Professional business Speech

Final Report

Group members: Ashoni kumar Naresh kumar Rida pervez Noor-ul-hafin

Background--- Ashoni
HANDS is one of the Not for Profit organizations working in social sector to meet the challenges of 21st century. Its mission is to provide basic health services, primary education, income generation opportunities and development of institutions to empower the underprivileged communities. HANDS is benefiting more than 8 million population of 15000 villages in districts Matiari, Tando Mohammad Khan, Tando Allahyar, Hyderabad, Shikarpur, Sukkur, Dadu, Umerkot, Sanghar, Badin, Thatta, Shahdadkot, Ghotki, Karachi, Jacobabad, Khairpur, Kandhkot and Lasbela (Balochistan), Rahim Yar Khan (Punjab), Kashmir and Islamabad (liaison office) with 48 ongoing projects. HANDS is certified by Pakistan Center of Philanthropy (PCP) and Institutional Management Certification Program (IMCP) by USAID for management standards and registered with European Union. HANDS is also exempted for income tax by the concern authorities. HANDS evolved with three key programs that is Health Promotion, Education & Literacy Promotion and Poverty Alleviation. Several programs developed as cross cutting theme that is Gender and Development Monitoring, Evaluation and Research, Human Resource & Institution Development and Information & Communication Resource. HANDS policy making institution is executive committee, Chief Executive works as per guidance provided by them. Deputy Chief Executive and seven General Managers work under him. They lead different programs with the support of team. General Managers are based at head office Karachi. All General Managers provide facilitation in project strategic planning, development, trainings, monitoring & evaluation, human and financial resource mobilization to the district teams. The district teams are led by District Executive Managers. During 2007 2008 HANDS addressed all the eight Millennium Development Goals (MDGs) in intervention population. HANDS strived to achieve MDG1 to eradicate extreme poverty and hunger through its Poverty Alleviation and Health Advocacy Program. HANDS worked on MDG2 to achieve primary education through its Education and Literacy Promotion Program. We intervene on MDG3 to promote Gender equality and empower women through Gender and Development Program and education literacy promotion program. HANDS worked on MDG4 to reduce child mortality MDG5 to improve maternal health through health promotion program. We also worked on MDG6 to combat HIV/AIDS , Malaria and other diseases with health promotion program. HANDS also worked on MDG7 to ensure environmental sustainability through infrastructure development and Poverty Alleviation Program. We also worked on MDG8 to build global partnership through our Institutional Development , Information & Communication Resource Program and networking by other cross cutting programs. HANDS Human Resource & Institutional Development (HR & ID) Program offers specialized services to public and private partners in training need assessment, training design and curriculum development, Capacity Building of trainers, Development of training manuals, Training of trainers, Training appraisals & evaluations, Human Resource Management and Institutional Building. Considering the fact that HANDS is extensively involved in capacity building of public and private sectors

institutions there was a dire need of erecting an infrastructure as an institute. HANDS therefore purchased 6.63 acres land near the tool plaza on superhighway Karachi to Hyderabad which is literally at the gateway of Karachi to establish and develop Institute of Community Development (HANDS ICD). HANDS offers different training packages that is, 16 courses on Gender & Development, 14 on Health, 15 on education, 09 on Research, Monitoring & Evaluation, 06 in Information and communication resource, 08 in Poverty Alleviation, 06 in Resource mobilization and 10 in other subjects. While in 2007-08, 179 trainings were held for capacity building of 1395 staff members in various discipline of life. HANDS conducted 991 trainings for different organizations and communities and trained 12282 participants. HANDS Health Program offers several tested strategies like project designing and implementation. HANDS Health Promotion Program designed and implemented more than 26 projects with public and private institutions throughout Sindh. Three major research studies on reproductive health and family planning services were conducted. HANDS Health Promotion Program as a part of its professional development strategy developed the capacity of 1011 professional staff through 139 trainings of which 34 got diploma of 18 months in community midwifery and completed this program in 2008. One of the objectives of Health Program is to develop health education material for different behavioral change communication strategies in collaboration with Information and Communication Resource Program. HANDS Health Promotion Program has services as one of its strategies includes establishment of Community Midwifery Training Program. Two schools have been established one in Karachi and the other one in Hala, District Matiari. Both of these schools are attached with functional secondary care facilities so that Community Midwives (CMWs) get exposure to clinical practices and community at the same time. HANDS offers Primary Health Care Services like; immunization for women and children, Oral Re-hydration Therapy and Control of Diarrheal Diseases, Nutrition counseling, growth monitoring, treatment of minor illness, antenatal, postnatal, delivery services, treatment of Acute Respiratory Infection, referral services to secondary care facility. HANDS Health Promotion Program also developed public private partnership strategies like adopting a government health facility project. The process of adopting a government health facility starts with identification of partially/non functional govt. health facility and signing of MoU with the district government. Later HANDS forms Health Management Board, opens joint account and initiates user charges in consultation with district government. Community Midwifery Training school is also established in hospital premises and health management information system is established. There is significant decline in the MMR (Maternal Mortality Rate) in HANDS intervention areas where its trained Community Midwives provide health services. 86% women are delivered by skilled birth attendants as compare to national figures of 20% and antenatal coverage is 84% in HANDS intervention areas. HANDS Health program is running huge family planning intervention in all districts with the objective of increasing demand of family planning, repositioning birth spacing as a health intervention and to address the unmet needs by improving knowledge and access to quality family planning and birth spacing services in all the districts of HANDS intervention. HANDS also extended its partnership to implement these programs with Rural Support Program Network (RSPN) and their representative National Rural Support Program

