Directorate of Rural Health Services & Training Programme
Item
- Title
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Directorate of Rural Health Services &
Training Programme - extracted text
-
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST OOHN'S MEDICAL COLLEGE
PROFORMA
Section A and C to be filled in by all Community Health Workers
Section 8 to be filled in by those who are doing health work
at present.
instructions :
(please keep us informed regarding change of Address!
A
GENERAL INFORMATION
SECTION - rA
a)
nn-
Name :
<=) CHW Course No.:
e)
b) /Age:
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d)
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Name of Congregation:
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Biocese:
Address
n Permanent
(Mother House/Superior) :
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fp * 0 •
JAcAcJLivvmX Jbib
o) Present /Address
(For future correspondence)
:
HoK) (°n.ar3
SoulHt®0*^
h) tfhat have you been doing after the course ?
(if you have changed from place to place give
.in each place).
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some details of your work
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i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
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Community Health ijorksrs? If so
ire you in touch with any of the other
give us their recent address.
k)
- 3 working
description of the poeple you are
1) Give in1 a few sentences a
main occupation, other characteristics
with (rural, urban, tribal, non—tribal, f.——
, what distances apart ?
etc).
How many villages? Total population
Tiuvol,
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SECTION B
a)
Give a
b)
rr-'uj
short description of the health activities you are involved in.
How many .hours
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are,
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allotted for this daily/weekly ?
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c)
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^ro you functioning independently or with a team of workers?
If so,
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assistance from the local Primary Health Centre?
d) Do you get any
If so, specify ?
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e) Do you get any
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assistance from a Taluk/Mission Hospital?
f) Do you work with any special groups
yout hf mothers* harijans etc.)?
If so, specify?
in the village (young farmers^
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I
: 3 :
g) Do you participate in training of local people ? Grihinis, village level
worker, mothers etc.
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h) Do you have any of the following programmes?
Food for work, Health Insurance, CHS- l*ICH Programme, any others
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i) ^re you part of any Diocesan Society or Health Team ?
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If
If so,
so specify.
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SECTION C (Regarding 1982 project)
a) Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and ^us stop),
Co YnA. Jto
oy
Fr^ Uuok.
. Fto>n AVoJluzvoJ hi
btiuc*^
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,
b) iflre there any forms of support which a visiting team can give you next year ?
tl fa”!.
•ate:
Signature®. ©. II. OrganlBCtj
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was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED I N ST 30HN(S MEDICAL COLLEGE
PROFOIW
Instructions :
Section A and C to be' filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Addressl
SECTION - A
a)
Name :
GENER3L INFORMATION
P?-
l<OCHu.ptJHBNpu^) Ages
c) CHJ Course No*:
e)
Sc // b ,
d) Name of Congregation:
Biocese:
Permanent Address
(Mother House/superior)
:
g) Present Address
(For future correspondence)
tA V’
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
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i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
-
j)
Have yiu attended any course/meetings/workshops since you completed the
Course ?
...2
s 2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
1) Give in1 a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
How many villages? Total population, what distances apart ?
etc) •
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a
SECTION 8
a)
involved in.
Give a short description of the health activities you are
b)
How many hours are allotted for this daily/weekly ?
NCruL ,.J cUvr11 cU ■
c£o bL<.~
-
c) (^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
Af£>E
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
XO
e) Do you get any assistance from a Taluk/Mission
Hospital?
If so, specify?
/VP ’
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
2 3 ?
g)
Do you participate in training of local people ? Grihinis 9
worker, mothers etc.
village level
h) Do you have any of the following programmes?
food for work,* Health Insurance,
CR3- MCH Programme, any others
i) <Are you part of any Diocesan Society or Health Team ?
If SOj
specify.
/\/o
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
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tz
Kj^A-y)' Lie
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b) .Are there any forms of support which a visiting team can give you next year ?
late:
3
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions $ Section A and C to be filled in by all Community Health Workers
Section B to be Filled in by-those who are doing .health*work
at present.
(please keep us informed regarding change of Addr’essl
SECTION -
GENERAL IN FORMAT 10 N
a) Name :
b) Age: 3
c) CHW Course No.:
e) Bi o ces e:
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d) Name of Congregation:
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f) Perrfehent /Address
(Mother House/superior) :
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o) Present address
(For future correspondence)
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h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work-
Cc
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
.^i
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j) Have yattended any course/meetings/workshops siMce you completed the
Co urg e ?
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k) ,ire you in touch Wjith any of the other Community Health Workers?
give us their recent address.
If so
Aft’ ■
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc). How many villages? Total population, what distances apart ?
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SECTION 0
a)
Give a short description of the health activities you are involved
b) How many hours are allotted for this daily/weekly ?
c) $re you functioning independently or with a team of workers?
If so
how is the health work shared amongst you ?
..Zc/6 j
d)
i
you7 g^e^^n^4ssi§tan6e^fi^on
m the loca
If so, specify ?
7) ’/
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L/i*
e) Do you get any assistance from a Taluk/flission
Hospital?
If so, specify?
A=
Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
’-1
...3
: 3 •
g) Do you participate i
in training of local people ?' Grihinis,
worker, mothers etc.
*
village level
ly-. Lt^
*
h) Do you have any of the following programmes?
Food for work.,
Health Insurance,
crs-
MCH-orogramme, any others
z? /■} S _./7d H
i) ^re you part of any Diocesan Society
SECTION
a)
or Health Team ?
If so, specify.
C (Regarding 1982 project)
Give us detailed information on how to reach '
your village/project/centre?
(By bus and
- trgin
vradA’h. also from station and bus stop),
/7
zy
(3^1---
,
Lhct^
b) ^re there any forms of support which a
hate:
h
> / .
visiting team can give you next year ?
Si gnat ur e:
. /D <
Please use the remaining blank space to giveany further details
for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services
and Training Programmes
St John!s Medical College,
Sangalore
DR HSTP-ACC-81
Dear
23 Nov 1981
Sr M
Seasons Greetings for Chirstmas and the New Year from all of us
in the Department of Community Medicine at st 3ohnTsl
1982 is going to be a special year for us since a long standing
plan to meet all of you in the field has finally materialised.
Thelma and
I are on special leave for a year starting December 1981 and during this
year we plan to visit as many of you as possible in your own areas of work
to re-establish contact, share experiences, reflect together and grow
in our understanding of our people and our work.
We have already been in
touch with many of you and we shall be writing to others as the weeks go by.
We thank all those who have so promptly and enthusiastically received this
news and welcomed us to their villages in 1982.
We hope to hear from many
others amongst you soon.
In order to get some common information frram all of you in the
field we have drawn up a simple questionnaire taking ideas from many of
your own letters.
Please fill these up and add any other comments,
information, suggestions you would like to send us.
Those of you, who have
already sent us some details of your work recently fill in only those sections
which you did not cover in your personal letters.
We would like very much
to hear from each of the 150 Community Health Workers we have trained.
Even a blank tuestionnaire with only your latest address and information
on how to meet you next year would be most welcome.
Meeting you and seeing your programme will be a good experience
for us but in case you feel there are any other ways in which our visit
could be mutually beneficial please suggest this in Section C (b)•
In preparation for this visit many other materials are being
organized which we hope to send you soon - a list of Community Health
Workers addresses, news bulletins, list of new handouts and educational
materials and so on.
So please keep in touch.
Hoping to hear from you soon and also meeting you next year.
With best wishes and regards,
-Te
Yours sincerely,
•i
//\
0
PS: Please post this to Drs. Ravi & Thelma Narayan, D-10 Staff Quarters,
St John’s Medical College, Bangalore 560 034 before Christmas 1981)
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS NEDICAL COLLEGE
PROFORPM
Instructions :
Section A and C to .be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
SECTION - rfl
a) Name :
GENERAL INFDRWION
*5 . ^"1
/jj
b) fftge:
d) Ncame of Congregations
c) CHJ Course No.:
e) liocese:
Permanent Address
(Nother House/Superior) :
9) Present /Address
(For future correspondence)
:
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
i) Giuo us a short description of the present team you are working with and
what each member does
(not only health activities)
j) Have yiu attended any course/meetings/workshops since you completed the
Course ?
...2
*
?
2 :
k) .Are you in touch with any of the other Community Health Workers? If
SO
give us -their recent address.
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal,
non—tribal, main occupation, other characteristics
etc).
How many villages? Total population, what distances apart ?
SECTION B
fl
a) Give a short description of the health activities you are involved in.
b) How many hours are allotted for this daily/weekly ?
c) ..Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mot hers,, harijans etc.)?
. ..3
: 3 :
g)
Do you participate in training of local people ? GrihinisJ
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food fpr work,
Health Insurance,
CRS- FIC H Programing, any, others
i
i) .Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on Ihow to reach your village/project/centre?
(By bus and train, also from station and bus stop)
^cuu.'l&£'
b) .Ar® there any.» forms of ©'upport
wh-ich^a visiting^tt eam can -giye, -you next year ?
f
Bat es
Signature:
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FQLLOU-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFORMA
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
Instructions :
at present.
(please keep us
- GENERAL INFORMATION
SECTION a)
Name :
<3 It hl • (dc>ns^aYiee. .
c) CHJ Course No.:
b) age:
I 7
3<^
d) Name of Congregation:
HmcZie
e) Bioceses
f)
informed regarding change of .Address!
L rlewa a)A
Permanent address
(Mother House/Superior)
■
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■ 8i-al& ■
M. [£. owsl CVO.2J- .
g) Present Address
(For future correspondence)
sKoaKa'
:
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each ‘place).
C. ^Yne
^tLe
H
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C (n
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i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
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course/meetings/Workshops since you completed the
Have yiu attended ai
Course ?
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...2
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k) .ire you in touch with any of the .other Community Health Workers? If
give us their recent address.
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Tcrtxezk
CLUi>a
aJ l
U av I-L-Iaa ...
l) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
et c) .
Total population, what distances apart ?
How many villages?
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SECTION B
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a) Give a short description of the health activities you are involved in.
uj
b)
cor/<
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crrt
How many hours are allotted for this daily/weekly ?
| VJ*rk - S'I /’'M < •
—
ChvejL
&
.
c ) are you functioning independently or with a team of workers?
If so.
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
_
(Vo.
e) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
tJo f) Do you work with any special groups
youth, mothers, harijans etc.)?
in the village (young farmers.
■
...3
I
*
: 3 :
9)
Do you participate in training of local people ? Grihinis,
worked, mothers etc.
village level
y y6”ir€U/VV
■u
h) Do you have any of the following programmes?
Food for work, Health Insurance, ERS- FICH Programme, any others
m-e ,
hx C H — p'”'0
If so, specify.
i) ^re you pajt of any Diocesan Society or Health Team ?
/4-
■ Q-gyw
f^ovd'
eZs-4/v^
Q) Co
80
SECTION C (Regarding 1982 project)
a) Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
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b) .^re there any forms of support which a visiting team can give you next year ?
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•ate:
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Signature:
■
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Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FQLLOU-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
1
PROFOIW
Section A and C to be filled in by all Community Health Workers
Section 8 to be filled in by those who are doing health work
at present.
Instructions :
(please keep us informed regarding change of Address!
GENERAL INFORmTION
SECTION - 4
a)
Name ;
c
Sr •
Bo
c) CHJ Course No.:
3 1
b) Age:
n.
d) Name of Congregation: T
M.cr-0
e)
Biocese:
Permanent Address
(Mother Ho use/Superior) :
o)
•
Present Address
(For future correspondence)
i y Kozxm. ,
i
i
C cLlX|<x<
,
: Kzvlcl DA.
-JL Dk /'I Ph) IJhat have you been doing after the course ?
(if you have changed from place to place give us some details .of your work
in each place).
J
c^enmj
O/m
tst/by //ui
Cue! ,
Lkn
/hr
c/l{
c
t/r]
Crnc-nfk. ) t
CJ)/-
Kb
f-
-
crrijf
'P^td
fySc/t'r)
/re-working with and
i) Give us a short'descript/on of the present team you awhat each member does (not only health activrties),
r
,
£)ctY
j)
Cl
ClC
A'fc'nc/&S Ctnffc.
Have yiu attended any course/meetings/uiorkshops since you completed the
Course ?
P
,
<j ad&ruAi/ one
M
orU ee>m,eritd*n<j SzdnintM'dpiOM
ed n"
i/or ad:
(i11 \Jee
cl^Ccm
c/d
Herve
f1
/dh^paJ!.
C cm/e/ntem eimn.e:.
...2
s
2 :
the other Community Health Workers? If so
Are you in touch with any of
give us their recent address.
k)
1) Give in a few sentences a description of the poeple you are working
with (rural , urban, tribal, non-tribal, main occupation, other characteristics
?
etc) . How many villages? Total population, what distances aPa^ ?
A.r)/^/Il/CcsD
SVT> /h
TYVi c/if'
c?’/r/h oo
'tna-vw
Ln/Hee
t
.
SECTION B
a)
Give a short description of the health activities you^re involved in.
Atalfit, t-oUce-
Jr/W
/A.Z
b)
•
How many hours are allotted for this dai 1 y/*wcck-ly— ?
c) .^re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
Ucy/a
-fjcuYi e2*'<m
fan
/fart) < Jr
^hCtsULo/ JJ ptolj
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
/Vo,
e) Do you get any assistance from a Taluk/flission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
x-5 ojA
J^UL M
trfy (Troj^
da*'1
m ^.ormsLc/
. ..3
l
‘ ?
3 .?
g) Do you participat e in training of local people ? Grihinis,
wo rker9 mothers etc.
village level
/Vo -
h) Do you have^py of the following programmes?
Food for work, Health Insurance, CRS- PICH Programme, any others
i) /Are you part of any Diocesan Society or Health Team ?
If SO,
specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
.c/
b) i^re there any forms of support which a visiting team can give you next year ?
■
Signature:.
•ate:
I izI
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
</
Directorate of Rural Health Services &
Training Programmes
FQLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
j) Have yw attended any course/m
Course ?
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
SECTION -
GENERAL INFORMATION,
Name :
/3ro. flf'l- C
a)
c) CHW Course No.:
52// X
b) Ages
d) Name of Congregation:
e) Biocese:
f)
Permanent Address
(Hother House/superior)
:
‘X-
g) Present Address
(For future correspondence)
:
>>
h) IJhat have you been doing after the course ?
(if you have- changed from place to place give us some details of your work
in each place).
.
c-v-xj
c\.
d,
$
'
Cclti-wk €*vQxS
J
________
*
tV'A^
Pwvv
t
|
short description of the present team you are working with and
i) Give us a sho
what each member does (not only health activities)
Cl/
.
•
L.
vJcmJU
jtings/ workshops
□ ...2
s 2 :
k) Are you in touch with any of the other Community Hsalth Workers?
give us their recent address.
all *
If so
//
Jw-n'/- J-xjLi
Qi/tC w^)
Give in 4 few sentences a
l)
rtinV)
Ow^V<v\JL’
description of the poeple you are working
’non-tribal, main occupation, other characteristics
with (rural, urban, tribal,
Total population, what distances apart ?
etc).
How many villages?
Oi
, CaJI
Vvx/
(HvG_
5d
SECTION 8
a)
. ’X
involved in.
Give a short description of the health activities you are
(xJk. J fedtk, dU
r
t/vv
7
iaXiobve^ 84-Vif oXcl
(xXct
b)
,• L
0_
r-
is daily/weekly
oaily/wutikly .?
How” marly hours are allotted for this
VV C-a1<
^3
Functioning independently or with a team of workers?
c) (^re you f j-.o1
is
the
health work shared amongst you ?
how :
•■•
^l/c
tvJee|vtwcZA*C^A
GkS
If so,
.
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any
assistance from a Taluk/Mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothpars^, harijans etc.)?
fiy LvOwwc
. ..3
r
s 3 ?
g)
Do you participate in training of local'people ? Grihinis 9
worker, mothers etc.
village level
h) Do you have any of the following programme^?
t Food for^werk. Health Insurance, CR3^ MCH Programme, any others
1) 4re you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
i
a)
Give us detailed information on how to reach.your village/project/centre?
(By bus and train, also from station and bus stop)
Oil. I 7
<^A
z
ay. m ft.
b) ^re tlhere any Forms of support which a visiting team c^ari give y&c next year ?
(I© cjud
* C6/U
•at ef
«zvv
Signature:
IZ.
4vwl
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EV-ALdATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST HOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section a and C to be filled in by all.Community Health Workers
Section :B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of .Addressl
SECTION - 4
a)
Name :
GEIMER3L INFORMATION
„ /7^
c) CHW Course No.:
/ ^'b-'ttzee^
b) <Age:
s/l
d)
Name of Congregation:
/■W*
e) Bio case:
/v
y
S-yj ck/L
I
f)
Permanent .Address
(Mother Ho use/Superior)
:
'it
g) Present .Address
(For future correspondence)
/y
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place), y
<j^j2
Am.
J i/b^J &
A', VjAAy*
JYbty
77^6
r.S^ sx/Z,
y
'T
/C *
-d/
1<S
^’ -"7
i) ^S^ve^tis"a ^h'o^ dese^iptlon^of 't^e presoht-'team^you'are working with and
what^each'nTember does — (not— only health activities)
/^i
•-••.y,.-/-
,
a) e
vuity
w'i
rp
i
Uh
l
45
Ct>m (^-
j) Have yw attended any course/meetings/workshops since you completed the
Course ?
...2
nii; ;H y.iHj >
^d- pni.-h
s 2 :
fT.i
ire you in touch with any of the other Community Health Workers? If so
k)
give us their recent address,
f
ridiw (•ni^-iuw oos u o
-2) 14
A
/j.cJtf'i
_
7
ltA'
'
S
/ /T’
°
ly£
Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages? Total population., whaf distances apart .
l)
1) Gik/e in
Z,c< v-vu
I 1
C^7)
d v /hyA U;,
-?
...^ ia~
S' J?/, fcST
®
C3 ■-•-IZ.-.4.
SECTION B
a)
4'
Give a short description of the health activities you are involved in.
zk ^reu^-ck
b)
How many hours are allotted for this daily/weekly ?
o
c) $re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
'
.
If so,
.
. n
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
..in
e). Do you. get any assistance from a Taluk/Mission Hospital?
■
f) Do you work with any special groups
yout h, mothers, harijans etc.)?
• •.
yrb- o :■
u1 '
If so, specify?
-•V'.ri fr
in the village (young farmers,
iu.'i
. ..3
4
: 3 :
g) Do you participate in training »f local people ? Erihinis.,
worker, mothers etc.
/
village level
h) Do you have any of the following programmes?
Food for work. Health Insurance, CRS- MCH Prograjirpe, any others
■ >
^4
i) /Are you part of any Diocesan Society or'Health Team ?
c
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(8y bus and train, also from station and bus stop)
,
tMi<■ '7^’
3 k
6- /&
o.
4 <=/H-37-/<?nT(
/y
b) ^re there any forms of support which a visiting team can give you next year ?
y
Z4T
e^-
*
late: /q- /Z-Qj
Signature:
Please use the remaining blank space to giveany further details for u/hich there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHNrS MEDICAL COLLEGE
PROFORMA
Instructions .:
Section
and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present• •
. . •
(please keep us informed regarding change of -Addressl
SECTION - 4
- GENERAL INFORMATION
/^Y ■
a)
Name :
c)
CHW Course No.: 3^
35
b) i^ge:
Name of Congregation:
/\nri
e) Uiocese:
-
ST. ANN’S CONVENT.
/Address
n Permanent
(Hother House/superior) :
WINDERMERE, WELLINGTON,
ARUVANKADU P. O„ (Nilgirls)
9) Present /Address
(For future correspondence)
ST. ANN’S CONVENT.
:
W1N DE RM E KE, W£LLINGTON,
ARUVANKADU P. O., (Milgiris/
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
-
^k-AnrU
I homunuXiiZuJP
rxwju C^-
is
’
[/•e
- Eo
VlAll'j
U
Ld
e •
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
14 D'h
J)
O-
Have yiu attended any course/meetings/uiorkshops since you completed the
Course ?
...2
■*
s
2 :
in touch with any of the other Community Health Workers? If so
k) Are you
give us their recent address.
•
1) Give in a few sentences a description of the poeple you are working
non-tribal, main occupation, other characteristics
with (rural, urban, tribal,
Total
population, what distances apart ?
et c). How many villages?
/Jcmi - Vrkan .
SECTION B
a)
Give a
*»
involved
in.
short description of the health activities you are
4-.
g-
b)
■yrezJrruntnY
/Ar
rrxAjalf
<5 ■
allotted for this daily/weekly ?
How many hours are
.
T
■
3
team of workers?
c) ..^re you functioning independently or with a
If so,
how is the health work shared amongst you ?
J
1
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
-^Di
i^mcifLi
■
e) Do you get any assistance from a Taluk/Mission FPspital?
If SO, specify?
Ho
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
No
. ..3
t 3 2
g) Do you participate in training ef local people ? Krihinis., village level
worker, mothers etc.
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH-Programme, any others
C X 5 - JYl CH
i) /Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give Us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
\'a Odff ,
i
Od^ gY
i1
/&■
{jIacc
t'o
l-o
get'
off -fr^n
it
get' off
/i
u
- Gyrr^a-hy .
b) .Are there any forms of support which a visiting team can give you next year ?
lJj.
•ate:
g
£ j gl
Signattire:
Please use the remaining blank space to giveany f<jrthep details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFORMA
Instructions : Section A and C to be filled in by all Community Health Workers
............................... Section g to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of address!
GENERAL INFORMATION
SECTION - 4
a) Name :
b) ages
c)
d)
CHW Course No.:
y
Name of Congregations
q)/4-^XS
e) Biocese:
0 Permanent Address
^cyjcx - fam -
(J3
2- b *735"
o) Present Address
n *
(For future correspondence) :
ijofyAlA.
z
H MR
h) What have you been doing^after the course ?
(if you have changed from place to place give us some details of your work
in each place) • /J J/
r
K£TC o^flACi
\xjo
7) My
/ ’k
<
xcc/
7)
UCLJZx^
UJO
4-tV
■
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
/&.O-'ko^e^ichi
taJ/ /M
j)
Have yau attended any course/meetings/workshops since you completed the
Course ?
...2
/
s 2 :
I
k)
Are you in touch with any of the other Community Health ijorkers? If so
give us their recent address.
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc). How many villages? Total population, what distances apart ?
SECTION B
a)
involved in.
Give a short description of the health activities you are
b)
Hdijj many hours are allotted for this daily/weekly ?
c) ^re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
...3
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
PROFORMA
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
Instructions :
(please keep us informed regarding change of Address!
GENERAL INF0R1MTI0N
SECTION - A
a ) Name tfyio- $-u^Y)i-o Kuna* Dfyfe') Age:
3> I
c) C.HW Course No.:
d)
Name of Congregations
Cfr'/h
e) Wiocess: ft'rC^k.
f)
Permanent /Address
-»-*--v/v/v**?*^
(Mother Hou3e/superior)^^y^/?^^(^
9 C
g) Present. Address
(For future correspondence)
***
Kia-tc^Y
:
-
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htM. *. <
se ? PU
r
h) What have you been doing after the course*
$4.
(if you have changed from place to place give us some details of your work
in each place).
* *
^r^C-A’
9 <2*7
C H-OJ
3 hJ-
A p>^- ■ p» 4
v fl pTt^arri-hlr^ }
t
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
A/ c- Arp,
(kry J
J)
u-- .
^,<n4^)hcr
&r)
■
09^ byr/kuY
'' O
7*'
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byrfkcY
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frrf'Ct/ #*(/
fia> &
ir^rf gflT- ?tc>-4/vv- Jtwri
/£
Have you attendeoFany course/meetings/workshops
gs/workshops since you completed the
Course ?
kfiJTL.
C^^-yxclcc/
I $4- ^•nC^
Z>A^rJ<_ •.
$ /. p^ns
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2 :
k) are you in touch with any of the other Community Health ijorkers? If so
give us their recent address.
iku
/
kfi^c
-4^ CuV''r, sentences a descrifprion
ion of theToeple
the^poeple you are
. working
..
1) Give in a fe^
non-tribal, main occupation, other characteristics
with (rural, urban, tribal,
hat distances apart ?
How many villages? Total population, wl
etc).
trc
K
64-KvM^
ycdfai,
rc-t|
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SECTION B
a)
involved in.
Give a short description of the health activities you are
C^fcr
’
(/T) Ob
C^'rc'^fLo S/^l
b)
•
'n'
ff-lf
/ Zax/
How many hours are allotted for this daily/weekly ?
a
^2
c) Are /ou ftinotidnli^g independently or with a team of workers?
c) Are
If so,
/it
how is the health work shared amongst you ?
v ~S<^.i37
- "7
i f-'
ocal Primary Health Centre?
d) DQ you get any assistance from the lot
"•VcA’
*
e) Do^you get
r
iy assistance from a Taluk/flission Fpspital?
£iy ___
If so, specify?
