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APPENDIXES
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APPENDIXES APPENDIX 1 A Chronology of Health-Sector Events in Nepal Year 1925 1934 1952 1954 1956 1958 Population X 10" 5.5 8.7 Physicians 1 12 Other health workers: Training Civil Medical School (CMS) WHO, USAID Participant training Health Assistant Training School (HATS). NMEO begins to train 100s of workers Planning Rapti Valley (Chitwan) Multi-Sector Development 1st Plan: Hospitals upgraded; Ministry of Health organized Services development Categorical programs Malaria survey Malaria pilot project 2,000,000 cases NMEO formed Hospitals 33 Health posts 0 24 [3.17.150.163] Project MUSE (2024-04-17 21:47 GMT) 1962 1964 1965 1971 1972 1974 1975 9.8 11.4 12.9 311 288 348 450 auxiliaries since 1934 900 nurses and auxiliaries Ministry of Education/Institute of Medicine takes over training most auxiliaries Over 1,000 health workers trained by IOM; DHS trains VHWs; FP/MCH trains panchayatbased workers (PBWs) 2d Plan: Hospitals upgraded; manpower planning National Health Survey Kaski-Bara Pilot; Integrated Health System Planning cell in MOH 5th Plan: Formulation for nationwide integrated health services; National Nutrition Survey Smallpox MCH TB/Leprosy; FP/MCH UNICEF Community Water Supply Project 2,500 cases of malaria Last case of smallpox; malaria resurges FP/MCH expands to all districts; malaria program revitalized 36 58 9 153 251 351 Year 1978 1979 Population X W 13.9 14.0 (est.) Physicians 375 457 Other health workers: Training About 1,000 VHW, 450 FP/PBWs, 2,000 health-post and hospital midlevel workers; over 3,000 malaria workers About 270 VHWs, 77 ANMs, 34 AHWs, 61 HPIs* and 500 PBHWs provided in-service training; 10 ob/gyns provided laprocatorminilap training; 25 physicians trained in vasectomy Planning Presumptive Sixth Plan: Push for integration of all rural health services Sixth Plan: Revised to postpone development of ward-level health workers Services development Categorical programs Malaria stable; smallpox program turns to other immunizations; increase in sterilizations; expanded primary care 48 district health offices in operation; 13 fully integrated districts; increase in sterilization services provided at mobile camp and permanent centers; malaria field tests malathion Hospitals 69 70 Health posts 483 (233 integrated) 533 (283 integrated) Note: Dates given in chart may indicate when activities began and not the official inauguration of a program. *HPI—Health worker in-charge of Health Post. SOURCK: Health Associates 1978 [3.17.150.163] Project MUSE (2024-04-17 21:47 GMT) APPENDIX 2 Profile of Health Workers in ICHP Health worker Village Health Worker (VHW) Auxiliary Health Worker (AHW) Assistant NurseMidwife (ANM) Educational requirement 8th Grade plus inservice training. 8th or 10th grade plus AHW course or vertical-project supervisory experience. 8th grade plus ANM course. Where educated ICHP in-service training of one month. 1OM, Lazimpat, and Birgunj campuses; 1year (10th grade) or 2-year (8th grade) course. 1OM, several campuses ; 1 '/2-year course. Source Vertical projects; local recruitment by chief district officer. IOM graduates; vertical projects. IOM graduates. Responsibilities Regular home visits to all families in defined area for family planning motivation and services, communicable disease and nutritional surveillance and oral rehydration. Assist HA in curative and preventive services at health post and in supervision of VHW. Manage FP/MCH activities at health post and outreach clinics, provide midwifery services in health post area, and supervise VHW in FP/ MCH activities. Senior Auxiliary Health Worker (SAHW) Health Assistant (HA) AHW or earlier compounder or equivalent course, plus work experience and upgrading course. 10th grade plus certificate course. IOM upgrading course of several weeks' duration IOM, Maharajganj Campus; 2'/2-year course. AHW or equivalent. IOM graduates. Equivalent to HA, acts as HA in health post management and supervision. Manage health post, supervise curative and preventive services provided by health post and fieldworkers. Health Inspector (HI) Medical Officer (MO) At least 10th grade (some B.A. or higher), plus work experience and inservice training. M.B.B.S. or equivalent. ICHP in-service training of 2 to 4 weeks. India, other foreign universities. Vertical projects, HAs. M.B.B.S. graduates. Manage district health office (48 sanctioned) and supervise healthpost operations. Curative services at district hospitals, administrative and technical responsibility for district health offices, surgical family planning services at hospitals and in camps. SOURCE: Health Associates 1978 [3.17.150.163] Project MUSE (2024-04-17 21:47 GMT) APPENDIX 3 Job Descriptions for ICHP Workers (Unofficial translation from Nepali text) Functions of Community Health Volunteer 1. To remain conscious of the ward's* problems related...