Mid Term Assessment Report
Home Health Education Program for Pre-Marital Girls in Pakistan
Jan 2015 - Jun 2016

Union Council Sukhpur District Thatta, Sindh Pakistan
October, 2016
Supported by:
Association of Medical Doctors of Asia (AMDA)
Funded by:
Chigasaki-Chuo Rotary Club (CCRC)-Japan
Implemented by:
National Rural Support Programme – Pakistan
2nd Floor, Block-5B, F-6, Markaz, Super Market, Islamabad.

2

Contents.................................................................................................................................................................. 1
List of Acronyms ............................................................................................................................................ 3
Executive Summary....................................................................................................................................... 4
Background and Situation Analysis ............................................................................................................... 6
Health Situation in Thatta ......................................................................................................................... 6
Project Intervention .................................................................................................................................. 7
Project objective and Role of NRSP .......................................................................................................... 7
Evaluation ..................................................................................................................................................... 9
Evaluation Focus ....................................................................................................................................... 9
Study design method and technique ........................................................................................................ 9
Demographic Profile of Respondents ....................................................................................................... 9
Ethical considerations ............................................................................................................................. 10
Findings of the Survey ................................................................................................................................. 11
General Findings ..................................................................................................................................... 11
Detail Analysis of Impact Assessment Survey ............................................................................................. 12
Increase in Knowledge ............................................................................................................................ 12
Personal Hygiene ................................................................................................................................ 12
Knowledge about Diarrhea ................................................................................................................. 13
Immunization ...................................................................................................................................... 14
Polio .................................................................................................................................................... 15
Measles ............................................................................................................................................... 16
TT Vaccination ..................................................................................................................................... 16
Knowledge about Importance of Nutrition......................................................................................... 17
Knowledge about Reproductive Health (ANC, Birth preparedness, Contraceptives methods) ......... 18
First Aid ............................................................................................................................................... 20
Dissemination of Knowledge and practices improved ........................................................................... 20
Health seeking behavior ..................................................................................................................... 21
Lesson Learnt and Recommendations ........................................................................................................ 25
Conclusion ................................................................................................................................................... 26
Appendix I ................................................................................................................................................... 27
Appendix II .................................................................................................................................................. 41
Appendix III ................................................................................................................................................. 491

2

List of Acronyms
AMDA

Association of Medical Doctors of Asia

CCRC

Chigasaki-Chuo Rotary ClubPDHS

Pakistan Demographic Health Survey

LHWs

Lady Health Workers

CHWs

Community Health Workers

RH

Reproductive Health

ANC

Antenatal Care

PWs

Pregnant women

EPI

Expanded Program of Immunization

FP

Family Planning

PNC

Post Natal Care

SBA

Skilled Birth Attendant

TBA

Traditional Birth Attendant

UCs

Union Councils

3

Executive Summary
National Rural Support Programme started Home Health Education Program in District Thatta, Pakistan
in partnership with Chigasaki-Chuo Rotary Club (CCRC) and Association of Medical Doctors of Asia from
June 2014. Project aimed to improve the life skills of women of Reproductive Age which can contributesignificantly in improving their and their family’s health and quality of life. Project activities included
awareness raising meetings and session with girls in targeted Union Counsel. Project completed its
assignment in given union council in June 2016. To meet project targets one more union council is
proposed to be added in the programme. However it was necessary to assess the outcome ofinterventions in previous union council before moving in new one.
Purpose of this assessment was to know:
1. Knowledge gained and practices improved
2. Identify the factors that facilitated or hampered the achievements
3. Compile lessons learned and recommendations to contribute towards the continuation of
Project interventions in rest of project period.

It was kind of KAP survey. We took a random sample of 305 girls out of project beneficiaries. 72 % girls
were less than 19 years old. 63 % of the respondents were illiterate. 23 % of the girls had married whileduring project intervention stage they were unmarried.
S
No
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.

Knowledge Area

Baseline

Awareness regarding washing hands with soap
Knowledge about diseases transmitted through open defecation
Percentage households having flush latrines
People going out for defecation
Girls started using cloth pads after getting training. (however
personal hygiene is still not maintained)
Breast feeding should continue during disease
Respondents knew that their source of drinking water isdrinkable and tested.
ORS preparation method
Knowledge about schedule of EPI
Names of diseases covered in EPI schedule
Danger signs of measles
Information about the vaccination against Measles
Age to get vaccination
No of antenatal care visits during pregnancy
Names of contraceptive methods
Knowledge about birth preparedness
Knowledge about identification of skilled birth attendant andplace of delivery
Knowledge about first aid

0%
29 %
15%
56%
*

Current
Finding
99 %
91 %
51%
21%
76 %

27%
*

99%
61%

5%
0%
0%
23%
11%
3%
1%
28%
25%
1%

99%
84%
90%
70%
94%
71%
68%
54%
97%
57%

6%

51%
4

S
No
19.
20.
21.
22.


Knowledge Areaknowledge about balanced diet
Practices for ANC and deliveries
Preferences for RHC and public hospitals
Access to traditional healers
Not part of baseline

Baseline
2%
5%
4%
30 %

Current
Finding
60%
10%
54%
8%

Second important part of the programme evaluated is dissemination or cascade of increased knowledge
to family members, relatives or communities. It was found that trainees not only cascade thisknowledge to their family members but also responded practices improved on different component ofprogramme.
a. Mostly disseminated messages are of health hygiene practices reported by 49% respondents
and vaccination to children and pregnant women by 29%.
b. Regarding First Aid and personal hygiene, hand washing with soap and water practice wasmostly improved practice among family members. Brushing teeth two times in a day, drinking
safe water and preparation of ORS in diarrhea were adopted and improved practices among.
Respondents also mentioned to make first aid box at home by mothers and sisters.
c. Respondents shared that practices about antenatal checkup increased. 81 mothers, 30 sisters
and 17 aunties took antenatal checkup during this period. Contraceptive methods have also
been adopted by 48 mothers, 18 aunties and 8 sisters to keep healthy spacing in pregnancy.
The findings suggest good impact of the intervention. This end line survey of pilot Union Counsel shows
remarkable impact on knowledge gained and practices improved in family members. But few of thecomponents like personal hygiene practices and MHM, nutrition etc needs improvement. Knowledge
can be increased in such a short duration intervention but for practices change we need to follow oursessions. We recommend replicating this programme in new union council where NRSP has its
programme presence as well as continuous Follow up with these girls on limited scale as well.