AJO
f)
yoy work^with any special groups
youth, mothers, harljans etc.)?
do
in the village (young farmersj
/y •CyVja.'TkS
•
/
...3
: 3 ;
g)
Do you participate in training of local people ? Grihinis,
worker, mothers etc.
ycii^c
5^4^
village level
i)^/
y.
h) Do you have any of the following programmes? c
~
_’ j
k/Tood_’ for
work.
y4
Health Insurance,vlRS- MCH Programme,
Programme any others
.
pr^ccfa,
pT^jee/^ A Vc7f^
part of
of any
any Diocesan
Diocesan Society
Society or
or Health
Health Team
Team ?
i) <Are you part
?
If so, specify.
o<tS*'^V^
*"4-'3^^^
4 C-H-^,.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your villagc/project/centre?
(Sy bus and train, also from station and bus stop)
4
b) tVe there any forms of support wh’ich a visiting team can give yocrriext year
■ate:
— 12--
/
Signature:
Please use the remaining blank space to giveany further details for uhich there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services
and Training Programmes
St John’s Medical College,
DR HSTP-,ACC-81
Bangalore
2C Nov 1981
Dear
Seasons Greetings for Chirstmas and the New Year from all of us
in the Department of Community Medicine at st John’si
1982 is going to be a special year for us since a ?long standing
plan to meet all of you in the field has finally materialised.»
Thelma and
I are on special leave for a year starting December 1981 and during this
year we plan to visit as many of you as possible in your own areas of work
to re-establish contact, share experiences, reflect together and grow
in our understanding of our people and our work.
We have already been in
touch with many of you and we shall be writing to others as the weeks go by.
IJe thank all those who have so promptly and enthusiastically received this
news and welcomed us to their villages in 1982.
We hope to hear from many
others amongst you soon<>
In order to get some common information from all of you in the
field we have drawn up a simple questionnaire taking ideas from many of
your own letters.
Please fill these up and add any other comments,
information, suggestions you would like to send us.
Those of you, who have
already sent us some details of your work recently fill in only those sections
which you did not cover in your personal letters.
We would
’ ' like
’ *‘
very much
to hear from each of the 150 Community Health Workers we have trained.
Even a blank
uestionnaire with only your latest address and information
on how to meet you next year would be most welcome.
Meeting you and seeing your programme will be a good experience
for us but in case you feel there are any other ways in which our visit
could be mutually beneficial please suggest this in Section C (b).
In preparation for this visit many other materials are being
organized which we hope to send you soon - a list of Community Health
Workers addresses, news bulletins, list of new handouts and educational
materials and so on.
So please keep in touch.
Hoping to hear from you soon and also meeting you next year.
VJith best wishes and regards,
Yours sincerely,
Pa yi' ■+ vf
PS: Please post this to Drs. Ravi & Thelma Narayan, D-10 Staff Quarters,
St John’s Medical College, Bangalore 560 034 before Christmas 1981)
'CrX-^-Q.
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS NEDICAL COLLEGE
PROFOOTA
Instructions :
Section a and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
r1 •■-
(please keep us informed regarding change of <Addressl
- GENERAL INFORMATION
SECTION a)
Name :
b) <Age:
Sa /^tpHon/sa
i
zVs".
c) CHJ Course No.:
e) Bioceses
A
B
Permanent Address
(Nether House/superior)
m ftjVy/}
9)
•0
Name of Congregation:
SiS'Pe/QS
f' s-pvJrt c-'*
<5f
:
Tivoli.
(out^T)
Present /Adaress
(For future correspondence)
s <^u<2 -Aaoy op PtCL-eR-
TllG6bOfO jr C.<aHp - &F4 f<op/9 •
2.
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)»
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c^J
c4j-tc^
k_j2X.C1-A-C_ .c^fc-ChT
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i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
JtRe
CV. V-V42
a/ <3C\^K
j) Have yw attended any course/meetings/workshops since you completed the
Course ?
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cAj v
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be
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DjlCK\
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...2
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s
Are you in touch with any of the
give us their recent address.
k)
2 :
other Community Health Workers? If so
Decked cnl) Givf^Vrf^slntences a description of t/e people you are working
with (rural,
etc).
urban, tribal, non-tribal, main occupation, other characteristics
How many villages?
Total population, what distances apart ?
J- C>
C,
'fe
SECTION B
involved in.
a) Give a short description of the health activities you are
b)
How many hours are allotted for this daily/weekly ?
• ’ ' > or with a team of workers?
c ) $re you functioning independently
is the
health work shared amongst you ?
how 1-------
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any
assistance from a Taluk/Mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
: 3 s
9)
Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work.
Health Insurance, CRS- |*ICH Programme, any others
i) /Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) .Are there any forms of support which a visiting team can give you next year ?
i
Signatures
Bate:
•iop^gi
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FQLLOU-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
Instructions :
(please keep us informed regarding change of Address!
SECTION - -A
1. n JT
CVjx O-f
a) Name ;
c)
GENERAL INFORMATION
4" 2.
b) .Age:
.
8^ s>//p
CHIj Course No.:
d)
L<A,a_j2_
*> CWvi. \XjAAa_
e) Bioccse:
f)
’Ll
Name of Congregation:
Permanent Address
(Mother House/superior)
v-Vc^Uj
:
TJ3i S e^TA.1
oo:i-
H^A/CnAcoke g) Present /Address
(For future correspondence)
ClAn^otjiL
? <x
:
Uilfl ^.-T RS T
<| si
-
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
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1
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cAx d
^Aaa-C •
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a
4,-f IKl.
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Give us a short description of the present team you are working with and
what each member does (not only health activities)
■' r
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iVx.
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Have yiu attended any course/meetings/workshops since you completed the
Course ?
A
cv-4
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/x) ■
.
..2
s 2 :
k)
ire you in touch with any of the other Community Health Workers? If so
give us their recent* address.
Mo ■
working
1) Give in a few sentences a description of the poeple you are
non-tribal,
main
occupati'on,
other
characteristics
with (rural, urban, tribal,
How many villages? Total population, what distances apart ?
etc).
■’
/AJO JI
V
\/\z 'X
J
Al
'A-XX.
toiXckAlob Vk.
r:
SECTION B
a)
involved in.
Give a short description of the health activities you are
1 ^3— N F-P
b)
t
-1
How many hours are allotted for this daily/weekly ?
Axzvl VjaouxX
i oc
c) ^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
No •
ei)
Do you get any assistance from a Taluk/Miss ion Hospital?
If so, specify?
hlo •
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
Nosf
...3
V
; 3 ?
g)
Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
^4 • r
v-o
/^CXXV^C'tVsA-A^i
Ki
&
’?xjC^S CKa/wmkL
<r
aj
h) Du you have any of the following programmes?
Food for work. Health Insurance, CR3- MCH Programme, any others
uO *-
\A_
4.
<x_{
>v*-\
<Vs
piA.eyk
OvO
OvO
•
iBkx*—->
'VI aA'
'kUx \f .
i) /Are you part of any Diocesan Society or Health Team ?
If 30, specify.
t.
OyUsA O.
csO - £<* cK/c^. (xJlXSV*
^Az'
|V^X-
cK_
ck*A->«^.
Ca>>
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
KaJ
Jt?
■\2'-
^''-L
-
•kt/x. c
*
b) .$re there any forms of support which a visiting team can give you next year ?
VO Q.
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zA-
' Bate:
I Aj_
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-^|g_AJ^_zV
t^<KXX ,
<c. .
dtvCaAazva^X—
y> V_r-vX
CA
»
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Jirectorate of Rural Health Services
and Training Programmes
St JohnTs Hedical College,
DRHSTP-ACC-81
Dear
Bangalore
2t Nov 1901
<2
Seasons Greetings for Chirstmas and the New Year from all of us
in the Department of Community medicine at St Johnfsl
1982 is going to be a special year for us since a long standing
plan to meet all of you in the field has finally materialised.
Thelma and
I are on special leave for a year starting December 1981 and during this
year we plan to visit as many of you as possible in your own areas of work
to re-establish contact, share experiences, reflect together and grow
in our understanding of our people and our work.
We have already been in
touch with many of you and we shall be writing to ot*hers as the weeks go by.
We thank all those who have so promptly and enthusiastically received this
news and welcomed us to their villages in 1982.
We- hope to hear from many
others amongst you soon.
In order to get some common information from all of you in the
field we have drawn up a simple questionnaire taking ideas from many of
your own letters.
Please fill these up and add any other comments,
information, suggestions you would like to send us.
Those of you, who have
already sent us some details of your work recently fill in only those sections
which you did not cover in your personal letters.
We would like very much
to hear from each of the 150 Community Health Workers we have trained.
Even a blank tuestionnaire with only your latest address and information
on how to meet you next year would be most welcome.
meeting you and seeing your programme will be a good experience
for us but in case you feel there are any other ways in which our visit
could be mutually beneficial please suggest this in Section C (b).
In preparation for this visit many other materials are being
organized which we hope to send you soon - a list of Community Health
Workers addresses, news bulletins, list of new handouts and educational
materials and so on.
So please keep in touch.
Hoping to hear from you soon and also meeting you next year,
bjith bast wishes and regards,
Yours sincerely.
PS: Please post this to Jrs. Ravi & Thelma Narayan, D-10 Staff Quarters,
St John’s medical College, Bangalore 560 034 before Christmas 1981)
V
i
i !.
?
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHNfS MEDICAL COLLEGE
PROFORMA
Instructions :
Section a and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep, us informed regarding change--of .Address!
GENERaL INFORMATION
SECTION - 4
a)
b) /Ages o3^
Name :
c) CHIJ Course-No.:
’-'j
2 /' ( 3,
d) Name of Congregations
e) Biocese:
v)
0 Permanent /Address
(Mother Ho use/Superior) s
rOL-tt^
(OAt
o) Present- /Address
(For future correspondence)
:
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place) .
&Xry\
CccaMx J cutiked’
JU.otfcAM\
euhj
5)
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Jks-
LCclX
u.pt GeXAi-y
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-
k Q\£aJL
<rfcefci..
'V-jjaamjs cuA-d?
r^eV-
-~
-AAA
S Lcv-xc^. owU.
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
oM Cw.
Ox^ei
SUxAdtOA^
16 A.
v^.JL OV qXa- X
ViAil- J8~X
JLM.
Kx ^eUrf.
c-h
JIjLg<\i£v
j) Have yiu attended any course/meetings/workshops since you completed the
Course ?
...2
i
? 2 :
Are you in touch with any of the other Community Health Workers? If so
k)
give us their recent address.
JjU
.
fcttav
description of the poeple you are working
.
.
1) Give in a few sentences a
non-tribal, main occupation, other characteristics
with (rural, urban, tribal, Total population, what distances apart ?
etc). How many villages?
"'4
SECTION B
a)
of the health activities you are
Give a short description
b)
this daily/weekly ?
How many hours are allotted for
involved in.
team of workers?
c) 4re you functioning independently or with a
how is the health work shared amongst you ?
If SO j
the local Primary Health Centre?
d) Do you get any assistance from
If so, specify ?
ei) Do you get any
assistance from a Taluk/Mission Hospital?
f) Do you work with any special groups
yout h, mothers, harijans etc.)?
If so, specify?
in the village (young farmers,
. ..3
: 3 :
g)
Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work,
Health Insurance, CRS- PICH Programme, any others
i) /Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) -Are there any forms of support which a visiting team can give you next year ?
Bate:
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST OOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 5 to be filled in by those who are doing health work
at present.
(Please keep us informed regarding change of -Address!
SECTION - A
a)
GENERAL INFORMATION
U Ann fl
b) Ages L/l
Name : /
d)
c) CHW Course No.:
e) lioceses
9)
CMoSSlM
of cha Rjry.
BEL& rt u H
Address
n Permanent
(Mother Ho use/Superior) :
Present Address
(For future correspondence)
Name of Congregation:
6lcc
H-o£Lc<v
:
^Warfa Niwaa*^
Canoesian Sisters,
BALKaRNI -410§Of
h) What have you been doing after the course
Beteaum
(if you have changed from place to place give us some details or your work
in each place).
r
'
_.
„ #r
i *
l\J(^ tL^. c^^uul AXX '1
^Vjuxltk j2_xAa,x «iZX^Ka£l'vx.
£)/l xi^ <X ^XaJLx^
1
i) Give us a short description of the present team you are working with and
.
4^what each member does (not only health activities)
yCCTjc
S G^a^v. Oxi"
£e
o<
eoMvxjtu.
k<x^K
j)
Uvct
tEu?. ?crK
C^'—J
-tUUkko *
Have yiu attended any course/meetings/workshops since you completed the
Course ?
Ne -
...2
2 2 :
........touch I with
of the
k) .Are you in
anyother Community Health Workers? If so
give us their recent address.
1) Give in a few sentences a description of the poeplu you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
et c). How many villages? Total population, what distances apart ?
fL j,
/U P
‘•io
io IciiLol^JLc - c^J
‘L-Qu^' 'X)
f
SECTION B
a)
Give a
short description of the health activities you are involved in.
b) How many hours are allotted for this daily/weekly ?
c ) <.<re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
ei) Do you get any assistance from a Taluk/wission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
...3
,
i-
S 3 s
g)
Do you participate in training of local people ? Grihinis 9
worker, mothers etc.
village level
...___ - Ha-C
h) Do you have any of the following programmes?
Foqd for work, Health Insurance, CRS- MCH Programme, any others
i) -/Are you part of any Diocesan Society or Health Team ?
If SO, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your viIlage/prujeet/centr-e?
(By bus and train, also from station and bus stop)
b) ^re there any forms of support which a visiting team can give you next year ?
JU^
3
Bate:
I
Signature:
Please use the remaining blank space to give any further details for which there
uas not adequate space in the questionnaire.
C - <x .
e^x/^ £c-y aK/Xz^^
TuxJI ^>-0-,^
JLjlCxX
JJJLut
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i-X-
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP'EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFOtW
Instructions :
SECTION - 4
a)
c)
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
GENERAL I NFORJMTI ON
Name^-‘^W^
CHI J Course No.:
e) lioceses
b) ^ge:
Z//Zy
d) Name of Congregations
'UA- 5
f) Permanent Address
(Mother Ho use/Superior) s
/1
g) Present address
(For future correspondence)
:
cj^<^tZts'C'
h) IJhat have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each placs) . J WTX^ijL^L
<}ct^
Okock.
i) Give) us a short description of the present team you are working with and
what each member does (not only health activities)
.tku- C..U-
'J
covl
..
a,
•’’K
y^,
J) Have yw attended any course/meetings/workshops since you completed the
Course ?
...2
/
9
X
s
k)
2 :
' the other Community Health Workers? If so
you in touch with
-- --------- any of
give us their recent address,
ire
xxe
Give in a few sentences a description of the poeple you are working
non-tribal, main occupation, other characteristics
with (rural, urban, tribal,
etc).
How many villages? Total population, what distances apart ?
..
. 14^4
£/:j b'c .
o o o j
3 o R* M. -
SECTION B
a)
involved in.
Give a short description of the health activities you are
b)
How many hours are allotted for this daily/weekly ?
Q/Uiz
«>
^/c) are you functioning independently or with a team of workers?
how is the health work shared
If so,
i
(3
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you
get any assistance from a Taluk/Miss ion Hospital?
If so, specify?
izF) Do you work with any special groups in the villag e (young farmers.
youth, mothers, harijans etc.)?
6 (9
(r
...3
: 3 ?
9) Do you participate in training of local people ? Grihinis,
worker, mot hers et c.
village level
h) Do you have any of the following programmes?
Food for work,
c. R, S ■
Health Insurance, CHS- MEH Programme, any others
ft'J ' H ‘
yi) /Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
^b) iAre there any forms of support which a visiting team can give you next year ?
.
•a‘»
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
.
j ok
de Ci .
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a
<3
2A.
A-
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t
Direct drat e of Rural Health Services &
Training Programmes
FQLLOIJ-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
SECTION - 4
GENERAL INFOR MAT I 0 N
a) Name : SPfToxi^
b) -Age: 9/
c) CHj Course No.:
Name of Congregation:
tyC* O) @4
e) Bioces et HG T)G n Hr*
0 Permanent /Address
(Mother House/Superior)
^Ce (Y?
-X •
:
...
g) Present Address
(For future correspondence)
Naff(pa Hc<TionH?6
•
9iQ .fcG c] 6 G ■^'3"
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
/?u sic.i
)
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
'J S.5S
M
: (fbu
W i Mf
J-
vij iTC'DC
c/
(P
t
1-
o (P'
j) Have yiu attended any course/meetings/workshops since you completed the
Course ?
/
3/
c
XcA
HC.»c,s»H<,<oclj(liJ SloecM‘t HOnoltaooi^
J2,£Oi*.iC»oar| <i
AocP^lin.Q
•
. . .2
s
2 j
k) Are you in touch with any of the ether Community Health Workers? If so
give us their recent address.
1) Give in a fw sentences a description of the poeple you are working
main occupation,:*ot'hef characteristics
with (rural, urban, tribal, non—tribal, r..__
etc).
dosiGYieog) ■
/'4
Total population , what distances apart ?
How many villages?
,
\j i
-
. .
SECTION B
a)
Give a short description of the health activities you are
1
involved in.
allotted for this daily/weekly ?
b) How many hours are
<c/
team of workers?
c) $re you functioning independently or with a
is
the
health
work
shared
amongst
you
?
how
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
'll
I
Taluk/Miss ion Hosp it al?
ei) Do you get any assistance from a
If so, specify?
... VlcJ). ■
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
S 3 •
g) Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
0
t
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- PICH Programme, any others
Q Q 5 - M c H (p3q.j9G<f»^ ■
'
i) /Are you part of any Diocesan Society or Health Team ?
di' T>'
If so, specify.
11.4 c.t h
Xi\)<£. -S •
SECTION C (Regarding 1982 project)
a ) Give us detailed information on how to reach your village/project/centre?
(By bus and train, also
from station and bus stop)
.
“To & J
cr^
r
C'Jr'
fc. c iJoHr ^ s^a!’K.fe's
n-^ X.
------- any
----- r>
------- «£.ofsupport which a visiting team -Can give you next year ?
b) ^re
there
forms
kjtLk^>iJi
i t '\) I \Q'
CWJJ2
H i’' * CtfcJ29L>> (j
Ita UPS^S
j
p -j
SGJftTtjj
h
V
•ate:
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
,
J-
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M
cl°^ becl^'yj ■ ?- 5iv, Ac. /fe -.'y
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(C? Cjf 6
)
)
Directorate of Rural Health Services &
z
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
GENERAL INFORMATION
SECTION - A
b) Ages 3
a) Name ;
c)
CHJ Course No.:
e) liocese:
y
gc s/m
L L o pv c
0,^. pp.c?v<r/c'^t_
Permanent Address
(Mother Ho use/Superior) :
coi'"7'1'*
a o a £> >
M g)
St oosePH or
d) Name of Congregations
Present Address
(For Future correspondence)
:
& eir'oiS
^6og^3
Sr- “o’i14 %
t
L)Ctl KA POMK,
h) What have you been doing after the course ?
HaQ-pt nc
6 6 6 9 Oo2/
ibw
’ (Ax
(if you have changed from place to place give us some details of your work
in each place).
i) Give us a short description of the present team you are working with and
what each member does
(not only health activities)
4 ■-C‘^
,X c w'
.
i-
i
cr
n<ntv*
j) Have you attended any course/meetings/workshops since you completed the
Course ?
0
...2
c
f
2 :
Community Health ijorkors? If so
Are youj in touch with any of the other
give us their recent address.
SP
TijoHn^ Hoey C RoS'S Co <4 Ub KJ 7 , M APJ AH Gfl M
k)
; BIHOR.
fto-HrfV
KoAth Po,
O AA I b •
description of the poeple you are working
1) Give in a few sentences a
non-tribal, main occupation, other characteristics
with (rural, urban, tribal,
Total population, what distances apart ?
etc).
How many villages?
Q
cMC
___
Al/V
, ,
Hk QAzvk,
A
(VkJ4-®*A/?
0 £-
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i(»ei
a *
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S'' £.<V
Y
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JL X
yjS^S-SfZ^j
o > ErO^
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f< h'
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<
SECTION B
a)
of the health activities you are involved in.
Give a short description
<-} 'ZS~d
S O H
* /
2)
/C<-V¥xJ^ 'j
'V<> * Y ‘x
rvX7 i '
b)
for this daily/weekly ?
How many hours are allotted
i
(2
'
c) .;Are you functioning independently or? with a team of workers?
shared amongst you ?
how is the health
L~__ . work
-
p<^-cX_ T-X Ca^
U.
X/L-
If so,
-i
the local Primary Health Centre?
d) Do you get any assistance from
If so, specify ?
'Uzj
7^ ■
e) Do you get any
assistance from a Taluk/flission Hospital?
~
tt
- -J
Xoo tL-
j, )r .S~T.
-j) H O
U-7 ■'
eV T fvi-Y/* v c< Vs
If so, specify?
TT^Pf
Hocaj^—
Hoof**-
V - (r ft
xtfi 4^ C ZKj-^. ft a 'VV-
cJLa.Z
e
in the village (young farmers.
f) Do you work with any special groups — —
youth, mothers, harijans etc.)?
J
>
/yry
K c H
<v <2^ 'ir>
Tv o
-S
o A
c- 4
e =< e-^
Xj u tA
...3
1
4i
: 3 :
g) Do you participate in training of local people ? Grihinis,
worker, mothers etc.
nfT)
A/
^ c77
r'
K c a
Y' /< JL ^Z’>
0
'V
village level
h) Do you have any of the following programmes?
Food for work. Health Insurance, CRS- l*ICH Programme, any others
<*. /> J
P V'o^g'&-mrr>c
Kt H
i) ^re you part of any Diocesan Society or Health Team ?
N i- r
(/
J9
If SO, specify.
e
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
i3ou^J2oTz.
h
i/UZoYX
Po.^r-
/V'v fnO c-fizK
^eUpocLc
RjOjy,/.
Pol^Y
£
■
b) -^re there any forms of support which a visiting team can give you next year ?
( Z <k- 'X-t
■i
Wat e:
Signature:
£
.
Please use the remaining blank space to givesny further details for which there
was not adequate space in the questionnaire.
t
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORPM
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 8 to be filled in by those who are doing health work
at present.
(Please
keep us informed regarding change of address!
GENERAL INFORIMTION
SECTION - A
a) Name : 5^.
CL
c) CHW Course No.:
e)
3S
i- L. ■
b) Ages
3'117
d) Name of Congregations
t&A
liocese:
Address
0 Permanent
(Mother Ho use/Superior) : c’ ^2 . pA.&Uv^’i
( si -
: htu
D6) O 5 O ■
. /3 0
, p,
9) Present Address
(For future correspondence)
:
• 1<LcX/*AU?W<zI
t<jDt'v»\UxL‘GlG£X. - *3 S I 3
*1 •
h) Uhat have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
UA CKx
43)(uG^4
Ut-Stll 4 VW• G - pl
■ (J
i) Give us a short description of the present team you are working with and
what each member does
(ax
Ci-
(not only health activities)^
P/uX2^AuX-.w»m--G
M <. c • Z-i
L<X—
J)
ttCOeJi * 3<x*^
M i. C ' L-4 L^
Vvx^.vvC^-vA--^ ‘ C| v0"0
<5^
LC^ji^
Have you attended any course/meetings/workshops since you completed the
Course ?
M* t- w■
G
LlLc*-C<-*
€-C>
O‘-AZ-
...2
C
I
A '
2 2 :
k)
Are you in touch with any of the other Community Health ijorkers? If so
give us their recent address.
9 WJUL
<0.' Hu.k.dg,oJl
^j-uvc «X' S I «?-S l 4 sx CmiLa- aX
g «, .
-
of the poeple you are working
l) Give in a few sentences a description
l
non-tribal,
main occupation,, other characteristics
with (rural, urban, tribal,
Total
population,
what distances apart ?
etc).
How many villages?
uallt
aolh^L ‘ixJut
|>6iuX <5^
©ttzU. tzluU Im- GA ^
a
^0^0 p
SECTION B
a)
Give a short description of the health activities you are involved in.
’•
• M cci A-t t'-<D a
J rf\ n<vL4-4nA^L£k^-<_-^> vv
b)
'j-v> c
cIajz^j
How many hours are allotted for this daily/weekly ?
If so,
c) $re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
Ldt 6u. ijLLx-.^
3
tfce
^0X63
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/nission
Hospital?
If SO, specify?
hie •
f) DO you work with any special groups in the village (young farmers,
yo ut h, mothers, harijans etc.)?
...3
)
4
:
3 ?
g)
Do you participate in training of local people ? GrihinisJ
worker, mothers etc.
h)
Do you have any of the following programmes?
>
Food for work. Health Insurance, CRS- FICH Programme, any others
'
i
i) /Are you part of any Diocesan Society or Health Team ?