(NRSP), Sindh Rural Support Organization (SRSO), Thardeep Rural Development Program (TRDP), Sindh Graduate Association (SGA) in districts Thatta, Sukkur, Umerkot and Sanghar respectively. HANDS Social Marketing plan is consumer focused. The project has trained community based workers in social marketing and has established supply chain mechanism. More than 400 providers are engaged with HANDS social marketing team. HANDS market products like safe delivery kit, contraceptives pills & condoms, emergency contraceptives, essential medicines, sanitary pads , oral rehydration salt etc. School Health Program methodology detects primary impairments of students, administer de-worming, develop health monitoring mechanism and establish referral for treatment of ailing students at secondary care health facility. HANDS Life Skill Based Education (LSBE) model starts with signing of MoU with the district government. Educators are identified from public sector high schools and are trained in life skill based education for onward training of Govt. High School Teachers. These teachers teach students LSBE in classes VI, VII, VIII, IX and X. HANDS has trained 8 Educators (Master Trainers) and 34 Govt. High Schools have adopted LSBE curriculum, 49 Govt. High School Teachers have been trained and have improved knowledge, positive attitudes and life skills of 2327 adolescents (students). HANDS Education and Literacy Promotion Program improves the literacy status of poor, marginalized children and adults through formal and non formal education both in private and public sectors through specialized strategies like research. HANDS Education and Literacy Promotion Program has conducted 6 different researches in intervention areas. One of the strategies of the program is project designing and implementation. The program has designed and implemented more than nine projects in different districts of Sindh. HANDS Education Promotion Program has published more than 17 publications. One of the strategies of HANDS education program is to develop capacity of educators. In this regard 51 trainings and 9102 on job sessions were conducted for 1065 Govt. staff, community teachers (male & female) and community members (males & female). To develop the capacity of Community Organizations (COs)/School Management Committees (SMCs) as well as community members, 56 trainings were conducted and 933 members were trained. HANDS organized 23 external and 49 internal trainings on different subjects for HANDS staff. 148 trainees were trained in external and 543 in internal trainings. All trainings were organized through need assessment of the individuals. HANDS Early Childhood Development (ECD) model incorporates and institutionalize a range of replicable supports for childrens overall development as confident, capable, creative and caring persons. This is an integral part of the education system and implements with the participation of the communities. The scope of the model is to ensure access to quality education and improve the quality of teaching/learning in government schools kachi classes and classes 1 and 2 with an emphasis on reaching girls and poor communities. HANDS literacy course is phonetic based and encompasses social issues focused to develop a functional literate. Program offers six months course to become literate. The literate later may join Family Reading Program (FRP) and help his / her illiterate family members to get literate. Periodical monitoring and

supervision is done by the field team. HANDS Poverty Alleviation Program (PAP) as a part of its strategy has designed and executed 16 projects in different districts of Sindh in partnership with public and private institutions. PAP works on professional development and provides opportunities staff to build their capacity in different walk of life. In this regard 31 trainings were conducted for HANDS staff in which 218 staff have been trained.17 of these trainings were conducted internally and 14 were organized by other public and private institutions. One of the approaches of HANDS to address poverty is to enhance income generation skills in men and women specially in youth. HANDS has established three technical training centers in Karachi Rural, Matiari, and Thatta. They offer training courses in garments cutting & stitching, and embroidery. During 2008, 108 rural community adolescents have been trained. The aim of this intervention is to improve socio-economic condition of under privileged communities specially mothers /caretakers with the provision of income generating opportunities through skill enhancement trainings and establishment of enterprises. HANDS encourages local indigenous home based skills of handicrafts through selection of potential women for skill trainings, they are called Sughar. The process involves many steps like; identification of local indigenous trade and analysis. HANDS has conducted more than 600 skills enhancement trainings for more than 5000 trainees. Another strategy of PAP is social mobilization for microfinance project (SMF). This project is working in six districts of Sindh that includes Hyderabad, Matiari, Thatta, Badin, Tando Allah Yar and Tando Muhammad Khan. HANDS has generated 20168 members in 2008 for micro-credit disbursement. The approach of SMF is to mobilize the poor to form community groups for micro credit, enhancing capacity of the credit group members for community mobilization, social awareness, selection and management of income generating activities. Develop skills and providing basic community management skills to credit group leaders. This methodology facilitates Loan Products like Agriculture Development Loan, Livestock Development Loan, and Working Capital Loan. HANDS has facilitated Khushhali Bank Ltd. and community groups to disburse Rs.164.09 million.

HANDS with the collaboration of partners and local communities constructed Community Physical Infrastructure (CPIs) in intervention areas like; 81 street pavement, 8 drinking water supply lines, 91 drinking water schemes, 31 rooms, 10 wash rooms, 193 color & painting of class rooms, 9 vocational centers, 7 culverts, 7 eidgah boundary walls, 4 libraries and 7 hand pumps. HANDS Information & Communication Resource Program (ICR) designated to communicate to the people and disseminate information of what we are working at HANDS in the sectors of health, education and poverty alleviation. The program works closely with all the programs and projects working under aegis of HANDS. ICR Program is a very diverse program of HANDS; at one end it deals with the publication and material

development and on the other hand it develops human resource and highlighting the issues of social development. ICR Program has published 66 publications in 2008. HANDS quarterly Newsletters in Urdu & English is a regular feature of the ICR Program which also brings out annual profile of HANDS. Material (brochures, leaflets, posters) published to highlight various issues and messages for community in Urdu, Sindhi and English. Program has trained more than 367 members of HANDS, NGOs and COs in Strategic Communication, Press Release, Report writing, Library Management, Case Studies, Designing & Publishing, Letter to Editor, Script writing. ICR Program conducted various researches in collaboration with MER Program and developed BCC strategies based on the finding of these researches. These BCC strategies were developed based on the approaches; Reproductive health,Family Planning, social marketing products, Maternal and child health, Releasing confidence and creativity, Social mobilization and micro finance, and Life skill based education. HANDS Gender And Development (GAD) Program serves to promote rights of women in all projects and interventions. The focus is to provide equal opportunities to women in every sector of development. HANDS GAD intervenes in 18 districts. The geographical reach is in 51 Taulkas, 323 Union Council, 14962 villages and 817,1915 populations. GAD program has benefitted 92401 members of 7731 community organizations, 260 village based women entrepreneurs (Sughars), 447 HANDS Technical Training Center (HTTC) trainees, 4574 school management committees members, 350 MARVI workers, 172 LHWs and 350 TBAs. GAD Program has conducted 4 different researches on different topics of women issues. This year GAD Program conducted different trainings for Communities, government and NGOs representatives. Hence, 9447 trainings were conducted in which 64672 participants were trained. Community organizations are integral part of HANDS in all community based interventions. HANDS social mobilization strategy starts with the mobilization of community and formation of smallest group on each 5 to 8 households called community/para rganizations. HANDS social mobilizers conduct mobilization meetings with community/para organizations. The members of community /para organizations nominate one of them as focal person to represent at Village Development Organizations (VDO). Each VDO comprises of 10 to 15 focal persons. VDO is considered as elected body of village and community / para organization of the village. After the formation of VDO the office bearers of VDO get trained by HANDS in different topics of social mobilization and organization management. Later they form a network at each union council level where chairperson of each VDO represents his /her village. GAD Program provides opportunity to HANDS staff as well to build their capacity, in this regard 31 trainings were conducted in which 218 staff members have been trained. In this year three exposure visits were organized and 37 staff members have been exposed to various skills and experiences in different institutions. More than 5 publications were developed by GAD Program HANDS is proud to possess a strong monitoring and evaluation system, which not only enables it to meet its program objectives successfully but also to ensure facilitation to other public and private institutions in the area of MER. Millennium Development Goals are addressed through different projects of the organization and the MER unit through the development of LFAs ensures the inclusion of monitoring indicators to assess the progress