5

Background and Situation Analysis
Health Situation in Thatta
Women of reproductive age constitute almost one quarter of the total population in Pakistan andmarriage is universal. Pakistan faces broad challenges to improve women’s reproductive health. The
country falls in the high risk category for women’s sexual and reproductive health. Only 16 percent of
women have at least four antenatal care visits during pregnancy; less than one-third of births areattended by skilled health personnel, and the maternal mortality ratio, at 320 maternal deaths per
100,000 live births, remains high.
The lack in basic knowledge about health and hygiene issues is a major contributor to morbidities andmortalities within premises of a household in Pakistan. Variety of structural conditions in Pakistan
perpetuates the lack of awareness and acceptance of reproductive health, hygiene, family planning
services, nutrition and birth spacing practices. The low levels of education, especially among women,
reduce demand for health and hygiene practices in specific and well-understood ways.
Sindh Province has a population of approximately 43 million. The health care services are provided
through the public and private infra-structure and delivery system. Sindh is peculiar to have a robust andgrowing private sector in health that provides services not only to the urban but also to the rural
population.
Sindh is second most populous province of Pakistan with the maternal mortality rate (MMR) 200 per
100,000 live births which are more than MDG target of 140. According to PDHS (2012-13) neonatal
mortality rate in Sindh is increased from 44 to 54 deaths per 1000 live births and 68 % women in rural
Sindh cannot get access to any nearby health facility.
In Sindh, 67% women have no formal education and the median age at marriage is 19 years. Both thesefactors lead to early pregnancy, inadequate infant and child care. The high proportion (56%) of cosanguineous marriages in Sindh further complicate the issues as violence in the name of family or malehonor overrides the value of women’s life and their rights.
Sindh stands at lowest social and health indicators in Pakistan, only better than Baluchistan. Publichealth facility and service utilization is only 22% in Sindh with the worst under-utilized and underserved
are in districts of Thatta, Tharparkar, Jacobabad, Badin, Mirpurkhas, Kambar Shahdakot and Kashmore.
The health indicators are also worse in the same districts. This urban and rural difference in theperformance and indicators is visible from the comparison of same between urban and rural and withPakistan.
Thatta is one of the least developed districts in terms of socio economic and health indicators. In a social
context of Pakistan where role of women is already compromised in taking decisions for the bettermentof her and children become worst when we consider such geographical area. Normally after marriage
reproductive health issues come to knowledge and girls remain unaware of multiple primary health careissues. On issues like personal hygiene, family planning, immunization and even nutrition during
pregnancy, neo natal care etc girls need to be educated before marriage. According to PDHS (2012-13)
12 % teenagers from the poorest households began childbearing and teenage fertility is 8%. PDHS
(2012-13) also shows that average age of a woman to for marriage in Pakistan is 20 years. According to
6

PDHS 2012-13, ANC information reaches after second/third child. To control raised MMR and IMR in
Pakistan it is imperative to educate our unmarried women prior to marriage so that they would be able
to cope such issues. This situation calls for measures to ensure the awareness rising among the womenof reproductive age about reproductive health and hygiene.

Project Intervention
NRSP entered into agreement with AMDA for addressing the above mentioned issues in district Thatta,
UC Sukhpur, Pakistan. This programme targets women who play a key role in the health care of theirfamily. Training is provided to unmarried women of 16-22 years of age under Home Health Education
Program. Many initiatives have already been undertaken targeting married women of reproductive age
in Pakistan and according to PDHS the information related to reproductive health usually reaches quite
late by many years when it is required. Keeping in view the gaps and needs, NRSP is targeting unmarried
girls of reproductive age among the target population irrespective of wealth quintile. This according topopulation formulas would constitute 20 % of the total unmarried women and girls in the targeted
union council. These women will get knowledge before their marriage when there would be norestriction on their learning in their home environment and they would be able to take wise decision in
consultation with their parents, in laws and of course husbands. Rest of the women in the community
would also benefit indirectly as girls always discuss these learned things with them. Community would
benefit in the long run.
Chigasaki-Chuo Rotary Club-Japan (CCRC) is financially supporting this program facilitated by AMDA. In
June 2014, a formal agreement was signed between CCRC, NRSP and AMDA specifying role of eachpartner.

Project objective and Role of NRSPThe objective of project is to enhance women knowledge on how to protect themselves and their family
members from common illness. The project provided trainings to women with the expectation that thetrained women will cascade their knowledge to their families and neighborhoods. In addition, theproject supported Lady Health Workers (LHWs) or Community Health Workers (CHWs) to strengthen
their knowledge and skills on health care as a facilitator for training the girls in the field.
NRSP trained 18 trainers to train the girls / women in the field. On average 40 trainees were trained permonth. On the basis of baseline findings training modules were developed and updated. The contents ofthe course included:











Personal Hygiene
Menstrual Hygiene management
Health & Nutrition
Immunization
Polio
First Aid
ANC
Birth preparedness
Breast feeding
Birth Spacing

7

These modules were developed in Sindhi language. Each master trainer was given complete set of thesemodules to conduct session in community. Pictorial booklets were also developed for community.
We have to deal with both literate and illiterate girls. We designed our programme to cater for training
needs of both illiterate and literate girls. Similarly post and pretests were also designed to assess thelearner’s improvement in the learnings. For literate group there criteria was of at least primary pass (upto Grade 5) girls. Test was separate for both groups. For literate girls it was reading, oral or written andfor illiterate group it was only oral or pictorial.
516 learners graduated in posttest. However we needed an assessment at midterm level to know aboutchanges these learners have brought in their lives after completing the course and improvement in the
project design. So we conducted this assessment after completion of identified unmarried girls from UC
Sukhpur in 18 months duration.
NRSP is well placed in this UC Sukhpur and different initiatives have been taking in terms of social
mobilization, sanitation and health interventions particularly related to Malaria. But an unmet need isthere to provide health education Reproductive health and nutrition.
Union Council Sukhpur, Tehsil Mirpur Sakro Profile

S.#

Descriptions

Achievement

1 Total Revenue Villages

7

2 Covered by NRSP

7

3 Total Households

4399

4 Total Community Organizations (COs)5
6

Men COs

58
38

Women Cos11

Mix Cos

9

7 Total Members in COs
8
9

1311
Men
Women

927
384

8

Evaluation
The overall purpose of evaluation was to assess learning and adoption of practices recommended by ourinterventions. The evaluation was based on the indicators mentioned in training modules as well asbaseline survey. The purpose of conducting the midterm evaluation was also to identify key areas which
require improvement and for designing of similar interventions in future. The purpose of this evaluation
was to know:
1. Knowledge gained and practices improved
2. Identify the factors that facilitated or hampered the achievements
3. Compile lessons learned and recommendations to contribute towards the continuation of
Project interventions in rest of project period.

Evaluation Focus
The objectives of evaluation were:
1) To assess knowledge gained by trainees against baseline findings through KAP survey.
2) To asses improvement in knowledge dissemination and practices improved.

Study design method and technique
Detailed questionnaire was developed for Mid Project Evaluation. Questionnaire was developed keeping
in view the baseline finding to assess the impact before and after completion of targets. Team of 10
enumerators were selected and give orientation about project contents and trained in getting
information from trainees through survey.
On average three interviews were taken per day by each enumerator and in total 305 interviews weretaken.
Survey tool and list of enumerators as well as list of interviewees is annexed with the report. Data
collected was punched in Excel sheets by local team, while data was analyzed with the help of MER
department at head office of NRSP.
Initial baseline was conducted in October / November 2014 while project interventions were carried out
during Dec 2014- June 2016.
End-line questionnaire was developed in July 2016. Data collection and interviews were conducted inAugust 2016 and data punching in September, 2016.

Demographic Profile of Respondents
100% of the respondents were Muslims. All respondents were between the ages of 16 to 22 years.
Following was the age wise breakup of respondents.
Age

Number of Respondent

16
17
18
19

37
68
112
40

Percent
Respondents
12%
22%
37%
13%
9

Age

Number of Respondent

Percent
Respondents
20
14
5%
21
12
4%
22
20
7%
23
2
1%
Total
305
100%
67% of the respondents were of 17-20 years of age.
Education status (number of years)
Years ofYears ofeducation
education
0 (illiterate)
191
5
65
7
1
8
14
10
7
12
27
Total
305
88% of the respondents were illiterate.

