dh lja puk95 dh gS] ftlds

mi;ksx ls ljdkjsa o vU; lk>ns kj jk"Vªh;

uhfr;ksa vkjS ekuo vf/kdkj opuc)rkvksa

ds chp ds varj ¼tSls] vfookfgr efgykvksa

dks xHkZ fujks/kd u nsuk gkykafd lhMkS

(CEDAW) dks dkuwuh :i ls Lohd`r dj

fn;k x;k g½S dks igpku dj] vPNh

;kSfud vkjS iztuu LokLF; los kvksa] ftlesa

ifjokj fu;kstu 'kkfey gS] rd igaqp

LFkkfir djus esa vkus okyh bu ck/kkvksa dks

gVkus ds mik; ykxw dj ldrh gaSA ,slh

izfØ;k,a] ifjokj fu;kstu dh viw.kZ

vko';drkvksa dh iwfrZ esa egRoiw.kZ

;ksxnku ns ldrh gaSA

y[s kd

lHkh y[s kdksa us ;g fjiksVZ fy[kus esa cjkcj dk

;ksxnku fn;kA

erHksn

ge ?kks"k.kk djrs gSa fd gekjs chp dksbZ erHksn

ugha gAS

vkHkkj

ge jscdS k dqd] ,sysu ek'kZy] vkjS :Fk

fMDlu&E;wyj dh fopkj'khy fVIif.k;kas vkSj

lq>koksa dk /kU;okn nsrs gSa] vkSj tw&;ax yh dks

lanHkZ lwfp esa enn ds fy, HkhA

7.2 Page 62

▲back to top

lanHkZ

1 UN. General comment no. 14: the right to the highest attainable

standard of health. Geneva: United Nations Committee on Economic,

Social and Cultural Rights, 2000: paras 33–37. (E/C.12/2000/4).

2 Bland A. Chinese state holds parents hostage in sterilisation drive.

The Independent (London). April 17, 2010.

http://www.independent.co.uk/news/world/asia/chinese-state-holds-

parents-hostage-in-sterilisation-drive-1947236.html (accessed Aug

25, 2011).

3 Greenhalgh S, Winckler EA. Governing China’s population: from

Leninist to neoliberal biopolitics. Stanford: Stanford University Press,

2009.

4 Dhanraj D (director). Something like a war. VHS/DVD. India/England,

1991.

5 Schmidt B. Forced sterilization in Peru. Political Environ 1998.

http://cwpe.org/node/49 (accessed Nov 8, 2011).

6 María Mamérita Mestanza Chávez, Perú. Inter-American commission

on human rights, friendly settlement, report no 71/03, petition 12.191.

Oct 22, 2003.

7 AS vs Hungary. UN Committee on the Elimination of Discrimination

against Women (CEDAW), communication No 4/2004. Aug 14, 2006.

(CEDAW /C/36/D/4/2004).

8 Center for Reproductive Rights. Dignity denied: violations of the rights

of HIV-positive women in Chilean health facilities. New York, NY:

Center for Reproductive Rights, 2010.

9 Namibia: women take legal action over alleged sterilisations. Irin

PlusNews. June 25, 2009.

http://www.plusnews.org/report.aspx?ReportId=85012 (accessed

Aug 19, 2011).

10 International covenant on economic, social and cultural rights. New

York: United Nations, 1966.

11 Convention on the elimination of all forms of discrimination against

women. New York: United Nations, 1979.

12 Convention on the rights of the child. New York: United Nations,

1989.

13 Center for Reproductive Rights, UNFPA. Briefing paper: The right to

contraceptive information and services for women and adolescents.

New York: Center for Reproductive Rights and United Nations

Population Fund, 2010.

http://reproductiverights.org/sites/crr.civicactions.net/files/documents/

BP_unfpa_12.10.pdf (accessed Aug 25, 2011).

14 IPPF. Charter on sexual and reproductive rights. London:

International Planned Parenthood Federation, 2003.

15 UN Committee on Economic, Social and Cultural Rights. General

comment no. 14: the right to the highest attainable standard of health.

Geneva: United Nations, 2000. (E/C.12/2000/4).

16 Office of United Nations High Commissioner for Human Rights.

International law. http://www2.ohchr.org/english/law/ (accessed

March 15, 2012).

17 Programme of action adopted at the International Conference on

Population and Development, Cairo. Sept 5–13, 1994. New York:

United Nations Population Fund, 1994.

18 Tysiac vs Poland. European Court of Human Rights, application no.

5410/03. March 20, 2007.

19 Paulina del Carmen Ramírez Jacinto, Mexico. Inter-American

commission on human rights, friendly settlement, report No. 21/07,

Petition 161–01. March 9, 2007.

20 WHO. Safe abortion: technical and policy guidance for health

systems. Geneva: World Health Organization, 2003.