and achievements of the projects against the MDGs. The indicators are set against the national targets and timelines to keep tracking of national development. HANDS MER Program has conducted 22 researches in different areas of Sindh for public and private institutions. HANDS MER program assess the need of target population and conduct baseline survey at the village level to identify areas through different qualitative and quantitative tools and techniques including PRA (Participatory Reflection Analysis) , social Mapping, well being, Focus Group Discussions (FGDs) and structured questionnaire. MER Program conducted different need assessment in different projects. Program Reviews were conducted to assess the progress against the targets identified in log frame through participatory approach, identify issues and challenges for achieving the targets and places recommendations for improving the performance till the project life. It is the responsibility of MER program to conduct evaluation of the ongoing programs of the organization to assess the progress and performance against the already set targets. HANDS several times hired by many public and private organizations to evaluate their programs. HANDS conducted an external evaluation of READ Foundation in Azad`Jammu & Kashmir. Evaluation checklist, questionnaire and guidelines were used for the assessment and review of existing status and progress of the organization and its intervention units in perspective of the mission of the organization. Monitoring and Evaluation (M&E) is necessary to measure the program performance and effectiveness. HANDS has well established Monitoring and Evaluation system, which supports all projects, programs and district offices in their data collection data management and information generation. In addition through the supportive supervisory mechanism at all program levels, keep the communication of information and feedback mechanism more effective. This information is used to review the progress, to take timely decisions regarding the modification in project implementation and future planning. HANDS achievements of last year has made it fastest growing Non Governmental Organization of the country. The horizontal and vertical expansion is evidence of HANDS quality of services.

Vision
Healthy, Educated, Prosperous Pakistan

MISSION
To provide basic health services, primary education, income generation opportunities and development of institutions to empower the underprivileged communities.

Objectives
To provide basic health services, primary education, income generation opportunities and development of institutions to empower the underprivileged communities. Objectives To improve the living status of poor specially women and children by sustainable, participatory and integrated development. To strengthen institutions / human resource in different sectors of life at all levels. To improve the health status of under privileged with special focus on women and children health. To increase literacy with especial focus on girls primary education. To increase income generation opportunities in rural communities. To initiate the process of development in other related sectors.

Functional Areas
1. Health== nooor
HANDS Health Program offers several tested strategies given below, which contribute in MDG 4 Reduce child mortality and MDG 5 to improve maternal health, MDG 6 to combat HIV/AIDS, malaria and other diseases (Hepatitis) in addition to other MDGs.

STRATEGY I: PROJECT DESIGNING AND IMPLEMENTATION

HANDS has designed and implemented following projects with different public and private organizations last year.

Strategy II: Research

HANDS Health Promotion program conducted many researches last year. Following are the key findings of few of these.
Key Findings of Marginalized Areas Reproductive Health Viable Initiatives (MARVI) Survey

Total maternal deaths are 51 during last two years, 70% occurred in lower income groups. Most of the women (62%) either did not receive any antenatal care or less than the recommended number of antenatal visits. 73% received care from private health care providers, only 22% women sought advice from some government health facility. Most of the respondents (70%) knew about at least one modern method of contraception.
Key Findings of School Health Survey

4484 children were found to have abnormal weight out of total 21247 screened children. 2808 girls were malnourished out of 14158 girls screened and 1676 boys out of total 7089 screened boys were malnourished. The frequency distribution of abnormalities showed highest incidence (43.1%) of Oral / Dental problem category among the total abnormalities. The frequency distribution of abnormalities in the screened school children in district Umerkot showed frequency of malnourishment as 55.8%, stunting 31.2%, Oral/Dental 40.2%, ENT 25.5%, Eye 27% and skin 36.1%. In district Thatta 2808 girls were malnourished out of 14158 girls screened and 1676 boys out of total 7089 screened boys were malnourished. The frequency distribution of abnormalities shows highest incidence (43.1%) of Oral / Dental problem category among the total abnormalities. The other category of abnormality of significance is malnutrition which is 39.8% and stunting (height for age) which showed and incidence of 31.2% among the total abnormalities. The remaining categories of problem are less than 10% of the total abnormalities in the district.
Key Findings of Sexual and Reproductive Health Services for Adolescents and Youth: Project Survey

Poor knowledge was found about reproductive health among health care providers particularly Traditional Birth Attendances and religious person. Weakness in education system, negative thinking, desire of getting married; Leucorrhoea in women were the SRH identified problems by them. Modern methods of FP were more prevalent compare to traditional methods. It was observed that respondents of all groups were familiar with Sexual diseases such as AIDS, Hepatitis, T.B. Besides that they also acknowledged cancer, secretion from vagina, swelling on womb, menses disorder.

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Strategy III: Capacity Development

The program offers several capacity development packages in addition to tailor made trainings. The program offered following trainings during last year.

Professional Development
Program developed the capacity of 654 professional staff through 94 trainings. The health program trained 352 staff through 45 internal training and 71 of them were trained through other NGOs /Public Sectors training institutes. The program has trained 231staff members of partner NGOs / Public Sector who received trainings from other training institutes.

Capacity building of Health Care Providers

HANDS Health Promotion Program in collaboration with Human Resource Program trained nearly

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357 health care providers in 45 trainings programs, 34 of them got diploma of 18 months in community midwifery.

