Expression of Interest. Submitted By

Transcription

1 Expression of Interest For CSOs/ NGOs Elections for Honorary Membership of CCM Pakistan From Sindh Province Submitted to Country Coordinating Mechanism Secretariat National Institute of Health Ministry of Health Regulation and Coordination Pakistan Submitted on 19 th September 2016 Submitted By Address: 140 C- Block II, PECHS, Karachi, Pakistan Tel: +92 (0) , (0) , +92 (0) Fax: (0) UAN # info@hands.org.pk, Website:

2 Expression of Interest: Election of CSOs/NGOs for CCM Membership Submitted to:national Institute of Health Name of Organisation: Health And Nutrition Development Society (HANDS Pakistan) Focal Person: Dr. Shaikh Tanveer Ahmed (Chief Executive -HANDS) Mbl. +92 (0) Technical Focal Person: Dr. Anjum Fatma General Manager Health Mbl. +92 (0) Address: 140 C- Block II, PECHS, Karachi, Pakistan Tel: +92 (0) , (0) , +92 (0) Fax: (0) UAN # info@hands.org.pk, Website: Account Information: Account Name: HANDS Bank Name: HABIB BANK Limited Bank Branch: Tariq Road Branch Karachi Pakistan Bank Address: Ahmer Arcade, 172-U, Block 2, PECHS, Karachi 75400, Pakistan Account No: Account Currency: Pak Rupees SWIFTBIC: HABBPKKA 038" Branch Code: 0038

3 Organizational Capacity: Health And Nutrition Development Society -"HANDS" started its formal journey of intervention from a public sector hospital in Karachi as Health And Nutrition Project in 1979 lead by the then head of the department of pediatrics, Prof. A. G. Billoo (Sitara-e-Imtiaz). HANDS is working on Mission to "improving health, promoting education, alleviating poverty and developing social institution for community empowerment". And its Vision is "Healthy, Educated, Prosperous and Equitable Society. HANDS has a network of 31 offices across the country and has access to more than million population nearly 22,013 villages/ settlement in 47 districts of Pakistan. HANDS strength is 12 volunteers Board Members, more than 1900 full time staff and thousands of community based volunteers of >5600 partner organizations. HANDS International recently established its offices in London, United Kingdom and Kathmandu, Nepal. HANDS international -UK is registered as Non-Profit Organization in Companies Act 2006 of England and Wales. HANDS has evolved as one of the largest Not for Profit Organization of the country and depicts an excellent model of community development. HANDS is also certified by Pakistan Center for Philanthropy (PCP) and is tax exempted by Income tax department Government of Pakistan. HANDS has also successfully completed the Institutional Management Certification Program (IMCP) of USAID for management standards. We are accredited with European Union and have central contractor registration with US Government (DUNS No.). HANDS also possess membership with Humanitarian Accountability Partnership (HAP), member of IUCN (International Union for Conservation of Nature) & SUN CSA (Civil Society Alliance for Scaling up Nutrition). Dr. Shaikh Tanveer Ahmed (Chief Executive HANDS) is elected Chairperson of SUN CSA (Pakistan Chapter). HANDS has developed as one of the largest Not for Profit Organization of the country and exhibits an excellent integrated scientifically proven development model comprising of key programs of Social Mobilization, Gender & Development, Human & Institutional Development, Monitoring Evaluation & Research, Information Communication Resource and Advocacy, Health Promotion, Education & Literacy, Livelihood Enhancement, Infrastructure Development Energy Water & Shelter, Disaster Management, WASH and Social Marketing. These models can be easily replicated in the country as per requirement. HANDS have strategy to foster partnerships with the likeminded Public & Private organizations/ institutions and network for mutual benefits and causes. Human Resource Capacity: HANDS is governed by 12 members elected "Governing Board" who are volunteers and are led by Chairman of the organization. The Chief Executive is defecto member of the Governing Board as well. The Board provides policy guideline and follows the management to pursue management policies in the spirit of the organization's vision. The board is comprised of professionals of different sectors, philanthropist and ex-employees of HANDS. There are four tiers in management structure, first tier is the Senior Executive Committee which is top management and comprise of 04 executives and a Chief Executive. The second tier is Steering Committee" which comprise of 13 General Managers (GMs) and the 04

