1

.egqf fkdms

2

.egqf fkdms

3

mgqk

msgqj1' yekau''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 15

1'1 m%ckk whs;sjdisl rduqjla ms

4 iv

2'4 l%shdld .egq meje;s ld,fha m%ckk fi!LHh''''''''''''''''''''''''''''' 64

2'4'1 l%shdld .egq iufha ore Wm;a'''''''''''''''''''''''''''''''''''''''''''''''' 66

2'5 iudc neyerlrKh iy fiajdjkag m%fYfha jHqyd;aul

ndOl''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 68

2'5'1 m%ckkh f;dard.ekSf ksoyi''''''''''''''''''''''''''''''''''''''''''''' 70

2'5'2 oekqj;a f;dard.ekSu'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 73

2'5'3 .idj'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 76

2'6 ia;%Skaf.a m%ckk fi!LHh yd whs;Ska flfrys iqkd jHikfha

n,mEu'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 79

3' ia;%sla ugf mfhaIK fidhd .ekS''''''''''''''''''''''''''''''''''''''''''''' 95

3'1 mq;a;,u ia;%slalh''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 97

3'2 ukakdr ia;%slalh''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 113

3'3 fmdf

5 v

j.=

msgqj

1' .egqfuka m;g m;a W;=r yd kef.kysr iy

Y%S ,xldj inkaO f;dard .kakd ,o fi!LH ;;a;aj oYl'''''''' 31

2' iuqL idlPdjkag Ndckh jQjkaf.a ckjd.sl

fNaokh" ia;%slal wkqj'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 39

3' m%;spdr oelajQjkaf.a jhia fNaokh''''''''''''''''''''''''''''''''''''''''''''''''''''' 39

4' ia;%slalj,g wkqj wOHdmk ugu'''''''''''''''''''''''''''''''''''''''''''''''''''''' 40

5' iuqL idlPdjkag Ndckh jQjkaf.a jdyl wjdyl nj''''''' 41

6' jehg m;af jhi'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 42

7' ia;%slalj,g wkqj jdyfha jhi''''''''''''''''''''''''''''''''''''''''''''''''''''''''43

8' ia;%slal wkqj m

6 vi

7 vii

fmrjok

1990 .Kkaj, mej;s cd;Hka;r if,k whs;sjdisl ms

8 viii

ksrka;rj wdOdr lsu fiau ;srirj uey;au wjYH h' fYaIs;

wdOdr ixOdk m%uqL lr .;a ,sx.sl yd m%ckk fi!LH ^SRH& m%Yak ms

9 ix

g jvd;a jdoimkak ,sx.sl yd m%ckk whs;Ska wdrlaId l<

yelafla flfia o hkak iy ck jd.sl wkkH;djh" mx;s fyda

wd.l iq;r fn u; mok jQ ikakoaO .egq jeks m%cdjf.a

iuia; whs;Skau ;ckhg ,laj ;sfnk ikaoNhla ;=< ia;s%hlg

fuu whs;Skag ysl lshd mE yelafla flfia o hkak h' tfyhska

fjkila we;s lrkq i|yd Nd;d lrk l%fudamdhhkag ol=Kq

wdishdkq l,dmfhys m%K;djfha iy WmfoaYkfha ia:Nhka jkq

we;a;d jQ Yla;su;a ia;S% udkj ysl ixOdk f.dvke.Sug( .=

ld,Sk wdh;ksl iydh fhou fuys w;HdjYH f' fYaIfhka

ia;S%kaf.a whs;Ska idlaId;a lr .ekSf ndOd meKug O

ld, ksfIhkays fjkiau iy tlsfkl iuqLu Odldrj

mj;ajd .kakd wka; inka; iudc" wdl" ixialD;sl

idOlhkaf.a O;aj rgdjg wduka;%Kh lsula ish hq;=h'

fuys ;r.ld iy ikakoaO .egq lafIa;%hkays " m%pKav;ajfha

iudc foaYmd,k mok o l=," mx;s" ckjd.sl fukau wd.l

wkkH;djkaf.a wka; inJO;djhka o u;= lr .ekSug yd

tajdg wduka;%Kh lsug ia;%S jHdmdrhg wdOdr lsu we;=

10

iy ia;S%kaf.a udkj whs;Ska ms

11

fldGdY yqfola iQrdlkq ,eu u muKla fkdj iudcuh

jYfhka neyer lrkq ,nk fjk;a ldrKdjka tk wdydr" c,h"