Strategy IV: Services HANDS Community Midwifery Training School

To improve the safe motherhood status and to reduce maternal, infant and neonatal mortality and morbidity, HANDS started Community Midwifery Training Program in 2002 in two schools one in Karachi and the other one in Hala, District Matiari. Both of these schools are attached with functional secondary care facility so that CMW get exposed to clinical practices and community at the same time. These schools are recognized by Pakistan Nursing Council. HANDS is pioneer in the community midwifery training program in Pakistan. HANDS Health program has trained 183 community midwives 21% have been dropped out and 121 have passed out (66%). The trained community midwives later go back to their own villages and established primary health care centers and start midwifery practices. HANDS Health team facilitate them for next two years to establish rational and low cost practices.

Primary Health Care Program

Following services are available at the Primary Health Care Centers. Immunization for women and children, Oral Re-hydration Therapy and Control of Diarrheal Diseases, Nutrition counseling, growth monitoring, Treatment of minor illness, Antenatal, postnatal, delivery services, Treatment of Acute Respiratory Infection and Referral services to secondary care facility .

Adopt a Govt. Health Facility

HANDS adopted a government health facility project starts with identification of partially/non functional govt. health facility, signing of MoU with district government, formation of Health Management Board, opening of joint account, initiation of user charges, establishing Community Midwifery Training school in hospital premises, establishment of health management information system. HANDS in 1999 signed an agreement of partnership with District Council Karachi and made Jamkanda Hospital functional. Before this the health facility was not functional . Now this 20 bedded hospital is providing quality health services with special focus on mother and child health to about 2,00,000 population of 84 villages of Bin Qasim and Gadap towns. HANDS gradually expanded health services and presently this hospital is Providing secondary health care services to more than 300000 people of 70 villages of rural Karachi. 30 bedded hospital

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(CDG-HANDS Hospital) , 24 Hours Emergency, In & out patients dept., EOC (Emergency Obstetric Care), Operation Theatre, Ambulance, Laboratory, Blood Bank, Ultrasound, X-ray , Gyne Specialist , Vaccination and Family Spacing Services.

Reproductive Health Services

Health Promotion program has benefited nearly 6.4 million population and 55249 clients out of which 54% were female , 26% children and 20% were male. This year 84% antenatal coverage achieved in the target population as compare to 91% previously. Total No of delivery on records are 571 , 90% these were with normal birth weight. There is significant decline in the MMR (Maternal Mortality Rate) within HANDS intervention areas where its trained community midwives provide health services. 86% women are delivered by skilled birth attendants as compare to national figures of 20%. Antenatal coverage was 84% in 2006-07.

Family Planning
HANDS Health program is running a large family planning project in all districts with the objective of increasing demand of family planning repositioning birth spacing as a health intervention and to address the unmet need by improving knowledge and access to quality family planning and birth spacing services in all the districts of HANDS. All the concerned staff is trained in reproductive health and family planning. 5 consultation meetings were conducted in this year one at provincial level and five at district level. HANDS also extended its partnership with Rural Support Program Network (RSPN) and their representative National Rural Support Program (NRSP) , Sindh Rural Support Organization (SRSO), Thardeep Rural Development Program (TRDP), Sindh Graduate Association (SGA) in districts Thatta, Sukkur, Umerkot and Sanghar respectively.

Community Based Social Marketing

HANDS Social Marketing plan is consumer focused addressing the elements of "marketing mix. "Four Ps" of marketing concept is adopted Product, Price, distribution (Place), and Promotion. HANDS trained community based workers and then established supply chain mechanism. more than 400 providers are engaged with HANDS social marketing team. HANDS market product like safe delivery kit, contraceptives pills & condoms, emergency contraceptives, essential medicine, sanitary pads, oral rehydration salts.

School Health Program

School Health Program objective is to detect primary impairments of children at school, conduct

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de-worming at schools, develop health monitoring mechanism, establish referral and treatment through secondary care health facility. The initial assessment results show that children are having problems of vision error, hearing problems, dental caries, throat and skin infections like scabies. To detect impairments 63 doctors and LHVs were trained .Health screening of 42310 children from 577 schools of Umerkot and Thatta were carried out for height, weight, ENT examination, oral and dental examination, skin examination, deworming children. 56 trainings of 933 teachers & SMC members in child health and development, corporal punishment, breast feeding, Expended Program on Immunization (EPI), maternal health, nutrition personal hygiene were held. 800 follow-up sessions with mothers on health & hygiene were organized by SMCs and teachers.

2. Education & Literacy== rida

HANDS Education and Literacy Promotion Program (HELP) works on several strategies and ensures provision of different services to address MDG1 i.e. to eradicate extreme poverty and hunger, MDG2 to achieve universal primary education and MDG 3 to promote gender equality and empower women. HANDS Education and Literacy Promotion Program improves the literacy status of poor, marginalized children and adults through formal and non formal education both in private and public sectors through following specialized strategies.

Strategy I: Research
HANDS Education Program carried out following researches during this period. Training Need Assessment of nearly 1200 teachers Participatory Reflection Assessment (PRA) in 30 villages to assess the needs of communities 23 new schools screened for interventionBaseline Survey for RCC Phase III School was conducted in 99 schools for District Matiari and Hyderabad. Data was collected from 46 schools of Phase I & II and 53 schools from phase III. Internal Evaluation of RCC Project was also conducted. The data collected by HANDS-ME&R department through monthly monitoring, clearly shows that enrollment rate is increasing while dropout rate is decreasing during the academic years 2004-05 to 2007-08.

Strategy II: Project Designing and Implementation

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HANDS Education and Literacy Promotion Program designed and implemented following projects for different public and private organizations

Strategy III: Capacity Development

HANDS education team has conducted a series of trainings to improve the quality of teaching and learning at school and community. In this connection 51 trainings and 9102 on job sessions were conducted for 1246 govt staff , community, teachers (male & female). To develop the capacity of COs/SMCs as well as community members, 56 trainings were conducted and 933 members were trained. In this regard 23 external and 49 internal trainings were organized/conducted by HANDS education team on different subjects and topics, all trainings were organized/ conducted through need assessment of the individuals. Total participants were 148 in external and 543 in the internal trainings. Training Packages offered by HANDS Institute of Community Development

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Strategy V: Services Early Childhood Development

HANDS ECD Model Incorporate and institutionalize a range of replicable supports for childrens overall development as confident, capable, creative and caring people as an integral part of the education system and of the way communities operates. The scope of the model is to expend the access and improve the quality of teaching / learning in kachi classes and classes 1 and 2. (with an emphasis on reaching girls and poor communities). The ECD Model develops a range of approaches which assist families and communities to increase their knowledge and skills, and their confidence in their abilities to support their childrens development. It builds the capacity and commitment of key stakeholders at different levels, particularly within the education system. It also Influences ECD policy and practice and strengthen ECD learning networks.

