o © © {OO BIOLOG) SESSION : 2025-2026 SUBMITTED B7 : CLASS : 2” [ SCIENCE J 2 | ROLL NO [ CBSE ]: 09 3 CYoo > CAMBRIDGE SCHOO 3 DUMRAON 9 OeT Would Like To Express My Gratitude To My , Science Teacher___________ Provided Me ‘With 4 Valuable Advice And Suggestions To Improve My Experiment. TAn Tharkfi To My Principal ________for Providing Me With The Resources And. Facilities Needed For My Experiment. Their Encouragement And Motivation Pushed Me To Work Hard And Strive For Excellence TAn (Gratefid To My Parents For Their Unwavering Support Throughout This Project0——S$—$—$T$—S$=o——SS————————————F This is to certify that_____________has satisfactorily completed herthis investigatory project for the biology prescribed for class XII by the central board of secondary education in the biology laboratory for Cambridge school school Dumraon in the year 2025-26. Roll No : Signature : Principal Teacher—In-Charge Date : External Examiner Date : —O=—LESS eaeINTRODUCTION PRA ee a easy SCHEMES UNDER NATIONAL FAMILY PLANNING PROGRAM ROLE OF CHO IN PROVIDING REPRODUCTIVE HEALTH SERVICES @ op) _ rs re _ rs O O TABLE OFo e —@) Introduction oO Couples have the right, as well as the responsibility, to plan their families ie. deciding whether to have children, when to have children and taking appropriate steps to achieve the goal of a desired family size. Family planning methods help to prevent unwanted pregnancies and preventable deaths occurring due to ‘too soon/ too many’ births, thus impacting maternal, newborn, and child health outcomes. eae Cee ee ed ro Prucitod Peritekty fenestrae Dey Leis Pe Ry Tooearly/ | Age of mother <18 years or | + Anemia Too late >36 years increased chances of = ~ Infections weight () Interval between two pregnancies is less than 2 years ~ Abortions + Increased (ii) After miscarriage or ~ Hemorrhage chances abortion, next pregnancy | obstructed labour | of at within 6 months mortality Too frequent ~ Pre-eclampsia/ eclampsia Women is pregnant for the ~ Premature rupture Sth time or more Too many of membrane Healthy Timing and Spacing of Pregnancy (HTSP): A woman considering using @ family planning method before trying to become pregnant should © Wait until the age of 20 years before she conceives for the first time. Wait at least 24 months after childbirth to become pregnant again (the recommended birth interval between two births is minimum 36 months) * Wait at least 6 months after miscarriage or abortion to conceive again.Use of contraceptives helps in maintaining HTSP, because pregnancy can occur as early a! * 6 months postpartum, if woman is exclusively breastfeeding her child * 6 weeks postpartum, if woman is not exclusively breastfeeding her child * 4 weeks postpartum, if woman is not breastfeeding at all * 10 days of first trimester abortion « 4 weeks of second trimester abortion Pregnancy can occur even before resumption of menses after childbirth/ abortion —Q) Family Planning Methods e@ The beneficiaries for family planning services are women/couples of reproductive age group (15-49 years). The contraceptive basket of choice under National Family Planning program includes following methods: Serr Muu seuss Intra-Uterine Contraceptive Device - IUCD 380A, IUCD 375 © Injectable Contraceptive MPA (under Antara Program) © Subdermal Contraceptive Implant (Single Rod) © Combined Oral Contraceptive Pills (Mala N) © Centchroman Pills (Chhaya) Condoms (Nirodh) Female Sterilization (Laparoscopic/ Minilap Sterilization) © Male Sterilization (Conventional/ Non- Scalpel Vasectomy) Note: All available methods are provided free of cost through public health facilities and ASHAs. 2.1 Intra-uterine Contraceptive Device (IUCD) A method of contraception, made of plastic and copper, inserted in uterus. There are two types of IUCD:« IUCD 380 A- protection for 10 years * UCD 375- protection for 5 years. After informed verbal consent from. the client, the IUCD can be inserted by trained providers. «Interval IUCD- Any time during menstrual cycle/ after 6 weeks of delivery/ after 12 days of completion of abortion. + Postpartum IUCD (PPIUCD)- Within 48 hours of vaginal delivery / concurrent with C Section + Post-Abortion IUCD- within 12 days of completion of abortion (surgical abortion). In case of medical abortion, the completion of abortion is ascertained on 12th day after the intake of second pill or 15th day after intake of first pill Follow up: Woman must visit health facility at 6 weeks or after first menstrual cycle (whichever is earlier) erale) Crys shes Highly effective long acting reversible contraceptive method. * Nohassle of remembering to use contraceptive before each sexual contact * Immediately