21 UN Committee on the Elimination of Discrimination against Women.

General recommendation No. 21: equality in marriage and family

relations. New York: United Nations, 1994.

22 Silva-de-Alwis R. Child marriage and the law. New York: UNICEF,

2008.

23 WHO. Eliminating female genital mutilation: an interagency

statement. Geneva: World Health Organization, 2008.

24 Singh S, Darroch JE, Ashford LS, Vlassoff M. Adding it up: the costs

and benefits of investing in family planning and maternal and

newborn health. New York: Guttmacher Institute and United Nations

Population Fund, 2009.

25 Guttmacher Institute, IPPF. Facts on the sexual and reproductive

health of adolescent women in the developing world. New York and

London: Guttmacher Institute and International Planned Parenthood

Federation, 2010.

26 WHO. Why is giving special attention to adolescents important for

achieving Millennium Development Goal 5? Factsheet. Geneva:

World Health Organization, 2008.

27 UNESCO. International technical guidance on sexuality education.

Paris: United Nations Educational, Scientific and Cultural

Organization, 2009. (ED-2009/WS-36).

28 Muñoz V. UN Special Rapporteur on the right to education—sexual

education. A/65/162. Geneva: United Nations, July 23, 2010.

29 UN Committee on the Rights of the Child. General comment no. 4:

adolescent health and development in the context of the Convention

on the Rights of the Child. Geneva: United Nations, 2003.

(CRC/GC/2003/4).

30 UN Committee on the Rights of the Child. General comment no. 3:

HIV/AIDS and the rights of the child. Geneva: United Nations, 2003:

paras 15–21. (CRC/GC/2003/1).

31 Curtis S, Evens E, Sambisa W. Contraceptive discontinuation and

unintended pregnancy: an imperfect relationship. Int Perspect Sex

Reprod Health 2011; 37: 58–66.

32 UN Committee on the Elimination of Discrimination against Women.

Concluding comments: Azerbaijan. New York: United Nations, 2007:

paras. 31–32. (CEDAW/C/AZE/CO/3).

33 UN Committee on the Elimination of Discrimination against Women.

General recommendation no. 24: women and health. New York:

United Nations, 1999.

34 UN Committee on the Elimination of Discrimination against Women.

Concluding observations: Myanmar. New York: United Nations, 2008.

(CEDAW /C/MMR/CO/3).

35 UN Committee on the Elimination of Discrimination against Women.

Concluding observations: Slovenia. New York: United Nations, 2008:

paras. 35–36. (CEDAW/C/SVN/CO/4).

36 UN Committee on the Elimination of Discrimination against Women.

Concluding comments: Kazakhstan. New York: United Nations, 2007:

paras. 25–26. (CEDAW/C/KAZ/CO/2).

37 UN Committee on the Elimination of Discrimination against

Women.Concluding comments: Chile. New York: United Nations,

2006: para. 19. (CEDAW/C/CHI/CO/4).

38 UN Committee on the Elimination of Discrimination against Women.

Concluding comments: Serbia. New York: United Nations, 2007:

para. 33. (CEDAW/C/SCG/CO/1).

39 UN Committee on the Elimination of Discrimination against Women.

Concluding comments: the former Yugoslav Republic of Macedonia.

New York: United Nations, 2006: para. 32. (CEDAW/C/MKD/CO/3).

40 UN Committee on the Elimination of Discrimination against Women.

Concluding comments: Azerbaijan. New York: United Nations, 2007:

paras. 25–26. (CEDAW/C/AZE/CO/3).

41 UN Committee on the Elimination of Discrimination against Women.

Concluding comments: Suriname. New York: United Nations, 2007:

paras. 31–32. (CEDAW/C/SUR/CO/3).

42 UN Special Rapporteur on the right of everyone to the enjoyment of

the highest attainable standard of physical and mental health (Hunt

P). (The rights to sexual and reproductive health) Geneva: United

Nations, 16 February 2004. (E/CN.4/2004/49).

43 Grover A. UN Special Rapporteur on the right of everyone to the

enjoyment of the highest attainable standard of physical and mental

health—criminalisation of sexual and reproductive health. Geneva:

United Nations, Aug 3, 2011. (A/66/254).

44 Center for Reproductive Rights. In re access to emergency

contraception in Colombia (amicus brief) (Colombian Council of

State). http://reproductiverights.org/en/case/in-re-access-

toemergency-contraception-in-colombia-amicus-brief-

colombiancouncil-of-state (accessed April 21, 2012)

45 Mulama J.Contraceptives: stock-outs threaten family planning. Inter

Press Service. May 15, 2009.

http://ipsnews.net/africa/nota.asp?idnews=46854 (accessed July 20,

2011).

46 Nigeria: contraceptive stock-out puts more women on the brink. Daily

Independent (Lagos). Nov 24, 2010.

http://allafrica.com/stories/201011250526.html (accessed July 20,

2011).

