Home Health Health Program

Health Program



HANDS Health Promotion program has evolved over last 36 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 to the community in coordination with local Community Based Organizations (CBOs).

Best Practice Service Models Model-1

Misali / Marvi Workers (Community Health Workers)

HANDS has the honor to introduce a cadre of community based outreach health workers in areas where there is no LHW. This initiative was piloted in district Umerkot of Sindh and the community health worker was named Marvi after the popular female character that is also a symbol of women empowerment and integrity. The Marvi workers are local females who after getting trained provide health promotion services to their communities. There is a selection criterion for the Marvi and the process of selection, monitoring, supervision and reporting is carried out in close coordination with the local Community Based Organization (CBO). Just as the LHW model of community based health worker, Marvi worker is also assigned an approximate target of 1000 population or 100 to 150 household where she is responsible to provide health services. The core difference in LHW and Marvi model is that the Marvi workers are low literate females as compared to the LHW who are matriculate. Due to low female literacy especially in rural areas, the training contents and methodology for the training of Marvis is also different. Since more than 40% of the Marvis are either low literate or not literate, an LHV is appointed for 30 to 50 Marvis to provide technical and supportive supervision. The trained Marvis under the supervision of LHV provides services related to reproductive health, family planning, nutrition, WASH, MCH etc. Besides provision of health services the Marvi worker also sells social marketing products including safe delivery kit, sanitary pad, iodized salt and Oral Rehydration Salt (ORS) and some essential drugs.


The objectives of the model include:

  • Provide basic health services in the communities where there is no LHW
  • Improve access of vulnerable communities to primary health care services


  • Identification of Marvi worker as per selection criteria in coordination with the respective local Community Based Organization (CBO)
  • Signing of Memorandum of Understanding (MoU) with CBO and Marvi worker
  • Training of Marvi worker
  • Establishment of Marvi Markaz (centre for work)
  • Supply of equipment, social marketing products and essential medicine to the Marvis
  • Initiation of health services by the Marvi worker including health awareness sessions and home visits
  • Surveillance and supportive supervision of Marvi worker activities and on job training
  • Conduction of monthly meeting with Marvi and CBO for sharing of monthly progress report of Marvi activities

Services Provided by Marvi in target area

  • Listing women of Child Bearing Age
  • Listing of under 5 years children
  • Listing of Married women of Child Bearing Age for family planning services
  • Listing of Lactating women
  • Listing of adolescent girls
  • Identification and listing of pregnant women for antenatal
  • Establishment of referral linkages with health facilities in coordination with the CBO for complicated and high risk
  • Conduction of awareness raising session for promotion of healthy behaviors among the communities
  • Conduction of home visits to provide basic health services at the doorstep
  • Growth monitoring and nutrition counseling for under 5 year children
  • Counseling for promotion of immunization/vaccination of under 5 year children, pregnant women and Child Bearing Age women
  • Referral of complicated cases
  • Provision of family planning services with the technical assistance of LHV
  • Sale of social marketing products including
  • Identification, referral and follow up of psychosocial cases in the community
  • Identification, referral and follow up of physically disabled person in the community