%!^> •
15
G^lX^WL
J
3
village level
If SO,
specify.
H. C 44
{jmju.£
a 3 <- c> CC<3
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
y Ott c-Lca^a tk-Le
TJc UuJU-L *
e>ou
b) .ve there any
.
tueXxi
UiU>^ U
. !<cuxo^c* #
l>vj
forms of support which a visiting team can give you next year ?
Ijjc C-CXaa GlksLcuas
\j
AJ.
.
<i ^UiX-
Lc-S
VA_^5_ii_
•ate: Cp IS,* 81
(L-Ouw Qv^ 11' 4^-*-^
<b'-v
Signatures
-X • v U
A, -V • c
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Ue>
3 lc<U
OlaA-j=^'
du^utc -i CLvv<^_
kvx^-.
AiXwui-
aL"
sill
,
J
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
/
PROFOfW
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
SECTION - A
GENERAL INFORM,ATI ON
a) Name :
. PautAtHJ > !)
c)
CHJ Course No.s
b)
liocese:
b) Ages
ri) Name of Congregations
nij.
Address
n Permanent
(Mother House/Superior) :
9)
^yir-xt o %
(1'
Present Address
(For future correspondence)
Jc<<
‘. t?s tx
CZv/v/
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
'
i)
j)
Give us a short description of the present team you are working with and
what each member does (not only health activities)
Have yiu attended any course/meetings/workshops since you completed the
Course ?
...2
f
i.
3
2 :
k) ,Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
1)
few sentences a description of the poeple you are working
Gi</e in a
urban, tribal, non-tribal, main occupation, other characteristics
with (rural,
How many villages? Total population, what distances’apart ?
etc).
1
UM
Hc*^
VYve-^vvyu2_. •
U
x.
■
SECTION 8
a)
Give a short description of the health activities you are
b)
How many
involvec? in.
hours are allotted for this daily/weekly ?
team of workers?
c) ,^re you functioning independently or with a
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the, local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Mission
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
■
*
: 3 ?
9)
Do you participate in training of local people ? Grihinis,
village level
worker, mothers etc.
*
h) Do you have any of the following programmes?
Food for work,
Health
Insurance,. CRS- MCH Programme, any ot hers
L_...
ZYl a H
i) ,!\re you part of any Diocesan Society o r Health Team ?
If so, specify.
SECTION C (Regarding 1902 project)
a) Give us detailed information on how to reach your village/project/centre?
(By bus and train, also
from station and bus stop)
Cj9-^
c
'(
b)—<r-e-t here any- ■tor mo-of-support -whieh -a visiting -te&ffl Gan -gi.
ecu/
ol
Ik&ui .
ou next
— fZe>•
Signatures
•ate:
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
&
<£>7 RlM^) ,
crVL’
<Tr\0sA'
c^v'-
Directorate of Rural Health Services & .
Training Programmes
FOLLOW-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S NEDICAL COLLEGE
\
PROFORPM
Instructions s
Soction 4 and C to be filled in by all Community Health Workers
Section B to be filled in by"those who are doing health work
at present.
(Please keep us informed regarding change of -Address!
SECTION - A
a)
GENERAL INFORMATION
Name
b) Ages
V'
c) CHJ Course No.:
&C Qji
2-
d) Name of Congregation:
e) Biocese:
Permanent Address
(Nother House/Superior)
L J L Q h civ &uY)A2^
:
b Co') i V wd ~
g) Present Address
(For future correspondence)
Sa •
L(9 j".
Yfrcl
•<9 ’
:
t al(L[x
RfR0CO
h) What have you been doing after tfhe course ?
(if you have changed from place to place give us some details of your work
in each place).
.
//id
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
are
Sev£n
m ohji
Acw t Jwc ant/nal’i'is -bnel
/b <=<?</ C<s>^by.
Caurit^
Chit'S
^CY acCH;
-
j) Have yiu attended any course/meetings/workshbps since you completed the
Course ?
Cauyie
d
\
j
...2
g 2 :
ire you in touch with any of the other Community Health ijorkars? If so
k)
give us their recent address.
c <-
JZ’ Jobi ffei
'
j-
c^^rfe^enCnces Zdescription of the poeplejouuarehWP-rk^
l)
with (rural,
etc).
urban, tribal,
r many villages?
]fYt LCUlie.
r
c
non-tribal, main occupation, other characteristics
Total PoP^W^hat^stanc^
Lo^
if)
b~ /xil&ntJthKS <
D/stc^tJ
SECTION B
a)
Give a short description of the health activities you are involved in.
Hea/lC
b)
^p.
How many hours
C H
.
are allotted for this daily/weekly ?
clapi e^^p'r
3cvnJ^i -
• ’ f or with a team of workers?
c) $re you functioning independently
how is the health work shared amongst. you S>
If so,
/o
uJejh x
d) Do you get any assistance fromi the local Primary Healt h J3ent re?
'ujT'
ye6. kc vijihd
IpgcJl'i*'/
~
If so, specify ?
0^ p l/c \
Carops
C/lf a
mn e rn
p) 7
.
e) Do you get any
assistance from a Taluk/wission Hospital?
<2 jLikrr?
If so, specify?
*
• "
-j in the village (young farmers,
f) Do you work with any special groups
yo ut h, mothers, harijans etc.)? jyjg
...3
z
; 3 s
g)
Do you participate in training of local people ? Grihinis,
worker, mothers etc.
d •
village level
h) Do you have any of the following programmes?
Food formwork.
Health Insurar^/e, CRS- MCy^rogramme, any others
i) 4re you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
L>
yj
slop
runar
*
b) i^re there any forms of support which a visiting team can give you next year ?
•late:
Signat lire:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FQLLOU-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present•
(please keep us informed regarding ' change ’ of .Address!
SECTION - 4
a)
GENERAL INFORMATION
b) Ages
Name :
c) CHJ Course No.:
2<^-
d) Name, of Congregations
C J r? 7
e) Bioceses
f)
Permanent Address
(Mother House/superior)
Ho use/Superior) :
g) Present Address
(For future correspondence)
A
7
’ S/ ■ M
.
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
t/j.
i) Givej us a short description of the present team you are working with and
what each member does (not only health activities)
/
j)
Have yiu attended any course/meetings/ujorkshops since you completed the
Course ?
.
...2
s 2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
l)
Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non—tribal, main occupation, other characteristics
etc).
How many villages? Total population. what distances apart ?
A/
rrJL^iiJ^ ,
y
■(^Lvy(c^eJ
SECTION B
short description of the health activities you are involved in.
a)
Give a
b)
How many hours are allotted for this daily/weekly ?
team of workers?
c) ,Are you functioning independently or with a
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Miss ion Fpspital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
2 3 s
g)
Do you parti cipat e in training of local people ? Grihinis,
worker. mothers etc.
village level
h) Do you have any of the following programmes?
Food for work. Health Insurance, CRS- FICH Programme, any others
i) ^re you part of any Diocesan Society or Health Team ?
If so, specify.
3ECT ION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
■
b) i^re there any forms of support which a visiting team can give you next year ?
•ate:
Signat ure:
- -J ccZccX
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
/3 y l/^/)
I
ih o/juhh
th.
c
c
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
PROFOFW
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who.are doing health work
at present.
Instructions :
(please keep -us informed regarding change of Address!
SECTION - A
GENERAL INFORMATION
n/VWAJL| A-•Nv^ b) Age:
a)
Name :
c)
CHJ Course No.:
e) 3iocese: /\J
d)
33
Name of Congregations
U^j&aJ fr ft .
- f) Permanent Address
(Mother Ho use/Superior)
:
- ,—
no
o)
Present Address
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:
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what each member does (not only health activities)
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AJi. I
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etc). How many villages? Total population, what distances apart ?
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how is the health work shared amongst you ?
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cvtToo,
If so, specify ?
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Do you participate in training of local people ? Grihinis,
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s ci
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i) are you part of any Diocesan Society or Health Team ?
OYQ
If so, specify.
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SECTION C (Regarding 1982 project)
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(By bus and train, also from station and bus stop)
a)
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST HOHN'S MEDICAL COLLEGE
PROFOJW
Instructions :
SECTION - A
a)
Name ;
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
- GENERAL INFORMATION
5x-
KiAY<5S<? rj
•t|W c) CHJ Course No.:
d) Name of Congregation:
L|e<
e) Diocese:
f)
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g) Present Address
(For future correspondence)
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:
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(if you have changed from place to place give us some details of your work
in each place).
Vu2_
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i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
(Pu/
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0 ,
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2 :
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give us their recent address.
/V o
1)
Give in a feur
few sentences
sentences a
a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other- characteristics
etc).
How
How many
many villages?
villages? Total population, what distances apart ?
SECTION B
a)
«
Give a short description of the health activities you are involved in.
f
MeiL-ut/O-U'tTWO
b)
’
How many hours are allotted for this daily/weekly ?
tw/.
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c) $re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
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worker, mothers etc.
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Food for work.
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programmes?
Health Insurance, CRS- NOH Programme, any others
fY\^C-R
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i) ^re you part of any Diocesan Society
,
or Health Team ?
If so, specify.
k-ct d c%wi
SECTION C (Regarding 1982 project)
a)
Give us detailed information
on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
A^? i<5
Xu U
CO <?<_c=^A.
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■ate,
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A - M^y^z ,
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t here
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE.
PROFORPM
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of .Address!
SECTION - A
a)
GENERAL INFORIMT10N
M- 7i4v£x>lj>^CVv^L b) Age:
Name J:
c) CHW Course No.:
e_i) Biocese:
x
f)
5
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Permanent Address
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V/V d IxXzv.
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vjo
1) Give in a few sentences a description of the poeple you are working
occupation, other characteristics
rwith (rural, urban, tribal, non-tribal, main
,
what distances apart ?
How many villages? Total population
etc).
c;
SECTION B
a)
involved in.
Give a short description of the health activities you are
b)
How many hours are allotted for this daily/weekly ?
c) ,^re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
i) Do you get any assistance from a Taluk/ Miss ion Hospital?
e
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
: 3 ?
9) Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work.
Health Insurance, CRS- MCR.‘Programme, any others
i) 4re you part of any Diocesan Society or Health Team ?
If so, specify.
SECTIQN C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also, from station and bus stop)
'
u-wi
3^0 arr'-
(pvcwz.
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b) i^re there any forms of support which a visiting team can give you next year ?
5
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was not adequate space in the questionnaire.
? (^0.0^
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5
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST JOHNfS NEDICAL COLLEGE
PROFORMA
InstTructions •
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who a,re doing health work
at present•
(please keep us informed regarding change of Address!
SECTION - 4
a)
GENERAL INFORMATION
Name
b) Ages
c) CHIJ Course No.:
e)
0
d) Name of Congregation:
Biocese:
Address
n Permanent
(Nother House/superior)
///
r
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g)
Present Address
(For future corrospondence)
U P.
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:
2
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in each place).
a
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k) .ire you in touch with any of the other Community Health Workers? If so
give us their recent address.
/Vo9
1)
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a few sentences a description of the poeple you..a.r.e UPrking
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages? Total population, what distances apart ?
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SECTION B
a)
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b)
How many hours
are allotted for this daily/weekly ?
*'‘ia team of workers?
c ) Arc yuu functioning independently or with
how is the health work shared amongst you ?
If so,
d) D° you get any assistance from the local Primary Health Centre?
If so, specify ?
i) Do you get any assistance from a Taluk/Miss ion Hospital?
e
If so, specify?
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
...3
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s 3 :
g) Do you participate in training of local people ? Grihinis, village level
worker, mothers etc.
h) Do you have any of the following programmes?
Food for work. Health Insurance, CRS- l*ICH-Programme, any others
i) //Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
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prr&'i'f'
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
PROFORMA
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
Instructions :
at present.
(please keep us
GENERAL INFORMATION
SECTION - A
a)
Name ;
b) /Ages
&5V
c) CHW Course No.:
S<^
j1’1
d)
£
Name of Congregations
J
I *
-00
r\
e) Biocese:
f)
informed regarding change of .Address!
Permanent Address
(Mother Ho use/Superior) :
ScV <=^A
’-v c> <> L
g) Present Address
(For future correspondence)
IVj
r
---
UV
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h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
\^X^^z>r.
V JAk
Ak C Vi
C
YUCx
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us a short description of the ptlsent team you are working with and
i) Give
what each member does (not only health activities)
Yxer'J .S-
<J1
S
j)
Have yw attended any course/meetings/workshops since you completed the
Course ?
...2
3
k)
2 :
ire you in touch with any of the other Community Health Workers? If SO
give us their recent address.
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non—tribal, main occupation, other characteristics
etc).
How many villages? Total population, what distances apart ?
sVt
kj-A,'--Q ■
SECTION B
a)
Give a short description of the health activities you are involved in.
3
b)
How many hours are allotted for this daily/weekly ?
c.) 4re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers^
youth, mothers, harijans etc.)?
...3
♦ ■>
: 3 s
g) Do you participate in training ef local people ? Erihinis,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work.
Health Insurance, CR3- l*ICH-Programme, any others
i) 4re you part of any Diocesan Society or Health Team ?
If so. specify.
SECTION C (Regarding 1982 project)
a) Give us detailed information on how to reach your
(By bus and train, also from station and bus stop)
Srh ■
t -s^ VsJvl
-I'
rs
<5 p'
S A-
SV‘ K
b) ^re t here 4i ny forms of support which a visiting team can give you next year ?
\ts -\§L- ^V.
Bate:
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
3 rvx=.
/x^5
F
■
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section a and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of -Addressl
SECTION - .-A
GEl\lERAL INFORMATION
a)
Name :
c)
CHW Course No.:
-Ages
e) Biocese:
/Address
n Permanent
(Mother Ho use/Superior)
o) Present .Address
'
(For future correspondence)
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
j) Have yiu attended any course/meetings/workshops since you completed the
r
Course ?
/
.. .2
«
s 2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
description of the poeple'ybu are working
1) Giv/e in a few sentences a
main occupation, other characteristics
with (rural, urban, tribal, non-tribal, r..-—
How many villages? Total population 9 what distances apart ?
et c).
3
SECTION B
a)
involved in*
Give a short description of the health activities you are
b)
allotted for this daily/weekly ?
How many hours are
c) ^re you functioning independently or with a team of workers?
you ?
how is
-- the
----- health
- - - work shared amongst
-
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/flission
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers*
youth, mothers, harijans etc.)?
. ..3
t 3 s
g)
Do you participate in training of loanl p-eople ? Hrih.inis.j’S
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work. Health Insurance, CRS- PICH- °rogramme, any others
i) /Are you part of any Diocesan Society or Health Team ?
If so,
specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) -Are there any forms of support which a visiting team can give you next year ?
Wat ej
Signat ure:
i
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
.
>1---------J
Directorate of Rural Health Services
and Training Programmes
St Johnfs Medical College,
Bangalore
DRHSTP-ACC-81
2u No v 1981
Dear
Seasons Greetings for Chirstmas and the New Year from all of us
in the Department of Community Medicine at St John1si
1982 is going to be a special year tor
for us since a long standing
plan to meet all of you in the field has finally materialised.
Thelma and
I are on special leave for a year starting December 1981 and during this
year we plan to visit as many of you as possible in your own areas of work
to re-establish contact, share experiences, reflect together and grow
in our understanding of our people and our work.
We have already been in
touch with many of you and we shall be writing to others as the weeks go by.
We thank all those who have so promptly and enthusiastically received this
news and welcomed us to their villages in 1982.
We hope to hear from many
others amongst you soon.
&
In order to get some common information from all of you in the
field we have drawn up a simple questionnaire taking ideas from many of
your own letters.
Please fill these up and add any other comments,
information, suggestions you would like to send us.
Those of you, who have
already sent us some details of your work recently fill in only those sections
which you did not cover in your personal letters.
Ue would like very much
to hear from each of the 150 Community Health Workers we have trained.
Even a blank tuestionnaire with only your latest address and information
on how to meet you next year would be most welcome.
Meeting you and seeing your programme will be a good experience
for us but in case you feel there are any other ways in which our visit
could be mutually beneficial please suggest this in Section C (b).
In preparation for this visit many other materials arc being
organized which we hope to send you soon - a list of Community Health
Workers addresses, news bulletins, list of new handouts and educational
materials and so on.
So please keep in touch.
Hoping to hear from you soon and also meeting you next year,
bjith best wishes and regards,
Yours sincerely,
7
PS: Please post this to Drs. Ravi & Thelma Narayan, D-10 Staff Quarters,
St Sohn’s Medical College, Bangalore 560 034 before Christmas 1981)
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST HOHN'S MEDICAL COLLEGE
PRO FORM
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
- GENER3L INFORMTION
SECTION -
Sr. a/
a)
Name :
c)
CHIJ Course No.:
b) ^ges
d) Name of Congregation:
e) Biocese:
•
/ Cj)
/Address
n Permanent
(Mother Ho use/Superior)
1
Present /Address
(For future correspondence)
9)
/•
^3
■
:
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tZ5 CXzK.^^
pit
h) IJhat have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
■u>.
4
'U^UC
ZU>C>^
HC >'V'/4
L/-;/
J
J
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description of the present team you are working with and
!
i) Give us a short
what each member does (not only health activities)
aZl
//
‘>ZzC-«
/vC
-f&
.Ajuq^^
?7
J) Have yw attended any course/meetings/workshops since you completed the
Course ?
/
J dl
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...2
I
g
2 :
k) Are you in touch with any of the other Community Health Workers? If so
JOO •
give us their recent address.
.
,
.
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dLuy am.
S/d/-^
OAJ-
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xr ..
pie you
are working
/
few
sentences
a
description
of
the
poeple
you
Give in a
main occupation, other characteristics
urban,
tribal,
non
—
tribal,
r.-^.with (rural,
etc). How many villages? Total population , what distances apart ?
\ -
1)
/ dsxd
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ajc/L
J. A ^Z44<
(pd/adie^L’^-d
SECTION B
^wu^c-tx.
{ftf-Jl
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a) Give a short description of the health activities you are
involved in.
dji.
Q’^'l duud" -/Cul
Jud/
c/
b)
How many ho
hours are'allott ed
or
^I'ldLcd
’his daily/weekly ?
• ' r or with a team of workers?
c) ^re you functioning independently
how is the health work shared amongst you ?
If SO,
d) Do you get any' assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/flission
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
A1 7^
J
. £ sJ-
...3
*
f
: 3 •
g) Do you participate f
in training of local
people ? Grihinis,
worker, mothers etc.
village level
ft/?.
h) Do you have any of the f '■
following Programmes?
Food for work, Health Insurance
_
CRS- PICH Programme, any others
A,
i) 4re you part of
any Diocesan Society
or Health Team ?
&T4^L^a^>
SECTION C (Regarding 1982
a)
project)
Give i'
us detailed information c..
(By bus < - ‘ 1
J and train, als0 from stat.ioh
J/'
<va^ 6)6.^ cjudtf
t Jj)
h
If so, specify.
.
Zr)
h
b) .flre there any forms of
support which a visitino
visiting t^m
team Can give yQU next
•at e:
year ?
/
Signat ure:
Please use the remaining blank
: space to giveany further details
was not adequate space in the .
for which there
questionnaire.
t
X
■*
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
SECTION - fl
a)
- GENERAL INFORMATION
b) flge:
Name ; Sa •
3
■
d) Name of Congregation:
c) CHW Course Nt*.:
0Wv^
"3l
e) Biocese:
f)
Permanent Address
(Mother House/superior) :
g) Present Address
(For future correspondence)
8
Q . PcJUvcui foJLkJ^.
«© I
h) What have you been doing after the course ?
' (if you have changed from place to place give us some details of your work
in each place).
n
-w’tnAa
e. -M 'U/ .
X>Ornjt JUty*
i) Givej us a short description of the present team you are working with and
what each member does (not only health activities)
. I-
4 I** AuJK
p3X/nx|4*^(X4A^
j)
• H' U***
•
Tt-fJ
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/pjU’cMji -urtlt*
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.
J
Have you attended any, course/meetings/workshops since you completed the
Course ?
.. .2
i
s 2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
No •
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc). How many villages? Total population, what distances apart ?
o
pl- e-H
2) O H
SECTION 8
a)
4
Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c) Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/nission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
? 3 ;
g) Do you participate
in training of local
people ? Grihinis,
worker, mothers etc.
village level
h) Do you have any of the followin
Food for work.
i) »Are you part of
g Programmes?
Health Insurance,“
CR3- PICH Programme, any others
any Diocesan Society o r Health Team ?
SECTION £ (Regarding 1982
a)
If so, specify.
project)
Give ius detailed information cr.
on how to reach 5your village/project/centre?
( By busJ and train, also from station
------------ ] and bus stop)
•hf
• Jny
cXoJ a kaZ
-Aaj4<4 ’cXl
■*v'
6?-n
b) -Are there
-v4a Uueza
aj~
| • /6‘ P■
Gxa/ J>^J3 /b
^U^-Cyt .
any forms of support which
a visiting team can give
you next year ?
3
Io jtaL^L^
7^ •
•ate:
■ Na'c
Signat ure:
Please use the
remaining blank
was not adequate space in the
SP8ce to gi^y further details
for which there
questionnaire.
Directorate of- Rural Health Services &
Training Programmes
FQLLOIJ-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN’S MEDICAL COLLEGE
PROFOfW
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present#
(please keep us informed regarding change of Address!
SECTION - .-A
a)
GENERAL I NFOR^TI ON
Li t| .
b) <Age:
Name ;
S c. *r/7.
c) CHIJ Course No.s
d) Name of Congregations
Sights
\/tr\n
e) Bioceses
f) Permanent Address
(Frother Ho use/Superior)
:
The pSW/hf
o) Present Address
•
14
(For future correspondence)
r‘
&■
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
ttc $
.
fan fa
CkiJ^
Jr
>Gh.
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
i (Xnm
CCL^e of oij
eve
jfayrz
J)
Ct^C- 1
!. we ainc
Sbr(.kJ***fa'*’
<2.
A'*#
Have you attended any course/meetings/workshops since you completed the
Course ?
**
' w<? •
I
...2
3
2 i
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
A/a.
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
How many villages? Total population, what distances apart ?
etc).
t
?!
SECTION B
a short desert
ition of the health activities you are involved in.
a) Give
b)
How many hours are allotted for this daily/weekly ?
c) f.^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you (jet any assistance from the local Primary Health Centre?
If so, specify ?
If so, specify?
e) Do you get any assistance from a Taluk/Nission Hospital?
r
f)
you work with any special groups
youth, mothers, harijans etc.)?
do
in the village (young farmers,
. ..3
: 3*?
g) Do you participate in training of local people ? Grihinis,
worker, mothers et c.
village level
h) Do you have any of the following programmes?
Food for work,
Health Insurance,- CRS- PICH Programme,
i) /Are you part of any Diocesan Society
or Health Team ?
any others
If so, specify.
SECTION C (Regarding 1982 project)
c
a)
Give us detailed information on how to reach your village/project/centre?
(.By bus and train, also from station and bus stop)
H, 0(^4'G(JsC'che,
.
oWuJL'
b) 4re there any forms of support which
a visiting team can give you next year ?
•ate:
Signat ure:
Please use the remaining blank space to giveany further details for which there
was not adequat
adequate space in the questionnaire.
-Mox.
Krw-/
4^5^
PUL'
i/
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFOfW
Instructions :
SECTION - A
a)
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
GENERAL INFORMATION
b) Age:^^
Name
c) CHW Course No.:
e) liocese:
f)
d) Name of Congregations,
,
•
Permanent Address
(Mother F.House/ Superior)
sin
g) Present Address
(For future correspondence)
:
<9 &
h) What have you been doing after thivcourse ?
(if you have changed from place to place give us some details of your work
in each place).
77 Z
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
j)
Have you attended any course/meetings/workshops since you completed the
Course ?
...2
s
2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address..
zir-
1)
are working
Give in a few sentences a description of the poeple you
non—tribal, main occupation, other characteristics
with (rural, urban, tribal,
etc).
How many villages? Total population, what distances apart ?
i-
SECTION B
a)
involved in.
Give a short description of the health activities you are
b)
How many hours are allotted for this daily/weekly ?
c) .^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e
Do you get any assistance from a Taluk/piission
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
•...3
: 3
g)
Do you participate in training of local people ?^Grihinis,
worker, mothers etc.
village level
h) Do you have any of the following
Food for work.
programmes?
Health Insurance 9 CRS- MCH Programme, any others
i) <flre you part of any Diocesan Society
or Health Tearn ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information
on how to reach your village/project/centre?
(By bus and train, ;also
’
from station and bus stop)
(.'rr^
/7
j
./orc
,
//a. // './orc
-2-^
------
fy rLu^/s fii/nwi
b) <flr« tNere>any Ferms—of suppdT?t which-a
(st C" r/ /l
t (A.
Lyz) $70 ML-
• //^l/r/cJjL
•ate:
visitiug- teanu.can ^ive -you Aext-year ?