fi!LHh" wOHdmkh fukau jfkdamdud. jekss wju iudc

wdl wjYH;djkag mjd wvq m%fYhla iys;" fjkia lsug

wiSre wkaoka ia:dms;j mj;sk wiudk;djhkaf.a ikaoNhla

ksidfjks' mQj .egq iys; iudchl we;e m%j.hkag tfrys"

fjkia lsug wiSre fia mj;sk ia:dms; wiudk;djka .eUqrejk

;rug fuu neyer lrk ,o m%j.hka flfrys .egqu iska

we;s lrk n,mEu jvd;a Yd, f' n,mEu lKavdhf fyda

iduqyslfha ydkshg m;a mdYjhg >Dcqj n,mdkafka hehs lsj

yels w;r f,dj mqrdu jd;d" rmr ia;S% mqreI iudcNdh

wiudk;djhka m%lg lsu o khka ms

12

jvd" jvd fyd| fi!LH m%;smdokj,ska hqla; jkafkah hk

ldrKh ;shu O iA;s%lalj, o O ck jd.sl m%cdjka

w;r o Iu;djka mj;sk nj yd .egqu iska Iu;djka je

lr ;sfnk nj wOHhkh fmkajd fokq ,nhs' tf,i we;e

ia;s%lal uyck fi!LH imdok moaO;Skaf.a imQK |

jeula fyda yeu fohlau jir .Kkdjl ikakoaO .egqu

fya;=fldg f.k wjq,a ;sfh hk ldrKh ie,ls,a,g .;a

l, ia;S%kaf.a m%ckk fi!LH tlaflda fYaIs; wjYH;djkag jvd

wju uyck fi!LH fiajdjka iemhSu ms

13

,nk w;r mS;D uQ,sl" uQ,Oujd idrOu yd oDIajdohka

Yla;su;a lrkq ,ef' ia;S%ka f.ka m%Yak lsulska f;drj

Tjqkaf.a wdfKsl ixialD;Skaf.a idOkSh yd ksfYaOkSh hk

me;s folu ms

14

fuu is;s,s iu.ska ud" fuu mfhaIK fidhd .ekS ykajd

u inkaOfhka i;=gg m;a fjk w;r m%;sm;a;s imdolhska

iska ie,ls,a,g .kS hehs ud wfmalaId lrk fuu jeo.;a

fidhd .ekS m%ldYhg m;a lsu inkaOfhka ldka;dj iy

udOH iduQyslhg Y=NdYsxikh lr'

frdIa f.diajdysgmq jev igyka ks,Od - f*da moku" kj ,a,sh'

ysgmq tall m%OdkS" ol=Kq wdishdj i|yd jQ ia;S%"

iduh yd wdrlaIdj" tlai;a cd;Skaf.a ia;S%ka'

xiv

15

1' yekau

fuu wOHhkh oYl follg wl ld,hla ikakoaO

.egqfuka m;g m;a YS% ,xldf m%foaYj, j;ajk ia;S%kaf.a

w;aoelS Yaf,aIKh lrhs' th mok jQfha hdmkh ^W;=r&"

ukakdru yd mq;a;,u ^jhU& hk ia;s%lalj," fmdf

16

lr ;sf' fuu mfhaIK ,sh,af,ys wruqKq fohdldr h'

tla w;lska th m%;sm;a;s imdokhg o Ydia;S%h idlPdjkag

iy uey;aj,g o ia;S%kaf.a y`v f.k tau u.ska YS% ,xldf

m%ckk fi!LH ms

17

fi!LH ugu nqla;s f iudk wjia:dj i,ik fi!LH

wdrlaIK l%uhlg we;s whs;sh we;=

18

;;a;ajfha wvqjla iys; ;;a;ajhla YS% ,xldf ckjd.sl

m%Yakfha ldYkh inkaO m%Odk idOlhla f,i oeka meye,sj

ms

19

ms ld,Skj ia:dms; jQ" Yd, jYfhka

id:l yd cd;Hka;r jYfhka ms

20

yelshdj we;s lr ;sf' ck.ykh iy ixjOkh ms

21

u. mE h' th jhsfka j;a jk O ckjd.sl" NdIduh iy

wd.l lKavdh w;r O%elrKh fiau fnu ;Sj% lf

22

m%Yak ms

23

m;aj ;sfnk nj10 yd ffjoH ;k;=re m%Odk jYfhkau mqyqKq

yd jD;a;Sh fkaf.ka ysiaj ;sfnk njo fmkajd fohs' m%ckk

i;aldrh iemhSu o fndfyda ndOlhka ord is' frday,a ydkshg

m;aj ;sfnk m%foaYj, m%iQ;sl i;aldrhg ndOd we;s lrkq ,nhs'

