Health, Education and Literacy Programme Annual Report

Home , Gadap Town, Gizri, Saddar

Health, Education and Literacy Programme

Annual Report

2016-2017

Contents

Mission

Executive Committee

Management

General Body Members

Sub committees

Chairperson’s Message

About HELP

Our Donors

Accountability and Transparency

Monitoring, Evaluation and Reporting

Our Projects

Our Friends

Financials / Audit Report

Our Mission

“Through needs assessment to design and implement replicable models of health promotion, health delivery and education for women and children”

Executive Committee (Honorary)

Prof. Dure Samin Akram Chairperson Associate Prof. S.K Kausar Vice President Prof. Dr. Fehmina Arif General Secretary Dr. Gulrukh Nency Joint Secretary Associate Prof. Dr. Neel Kanth Treasurer Members

Ms. Mona Sheikh. Mr. Fareed Khan Ms. Hilda Saeed Ms. Rabia Agha Ms. Reema Jaffery

Management

Senior Program Manager Dr. Yasmeen Suleman Program Manager Dr. Amara Shakeel

General Body members

Dr. Fazila Zamindar Dr. Jaleel Siddiqui Dr. Sabin Adil Dr. Qadir Pathan Dr. Shakir Mustafa Ms. Shala Usmani Ms. Erum Ghazi Dr. Imtiaz Mandan

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Sub committees

Audit Committee Mr. Farid Khan Prof. Dr. Fehmina Arif Dr. Yasmeen Suleman

Fund Raising Committee Ms. Reema Jaffery Dr. Fazila Zamindar Dr. Amara Shakeel Ms. Mona Shaikh Ms. Rabia Agha

Research Committee Prof. Dure Samin Akram Associate Prof. Dr. Neel Kanth Associate Prof. S.K Kausar Prof. Dr. Fehmina Arif

Purchasing and Procurement committee

Prof. Fehmina Arif Dr. Yasmeen Suleman Associate Prof. Neel Kanth

Editorial Board Dr. Yasmeen Suleman Ms. Hilda Saeed

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Chairperson’s Message

HELP has been blessed with many friends, well-wishers and philanthropic assistance. In return, we continue to push towards our Mission “to help those who help themselves”. This translates to empowering people in communities towards improving their living environment and standards of living.

Two major projects are noteworthy to mention here. The first involves our efforts in Chachro Tharparkar. After Tharparkar went through severe drought 2 years ago, we planned not to give just short terms relief but empower the inhabitants of a village Charnore to be self -sufficient now and in the future. Read about this wonderful work in our report.

The second noteworthy project we have been pursuing is in Karachi itself. Most of us do not appreciate the fact that urban slum dwellers face a double-edged sword. They are faced with poverty, lack of skills together with the loss of the support system which is available to rural families. In fact, health and nutrition indicators in urban slums are often times worse than those seen in rural communities.

Therefore, HELP has concentrated on working in urban slums since 1991, with support from our German donor MISEREOR and other generous donors. We have successfully worked in a number of katchi-abadi’s. For instance, in Khuda ki Basti and surrounding areas in Gadap Town and part of Lower Gizri we have been working with the community for the past few years. The population in this area is empowered and aware of their own health nutrition and education needs. Resources, such as schools and government health facilities are also available. After doing a KAP survey in these 2 areas, we were satisfied with the knowledge and practices of the community regarding their health and education for their children. We therefore now plan to move ahead, to new areas, to empower more communities. This year we have started work in Bin Qasim Town and in small villages which surround Khuda ki Basti. This is work is in progress. We will be sharing details of the process and progress in reaching out to those communities, as we engage and work with them. Stay with us, we need the continued support of our well-wishers, volunteers and guides.

Annual Report 2017

About HELP

HELP is a non-Government, non-profit Community Based Primary Health care and Education Programme. It was established in 1990 and is registered with the Government Department of Social Welfare SSWD since 1991. Since Feb 2009, HELP is certified by Pakistan Centre for Philanthropy (PCP).

HELP’s team comprises of highly committed professionals committed to the development of primary health care. These include expert master trainers serving in highly reputable medical institutions, experts partnering with UNICEF, WHO, National BFHI & IYCF programs on nutrition related issues, chartered accountants, journalists and social scientists. HELP is also a member of Nutrition Working Group as well as the Infant Feeding Board in Sindh and Punjab HELP is also a member of South Asian Infant Feeding Network.

The organization’s focus is on the health care of women of child bearing age and children, with special emphasis on nutrition, immunization, reproductive health, and family planning. HELP is also involved in pre-primary education of children, early child development and adult literacy.