Years of education
63%
21%
0%
5%
2%
9%
100%

Current Marital status
Numbers
Percentages
Married71
23%
Separated/ Divorced
13
4%Single/Never married
221
72%
Total
305
100%
23% of the girls got married after getting training and part of this survey.

Ethical considerations
An informed consent was taken from all participants of the study. This study did not require any otherintervention. It was the duty of data collectors to narrate and explain the objective and contents ofinterviews to participants. The participants were encouraged to ask questions and queries regarding theassignment.

10Findings of the Survey
General Findings
NRSP project was planned according to the requirements of local communities of district Thatta. The
objectives of the project are relevant in terms of government’s priorities, policies and community needs.
Given the limited time span of the programme, high illiteracy among women and delay of the training
sessions, overall project has produced good results. The programme has been focused on creatingawareness in the community.
The major barrier reported by the trainers was cultural taboos in the region. Response on familyplanning was low due to these taboos. Project coordinator and master trainers had to convince people
that NRSP has hired local people familiar with the local problems for this purpose and they need tocome in counseling sessions to benefit from the programme.
Awareness raising training sessions/lectures of the project have improved awareness amongst most of
the trainees whether they got passed at the end of sessions or not. One of the important findings wasthat community had knowledge whether their drinkable water is tested or not. Their knowledge about
diarrhea has increased to an extent that they know management of diarrhea at household level and canmake ORS at home to save children death which is second bigger cause of children under 5 deaths inPakistan.
Regarding Immunization, knowledge was already there that children and pregnant women should get
vaccination but after this programme, knowledge about exact schedule of EPI, diseases against whichchildren vaccinated is known by communities now. They responded about TT vaccination schedule andsign and symptoms of Polio and Measles.
Knowledge about benefits of balanced and side effects of imbalanced diet has also improved.
Reproductive health sessions were the most important sessions and most difficult as well to deliver inthis society. But because of local trainers and confidence on NRSP parents were convinced to give thisknowledge to their unmarried girls. Although Family planning session was less responded, respondent’s
knowledge about names of different methods available increased from 28% to 54% but their responses
regarding purpose of usage still needs to increase. They were shy in responding to these questions.
Overall knowledge regarding RH has been increased a lot and girls who got married after taking thesetrainings are utilizing this knowledge. In addition, the importance of colostrum and exclusive breast
feeding is ingrained in them through sessions under this project and majority of the community
members shared that now they follow the practices learned in the sessions.
Knowledge dissemination was the most important part of the programme. Trainees cascade thisknowledge to their family members, neighbors and village communities. They observed improvement inpractices and shared most impacted practices in their surroundings.
The situation in the government health facilities are quite critical since there was shortage of essential
medicines. Community approaches and practices to access public and private facilities was assessed at
the end for health seeking behavior. Community practices have improved but we are lacking at service
side.
11

In general, the mechanism for implementation of the project has worked efficiently. This means, inmanagement terms, representative of a mature organization that has an organization-wide ability for
managing initiatives based on standardized, defined management processes. These processes can be
tailored to meet specific organizational needs and are increasingly likely to be updated whenevernecessary with improvements developed and implemented in accordance with a sound development
plan.

Detail Analysis of Impact Assessment Survey
Increase in Knowledge
The knowledge of target group regarding different components of health was assessed according totheir responses to the questions mentioned in the questionnaire and the impact on their knowledge wasrecorded after training.

Personal Hygiene
In the baseline survey, 92% of the respondents reported hand washing before eating meals, 68%
responded for washing hands before cooking and 100% agreed for washing hands after using toilets but
all the respondents agreed for hand washing with only water none of them had the information about
the benefits of soap.
After 18 months intervention, washing hands with soap and water is increased from 0% to 99%. Hand
washing before eating meals is improved from 92% to 99% and before cooking is increased from 68% to100%.
99% responded forhand washing withsoap and water
after and before any
activity.

Handwashing
120
100
80
60
40
20
0
Before eating meals

Before cooking
BeforeAfter toilet usage

Handwashing with
soap

After

Regarding behavior of having latrines and types of latrines at homes was also evaluated. Community
practices of going out for defecation in open air is decreased from 56% to 21%. Respondents having no
latrines decreased from 47% to 2%. Percentage of flush latrines increased from 15% to 51% while pit
latrines decreased from 29% to 26%. Reason of increased in flush latrines construction is that NSRP is
implementing a WASH project in the same area complimenting increase in construction of flush latrines
instead of pit latrines.

12Another important indicator asked in evaluation survey is respondent awareness about source ofdrinking water. 61% respondents knew that their source of drinking water is drinkable and tested.

61% respondents
know that theirsource of drinking
water is drinkable
and tested.

Toilet Facility
60
50
40
30
20
10
0
Respondents with
Flush Toilet

Respondents using
Pit Toilet/Latrine
BeforeNo Laterine at allOpen Defecation

After

Menstruation hygiene practices were not part of baseline survey in detail but in evaluation survey 76%
responded for started using cloth pad but still not practicing of taking bath during menses and wearing
clean clothes.

Practices during Menstruation
80
70
60
50
40
30
20
10
0
Usage of clothes pad

Usage of commercial
padStart eating hot things Start wearing of clean Start eating Fruits andclothes
Usage of milk

Knowledge about Diarrhea
Regarding knowledge on diseases spread due to open defecation was 29% increased to 91%. 27%
respondents shared that breast feeding should continue during breast feeding at the time of baseline isincreased to 99%. Regarding ORS giving in diarrhea and preparation of ORS increased from 40% to 98%
and 5% to 99% respectively.
13

Knowledge about Diarrhea
120
100
80
60
40
20
0
Disaeses spread due to open Breastfeeding during diarrhea Giving ORS during diarrhea
defecation
BeforeProcedure to make ORS

After

Immunization
Among the respondents high knowledge about immunization was available at the start of the project as
96% respondents knew the importance of immunization and 98% said that the children in theircommunities were receiving vaccination services. But none of the respondents knew about the age at
which the vaccination schedule is completed. Now, 84% responded about the age of schedule
completion.

Immunization
120
100
80
60
40
20
0
BeforeAfter

Do you know by which age children complete their immunization course in Pakistan?
Why children should get vaccination

In the baseline survey some basic indicators were part of the questionnaire but in evaluation we probe
some detailed questions too. Like knowledge about Immunization, measles and TT vaccination was not14

part of baseline survey in detail. In evaluation survey increased in knowledge of vaccinations came out
significantly.
90% respondents
told diseases names
covered in EPI
schedule.

Knowledge about Immunization
100
80
60
40
20
0
Age at which EPI schedule
completed

Number of visits tocomplete scheduleNames of diseases covered
in EPI schedule

According to the survey, 85% said the vaccination services are received from LHWs, 8% from EPI centers
7% and 2% from dispensaries or other facilities.