4 senior executives are also member of the steering committee. The GMs are responsible for operation of different project activities of their program under the leadership of Chief Executive and senior Executives. All the districts heads that is Districts Executive Managers (DEMs) and members of Steering Committee form a 3rd tier called Management Committee. The fourth tier exists at district level called the District Management Committee which comprise of district project staff, DEM and is chaired by District Patron and representative of head office staff. HANDS at present has more than 1900 full time office based and community based staff and more important is out of them 79% (1518) are female staff and 21% (410) are male staff. HANDS also has more than a million Community Based Volunteers (CBVs) who participate at "Monthly Community level forums" lead by Chairperson of Community Based Organization (CBO) and respective district staff participate as defecto member in these forums. Geographical Outreach: At Present HANDS has a network of 31 offices across the country and has access to more than million population nearly 22,013 villages/ settlement in 47 districts of Pakistan. S# Office Province S# Office Province 1 Islamabad Federal Capital 17 Badin Sindh 2 Lahore Punjab 18 Sanghar Sindh 3 Muzaffargarh Punjab 19 Shikarpur Sindh 4 Chiniot Punjab 20 Sukkur Sindh 5 Jhang Punjab 21 Tharparkar Sindh 6 Mandi bahauddin Punjab 22 Thatta Sindh 7 Head Office Karachi Sindh 23 Umerkot Sindh 8 Hyderabad Sindh 24 Dadu Sindh 9 Jacobabad Sindh 25 Mansehra KPK 10 Karachi Rural Sindh 26 Peshawar KPK 11 Karachi Urban Sindh 27 Chitral KPK 12 Kashmore Sindh 28 Shangla KPK 13 Ghotki Sindh 29 Lasbella Balochistan 14 Larkana Sindh 30 Quetta Balochistan 15 Matiari Sindh 31 Bajaur FATA 16 Mirpurkhas Sindh

5 HANDS have most Provincial Liaison offices and district/field offices than any other local NGO. The list of intervention is further expanding. Major Funding Partners: The list of major funding partners includes; International Organization of Migration (IOM), UKAID/DFID, Sindh Education Foundation, Chemonics, International Relief & Development (IRD), USAID, Marie Stopes Society, Jhpiego, Green Star Marketing, The David & Lucile Packard Foundation, Zakat Foundation USA, Oxfam Novib, Engro Foundation, Idara-e-Talim-o- Aaghai (ITA), Khushhali Bank, Aurat Foundation, BSR, Levi Strauss Foundation, Polladium, UNICEF, World Food Program, Basic Needs / Basic Rights, GAVI Alliance, HUBCO, Medico International, Pakistan Poverty Alleviation Fund, Rutgers WPF, WaterAid, HSBC, UN Habitat, Population Services International (PSI), Institute of Development Studies Pakistan, Premier Cables/Premier Home, Billoo Travel Service (Pvt) Ltd, Pioneer Distributior, Sohni Textile Ind, Switzerland Consulate Karachi, Bashir Kasmani Security Pvt Ltd, Meezan Bank Limited, Din Leather (Pvt) Ltd, Pakistan State Oil Company Ltd (PSO), Helpline Trust, Cyan Limited, AlBaraka Bank, Rehnuma Turst, St.Patrick's High School Karachi, I-Care International, Rotary Club Bradford, Karachi Grammar School, R.A Management, Jan Mohammad Dawood Trust, Arif Habib Foundation, Efroze Chemical Industries (Pvt.) Ltd, Nouman Enterprise Private Limited, Pfizer Pakistan Limited, PharmEvo (Private Limited), Pakistan Beverages Pvt. Ltd., Popular Pvt Ltd, Burj Bank Limited, Human Development Foundation, Haji Ibrahim Trust, Hilton Pharma, AMWA Trust, Fountain House, Steun Pakistan, Habib Bank Ltd., Abu Faisal Trust, Shell Pvt. Ltd. All Provincial and Federal Government of Pakistan. Working Experience with Government: HANDS have extremely good working relations with District Government, Provincial Government and various Govt. Departments like Community Development, Education Department, and Health Department etc. HANDS always strives its best to improve the services through partnership with District, Provincial and Federal Government. Several Memorandum of Understandings are signed in this regard. HANDS Public Private Partnerships are in 13 District Disaster Risk Management Centers and 01 Provincial