>
$•
/f
3 C
Signature:
G.\
JT-LtZS)
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section .A and C to be filled in by all Community Health Workers
Section S to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of -Addressl
SECTION - 4
a)
Name :
<53
GENERAL INFORMATION
^t'u/vcx
b) Age: <53
d) Name of Congregation:
c) CHJ Course No.j
(Z.O'n^^^LX.U^
<
e) Biocese:
f)
Permanent /Address
(Mother House/superior)
g) Present /Address
(For future correspondence)
■
(J
8fwA/W:
^77/3^
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
/V
(PuAa-
S a'^x
M- (L- H- tyre
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
/42s
1' C- P--S- 'Pe&d'
,/(2w
j) Have you attended any course/meetings/workshops since you completed the
Course ?
/^ /
7
f
...2
s
2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc). How many villages? Total population, what distances apart ?
d tf\/ 'fi- ^laA-R. .
cnx
z
w //^x
a
61^1 e
SECTION B
a)
Give a short description of the health activities you are involved in.
&-P'T'
a
b)
u
Vacc^
/j
f
How many hours are allotted for this daily/weekly ?
(f*^(/LzC 'lxarY\A
‘■‘la team of workers?
c) i^re you functioning independently or with
If so,
how is the health work shared amongst you ?
d) D° you get any assistance from the local Primary Health Centre?
y^S •
ei) Do you get any assistance from a Taluk/flission Hospital?
If so, specify?
K13'
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
...3
: 3 ?
g) Do you participate in training of local people ? Grihinis
9
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work.
Cl
Health Insurance,
CRS- PICH Programme, any others
- Xf C
i) <Are you part of any Diocesan Society or Health Team ?
If so. specify..
SECTION C (Regarding 1982 project)
a)
Give Us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
/J -
b) ^re there any forms of support which a visiting team can give you next year ?
/VS•ate:
I^SoL-
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
I
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COHNUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
PROFOFW
Instructions :
Section a and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of .Addressl
SECTION - 4
a)
- GENERAL INFORmTION
. 3• 7
Name :
b) 4ges <3c5
d) Name of Congregation: J
c) CHlj Course No.:
e) Diocese:
f)
Cj^J^ (fl-p))
Permanent /Address
(riot her House/ Superior)
1WAA<^
EV—J
gA-
• A -P-
• o^" A
g) Present (Address
(For future correspondence)
t
S^<
I If , C
&JI
A ere—d ■
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)
^^iCoVXWXXu^-A^
rx
f)L-
-
i) Give us a short description of the present team you are working with and
what
each member does (not only health activities)
.
a
r’1AT
J
j)
‘ -p i
Have yw attended any course/meetings/workshops since you completed the
Course ?
...2
0
40
s
2 :
of the other Community Health Workers?
k) Are you in touch with any
give us their recent address.
If so
few sentences
sentences aa description of the poeple you are working
1) Give in] a few
non-tribal, main occupation, other characteristics
with (rural, urban, tribal,
How many villages? Total population, what distances apart ?
etc).
J
.
zx
SECTION
■
.
G4v.l4 dsr**'*'' cf^L^-
a)
Give a short description of tho health activities you are involved in.
^‘—-7
b)
P^T^-
How many hours are allotted for this daily/weekly ?
L» (I rVvZJvxjAJ
c) Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
C
t/Jc—>(x_
h <1 4^Lf^c\ '
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ? ’ 0 ‘
‘
‘
'
lAvvw t
e) Do you get any assistance from a Taluk/Flission Hospital?
J
If so, specify?
loc.
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
tr
\r>J^eL
. ..3
: 3 ?
g)
Do you participate in training of local people ? Grihinis,
worker, mothers etc. . •
village level
1Z AsYi 'v
fl /- z/z
h) Du you have.any of the following programmes?
Food for work, Health Insurance, CR^HCH Programme, any others
c"? L.
i) (Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION £ (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) .^re there any forms of support which
a visiting team can give you next year ?
•at e:
Signature: c$A -
y
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
jM*-—
n
\d-k
/
X4x-uA
•
4
crn^ l^trlr
InrU^/l' '’
g^. e£^‘
t£
'j;
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST OOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Addressl
- GENERAL INFORMATION
SECTION - A
a)
Name :
‘Sf.
Mee ya
Re.
b) /Age:
d) Name of Congregations ’
sirs
c) CHW Course No*:
^■e
e) Dioceses
f)
Permanent Address
(P^b 11 ei I'trube/Superior) :
g) Present Address
(For future correspondence)
TUksUB*
:
‘------------
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
itA
Kcu-e (nuua tV
S. P
tc
(jsrtrUKxCs
a(rtnJr
j^to
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'TuxCuiXeru 4
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0^ '<!> 44aaXaa *-<£.
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a ,
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tkju*x. -
s|»tklLK u
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.
ccrtrv^
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i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
j) Have you attended any course/meetings/uiorkshops since you completed the
Course ?
...2
?
2 :
k) are you in touch with any of the other Community Health Workers? If so
give us their recent address.
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
Total population , what distances apart ?
How many villages?
etc) .
7ke |
cxxe
trtvx.
_____ X4LiL^k(reuav
a*
oeie
o-elGjXjC t
«
HaXULVV
c
^•voA jj
<TLiLk£|
SECTION B
a) Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c). $re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e>) Do you get any assistance from a Taluk/nission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
.V
r-
: 3 ;
g) Do you participate in training of local people
worker, mothers etc.
? Grihinis, village level
h) Do you have any of the following programmes?
Food for work.
CRS- MCH Programme, any others
Health Insurance,
i) <,Ve you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a) Give Us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
-7?>y
pui-y
- 'Tc
L*/
c/elta/xuA
Y- ^o
oV
“TSy
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hux/cdlc
IrVLS
(q
OlV
a.*n.
'n^CL*KX^<xCts( € - KuIAa ■
ya_L<A.
^cltajxux 4JUrlR HuWa ,
b) ^re there any forms of support which a visiting team can give you next
•ate;
year ?
(=zC.
Sa,
Signature:
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
j-eY
ct
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I
Directorate of Rural Health Services &
Training Programmes
FQLLOlJ-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST OOHN'S NEDICAL COLLEGE
PROFORMA
Inst ructions :
Section 4 and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of .Addressl
SECT LON - 4
a)
Name :
- GENERAL INFORMATION
Sr. Jude
b) -Ages
Name of Congregation:
c) CHJ Course No.s
e)
(Nether House/superior)
Society of the
Sisters of St. Joseph of Tarbes
Biocese: Bangalore
0 Permanent /Address
40 years
•TARBES’
Promenade Road,Fraser Town,
Bangalore - 560 001
:
g) Present -Address
• (For future correspondence)
Sunandha
:
St. Joseph’s Convent
Coromandel Post, KGF - 563 118
h) Uhat have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
I have taken over as Sr - in - Charge of the Health team
in Sunanda
i)
Give us a short description of the present team you are working with and
what each member does (not only health activities)
Enclosed Sunanda Project writeup
j)
Have yiu attended any course/meetings/workshops since you completed the
Course ?
Attended Course in Community Health Work at Ecumenical
Christian Centre, Whitefield.
...2
s
2 s
'■* ‘i J < ?
k) Are you in touch with any of the
give us their recent address.
other Community Health Workers? If so
No
description of the poeple you are working
1) Give in a few sentences a
non-tribal, main occupation, other characteristics
with (rural, urban, tribal,
Total
population, what distances apart ?
etc).
How many villages?
Working among people in 18 villages with a population of about
6000. These villages are about 3 kilometers apart.
The people are mainly landless labourers and small farmers
with an average of about 2 acres land.
(
f
$
SECTION B
!
I
a) Give ac short description of the health activities you are involved in.
Health education , both preventative and curative aspects#
______ Anti natal and post natal care#
Nutrition classes for women
of
minor
illness
and referral of serious cases#
Treatment
b)
How many hours are
are allotted,for
allotted, tor this
tnis daily/weekly
oany/wubMy ?»
The health team is an integrated part of Sunanda s program and
regular 8 hrs# a day is allotted for this work#
c) Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
With a team# The team comprises of 2 ANM’s , 2 Leprosy para
medical^workers, 2 community health Guides, a helper,
and myself
assistance from the local Primary Health Centre?
d) Do you get any
wVwo^Tery7closely with the PHC. From them we are able to
get our immunisation requirements.
' assistance from a Taluk/l»lission Hospital?
e) Do you get any
If so, specify?
Aid in the form of Medicines is received from CHA New Delhi,
Direct Relief Foundation USA and Action Medeor - Germany
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
Yes«
f-
...3
♦- *
: 3 ;
g) Do you participate in training of local people ? Gjihinis,
worker, mothers etc.
village level
fes. Village level workers. In each village one or two are
trained by us.
h) Do you have any of the following programmes?
Food for work.
Health Insurance,
CR3--H“ICH Programme, any others
Our MCH program sponsored by CASA has stopped since
August 1981 due to a change in their program. However,
Milk powder distribution is now being carried on.
i) iAre you part of any Diocesan Society or Health Team ?
If so,
specify.
No
SECTION C (Regarding 1982 project)
i
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
By train get down at Bangarapet Junction and catch the KEF
local. Get down at Coromandel Railway station and our project
is just behind the station in the premises of St. Sebastian's
Ghurch. By bus get down at Robertsonpet and f£8n!cS^Si51nS’?lauto
b) ^re there any forms of support which a visiting team can give you next year ?
•ete! January 18,1982
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
r’s
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Directorate of Rural Health Services &
Training Programmes .
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH .
WORKERS TRAINED ^N ST JOHN'S MEDICAL COLLEGE
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
PROFOFW
J
Inst ructions :
Section
and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of .Address!
SECTION -
GENERAL INFORIMT10N
a)
Name s MfKTlN
c)
CHW Course No.:
Cusurs/n^'
b) -Ages
"1
d) Name of Congregations
^tbEMPro^S T
(Go )
f) Permanent Address
L
e) Biocese:
(Mother House/superior) :
g) Present /Address
(For future correspondence)
S3.1 /
BftwG-ftuoRu
^cS-
REDEMPTORIST FATHERS
199/A, ALTO - PORVOR’M
BARDEL GOA- 403501
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
CaZ)^
rvx y
a&A
j)
c
ur?
Have yiu attended any course/meetings/workshops since you completed the
Course ?
(Alo
...2
A
s 2 :
Community Hsalth Workers? If so
k) Are youj in touch with any of the other
give us their recent address.
few sentences a description of the poeple you are working
1) Give in] a
urban, tribal, non-tribal, main occupation, other characteristics
with (rural.
- etc).
How many villages?
Total population, what distances apart ?
_ nJV
SECTION B
a)
description of the health activities you are involved in.
Give a short
b)
How many hours
are allotted for this daily/weekly ?
functioning independently or with a team of workers?
c ) Are you
how is the health work shared amongst you ?
d) Do you get any assistance from
If so, specify ?
e>) Do you get any
If so,
the local Primary Health Centre?
assistance from a Taluk/flission Hospital?
If so, specify?
f special groups in the village (young farmers,
f) Do you work with any
youth, mothers, Iharijans etc.)?
...3
: 3 ?
g)
Do you participate in training of local people ? Grihinis
9
worker, mothers etc.
village level
*
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH Programme, any others
i) <Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECT I DM 0 (Regarding 1982 project)
a)
ij
7^-<
l-'-k.
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
f‘,z|(<4jC-v-o_x3 to
I
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C-v-| (JLn-
c #g~NC H-Up^r.
. C^~ Ov-? qJLjL.
GjC^^- (j^-
c€
1
/
b) ^rs there any forms of support which a visiting team can give you next year -?
J
lo
k
•ate:
Signature:
< a • 2-1
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
-V
rXtSje-^ A
3
3
/
3
Directorate of Rural Health Services &
Training Programmes
FQLLOIJ-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST 30HNrS NEDICAL COLLEGE
PROFORMA
Instructions :
Section 4 and C to be filled in by all Community Health Workers
Section B to be filled in by those who. are doing health work
at present.
(please keep us informed regarding' change of address!
SECTION - A
GENERAL IN FORMAT 10 N
a)
Name :
b) -Ages
c)
CHi) Course No.:
d)
e) !)iocese:
f)
31
Name of Congregation:
jVxvucii > U- p 'XXlQ
Permanent /Address
(Hother House/superior)
:
Ip
vJX- Cu
g) Present /Address
(For future correspondence)
-iStv
LfoS'
- —-
:
_-i_V W \_t_
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)»
l^Tl^ L \
XeC UXtX__f
L^Xt
I LvX.
^-0
Cl
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i
u-
C/i
9
iLvGzwu- '
£7tC>>-uX
LlX
J
uX
tX
tX- C-x_Xx-
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
C
L
c.
j)
30
V
iu.
Skrvauig
Have yw attended any course/meetings/workshops since you completed the
Course ?
0
•. »2
? 2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
R^-L
.
STLt -
poep.l", e yo u • •erire working
1) Give ini a few sentences a description of the occupation,
other characteristics
with (rural, urban, tribal, non-tribal, main
what distances apart ?
etc).
How
How many
many villages?
villages? Total population,
L Z5W
6 q. CidLQox—
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C^l-'
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SECTION 8
a)
—? involved in.
Give a short description of the health activities you are
L (zvc
1—
9 C?c-ML-'
b)
■kve^4
’,.X-X-Cv' iX- (L,
Cs-<-■
'
How many hours are allotted for this daily/weekly ?
c) 4rG you functioning independently or with) a team of workers?
health work shared amongst you ?
how is the
----- -----
If so,
ctv^-c
9-
^\vv-<L---tV'<^-<--vxLA
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
If so, specify?
e) Do you get any assistance from a Taluk/Miss ion Hospital?
f) Do you work with any special groups
youth, mothers, harijans etc.)?
in the village (young farmers,
I-
3
Lt-
LvC
U-ua
u.
it
bzlU
If
; 3 ?
g) Do you part’icipate in training of local people ? Grihinis,
wo rker, mothers etc.
village level
Iw
9
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH Programme, any others
i) -Are you part of any Diocesan Society
9
□ r Hea It h T ea m ?
If so,
specify.
i
Li
J
SECTION C (Regarding 1982 project)
a) Give us detailed information
on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
%
'9$'
L-t^. )<• /<
h
iorte.
L •
C>e-r-we,
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Li
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Li
Li
sre any/formg of support which a visiting team can give you next year ?
•ate:
Signat ure:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
as
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of flddressl
SECTION - fl
a)
- GENERAL INFORMATION
b) Age: 36
Name :
c) CHW Course No.:
e)
Diocese:
0 Permanent Address
d)
c
:
g) Present Address
(For future correspondence)
Q
C^i>S
. I]/
(Mother House/superior)
Name.of Congregation:
CAoor/
:
523S^?
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
i) Give us a short description of the present team >you are working with and
what each member does (not only health activities)
j)
Have you attended any course/meetings/workshops since you completed the
Course ?
ND
...2
'-.i
2 2 t
k) .Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
1)
Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
How many villages? Total population, what distances apart ?
etc).
SECTION B
a) Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c) ^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) D° you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/flission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
: 3 ;
g)
Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
h) De you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH Programme, any others
i
i) <flre you part of any Diocesan Society or Health Team ?
If so. specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus
bus_stop)
stop)
(
QuhbuX
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/ J5
rr
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r*,
it
rf .
i
b) -flre there any formiis of support which a visiting team'can give you next year ?
Oc
'A
j
>at e:
Signat ure:
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
/
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and’C to be filled in by all Community Health porkers
Section 0 to be filled in by those who are doing health work
at present.
(Please keep us informed regarding change of flddressl
SECTION - fl
a)
Name ;
- GENERAL INFORMATION
s&aeN/
b) flge:
c) CHW Course No.:
f)
Name of Congregation:
CK^ZX. VV
e) Biocese:
H’* SSte>iMP>SOB
(X- .
Permanent Address
(Mother House/Superior) :
Present Address
(For future correspondence)
H-C
fi-rc.
/?ow/
7
'
g)
St
I o
r>
. \n-53>.
* •3'tissioric<fii.-s oj Cliu'ily ( ^Biothets')
N U N N A 212. .
KRISHNA DIST. ANDHRA PRADESH
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
SocsrO
(J^ L<^ K» vJ
C—
Xrvxr^-,*^-^
0
1
\--X
VW-
i) Give us a short description of the present'team you are working with and
what each member does (not only health activities)
Vjq_ (XAA- cJaAAX.
S
Co**vs'
0<A* booU-V^I
C, V^A^-4>*V»C
£
j) Have yau attended any course/meetings/workshops since you completed the
Course ?
VJo.
..2
s
2 :
of the other Community Health Workers? If so
k) .Are you in touch With any
give us their recent address.
No*
i
few sentences a description of the poeple you are .working
urban, tribal, non-tribal, main occupation, otfrer characteristics
with (rural,
How many villages? Total population, what distances apart ?
etc).
1) Give in1 a
% \
Ovxju
£
<Xrx. or^A-Ft—£
V
------ Vi •
,
r.
SECTION B
2
•t
a)
involved- in.
Give a short description of the health activities ^ou are
b)
How many hours are allotted
for this daily/weekly ?
• ’ f ar with a team of workers?
c) ^re you functioning independently
is the
work shared amongst you ?
how ------ health
-
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any
assistance from a Taluk/poission Hospital?
f) Do you ujork with any special groups
youth, mothers, harijans etc.)?
If so, specify?
in the village (young farmers,
...3
s 3 ?
Do you participate
g)
in training of local people ? Grihinis, village level
worker, mothers etc.
h) Do you have any of the following programmes?
Food for work,
Health Insurance,
CR3- PICH Programme,
i) 4re you part of any Diocesan Society or
Health Team ?
any others
If so,
specify.
SECTION £ (Regarding 1982 project)
a)
Give us detailed information
on how to reach your village/project/centre?
(Sy bus and train, also from station and bus stop)
CA^cx
5
dL
OcX<S-
V cXo ucrvx
bJ LA vV J\/ A
c\3
b) ^re there any forms of support which a
visiting team can give you next year ?
^vVI tYx
A<4^<5
%
•ate:
-s
Signat ure:
z
Please uss the remaining blank space to giveany hurt
?ther details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROTO FW
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
SECTION - 4
a)
GENERAL INFORIW10N
S’§Uwi.
Name :
c) CHJ Course No.:
e)
Biocese:
b) Age:
3
d)
^*1
Name of Congregation:
6juucl<!La|faXj
Permanent /Address
(Plot her Ho use/Superior)
FcxjLvnaA
FzjJtwtfi
Ale
S• Il o. M%/i7
- HI*
g) Present Address
(For future correspondence) : St• Tc^hl»*jS ^e»iou4*
g
, FT
■
U- - A.p.
h) Uhat have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
S-A/WCX.
COC>~c^
.o--- cf
J4.e-H*
< n/r-p.
Sju—e/t
i) Give us a jshort description of the present team you are working with and
what each member does (not only health, activities)
J) Have yiu attended any course/meetings/workshops since you completed the
Course ?
». • 2
s
2 :
k) Are you in touch with any of the other Community Health Workers?
give us their recent address.
If so
|\1€> .
1)
Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non—tribal, main occupation, other characteristics
etc).
How many villages? Total population, what distances apart ?
i
SECTION B
a) Give a short description of the health activities you are_ involved in.
4-cAMv ^alaa\.<.
(5
» . . -»*- « -tA_
j >
Q ^vc
U-CcailjU.
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X -—y Q-xl-ck-o 4-
b)U'Hou^rnany ho^^ are allotd^ily/weekly ?
this
b) How rrrany hours are allottc.
W
Jbu
X .
V ., cko-^ .
V<L V-X <c
— 2
If so,
c) ^re you functioning independently or with a team of workers?
how is
the health ______
work_ shared
amongst you ?
.
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d) Do you get any
any ’assista
assistance from the local Primary Health Centre?
If so, specify ?
NlO
©) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
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f) Do you work with any special groups in the village (young farmers,
youth,
mothers, harijans etc.)?
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: 3 :
g) Do you participate in training
worker , mothers etc. f
Vi
\ (CCXClL- ik/JL
Of local people ? Grihinis ,
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Cx^-A VoC(M--i Ckno^A
fecx
■^jLSvk?
SVv*aA<cl
village level
<
h) Do you have any of the following programmes?
Food for work,
G
Health Insurance, CRS- PICH-Programme, any others
S - vt Vi ?»e<i
-k N ?
‘yv
i) ftre you part of any Diocesan Society or Health Team ?
If so , specify.
z ^OO-V
vv—e
\Vo
T
CjLX-Askok^oX-
0
SECTION C (Regarding 1982 project)
a) Give us detailed information c
on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
|<oJLoJ^pojlc>vi^ar)
b) ^re there any forms of support which
•ate: /<) |q
to
d^ULel" -4^-b.
a visiting team can give you next year ?
Signatures
K|iU V7—
Please use the remaining blank soace to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
■ 1
.
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TR.AINED IN ST JOHNfS MEDICAL COLLEGE
tf
*
PROFORMA
Instructions : Section .A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(Please keep us informed regarding change of .Address!
GENER3L INFORMATION
SECTION - .A
b) .Age:
a)
Name :
c)
CHIJ Course No.:
5 T
e). iiocese:
f)
6/^
Jf
d) Name of Congregation:
[la
|X/(
Permanent .Address
(Mother House/Superior)
/-/tfLi Q-yc:^
p 01
:
ix
g) Present .Address
(For future correspondence)
:
Ho'^’ZcZz
J-1 cCq
P?
h) What have you been doing rafter the course ?
(if you have changed from place to place give us some details of your work
in each place).
.
(^./vAvZ
Laa-'
/uv^ Zvoixw l V' C|
.xA'VM?* c^ci^c
VV
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
/VrC ZuvvAt q
/wt
Cj
a
Cr^
-
/V-Mc4’
v 11
/\
pA/U^ HZza£4^v
3 r/
J) Have you attended any course/meetings/workshops since you completed the
Course ?
'J
wtZ cvtG-^cC J
0
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k)
give us their recent address.
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Total
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etc).
How many villages?
1)
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,
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in.
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how is the health work shared amongst you ?
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(
If so, specify ?
e) Do you get any
assistance from a Taluk/Mission Hospital?
IF so, specify?
1
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youth, mothers, harijans etc.)?
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village level
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(No
SECTION C (Regarding 1982 project)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
a)
b) ^re there any forms of support which a visiting team can give you next year ?
lat e:
J©
Signature:
ft \
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
3'
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Directorate of Rural Health Services &
Training Programmes
FQLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
PROFOFW
Section A and C t.o be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
Instructions :
at present•
(please keep us informed regarding change of Address!
GENERAL INFORMATION
SECTION - A
a)
b) Ages S'!
Name :
d) Name of Congregation:
c) CHW Course No.:
• (*1 * Fl
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(Mother House/superior)
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what each member does (not only health activities)
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1) Give in a few sentences a description of the poeple you are working
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How many villages?
Total population, what distances apart ?
etc).
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a)
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SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
(?) aS *
b) i^re there any forms of support which a visiting team can give you next year ?
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Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FQLLObJ-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFOFW
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us
SECTION - A
a)
informed regarding change of ^ddressl
GENERAL INFORMATION
b) Age: 3^
Name : Sft Li N Jr /
«*) Name of Congregationr"jt\£
c) CHJ Course No.:
e) Biocese:
f)
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La^-. a—d Its
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(\/o •
... 2
? 2 :
k)
Are you in touch with any of the other Community Health Workers? If so
d
give us their, recent address.
3f.
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C
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3
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1) Give in a few sentences a descripo'ion <of the poeple you ar'e working
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etc). How many villages? Total population , what distances apart ?
0
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SECTION B
a)
n of the health activities you are involved in.
Give a short description
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,
LtV -4
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How many hours are allotted for this daily/weekly ?
c) 4re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
KI
,
e) Do you get any assistance from a Taluk/flission
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
: 3 ?
g) Do you parti cipat e in training of local people ? Grihinis,
worker. mothers etc.
village level
h) Do you have any of the following programmes?
Food for work,
Health Insurance,
CR3- FICH‘Programme, any others
N<i
i) /Are you part of any Diocesan Society of Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Givfe us detailed information on how to reach your village/project/centre?
Iso from static and bus stnp)
.
.J
p
eW •
J^T tr
b") -Are there any forms o'
eq
co. I)
S 'l A.u •7 HelV
■
3^ iM&thi
support which a visiting team can give you next year ?
Signature:
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
Directdrate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST JOHNfS NEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
SECTION a)
GENERAL IN FORMAT I 0 N
Name ;
f^9e: 33
l<7y
c) CHIJ Course No.:
e) Biocese:
d) Name of Congregations
C tiCexiw.
address
n Permanent
(Nother House/superior) :
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g)
(Ja<SC'.<(zL^C
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Present Address
(For future correspondence)
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in each place).