Places children get vaccination from
Vaccinator
2%
Dispensary
1%
EPI Centre
8%

LHW
84%

DHQ
1%
LHV
1%
Private doctor
3%

Dispensary

EPI Centre

DHQ

LHV

Private doctor

LHW

Vaccinator

Polio
Knowledge regarding polio disease has been increased remarkably too. 85% of the respondents had theknowledge about quantity Polio drops against 52% in baseline and 76% knew about the effects of Polio
drops whereas in baseline 42% knew about the signs and symptoms of Polio.
15

Knowledge about Polio
90
80
70
60
50
40
30
20
10
0
Age at which polio vaccine
startedAge when polio affects
BeforeNo. of drops of polio given

kmowledge about sign andsymtoms of polio

After

MeaslesAt the time of baseline, 23% had information about the danger signs of measles is increased to 70%.
Only 11% had the information about the vaccination against Measles is increased to 94% and knowledge
about age to get vaccination is increased from 3% to 71%.
70%
respondents
knew thedangerous signand symptomsof measles.

Measles
100
80
60
40
20
0
Knowledge about Measels
preventive Injection

Dangerous sign of Measels
BeforeKnowledge about time to get
injection

After

TT Vaccination
Regarding TT vaccination in pregnant women 80% responded the name of vaccine name given in
pregnancy and 49% told schedule of vaccination given in Pakistan.

16Knowledge About TT Vaccination
90
80
70
60
50
40
30
20
10
0
Name of Vaccine During Pregnancy

TT Vaccination Schedule

Knowledge about Importance of Nutrition
2% of the respondents had the information about balanced diet and its side effects; however, 35% had
the knowledge that more than three meals should be given to the children of 2 to 5 years of age.
After Intervention of HHEP, 60% respondents told benefits of balanced diet. While knowledge regardingside effects of imbalanced diet and number of meals 2-5 years children in a day has been increased to
69% and 54% respectively.

Knowledge abut Importance of Nutrition
80
70
60
50
40
30
20
10
0
Benefits of balanced dietSide effects of imbalanced diet
BeforeNumber of meals of 24 - 60 months
children

After

17

Knowledge about Reproductive Health (ANC, Birth preparedness, Contraceptives methods)
Regarding Antenatal care, 25% of the respondents had the information that unforeseen problems canoccur during pregnancy and child birth in the baseline survey has been increase to 88%. But only 11%
were able to identify bleeding as a complication during pregnancy and only 1% had the idea about theminimum required antenatal visits during a pregnancy and responded as four visits in baseline survey
has been increased to 59% and 68%.

Antenatal Care
80
70
60
50
40
30
20
10
0
Knowledge about most serious problem occur during
pregnancy
BeforeAwareness regarding number of Antenatal visitsAfter

25% had the knowledge about birth preparedness is increased to 97%; only 1% had the idea about
identification of skilled birth attendant and place of delivery is increased to 57%. Regarding thepreferred place for delivery 50% preferred home is decreased to 17%, 23% private facility increased to63%, 24% CMW house decreased to 23 and only 3% preferred Public facility for delivery increased to18%.

Birth prepardness
120
100
80
60
40
20
0
BeforeBirth preparedness

After
identifying skilled health provider and place of delivery

18

Preferred place for Delivery
70
60
50
40
30
20
10
0
Home (Including home ofrelative/TBA etc.)

Private facility

Public facility

BeforeCMW house

After

For Neonatal care, 34% responded that the child should be covered properly immediately after birth at
the time of baseline. 17% had the information about breast feeding and 53% knew about the duration of
exclusive breast feeding 18 months back.
Now, 53% shared the correct knowledge to covered properly newborn after birth whereas about breast
feeding their knowledge has been increased to 69% and duration to 82%.

Neonatal care
90
80
70
60
50
40
30
20
10
0
Most important thing to be done fornewborn care

Exclusive breast feeding
BeforeDuration of exclusive breast feeding

After

Regarding contraceptive methods, 28% respondents told names of contraceptive methods before
starting intervention is increased to 54% but information regarding purpose of using them is still not
improved.

19

Named the contraceptives methods
60
50
40
30
20
10
0
BeforeAfterFirst Aid
The baseline survey showed that the communities have very less information about First Aid as only 6%
knew about First aid and 4% had an idea about when first aid is to be provided but none of them wereable to mention any of the condition in which first aid is required.
In evaluation survey of piloted UC, 51% knew the names of emergencies in which first aid given and 28%
responded regarding accidental cases first aid given. Only 10% were unable to respond properly or had
incomplete knowledge.

First Aid knowledge
60
50
40
30
20
10
0
Emergencies in which First Aid given

Accidental cases in which First Aid given

Don’t know

Dissemination of Knowledge and practices improved
Second important part of the programme evaluated is dissemination or cascade of increased knowledge
to family members, relatives or communities. It was found that trainees not only cascade thisknowledge to their family members but also responded practices improved on different component ofprogramme.

20

Health seeking behavior
During the baseline survey questions were also asked to assess about the health seeking behavior forminor and major ailments and for seeking maternal health care services. According to the respondents
for minor ailments 41% prefer to go to traditional practitioners, 27% to private hospital, 30% to Public
Health Facilities including Basic Health Unit and Rural Health Center.
In the end-line survey, practices approaching to RHC and public hospital has been overall slightly
increased and access private health facilities increased remarkably. At the same time approach to
traditional healers has been decreased.

Places visited for minor ailments
40
35
30
25
20
15
10
5
0
BHU

RHC

Public hospitalother than RHC
Before Programme

Private Hospital

Hakeem

Traditional
Healer/pir etc

After Programme

For major ailments 63% of the respondents preferred to go to private hospital and 36% to Public Healthfacilities 35% to Basic Health Center and 1% to Rural Health center in the baseline.
This practice has also been improved as 22% respondents said to approach public health facility and RHC
and 48% to private health facility. While access to traditional healers has been decreased from 30% to8%.

21Places visited for major ailments
60
50
40
30
20
10
0
BHU

RHC

Public hospitalother than RHC
Before Programme

Private Hospital

Hakeem

Traditional
Healer/pir etc

After Programme

99% respondents said that they are disseminating knowledge further to communities, family members
and relatives. Mostly disseminated messages are of health hygiene practices reported by 49%
respondents and vaccination to children and pregnant women by 29%.

Mostly disseminated messeges

Health and hygiene practices
First Aid practices
Nutritional intake
Get vaccination of children and PW according to schedule and polio drops
Practice breast feeding, ANC and Family Plannaing
Nutritional intake & Get vaccination of children and PW according to schedule and polio drops

According to respondents, most improved practices improved in their families and communities are ofhealth and hygiene, vaccination of children and PWs and reproductive health. 81% responded reported
improved health and hygiene practices, 7% responded increased practice of getting vaccination ofchildren and pregnant women and 2% regarding practices breast feeding, ANC and family planning.
22

Most improved practices observed
90
80
70
60
50
40
30
20
10
0
Health and hygiene practices

Get vaccination of children and PW
according to schedule

Practice breast feeding, ANC and Family
Plannaing

Regarding practices for ANC and deliveries, preferences for RHC and public hospitals have been
increased from 5% to 10% and 4% to 54% respectively.

Places prefernces for ANC and Deliveries
70
60
50
40
30
20
10
0
BHU

RHC

Public hospital otherthan RHC

Before Programme

Private Hospital

Traditional Healer/pir
etc

After Programme

Mostly mothers, sisters, brothers, relatives and neighbors were reported impacted and influenced byprogramme interventions. These relations adopted most of the interventions and practices.
Regarding First Aid and personal hygiene, hand washing with soap and water practice was mostly
improved practice among family members. Brushing teeth two times in a day, drinking safe water andpreparation of ORS in diarrhea were adopted and improved practices among. Respondents alsomentioned to make first aid box at home by mothers and sisters.

