2. 1.Community Health Workers (MARVI): 447 MARVIs were trained in 06 districts of Sindh which included 350 in Umerkot, 25 in Thatta, 25 in Badin, 25 in Karachi Rural, 11 in Jamshoro, 10 in Jacobabad and 1 in Sanghar. The assessment of MARVI workers showed that: 83 % of MARVI Workers know the recommended number of 04 antenatal checkups. 100% MARVI workers know recommended number of 02 postnatal checkups. 51% MARVI workers have knowledge of at least 4 danger signs of antenatal, natal and postnatal period. Health Promotion Program

4. 87% of the MARVI workers were able to identify the three delays. 83% could identify the first delay, 93% identified second delay and 83.3% identified the third delay. 100% MARVI workers have knowledge about Family Planning methods 70% able to generate some profit. Average income of MARVI's from the sale of RH-FP products,Rupees 1700 per-month. MARVI workers referred nearly 54255 women, 8594 children with complications to secondary care facilities and saved their lives. Health Promotion Program

5. 2. Rehabilitation of Disables: 4147 assistive devices were provided to the PWDs in 03 Union Councils i.e. Ibrahim Hyderi, Rehri and Landhi of Karachi Rural. Orthotic and prosthesis devices were provided to 395 PWDs, this included hearing aids to 876, vision glasses to 1073, wheel chairs to 159, crutches (Besakhee) to 50, walkers to 36, white canes to 19, toilet seats to 167, Cerebral Palsy (CP) Chairs for 26 Children and tricycles to 25 PWDs. Overall 2891 PWDs were provided support through this service model. Health Promotion Program

7. 119 family members of the bedridden Person with Disabilities (PWD's) were trained for attendant ship 150 teachers of Bin Qasim town trained on inclusive education. 83 PWDs were trained and supported to establish their enterprise. 77 Awareness raising sessions were attended by 64354 PWDs and their family members on genetically transmitted disease, family marriages, health and hygiene, reproductive health, care during pregnancy, vaccination, family planning and breast- feeding etc. Health Promotion Program

8. 3. Output Based Aid (OBA) voucher scheme (NARI): 09 public and private secondary health care facilities were identified/strengthened for EmONC services. Identification of 1000 high risk pregnancies Conduction of 740 complicated deliveries including caesarian sections 168 neonates of complicated pregnancies were managed during the year and overall 1003 neonates were managed Reimbursement of Rs. 14,780,000 was made for overall 1830 women and 168 neonates in last year During the year 2011-2012, 590 referral forms were distributed and overall 2643 NARI referral forms were distributed.

9. Health Promotion Program

10. 3244 NARI Referral Forms (Output Based Aid Voucher) and thousands of posters and brochures were printed and distributed. 894 counseling sessions on Safe motherhood were conducted. 1333 antenatal checkups and 488 postnatal checkups were conducted. 848 women were provided transportation services for referral. FM Radio message developed and relayed to introduce NARI referral voucher (no. of time as per agreement with local FM radio) in the target area. Health Promotion Program

11. 4. Secondary Health Care Facility model: Through this model HANDS provided support to several health facilities which included: HANDS Hospital Bin Qasim Town Karachi BHU Lath Basti Karachi BHU Dawood Usman Goth Karachi BHU Noor Muhammad Goth Karachi BHU Deh Allah Bano Karachi BHU Chashma Goth Karachi BHU Garrix Karachi BHU Baba Island Karachi BHU Bhit Island Karachi Health Promotion Program

13. Sindh Government hospital Ibrahim Hyderi Karachi SGD Charan Para Ibrahim Hyderi Karachi THQ Chohar Jamali Thatta THQ Gharo Thatta THQ Daharki Ghotki The major achievement of this model was HANDS Hospital Bin Qasim Town Karachi. The following Services were provided at the hospital: Round the clock Out Patient Department (OPD) and emergency services. Health Promotion Program

14. Labor Room. Operation Theatre Emergency Obstetric Care Indoor Patient Services Family Planning services. Laboratory Ultrasound facility X-ray facility Blood bank facility Ambulance Services Health Promotion Program

15. Male patients31669 Female patients55716 Children patients16592 Total patients103977 Admitted cases15024 Antenatal checkups76195 Post natal check-ups7833 Laboratory tests carried out120003 Ultrasounds26823 EPI utilization34050 Family Planning clients28706 Women for TT shots2516 Health Promotion Program

17. 5.Community Based management of Acute Malnutrition (CMAM): Following were the achievements during 2011-2012: S/NoActivityTotal 1No of childeren (24-60 months)116790 for De-worming 2No of childeren nutritional status improved5726 3No of children for Micronutrient Supplementation137910 4No of MAM children (20% of 6-59 months) 60% for S31802 5No of PLW for Micronutrient Supplementation125311 6No of PLWs nutritional status improved5249 7No of PLWs screened179868 8No of SAM children under 6 months 60% of SAM for SC412 9No of SAM children( 3% of 6-59 months) 60% of SAM for OTP9480 10No of under 5 childeren screened for CMAM213719 Health Promotion Program

19. 6. Birthing Station Model: HANDS established 62 Birthing Stations in last years for provision of RH services to the communities. 7.Community Midwifery (CMW) Training School HANDS established 02 Community Midwifery schools including 01 in Karachi rural (Jamkanda Hospital) and 01 in Matiari district (THQ Hala). Both schools were registered with PNC and hold a good reputation among the Midwifery schools in the province and country. 363 CMWs were enrolled, out of which 302 successfully completed their training. 61 (16%) candidates either dropped out or did not succeed in examination. Health Promotion Program

22. 8.Training of Traditional Births Attendants (TBAs) Duration 08 days, 12775 TBAs were trained under this model till date. In 2011-2012, 10 TBAs trainings were conducted and 161 TBAs were trained. 9.Psycho Social Wellbeing Training Duration 07 days, 30 professionals were trained by HANDS from 26 NGOs and 201 professionals of 78 NGOs were trained through step down training 10. IUCD Training Duration 06 days, 175 participants were trained on IUCD insertion in 06 trainings in last couple of years. Health Promotion Program

25. 11. Community Health Workers (MARVI Workers) Client Centred training: Duration 5 days, in year 2011-2012 HANDS conducted 28 trainings for MARVI workers and 559 MARVIs were trained 12. SRH (Sexual Reproductive Health) Trainings: Duration 5 days, 28 trainings were conducted in year 2011-2012 and 559 participants were trained. Health Promotion Program

27. 13. Client Centered Approach (CCA) Training for Health Care Providers: Duration 4 days, 33 CCA training were conducted for 442 participants during 2011-2012. Overall 141 training have been conducted for 2421 participants. Project Evaluation Report VariablesBaselineEvaluation Mean age at marriage18.5 years20.04 years Unwanted Pregnancy47%37% Child immunization for measles48.185.50% Health Promotion Program