mjq,a ie,iq fiajd iy fi!LH wOHdmk fiajd mj;skafka

wm%udKj;aj h' ;jo ;lafiarej iska STD/HIV/AIDS md,kh lsf yd je

24

fkdmj;sk f,ig yd ud;D IKAK;dj ^maternal morbidity) iy ud;D urK wkqmd;h rf wfkla m%foaYj,g jvd je nj

wfmalaIs; f,ig h'12

1'3 cd;sl fi!LH m%;am;a;sh iy jevigyka

Y%S ,xld wdKavqf fi!LH wud;HxYh m%;sm;a;s udf.damfoaY

ilia lsu" ffjoH yd mmQrl ffjoH i;aldrl fiajh"

wOHdmkh" ffjoH wdh;k l

25

fi!LH wud;HxYh iu. tlaj m%ckk fi!LH fiajd jHdmD;sh"

ud;D yd

26

is' tfiau ck.yk fiajd ,xld" fi!LH wud;HxYh iu.

tlaj mjq,a ie,iq ls" jkaOHlrKh we;= Wm;a md,k

l%u Nd;h ms

27

iuia; ud;D urK wkqmd;h my< ugul mej;sh o ia;%sla

w;r Yd, O;ajhla iy fjkila mj;S' ia;%slal oyhl -

bka je yhla msysgd ;sfnkafka .egqfuka m;g m;a W;=re

iy kef.kysr h - ud;D urK wkqmd;h cd;sl idudkHhg jvd

fnfyka je" 14'3] isg 9'7] olajd mrdihl mj;S'17 flfia jqjo

is;a ;ejq,g m;a lrk m%Odk ldrKh we;af;a .egqfuka m;g

m;a m%foaYj, ,nd .; yels m%ckk fi!LHdrlaIK ;;a;ajh

ms

28

Tjqkaf.a iehka fi!LH wxYfhka fokq ,nk iq uqo,a jkah

,nd .ekSu i|yd fyda jHkaOlrKhg ;,a lr oef ldhsl

iy udkisl laIs;sh ^trauma& iu. iucd; ;sfnk ia;%Skaf.a Wm;a md,kh iy Wm;a md,k l%u Nd;h flfrys wjOdkh

fhduqj ;sfnk j;=lr fou< ck;dj rf

29

flK' ia;%Skag tfrys ish wdldrfha fjkiafldg ie,lS

msgqlSf cd;Hka;r iuq;sfha ^CEDAW& uQ,Ou cd;sl kS;sfha fldgila njg m;a lsu iy ia;S%ka ms

30

.egq iy wj;eka f jd;djrKhla ;=< j;ajk ia;%Ska ldhsl

fukau udkisl wmfhdackhg o ,sx.sl yd ldhsl ysxikhg o

jvd;a myiqfjka f.dre h yels h' iudc cd,hkaf.a | jeu"

iajhx wldrfha Ldokh iy ;a;f.d;aul iydfha wvqj o

tf,iu hqoaOfhka m;g m;a ia;%Ska m%ckk fi!LH id;a;=

fiajdjkaf.ka Tfnka ;nk yqfol,djg iy wdka;SlrKhg

odhl h yels h'23

j;auka mfhaIK wOHhkhg miqula f,i yis udkqISh iy

mqkre;a:dmk wjYH;d i|yd jk f,al ldhd,h ^SIHRN& Wfoid jQ wjYH;d ;lafiarej m%ckk fi!LHdrlaIKh we;=j

uQ,sl fi!LHdrlaIK fiajdjkag wod

31

tfiau yis udkqISh yd mqkre;a:dmk wjYH;d i|yd jk f,al

ldhd, ^SIHRN& ;lafiarej" W;=re yd kef.kysrg fi!LH fukau m%ckk fi!LH fiajd m%udKh wvq lsf nrm;, ia;%S

mqreI iudcNdjuh fYaIs; m%;smdl yd ia;%Skaf.a ; flfrys

tys n,mEu u;= lr .ekSugo fiajh lrhs'

j.=j 1

.egqfuka m;g m;a W;=r yd kef.kysr iy Y%S ,xldj inkaO

f;dard .kakd ,o fi!LH ;;a;aj oYl

oYlh Y%S ,xldj W;=r yd kef.kysrwvq nr - wjqre 0-5

idudkH

mqreI

ia;%S

24'9]