effective on insertion/ immediate return of fertility on removal. * Free from side effects of hormonal methods. * Can be used as emergency contraception if inserted within 5 days of unprotected sex. Does NOT cause Infertility. Does NOT cause Cancer. Does NOT travel from uterus to other parts of the body. Does NOT increase risk of infection, Does NOT cause discomfort during sex. Does NOT lead to frequent abortions.Effects of IUCD insertion (non-harmful and reversible) ‘* Slight bleeding/ spotting after insertion. Increase in duration/ amount of menstrual bleeding/ spotting/ light bleeding during first few months after insertion. * Discomfort or cramps during insertion and for the next few days. 2.2 Injectable Medroxy Progestrone Acetate (Antara Programme) Intramuscular hormonal method for women that provides protection for 3 months with a single dose. First dose is given only after screening by a trained “ doctor (MBBS and above) and subsequent doses may be given by trained health provider (Doctor/ CHO/ SN/ ANM) in the health facility. Dose and site: The injection is given intramuscularly in the upper arm, buttocks or thigh, as per the client preference Subsequent doses: Woman must visit the health facility on scheduled date (8months from earlier dose). It is best to come on the scheduled date, though there is a flexibility of (2 weeks earlier or 4 weeks later) than the exact date. TUT ORC ue * Take the next dose on scheduled date. * Donot massage the injection site. * Donot apply fomentation (hot or cold) * Always carry your MPA card whenever visiting health center. If the client does not take the subsequent dose in the stipulated period (grace period), she seeks the injection as a new client.Ceci ea eccscn oy Cea nue sucess No interference with sexual intercourse. Does NOT cause Infertility. * Does NOT cause weakening of bones. * Does NOT lead to Abortions or birth defects. © Private and confidential method. * Can be adopted as postpartum (Breastfeeding: At 6 weeks of delivery and Non-Breastfeeding at 4 weeks after delivery) or post-abortion contraception (within 7 days of completion of abortion). *Noeffect on quantity and quality of milk © Decreases menstrual cramps and menorrhagia (heavy bleeding), * Prevents/ improves anaemia. «Protects against endometrial & ovarian cancer. * Can be safely used by adolescents. * Does NOT cause cancers (breast/ cervix/ endometrium). Protects against ectopic pregnancy, © Menstrual Irregularities: Light/ Heavy/ No bleeding © Delay in return of fertility (7-10 months from last dose of injection). © Slight weight gain. «Mood swings. * Headache. 2.3 Subdermal Contraceptive Implant (Single Rod) A Contraceptive Implant is a small flexible rod about the size of a matchstick, placed under the skin of the upper arm of the woman, using a pre-loaded sterile disposable applicator. It is a long acting reversible hormonal contraceptive method effective for 3 years after insertion. It is inserted by a trained provider (MBBS and e Above) at the designated health facilitiesImplant is inserted just under the skin, on the inner side of the non-dominant upper arm Site of the insertion Benefits of Contraceptive Implants Effects of Contraceptive Implant (non-harmful and reversible) © Highly safe and effective long- | Some women may complain of acting reversible contraceptive changes in monthly bleeding method. pattern: Irregular/ prolonged/ heavy bleeding often followed by © There is early retum of fertility following removal ne Eieed) * Can occasionally be associated with headaches, mood changes, breast tenderness etc. © Can beused by nearly all women, including those who are breastfeeding, © Can be taken safely immediately after delivery and abortion © Helps protect against risks of pregnancy, including ectopic pregnancy © Helps protect against symptomatic pelvic inflammatory disease © May help protect against iron deficiency anaemia, by reducing menstrual flow as amenorrhoea sets in. ‘© Does not require any action from the user after insertion © Does not interfere with sexual activity or pleasure Post Insertion Instructions or messages: * Insertion site should be kept dry and clean for at least 2 days, to prevent chances of infection. After 2 days, the outer bandage may be removed * Puncture site usually heals in 3-5 days. The inner dressing can, thus, be removed after 5 days.Can resume routine work immediately; only caution is to avoid repeated touching of the insertion site or applying unusual pressure and, carrying heavy loads for 5 days Some swelling or bruising may be experienced for a few days at the insertion site which is normal Return to the health facility anytime in