Literacy
HANDS literacy team conduct situation analysis of literacy status of community in the target villages. Thereafter social mobilization strategies are developed and implement. A final selection of School Management Committees (SMCs) members takes place. SMCs members training is conducted in monitoring and supervision. Later school management committee and HANDS

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literacy team recruit the community teachers for adult literacy program. Community teachers trainings is organized and after training these teacher established adult literacy centers. Adult Literacy centers established. The course is phonetic based and encompass social issues focused to develop a functional literate. Program offers six months course to become a literate. The literate later may join family reading program (FRP) and help his / her illiterate family members to get literate. Periodical monitoring and supervision is done by the field team.

Primary Education
HANDS education model is for the population, where no government school is available and the community is keen to run their own school. HANDS model school starts with pre-primary class that focuses Early Childhood Development. A monitory assistance in the form of subsidy is offered to the school for acquiring school equipment / materials and to pay teachers salaries etc. It covers maximum four years and is paid to each qualified school on a decreasing basis. At the end of four years the school is expected to be able to operate itself. The subsidy is divided in facilities and material, enrolment subsidy, attendance bonus and its effective use is monitored. In poor communities HANDS offers school feeding program to improve the health of the children.

Adopt a Government Primary School

This program is for the population, where government school is available but lacking in infrastructure and quality education. HANDS signs MoU with District Govt. / Education department before intervening in partially/non-functional schools. HANDS improves quality of education through teachers training. HANDS model school starts with pre-primary class that focuses Early Childhood Development. In poor communities HANDS offers school feeding program to improve the health of the children.

Outcomes of the program

The program has enrolled 58,604 students in primary and higher secondary schools in the reporting period. Program trained 1246 government and community teachers on provision of quality education, meanwhile 7387 adolescents improved their communication skills in intervention areas through planned and vigorous efforts of the education team. The infrastructure of 289 primary schools has developed to provide quality education enviroment, thereby the enrollment of 732 primary and higher secondary schools has improved significantly and teachers and students attendance has also improved. HANDS visible efforts and trainings of SMC members convinced them to visit schools, hence 4574 SMC members paid regular visits of schools. 690 education staff trained on multiple professional development packages. HANDS education team developed technical competencies for ECD in government officials during the reporting period. HANDS

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strengthened the ECD components of the program and the district government education department to provide quality education.

3. Gender Development== Rida

Gender And Development (GAD) Program of HANDS developed different strategies to contribute and achieve Millennium Development Goals MDG1 to eradicate extreme poverty and hunger, MDG3 to promote gender equality and empower women, & MDG7 to ensure environmental sustainability. HANDS GAD is a cross cutting program of the organization. It implements gender policies and monitors it in all the projects and the programs of the organization operational in 17 districts of Sindh. HANDS GAD program has benefitted 92401 members of 7731 community organizations, 260 village based women entrepreneurs (Sughars), 447 HANDS Technical Training Center (HTTC) trainees, 4574 school management committees members, 350 MARVI workers, 172 LHWs and 350 TBAs. HANDS Gender and Development Program designed and executed different strategies in following projects.

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Strategy I: Capacity Building

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Strategy II: Research

Following researches conducted on gender perspective.
Key Findings of baseline survey of Marginalized Areas RH and FP Viable Initiatives (MARVI) project.

78% of the women have been married before 20 years of age, early marriage trend is still prevalent. Nearly 90% of the women in age groups of more than 40 had 5 or more children. 52% of the husbands are literate as compared to 14% of women.
HANDS School Health Screening Survey

The survey found a number of boys stunted among the screened children, 1293 out of total 7089 boys in the sample. Similarly 2223 girls were stunted among the total 14158 girls screened for abnormalities.
Findings Post project evaluation report of Pakistan Initiative for Neonate and Mother (PAIMAN)

The study revealed that 13% of the respondents that is women of reproductive age (15-45) were literate, 13% attended school and only 1% women were matric or above. The husbands literacy level (44%) was better, only 15% husbands had passed matric. That many of the women 63% are involved in income generation and almost all of them contributed their income in daily household expenses. Nearly 23% are involved in agriculture related labour and 20% in stitching or embroidery work.
Violence against women

HANDS also facilitated Aga Khan University in conduction of community based study on women violence.

Strategy III: Training

GAD program provides the opportunity to staff as well to build their capacity. In this connection 31 trainings were conducted for HANDS staff in which 218 staff members have been trained. In this year total 3 exposure visit were organized for staff of different institutions, 37 staff have been exposed. GAD program has strengthened 7731 community organizations and groups in previous year and built the capacity of 92401 members of communities. The graph shows HANDS working with community organizations /groups. There were total 7731 community organizations established and strengthened during reporting period.

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Strategy IV: Services

Community organizations are integral part of HANDS in all community based interventions. HANDS social mobilization strategy starts from the mobilization of smallest group formation on each 5 to 8 households get trained by HANDS GAD Program in different topics of social Following are the different models of mobilization events the GAD program use for community mobilization. 1. Service Introduction (Taarufi Program) 2. Formation & Strengthening of Community Organizations (Tanzeem ki Tarbiat - Rehnuma) 3. Awareness Raising Session (Shaoori Nashast) With Men & Women 4. Interactive Theatre (Bedari Natak) 5. Women Support Group (Madadgar Sahelyan) 6. Life Skill Base Education (Nojawano me zindagi ki maharaten) 7. Special Event (Khasoosi Sargarmi)

Strategy V: Women Empowerment

HANDS Gender and Development Program serves to promote all above rights of women and all projects interventions are women focused and provide equal opportunities to women in every sector of development. Following are the contribution of GAD program to promote socioeconomic status of rural women. HANDS has established 2280 women community organizations, in which 28850 women are members. 2792 community women got loan for small enterprises, livestock and agriculture. 400 Marvi workers received loan to continue family planning services. 334 community women received training in embroidery and stitching. 659 community women got jobs at their door step through HANDS as HANDS community based staff. 1065 teachers trained in record keeping, quality assessment & class room management 3063 women members of COs trained through HANDS capacity building training module. 9120 training sessions conducted in different districts of Sindh with women organizations/groups in which 63840 women trained. International Women day celebrated with the support of Karachi based NGOs. International Women day was celebrated at district office Hyderabad.