Awl'
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i) Give us a short description of the present team you are ujorking with and
what each member does (not only health activities)
J)
Have yiu attended any course/meetings/workshops since you completed the
Course ?
No
*■
s 2 :
k) are you in touch with any of the other Community Health Workers? If so
give us their recent address.
A/o
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
How many villages? Total population, what distances apart ?
etc).
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a) Give a short description of the health activities you are involved in.
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b)
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How many hours are allotted for this daily/weekly ?
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c) ^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
CisA.
JU uivi
e) Do you get any assistance from a Taluk/Hiss ion Hospital?
If so, specify?
Af#
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
...3
: 3 ?
g) Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- PICH Programme, .any others
i) /Are you part of any Diocesan Society or Health Team ?
If so, spucify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) ^re there any forms of support which a visiting team can give you next year ?
fates JLg
Signaturss
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
........
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN’S MEDICAL COLLEGE
PROFORPM
Instructions : Section A and C to be filled in by all Community Health Workers
””
Section B to. be filled in by those who are doing health work
at present.
(Please keep us informed regarding change of ^ddressl
GENERAL INFORMATION
SECTION -
a)
' b) /Ages
Name :
d)
c) CHJ Course No.:1
e) Diocese:
f)
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Name of Congregation:
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Permanent Address
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Give in a few sentences a description of the poeple you are working
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How many villages? Total population, what distances apart ?
etc).
J5 .
SECTION B
a)
Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c ) $re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/l^ission
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers*
youth, mothers, harijans etc.)?
. ..3
: 3 :
g)
Do you participate in training of local people ? Grihinis 9
worker, mothers etc.
village level
it
h) Do you have any of the following programmes?
•
Food for work, Health Insurance, CRS- NOH Orogramme, any others
- \\\CH
CL
V*
i) 4re you part of any Diocesan Society or Health Tearn ?
If SO, specify.
SECTION C (Regarding 1982 project)
a)
Give Us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
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CoA0
<£rvv£-
Signature:
•ate:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
Inst ructions :
(Please keep us informed regarding change of address!
GENERaL INFORmTIQN
SECTION - 4
$Tr- \/k 1-aL.a^,
a)
Name :
c)
CHJ Course No.:
d)
Name of Congregation: S
I dm -o^
b•
\^or> Ak C
e) Diocese:
f)
b) 4ges
Permanent /Address
(Mother House/superior)
:
■ Q-ft
g) Present Address
(For future correspondence) :
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h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)o
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2 :
3
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
A/o .
1) Give in a few sentences a description of the poeple you..a,T.e workingwith (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How
How .many
.many villages?
villages? Total
Total population,
population, what distances apart ?
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SECTION 8
a) Give a short description of the health activities you are involved in.
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How many
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how is the health work shared amongst you ?
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e) Do you get any assistance from a Taluk/Miss ion Hospital?
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f) Do you work with any special groups
youth, mothers, harijans etc.)?
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in the village (young farmers,
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h) Do you have any of the following programmes?
Food for work,
Health Insurance, CRS- MCH Programme, any others
F-
-
i) <Are you part of any Diocesan Society or Health Team ?
If so. specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
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G--S «£* z 11 - I S’-
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b) <Are there any forms of support which a visiting team can give you next year ?
•ate:
Signat ure:
Xi*
—
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
t
Directorate of Rural Health Services &
Training Programmes
FQLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
PROFOfW
Inst ructions :
Section a and C to be filled in by all Community Health Workers
Section a and C to be filled in by all Community Health
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
- GENERAL INFORmTIDN
SECTION -
A
c-zL1—b) /Age.
J oAuswy-c
a)
Name : f
c)
CHJ Course No.:
3c- 6/^22
d) Name of Congregation:
e) Biocese:
Address
0 Permanent
(Mother Ho use/Superior) :
g)
<N rt
Present /Address
(For future correspondence)
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h) Ijhat have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
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i)
Give us a short description of the present team you are working with and
what each member does (not only health activities)
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Have you attended any course/meetings/workshops since you completed the
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k) are you in to-uch with any of the other Community Health Workers? If so
give us their recent address.
1.) Give in a few sentences a description of the poeple you are wb^rking
with (rural, urban, tribal, non—tribal, main occupation, other characteristics
etc) .
How many villages? Total population, what distances apart ?
A'"1
SECTION B
a)
Give a short description of the health. activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c ) i.^re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Miss ion Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
I
: 3 ;
g) Do you participate in training of local people ? Grihinis ,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- PICH Programme, any others
i) /Are you part of any Diocesan Society or Health Team ?
specify.
If SO,
J
SECTION C (Regarding 1982 project)
a) Give Us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
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Signature:
Cl
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Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
4
Directorate of Rural Health Services &
Training Programmes
FOLLOld-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
SECTION - gA
GENERAL INFORMATION
PR JOSEPH PuRAyiSoi^
a) Name :
b) -Age:
c) CHJ Course No.:
Name of Congregation:
<31
e)
3^
St/l'vtO'Yvt^o
Diocese: t^cK/vvc\AYH'-A^
Address
n Permanent
(Mother House/superior) :
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h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
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Sirvci-J^ _S-37
give us their recent address.
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poeple you are working
occupation, other characteristics
what distances apart ?
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h) Du you have any of the following programmes?
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village level
any others
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i) /Are you part of any Diocesan Society or Health Team ?
ni^’iovj
st.
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If so, specify.
M ^7V3)y f)
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
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b) ^re there any forms of support which a visiting team can give you next year ?
fates
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Signat ures
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Ssrvices &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Section A and C to be filled in by all Community Health Workers
Section B to' be filled in by those who are doing health work
Instructions :
at present.
(please keep us informed regarding change of lAddressl
GENERAL INFORMATION
SECTION a)
b) Ages
Name :
Z , '
c)
CHJ Course No.:
e)
Diocese:
Sc 7//
d) Name of Congregation:
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j) Have you attended any course/meetings/workshops since you completed the
Course ?
IV 0-
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Ire you in touch with any of the other Community Health Workers? If
k)
SO
give us their recent address.
1) Give in a few sentences a description of the poeple you .a.re_wprking
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
How many villages? Total population, what distances apart ?
etc).
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SECTION B
a)
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short description
description of the health activities you are involved in.
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SECTION C (Regarding 1982 project)
a)
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Give us detailed information on how to reach your.village/project/centre?
(By bus and train, also from station and bus stop)
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"LIFE"
Inauguration Prayer Service
CHW (BC 8) JOth August 1981
1.
2.
3.
4.
5.
6.
<•
8.
9.
Introduction
Bhajan - lighting of the Lamp - Pause for
Reflection
Reading from Scripture - Ps.138. Pause
Reflection & distribution of books
Song: "It shall be my endeavour"
Final Reflection
Receiving of lighted candles
Final Song: "This little guiding light of mine"
+ + + +
f
I
Lighting of Lamp
Bhajan
He prabhu Darashana dho )
2
Mere dil me ahvo
)
Tu hi prabhu jivan dhata
Muje pare dhanya karo
Tu hi prabhu mukti dhata
Huje pare dhaya karo
Tu hi prabhu Shanti dhata
Muje para dhaya karo.
It Shall Be My Endeavour
Refrain:
It shall be my endeavour
To reveal thee in my actions
To reveal thee in my actions
Knowing it is thy power
Gives me strength to act.
1. Life of my life, 1 shall ever try
To keep my body pure
Knowing that Thy living touch is
Upon all my limbs (It shall....)
2. I shall ever try to keep all untruth
Out from my thoughts,
Knowing that thou art that truth
Which has kindled the light of
reason in my mind (It shall....)
J. I shall ever try to drive all evils away
from my heart and keep my love in flower
Knowing that thou hast thy seat in
the inmost shrine of my heart (It shall...)
INAUGURATION PRAYERSERVICE
Theme
"Life"
Introduction (Slow - prayerful - loud & clear)
"You eat a piece of bread.
The bread ceases to be bread
and becomes part of you--It rises to a new life
We (like bread) are consumed in the gift
of ourselves to our fellowmen and women.
We die in order to rise to New Life
(As bread that is broken by Peter G. Van
Breemen, S.J.).
Dear friends we have all come together for a
single purpose to know more about life and the
motivation to be more serviceable to our brothers
and sisters by giving them a healing touch in
order to save life.
To be more fully aware of God’s life in us and
with a deep and sincere longing to renew this
life in Him, let us call upon Him with the help
of the following Bhajan.
♦
"He prabhu darashan do )
Mere dil me ahvo
) 2
Tu hi prabhu jevan dhata
Huje pare dhaya karo
Tu hi prabhu mukti dhata
Huje pare dhaya karo
Tu hi prabhu shanti dhata
Huje para dhaya karo."
* (the director lights the lamp while the
Bhajan is being sung).
Slight pause for reflection.
Leader:
Leader:
"The providential care of God
is strikingly realized in the
2.
miracle of every birth, each new born
infant demonstrates the tremendous
care and attention which God has for
That I am what I am is
each of us.
His knowledge is creative.
due to God.
God does not know me because I am but
I am because He knows me.” (Ref. from
As Bread that is broken).
Let us listen to the feelings of the psalmist
expressed in the following psalm.
Reader;
It was you who created my inmost self
and put me together in my mother’s womb;
for all these mysteries I thank you:
for the wonder of myself, for the
wonder of your works.
You know me through and through
for having watched my bones take shape
When I was being formed in secret,
knitted together in the limbo of the womb.
You had scrutinised my every action,
All were recorded in your book
My days listed and determined,
even before the first of them occured.
God, how hard it is to grasp your thoughts!
How impossible to count them!
I could no more count them than I could
the sand,
and suppose I could, you would still be
with me.
Pause for silent reflection•
Leader:
At the beginning of this serch together
to enter into this great being ”MAN” and
discover every bone and fibre, every
heart beat and to every blood cell,
we need others in the persons of our
directors and professors but we also need
books, books will be our constant and
faithful companions day and night.
Let us use them and draw out all the
hidden knowledge therein.
(Books are distributed while the follow
ing song is sung).
It Shall be my endeavour
Refrain:
It shall be my endeavour to reveal Thee
in my actions, to reveal Thee in my
actions knowing it is Thy power
Gives me strength to act.
1. Life of my life, 1 shall ever try to keep
my body pure, knowing that Thy living
touch is upon all my limbs. (Refrain).
2. I shall ever try to keep all untrouths out
from my thoughts, knowing that thou art
that truth, which has kindled the light of
reason in my mind.
(Refrain).
5. I shall ever try to drive all evils away
from my heart and keep love In flower,
knowing that Thou hast Thy seat in the
Inmost shrine of my heart.
(Refrain).
Very often we have heard the words of
Christ said a number of times as he
walked the streets of Galilee - as the
people cried out to Him to heal them
and make them whole again "Go your faith has made thee whole",
or "I wish they would have life and
have it more abundantly."
Friends, as a symbol of our search together to
discover man and ways to preserve life, let us
receive this lighted handle, symbol of life,
symbol of myself, spreading warmth, light and life.
Keep this candle with you so that at the end of
the Course we may light it once again and take it
Leader:
4.
with us as a symbolic gesture.
(Lighted candles are distributed to all
the participants of the Course).
The following song is sung.
This Little Goldins Light
1. This little guiding light of mine
I am going to let it shine (3 times)
Let it shine all the time, let it shine.
2. Hide it under the bushel oh No!
'I am going to let it shine (3)
Let it shine all the time, let it shine.
3. Take my little light round the world
I am going to let it shine (3)
Let it shine all the time, let it shine.
♦*
♦♦
♦*
This Little GUIDING LIGHT
1. This little guiding light of mind
I am going to let it shine (.3)
Let it shine all the time let it shine.
2. Hide it under the bushel Oh no
I am going to let it shine (3)_
Let it shine all the time let it shine.
3. Take this little light round the world
I am going to let it shine (3)
Let it shine all the time let it shine.
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Directorate of Rural Health Services &
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FOLLOW-UP -EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
T
PROFORMA
Section A and
Section
and Cto be filled in by all Community Health Workers
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Instructions $
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SECTION - rA
- GENERAL INFORMATION
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SECTION C (Regarding 1982 project)
a)
Give Us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) -^re there any forms of support which a visiting team can give you next year ?
late:
Signature:
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP 'EMLOPTION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFOJW
Section a and C to be filled in by all Community Health Workers
Section B to-'be filled in by those who are doing health work
Inst ructions :
at present.
informed regarding change of .Addressl
(please keep us
GENEFUL INFORmTIQN
SECTION - 4
3)
b) iflge:
Name :
d) Name of Congregation:
C) CHU Course No.:
Diocese:
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Permanent /Address
(Mother Ho use/Superior)
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(For future correspondence)
r,?/A.r^ '■'•‘j
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h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)/
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i)
Give us a short description of the present team you are working with and
what each member does (not only health activities) ^/,-
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k) .Are you in touch with any of the other Cornmunity Health Workers? If so
give us their recent address.
W
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
How many villages? Total population, what distances apart ?
et c) .
<4
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A
SECTION B
a)
Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c ) $re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/flission
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
'/t
■
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g) Do you parti ci pat e in training of local people ? Grihinis,
worker. mothers etc.
village level
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- PICH Programme, any others
i) ^re you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 198 2 project)
Give us detailed information on how to reach your village/project/centre?
(By bus and train,.also from station and bus stop)
a)
~qJd
1 &<'<.
dL /t... /:
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re any forms of support which a visiting team 'can give you next year ?
b) 4 re there
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Signature:
late:
J/ Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services
and Training Programmes
St JohnTs Medical College,
Bangalore
23 Nov 1981
DRHSTP-..ACC-81
Dear
Seasons Greetings for Chirstmas and the New Year from all of us
in the Department of Community Medicine at St Sohn1si
1982 is going to be a special year for us since a long standing
plan to meet all of you io the field has finally materialised.
Thelma and
I are on special leave for a year starting December 1981 and during this
year we plan to visit as many of you as possible in your own areas of work
to re-establish contact, share experiences, reflect together and grow
in our understanding of our people and our work.
We have already been in
touch with many of you and we shall be writing to others as the weeks go by.
IJe thank all those who have so promptly and enthusiastically received this
news and welcomed us to their villages in 1982.
We hope to hear from many
others amongst you soon.
I
In order to get some common information frrom all of you in the
field we have drawn up a simple questionnaire taking ideas from many of
your own letters.
Please fill these up and add any other comments,
information, suggestions you would like to send us.
Those of you, who have
already sent us some details of your work recently fill in only those sections
which you did not cover in your personal letters.
Ue would like very much
to hear from each of the 150 Community Health Workers we have trained.
Even a blank tuestionnaire with only your latest address and information
on how to meet you next year would be most welcome.
Meeting you and seeing your programme will be a good experience
for us but in case you feel there are any other ways in which our visit
could be mutually beneficial please suggest this in Section C (b)•
In preparation for this visit many other materials arc being
organized which we hope to send you soon - a list of Community Health
Workers addresses, news bulletins, list of new handouts and educational
materials and so on.
So please keep in touch.
Hoping to hear from you soon and also meeting you next year.
I-Jith bast wishes and regards,
Yours sincerely,
"*
JL
I
'
PS: Please post this to Drs. Ravi & Thelma Narayan, D-10 Staff quarters,
St Sohn’s Medical College, Bangalore 56D 034 before Christmas 1981)
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP •EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFOR^
Instructions :
Section A and C to be filled in by all ‘Community Health Workers
Section 0 to be filled in by those.who are doing health work
at present.
(please keep us informed regarding change of flddressl
SECTION - fl
a)
GENERAL INFORMATION
b) flge:
Name :
c) CHW Course No.:|7/4
I
d) Name of Congregation:
e) Biocese:
f)
Permansnt Address
(Mother House/Superior) :
_____ ______________-
I%
QJb:
g) Present Address
(For future correspondence)
:
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
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ire you in touch with any of the other Community Health Workers? If so
k)
give us their recent address.
3
bJrJAn>
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Sr.
y. 1
-Arrive'in a few sentences a description of the poeple you ar^ working
Saijith (rural, urban, tribal, non-tribal, main occupation, other characteristics^
etc).
How many villages? Total population, what distances apart ?
oJlC^_ /uTp
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Y jSTD
-^yJhxT Sjldb
SECTIOIM B
involved in.
a) Give a short description of the health activities you are
uxA PH
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st^iJ
i 1 \//i.innl/ 1 \/
b)
Q
How many hours arc allotted for this daily/weekly ?
c) $re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e>)
Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
...3
: 3 ?
9) Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
h) □□ you have any of the following programmes?
Food for work.
Health Insurance, CRS- MCH Programme, any others
i) //Are you part of any Diocesan Society or Health Team ?
If so, specify.
t
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
0
isivJslb
Crwa^vk A/ d3ez?M7=u‘ . M'
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b) ^re
any forms „£.
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Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST HOHN'S NEDICAL COLLEGE
PROFWW
Instructions : Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of Address!
GENERAL INFORMATION
SECTION - .,A
a)
Name :
xX ■ pt. i/|
c) CHIJ Course No.:
e) Biocese:
b) /Age:
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Name of Congregation:
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Pl-
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(rqot her Hausq/Seperier) :
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Present /Address
(For future correspondence)
:
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h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)»
.
*
i) Give us a short description of the. present team you are working with and
what each member does (hot only health activities)
’
j)
Have you attended any course/meetings/workshops since you completed the
Course ?
.. .2
'
s 2 :
k) Are you in touch with .any of the other Community Health Workers? If so
give us their recent address.
,
St* ’
.
f
j<) 7c3Stol
1) Give .in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation-^ other characteristics
How many villages? Total population, what distances apart ?
etc) .
/CZ
i
SECTION B
a)
b)
involved in.
Give a short description of* the health activities you are
How many hours are allotted for this daily/weekly ?
c) (^re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Miss ion Hospital?
f)
If so, specify?
you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
do
. ..3
: 3 ?
g)
Do you participate in training of local people ? Grihinis
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work,
Health Insurance,
CRS- PICH Programme 9 any others
i) /Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) .Are there any forms of support which a
a visiting team can give you next year ?
*
♦
_ r.
C3lzVv<
/<?' 19-^1
Signat ure:
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOtJ-UP EVaLUATION OF COMMUNITY HEALTH
WORKERS TRaiNED IN ST SOHN'S MEDICAL COLLEGE
PROFORMA
Inst ructions :
Section a and C to be filled in by all Community Health Workers
Section B to be'filled in- by those who are doing health work
at present.
(please keep us
SECTION - 4
a) Name :
informed regarding change of address!
- GENERaL INFORMATION
5^ L«Ll<T44 A
b) /Ages
c) CHIj Course No.d7/6
d)
Name of Congregation:
e) Biocese:
f)
Permanent address
(Mother House/superior)
:
S‘7'- ^UQ,iAShn
)-n Ma
g) Present address
-
-
(For future correspondence) :
L.’^L < TV( tej’
J
c N05’
,P-‘Of
p1
fJfZtttt- 04-^
p; f~V - 60 6^ O I
LArvmixZ vyadiA
h) What have you been doing aft er'th~e~coufse ?
(if you have changed from place to place give us some details of your work
in each place).
/V. j
ch ehdibi
.
,
//_
(3^c[
b
/
/M.Z'c/Lc'U’ zV4o
C«^^5C
p-/>-
i) Give3 us a short description of the present team you are working with and
what each member does
(not only health activities)
‘f '6& tAb/l lz
(a/ C tlAX.
D£^<, cZVuy
'
v’
/AzU C<o M S-e
JI
/
/
_L r> t J
; /jt
n cd p »<o e-e
1^4- ‘
j
S&O 'rX
J
j) Have you attended any course/meetings/workshops since you completed the
Course ?
...2
hS fa
s 2 :
k)
Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non—tribal, main occupation, other characteristics
etc). How many villages? Total population, what distances apart ?
a
SECTION B
a)
involved in.
Give a short description of the health activities you are
b)
How many hours arc allotted for this daily/weekly ?
c) 4re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e>) Do you get any assistance from a Taluk/flission Hospital?
f)
If so, specify?
you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
do
. ..3
s 3 :
g) Do you participat e in training of local people ? Grihinis,
worker, mothers etc.
/V0>
Ko
village level
'■
C
k. h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH Programme, any others
ptcwi’DiXj
&
i) ^re you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
Ich CcV Aj-z
©
KiiX.^5
0V^eAjCl>y<,
4v’/Z< b/ClcA-up>
- •
as uv>vttvV-tc r-)mCVTel-V‘'-v
» /<_
O uvtw
S
'
b) <Mre there any forms of support
ipport 'which a visiting team can give you next year ?
■ate:
Signatures
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFORIM
Instructions $
Section A and C to be filled in by all Community Health porkers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of -Addressl
- GgNERaL INFORMATION
SECTION - 4
a)
Name :
5-^
• S' H
b) -Ages
d) Name of Congregations
c) CHJ Course No.:
e) Biocese:
f)
7'^L<x Jptkah
Permanent /Address
(Mother Ho use/Superior)
HcgmI
S
cv i <nZc
:
8.H
■
*
g) Present Address
(For future correspondence)
:
Nyw
Skew
ehis 'Bl^vP-G h
- S’?/ LfO(
h) What have you been doing after the course ? /
(if you have changed from place to place give us some details of your work
in each place)»
P J 4 (■
a£—
eeo-M^c.
SuJwe^l ■
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
I'ldc
pMlrn
/?// 4' M
Z^I/uM f LwecS^lw
iXYYfi!
'BeStM //
>
jiTt
/&
/lekdl;
cJ-^
j)
■
Have you attended any course/meetings/workshops since you completed the
Course ?
^0-
...2
S 2 s
k) are you in touch with any of the other Community Health Workers?
If so
give us their recent address.
A 2.
1)
sen?wfces a desc^?ip^tion of the poeple you are working
ces
Give in a
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
many villages? Total population, what distances apart ?
etc). How
I
wHb p
hod'W i/hie^ak
Z) o OO
‘Jro
J-Aonn
fa
07^
'
k?!
SECTION 8
a)
Give a short description of the health activities you are involved in.
//e c)u
b)
How many hours are allotted for this daily/weekly ?
■iiOinK >'
6^00^
c) i.^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
I
If so, specify ?
ckbMoflMrnL
e•) Do you get any assistance from a Taluk/ Miss ion Hospital?
If so, specify?
—ioCC^
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
J/
^>>ik
(I
...3
: 3 :
g) Do you participate in training of local people ? Grihinis 9
worker, mothers etc.
village level
/Vo
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- NCH Programme, any others
pro1) /Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on houi to reach your village/project/centre?
(By bus and train, also from station and bus stop)
OS
Ih^l-
y6/x_^j'c)<?.nr3
b) .Are there any forms of support which a visiting team can give you next year ?
Bates
Signat ure:
8-A
■
Please use the remaining blank space to givesny further details for which there
was not adequate space in the questionnaire.
♦
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF CONNUNITY HEALTH
WORKERS TRAINED IN ST JOHN’S NEDICAL COLLEGE
PROFORIM
Instructions :
SECTION - a
a)
Section a and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of address)
GENERAL INFDRIMTION
Name :
b) ages
•
c) CHW Course No.i^Sc
7/^,
£7
d) Name of Congregation:
e) Bioceses
f)
Permanent address
(Nother House/superior)
'^O’V
:
. 0
r
V’0'
g) Present Address
(For future correspondence)
\Ji«WXCK^.
CaaV,
:
j qs
P’O •
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
I
'V\
t
Kul
^’VYJ 'YAU.VUL^xxA^JC
•
i)- Give us a short description of the present team you are working with and
what each member does (not only health activities)
1
Sjlajwa
icnj^ci
\J oL*a'vJUlk
VVV-<L OcO-n
out lUL
<Tov^
. Sa^a. <AaJL VXkO
CaA'vx
j) Have you attended any course/meetings/workshops since you completed the
Course ?
No *
...2
i
s 2 :
k) are you in touch with any of the-other Community Health Workers? If
give us their recent address.
SO
•
^XLfC tBVcUj
5^Du\Ak«A.*AJ
'■'^^A-aaSccva -vxa^eiA t^xMAJL^A.
1)
Give in a few sentences a description of vthhe poeple you areSuorking
with (rural , urban, tribal, non—tribal, main occupation, other characteristics
How many villages? Total population 9 what distances apart ?
etc).
I C\JVV^
^VbJUh
CcAter
CWJJJW\
•9
^aJULAu
leiCvA/^
VA^kztAa<AaAi_n
^AA'YVLjJp
k 'Vyl
'*>1 /
Iaouo^ C\
CKftiA. ■VX5L MJuc >
5jo
t 'T v<q^
Ur
CAaaJ| Z-|
dl(TO •
CS^X\’"vaoAL
SECTION B
a)
Give a short description of the health activities you are involved in.
C^l
/'AA^MA£^\£jnn
\aJL£\S11\. Q-^JAaA.Vi
0'&Aj
i^-AA4^ V\_Aa^aAXo^
I CXaaA
cJUo
b)
GVwv
’vvyv
^-AArukx eoJut
How many hours are allotted for this daily/weekly ?