47 Gathura G. Substandard drugs fast becoming threat to Kenyans.

Daily Nation. Sept 27, 2009. http://www.nation.co.ke/News/-

/1056/664554/-/item/1/-/biqo8fz/-/index.html (accessed July 20,

2011).

48 WHO. WHO model list of essential medicines: 17th list. Geneva:

World Health Organization, 2011.

49 PATH, WHO, UNFPA. The interagency list of essential medicines for

reproductive health. Geneva: World Health Organization, International

Planned Parenthood Federation, John Snow, PATH, Population

Services International, United Nations Population Fund, World Bank,

2006.

50 Bruce J. Fundamental elements of the quality of care: a simple

framework. Stud Fam Plann 1990; 21: 61–91.

51 Koenig MA. The impact of quality of care on contraceptive use:

evidence from longitudinal data from rural Bangladesh. Baltimore:

Johns Hopkins University, 2003.

7.3 Page 63

▲back to top

52 Arends-Kuenning M, Kessy FL. The impact of demand factors, quality

of care and access to facilities on contraceptive use in Tanzania. J

Biosoc Sci 2007; 39: 1–26.

53 RamaRao S, Lacuesta M, Costello M, Pangolibay B, Jones H. The

link between quality of care and contraceptive use. Int Fam Plan

Perspec 2003; 29: 76–83.

54 Sanogo D, RamaRao S, Jones H, N’diaye P, M’bow B, Diop CB.

Improving quality of care and use of contraceptives in Senegal. Afr J

Reprod Health 2003; 7: 57–73.

55 Pichon and Sajous vs France. European Court of Human Rights,

application no. 49853/99. Admissibility decision. Oct 2, 2001.

56 Westeson J. Sexual health and human rights: European region.

Geneva: International Council on Human Rights Policy, 2010.

http://www.ichrp.org/en/projects/140 (accessed Aug 18, 2011).

57 FIGO Committee for the Ethical Aspects of Human Reproduction and

Women’s Health. Ethical guidelines on conscientious objection. Int J

Gynaecol Obstet 2006; 92: 333–34.

58 WHO. Making decisions about contraceptive introduction: a guide for

conducting assessments to broaden contraceptive choice and

improve quality of care. Geneva: World Health Organization, 2002.

59 Alves JED. The context of family planning in Brazil. In: Cavenaghi S

ed. Demographic transformations and inequalities in Latin America.

Rio de Janeiro: Latin American Population Association, 2009: 297–

302.

60 The family planning law of Brazil (no 9263), Art. 1.

61 WHO. Universal access to reproductive health: accelerated actions to

enhance progress on Millennium Development Goal 5 through

advancing Target 5B. Geneva: World Health Organization, 2011.

62 Oringanje C, Meremikwu MM, Eko H, Esu E, Meremikwu A, Ehiri JE.

Interventions for preventing unintended pregnancies among

adolescents. Cochrane Database Syst Rev 2009; 4: CD005215.

63 Robin L, Dittus P, Whitaker D, et al. Behavioral interventions to

reduce incidence of HIV, STD, and pregnancy among adolescents: a

decade in review. J Adolesc Health 2004; 34: 3–26.

64 Kirby D. The impact of schools and school programs on adolescent

sexual behaviour. J Sex Res 2002; 39: 2733.

65 Lazarus JV, Sihvonen-Riemenschneider H, Laukamm-Josten U,

Wong F, Liljestrand J. Systematic review of interventions to prevent

the spread of sexually transmitted infections, including HIV, among

young people in Europe. Croat Med J 2010; 51: 74–84.

66 Michielsen K, Chersich MF, Luchters S, De Koker P, Van Rossem R,

Temmerman M. Effectiveness of HIV prevention for youth in sub-

Saharan Africa: systematic review and meta-analysis of randomized

and nonrandomized trials. AIDS 2010; 24: 1193–02.

67 African Union, Maputo plan of action for the operationalisation of the

continental policy framework for sexual and reproductive health and

rights 2007–2010. Sp/MIN/CAMH/5(I). Addis Ababa: African Union,

2006.

68 Ministers of Health and Education in Latin America and the

Caribbean. Ministerial declaration: preventing through education. First

meeting of Ministers of Health and Education to stop HIV and STIs in

Latin America and the Caribbean; Mexico City, Mexico; Aug 1, 2008.

http://data.unaids.org/pub/BaseDocument/2008/20080801_minsterde

claration_en.pdf (accessed Aug 18, 2011).

69 Santelli J, Ott MA, Lyon M, Rogers J, Summers D. Abstinence-only

education policies and programs: a position paper of the Society for

Adolescent Medicine. J Adolesc Health 2006; 38: 83–87.