case of any side effects / problems or if she wants the implant to be removed. Follow up: Contraceptive implant users do not require a routine return visit untilitis time to replace the implant ie,, after 3 years of insertion. However, visits at 6 weeks and 3 months after insertion are encouraged to review her menstrual pattern, and address concerns, if any, Ask client to return to the health facility if she experiences any of the following: + Menstrual Changes affecting her daily routine work Pain, swelling, pus, or redness at the insertion site that becomes worse, or she sees the rod coming out Ensure that every client who has got implant inserted has received Implant card, Explain her details in the Implant card like do's and don'ts along with other necessary information like date of Insertion, due date of removal, site of insertion, expected menstrual changes etc. Explain that it is important to retain card if she wants to get implant removed at the designated facility Post Removal Instructions or messages: Keep the area around the insertion site dry and clean for at least 2 days. The incision could become infected if the area gets wet while the client is bathing Remove the outer bandage after 2 days and inner dressing until the incision heals (about 5 days). There may be bruising, swelling, or tenderness at the insertion site for a few days. This is normale° * Routine work can be done immediately. Avoid repeated touching or applying unusual pressure to the site, including carrying heavy loads. After healing, the area can be touched and washed with normal pressure. « Askher reproductive intentions and if she wants contraceptive protection, implant needs to be reinserted or another method may be offered. 2.4 Centchroman Pills This is a non-hormonal, non- steroidal, weekly pill which is suitable for nearly all women including those who are unmarried and have no children. It is available as 8 tablets per strip. For initiation, the first pill is to be taken on the first day of period (as indicated by the first Ifistday | First3 Nica) eats, phe, day of menstrual bleeding), next pill three days after. Sun, Wed _| Sunday Therefore, one pill is taken Mon Thu |Monday twice a week for first three Tuesday _|Tues,Fri__| Tuesday months; Starting from Wednesday _| Wed, Sat Wednesday fourth month, the pill is to Thursday Thu, Sun, Thursday} be taken once a week on Friday Fri,Mon _| Friday the first pill day and should Saturday _|SatTues | Saturday be continued on the weekly schedule. Penne ur Ty «Take a pill as soon as possible after it is missed © Ifpillis missed by 1 or 2 days but lesser than 7 days, normal schedule should continue and use a back-up method (e.9. Condoms) tll next period + Ifpill is missed by more than 7 days, discard the pill, use condom till next cycle and start the pack as a new beneficiaryLair eee e Cu Pee aeeden Gace harmful and reversible) + No hormonal effects * Delayed / Prolonged * No interference with sexual intercourse/ | Periods. pleasure. © Scanty Periods over time. * Can be adopted as postpartum (earlier than 4 weeks of delivery) or post- abortion contraception (within 7 days of completion of abortion) * Noeffect on quantity and quality of milk + Immediate return of fertility on discontinuation. * Prevents/ improves anaemia 2.5 Combined Oral Contraceptive Pills (Mala N) Combined oral contraceptive pills (COCs) are available in strip of 28 pills, (21 are hormonal (combination of Levonorgestrel (0.15mg) + Ethinyl estradiol (30 micrograms). The pill must be taken daily, without any break to avoid risk of pregnancy. Who cannot use COCs « Breastfeeding women <6 months postpartum * Non-breastfeeding <3 weeks postpartum. * Women who smoke >15 cigarettes/day and are more than equal to 35 years old, © Women with the following conditions: — Deep vein thrombosis — Heart disease, bleeding disorders e — Liver disease— Recurrent migraine headaches — Unexplained abnormal vaginal bleeding — Breast cancer — Currently taking anticonvulsants for epilepsy * With advice of clinician, in case of following conditions — Women with hypertension (BP 140/90) — Diabetes, (advanced or long standing), with vascular problems, or central nervous system, kidney, or visual disease De tue Tal Missed 1 or 2 pills Take one hormonal pill as soan as possible/ two pills at scheduled time. Missed 3 or more Is in 1s/2nd week Take one hormonal pill as soon as possible and continue scheduled pill Use back up method (condom) for next 7 days Missed 3 or more Take one hormonal pill as soon as possible and hormonal pills (Iron pills) Pe ae oF endometrial cancer. discontinuation. pills in 3rd week finish all hormonal pills