9 Cvva c\.
^ULaJllU.
•
c ) 4re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
' <Aaaa vCT^Aqv
If so,
'^f
ufc «
. SAflluOAM cJriW'to Ias^T1*'^
VvxJiltC
d) Do you get any assistance from the local Primary. Health Centre?
If so, specify ?
yejs •
H^a.1^ ^qaaIuo
Pcwaaav'
8\aAaJ^ Qaa^ 'WlcAa. SAJAlS
V
e) Do you get any assistance from a Taluk/Hiss ion Hospital?
If SO, specify?
AJo •
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijahs etc.)?
aa^
XJv^^
9A^t U. Mkr ^fr
c-^XsT
^t><AA ^aA
ci^VAwaa-
. ..3
: 3 :
g)
Do you participate in training of local people ? Grihinis 9
worker, mothers etc.
\
village level
•v'XA flp
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH Programme, any others
/xj-o .
i) (Are you part of any Diocesan Society or Health Team ?
p ovJb
‘ r'^YV\<_2>
If so, specify.
7
SECTION C (Regarding 1982 project)
a)
Give Us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
cIxAju
<XAA
KU-
CcVajbAa lA <5 KvA
VUA5L CV*-
™
y «CT
■
r.
• (SVtjvA 'kX
Ks.•U
—
b) .Are there any forms of support which a visiting
ing team can give you next year ?
■^AaIIua
OlAA V C_>XJUJL_
‘
&
late: 3>o- »
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFORPM
Instructions :
Section A and C to be filled.fin by all Community Health Workers
Section B to be filled in by those who are doing health work
at' present.
(please keep us informed regarding change of Addressl
GENERAL INFORIWION
SECTION - A
a)
Name : 5 A t UAxj lj2a
c)
CHj Course No.:
e) Bierces e:
b) Ages
C t
3 6
d) Name of Congregation:
V^ouAJ^-eie^
Permanent Address
(Mother House/superior)
:
S\'■ Vr\ &UY\Jb'A Howz. (
y'Siol/VxoacL
6
g) Present Address
(For future correspondence)
H-tQAj''' C
:
a
y <^XvO^WAX
7 ~f 0 0 5^
V
A_1^
9 la
cAAWA-pCMni
r>' O •
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)»
©IzkU
VV\O ttcQ/L
i)
o\a-<A
^<5^5
/
(SccA-^.
Give us a short description of the present team you are working with and
what each member does (not only health activities)
j) Have you attended any course/meetings/ujorkshops since you completed the
Course ?
Vvot
i
...2
s
2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
a few sentences a description of the poeple yo’u ate working
1) with
Give in
(rural, urban, tribal,, non-tribal,
non-tribal, main occupation, other characteristics
etc).
Um.r
manv willaQRs?
How many villages?
Total
Total population,
population, what distances apart ?
SECTION B
a)
are
Give a short description of the health activities you
b)
How many hours are allotted for this daily/weekly ?
involved in.
c) i^re you functioning independently or with1 a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from ths local Primary Health Centre?
If so, specify ?
e) Do you get any assistance . from a Taluk/roission
f-pspital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
:3s
g)
Do you participate in training of local people ? Grihinis,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work,
Health Insurance,
CRS- MCH Programme, any others
i) /Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us, detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) -Are there any forms of support which a visiting team can give you next year ?
0(/W\ (/y\
J
•at e:
Signature:
please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services
and Training Programmes
St John’s Medical College,
DRHSTP-ACC-81
Dear
Bangalore
21 Nov 1981
/
Seasons Greetings for Chirstmas and the New Year from all of us
in the Department of Community Medicine at St John’si
1982 is going to be a special year ror
for us since a long standing
plan to meet all of you in the field has finally materialised.
Thelma and
I are on special leave for a year starting December 1981 and during this
*year we plan to visit as many of you as possible in your own areas of work
to re-establish contact, share experiences, reflect together and grow
in our understanding of our people and our work.
We have already been in
touch with many of you and we shall be writing to others as the weeks go by.
We thank all those who have so promptly and enthusiastically received this
news and welcomed us to their villages in 1982.
We hope to hear from many
others amongst you soon.
In order to get some common information frram all of you in the
field we have drawn up a simple questionnaire taking ideas from many of
your own letters.
Please fill these up and add any other comments,
information, suggestions you would like to send us.
Those of you, who have
already sent us some details of your work recently fill in only those sections
which you did not cover in your personal letters.
IJe would like very much
to hear from each of the 150 Community Health Workers we have trained.
Even a blank
uestionnaire with only your latest address and information
on how to meet you next year would be most welcome.
Meeting you and seeing your programme will be a good■ experience
for us but in case you feel there are any other ways in which our visit
could be mutually beneficial please suggest this in Section C (b).
In preparation for this visit many other materials are'being
organized which we hope to send you soon - a list of Community Health
ijDrkers addresses, news bulletins, list of new handouts and educational
materials and so anso please keep in touch.
Hoping to hear from you soon and also meeting you next year.
VJith best wishes and regards,
Yours sincerely,
PS: Please post this to Drs. Ravi & Thelma Narayan, D-10 Staff Quarters,
St John’s Medical College, Bangalore 560 034 before Christmas 1981)
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN’S MEDICAL COLLEGE
PROFORMA
Instruct-jans :
section a and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us
SECTION - A
a)
c)
informed.regarding change of ^ddressl
- GEN ERA LIN FORMAT ION
Name : Sa »EVclS-S--
b) ages 5 )
ojptUGiMb
d) Nam.e of Congregation: 3
7//©
CHW Course No. s7fe<=
e) Biocese: V Ctuv
Permanent Address
(Mother Ho use/Superior)
1 *■ 'U'V'* v
'“V
:
UajArowv P.ortA,
W
g) Present Address
(For future correspondence)
-■
CcJteJC^-yooois
0Exva(
T>-o
h) What have you been doing after t’
(if you have changed from place to place give us some details of your work
in each place).
OVWX
eAAA
Qk G c^
U^k.
U*icLtn_
short description of the present team you are working^with and
i) Give us a
(not only health activities) 3^ ^5^ ^cvJLva* pCLruz^/
what each member does
i>*. V'OAAfe. -t®a>
*
w
Q ~
K
'Y~ -
Cj(Jutt\jD-QxX2A
j)
‘
tfeujb
K
- 3>\ (run
VF.
Tu-uih o'iwn.'U,
Have you attended any course/meetings/workshops since you completed the
Course ?
o . .2
I
? 2 :
k) Are you in touch with any of the other Community Health Workers? If
give us their recent address.
1)
SO
|\|q
Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages? Total population, what distances apart ?
■v
SECTION B
a)
Give a short description of the health activities you are involved
b)
How many hours are allotted for this daily/weekly ?
c ) i^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
in.
If so,
d) Do you get any assista^cie from the local Primary Health Centre?
TP
ononi
*?
If so,
specify
?
>) Do you get any assistance from a Taluk/nission
e
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
? 3 ?
«
g)
Do you participate in training of local people ? Grihinis,
village level
worker, mothers etc.
h) Do you have any of the following programmes?
Food for work,
Health Insurance,
CRS- PICH Programme, any others
If so, specify.
i) 4re you part of any Diocesan Society or Health Team ?
SECTION C (Regarding 1982 project)
a)
detailed information on how to reach your village/project/centre?
Give us
(By bus and train, also from station
JAcmAj’
Qx7V\'U^aX
•
'orms af support which a visiting team can give youj next year ?
b) ^re there any forms
<WU1
3 el© *
J^eecuu-e-
'yx^J^clW &
ttf GoXW
Xi
t^rvu inx
Signature:
Bates
uxm.
Sux
f-e.
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
c^9rcllzz\*Lw
k \)ie-
■
SLU-u
SWYV
__
^-n.a.eJCv?> -{nxi, 3 ^cuue,
xo 2s>rvvbxeij
■5
cui&A
tfex
Hod^-C^dUL •
.5
-u
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COmUNITY HEALTH
WORKERS TRAINED IN ST -JOHN'S MEDICAL COLLEGE
PROFOfW
Instructions s
Section a and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of -Addressl
SECTION - 4
GENERAL INFORMATION
a)
27
b) /Age:
Name ;
c) CHJ Course No.:
3C 7///
d) Name of Congregations
-Presen Tfi / /on
e) Biocesss XaI RKAN GiAL
f)
COMVfN’T
Permanent /Address
House/superior)
(Flather
F.
.
:
O
H.
CBUCW
g) Present /Address
(For future correspondence)
£ 8£ Nim IfcM Co nW £ M i
:
F FFT'
A A Ci
• -Po •
50G0CS- a-'p-
h) What have you been doing aft er the course ?
(if you have changed from place to place give us some details of your work
in each place).
vfj
cvyt'l,
c^orakvicg
Gi’urp^
H C H* E
te
bo <3
GyrOvy^1
Is
CcX^JL CsxM.
<ba-buu psyig\
<^5
CVix-l
(3t0IC,C^
Cooul .
Qvt^kxjoJix.^
,
K>J>;voU TW^JbucO C’Vod
description of the present team you are working with and
i) Givej us a short"
;
what each member does
rljkjse.
Qc<gLu^5
(XbovJ IKis
j)
(not only health activities)
<2OC^
<5<vtjacU
0<.£>rQ
GgdcI
ViltajjfiL
Q
<1cg3^
""a Coi(A do bo’xSe infeffcAQQ .
Have you attended any course/meetings/workshops since you completed the
Course ?
y.u
oJCsrndfid
OrJ2 LtoCvJ^ >
. .2
2 2 :
k) Are you in touch with any of the'other Community Health Workers? If so
give us their recent address.
i are working
1) Give in a few sentences a description of the poeple you
with (rural, urban, tribal, non-tribal, main
r— occupation, other characteristics
etc).
How many villages? Total population , what distances apart ?
vx)
CvoA
CtO
ertx?. V
<X\Sl.cC6 <-^*oA
Cot&L . -xE&HG!
SECTION B
a)
involved in.
Give a short description of the health activities you are
b)
How many hours are allotted for this daily/weekly ?
indepenocnLxy or with
wxuu a team of workers?
c) Are you functioning independently
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
,r5>U CTV 9 oJj>c
o
f) Do you work with any special groups in the village (young farmers,
youth, mothers, hariJans etc.)?
. ..3
: 3 ;
g)
Do you participate in training of local people ? Grihinis 9
worker, mothers etc.
village level
h) De you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH Programme, any others
i) ^re you part of any Diocesa^^ociety or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on Ihow to reach your village/project/centre?
(By bus and train, also from station and bus stop)
0^ ,
'
ktHCVtfk-
-
Gov* -
J
o’
b) ^re there any forms of support which a visiting team can give you next year ?
•ate:
IS )sl.- Si
Signature:
Please use the remaining blank space to give any further details for which ther
was not adequate space in the questionnaire.
9
*
0
0^^
Directorate of Rural Health Services &
Training Programmes
FQLLOU-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present,
(please keep us
GENERAL INFORMATION
SECTION - A
a)
informed regarding change of .Address!
^7
s’ o b) Age:
Name
7//s
c) CHIJ Course No.: 5
d) Name of Congregation:
)■> kVA
e) Biocese:
f)
Permanent Address
(Mother F
House/superior)
/ .
:
{
SvV>
g) Present Address
(For future correspondence) :
Dr s<
S3
I y'.
!
-------- Lz
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
■W- c.
Q-
i.
t VX-C4 s -
U- c- tA
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
f
f
•a
C'^-v
/
(4 ■
I
V'V'
’
j) Have you attended any course/meetings/workshops since you completed the
Course ?
...2
■)
s
2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
A
Vi -x
1) Give in a few sentences a description of the poeple you are working
urban, tribal, nun-tribal, main occupation, other characteristics
with (rural,
How many villages? Total population, what distances apart ?
etc).
7"^ »
VJ
4U
$
ro V'uix
VxAF^kJv
3,
SECTION B
a)
Give a
short description of the health activities you are involved in.
C.sX <
b)
jlU
L<
; Jeekly
How many hours arel allottee for this daily'/
5
c)
C-Uv-C^-x. UM
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lAV*- 1
Ji pr^Ir-t—-'
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team of workers?
Are you functioning independently or with a
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
(
A
e) Do you get any assistance from a Taluk/flission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers^
youth, mothers, harijans etc.)?
. ..3
h
: 3 :
g) Do you participat e in training of local people ? Grihinis,
worker. mothers etc.
rU Ur
village level
Y<)[oG
<2-
h) Do you have any of the following programmes?
.
Food for work, Health Insurance, CRS- PICH Programme, any others
i) /Are you part of any Diocesan Society oc Health Team ?
If so. specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
Vi
uv\
AV
a
VA
sth -
f
CUS'--.
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rh
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late:
------
signature:
\
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VV
Please use the remaining blank space to giveany further details for wfw
was not.adequate space in the questionnaire.
■ tU<
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L'^C fr
1
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t her e
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST ZJOHN'S MEDICAL COLLEGE
PROFORMA
Inst ructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of flddressl
SECTION - fl
- general information
a) Name ;
5y»
.
c) CHj Course No.:
e) Diocese:
♦
f)
8^ ?//S')
Ages 3^
d)
Name of Congregation:
KckHKvOJi
Permanent Address
( Hot h er Ho us e/£up ericrr)
:
. vVvvv<3zxI^
o) Present Address
(For future correspondence)
:
rj W K
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
X
.
CMxJjh
•/A-Axf'k^r'cl
A
*^6(/YV>*XAj •
Jc/vx
.
|
.
,.
•xJ'TA/V-' Aj
Ha aa-J
buOt
IaXVV*^* txt'
QTXAjritlA V<_O/V' CV^X_
i) Give us a short description of the present team you are working with and
• I
what each member does (not only health activities)
3n
'^pjuuvi tx
VAJY
\\'
• \A •
b SL
j) Have yiu attended any course/meetings/workshops since you completed the
Course ?
... 2
I
s
2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
1) Gi\7e in a few sentences a description of the poeple you are-workingwith (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages?
Total population, what distances apart ?
SECTION B
a)
involved in.
Give a short description of tho hoalth activities you are
b)
How iriany hours are allotted for this daily/weekly ?
c) Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e•) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers^
youth, mothers, harijans etc.)?
...3
6
: 3 :
9) Do you participate in training of local people ? Grihinis, village level
worker, mothers etc.
Do yc|u have any of the following programmes?
Food for work, Health Insurance, CRS- MCH.Programme, any others
h)
If so, specify.
i)) -Are you part of any Diocesan Society or Health Team ?
(
VxwJult)
Wul V
LfVrYvxJLzl • cJkkJxA
olA
00 JU
-V
SECTION C (Regarding 1982 project)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
.
a)
eU— V” ^<H*X
_ oku AAn^a
u
•
b) i^re there any forms of support which a visiting team can give you next year ?
Signature:
Mate:
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
A-V
2) n<>rt€X,di
\
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^JJkA
CVV- ^A
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST ZJOHN'S MEDICAL COLLEGE-
PROFORMA
Section a and 0 to be filled in by all Community Health Workers
Section B to be, filled in by those who are doing, health work
Instructions :
at present. .
(please keep us informed regarding change of Addressl
GENERAL INFORMATION
SECTION - A
a)
Name
z pv. faritan-c'- C~j^n
c) CHW Course No.:
15 e yllt>
‘ b) Ages q2
•
d) Name of Congregation:
e) Diocese:
f)
Permanent ^Address
(Mother Ho use/Superior) t-y-
Ccm 17-e-n
cfe. Qa.'roley
<2^[an
g) Present Address
(For future correspondence)
:
)iey
/2a
7.
fera^e-^-y^
p^noML:^ea^.
course ?
' 4- o 3
IC
(if you have changed from place to place give us some details of your work
in each place).
_.? the
h) What have you been doing after
C
P
c(iZ
I
p,
f\
1g (cA p-^JZp^i'<3 t
o’yuz. o
S,3Te ?r
/'XI
—
to
/.
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a LcU
/i/e> i^>
pe o p~f z t c^~
-
i) Give us ■<3 short description of the present team you are working with and
what each member does (not only health activities)
‘n fc- z;7‘tf^/7^
zz?
Qp/
Co)>.m7
nZj^'y^'
Ljzr')'y ^-;
J. s^r c
j)
Have yiu attended any c:ourse/meetings/workshops since you completed the
Course ?
o
s
2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address, h/
1) Give in a few sentences a description of the poeple you are working
with (rural, urban,
tribal, non—tribal,9 main occupation, other characteristics
urban, tribal,
etc).
How
many
villages?
How many villages? Total population, what distances .apart ?^
SECTION B
a) Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c ) Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/flission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
. ..3
S 3 ?
g) Do you participate in training of local people ? Grihinis 9
worker, mothers etc.
village level
h) Do yqu have any of the following programmes?
Food for work, Health Insurance, CRSz'rlCH Programme, any others
i) /Are you part of any Diocesan Society or Health Team ?
specify.
If SO,
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop3)
c /'(
yfcp iau^s
I
i^C’/ f kjA^ 'ti>
Cc!•Hr' t';
7
.
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s up
b) r^re-there any forms af;
, ,po rt which a v i s it i n g tr ea m ca n g i v e yo u- n e xt y ea r ?
(2aji
/-o Us l^f
..
,
)i
a>re-
z
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f
by
//. 7Ci IxJ^iz
. fl
cfr
(AclTc
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c/v^—
Signatures
•ate:
/<-€>
Please use the remaining blank space to give any further details for which there
was not adequate space in the questionnaire.
£ .f'
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b <?
t<,.
/fr
Z 7? T'lC/7 fry
[aJ L-*
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Ha)
Directorate of Rural Health Services &
Training Programmes
FQLLOlJ-UP EVALUATION OF COIWNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORIVH
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
Instructions :
(please keep us informed regarding change of Address!
SECTION - 4
a)
GEl\lERAL INFORIWION
Name ; SV*
?// 7)
c) CHJ Course No.:
e)
b) 'Ages
lit
«0 Name of Congregation:
yrccy 'I
Diocese:
Cm iM rvi/ Cyd. <Vn
Permanent Address
( Mot her Ho us e/ Superior)
9) Present Address
(For future correspondence)
h)
3-4
:
*yl'k
0^ Jla7u
s<id. ax; - <3o<^
What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
n
A
'H’iC
fe>
cX. Txxmj
4
<Xm
ZA<- cCi
-®
4
-E- x ch.
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
j .'txj
ybv
Lmj-o . 4
I
cr^
rt€u >
CL4JL
mTu^rk.
U3C<
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, <
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i
c^i^SL
cJy a
-c/o
j) Have you attended any course/meetings/workshops since you completed the
Course ?
Ko
...2
>
3
2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
(Vo
1) Give in a few
few sentences
sentences aa description of the poeple you are. working
non-tribal, main occupation, other characteristics
with (rural, urban, tribal,
Total
population, what distances apart ?
How many villages?
et c).
«. A
7^
d Lz
3 $7
a
SECTION B
a)
are
Give a short description of the health activities you
b)
How many hours are allotted for this daily/weekly ?
involved in.
team of workers?
c) $re you functioning independently or with a
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
3 3 s
g)
Do you participate in training of local people ? Grihinis 9
worker, mothers etc.
village level
i
h) Do you have any of the following programmes?
Health Insurance, CRS- MCH Programme,
Food for work,
i) <Are you part of any Diocesan Society or Health Team ?
any others
If so.
specify.
SECTION C (Regarding 19^ project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
/
.
>
jJ
hivo
AA y kt
w hr ^4:^
'+kx
(j,Lu. cT U vuX^erc
ifciA'Irt'’*
~rry CCL<zL^t ’
b) iAre there any forms of support which a visiting team can give you next year ?
U Ct’vo^)
•at e;
^3
O. s^l
Signat ure:
/■
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFOFW
Instruetjons •
Section ,A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of .Addressl
SECTION - 4
a)
Name :
GENERAL INFORM I 0 N
I OH MV
V/i-LiA
b) /Ages
c) CHW Co urs e No.:
d) Name of Congregations
.e) .Biocese:
f)
Permanent /Address
(Hother House/superior)
ST.
Pi U
Co L. L £67 C ,
I
:
Ofe’O ____ j
g) Present /Address
(For future correspondence)
M>vy I ^22- .
:
£JZ)HV/9 P o .
iiOi
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
w) O
ux. lKc\ lydLc^^ .
t***ElLL
^.CiZp vTv (Li
1^82. .
O-Z*
S
VJLic't-
LrClt,
Gt ls. cj
'Ce-A-< I'r e .
Zz/'iTCvl
►'O-C./LL
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
'
P'gwf^L
Me cZxCfai
Sr.
(Kot/' z<!x>-y-v^vtD<aa--
tr cri.
OLl toy>e
Ck O<x.v<Trol ix-a_x|
14
r-
j) Have you attended any course/meetings/workshops since you completed the
Course ?
/y . 4.
•. • 2
? 2 :
k)
ire you in touch with any of the other Community Health Workers? If so
give us their recent address.
N
.
description of the poeple you are working
1) Give in a few sentences a
with (rural,• urban, tribal,f non—tribal, main occupation, other characteristics
etc).
How many villages? Total population, what dist-a-nces apart ?
fG^OO •.
1
Cwiru-crw,
’T
IO
Lyut, ■ "
CvtlcK
’
'^aes^cat ca. i
SECTION B
a short description of the health activities you are ipvolvedin.
a)
Give
b)
allotted for this daily/weekly ?
How many hours are
J<b
.
c ) 4re you functioning independently or with a team of workers?
how is the health work shared amongst you ?^
d)
do
If so,
you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/flission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
:3s
g) Do you participate fin training of local people ? Grihinis
worker, mothers etc.
village level
r>"
-2-1^
L^l /Csx^
h) Do you have any of the following programmes?
Food for work,
Health Insurance,
CRS- f*ICH. Programme, any others
No .
i) c^re you part of any Diocesan Society
or Health Team ?
If so, specify.
No
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
By bus and train, also
from station and bus stop)
^-''Y-irrx
c^>
<zkx «
•ovV' -Dtxotcx'v
^*,c
b) 4re there any forms of ^W^rt^ch a^sSing't
k>ctl
•ate:
8l.
ex ZekxA?
fr<. Pe^
i can give you next year ?
,
SAgnat ure:
Please use the remaining blank space to give fry
further details for which there
was not adequate space in the questionnaire.
Directorate.of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 3O.HNfS MEDICAL COLLEGE
PROFORMA
Section A and C to be filled in by all Community Health Workers
Section B to be- filled in by those who are doing health work
at present•
Inst ructions :
(please keep us informed regarding change of address!
SECTION -
GENERAL INFORIMTI 0N
Name :
Sb6^>kc4jn<k-fl(Wrt|
a)
b) 'Ages
3 t>
c) CHi) Co urs e No. :
d) Name of Congregation:
e) Bioceses
£ inkers
f)
Permanent Address
(Mother House/superior)
dtirnsrnCi
Moa^-
:
Hmaur
H-ecvJ.- e
\J^n h
L’lfD'flL'ft.
pofhklhanovrpc
g) Present Address^"
(For future correspondence)
cT^OT>;^
pi'OinSl^C^
:
l4eu£.lhS (ScAnlxd^
*(pd. (•ZoYO^tUr CDlllO
h) Ijhat have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)•
CUOS
COOtf 1**^
l*»rs
in Ut2
P
‘
, owe.
3 VkW/k' -feiveAi
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
CVYvcL Cm. ^CM^. (^
bo (So-oreZAKo^Z €>U4r
Ik^ii
j)
h(^t. Set>tA/n v/tlcufreYs.
Jhudlt^ cdoirf^c^ •
c^dl
I'jorl'lthc^ ity
<J
Have yiu attended any course/meetings/workshops since you completed the
Course ?
Ml
.. .2
? 2 :
k) Tre you in touch with any of the other Community Health ijorkers? If
give us their recent address.
SO
-
nj iZ
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages? Total population , what distances apart ?
^Iki S>cdi
Cte/SSA •
)kC S^oJxs a-iT
Mjz/uc .
otxsJbu.e^" cr^ Iccryc^pdL'
Ikl
CX viltcx^Q- u
XS
9j25^O’
(jWj cr£
I
Mo^cnr/l^
(P311opAi.
aj-
■
r^Lxxb
SgAxcLcJjtoI Pctj/I
SECTION B
a)
e^C
Give a short description of the health activities you are involve^
H(t6cu£(l (2^nze J HouArfVi’^H^
b)
in.
pjlopS-c.
r' ■
3 fauMh"
How many hours are allotted for this daily/weekly ?
^Ccc£^ ^0Lc6
houjrs
irf<
c) ^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
ca^jl
If so,
r>c/
'■ : Vwufl. Wif EiuntuT
to
hMxkUX
Gto <m» n « one*, in
(Vui.
w;ib~
luT
Sbou-f'nQHK^io
tu,
n
r>'
d) Do yotP get any assistance from the local Primary Health Centre.