23

Changes in practices about First Aid and hygiene
140
120
100
80
60
40
20
0
Made first Aid Clean teeth 2 Hand Wash
box in our times in a day with Soup afterHomeand before
eating,cooking, using
toilet etc.
MotherDrink Safe
Water

SisterMaking ORS
Usage of
Clean homeand used it in washroom anddiarrhea
its cleaning

Brother

Familyto takemeasure about
good health

AuntieRespondents shared that vaccination for children and pregnant women is remarkably increased andpractices to get vaccination among family members and relatives affected.

Changes in practices about Immunization
250
200
150
100
50
0
Started vaccination ofChildren’s in my family

Started vaccination ofChildren’s in my family &Started vaccination of PW
MotherSisterFamilyVaccination of Measles

AuntieNow I am vaccinatedFriendNutritional intake and concept of balanced diet was the most difficult practice to adopt. Intake ofbalanced diet was adopted by family members, importance of girl’s education and equal diet to girls andboys were major practices adopted by mothers.

24

Nutrition intake practices
100
80
60
40
20
0
Intake of balance Diet
/use of meat and Fish

Importence of girls
Education
MotherUsage of meat, oily
things and milk

Give the equal diet togirls and boys

SisterAuntieBrother

FamilyGive the fruit andbalanced diet tochildren

FriendRespondents shared that practices about antenatal checkup increased. 81 mothers, 30 sisters and 17
aunties took antenatal checkup during this period. Contraceptive methods have also been adopted by
48 mothers, 18 aunties and 8 sisters to keep healthy spacing in pregnancy.

Changes in practices for ANC and FP
LHW contact
Advise and knowledge to PW
Use of Contraceptive methods
Health and Personal Hygiene
Antenatal Care
Delivery at hospitals
0

20

40

60

MotherSisterBrother

Family80
Auntie100
Friend

120

140

160

Neighbour

Lesson Learnt and Recommendations
This end line survey of pilot Union Counsel shows remarkable impact on knowledge gained and practices
improved in family members. But few of the components like personal hygiene practices and MHM,
nutrition etc needs improvement. Knowledge can be increased in such a short duration intervention but
for practices change we need to follow our sessions.

25

Feedback recorded by our field team is that trainees are hesitant and feel shy in getting FP methods
sessions and First aid session is tough for them to understand. It should be simplified or can be divided
in two sessions. Keeping in view the literacy level and sessions technicalities, refreshers should be plan.
NRSP three tier structure is well placed in SukhPur and helped in accessing refusal villages. Thoughcommunity organizations is mixed (men and women) where ratio of women is low as compared to men
but for delivering culturally resistant messages; NRSP core mobilization network helped in convincing
parents to send their daughter for this programme.
Most importantly it is very hard to digest and sustain knowledge in one time training session. Follow up
is necessary and duration of session should also be increased as in this duration (60-90) taking
attendance, helping in pre and post-tests specifically for illiterate increased the time recommended forsession.
Engaging LHWs officially in the programme is helpful in gaining confidence of health department andbuilding community links with them.

Conclusion
The findings suggest good impact of the intervention. This end line survey of pilot Union Counsel shows
remarkable impact on knowledge gained and practices improved in family members. But few of thecomponents like personal hygiene practices and MHM, nutrition etc needs improvement. Knowledge
can be increased in such a short duration intervention but for practices change we need to follow oursessions. We recommend replicating this programme in new union council where NRSP has its
programme presence as well as continuous Follow up with these girls on limited scale as well.

26‫‪Appendix I‬‬‫)‪Questionnaire designed (Sindhi / English‬‬‫عورتن الء سوالنامو‬‫)‪Respondent Information (for adult who answers door‬‬‫السالم عليڪم‪ .‬منهنجو نالو _____________________________ آهي ۽ آئون نيشنل رورل سپورٽ پروگرام‬‫طرفان سروي ڪري رهي‪ /‬رهيو آهيان‪ .‬ڇا توهان ( ‪ 17-22‬سالن جي ڇوڪري) ڪجه سوالن جا جواب ڏيڻ پسند ڪندو؟‬‫جيڪڏهن ها ته شڪريو ادا ڪريو ۽ انٽرويو جاري رکو؛ جيڪڏهن نه ته شڪريو ادا ڪريو ۽ انٽرويو بند ڪري‪ ،‬هيٺ‬‫ڏنل خاني تي نشان لڳايو‪.‬‬‫‪ ‬انٽرويو ڏيندڙ سروي ۾ شرڪت ڪرڻ کان انڪار ڪري ٿي‬‫صحيحون‬‫جيڪڏهن توهان کي ڪو ٻيو سوال نه آهي ۽ سروي ۾ شرڪت ڪرڻ الء تيار آهيو ته آئون توهان کي گذارش‬‫ڪندس‪/‬ڪنديس ته توهان هن فارم تي صحيح ڪريو‪ .‬جيڪو بيان ڪري ٿو ته آئون انٽرويو وٺندڙ توهان کي انٽرويو‬‫ڏيندڙ طور توهان جي حقن جي باري ۾ ٻڌايو آهي ۽ توهان انٽرويو ۾ شريڪ ٿيڻ الء راضي ٿيا آهيو‪ .‬اسان توهان جي‬‫وقت ڏيڻ الء شڪر گذار آهيون‪.‬‬‫مون هن راضي نامي واري فارم تي ڏنل معلومات پڙهي آهي يا مون کي پڙهي ٻڌائي وئي آهي‪ .‬سروي بابت منهنجن‬‫سمورن سوالن ۽ شرڪت بابت سوالن جا جواب ڏنا ويا‪ .‬آئون سمجهان ٿي ته ان سروي ۾منهنجي شموليت جو مقصد ڇا‬‫آهي ۽ آئون سمجهان ٿي ته منهنجي شرڪت رضاڪارانه آهي‪ .‬آئون ڪنهن به وقت‪ ،‬ڪنهن به سبب جي ڪري‪ ،‬سروي‬‫۾ شرڪت کان بغير ڪنهن ڏنڊ جي انڪار ڪري سگهان ٿي‪.‬‬‫شرڪت ڪندڙ جو نالو‬‫_____________________________‬‫___________________‬‫شرڪت ڪندڙ جي صحيح‬‫تاريخ‬‫______________________________‬‫شرڪت ڪندڙ جي آڱوٺي جو نشان‬‫جيڪڏهن صحيح نه ٿو ڪري سگهي‬‫انٽرويو وٺندڙ جو نالو‬‫_____________________________‬‫___________________‬‫‪27‬‬‫انٽرويو وٺندڙ جي صحيح‬‫تاريخ‬‫______________________________‬