6 Disaster Risk Management Centre with Provincial and District Disaster Management Authorities. The partnerships with education department are in 997 Govt. Schools. The partnership with Health Department is in 92 Hospitals and 02 Community Midwifery Schools. It includes 01 District Headquarter, 07 Taluka Headquarter, 09 Rural Health Centre, 07 Maternal and Child Health Centre, 40 Basic Health Units, 28 Dispensaries and 2,175 Health Houses of Lady Health Workers. HANDS as a strong development institution have become one of the important service providers in the country where the government is unable to fulfill its traditional role. (List Attached as Annexure) Networking with Civil Society Organizations: HANDS has chair of 108 National Organizations network under the umbrella of Scaling Up Nutrition (SUN) Civil Society Organization Alliance (CSA). HANDS is also holding the chair of South Asia Coordinator for People Health Movement (PHM). HANDS is also a member of National Humanitarian Network (NHN) and Pakistan Humanitarian Forum (PHF). HANDS is also a member of National Disaster Risk Reduction Forum (DRR) and Human Resource Development Network (HRDN). HANDS Health Program: HANDS Health promotion program has evolved over last 35 years and is providing integrated health services at national level. The program includes integration of health interventions with other social development initiatives. Health services are provided with facilitation of the Government Health department & Population Welfare department and in coordination with the local community organizations. HANDS has developed several Best practicing models for improving access to the underprivileged and rural remote communities by providing basic strengthening linkages and quality of services by the Public and Private sector. Over the last 3 decades HANDS health team has developed several best practicing models and many of them have been scaled up with support of different development partners, Health and Population Welfare department Government of Pakistan, Sindh, KPK, Balochistan and Punjab. HANDS has different health componnets interventions in 23 districts of Sindh, working through 17 district offices. HANDS has following health components; A. Community Based Health (Marvi) Workers for non LHW areas coverage: 1800 Marvi (Community based health) workers working in non-lhw areas of 11 districts, covering poluation of about 2.0 million. HANDS introduced this Community Health Worker model for the areas where there is no Lady Health Worker (LHW). This model works on the same pattern as LHW model where the Lady Health Worker has a static centre at her residence and makes home visits as well for service delivery. She is supported by a health committee and women group that are voluntary assisting boards formulated by her for providing health services in the target area. Each health worker is assigned anapproximate population of They performed the community Mobilization related to maternal health, antenatal care, nutrition counseling, child care, promotion of breast feeding, child immunization, institutional deliveries, birth preparedness by the family, birth spacing, demand creation and sale of social marketing products (Family Planning methods, safe delivery kit, iodized salt, oral rehydration salt, essential medicines), Treatment and care of common ailments acute Respiratory Infection (ARI),

7 Diarrhea, Malaria, Common skin diseases, Growth monitoring of under 3 years' children, Referral of normal delivery or complicated cases to nearby functional public health facility, to nearby health facility, facilitation to Expanded Program on Immunization (EPI). They took the health awareness sessions and health education to the family and individual women on home visits. They are supervised by the trained LHV. Each LHV is assigned to supervise and provide services in the cluster of villages of Marvi workers. HANDS has created different community based service delivery model to improve the access to the basic health care services to the rural remote communities Community Based Nutrition Program through Marvi workers Community based Comprehensive Reproductive health services Community based Maternal and Child health care services Community based Family planning services through Marvi workers Community based preventive health care mobilization and health education of the communities for prevention of Malaria, Tuberculosis, Hepatitis B&C, HIV/AIDs, and other common infectious diseases through promotion of health and hygienic practices Community based psychosocial well-being, mental health and disability care and rehabilitation services. B. Community Midwifery (CMW) Training School HANDS has established two Community Midwifery Training Schools in Sindh. The school provides 18 months residential training to willing and committed local community females who have passed matric examination to provide services to their respective communities after successful completion of this course. The duration of midwifery training course is 18 months which includes initial 3 months of Preliminary Training Session (PTS) followed by community obstetrics. During the course, the CMW is also assigned in her respective community to provide services for 3 months. The Midwifery school is registered with the Pakistan Nursing Council under PNC Act 1973 (Item 15) and only this body is authorized to conduct examination and issue certificates to the successful midwives. PNC has declared certain criteria for the registration of school to be followed by school authorities. The basic prerequisite for the training is a 50 bedded hospital with full fledge labor room and teaching faculty. HANDS has been trained more than 500 CMWs belongs to all across the country. C. Capacity Building Packages for Health Care providers: HANDS has developed many training modules for enhancing capacity of health care provider in delivery of quality care services. Through these trainings so far we have trained more than 1800 Public sector health care providers in 13 districts of Sindh over the last 8 years. HANDS has developed Community Based Nutrition promotion and stunting prevention model training for managers involve in MNCH and Nutrition program, health care providers and community based workers such as LHWs or Marvi workers. In addition, training module on Management of Acute Malnutrition has also been developed, for health care providers and health workers. HANDS has developed Standard Based Management & Recognition (SBMR) training and Performance monitoring system for delivery of quality care services as per standards. This package includes the training of all staff of health facilities including management staff,