If so, specify ?
V
e>) Do you get any assistance from a Taluk/fflission
Hospital?
If so, specify?
*
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
X
...3
: 3 ?
g) Do you participate :in training of local people ? Grihinis,
worker, mothers etc.
village level
\
h) Do you have any of the following programmes?
Food for work,
Health Insurance,
CRS- FIGH-Programme, any others
Insurance
■
I^CH ^/to^-iO^mcrru nt-f- Q_or)eUi'Ih'C/Q S
hA
i) /,-Are you part of any Diocesan Society or Health Team ?*
^■e^/
cvul
'
If so, specify.
Wvjf
SECTION C (Regarding 1982 project)
a)
Give us detailed information
on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
■cC lc>
Io
—
VfQ'otcxVCUyp
nOL^ovnrrn —
•
'PrnynP)
to S^rrn',li
- 5 y ^5 ^0^03^0^
8*$ .
b) i^re there dtiy forms of support wmcha visiting team can give you next year ?
Bate: <% - /2 .
Signatures <Sv.’
Please use the remaining blank space to giveany further details for which there
was not adequate space in the iquestionnaira.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN’S MEDICAL COLLEGE
PROFORMA
Inst ructions :
Section fl and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of flddressl
SECTION - fl
a)
GENERAL IN FORMAT! ON
Name ;
CT'J.^ ■ f ‘
c) CHIil Course No.:
b) Age:
9/5
al l
e) Bio’cese:
f)
g) Present Address
(For future correspondence)
-
JU
CAoierC
A a-
i
Permanent Address
(Mother House/superior)
SkSuSs
Name of Congregation:
et)
CqIIS'lAC/d )a.jO
Q '-O •
: yia)a
I
rTJo5^uc5)>
Ofin^ou^e SrC.Jt^7
P
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each pla.ce).
Cu us itT n. oi
Ike
It ft (A * V-t crxa^cj'-^-C’-^/ Of
r>^ Cl/- He (a&’O{‘l'»cL .
c£
i
(TLl (Ti i
(£'/■/ (L
(2 no
]y t
fanakjctJ, pevSofyaiQ
^C-U^.£/-
o lu
1/; j, C~kcj i(\g_ V >
ay^~^'7<72>-<cUf. ’ $ r\ e V^At w
i) ^ffivl3 us a Z^H^t^^s^i^ion^fAhe pS?esent telm you are^worlcLng with and
J
what each member does (not only health activities)
od.' y't r>xou^cdo-^ii
&nu
J//1 /nc>ar/)/A J
SWW<->7
a~>cLi
bd/)'r>cf ,'o/k^
■
j) Have yiu attended any course/meetings/workshops since you completed the
Course ?
Nil
...2
?
2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
No
Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
How many villages? Total population, what distances apart ?
et c) •
1)
y
Ujo 7f /- (
y gu&va&oin,
Ci
SECTION B
a)
*
Give a short description of the health activities you are involved in.
fls
b)
$ l\lo' A '
How many hours
e allotted for this daily/weekly ?
/n
1
■ CkJce^J^J
endently
or
Qith
c) Are you functioning independently or 6ith a team of worker/?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
la
ei) Do you get any assistance from a Taluk/flission Hospital?
%
r W
If so, specify?
/kjC~ / mmuni>2(xMo-3)
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
. ..3
s 3 ;
g)
Do you parti cipat e in training of lodal people ? Grihinis,
worker, mothers etc.
*
<
village level
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- PICH-°rogramnie, any others
s
i) /Are you part of any Diocesan Society or Health Team ?w
If so, specify.
SECTION C (Regarding 1902 project)
a)
Give us detailed information (
on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
Ho ' <3HC]'
/V»
J JSTf,
Arvctfue^
- ZT 'T $
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■
b) ^re there any forms of support which a visiting team can give you next year ?
•ate:
•
Signature:
Please use the remaining blank <space to give any further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
. WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Inst ructions :
Section A and 0 to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us
SECTION - .-A
a)
Name
GENERAL IN FORMAT I 0 N
’ Sv. Xpk-
c) CHW Course No.:
e)
informed regarding change of -Address!
b) 'Ages
fee ?I
30
pk
ri) Name of Congregation: Qj. 4oS<2-l
Biocese: ©ol'cj
•
■
d
Permanent Address
n (Mother
Ho use/Superior) :
9) Present /Address
(For future correspondence)
:
5I ■ CTKsul9 clox
h) What
have
lu>.iow
iiavc you
yjui been
ucvsu doing
uuAiiy after
aiUbr the,course
b UU.. UU ITS U ?
!
GoneQ/vA t lu Q-l I
-JJ
(if you have changed from place to place give us some details of your work
in each place).
i) Give us a short description of the present team- you are working with and
what
each member does (not only health activities)
j) Have you attended any course/meetings/workshops since you completed the
Course ?
... 2
I
s 2 :
k)
Are you in touch with any of the other Community Health Workers? If so
give us their recent address.
1) Give in a few sentences a description of the popple you are working
with (rural, urban, tribal, non—tribal, main occupation, other characteristics
How many villages? Total population, what distances apart ?
etc).
t:
SECTION B
a)
involved in.
Give a short description of the health activities you are
b)
How many hours are allotted for this daily/weekly ?
c ) $re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e■) Do you get any assistance from a Taluk/mission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
: 3 s
g) Do you participat e in training of lot*al people ? Grihinis,
worker, mothers etc.
village level
h) Do you ha-ve any of the following programmes?
Food for work, Health Insurance, CRS- PICH Programme, any others
i) »Are you part of any Diocesan Society o r HeaIt h T eam ?*
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information (on how to reach your village/project/centre?
(By bus and train, also from station and bus sto
©oiy.
©oty to
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b) ^re there any forms of support which a visiting team can give you next year
•ate:
I .
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROTORE
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
Instructions :
.
(please keep us informed regarding change of Address!
SECTION - rA
a)
Name ;
GENERAL INFORMATION
■
gr
b) Age:
Name of Congregation: /- f
c) CHi) Course No.:
e) Bioceses
f)
j^pc
Permanent address
/-1TC-<a
(Mother House/superior) :
/3 0 r»‘ V -Z -
>
g) Present Address
(For future correspondence)
:
P
,T)1
C.
,4xj
p or
~
)
ar L
— pc§^
Tt^ -
CX i K
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place)»
(Tvv-'-
<>v///
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
L > V^C
C'-
& jA/ U".
&
j) Have yau attended any course/meetings/workshops since you completed the
Course ?
NO
t
...2
I
*
L^C-O2
2 :
k) .ire you in. touch with any of the other Community Health ijorkers? If so
give us their recent address.
l)
$-e^0(
^Zci^y
i\i o ■ 7
1
Give in a few sentences a description of the poeple you are_.working
-with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages? Total population, what distances apart ?
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■
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7
SECTION B
<-a
v
u
a) Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
'X tc
y^chr
tti- ot^
&
L*A-'$rClZvJJ *
■‘ha team of workers?
c) 4re you functioning independently or with
If so,
how is the health work shared amongst you ?
S<9
VvscttJ.RA^
1
it,
cAo
pt
6>l^'
ivibk V^-'
O.
Ci—
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
/I/Oe) Do you get any assistance from a Taluk/nission Hospital?
If so, specify?
f\ro ■
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
f)
9^V,
uoerk U-lt)
Ct^w‘
C
...3
4
oV/' O-- rn-ezv-w
Q /it
a-
A/^u/ v
: 3 ?
g) Do you participate in training oC lotfal
worker,
people ? Grihinis,
mothers etc.
village level
A'o*
h) Do you have any of the following
4
Food for work,
V
programmes?
Health Insurance
9 CRS- PICH Programme, any others
K o ■■
i) <flre you part of any Diocesan Society
or Health Team ?
If so, specify.
/Vo
J
SECTION C (Regarding 1982 project)
Give us detailed information
(By bus and t-pain, e.l__
a)
A_ ’P^ to*-*
^-c'
-^Ltvcv^o
3
c^i-ceX.
/o-^o py
KolCe^i pTLC VC_ *
Z't'czc^/^
t^4<^
. b) (^re there any forms of support which a
visiting team can give you next year ?
/-/
§
Ar>
•*-
l A> t^yVA
I
dy Hsyo^^z)
?I
Cjdyv ^yp^vvcto-
•ate:
Signature:
Please use the remaining blank space to giveany further details
for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FQLLOlJ-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED I N ST SOHN'S MEDICAL COLLEGE
- PROFORMA
Instructions :
Section a and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of ^ddressl
SECTION - 4
a)
Name :
- GENERAL INFORIWTON
Bro. Joseph
c) CH>i) Course No.:
e) biocese:
f)
M.C.,
^ib
b) /Age:
d) Name of Congregation:
:
g) Present /Address
(For future correspondence)
■-noisean
Brothers.
Tellieherry.
Permanent /Address
(Mother House/superior)
37
Sevasadan, Kor amangala, P.B.NO. 3M 7
Bangalore - %0 03^.
:
(Bro. Joseph M.C., Padua Estate,
P.O. Manadukkam, Chengala (-Via),
Cannanore Dist. Kerala - 670 5M-1.
h) IJhat have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
At present, I am having some practical experiences in
Vimalalaya Convent Dispensary Hebbagodi.
i) Give us a short description of the present team yz
you are working with and
what each member does (not only health activities)
j) Have yiu attended any course/meetings/workshops
since you completed /the
Course ?
...2
?
2 :
k) Are you.in touch with any of the other Community Health Workers? If so
give us their recent address.
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
population. what distances apart ?
et c). How many villages? Total population,
SECTION B
a)
Give a short description of the health activities you are involved in.
u .
a
b)
How many hours are allotted for this daily/weekly ?
c) Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/flission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
4
: 3 ;
g) Do you parti cipat e in training of local people ? Grihinis,
worker, mothers etc.
village level
J!
h) Do you ha»ve any of the following programmes?
Food for work, Health Insurance 9 CRS- PICH Programme, any others
1) //Are you part of any Diocesan Society or Health Team ?
If so. specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information c..
‘
on how
to reach your village/project/centre?
(By bus and train, also from station and bus stop)
By ^U3
>
/Ovi-A/t;
Bangalore to Mangalore. Then Mangalore to Kasarcodu.
From
--ircodu to BandaiuW ■a. From Bandadukka
K.rn.
b) <^re there any forms of support which
•at e:
a visiting team can give you next year ?
Signature:
/dyroPlease use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
I 'ill 'he going hack to Padua Estate by the end of
J ij
After reaching
<' ■ ■
—g the
the place.
T shall let you know all
about ny activities concerning this subjects which you have
a ske d T or < B e Toro c •j ni n to my place, kindly let me know the
date in .dvance . I ^h IT inform you uhe idial time to come
to my place.
Directorate of Rural Health Services &
Training Programmes
FQLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST SOHN'S MEDICAL COLLEGE
PROFOFW
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
Inst ructions :
(Please.keep us informed regarding change of ■Address!
SECTION - A
GENERAL I NFORIMTI 0N
a)
Name :
MAR
c)
CH J Course No.:
e) Diocese:
HeJ-'enot
s /tJ
■
T3
d) Name of Congregation:
6 HleKMAGtAA-OKX
f) . Permanent Address
(Mother House/superior)
g)
b) Ages
:
Present Address
(For future correspondence)
HiRMAJl-A
:
WflSpL'oT
Ohj) ToviK"
_BH AJJKAVATHI
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
[ ,^c X&JL
1— J oum
■'VIOC/V^ve
.
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ouvv<.ot
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Give us a short description of the present team you are working with and
what each member does (not only health activities)
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■
Have y^u attended any course/meetings/workshops since you completed the
Course ?
^O.
o . .2
Z1
i
s
2 :
ire you in touch with any of-.the other Community Health Workers? If so
k)
give us their recent address.
. J
U
' Tk^ he4 Qvijt jKa.oX''
\dl
UM>V\
vl)
-
XxjoU€
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Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How r^any villages? Total population , what distances apart ?
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SECTION 3
.
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d
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&
Give a short description of the health activities you are involved in.
a)
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b)
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Y'C'i’&ilfid
U CaJI'-A&l'L
HOW many hours are allotted for this daily/weekly ?
AVi^-^viv ZIAcu-a — 3
,
.
f .
4U$(
c ) i.^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
XA'V
,
If so?
-
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
t/o.
e) Do you get any assistance from a Taluk/Mission Hospital?
If so, specify?
Kro,
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
t
^rvv*^ V
. ..3
i
• 3 s
g)
Do you participate in training of local people ? Grihinis
9
worker, mothers etc.
village level
j
h) Do you have any of the following programmes?
Food for work.
Health Insurance,
i) »Are you part of any Diocesan Society
CRS- PICH Programme, any others
or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
Give us detailed information i
on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
)
'TtuA*' Oi^c^v€4c-5 Stn-nvvnfovvJ.aSdc
a)
In
(Lt^f
^7:^;
Teton
b) -Are there any forms of support which a visiting team can give you next year ?
S%.
•ate:
Signatured
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
X",Training Programmes
FOLLOW-UP EVaLUATION OF COMMUNITY HEALTH
WORKERS TR4INED IN ST 30HNfS MEDICAL COLLEGE
PROFORMA
Instructions :
Section a and C to be filled in t,
” Community
"
by all
Health Workers
Section B to be filled in by those who are doing health work
at present.
(Please keep us informed regarding change of addressl
SECTION - 4
- GENERaL INFORMATION
a)
Name ;
c)
CH J Course No.^C/5^-
b) ages A-Z*I^J
e) Biocese:
f)
d)
Name of Congregation:
,
Permanent address
(Mother House/superior)
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(For future correspondence) :
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h) What have you been doing after the course ?
(if you have changed from place to place give
us some details of your work
in each place).
i) Give us a short description of the present team \you are working with and
what each member does (not only health activities)
X'. t
j) Have yiu attended any course/meetings/workshops since
you completed the
Course ?
4
...2
f
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k)
2 :
Are you in touch with any of the other Community Health Workers?
give us their recent address.
If so
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, ;non-tribal, main occupation^ other characteristics
etc). How many villages? Total population, what distances apart ?
SECTION B
a)
Give a’ short description of the health activities you are involved in.
t-
b)
Houj many hours are allotted for this daily/weekly ?
c) ^re you functioning independently Or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/nission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth,
mothers, harijans etc.)?
...3
s 3 ?
w
• g)
Do you participat e in training of local people ? Grihinis,
wo rker. mothers etc.
village level
i
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH Programme, any others
i) ./Ue you part of any Diocesan Society or Health Team ?
If so, specify. "
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
/IK, m
ecc-^i.
b) .Ve there any forms of support which a visiting team can give you next year ?
Bate: i SL I
Signat ore:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
<
Directorate of Rural Health Services &
. Training Programmes
FOLLOW-UP EVALUATION OF COHNUNITY HEALTH
WORKERS TRAINED IN ST DOHN'S MEDICAL COLLEGE
PROFORIM
Inst ructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
*
I
J
(please keep us informed regarding change of Address!
SECTION - 4
a)
Name :
GENERAL INFORIMTION
C bo rl m 1
c) CHJ Course No.:
IN f\ 1X1 JD
&G
Jo
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b) Ages
d)
j-f 6 .
Name of Congregation:'
e) liocese: AuRanGA6rj).
f)
Permanent /Address
(Mother Ho use/Superior)
Hous e
ib l S Ho p ’ 3
L i rr c e F"i—oe
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:
i^URAOJCrA & AD
g) Present Address
(For future correspondence)
:
Shanti
O n(mmt . - k> o o Q .
A £> p CM’
Pos T.
Po'J: ilSS l7o3.
Maharashtra.
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
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H //
j) Have yiu attended any course/meetings/workshops since you completed the
Course ?
/JO .
c • •2
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k)
2 :
ire you in touch with any of the other Community Health Workers? If so
give us their recent address-..
t
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
How many villages? Total population,
population, what distances apart ?
et c).
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a)
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A_£aZ6il
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How many hours are allotted for this daily/weekly ?
y4o.4
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how is the health work shared amongst you J?
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d) D(j you get any assistance from the local Primary Health Centre?
If so, specify ?
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f) Do you work with any special groups in the village (young farmers,
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-Zpe c^i^c. -^JLq^aa.
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h) DO you have any of the following programmes?
Food for work, Health Insurance 3 CRS- PICH-Programme, any others
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SECTION C (Regarding 1982 project)
a) Give Us detailed information on how to reach your village/project/centre?
x(Sy bus and train, also from station and bus stop)
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b) ^re there any forms of support which a visiting team can give you next year ?
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Signature:
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Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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1
Directorate of Rural Health Services &
Training Programmes
FQLLOU-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
PROFORMA
Instructions s
Section a and C to be filled in by all Community Health Uorkers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of .Address!
SECTION - 4
a)
GENERaL INFORIWI 0 N
Name :
b) 4ges
S //O
c) CHJ Course No.:
e) Bio'cese:
<.*
d) Name of Congregations
.vm
Permanent Address
(Mother House/superior)
3 e . Pl ■ 61 • T? era-J •
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g)
Present /Address
(For future correspondence)
:
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A (J pl .
iIo3.
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
i) Give us a short description of the present team you are working with and
what each member does (not only health activities)
j)
Have yiu attended any course/meetings/workshops since you completed the
Course ?
...2
c
? 2 :
k) Are you in touch with any of the other Community Health Workers? If SO
give us their recent address.
r
1) Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non
—tribal, main occupation, other characteristics
non-tribal,
etc).
How many villages? Total population, what distances apart ?
7.
SECTION./ B
a) Give a short description of the health activities you are involved in.
a
b)
How many hours are allotted for this daily/weekly ?
c ) $re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Hission Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
: 3 :
•g)
Do you participate in training of local people ? Grihinis
9
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- NOH °rogramme, any others
i) ^re you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to i___..
reach your village/project/centre?
(By bus and train, also from station and bus stop)
b) ^re there any forms of support which a visiting team can give you next year ?
•ate:
Signat ure:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
.!? C . / • S /
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Directorate of Rural Health Services &
Training Programmes
raLLOU-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFOFW
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who. are doing health work
at present.
(please keep us informed regarding change of -Addressl
SECTION - 4
GENERAL INFORMATION
S>R<>.
a)
Name :
c)
CHIJ Course No.:
b) iAge:
d) Name of Congregation: f R fl
t
Auw/ny.
e) Biaces e:
/Address
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(Mother House/superior)
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(For future correspondence)
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h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place). Q|
j)
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what each member does (not only health activities)
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Have you attended any course/meetings/workshops since you completed the
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...2
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s
2 :
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k) Are you in touch with any of the other Community Health Workers?
give us their recent address.
If so
1) Give in a few sentences a description of the poeple you are working- • •
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages? Total population, what distances apart ?
CixpcM' «'V
etc
1-
a
SECTION 0
a)
Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c) i.^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
U
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
z
e) Do you get any assistance from a Taluk/Miss ion l-pspital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
A/
. ..3
3 3 ?
g)
Do you participate in training of local people ? Grihinis,
mothers, etc
worker,
village level
h) DO you have any of the following programmes?
Food for work,
Health Insurance, CRS- FIC H Programme, any others
i) .Are you part of any Diocesan Society
□ r Health Team ?
If so , specify.
4/^
SECTION £ (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
I By bus and tram, also from station and bus stop)
b) ^re there any forms of support which
•ate: / $f
a visiting team can give you next year ?
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
f
Franciscan Missionary Brothers
MOUNT ASSISI
P.O. SAMELANGSO
DIST. KARBI ANGLONG
ASSAM - 782440
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MOUNT ASSISI
P.0. SAMELANG SO
DIST. KARBI ANGLONG
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Directorate of Rural Health Services &
Training Programmes
FQLLOlJ-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
,
(please keep us informed regarding change of Address!
SECTION - 4
GENERAL INFORIWION
a)
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Name :
c) CHW Course No.:
Age:
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3^
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d) Name of Congregations
e) Biocese:
f)
Permanent Address
(Mother House/superior)
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g) Present Address
( For future correspondence)
a eJ-
:
S'zkekk.jp ftOy
( 3>t
h) What have you been doing after the course ?
(if you have changed from place to place give
in each place).
'/A
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—
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some details df your work
a-
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i) Give us a short description of the present team \
you are working with and
what each member does.(not only health activities)
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j) Have you attended any course/meetings/workshops since
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...2
s 2 :
*
k) Are you in touch with any of the other Community Health Workers?
If so
give us their recent address.
1) Give in a few sentences a description of the poeple’ you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages?
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a
distances apart ?
Total population, what
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a ^Ae L^1-^
Give a short description of the health activities you are
o
(f
b)
How many hours are allotted for this daily/weekly ?
.i. fTf
7
c) 4re you functioning independently or with a team of workers?
If so,
how is the health work shared amongst you ?
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/flission Fpspital?
If so, specify?
f) Do you work with any special groups in the village (young farmers.
youth, mothers, harijans etc.)?
. ..3
s 3 s
g) Do you parti ci pat e in training of local people ? Grihinis,
worker. mothers etc.
.
village level
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH-Programme, any others
&
i) ^re you part of any Diocesan Society or Health Team ?
If so, specify.
zz
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your viIZage/prZjoct/ccntre?
(By bus and train, also from station and bus stop)
/ 7%>.(
jX 4Vyi_>ZC_fi_A
b) ,Are there any fo^nS of support whi/hTvisit inf te^^can0 give ^u'ne^yeaf
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Signature:
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Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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4 ■
Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVaLUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST 30HNfS MEDICAL COLLEGE
PROFORMA
Instructions :
Section
Section A
A and
and C to be filled in by all Community Health Workers
Section B to be filled in by those who'are doing health work
at present.
(please keep us informed regarding change of .Addressl
SECTION - 4
a)
GENERaL INFORMATION
b) Age:
Name :
Name of Congregation:
c) CHi] Course No.:
e) >iocese:
62.^1 Cut tp>
address
n Permanent
(Fleth-er. W-use/Superior) :
vA G A*'
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7^ 3
o)
Present Address
(For future correspondence)
h)
What have you been doing after the course ?
(if you have .changed from place to place give us some details of your work
:
in each place) »
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(
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what each member does (not o nly health activities)
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Are you in touch with any of the other Community Health Workers?
give us their recent address.
If so
0
1)
Give in a few sentences a description of the poeple you are working
with (.rural, urban , tribal, non-tribal, main occupation, other characteristics
eto) .
How many villages? Total population, what distances apart ?
?
•jTMitcA
IN t
cvoc\ i--.
TWajl
a)
Give a short description of the health activities you are involved in.
b)
HoijJ^many hours are allotted for this daily/weekly ?
c ) $re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
e) Do you get any assistance from a Taluk/Hiss ion Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
...3
: 3 ?
g) Do you parti cipat e in training of local people ? Grihinis,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- PICH Programme, any others
i) </Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
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b) .$re there any forms of support which a visiting team can give you next year ?
N t>
•ate:
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
4
Directorate of Rural Health Services &
Training Programmes
FQLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Instructions :
Section a and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of -Address!
GENERAL INFORMATION
SECTION -
Name :
c)
CHIj Course No.:
Sc- s j/qj
..
30
30
b) Age:
a)
d) Name of Congregatiorr:
e) Biocese:
Address
n Permanent
(Mother Ho use/Superior) :
o)
Present Address
(For future correspondence)
:
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in each place).
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Course ?
Mt
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.
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k)
2 :
Are you in touch with any of the other Community
Health Workers?
If so
give us their recent address.
1)
Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages?
Total population, what distances apart ?
People
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b)
How many hours .are allotted for this daily/weekly ?
-k-rw
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O^^O^xax^S
c ) Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
Ajoir kc
d)
Do you get any assistance from the local Primary Health Centre?
If so,
specify ?
I'd &
e) Do you get any assistance from a Taluk/flission
f)
Hospital?
Do you work with any special groups in the village
youth,
mothers,
harijans
If so,
specify?
(young farmers,
etc.)?
. ..3
: 3 s
Do you participate in training of local people ? Grihinis,
worker, mothers etc.
g)
village level
A/c -/
h) Do you have any of the following programmes?
Food for work, Health Insurance, CRS- MCH Programme, any others
-
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^vkoelI
tx
V (? Kp . ■
IdviZK;
i) ^re you part of any Diocesan Society or Health Team ?
44-
6 C>/?A» Liz
•
If so, specify.
-
A!d>
SECTION C (Regarding 1982 project)
■a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station and bus stop)
((
of M-Xcer
'C'ctj a.
nrj
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b) ^re there any forms of support which a visiting team can give you next year ?
AMc
Bat es
4i m>-e.
Vo
•/A/Vvu/o
o VQV ■
Signat ure:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
Directorate of Rural Health Services &
Training programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN'S MEDICAL COLLEGE
PROFORMA
Inst ructions :
Section A and C to be filled in by all Community Health Workers
Section B to be filled in by those who are doing health work
at present.
