Health And Nutrition Development Society (HANDS) started its intervention in 24 villages of rural Karachi in October 1993. The project goals were to develop health facilities in rural Karachi and promotion of rural development through developing leadership and decision-making capabilities of the communities. The selection of target population then needs Assessment and Formation of CBO / WO. The methodology comprised of selection of volunteers, later baseline survey conducted. Training of CHWs took place. Management Information System and initiation of PHC activities were established in step VI and then a Monitoring / Supervisory system was established. In the last, HANDS started working sustainability of primary and health care program.
The direct target population of 25 villages is 26017. The target groups include children under 5 years of age and Child Bearing Age (CBAs 15-45 years). Total beneficiary population in 1999 is 299157. 4053 pregnant women were registered. The antenatal coverage in 1998 was 70% and MMR was 283.6. However, in 1999 the MMR was 147. The TT coverage was 12.2% in 1995, raised 74% in 1999. The target population of under 5 children is 4343. The EPI coverage was 1.2% in 1994, which gradually increased to 90.6% in 1999. The IMR after 3 years intervention was 56.28 in 1996 and in 1999 this figures fell to 17. There is clear decline in the IMR, reflecting the impact of HANDS program in the target populations.
The prevalence of malnutrition in the villages has improved over the years. Growth monitoring of under 5 children is a regular activity of the field team. The figures of growth monitoring reveal that out 71955 children weighed. The malnutrition proportion were 53.52% in 1995 that is 46% population of children < 5 were normal only. the proportion of malnourished children decreased to 28% in 1998.
When HANDS started work in the selected villages, the knowledge, attitude and practices (KAP) of mothers were found to be very poor in baseline survey. The recent survey shows extensive improvement in the KAP of the mother of < 5 children, which in turn reflect the quality and coverage of service delivery.
HANDS has a unique community development participatory model. Community practically involved at all level of program cycle from Planning to implementation. To conclude we can say that impact of HANDS intervention not only evident in health status of community but also on overall development