8 health care providers and support staff for building a team of performers; and continuous monitoring of each facility, services and the health care providers. Training on Standards and Protocols of Quality Natal care and Basic Emergency Obstetrics & Neonatal Care (BEmONC) services Training of Health care providers who are involved in Natal services at MCH center, BHUs, RHC. THQs and DHQs on Neonatal Resuscitation and Prevention of Neonatal Sepsis under the initiative of New born Survival Initiative. Training of Health Care providers on Birth Spacing promotion and Quality care services through Client Centered Approach. This is based on learning of behavior change and Contraceptive technology skills. Training on Emergency management care and Infection prevention in facility settings for different services Training on Integrated Management of Childhood Illnesses HANDS Experience in HIV/AIDS, and TB control Program HANDS has been working on PHC and community mobilization for prevention of common communicable diseases since last two decades. We have taken many projects/ initiatives in partnership with Pakistan and Sindh AIDS control program and National TB control program. HANDS HIV/AIDS Program: HANDS is currently working on implementations of HIV/AIDS and Hepatitis prevntion through community awareness interventions in 11 districts in Sindh, Punjab, KP and Balochistan. The interventions include the Communication strategy for behavior change (generalized and local specifics), community mobilization and awareness raising through education material, family and individual counseling by community based health workers. They material is comprised of HIV/AIDS and Hepatitis B&C introduction, its sign and symptoms, its complications, common mode of transmission and prevention of transmision of diseases. HANDS has implemented three major HIV/AIDS specific projects in Sindh, and since then continued its advocacy and community mobilization program in all its community based health programs. i. School Education Program in Karachi With Collaboration of Baqai Medical University and UNAIDS Pakistan, HANDS implemented the project during the period of November 1997-April Through the project 120 teachers have been trained in conduction of awareness raising sessions regarding HIV/AIDS. Then subsequent 60 sessions were conducted in 55 schools of District East (mostly located in Gulshane-Iqbal and PECHS), in those sessions total 1460 students have participated.

9 ii. Research Study State of Awareness Regarding HIV/AIDS among General Practitioners in District Sukkur, of Rural Sindh. The study was conducted by HANDS with support of Community Health Sciences Department, Baqai Medical University Karachi and Sindh AIDS control program. One of the study supervisor was the Director Sindh HIV/AIDS control program. The study was conducted in November- December 2000, in Sukkur district. BACKGROUND: Considering the fact that Pakistan is presently low prevalent but high-risk country regarding HIV/AIDS spread, and general population awareness is poor. No mass education and counseling program exists in the society especially rural areas. But 80% population is seeking medical advice/ care from general practitioners. These general practitioners can play vital role in educating people about high-risk behaviors in our society, which can otherwise lead to epidemic of HIV/AIDS in coming years. A cross sectional study was conducted in district Sukkur of rural Sindh, to assess the awareness among general practitioners regarding HIV/AIDS such as some basic information like modes of transmission, diagnosis, risk assessment, surveillance etc., to find out the areas of weakness. Then to suggest the health policy makers and planners, to develop the strategy to educate and facilitate these general practitioners and prepare them to be a major part of mass education program regarding HIV/AIDS. METHODOLOGY: Out of 220 general practitioners practicing in District Sukkur, 119 were randomly selected who were all qualified medical graduates, doing their practice at private clinics. The study was conducted through a questionnaire, which was filled by interviewing the general practitioners. RESULTS: 62% general practitioners correctly considered Pakistan as alow prevalent country where as only 16% correctly rated Pakistan as a high-risk country. 52% did not know breast feeding as a possible mode of transmission. While 34% had misconception about mosquito bite and 10% about social contacts as modes of transmission. 29% did not know the place and authority to whom the HIV/AIDS case should be notified. 69% did not know correctly the available facility for screening/diagnosis of HIV/AIDS. 52% did not know correctly where the screen blood for transfusion available. 74% did not know any tests for screening of HIV and 95% did not know any further diagnostic tests for AIDS. 30% did not know any associated finding of AIDS, while only 34% knew at least three associated findings of AIDS. CONCLUSION: To conclude the majority of general practitioners are not appropriately prepared to play their role in further prevention of HIV/AIDS epidemic in Pakistan. As evident by the fact that knowledge regarding many aspects from basic to practical was found much less than desirable. Integrating general practitioners in the health care delivery system and National AIDS control program through continuous training programs and follow up monitoring are recommended to update their knowledge.