as scheduled «Start new pack next day. # Use back up method (condom) for next 7 days Missed anynon- «Discard the missed non-hormonal pills) «Decrease in menstrual flow and cramps. |* Bleeding changes * Regulates menstrual cycle (irregular/scanty/no * Decreases ovarian cysts. bleeding/spotting). + Decrease benign breast iumps. © Nausea/vorniting/ © Protect against ovarian and headache. «Prevents ectopic pregnancy. © Immediate return of fertility on Continue taking COCs. Start new pack as usual. Effects of COC (non- Te Ter ci) * Weight changes/ Breast tenderness/Acne. Note: offer 10 choose another method if she v nat evercome the prablems,2.6 Condoms (Nirodh) It is a barrier method of contraception which prevents entry of sperms in genital tract. It is safe and suitable for couples of all age groups irrespective of the marital status. POW cu aed * Use a new condom each time. * Always check condom wrapper for any tear, holes or damage. If any, discard the condom. * Condom should be put on an erect penis only. * May tear or slip off if not used properly. * After use, always knot the condom and discard properly. XTreme Cay * Non-hormonal, free from side effects. * Only contraceptive that provides dual protection (from unwanted pregnancy and STI/ HIV infection). * No drug interactions. * Noeffect on quality and quantity of milk. * Can be used as soon as sexual activity resumes after delivery/abortion). * Nochange in fertility. * No requirement of follow up. 2.7 Sterilization Female Sterilization It is a permanent method of contraception which can be adopted once the couple's family is complete. Procedure involves ligation of both the fallopian tubes which can be done either through minilap procedure or laparoscopic procedure.Benefits of Female Sterilization © Safe, simple and highly effective method. Permanent and effective immediately. * No further contraceptive is required. * Nolongtterm side effects * Can be adopted concurrently with Delivery/Abortion or within 7 days. #_Noeffect on quality/ quantity of milk Follow Up + After 48 hours (first contact is established) + On the 7th day for stitch removal + After one month or first menstrual period, whichever is earlier. + Success of the procedure can be ascertained after first menstrual cycle The Sterilization Certificate can be collected after one month of the procedure from the health facility. Male Sterilization It is a permanent method of contraception which can be adopted once couple's family is complete. The procedure involves ligation of the vas deferens to prevent entry of sperms in the penis. CET Cure) rT MUR couts su) «Safe, simple and highly effective * Has no effect on Masculinity, method © Does not affect sexual © Nocut, no stiches required performance or drive. Acceptor can walk back after 30 * Does not cause weakness or minutes of the procedure. ability to perform day-to-day * Minimal/ no post-operative functions. complications or discomfort. * Does not cause lasting pain © Nolong+term side effects in back or abdomen.Follow up ~ * Client should report to the health facility for semen F S y| examination three months after the surgery, P (‘4 « It is important to use reliable contraceptive (J method till the success of the procedure can be ascertained. * Success of the procedure can be ascertained after semen examination only. The sterilization certificate can be collected after three months of the procedure from the health facility if the procedure is successful Key points to note (for female and male sterilization) * tis surgical procedure that has possibility of complications/ failure, requiring further management. © In unlikely event of complication/failure/death, there is redressal mechanism in form of indemnity cover. © Client must provide a written informed consent for the procedure. Reversal of procedure involves major surgery and success cannot be guaranteed Who can adopt sterilization in government health facilities? * Client should be ever-married + Age should be between 22-49 years (for females) and 22-60 years (males). * Should have at least one child who is above one year of age (unless medically indicated). + Client and their spouse/partner should not have undergone successful sterilization in the past. + Medical eligibility (to be ascertained by provider) Schemes under National Family Planning Program e 3.1 Home delivery of contraceptives by ASHA Under this scheme, ASHA delivers the contraceptives at the doorstep of the clients as per the need. The contraceptives include condoms (Nirodh’ @e° centchroman pills (Chaya), COCs (Mala-N) and emergency pills (Ezy Pill) The salient features of the scheme are as follows: « ASHAs would make a list of all the eligible couples of village and preferred method of contraceptive of each couple. This data of users should be updated regularly and shared with Sub center and PHC. * ASHA shall replenish her contraceptive stock every month from the sub center/ PHC/ block (as per the existing system established by the state). Monthly meetings could be one of the opportunities to receive contraceptive stocks every month. 