HELP has a network of Community Health Workers (CHWs) in its communities. These workers are trained on primary health care and deliver the same to the community at their doorsteps. Special emphasis is given on their training as well of other medical and paramedical staff on infant and young child feeding. Separate workshops are held on breast feeding. Nutrition counseling is provided through mother support groups, during home visits by the CHWs and at the MCH centres. Presently there are > 500 mother support groups in its communities. Growth monitoring and promotion of nutrition in children <5 years has been its focus. Mothers are encouraged to practice Exclusive breast feeding till 6 months and continuation of breast feeding till 2 years. HELP’s Nutrition Resource Centre has been involved with Government & UNICEF in providing Infant and Young Child Nutrition trainings in province of Sindh. It has also developed training material on Maternal, Infant and Young child feeding and has conducted trainings of government and non-government health care personnel on establishment of Stabilizing centers, MIYCF and counseling technique.

Annual Report 2017

Accountability and Transparency

HELP has a centralized financial management system being operated through finance section of the organization. Financial transactions at HELP are carried out through a separate bank account dedicated for each project. Each bank account is operated by minimum two signatories.

To ensure transparency and excellence in financial reporting internal audit has been sourced out to Haroon Zakaria and Company, Chartered Accountants. The team from the audit company carries out regular quarterly internal audits of all our sections independently and submits its report to the Board.

The internal audit committee of the organization consists of two members from the Board and one member from the management. One of the Board members is a senior FCA. External audit is performed annually by Ernst and Young Ford Rhodes Sidat Hyder, Chartered Accountants.

HELP is also regularly evaluated and certified by Pakistan Centre for Philanthropy (PCP) since 2009.

Monitoring, Evaluation and Reporting Each Project Manager is responsible for implementing the project as per work plan. The Project Managers submit regular reports to the Senior Program Manager. Monitoring is done by an independent monitoring and evaluation (M&E) officer. The M&E officer submits his report directly to the HELP’s Board. Regular internal monitoring is also performed by a team from HELP’s management from its Head office. The outcomes of both internal and external monitoring visits are documented. Appropriate and timely actions are taken in response to reports of monitoring.

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Our Donors

Mrs. Shahina Islam

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Our Projects

Health

. UN Maternal and Child Nutrition Stunting Reduction Program, District Naushahro Feroz . Effective Management of Malnourished Children Using Electronic and Mobile Phone Technology . Community- based Primary Health Care Project, Neelum Colony and Lower Gizri, Saddar Town, and Khuda Ki Basti, Gadap Town, Karachi . HELP Maternal and Child Health Centre, Lower Gizri, Saddar Town Karachi . HELP Maternal and Child Health Centre, Neelam Colony, Saddar Town, Karachi . HELP Maternal & Child Health Centre, Khuda Ki Basti, Gadap Town Karachi. . HELP Nutrition Resource Centre for training & research.

Education

. Pre-Primary School, Lower Gizri Saddar, Town Karachi . Pre-Primary School, Neelum Colony, Saddar, Town Karachi . Pre Primary School, Ghaggar bin Qasim Town, Karachi . Home Schools in Ghaggar, Bin Qasim Town

Research

. Exploring Opportunities to Strengthen Supportive Supervision of EPI services in Sindh’ . Research on Infant and young child feeding (IYCF) policies

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‘UN Maternal and Child Nutrition Stunting Program Sindh’

Pakistan suffers from some of the highest rates of malnutrition in the world with a National stunting prevalence of 43.7% among children under five. In 1994, the prevalence of stunting was 36.3% whilst it increased to 43.4% across Pakistan and 49.8% in Sindh by 2011. Chronic malnutrition or stunting is associated with suboptimal brain development, which is likely to have long-lasting harmful consequences on cognitive ability, school performance and future earnings. This, in turn, affects the developmental potential of nations.

To prevent stunting in children, HELP with support from UNICEF and USAID is implementing ‘UN Maternal and Child Nutrition Stunting Program’ in District Naushahro Feroz. The program commenced in July 2016. The focus of the program is on changing knowledge, attitude and practices of the community particularly the mothers and other household caretakers through behavior change communication. Through the program HELP will reach 50,000 pregnant and lactating women in the District, provide them with Micronutrient supplement and council them on maternal, infant and young children’s diet. Micronutrients are also being provided to children. Screening of the 69,000 children under 2 years is being done for malnutrition to identify children with severe acute malnutrition (SAM). Children with SAM are provided Ready to Use Therapeutic Food (RUTF). Twice yearly de- worming of the children is also part of this program.