10 iii. Adolescent Reproductive Health Project: HANDS in partnership with World Population Foundation implemented Adolescent Reproductive Health project in 35 target villages at Hala and Matiari region (then district Hyderabad), for the period of nine months from July 2001 to March Total 70 community mobilizers were trained regarding Reproductive and Adolescent Reproductive Health issues including HIV/AIDS. They were assigned to organize awareness raising sessions at their villages for parents separately for mothers & fathers, grandmothers & fathers, adolescent boys and girls, school teachers, and community health workers. Total 2520 awareness raising sessions were conducted during nine months, in which adolescent and their parents had participated. iv. HANDS Experience in Communication, Advocacy and Mobilization: HANDS has experience in developing the Community Advocacy Mobilization strategy (CAM) strategies for different components. HANDS has developed Behavior Change Communication strategy and Information communication material for promotion of awareness related to prevention, diagnosis and treatment of Tuberculosis, Malaria, HIV/AIDS and Hepatitis b&c, birth spacing and RMNCH issues such as antenatal care and institutional deliveries and birth preparedness, promotion of Immunization. The information education material included the brochures, messages posters, counseling cards messages for relay on FM radio and other electronic media. The dissemination strategy for the promotional material includes the involvement of the communities through community health workers and trained social mobilizers. Our work involved advocacy with: Prominent religious leaders/ scholars Community influencers Media representatives Parliamentarians Elected local government representatives Policy makers at the district, provincial and national level Professional health associations and academic institutions These key players are instrumental in creating an enabling and supportive environment, either directly or through the influencers at the community level, to bring about behavior changes. The community engagement activities are designed to garner support of these groups in favor of recommended nutritional and dietary practices to improve maternal and child health and overall family well-being in the communities. At the community level, the health workers (LHWs or other community based workers such as HANDS Marvi workers) organized various community activities to sensitize, create excitement and publicity for promoting the practice of healthy diet and nutrition on special events such as the World Health Day, Breastfeeding Day and Mother s Day. Short commercials promoting the benefits of recommended dietary practices for adolescents, women and children, breast feeding, intake of supplements such as multiple micronutrients /

11 iron-folate, utilization of fortified food such as iodized salt will be shown at cinema halls and through local TV cable networks to reach a wider audience and reinforce the messages. Radio especially popular FM channels, are also used to mobilize support for the cause of improving maternal and child health through proper nutritional and dietary practices. 3.2 HANDS TB DOT Program: i. Project on Urban DOTS program for Karachi: In year 2006, The Pakistan and Provincial TB control program Sindh with Partnership of FIDELIS (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) of France initiated a project to enhance comprehensiveness of Urban coverage. The implanting partners were Marie Adelaide Leprosy Center (MALC) Karachi, BEHBUD and HANDS. Geographically it was implemented in 13 towns of Karachi. The major aim was to achieve comprehensiveness of urban DOTS program in urban slums as well as in all other areas of the mega-city of Karachi, Pakistan through involvement of the nongovernmental organizations ( NGOs ), general practitioners ( GPs ) and traditional health care providers (HCPs) working in private sector. Specific Objectives were To significantly increase identification of suspects and case detection rate of estimated new sputum smear positive TB cases in urban slums and katchi abadis (squatter settlements ) and all other inhabited areas of thirteen out of eighteen towns of Karachi during project period. To develop an effective referral system between NGOs, public sector and private practitioners with the aim of decentralization of all services components to improve and facilitate case detection / holding and to reduce default rate. To increase treatment success of NSPs (New Sputum Positives) from existing 75 to 85% CDR (Case Detection Rate) from 36 to 60 %. To facilitate poor TB patients by reimbursing travel expenditure and giving incentives to them and treatment supporters to facilitate case detection and treatment completion. To undertake social mobilization campaigns in the project area. To field test the WHO concept of Stop TB Authorized Care Provider in the pursuance of these objectives prior to its replication in the other major cities of Pakistan. HANDS implemented the project 6 towns out of 13, in which HANDS has established 10 screening centers called as HANDS TB- DOTS SCREENING CENTERS. For this project HANDS has appointed one Project Coordinator and for each town six field supervisors. Name of the intervention Towns of Karachi S No. TOWNS POPULATION Union Councils 01. BIN- QASIM TOWN 500, GADAP TOWN 600, KORANGI TOWN 900, LANDHI TOWN 1,000,000 12