‫‪Section 1: Data Entry Information:‬‬‫‪.1‬‬‫ضلعو‪:‬‬‫‪.2‬‬‫تعلقو‪:‬‬‫‪.3‬‬‫ڳوٺ‪:‬‬‫‪.4‬‬‫تاريخ‪:‬‬‫‪.5‬‬‫گهر جو پتو‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫اسالم‬‫هندو‬‫عيسائي‬‫ڪو ٻيو‬‫‪6‬‬‫انٽرويو ڏيندڙ جو نالو‬‫‪.7‬‬‫مذهب‬‫‪.8‬‬‫عمر سالن ۾‬‫‪.9‬‬‫تعليم‬‫(‬‫معيار‬‫تعليمي‬‫_____________________‬‫‪.10‬‬‫گهر ۾ جيڪا ٻولي ڳالهائي وڃي ٿي‬‫(ڪنهن به هڪ تي نشان لڳايو)‬‫‪.11‬‬‫انٽرويو وٺندڙ جو نالو‪:‬‬‫‪.12‬‬‫شروع ٿيڻ جو وقت‬‫‪.13‬‬‫ختم ٿيڻ جو وقت‬‫‪.14‬‬‫نتيجي جو ڪوڊ‬‫‪28‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫سنڌي‬‫سرائڪي‬‫بلوچي‬‫پنجابي‬‫اردو‬‫ڪا ٻي‬‫مڪمل انٽرويو‬‫اڻپورو انٽرويو‬‫گهر ۾ ڪوبه موجود نه هو‬‫انٽرويو کان انڪار‬‫جا‬‫سال)‬‫‪Demographic and Household Information‬‬‫‪15‬‬‫‪.‬‬‫‪16‬‬‫‪.‬‬‫ڇا توهان لکڻ ۽ پڙهڻ جي قابل آهيو؟‬‫وڌ کان وڌ ڪيتري تعليم مڪمل ڪئي آهي؟‬‫(ڪنهن به هڪ جواب تي نشان لڳايو)‬‫‪17‬‬‫‪.‬‬‫هن وقت توهان جي ازدواجي حيثيت ڇا آهي؟‬‫(ڪنهن به هڪ جواب تي نشان لڳايو)‬‫‪18‬‬‫‪.‬‬‫‪19‬‬‫‪.‬‬‫جيڪڏهن شادي شده‪ ،‬ته ڪڏهن شادي ڪئي؟‬‫ڇا توهان اين آر ايس پي طرفان گهر جي سطح تي صحت بابت تعليم جو‬‫پروگرام تحت تربيت ڪئي آهي؟‬‫(ڪنهن به هڪ جواب تي نشان لڳايو)‬‫‪20‬‬‫‪.‬‬‫‪29‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫نه‪/‬ڪجه به نه‬‫پرائمري‬‫سيڪنڊري‬‫ٽيڪنيڪل اسڪول‬‫ڪاليج‬‫يونيورسٽي‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫شادي شده‬‫الهدگي‪ /‬طالق يافته‬‫بيوه‬‫ڪنواري‪ /‬شادي نه ڪئي‬‫آهي‬‫‪ .1‬تربيت کان پهرين‬‫‪ .2‬تربيت کان پوء‬‫‪ .3‬شادي َء الء رٿيو آهي‪.‬‬‫‪ .1‬نه‬‫‪ .2‬ها‬‫‪ .3‬خبر نه آهي ‪ /‬ڪوبه جواب‬‫نه‬‫‪.1‬‬‫جيڪڏهن ها‪ ،‬ته ڪهڙا موضوع؟‬‫‪21‬‬‫‪.‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫فقط پڙهڻ‬‫فقط لکڻ‬‫ٻئي لکڻ ۽ پڙهڻ‬‫لکي ۽ پڙهي نه سگهڻ‬‫ڇا توهان اين آر ايس پي طرفان صحت ۽ صفائي جي موضوع تي پوسٽ‬‫ٽيسٽ پاس ڪئي آهي؟‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫توليدي صحت ۽ کاڌ‬‫خوراڪ‬‫حفاظتي ٽڪا‬‫ابتدائي طبي امداد‬‫حفظان صحت جي تعليم‬‫ٻيو ڪو (وضاحت ڪريو)‬‫خبر نه آهي ‪ /‬ڪوبه جواب‬‫نه‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪Section 2: Health & Hygiene‬‬‫‪.22‬‬‫ڇا توهان کي ڄاڻ آهي ته ماني کائڻ کان پهرين اسان کي هٿ‬‫ڇا سان ڌوئڻ گهرجن؟‬‫‪.23‬‬‫ڇا توهان کي ڄاڻ آهي ته کاڌو پچائڻ کان پهرين اسان کي هٿ‬‫ڇا سان ڌوئڻ گهرجن؟‬‫‪.24‬‬‫ڇا توهان کي ڄاڻ آهي ته هاجت کان پوء اسان کي هٿ ڇا‬‫سان ڌوئڻ گهرجن؟‬‫‪ .1‬پاڻي ۽ صابڻ‬‫‪ .2‬فقط پاڻي‬‫‪ .1‬پاڻي ۽ صابڻ‬‫‪ .2‬فقط پاڻي‬‫‪ .1‬پاڻي ۽ صابڻ‬‫‪ .2‬فقط پاڻي‬‫‪.25‬‬‫توهان ڪهڙي قسم جو ڪاڪوس خانو استعمال ڪريو ٿا؟‬‫‪.26‬‬‫ڇا توهان کي ڄاڻ آهي ته کليل جڳهه تي ڪاڪوس ڪرڻ‬‫سان ڪهڙيون بيماريون ڦهلجن ٿيون؟‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫پڪو ڪاڪوس خانو‬‫کڏي وارو‪ /‬ڪچو ڪاڪوس خانو‬‫ڪوبه نه‬‫کليل جڳهه تي ڪاڪوس ڪرڻ‬‫ڪو ٻيو ( وضاحت ڪريو‬‫‪)......................................‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫دست الٽي‬‫ڪينسر‬‫ٽائفائيڊ يا مدي جو بخار‬‫يا ڪا ٻي ( وضاحت‬‫‪)......................................‬‬‫خبر نه آهي‬‫‪.5‬‬‫‪.27‬‬‫ڇا توهان ڄاڻو ٿا؛ ته توهان وٽ موجود پيئڻ جي نلڪي جو‬‫پاڻي چڪاس ٿيل آهي؟‬‫‪.28‬‬‫اها َپڪ ڪڏهن ٿيندي آهي ته ٻار کي ڊائيريا (دست ۽ الٽيون)‬‫آهي؟‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪.1‬‬‫ٻار کي ‪ 24‬ڪالڪن ۾ ٽي يا وڌيڪ‬‫دفعا پاڻي َء جهڙا دست ٿين‬‫ٻار کي ‪ 24‬ڪالڪن ۾ پنج يا وڌيڪ‬‫دفعا پاڻي َء جهڙا دست ٿين‬‫ٻار کي هڪ ڪالڪ ۾ ٽي يا وڌيڪ‬‫دفعا پاڻي َء جهڙا دست ٿين‬‫خبر نه آهي‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫ها‬‫نه‬‫خبر نه آهي‬‫نمڪول‬‫ٿڃ بند ڪجي‬‫چانهن‬‫خبر نه آهي‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.29‬‬‫‪.30‬‬‫‪30‬‬‫ڊائيريا (دست ۽ اُلٽيون) هئڻ جي صورت ۾ ٻار کي ما ُء جو کير‬‫پيارڻ گهرجي؟‬‫جيڪڏهن ڪو ٻار دستن جي بيماري َء ۾ مبتال هجي ته ان کي‬‫ڇا ڏيڻ گهرجي؟‬‫ڪريو‬