3.2 Ensuring spacing at birth scheme Under this scheme, the ASHA would counsel the newly married couples to ensure HTSP and limit family size. For this, ASHA is given incentives as per following - * Rs, 500/- to ASHA for delaying the birth of first child for two years after marriage. * Rs, 500/- to ASHA for ensuring spacing of 3 years between Ist and 2nd child birth * Rs. 1000/- to ASHA in case the couple opts for permanent limiting method after 1 or 2 children. 3.3 Pregnancy Testing Kit (Nishchay Kit) Under this scheme, ASHA would regularly collect Nishchay kit from the sub center and provide it to women for detection of pregnancy, Salient features of the scheme are as follows * ASHA should inform the women about availability of Nishchay Kit with them, D ‘* ASHA should counsel women regarding advantages of early detection of pregnancy.* ASHA should provide the Nishchay kit to client for early detection of pregnancy and tell her how to use the Kit. She should also tell the client how to read the pregnancy test results. ASHA may help and conduct the test for clients who are not able to understand how to read the results ‘on their own. « ASHA should refer the client, as per client's need and pregnancy test results, 3.4 PPIUCD/ PAIUCD incentive scheme Under this scheme: * Rs. 300 is paid to the acceptor of PPIUCD/ PAIUCD to cover their transport and incidental costs. * Rs. 150 is paid to the service provider per insertion. © Rs. 150 is paid ASHA for motivating/escorting the client to health facility 3.5 Sterilization Compensation Scheme Under this scheme, the acceptor, motivator as well as the service provider are given compensation for sterilization adoption/ service provision as following}arse cecal TNS Others | Total Male Sterilization 2000 _|300 _|ao0_|2700 High focus states (OD. | Female Sterilization 1400 {200 |a00__| 2000 UK, HR, GJ) Postpartum Sterilization |2200 _|300 _|s00__|3000 Male Sterilization 3000 _|400__|600_| aa00 Mission Parivar Female Sterilization 2000 |300 {500 _| 2800 Vikas Postpartum Sterilization | 3000 400 600 | 4000 Other High | Male Sterilization moo {200 |} 200 __|1500 focus (SK, Ladakh, Female Sterilization 600 150 250 | 1000 JBI, HP) Male Sterilization (All) [1100 |200 {200 _| 1500 Non-High Focus Sa, Sterilization (BPLY | éoq iso |250 | 1000 States Female Sterilization (APL) | 250 iso |250_ | 650 ee Crees beetle Ys High focus | Male Sterilization 1000 2000 _| 3000 states (OD, UK, HR, Gu) | Female Sterilization 1000 2000 | 3000 Male Sterilization 1000 2500 _| 3500 Mission Parivar Female Sterilization 1000 2500 3500 Vike mes Postpartum Sterilization | 1000 3000 4000 Other High | Male Sterilization 200 | 1300 _| 1500 focus (SK, Ladakh Female Sterilization 150 1350, 1500 J&K, HP) Non High Male Sterilization (All) 200 1300 1500 focus Female Sterilization 150 | 1350 | 1500 states (BPL/SC/ST)3.6 FP-LMIS (Logistics Management Information System) Family Planning Logistics Management Information System (FP-LMIS) is a user-friendly web based, mobile app based, and SMS based application for strengthening the supply chain of FP commodities. It is a unified computerized application developed to monitor and manage the family planning commodities at all levels. The application calculates annual demand, enables online indenting, distribution & stock management and provides critical information on stock outs, over stock, expired and damage stock in the form of reports and graphs to decision makers to assist in monitoring of the family planning commodities supply chain system. Salient Features of FP-LMIS: * Web based, Mobile App based, and SMS based application. * Instant access to stock information from national level to ASHA level * Auto forecasting of contraceptives. * SMS alerts for key indicators. * Auto generated reports for program review.