12 05. MALIR TOWN 700, LIAQATABAD TOWN 800, TOTAL 06 TOWNS 4,500, Names of Health Facilities where TB- DOTS screening centers established under the project: S. No. Name of Health Facilities where Screening center established Government and Private Health Facilities 01. CDG HANDS Hospital Jam Kanda Bin-Qasim Town Private 02. Noor Medical Center Daud Chaurangi- Landhi Town Private 03. Peerabad Dispensary Golimar- Liaquatabad Town Govt. 04. Sir Syed Medical College Hospital Qayoomabad- Landhi Private Town 05. Dar- ul - Sihat Imam Khumeni Hospital Malir Town Private 06. Landhi Medical Complex Landhi Town Govt. 07. Landhi- Korangi Medical Complex Landhi Town Private 08. Al Shafee Medical Center Quaidabad Landhi Town Private 09. Rafiqui Shaheed Hospital ( KMC Hospital ) New Chawli- Govt. Saddar Town 10. Rural Health Center Rehri Goth BQT Govt. Achievements: During the 12 months project period (April 2006 March 2007), total 360 health care providers working on private and government health facilities/ clinics were engaged. They have been trained by HANDS teams with facilitation of Provincial TB control program teams. Additionally, 120 volunteers were selected from local population and trained on community mobilization and referral of the suspected clients to the selected screening facilities. The community awareness sessions were conducted in the intervention areas located in 6 towns, by the HANDS team and volunteers. Through these activities including referral, diagnosis, treatment and continuous follow up by volunteers total 4860 clients got the treatment services. i (a). Community Based Health (Marvi) Workers for non LHW areas coverage: HANDS 1800 Marvi (Community based health) workers working in non-lhw areas of 11 districts, covering poluation of about 2.0 million. The TB control program is implented through community mobilzation, awareness raising, identtification and referral of suspected cases to the nearest government health facilities, and prevention of transmission of disease. The supervisor LHVs facilitated the Marvi workers in supporting the families for continuous treatment.

13 Monitoring evaluation and reporting Monitoring, Evaluation and Research (MER) program is responsible for the monitoring of projects / programs, interventions/activities as well as conduction of internal and external researches. The MER department keeps a track of all reports pertaining to the program/ projects through MIS. The Monitoring and Evaluation Conceptual Framework: Performance Monitoring Plan M&E Activities Data Collection erformance Monitoring Plan Matrix: Analysis of Data The M&E Conceptual Framework Strategic Plan Annual Implementation Plans IMPLEMENTATION Input Process Output Outcome Impact Communication of Results/Feedback The Monitoring and Reporting Flow: 1. The Monitoring Managers: monitors all the activities of District Offices; including operations, logistics, HR and program activities. They fill the monitoring checklist of every visit and prepare a monitoring report of the visit. They are responsible to provide the daily monitoring report to HO. 2. Monthly Progress Review (MPR): District Project Associates (DPAs) gather the village wise project data on developed reporting formats and cumulate all this data in District Monthly Progress Review (MPR) reporting format. All minutes of these meetings and visit details of DPA are properly registered. 3. Weekly District Internal Meetings: are mandatory to be conducted every week. District Project Managers (DPMs) share their project s updates and field issues in weekly meetings. Proper Minutes are recorded. 4. District Progress Review meeting (DPRM): This is the process to monitor progress of each districts on monthly basis. This is to monitor the progress of activities of each project separately. Each project progress is measured by the targets set for the period. Monthly Progress Report (MPR) is also presented by every DPM. The DPM presents the whole month activities report. The Report is submitted to Documentation Management Unit (DMU) on monthly basis for Record. (DPRM) is organized every

14 month after District MPR to share over all progress of districts by every respective DEM. 5. Project Committee Meetings: is conducted every month for multi districts projects, where project s progress and issues are discussed with the Provincial Project Manager of the project. This meeting is led by the GM coordination as per requirement. 6. Steering Committee Meeting: The second tier is Steering Committee which comprise of 12 General Managers (GMs) and the 4 Senior Executives. The Steering Committee Meeting (SCM) is organized every month. All the relevant issues of Programs/projects are also discussed in this forum and decisions are made. This meeting is chaired by Chief Executive.