‫‪.31‬‬‫‪.32‬‬‫ڇا توهان کي خبر ته نمڪول ڪيئن ٺاهجي؟‬‫جيڪڏهن ها‪ ،‬ته نمڪول ٺاهڻ جو طريقو پڇو؟‬‫‪.33‬‬‫هڪ ڏينهن ۾ گهٽ ۾ گهٽ ڪيترا ڀيرا ڏند صاف ڪرڻ‬‫گهرجن؟‬‫‪.34‬‬‫توهان کي ابتدائي طبعي امداد جي باري ۾ خبر آهي؟‬‫‪.35‬‬‫توهان کي خبر آهي ته ابتدائي طبعي امداد ڪڏهن ڏيڻ کپي؟‬‫‪.36‬‬‫ڇا توهان کي خبر آهي ته ڪهڙي قسم جي ايمرجنسين تي‬‫بنيادي طبعي امداد جي ذريعي قابو پائي سگهجي ٿو؟‬‫‪.37‬‬‫توهان ماهواري َء دوران ڪهڙا قدم کڻڻ شروع ڪيا آهن‪ ،‬جن‬‫جي تربيت کان پهرين ڄاڻ نه هئي؟‬‫‪.38‬‬‫تربيت حاصل ڪرڻ کان پوء‪ ،‬روزمره جي زندگي َء ۾ توهان‬‫ڪهڙيون تبديليون آنديون؟‬‫‪.39‬‬‫‪Section 3. Immunization‬‬‫‪.40‬‬‫‪31‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫هڪ ڏينهن ۾ٻه دفعا‬‫هفتي ۾ هڪ دفعو‬‫ضرورت مطابق‬‫خبر نه آهي‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪ .1‬ايمرجنسي َء جي صورت ۾‬‫‪ .2‬حادثي جي صورت ۾‬‫‪ .3‬خبر نه آهي‬‫‪ .1‬ساه گهٽجڻ‬‫‪ .2‬هڏي جو ٽٽڻ‬‫‪ .3‬دل جو دورو‬‫‪ .4‬زخمن الء بنيادي طبي امداد‬‫‪ .5‬ملم پٽي‬‫‪ .6‬عضوي جو ڪٽجڻ‬‫‪ .7‬ريڙه جي هڏي َء جي زخم جي چڪاس‬‫‪ .8‬مغز جو ڌڪ‬‫‪ .9‬جانور جوچڪ يا ڏنگ‬‫‪ .10‬سڙڻ‬‫‪ .11‬مٿيان سڀ‬‫‪ .12‬خبر نه آهي‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪ .3‬جيڪڏهن ها ته ڪنهن کي آماده ڪيو‬‫ڪريو‬‫وضاحت‬‫‪...............................................‬‬‫‪..............................................‬‬‫ڇا ان ڏس ۾ توهان ٻيو ڪنهن کي آماده ڪيو؟‬‫ڇا توهان جي عالئقي ۾ ٻارن کي بيمارين کان بچا َء جا‬‫ٽڪا لڳرايا وڃن ٿا؟‬‫‪.1‬‬‫‪.2‬‬‫‪.1‬‬‫‪.2‬‬‫ها‬‫نه‬‫چڱي نموني ڄاڻي ٿي‬‫گهر ۾ نمڪول ٺاهڻ جو طريقه ڪار‬‫نٿي ڄاڻي‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪.41‬‬‫ڇا توهان ڄاڻو ٿا ته پاڪستان ۾ ٻارن ۾ ڪيتري عمر ۾‬‫حفاظتي ٽڪن جو ڪورس مڪمل ڪرايو وڃي ٿو؟‬‫‪.42‬‬‫توهان جي عالئقي جي ٻارن کي ڪٿان حفاظتي ٽڪا‬‫لڳرايا وڃن ٿا؟‬‫‪.43‬‬‫ٻارن کي حفاّظتي ٽڪا ڇو لڳڻ گهرجن؟‬‫‪.44‬‬‫حفاظتي ٽڪن جو ڪورس مڪمل ڪرڻ الء هڪ ٻار‬‫کي ڪيترا ڀيرا ليڊي هيلٿ ورڪر ايندي آهي؟‬‫‪.45‬‬‫ڇا توهان انهن خطرناڪ بيمارين جا ناال ٻڌائيندا جنهن‬‫الء پاڪستان ۾ ٻارن کي حفاظتي ٽڪا لڳايا وڃن ٿا؟‬‫‪.46‬‬‫ڇا توهان ان ٽڪي جو نالو ٻڌائيندا جيڪو حامال عورت‬‫کي لڳايو ويندو آهي؟‬‫‪.47‬‬‫ڇا توهان ‪ 15‬کان ‪ 49‬سالن وارين عورتن ۾ جهٽڪن‬‫واري بيماري جي ٽڪن جو شيڊيول ٻڌائيندا ؟‬‫‪.48‬‬‫ڇا توهان ٻڌائيندا ته ٻار کي ڪهڙي عمر کان پوليو‬‫ويڪسين شروع ڪرائجي؟‬‫‪.49‬‬‫پوليو ڪيتري عمر تائين اثر انداز ٿيندو آهي؟‬‫‪32‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪ 5‬سالن تائين‬‫‪ 23‬مهينن تائين‬‫‪3‬سالن تائين‬‫خبر نه آهي‬‫ڊسپينسري‬‫اي پي آء سينٽر (حفاظتي ٽڪن جو مرڪز)‬‫ڊي ايڇ ڪيو‬‫ايل ايڇ وي‬‫پرائيويٽ ڊاڪٽر‬‫ڪو ٻيو هنڌ‪ ،‬وضاحت ڪريو ‪..................‬‬‫انهن کي بيمارين کان بچائڻ الء‬‫انهن کي صحتمند بنائڻ الء‬‫گورنمينٽ جي اسرار تي‬‫ايل ايڇ وي جي اسرار تي‬‫ٻيو ڪو سبب‪ ،‬وضاحت ڪريو ‪...............‬‬‫‪ 6‬دفعا‬‫‪ 9‬دفعا‬‫خبر نه آهي‬‫‪ .1‬ٽي بي‬‫‪ .2‬پوليو‬‫‪ .3‬تشنج يا جهٽڪن واري بيماري‬‫‪ .4‬خناق‬‫‪ .5‬ڪاري کنگه‬‫‪ .6‬هيپاٽائيٽس بي‬‫‪ .7‬نمونيا‬‫‪ .8‬گردن ٽوڙ بخار‬‫‪ .9‬ارڙي‬‫‪ .10‬مٿيون سڀ‬‫‪ .11‬خبر نه آهي‬‫‪ .1‬اورڙي‬‫‪ .2‬تشنج يا جهٽڪن واري بيماري‬‫‪ .3‬خبر نه آهي‬‫‪ .1‬شيڊيول ٻڌايو‬‫‪ .2‬خبر نه آهي‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.7‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫ڄمڻ وقت‬‫‪ 2‬کان ‪ 5‬سالن تائين‬‫‪ 2‬کان ‪ 12‬سالن تائين‬‫ڪنهن به عمر ۾‬‫خبر نه آهي‬
‫‪2‬‬
‫‪5‬‬
‫‪12‬‬‫ڪنهن به عمر ۾‬‫خبر نه آهي‬