(please keep, us informed regarding change of Address!
SECTION - 4
- GENERAL INFORMATION
a)
Name
c)
CHJ Course No.:
b).Age:
'%
8
s j T)
S) INTERS
e) Biocese:
Permanent Address
(Mother House/superior)
Present Address
(For future correspondence)
G. p. <0. B ox
OF CHA*l1y O F /V/7x^/?e-rH
:
Al^xe^k/TH <2t)AJvSKiT y
g)
d) Name of Congregation:
P. <0.
:
/^IzpAL.
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in each place).
0
4
i) Give us a short description of the present team you are working with and
what each
sach member does (not only health activities)
j) Have you attended any course/meetings/workshops since you completed the
Course ?
...2
s
2 :
k) Are you in touch with any of the other Community Health Workers?
If so
give us their recent address.
1)
Give infew sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages? Total population, what distances apart ?
SECTION B
a)
Give a short description of the health activities you are involved in.
b)
How many'hours are allotted for this daily/weekly ?
c ) /Are you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
j
e) Do you get any assistance from a Ta-1 uk/Nission Hospital?
f)
If so, specify?
wprk with any' special groups in the village (young farmers,
youth, vmothers, harijans etc.)?
. ..3
s 3 ?
g) Do you participate in training of local people ? Grihinis
9
worker, jpot hers et c•
“
village level
h) Do you have any of the foy^iwing programmes?
Food for work, Health Insurance, ffis- fICH-Programme, any others
i) <Are you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a)
Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from, station and bus stop)
k *64*. n le h*lJ
b) ^re there any forms of support which a visiting team can give you next year ?
J)
J)
'7^
•ate: 3/
Signature:
Please use the remaining blank space to giveany further details for which there
was not adequate space in the questionnaire.
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Directorate of Rural Health Services &
Training Programmes
FOLLOW-UP EVALUATION OF COMMUNITY HEALTH
WORKERS TRAINED IN ST JOHN’S MEDICAL COLLEGE
PROFOfW
Instructions :
Section A and C to be filled in by all Community Health Workers
Section 0 to be filled in by those who are doing health work
at present.
(please keep us informed regarding change of address!
SECTION - 4
GENERAL INFORMATION
a)
Name ;
c)
CHIJ Course No.:
e) >iocese:
f)
b) Age:
iSC
S //s)
Q.
d) Name of Congregation:
UTJfl/N
Permanent Address
(Mother Ho use/Superior)
:
g) Present Address
(For future correspondence)
FtMODOO^
CFTHO/jF
^T7/)/N- 7760/0
:
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HAWpo- UJJ/F^ UP
h) What have you been doing after the course ?
(if you have changed from place to place give us some details of your work
in saoh placa) ■ J
fFk/$'/it*
rT
i)
Give us a short description of the present team you are working with and
what each member does (not only health activities)
/ P
/<**
K
j)
Have yiu attended any course/meetings/workshops since you completed the
Course ?
.-.2
2 2 :
k) Are you in touch with any of the other Community Health Workers? If so
give us their recent address, /fa'
1)
Give in a few sentences a description of the poeple you are working
with (rural, urban, tribal, non-tribal, main occupation, other characteristics
etc).
How many villages? Total population, what -distances apart ?
•
SECTION B
-
7/
a)
Give a short description of the health activities you are involved in.
b)
How many hours are allotted for this daily/weekly ?
c ) ^re you functioning independently or with a team of workers?
how is the health work shared amongst you ?
If so,
d) Do you get any assistance from the local Primary Health Centre?
If so, specify ?
ei) Do you get any assistance from a Taluk/nission
Hospital?
If so, specify?
f) Do you work with any special groups in the village (young farmers,
youth, mothers, harijans etc.)?
. ..3
: 3 ;
g) Do you parti cipat e in training of local people ? Grihinis,
worker, mothers etc.
village level
h) Do you have any of the following programmes?
Food for work,
Health Insurance,
CRS- MCH-Programme, any others
i) ^re you part of any Diocesan Society or Health Team ?
If so, specify.
SECTION C (Regarding 1982 project)
a) Give us detailed information on how to reach your village/project/centre?
(By bus and train, also from station andbusstop)
and bus stop)
*
Ctcr<T/)lM
>
*
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M4H-|T?UR-^d W-
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to) ^re theje
any^forms
of^suppo^t which
wl)ich a visiting team can give you next year ?
‘ here any
forms of^support
•ate:
Signature:
■>
Please use the remaining blank soace to give any further details for which there
was not adequate space in the questionnaire.
/ *
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PROJECT LEAD-FREE FINDINGS
A study of blood lead levels in approximately 22,000 samples taken in 7 major Indian cities.
Study Conducted by
The George Foundation
1997-1998
2
1
U
C
PROJECT LEAD-FREE FINDINGS
THE GEORGE FOUNDATION
INTRODUCTION
Project Lead-Free sponsored by The George Foundation aimed at assessing the damage due to lead in Indian population, especially
in children.
In order to get good representative data of lead toxicity in various parts of India, large blood samples were taken by participating
clinics.
For our study Bangalore, Delhi, Mumbai, Calcutta, Chennai, Vellore and Hyderabad representing different parts of India were
selected.
Subjects under following categories were screened.
. Pre-school children including toddlers.
. Slum children and their parents.
. Working children in unorganized sector.
. School children in both low and high economic group in urban and rural areas.
. Pregnant women under poor and good nutrition background.
. High risk group under various categories such as traffic policemen
. Workers from battery and paint industry.
2
SELECTION OF SUBJECTS AND SCREENING METHODOLOGY ADOPTED
•
Selection of subjects was done on voluntary participation basis.
Preschool children and toddlers were selected at random as and when they visited hospital outpatient units.
Slums were selected for screening children and their parents at random.
Schools were selected for screening their children at voluntary participation.
Pregnant women attending antenatal clinics who volunteered were screened.
The only non randomized group of high risk individuals were from battery' and paint industry.
Traffic policemen were compulsorily made to undergo screening for their blood lead levels
•
Screening methodology adopted included evaluation of Zinc Protoporphyrin and blood lead levels
In the beginning of the project fairly good number of subjects belonging to various categories were screened for both Zinc
Ptotoporphyrin (ZnPP) and blood lead levels using haematoflurometer and Anodic Stripping Voltmetric methods, respectively.
Blood lead levels were tested for using 2 methodologies:
1. Only those with ZnPP levels of => 35 (5932 cases)
2. Regardless of ZnPP levels - 100% screening for lead levels (1857 cases)
Keeping in view the convenience of mass screening for lead exposure, field instrument haematoflurometer for the determination of
ZnPP levels. In all cases of elevated ZnPP, efforts were made in most of the cases to treat anemia and repeat of ZnPP was carried
out to see the effect. This methodology employed was cost effective. However in all cases of elevated ZnPP, samples were
collected as per the recommended procedure for the estimation of blood lead levels using ESA 3010 B Lead Analyzer.
In most cases with ZnPP lower than 35ug/dl, blood lead levels were not estimated under methodology 1. However, lead screening with ESA 3010B
was done for 1857 additional cases, regardless of ZnPP levels, and compared them against the lead levels of those with ZnPP =>35.
3
DESCRIPTION OF SAMPLES TAKEN
• Determination of ZnPP:
Disposable lancets were used to get arterial blood samples from the cleaned finger tips for the determination of ZnPP using AVIV
haematoflurometers calibrated as per the instruction provided and using the AVIV supplied Low Medium and High ZnPP
standards. Estimations were repeated at random to check reproducibility. Instrument was calibrated on the day of use. Cover slips
used for the estimation of ZnPP were of good quality. Care was taken to take readings with in the specified time after the blood
was taken on the cover slip. Cord blood using heparin as an anticoagulant was used for the estimation of ZnPP.
In cases of venous collected in disposable Syringes, ZnPP was estimated in the same sample.
•
Determination of blood lead levels:
Capillary tubes specially supplied for the collection of lOOul of blood samples from fingertip/venous blood were transferred to the
metaexchange reagent and mixed well for the estimation of blood lead levels 24 hours after the mixing
In all cases where capillary blood lead levels showed blood lead higher than 40ug/dl repeat estimation of lead with venous blood
was carried out as per the protocol suggested by CDC.
3010 B ESA Lead analyzer was calibrated on all days of its use using calibrators and the results were checked with controls
supplied by the company. The instrument was kept on round the clock.
In random samples blood lead levels were also estimated using Atomic Absorption Spectrophotometry and the results were
comparable.
With the operating range of 1-100 ug/dl lead and a detection limit of 1 ug/dl lead, the methodology adopted was sensitive with a
precision of 10% RSD at 10 ug/dl.
With the short analysis time of 90 seconds the method proved to be less cumbersome and reliable.
4
SCREENING METHODOLOGY AND PROTOCOL
• Methodology and protocol adopted prior to the screening:
Since the entire project involved participation of subjects at voluntary level, clinic representatives in all cities had to motivate the
public through briefing on the effects of lead on their health.
Efforts were also made through mass media to educate the general public as most of our population were ignorant about the effects
of lead.
Heads of schools were contacted for special meetings with parents of school children, and during parent teacher meetings adequate
information was provided which in turn encouraged parents and teachers to prepare students for screening.
Consent forms and detailed information forms were duly completed prior to the participation in the screening program.
No screening was undertaken unless the information forms were completed. However in some cases right type of information such
as parents income or the profession could not be collected due to many practical reasons.
As token of encouragement to participating children toffees/chocolates were provided after the finger prick.
Follow-up of the cases wherever possible was carried out. Due to logistics follow-up was difficult as the number of subjects
handled most of the time was large to manage.
5
SUSPECTED SOURCES AND PATHWAYS
•
General observations:
Urban children are found to have higher levels of lead in their blood as compared to their counterparts in rural areas as seen in our
results. One of the possible sources of lead in urban environment is from the vehicular exhaust. We do not have sufficient data on
the air lead levels in most of our cities.
Another possible source of lead in urban environment is the drinking water Urban population gets water through pipeline, which
is stored in containers made of metal or alloy of many metals In rural areas water source is either open or the bore well, and there
is less chance of lead coming in contact with water source.
In our urban environment amount of paints used is proportionately large as compared to the rural set-up.
Some of the common reasons for the source of lead in both rural and urban environment is the tin plated vessels.
•
Specific observations:
Family of three members had elevated blood lead levels. Two of them were asymptomatic and one had developed acute abdominal
pain. On detailed study it was found that the family had an electric grinder to get wheat flour, which had developed some problem.
On examination it was found that the lead from the grinder had coated the grinding plate, acting as the source of lead.
Number of children and adults were found to have elevated blood lead and all of them were on indigenous medicines which
apparently contained lead in some form. These medicines are still widely used by some quacks. There are many such isolated
incidences from which we were able to point out the probable sources of lead causing health hazard. On withdrawing the probable
sources, symptoms reduced gradually.
6
ANALYSIS OF RESULTS OF LEAD LEVELS BY GROUPS/CATEGORIES
Following observations are made during our study for analysis of results:
•
Children in different age groups having blood lead levels greater than 10 ug/dl, 20 ug/dl, 30 ug/dl and 40 ug/dl are noted in the
study.
•
Children are classified in to rural, urban slum groups for comparison purpose. Nutritional background information is collected.
•
Blood lead levels of school children are recorded and elevated levels are compared to their school location with respect to the
vehicular traffic in the area where the schools are located In couple of schools academic performance of school children is
compared with their blood lead levels.
•
Blood lead levels of pregnant women are indicated separately. Days and weeks of pregnancy are also noted in all cases.
•
In most of the cases of cord blood lead levels repeat investigations are made in mother’s blood after delivery.
•
Traffic policemen data of blood lead levels are correlated with the number of hours of duty per day and the intensity of traffic in
the area of their posting.
•
In high risk groups details regarding their profession is indicated along with their high blood levels. Efforts are also made to
find possible sources.
•
In case of isolated high blood levels detailed investigations are made to find out the source of lead.
7
OBSERVATIONS
The below mentioned figures are when ZnPP >35 (Methodology 1)
•
34.02% of children below the age group of 12 years in six major cities combined have blood lead levels higher than lOug/dl.
•
Amongst these cities Delhi has 64.38%, Mumbai 29.22%, Chennai 61.33%, Calcutta 57.36%, Hyderabad 34.78%, and
Bangalore 31.18%.
•
26.53% falling into age groups greater than 12 years have blood lead levels higher than 10ug/dl.
The Below mentioned figures are irrespective of their ZnPP levels (Methodology 2)
•
51.40% of children below the age group of 12 years in six cities combined have blood
lead levels higher than lOug/dl.
•
Amongst these cities Delhi has 54.10%. Mumbai 61.86%, Chennai 60.54%, Calcutta
55.78%, and Bangalore 39.94%.
•
40.22% falling into age groups greater than 12 years have blood lead levels higher than
10 ug/dl.
8
Znpp Levels in 6 cities
Sample Size Znpp >° 35
City
Age group
3422
12173
age<=12 3angalore
814
4401
age>12
%___
28.11
18.50
age<=12
age>12
Calcutta
474
656
197
167
41.56
25.46
age<=12
age>12
Chennai
272
544
75
177
27.57
32.54
age<=12
age>12
Delhi
549
532
160
235
29.14
44.17
age<=12
age>12
Hyderabad
34
449
23
206
67.65
45.88
age<=12
age>12
Mumbai
1165
227
373
48
32.02
21.15
age<=12
age>12
Nation
14667
6809
4250
1807
28.98
26.54
^14
Panp# 1T
Methodology 1: Lead levels in 6 cities (age <= 12)
Sample | City
%
Pb Levels Result
Znpp >= 35________ in ug/dl
34221 Bangalore Pb >= 10
31.18
1067
7.42
254
Pb >= 20
2.28
78
Pb >= 30
1.17
40
Pb >= 40
Methodology 1: Lear levels in cities (age >12)
Pb Levels)Result
Sample [ City
%
Znpp >= 35________ in ug/dl
28.38
231
814 Bangalore Pb >= 10
8.72
71
Pb >= 20
5.28
43
Pb>= 30
3.56
29
Pb >= 40
Pb>= 10
Pb >= 20
Pb >= 30
Pb >= 40
26
6
2
2
15.57
177 Chennai
Pb >= 10
Pb >= 20
Pb >= 30
Pb >= 40
9
2
1
0
5.08
1.13
0.56
0.00
64.38
20.00
4.38
1.88
235 Delhi
Pb >= 10
Pb >= 20
Pb >= 30
Pb >= 40
80
35
18
10
34.04
14.89
7.66
4.26
8
2
0
0
34.78
8.70
0.00
0.00
206 Hyderabac Pb >= 10
Pb >= 20
Pb >= 30
Pb >= 40
80
17
6
3
38.83
8.25
2.91
1.46
109
34
11
4
1446
379
108
52
29.22
9.12
2.95
1.07
34.02
8.92
2.54
1.22
48 Mumbai
Pb >= 10
Pb >= 20
Pb >= 30
Pb >= 40
Pb >=10
Pb >= 20
Pb >= 30
Pb >= 40
11
3
0
0
437
134
70
44
22.92
6.25
0.00
0.00
26.53
8.14
4.25
2.67
Pb >= 10
Pb >= 20
Pb >= 30
Pb >= 40
113
45
3
0
57.36
22.84
1.52
0.00
167 Calcutta
75 Chennai
Pb >= 10
Pb >= 20
Pb>= 30
Pb >= 40
46
12
9
5
61.33
16.00
12.00
6.67
160 Delhi
Pb >= 10
Pb >= 20
Pb >= 30
Pb >= 40
103
32
7
3
23 Hyderabac Pb >= 10
Pb >= 20
Pb >= 30
Pb >= 40
Pb >= 10
Pb >= 20
Pb>= 30
Pb >= 40
Pb >= 10
Pb >= 20
Pb >= 30
Pb >= 40
197 Calcutta
373 Mumbai
4250 Nation
1647 Nation
3.59
1.20
1.20
Dana
OT
Methodology 2: Lead levels irrespective of Znpp in all age groups
Cities
Bangalore
Calcutta
Chennai
Delhi
Mumbai
Nation
Pb>=10 Pb>=20 Pb>=30 Pb>=40
9
5
34
265
3
1
56
174
9
5
19
112
27
11
93
277
8 ______ 2
196 _____ 46
24
56
248
1024
Methodology 2: Lead levels irrespective of Znpp in age <=12
Cities
Bangalore
Calcutta
Chennai
Delhi
Mumbai
Nation
Sample
631
294
185
451
291
1852
Pb>=10
252
164
112
244
180
952
%____
Pb>=20
33
55
39.94
55.78
19
60.54
84
54.10
61.86 _____ 43
51.40
234
%____
Pb>=30
%____
5.23
8
18.71
10.27
18.63
14.78
12.63
3
1.27
1.02
9
4.86
23
5.10
2.75
2.75
8
51
Pb>=40
%____
5
1
5
11
______ 2
24
0.79
0.34
2.70
2.44
0.69
1.30
Methodology 2: Lead levels irrespectiveof Znpp in age >12
Cities
Bangalore
Calcutta
Chennai
Delhi
Mumbai
Nation
Sample
Pb>=10
%____
82
25
0
51
______21
13
10
15.85
40.00
179
Pb>=20
%____
1
1
1.22
4.00
Pb>=30
1
0
%___
1.22
0.00
Pb>=40
0
0
%___
0.00
0.00
f
;I
33
64.71
16
76.19
72
40.22
9
_3
14
17.65
14.29
7.82
4
0
5
7.84
0.00
2.79
0
0
0
0.00
0.00
0.00
Page # 3T
Comparisions of Methods 1 & 2 where aqe-qroup <=12
Pb>=10 & age <= 12
Method 1 Method 2
Cities
39.94%
31.18%
Bangalore
55.78%
57.36%
Calcutta
60.54%
61.33%
Chennai
54.10%
64.38%
Delhi
0%
34.78%
Hyderabad
61.86%
29.22%
Mumbai
51.40%
34.02%
Nation
Pb>=20 & age <=12
Method 1 Method 2
Cities
5.23%
7.42%
Bangalore
18.71%
22.84%
Calcutta
10.27%
16.00%
Chennai
18.63%
20.00%
Delhi
0%
8.70%
Hyderabad
14.78%
9.12%
Mumbai
12.63%
8.92%
Nation
Comparisions of Methods 1 & 2 where aqe-qroup >12
Pb>=10 & age >12
Cities 7 Method 1 Method 2
15.85%
28.38%
Bangalore
40.00%
15.57%
Calcutta
5.08%
Chennai
64.71%
34.04%
Delhi
0%
Hyderabac
38.83%
76.19%
22.92%
Mumbai
40.22%
26.53%
Nation
Pb>=20 & age >12
Method 1 Method 2
Cities
1.22%
Bangalore
8.72%
4.00%
3.59%
Calcutta
1.13%
Chennai
17.65%
14.89%
Delhi
0%
8.25%
Hyderabad
14.29%
6.25%
Mumbai
7.82%
8.14%
Nation
Paqe # 4T
Blood Lead levels of 10 ug/dl or higher
Methodology 1: Znpp>=35 for Age-groups <= 12
80.00%
3
£
#103/160
#46/75
WI
60.00%
O
O)
40.00%
I
20.00%
OJ
u
#8/23
#X06ZZ3422-
0.00%
Bangalore
[seriesl
Calcutta
Chennai
Delhi
Hyderabad
Mumbai
57.36%
61.33%
64.38%
34.78%
29.22%
31 18%
Cities
Blood Lead levels of 20 ug/dl or higher
Methodology 1: Znpp>=35 for Age-groups <=12
1
I
re
4>
O)
re
#45/197
20.00%
#254^3422
5
#2^23
#34/373
o
9)
0.00%
I Seriesl |
Bangalore
Calcutta
Chennai
Delhi
Hyderabad
Mumbai
7.42%
22.84%
16%
20%
8.70%
9.12%
Cities
Blood Lead levels of 10 ug/dl or higher
Methodology 1: Znpp>=35 for Age-groups >12
3
£
40.00%
I
20.00%
re
0)
S)
re
6.
#231/814
#11/48
#26/167
#9/177
o
0.00%
| Seriesl
Bangalore
Calcutta
Chennai
Delhi
Hyderabad
Mumbai
28.38%
15.57%
5.08%
34.04%
38.83%
22.92%
Cities
Blood Lead levels of 20 ug/dl or higher
Methodology 1: Znpp>=35 for Age-groups >12
3
Ire
9>
20.00%
#35/235
a
re
#711/814
I
#17/206
o
0.00%
|Seriesl
#3/48
#2/177
Bangalore
Calcutta
Chennai
Delhi
Hyderabad
Mumbai
8.72%
3.59%
1.13%
14.89%
8.25%
6.25%
Cities
Page # 1G
Blood Lead levels of 10 ug/dl or higher
Methodology 2: Agegroup <=12
| 80.00%
.jp
60.00%
a>
« 20.00%
O
0.00%
Q.
#1^85
#244/451
#252/631
Bg|
U
■■
Bangalore
Calcutta
Chennai
Delhi
I
Mumbai
60.54%
54.10%
I
61.86%
11Um
® 40.00%
o
#164/294
55.78%
39.94%
I Series 1
________________ i
Cities
Blood Lead levels of 20 ug/dl or higher
Methodology 2: Agegroup <=12
£03 20.00%
#84/451
#55/294
0J
CT
05
#19/185
I
#33/631
U
£
0.00%
I Bangalore
i Series 1 j
5.23%
i
Delhi
Calcutta | Chennai
T 18.71% I 10.27% I 18.63%
1 i
*
■.-;7
-
■-
Mumbai
|
14 78%
Cities
Blood Lead levels 10 ug/dl or higher
Methodology 2: Agegroup >12
#16/21
80.00%
#33/51
£05
0>
CT
03
I
Q
w
60.00%
#10/25
i
40.00% -20.00% -
#13/82
si
0.00%
#0/0
-
1
i Mumbai
Delhi
I Bangalore i Calcutta I Chennai
i
40.00%
!
0.00%
I
64.71%
I 76.19%
15.85%
Seriesl
Cities
Blood Lead levels of 20 ug/dl or higher
Methodology 2: Agegroup >12
Io
ra 20.00%
#9/51
#3/21
Delhi
Mumbai
17.65% I
14.29%
CT
05
I
#1/82
#1/25
#0/0
O
0.00%
I Bangalore | Calcutta ' Chennai
ISeriesl :
1-22%
4%
0%
I
Cities
Page # 2G
Blood Lead levels of 10 ug/dl or higher
Comparision of Methods 1 & 2 for age <=12
80.00% q
70.00%
60.00%
Ii
I
50.00%
.=-:
ex
05
5u
i
I
40.00%
30.00%
(X
20.00%
10.00%
0.00%
I
S
s
-
Bangalore
Calcutta
Chennai
Delhi
□ Method 1
31.18%
57.36%
61.33%
a Method 2 I
39.94%
55.78%
60.54%
f-------------- r
Hyderabad
Mumbai
64.38%
34.78%
29.22%
54.10%
0%
61.86%
Mumbai
I
Cities
Blood Lead levels of 20 ug/dl or higher
Comparision of Methods 1 & 2 for age <=12
30.00% n
■o
20.00%
I
00
ex
J;
03
5w
Q
O.
10.00%
0.00%
□ Method 1
■ Method 2 |
Bangalore
Calcutta
Chennai
Delhi
Hyderabad
7.42%
22.84%
16.00%
20.00%
8.70%
9.12%
5.23%
18.71%
10.27%
18.63%
0%
14.78%
Cities
Page#3G
Blood Lead level of 10 ug/dl or higher
Comparision of Methods 1 & 2 for age >12
80.00% ->
70.00%
60.00%
TJ
s 50.00%
£
S3
ex
40.00%
5u
30.00%
S3
(X
20.00%
J
Bangalore
Calcutta
Chennai
Delhi
Hyderabad
Mumbai
□ Method 1
28.38%
15.57%
5.08%
34.04%
38.83%
22.92%
H Method 2
15.85%
40.00%
0.00%
64.71%
0%
76.19%
10.00%
0.00%
Cities
Blood Lead levels of 20 ug/dl or higher
Comparision of Methods 1 & 2 for age >12
30.00%
1
1
20.00%
!
I
10.00%
0.00%
Bangalore
Calcutta
Chennai
Delhi
Hyderabad
Mumbai
14.89%
8.25%
6.25%
17.65%
0%
14.29%
□ Method 1
8.72%
3.59%
1.13%
■ Method 2
1.22%
4.00%
0.00%
Cities
Page # 4G
Estimation of National Blood Lead levels
of 10 ug/dl or higher
Age Group <=12
5140%
Estimation of National Blood Lead levels
of 10 ug/dl or higher
Age Group >12
4022%
Page # 5G
Position: 2821 (3 views)