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‘Effective Management of Malnourished Children Using Electronic and Mobile Phone Technologies’

To contribute towards strengthening of the Health Services System (HSS) pertaining to the CMAM program, HELP with funding from DFID and in collaboration with Palladium implemented a community based project in four Union Councils of District Bhakkar. This 13 months project ended in January 2017

The objectives of the project were to improve the process of identification and referral of malnourished children to fixed CMAM sites, increase attendance rate and reduce defaulter rate using mhealth and ehealth technologies.

In places where CMAM program is being implemented, increasing the attendance of the malnourished children at fixed CMAM sites remains a challenge. A significant number of children defaulting from the program before being cured is another issue. HELP’s project has shown a highly significant increase (97%) in the attendance as well as the reduction in defaulter rate by 53%. The project results have been shared with the stakeholders including the government, UNICEF, International aid agencies and National organizations involved in developing policies and guidelines for the project as well as implementation.

Annual Report 2017

6 months data 6 months data % change from target during project Health facilities, implementation prior to project July to implementation December2017 Number of 87/Month 202/Month 132% increase malnourished children referred to the Health facility by the LHWs

Number of 65/Month 128/Month 97.4% increase malnourished children attending the fixed CMAM sites Number of 16.89% 8% 53% reduction registered children, defaulting from the program at the fixed CMAM facilities Availability of Data was Online availability - data of the available in hard of data in real CMAM facilities copies at facilities time

Annual Report 2017

Community Based Primary Health Care Project To empower the community and improve the living conditions of the slum dwellers substantially, in particular with regard to environmental hygiene, health and education for mothers and children, HELP has set up a network of trained Community Health workers (CHWs) in its target communities. The CHWs deliver primary health care at the door steps of the community. These CHWs are assisted by Social Mobilizers and supervised by Lady Health Supervisors (LHS) and Field Coordinators.

Neelum /Shah Rasool Colony, Saddar Town, District Karachi South. Total population: 28,000

Lower and Upper Gizri, Saddar town, District Karachi South.

Total population: 35,000

Khuda ki Basti and adjacent villages, UC 5, Gadap Town, Karachi. Total population: 65,000

Annual Report 2017

National and Provincial Polio Immunization Days. HELP’s Community Health Workers (CHWs), Lady Health Visitors and Social Mobilizers actively participate in the national and provincial immunization days. There have been no cases of polio in HELP’s communities since past more than a decade.

Cooperation with other health structures A liaison with Government Secondary and Tertiary centres has been established for the referral of patients.

Training of Community Health Workers Training sessions are conducted for community health workers by qualified master trainers on different health issues.

Following refresher trainings were conducted during the reporting period:  Case finding of Tuberculosis in the Community.  Immunization  Maternal, Infant and young child feeding practices

Additionally, during weekly meetings, community workers are briefed on various topics related to primary health care.

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HELP Maternal and Child Health Centres

 HELP Maternal and Child Health Centres, Neelum Colony and Lower Gizri, Saddar, Town, Karachi.

 HELP Maternal & Child Health Centre at Khuda Ki Basti, Gadap , Karachi

Total number of patients treated in OPD: 17,061

Total doses of tetanus toxoid administered to women 15- 49 years old: 1,987

Total doses of BCG administered: 1,048

Total doses of OPV administered: 4,010

Total doses of Measles vaccines administered 1,195

Total doses of Penta vaccines administered: 2,962

994 Support group meetings were held, which were attended by 13,965 participants.

HELP Nutrition Resource Centre for Training and Research.

HELP Nutrition Resource Centre is involved in research and trainings on maternal and child nutrition. Nutrition related research articles have been published in National and International journals of repute.

It has a team of master trainers and has conducted numerous trainings on IYCF, CMAM and hospital management of malnourished children with complications, for government and non- government health care workers in collaboration with the World Bank, USAID, UNICEF and WFP. It has also conducted trainings of master trainers on IYCF for health care personnel of Agha Khan Health foundation.

Following research, it has formulated a special high caloric diet ‘NutriHELP” for management of malnourished children. A research paper related to it has been published in JPMA in Feb 2009 and another has been accepted for publication in JPMA. Nutri-HELP has been used in various projects funded by the World Bank, GAVI, Pakistan Pediatric Association, MISEREOR and local philanthropists. It is also being used by Pediatricians in private and Public Hospitals.

Annual Report 2017

Education

Preprimary school, Lower Gizri Saddar Town, Karachi Preprimary school, Neelum Colony Saddar Town, Karachi Preprimary school, Ghaggar, bin Qasim Town Karachi Home Schools in Ghaggar, Bin Qasim Town Primary school, Village Charnore, Nagarparkar, Tharparkar

Total enrolment in each school is 100

Annual Report 2017

Research

HELP is a member of South Asian Infant feeding Research Network (SAIFRN). In collaboration with other member countries of SAIFRN, HELP conducted research on Nutrition Policies in South Asia. Following two research articles have been published in February 2017:

1. Overview of the infant and young child feeding policy environment in Pakistan: Federal, Sindh and Punjab context BMC Public Health 2017, 17(Suppl 2):474. 2. Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis published in BMC Public Health 2017, 17(Suppl 2):404.