70 Santelli J, Ott MA, Csete J, Samant S, Czuczka D. Abstinence only

until marriage programs in the United States of America (USA):

science and human rights. In: O’Dea J ed. Current issues and

controversies in school and community health, sport and physical

education. New York: Nova Science Publishers, 2012.

71 Potts H. Accountability and the right to the highest attainable standard

of health. Colchester: University of Essex, 2008.

http://www.essex.ac.uk/human_rights_centre/research/rth/docs/HRC_

Accountability_Mar08.pdf (accessed Sept 1, 2011).

72 Minister of Heath vs Treatment Action Campaign. South Africa

Constitutional Court, case CCT 9/02. July 5, 2002.

73 Tribunal Superior de Justicia de la Ciudad Autónoma de Buenos

Aires, Argentina, Liga de Amas de Casa, Consumidores y Usuarios

de la República Argentina y otros c/CGBA s/acción declarativa de

inconstitutionalidad. Oct 14, 2003.

74 Constitutional Tribunal of Peru. Decision 7435-2006-PC/TC. Nov 13,

2006.

75 Council State of Colombia. Decision 11001-03-24-000-2002-00251-

01.June 5, 2008.

76 Supreme Court of Mexico. Decision CC 54/2009. May 26, 2010.

77 Smeaton vs Secretary of State for Health. England and Wales

Supreme Court of Justice. April 18, 2002.

78 K L vs Peru. UN Human Rights Committee, communication no

1153/2003. Nov 22, 2005. (CCPR/C/85/D/1153/2003).

79 A,B, and C vs Ireland. European Court of Human Rights, application

no 25579/05. Dec 16, 2010.

80 Center for Reproductive Rights, Federation of Women Lawyers—

Kenya (FIDA). Failure to deliver: violations of women’s human rights

in Kenyan health facilities. New York: Center for Reproductive Rights,

2007.

81 Lichuma W. The role of national human rights institutions in reduction

of maternal mortality: a case study of the Kenya National Commission

on Human Rights. Sept 2, 2010.

http://righttomaternalhealth.org/roundtable-presentations (accessed

Aug 18, 2011).

82 EnGendeRights. Advancing reproductive rights using the inquiry

procedure of the OP CEDAW and the UN special procedures: the

Philippine experience. Manila: EnGendeRights, 2009.

83 De La Cruz-Florez vs Peru. Inter-American Court of Human Rights

(merits, reparations and costs). Nov 18, e2004.

84 Open Door Counselling Ltd and Dublin Well Women Centre Ltd and

others vs Ireland. European Court of Human Rights, application no.

14234/88. Oct 29, 1992.

85 Women on Waves and others vs Portugal. European Court of Human

Rights, application no. 31276/05. Feb 3, 2009.

86 UN Commission on Information and Accountability for Women’s and

Children’s Health. Keeping promises, measuring results. Geneva:

UN, 2011: recommendations 7 and 10.

87 Backman, G, Hunt P, Khosla R, et al. Health systems and the right to

health: an assessment of 194 countries. Lancet 2008; 372: 2047–85.

88 UN Committee on Economic, Social and Cultural Rights (CESCR).

General comment no. 3: the nature of States parties obligations (art

2, par 1). Dec 14, 1990. Geneva: United Nations, 2000.

89 UN Office of the High Commissioner for Human Rights. Human rights

and poverty reduction: a conceptual framework. New York and

Geneva: United Nations, 2004: 22–26.

90 UN Office of the High Commissioner for Human Rights. Principles

and guidelines for a human rights approach to poverty reduction

strategies, Geneva: United Nations, 2006: guideline 4.

91 UN Office of the High Commissioner for Human Rights and WHO.

Human rights, health and poverty reduction strategies. Geneva:

World Health Organization, 2008.

92 Hunt P. UN Special Rapporteur on the right of everyone to the

enjoyment of the highest attainable standard of physical and mental

health. Mission to India. Geneva: United Nations, 2010.

(A/HRC/14/20/Add.2).

93 UN Special Rapporteur on the right of everyone to the enjoyment of

the highest attainable standard of physical and mental health (Hunt

P). Supplementary note on the UN Special Rapporteur’s Report on

maternal mortality in India. Geneva: United Nations, 2010: section III.

http://www.essex.ac.uk/human_rights_centre/research/rth/ (accessed

Aug 19, 2011).

94 WHO. The world health report—health systems financing: the path to

universal coverage. Geneva: World Health Organization, 2010.

http://www.who.int/whr/2010/en/ (accessed Aug 19, 2011).

95 Cottingham JC, Kismodi E, Martin Hilber A, Lincetto O, Stahlhofer M,

Gruskin S. Using human rights for sexual and reproductive health:

improving legal and regulatory frameworks. Bull World Health Organ

2010; 88: 551–55.

7.4 Page 64

▲back to top