4. Disaster Management Program==naresh

HANDS is one of the largest not for profit organization of country and having strong roots and work in all districts of Sindh & Baluchistan. HANDS working in Karachi Rural, Thatta, Badin, Matiari, Hyderabad, Dadu, Jacobabad, Sukkur, Umerkot, Shikarpur, Shahdadkot, Ghotki, Larkana,

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Kashmore, Jaferabad and Quetta since many years and has its regional offices at all places. HANDS has more than 1000 staff and about 100,000 volunteers available. HANDS has extensive experience of working for emergency response in many times in history like Badin Cyclone, Kashmeer earthquake, floods in many districts of Sindh etc. Like its previous extensive experience to work in emergency response and relief, HANDS also mobilized its all possible resources, HR, Financial resources, to help communities of these areas at this very hard time

Goal and Objectives:

The goal of HANDS response is to meet the immediate relief needs of women, men, boys and girls affected by any natural or human made disaster and to support target communities in recovering from the impact of the disaster over the short, medium and long term.

Key Interventions:
Key sector

Phase I Emergency Relief Activities Coordinating MET, NDMA, PDMA & other govt & private organizations for latest updates Dissemination of disaster updates with communities through regional offices of HANDS Establishing Relief Camps at safer places Evacuation of danger places and shifting people to safe places in relief camps Distribution of clean water Restoration of water supply systems (immediate repair, fuel, cleaning, etc.) Construction of Pit latrines, hand pumps etc Distribution of water purification supplies Restoration of sanitation facilities (cleaning of latrines, etc.) and hygiene promotion Distribution of water storage containers and hygiene materials Arranging medical camps, necessary medicines, mobile clinics, referrals etc Establishment of Diarrhea Treatment Centers (DTCs), EMoNC centers, secondary care temporary hospitals etc Developing & dissemination of health education, hygiene promotion material and conducting sessions

Evacuation from danger places

Water supply, sanitation and hygiene

Medical services

Establishing ORS corners in relief camps

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Distribution of temporary shelter materials (including plastic sheeting, tents) Support for mobilization of community base organizations (CBOs) in displaced persons centers to organize and improve shelter conditions Distribution of family household kits including basic items such as cooking utensils, soap, sanitary products for women, etc.

Emergency family Shelter and household recovery

Distribution of food, ration etc Distribution of Food & Nutrition supplements Support for recovery of food production, seeds, tools, cleaning of land, etc. Alternative livelihood recovery The response will pay particular attention to assessing and responding to the needs of women and children, particularly on protection issues arising from the disaster The response will also take a disaster risk reduction approach, considering in particular the environmental impacts of the disaster

Recovery of food security

Cross-cutting issues

Phase II and Phase III interventions to be developed based on further assessment and sound analysis of appropriate disaster relief and recovery measures and strategies. Immediate Actions & Resource Mobilization 1. Immediately mobilizing all possible HANDS available resources which are more than 1000 paid field base employees including medical staff of more than 100 persons and 10,000 volunteers, 50 vehicles and finances to affected areas 2. SoS appeal to all NGOs, donor agencies, public sector for their immediate support 3. Mobilizing HANDS executive committee for generating philanthropy support from national & international business communities as usual 4. Coordinating with District, Provincial & Federal Governments, NDMA, PDMA & other small NGOs, CBOs, 5. Mobilizing all Regional offices of HANDS for collecting cloths, food items, medicines, cash & kind from all areas of county.

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5. Monitoring,Evaluation & Research== naresh

HANDS is proud to possess a strong monitoring and evaluation system, which not only enables it to meet its program objectives successfully but also to ensure facilitation to other public and private institutions in the area of MER. Millennium Development Goals are addressed through different projects of the organization and the MER unit through the development of LFAs. It ensures the inclusion of monitoring indicators to assess the progress and achievements of the projects against the MDGs. The indicators are set against the national targets and timelines to keep track of national development. Following are the key researches carried out by ME&R Program during last year for public and private institutions.

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Strategies of MER Program

Major Step of Monitoring & Evaluation strategy

Development of M&E strategy Document The strategy document defines the steps and procedures that will ensure the smooth implementation of the project and its targets achievement.

Strategy I: Development of Logical Framework

The development of Logical Framework Analysis (LFA) is critical for monitoring and evaluation of any project. The document of LFA defines the hierarchy of objectives for every project and is critical for setting up of benchmarks for the target achievements.

Strategy II: Development of Management information System

To measure the program performance and effectiveness, management information systems are developed including tools of monitoring and evaluation.

Defining Level of Monitoring and Reporting

Different levels of data collection are defined for the projects for generating reports for the project/programs. The data from intervention level is collected and recorded at the regional/project office and from there monthly, quarterly, annual and completion reports for the projects are generated as per requirement.

Strategy III: Research Major steps of Research Strategy Screening

Screening is conducted for identification of target population with selection criteria defined specifically for individual projects depending on the interventions.

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Situation Analysis/ Baseline

This activity is conducted to analyze the existing situation thus it could also be the situation analysis. The situation analysis helps in setting up the bench marks for the progress and achievements of any project/ program.

Midterm Evaluations
This is a research activity which facilitates the monitoring and evaluation activities of any project/program. Quarterly monitoring and Mid-Term Review (MTR) facilitate the identification of shortcomings to be addressed and benefits to be expanded upon in the project.

End Project Evaluations

Post-project or end project evaluations are conducted. The reports of the evaluation include results to date, as reflected by the measurement of targets, lessons-learnt and an overview of program issues. The findings of the report are shared with stakeholders at the national and district level through workshops. HANDS MER program assess the need of target population and conduct baseline survey at the village level to identify areas through different qualitative and quantitative tools and techniques including PRA (Participatory Reflection Analysis) , social Mapping, well being, FGDs and structured questionnaire. MER Program conducted different need assessment in following projects.

School Health Screening Project

HANDS launched school health screening project in four talukas of District Thatta and Umerkot. UNICEF provided the financial support for this project to intervene in 240 Govt. Girls and Boys Primary Schools . Cross sectional survey was conducted to examine the general physical examination of children of 42310 students of 568 School of both districts.