@ @ Role of CHO in providing reproductive health services @ The service delivery by CHO must be ensured at two levels: Community Level interventions | | Facility level intervention (at HWC-SC) 4.1 Community Level Interventions Community level interventions/ services are provided through frontline functionaries (ANM, ASHA) and to be supervised by CHO’ * Support the frontline functionaries in identifying the level of health facilities according to specific needs of the clients, * Counselling on importance of appropriate age of marriage, delaying conception after marriage, spacing and limiting methods « Ensure community- based distribution of contraceptives (including Combined oral contraceptive pills (Mala N), Condoms (Nirodh), Centchroman pills (Chhaya). * Ensure provision of emergency contraceptive pills (Ezy pill), if required. * Follow up with spacing contraceptive users for continuing use/switching to other methods. * Counselling and referral for adoption of long acting reversible contraceptive methods (like injectables and IUCD) and limiting FP methods. * Ensure distribution of Pregnancy Testing Kit (Nishchay Kit) for early detection of pregnancy and registration thereafter. * Counselling on adoption of post abortion contraception. * Counsel the women and family during ANC, early labour and PNC period on importance of healthy timing and spacing of birth and encourage her for adoption of postpartum contraception 4.2 Facility level Intervention (at HWC) Ahealth sub-center is the first and peripheral most point of contact between the primary health care system and the community. Service delivery at HWC must be provided through trained Community Health Officer.Update the eligible couple survey register by ASHA/ ANM. Ensure that eligible clients requiring limiting options are included in line listing by ASHA. Counsel the women on importance of healthy timing and spacing of birth and encourage her for adoption of postpartum contraception during ANC, early labour and PNC period. Provision of short acting methods- condoms, oral contraceptive pills (Mala N, Chhaya). Provision of emergency contraception, if required Install condom boxes at the health facility to promote condom uptake and encourage male participation in family planning. Provision of long acting reversible contraceptive methods- Injectable Contraceptives and interval IUCD. Provision for PPIUCD insertion if the facility is a delivery point. IUCD removal and its reporting (both interval and post pregnancy) Follow up, counselling, early management and referral (if required) for side effects of contraceptives, if any. Ensuring continuity of contraceptive method and record method switching, if any. Counselling and referral for adoption of limiting methods to couples whose family size is complete. Conduct primary screening for Sterilization at HWC, if warranted, Early detection of pregnancies through pregnancy testing kits (Nischay Kit) Place indents and issue stocks through FP-LMIS and update the stock position regularly. Counselling for adoption of post- abortion contraception. Support conduction of IEC/ BCC activities to promote awareness and demand generation (Wall paintings, Display of contraceptive options, folk plays, interpersonal communication etc.) Maintain proper records of services provided at the HWC and referrals. 4.3 Services at Referral Site The CHO is responsible for appropriate referrals to PHC/ CHC and follow up on treatment protocol suggested by Medical Officers/ Specialists. Provision of long acting reversible contraceptive methods- Injectable and IUCD (interval, postpartum and post-abortion IUCD)oe # IUCD removal and its reporting (for both interval and post pregnancy) * Provision of permanent sterilization services- male sterilization, female sterilization in interval, postpartum and post-abortion period (Minilap sterilization at PHC and above facility and Laparoscopic sterilization at CHC level or above facility and at PHC only in fixed day mode services). © Ensuring continuation of contraceptive method and record method switching, if any. Management of all complications attributable to contraceptive use, including those not managed at community/ HWC-SC level, if any. 4.4 Trainings of Community Health Officer on Family Planning The CHOs must undergo following trainings to provide contraceptive services and information at facility and community level Contraceptive | Days of | Reference Manual | Eligibility Ret} lucp Sdays [Reference Manual _| Ayurvedic doctor/ Nurse (GNM for UCD services | or BSc). Additionally, if CHO is SBA trained, he/she can provide PPIUCD services. Injectable | 1 days | Reference Manual _| Ayurvedic doctor/ Nurse (GNM MPA for Injectable MPA | or B.Sc) Oral Pills |i days _| Reference Ayurvedic doctor/ Nurse (GNM Manual for Oral or BSc)/ B.Sc Community Contraceptives Health Counselling |6days | Reference Manual _| Ayurvedic doctor/ Nurse (GNM Skills for Integrated or BSc)/ B.Sc Community RMNCAH+N Health Counseling FPLMIS 2days Reference Manual _ | Ayurvedic doctor/ Nurse (GNM or for FPLMIS B.SC)/ B.Sc Community Health