15 Monitoring and Reporting Flow Chart: Types of Reports Reported by Report To Level Village wise report Community Based Workers Community Based District field Teams Village Progress Reviews Project wise report District Project Manager General Managers Progress Reviews at District Office District Commutative Report District Executive Manager General Managers/C hief Executives Manageme nt Committee Meetings Program wise report General Managers Chief Executives Steering Committee Meeting at Head Organization report Chief Executives Chairman/B oard Members Executive Board Meeting at Head

16 Methods of Evaluating and Storage: HANDS have designed comprehensive web based applications for data recording and storage. The applications being used currently are mentioned below; BMIS (Beneficiary Management Information System): The beneficiary management information system is online web based application, which enable us to have a meticulous profile/information of the beneficiaries and stocks/goods provide to them by the organization. It is also a tracking system which can track an individual beneficiary by search his/her CNIC in the centralized data base. This is not only a comprehensive source of keeping essential database of organization but also a token generating system which generates token of beneficiaries after receiving request from district/target population. MIS (Management Information System): The Annual Implementation Plan is developed for every project and program by MER with the consultation of all concerned General Managers and District Executive Managers using excel the format which is reviewed and approved by concerned general manager. The AIP for each project is developed for its complete during while for the program it is developed for one fiscal year.(for HANDS July-June) TMS (Training Management System): Training Management System is online web based application, where data of each training is conducted in different project of HANDS and stored. This online application is also generates different types of reports as per the requirement of project. D-Space: D-Space is used to collect and store different type of reports are generated at different level of HANDS and this data is also used for publications and media coverage as well but this data is shared with others through consent of beneficiary or related persons. CMMS (Complaint, Monitoring Management System): It s an online cloud-based Application, which enable us to monitor and compliance of project & Program activities within specified frame of time. In the history first time we are Introducing the online Complaint & Monitoring Management System to edifice HANDS Monitoring/Compliance further systematically & transparent. Evaluation: HANDS designed web based applications have built-in functions for analysis of the data according to requirement. Each application analysis the data at different level like, beneficiary data, project target vs. achievement data, training data, complaint and monitoring data, Project/Program data etc similarly for project activities and MS Excel and SPSS are also used if further analysis is required.

17 Project administration and financial management: HANDS has successfully managed 513 projects during last 22 years including 60 projects in the year Currently 41 projects running in different districts of Pakistan and 19 projects have been completed in last three quarter (July 2014 to March 2015). Finance Department is equipped with qualified personnel working in computerized accounting software (online in all districts) through Sidat Hyder Financials. Maximum Budget Managed Health And Nutrition Development Society -"HANDS" is working on various long term Programs of Health Promotion, Education & Literacy, Livelihood Enhancement, Social Mobilization, Disaster Management, Gender & Development, Human Resource & Institutional Development, Infrastructure Development Energy Water & Shelter, Information Communication Resource and Advocacy, WASH, Monitoring Evaluation & Research and Social Marketing.. Following is the detail of budget has been utilized by HANDS; S. No Year Budget in PKR ,292,517, ,534,099, ,542,378, ,106,329, ,749,317,610 Total Budget Managed in last 5 years 7,224,642,298 Internal Control System In order to maintain harmony and control among all programs HANDS have developed proper Operating Manuals for every program and department. The following is the list operating manuals; 1. Monitoring Evaluation & Research 2. Health Promotion 3. Livelihood Enhancement & Gender And Development 4. Information Communication Resource & Advocacy 5. Human Recourse Management 6. Education & Literacy 7. Infrastructure Development Energy WASH and Shelter 8. Disaster Management 9. Social Mobilization 10. Finance & Accounting Manuals 11. Human resources 12. Resource Mobilization 13. Procurement & Logistics 14. Administration 15. Information Technology

18 Annexure: HANDS Registration Document