Baseline Survey of MARVI Project

The Baseline Survey of Marginalized Areas RH and FP Viable Initiatives (MARVI) Project was conducted to assess the knowledge, attitude and practices on RH-FP, to identify the accessibility of RH-FP services & products and to determine the quality of RHFP services and availability of private and public sector facilities in the District. The sampling design adopted for the survey is a stratified systematic sample of households. Each union council was divided in to 30 clusters based

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on non-LHW areas. Each cluster comprised of 60-70 households. 5670 Households were surveyed for currently married women of reproductive age (15 49 years) who have ess than 2 years of age. Total 12 FGDs conducted including 06 each with married men women of reproductive age. Total 180 Client Exit Interviews were conducted of 36 government & private health facilities in rural, urban, semi urban and remote areas. Digital Mapping of all health facilities of the district was conducted with Geographical Information System (GIS) software by the Population Council Islamabad. The project is funded by David and Lucile Packard Foundation.

Key findings of MARVI Survey

78% of the women have been married before 20 years of age early marriage trend is still prevalent. Nearly 90% of the women in age groups of more than 40 had 5 or more children 52% of the husbands are literate as compared to 14% of women. Mean family size is 6.6 (2.87)

Sexual and Reproductive Health Services for Adolescents and Youth

A qualitative research study for action research was conducted in Union Councils Makhdoom Bilawal and Khudadad in District Dadu. The purpose of the study was to assess the knowledge, perceptions, practices among adolescents and health care providers. Total 12 Focus Group Discussions, 18 In-depth Interviews from male and female adolescents groups and 12 Key Informants Interview from health care providers were conducted in rural areas.

Key findings of Youth Survey

It was found that majority had more knowledge about physical changes than psychological

changes. TV, friends, relatives and friends are to be the main source of information regarding sexual and reproductive changes.

Baseline Survey of Releasing Confidence & Creativity (RCC) Project

Baseline Survey for RCC Phase III school was conducted in 99 schools for District Matiari and Hyderabad. Data was collected from 46 schools of Phase I & II and 53 schools from Phase III.

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Some (62) of schools are for girls only, 36 are for boys only and one school is mix school.

Other Achievements
Following activities were also carried out by MER program against the strategy of need assessment and baseline survey. 1. Child Tracking Study conducted for 1232 children of ECD classes of RCC project in 50 School of 03 clusters. 2. PRA conducted in 31 villages in RCC project. 3. Focus Group Discussion conducted with the teachers for the training need assessment in RCC project. 4. 76 Focus Groups Discussions conducted in Sindh Coastal Area Development Project (SCAD) funded by Pakistan Poverty Alleviation Fund (PPAF). 5. House to House survey of 2 villages conducted for Primary Health Care Exposure of CMWs.

Strategy IV: Periodical Reviews

Program Reviews were conducted to assess the progress made against the targets identified in log frame through participatory approach, identify issues and challenges for achieving the targets and place recommendations for improving the performance till the project life.

Strategy V: Internal Evaluations

It is the responsibility of MER program to conduct evaluation of the program and program within the organization to assess the progress and performance against the target. Findings of Internal evaluation of RCC Project Descriptive cross-sectional survey to compare the available baseline information with the project evaluation was conducted after completion of 2nd phase of RCC project. The target areas of the study were the 50 Govt. Girls/Boys Primary School of District Matiari and Hyderabad.

Strategy VI: External Evaluations

HANDS services were hired many times by many public and private organizations to evaluate their programs.
External evaluation of READ Foundation

HANDS conducted an external evaluation of READ Foundation in Azad Jammu & Kashmir.

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Evaluation checklist, questionnaire and guidelines were used for the assessment and review of existing status and progress of the organization and its intervention units in perspective of the mission of the organization.

Strategy VII: Post Project Evaluations

MER compared actual project impacts against the agreed strategic plans to assess the performance of the project and conduct post project evaluation at the end of the project. PAIMAN (Pakistan Initiative for Mothers And Neonates) was a project initiated by USAID & JSI, formally launched from July 2006 in Pakistan. HANDS conducted a Post Project Evaluation on completion of project. Descriptive cross sectional study was conducted to evaluate the project intervention. Qualitative and quantitative methods were used to collect the data and information. The result depicted that most of the communities consulted trained TBAs for the deliveries and preferred them for conduction of deliveries and post natal care. The other most likely possibility is that TBAs behaviors and practices had substantially improved after training and by continuous monitoring and supervision. The assessment of BHU Wahi Pandhi services revealed that the utilization of the BHU for antenatal registration and care, for deliveries and visits for immunization have markedly increased. The referrals from LHWs also contributed in increased utilization rate of the services at BHU Wahi Pandhi.

Strategy VIII: Capacity Building

MER Program is focusing on human resource development of organizations and individuals for enhancing the organizational capacity and offered many training packages related to monitoring, evaluation and research in partnership with Human Resource and Institutional Development program of HANDS.

6. Information & Communication=naresh

HANDS Information & Communication Resource Program was established in 1997 to communicate with the people through its publications, media and website. It disseminates the information of HANDS different activities in sectors HANDS is working. The program works as cross cutting theme and intervenes in all the programs and projects wherever it is required.

ICR Program contributes to MDGs

HANDS ICR Program is committed to achieve the MDGs as the organizations agenda for development as well as reducing the burden of poverty and disease. HANDS ICR Program is

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addressing the seven of eight goals through its various interventions in HANDS focus geographical areas of Sindh. The interventions outlined are Publication, Websitepublishing relevant material, Case studies, Articles, Videos, Training, Resource material, Networking.

Scope of work
The work scope of the program is described below. ICR Program is working in different dimension to carry out its activities and accomplishing innumerate assignments spreading from print to electronic media, video documentary to web designing, library to material dissemination and publication to Designing of behavioral change communication strategy. 1. Need assessment/ research as per organization requirement 2. Designing of behavioral change communication and advocacy strategy 3. Publishing 4. Desktop Publishing 5. Transcription and composing in English & Pakistani languages 6. Case studies / Story / article / script / material development & editing. 7. Web Designing / Development 8. Capacity Development Training in information and communication 9. Dissemination 10. Resource material

Strategy I: Behavior Change Communication

HANDS has developed BCC of the following projects: 1. School Health Screening (SHS) Project 2. Marginalized Areas RH and FP Viable Initiatives (MARVI Project) 3. Releasing Confidence and Creativity (RCC Project) on early childhood 4. e-Health Line

Strategy II: Research

ICR has conducted many researches with the facilitation of ME&R Program to formulate BCC strategy of the following projects.