29'0]

29'8]

46'2]

50'2]

42'3]

wvq Wm;a nr 16'7] 25'7]ksjfia Wm;a 4'0] 19'4]

^uvl,mqf 31'4]"

ukakdrf 38'4]&

ud;D ukaofmdaIKh 48'7]Wm;a md,k l%u Nd;h ^tod& 84'7] 51'3]Wm;a md,k l%u j;auka Nd;h 70'0] 36'2]uq idM,H wkqmd;slh 1'9 2'6

uQ,dY%h( SIHRN 2003 - wjYH;d ;lafiare ilaIKh'

j.=j 1 ys ia;r lrkq ,en we;s oYl Wm;a md,k l%u Nd;h

flfrys jQ .egqf nrm;, n,mEu fldf;la oehs fmkakq

lrhs' th cd;sl idudkHfhka wvlg wdikakjk w;r W;=r yd

kef.kysr ia;%Skaf.a idM,H;d wkqmd;h je lsug fya;= we;'

tfiau tajd ud;D ukaofmdaIKfhys o

32

yis udkqISh yd mqkre;a:dmk wjYH;d i|yd jk f,al

ldhd,fha (SIHRN) ;lafiarej ck ix.Kk yd ixLHd f,aLk fomd;fka;=j iska imdokh lrk ,o iyY% ixjOk

mrud: oYl jd;df ^2005& f;dr;=re u.ska W!K mQKh

lrkq ,nhs' .egqfuka m;g m;a ls,sfkdh yd uvl,mqj jeks

ia;%slalj, ud;D urK wkqmd;h cd;sl idudkHhg jvd by<

h' ^ms

33

lsug m%h;ak orhs'26 m%ckk fi!LH hkq m%Odk jYfhkau fi!LH

fiajdjka je hqKq lsu Tiafia ch.; hq;= fi!LH m%;sIaGdjla

f,i wduka;%Kh l< hq;a;la nj meye,s h' th Wm;a md,khg

fyda j; idM,H;djfha m%;smdlhkag ia;%Skag ;sfnk

m%fYfha wjldYhg fyda m%fYfha wvqjg Rcqj wduka;%Kh

fkdlrhs' tfiau th m%ckk fi!LH ia;%Skaf.a whs;shla jYfhka

yd yslula jYfhka f.k tajdg wduka;%Kh lsu o fkdlrhs'

tmuKla fkdj Yaf,aIKh ;=< fyda m%;sm;a;s ksfoaY ;=<

fi!LH oYl o ia;%Skaf.a iudk;au;djhg yd Y=NidOkhg

ndOd lrk jvd mq,a jHqyd;aul iy iudc ixialD;sl fukau

foaYmd,k ndOl w;r ne o we;s fkdlrhs'

26. tu'

34

35

2' ldka;dj iy udOH iduQyslfha mfhaIK wOHhkh

2'1 Ihm:h yd l%ufoh

my;ska tk fldgi Y%S ,xldf .egqfuka m;g m;a ia;%slal

lsysmhlska ,nd .;a mfhaIK fidhd.ekS l%lj olajk w;r

whs;sjdisl rduqjla Wmfhda.S lr .kska ia;%Skaf.a m%ckk

fi!LHhg inkaO we;e m%Odk m%Yakj,g wduka;%Kh lrhs'

mfhaIKh lrf.k hkq ,enqf hdmkh ^W;=r&" ukakdru yd

mq;a;,u ^ jhU&" fmdf

36

m%cduQ, ixOdk iy wdh;k iu. jevlrka mphla ,enQ

WmdOdkshkaf.ka iuka; ksfhda;jhka iska o;a; tla/ia

lsu myiqlrKh lrk ,' mfhaIKfha flakaSh fhduqj jQfha"

Tjqkaf.a jk pl% yd m%ckk fi!LH wjYH;djkag inkaO

m%Yak ms

37

wOHhkfha fojk whr iuka; jQfha ckjd.sl;ajh yd jhi

wkqj f;dard .kakd ,o iuqL idlPdjkag Ndckh jkakshka 30

fofkl=f.a isoa wOHhkhka ;=

38

iSudjka

mfhaIKfha m%:u whr 2004 ud;=-cQ,s w;r ukakdru"

hdmkh" fmdf

39

j.=j 2

iuqL idlPdjkag Ndckh jQjkaf.a ckjd.sl fNaokh"

ia;%slal wkqj

ckj.h

uk

akdr

u

hdm

kh

uvl

,mqj

wmdr

fmdf