‘Exploring opportunities to strengthen supportive supervision of immunization services: A Case Study of EPI Sindh’

Sindh is one of the provinces of Pakistan which has been showing a consistently low coverage of immunization. This research study supported by UNICEF and GAVI is being conducted by HELP in collaboration with APPNA Institute of Public Health Jinnah Sindh Medical University. The study Team consists of Prof. D.S. Akram and Dr. Yasmeen Suleman from HELP and Prof Lubna Baig and Dr. Sana Tanzil from APPNA Institute of Public Health.

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World Breast Feeding Week

World Breastfeeding Week (WBW) is celebrated worldwide every year from 1st to 7th August to encourage breastfeeding and improve the health of babies around the world. Breastfeeding has a huge impact on child survival, growth and development. Evidence shows that exclusively breastfeeding for 6 months and continued breastfeeding till one year can lead to 13% reduction of deaths in children under five.

Like every year HELP celebrated the World Breastfeeding Week by organizing a variety of activities to engage and collaborate with a wide range of actors around promotion, protection and support of breastfeeding.

Community awareness programs were held at various health centres of HELP as well as in its communities including Village Charnore, Tharparkar. A large number of mothers, other household caretakers and health care personnel participated in these programs. Participants were stressed on the importance of breast feeding particularly its early initiation and continuation till 2 years.

Annual Report 2017

Seminar on Universal Health Coverage

To mark the 3rd Universal Health Coverage (UHC) Day, HELP organized a seminar on “HEALTH FOR ALL”. The objective was to create awareness on the importance of Universal Health Coverage for sustainable development and advocate the Government to adopt UHC as their health priority.

Professor, Dr. D.S. Akram, talked about the role of Civil Society Organizations (CSOs) in UHC.

Ms. Rehana Memon, Secretary Planning and Development Department, Sindh shared government’s perspective, recounting the steps taken by the government and pledging to continue working to improve healthcare for the poor and vulnerable.

Chief Guest, Mr. Imtiaz Ahmed Shaikh, a Member of the Parliament emphasized that Universal Health Coverage is of paramount importance for the present government. He promised his support for health related activities to organizations and participants of the seminar.

An active open discussion followed. The seminar ended on a positive note as the audience were of the view that, with the right approach, planning and accountability, Universal Health Coverage was an achievable target for Pakistan.

Annual Report 2017

Free Medical Camp in Gadap Town

On the occasion of the third Universal Health Coverage Day, HELP organised a medical camp at its MCH Centre in Gadap Town Karachi. Free health check-ups, vaccinations and laboratory tests were performed.

In collaboration with Hashmani Eye Hospital, free eye check-ups and cataract surgeries were also conducted.

More than 700 patients benefited from these services.

Installation of Hand Pumps in District Naushahro Feroz HELP with support from Local Philanthropists installed 8 hand pumps at various places in District

Naushahro Feroz. The sites were identified by the Social welfare Department of the District.

Annual Report 2017

World Immunization Week 2017 Despite years of efforts by the Government and the EPI, the coverage of routine vaccination of children and women in the country remains low. Additionally, there is a high percentage of children suffering from malnutrition; together both contribute significantly towards the alarmingly high rate of morbidity and mortality in children under 5 years of age. Immunization is widely recognized as one of the most successful and cost-effective health interventions. It prevents between 2 and 3 million deaths every year. World Immunization day which is held every year from 24-30 April indicates global efforts for accelerated action to generate demand for improved delivery and services.

Workshop on Tuberculosis

A one day workshop was held by MALC on Thursday 29ththJune 2017, at MCH Center HELP, Khuda ki Basti, Gadap Town, Karachi for its 40 Community Health Workers. The objective of the workshop was to educate the health workers to increase awareness about Tb and detection of cases in the community

A two member team from MALC consisting of Mr. Daniel Karamat and Ms. Miss Sonia Chaudhary facilitated the workshop. Annual General Body Meeting

The General Body meeting of HELP was held on 24th December 2016, at HELP Head Office in Karachi. Annual programmatic report and financial reports were presented. Details of both reports were discussed at the meeting. The members reviewed ongoing projects and set targets for the future. Various committees including those of research, Audit and Fundraising gave their update.

Annual Report 2017

THANK YOU

FRIENDS OF HELP

Mr. AteeD Riaz Mr. Shahabuddin Mr. Fareed Khan

Mrs Nafeesa Haroon

Annual Report 2017