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Communication & Dissemination

Total 77 coverage of various HANDS Programs were made on different TV channels while 161 press coverage were made in various Urdu, English and Sindhi newspapers to highlight HANDS different activities. 65 articles were published in different newspapers and magazines. Sectoral Distribution of Articles Out of 65 articles 30 articles were written on health issues, 19 on education issues and remaining on other issues. However the focus has been on women and girls issues in either of the sector.

Strategy III: Trainings

Capacity Development Packages The program offers following capacity development packages to all NGOs, government officials and individuals. Strategic Communication Press Release Report writing Library Management Case Studies Designing & Publishing Letter to Editor Web Development Script writing Video Documentary Story writing

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Strategy V: Networking
ICR Program has developed a global network through its website and smart chart communication network. HANDS launched its new website with additional features like; job opportunities, mail box (web mail), publication, search, comments etc. besides update information about HANDS various programs and projects running in Sindh.

Salient features
Publications

Program Reports HANDS Webmail link Audit Report News box Job Current & Past project Pictorials

Material Published
5 publications of HANDS Last three years audit reports 11 health brochures 1 brochure on micro finance 6 publications of education

Smart Chart Asia Network

Smart Chart Asia Network is a network developed by 7 NGOs of Pakistan, 7 NGOs of India, 7 NGOs of Philippines and 2 organizations of USA. The objective of the network is to bring close together all the Packard Foundation grantees in Pakistan, India and Philippines to share their material, campaigns based on smart chart tool of communication.

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7. Poverty Alleviation=== noor

HANDS Poverty Alleviation Program (PAP) was initiated to integrate community development approach, supporting and strengthening of income generation, livelihood & skills development opportunities for women & men of under privileged communities. HANDS Poverty Alleviation Program (PAP) contributed in MDG1 that is "eradicate extreme poverty and hunger". The PAP is striving to reduce by half the proportion of people living on less than a dollar a day, to achieve full and productive employment and decent work for all, including women and young people.

STRATEGY I: Project Designing and Implementation

PAP has designed and executed following projects in the reporting year to achieve focused MDG

sTRATEGY II: Research

Key findings of MISALI Project To assess the socio-economic status of the households, the respondents were asked about the number of residents/household, number of rooms/household and type of the latrine used by the residents. Average number of residents/household was 7.0 + 3.9. The number of residents in each household varied from 1-31. Moreover, each household head was asked about the number of residents aged <18 and > 65 years to assess the proportion of dependency. Nearly 33% of the

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household had 3-6 persons in that age group. To assess the literacy status of the household members, questions were asked about the educational attainment of head of the household and about the number of children aged 5-16 years going to school. As describe in Figure 1.4.1, almost half of the head of the households had never attended school ever. A little over one quarter reported to complete class 1-5. Respondents were asked for the availability of household items, which indirectly reflect the socioeconomic status of the individual households. The items assessed for the purpose were electronic items (refrigerator, washing machine, deep freezer, Television, air conditioner, air cooler, geyser, heater, cooking range, microwave oven), availability of engine vehicle for transportation, availability of any animals and owing of any land. Nearly 40% of the respondents reported to own a land. Almost 75% owned a motor cycle or a scooter. Almost half of the respondent had at least a live stock.

Key findings of baseline survey of Rais Noor Muhammad MISALI Village Karachi Out of 356 male members, 196 were more than 12 years of age. The most common occupation taken up by these males was picking from garbage (44 percent). Out of 160 5-12 years of aged, about two fifth belonged of the working group of males. Similarly, females were also more frequently involved in the same profession of picking items from garbage. Out 160 girls of 512years of age, nearly half (46 percent) were in the working group. On the other hand, considerably higher proportion of females were also involved in household work, probably they were working as cleaners or maids in some households of upper socio-economic class. Average number of residents/household was 5.08. Moreover, each household head was asked about the number of residents aged <18 and > 65 years to assess the proportion of dependency. 46% household had 3 or more persons in that age group. The type of latrine used, 38% respondents reported that they had no latrine while 62% houses had Pit Latrine.

STRATEGY III: Capacity Building

PAP provides opportunity to HANDS staff to build their capacity. In this regard total 13 trainings were conducted in which 39 staff members were trained. 23 of these were conducted internally and 16 organized by other public and private institutions. In this year total 4 exposure visits were organized for the staff of different institutions and 13 staffs were exposed to various skills and knowledge.

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Community Trainings:
Hunermand Trainings Centre offered 3 month diploma courses on following trades.

Embroidery Domestic electrician Cutting & Stitching Mobile phone repairing Motor winding UPS maintenance over lock Flat Lock Single Stitch Pattern making & Cutting TV Repair & Maintenance

Strategy IV: Income Generation

HANDS in collaboration with Khushhali Bank Ltd is implementing the SMF Project in 7 districts of Sindh, including Hyderabad,Matiria, Thatta, Badin, Tando Muhammad Khan, Tando Allah Yar and Khairpur Total 30091 members were generated for micro-credit disbursement in the reporting period. The approach of SMF is to mobilize the poor to form community groups, enhance capacity of the credit group members for community mobilization, social awareness, selection and management of income generating activities, develop skills and provide basic community skills to credit group leaders. The approach is to facilitate the group to receive loan products like Agriculture Development, Livestock Development and working capital. HANDS have facilitated Khushhali Bank Ltd and community groups to disburser Rs. 271046850 since 2003. The Community Physical Infrastructure (CPI) component provided grants to the community on cost sharing basis for small-scale infrastructure projects through Partner Organizations who meet the eligible criteria. Partner Organization assist, communities in organizing, preparing, and implementing and managing these projects. The average size of a community physical infrastructure project is approximately Rs. 100,000-500,0000. The target population of the CPI component is poor and disadvantaged rural and urban communities especially women, under-served districts and communities that lack essential infrastructure and have high unemployment.

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HANDS CPI project is implementing in 57 villages of Sindh, we are identifying the need of the community through CPI project, give them better option for better livelihood. Provision of CPI schemes is actually the provision of access of community to their basics facilities, like street pavement, water and sanitation schemes, energy efficient stoves, Bio sand filters, hand pumps, protection walls, forms, solars and jetty. HANDS has completed following CPIs during reporting period.

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Organizational Structure== noor

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Sponser of Hands==noor

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