‫‪.50‬‬‫گذريل ‪ 5‬سالن ۾ توهان جي گهر‪/‬پاڙي‪/‬مائٽن ۾ ‪2‬کان ‪5‬‬‫سالن جو اهڙو ڪو ٻار آهي‪ ،‬جيڪو پوليو کان متاثر ٿيو‬‫هجي؟‬‫‪.51‬‬‫عام طور تي پوليو جا گهڻا ڦڙا پياريا ويندا آهن؟‬‫‪.52‬‬‫ڇا ٿيندو جيڪڏهن ڪو ٻار پوليو کان متاثر ٿئي؟‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪.53‬‬‫ڇا توهان ارڙي جون خطرناڪ عالمتون ٻڌائيندا؟‬‫‪.54‬‬‫ڇا توهان ارڙي خالف بچا ُء جي ٽڪي بابت ڄاڻو ٿا؟‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.1‬‬‫‪.2‬‬

‫‪5‬‬
‫‪2‬‬
‫‪3‬‬
‫وڌيڪ‬‫خبر نه آهي‬‫عضوا ڦري وڃن ٿا‬‫چڪر اچڻ شروع ٿي وڃن ٿا‬‫اکيون متاثر ٿين ٿيون‬‫سڀ‬‫خبر نه آهي‬‫فيس ريش‪ /‬ارڙي‬‫فيس ريش‪ /‬ارڙي ۽ بخار‬‫ڪو ٻيو‬‫ها‬‫نه‬‫‪.55‬‬‫جيڪڏهن ها ته ارڙي َء جو ٽڪو ڪڏهن لڳرائڻ‬‫گهرجي؟‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫ٽن مهينن کان پوء‬‫ڇهن مهينن کان پوء‬‫نون مهينن کان پوء‬‫پهريون نون مهينن جي عمر ۾ ۽ ٻيو پندرهن مهينن جي‬‫عمر ۾‬‫ڪو ٻيو‬‫‪.56‬‬‫تربيت حاصل ڪرڻ کان پوء‪ ،‬روزمره جي زندگي َء ۾‬‫توهان ڪهڙيون تبديليون آنديون؟‬‫‪.57‬‬‫ڇا ان ڏس ۾ توهان ٻيو ڪنهن کي آماده ڪيو؟‬‫‪.5‬‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪ .3‬جيڪڏهن ها ته ڪنهن کي آماده ڪيو وضاحت ڪريو‬‫‪........................................................................‬‬‫‪.....................‬‬‫‪Section 4: Nutrition& Youth Health‬‬‫‪.58‬‬‫متوازن غذا جا ڪهڙا فائدا‬‫آهن؟‬‫‪33‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫طاقتور محسوس ڪرڻ‬‫جسماني ۽ ذهني واڌ ويجه‬‫مٿيان ٻئي‬‫خبر نه آهي‬

‫‪.59‬‬‫غير متوازن غذا نـه وٺڻ‬‫جا ڪهڙا نقصان آهن؟‬‫‪ 24 .60‬مهينن کان ‪ 5‬سالن‬‫واري عمر جي ٻارن کي‬‫گهڻا دفعا ماني کائڻ‬‫گهرجي؟‬‫‪ .61‬توهان جي خيال ۾ توهان‬‫جي عالئقي جي نوجوان‬‫ڇوڪرين کي ڪهڙيون‬‫مشقالتون يا مسئال درپيش‬‫آهن ؟‬‫‪ .62‬ڇا توهان جي عالئقي ۾‬‫نوجوان ڇوڪرين کي‪،‬‬‫صحت ۽ صفائي بابت ڄاڻ‬‫حاصل ڪرڻ جو ڪو‬‫ذريعو آهي؟‬‫‪.63‬‬‫جيڪڏهن اهي صحت ۽‬‫صفائي متعلق ڄاڻ حاصل‬‫ڪري رهيون آهن‪ ،‬ته‬‫ذريعو ڪهڙو آهي؟‬‫‪ .64‬تربيت حاصل ڪرڻ کان‬‫پوء‪ ،‬روزمره جي زندگي َء‬‫۾ توهان ڪهڙيون تبديليون‬‫آنديون؟‬‫‪34‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫رت جي گهٽتائي‬‫جسماني ڪمزوري‬‫ذهني ڪمزوري‬‫مٿيان سڀ‬‫ڪي ٻيا‪ ،‬وضاحت ڪريو ‪................................................‬‬‫خبر نه آهي‬‫‪ .1‬ڏينهن ۾ هڪ دفعو‬‫‪ .2‬ڏينهن ۾ ٻه دفعا‬‫‪ .3‬ڏينهن ۾ ٽي يا وڌيڪ دفعا‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.7‬‬‫‪.8‬‬‫‪.9‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫ٻاهر نٿيون وڃي سگهن‬‫ماهواري َء جو سور‬‫ڪمزوري‬‫والدين نياڻين کي نٿا پڙهائين‬‫نياڻين کي ڇوڪرن جي مقابلي ۾ گهٽ خوراڪ ملڻ‬‫گهٽ عمر ۾ شادي‬‫‪ RH‬جي باري ۾ ڄاڻ نه هجڻ‬‫ڪي ٻيا وضاحت ڪريو ‪............................‬‬‫خبر نه آهي‬
‫ها‬
‫نه‬
‫خبر نه آهي‬‫‪ .1‬غير سرڪاري تنظيم‬‫‪ .2‬ليڊي هيلٿ ورڪر‬‫‪ .3‬پرائيويٽ ڊاڪٽر‬‫‪ .4‬اسڪول‬‫‪ .5‬سوشل ورڪر‬‫‪ .6‬مولوي‬‫‪ .7‬خاندان جو ڪو فرد‬‫‪ .8‬ساهيڙي‬‫‪ .9‬ٽي وي‪/‬ميڊيا‬‫‪ .10‬اين آر ايس پي جي گهرجي سطح تي صحت جي تعليم جون تربيتون‬‫‪ .11‬ڪو ٻيو‬

‫‪.65‬‬‫ڇا ان ڏس ۾ توهان ٻيو‬‫ڪنهن کي آماده ڪيو؟‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪ .3‬جيڪڏهن ها ته ڪنهن کي آماده ڪيو وضاحت ڪريو‬‫‪.............................................................................................‬‬‫‪Section5: Contraceptive Methods, Birth Preparedness and Antenatal care‬‬‫‪ .66‬ڇا توهان کي وقفي جي‬‫باري ۾ ڄاڻ آهي؟‬‫‪.67‬‬‫‪.1‬‬‫‪.2‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.7‬‬‫‪.8‬‬‫‪.9‬‬‫‪ .69‬ڇا توهان جي خيال ۾‪،‬‬‫حمل يا ٻار ڄمڻ دوران‬‫غير متوقع مسئال ان‬‫عورت جي زندگي َء کي‬‫خطري ۾ وجهي ڇڏين ٿا؟‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪ .3‬خبر نه آهي‬‫ڇا توهان کي ڄاڻ آهي ته‬‫وقفي جا طريقا ڇو استعمال‬‫ڪيا ويندا آهن؟‬‫‪.68‬‬‫ڇا توهان کي وقفي جي‬‫طريقن جا ناال اچن ٿا؟‬‫‪35‬‬‫ها‬‫نه‬‫حمل ۾ وقفو‬‫ما ُء جي صحت کي بهتر بنائڻ‬‫ٻارن جي صحت الء‬‫خاندان جي معاشي حالت بهتر بنائڻ الء‬‫مٿيان سڀ‬‫خبر نه آهي‬‫ڪنڊم يا ڦوڪڻو‬‫پيدائش ۾ وقفي جون گوريون‬‫ڇلو‬‫پيدائش کان ‪ 6‬مهينن تائين ٿڃ پيارڻ‬‫ميالپ کان پوء گوري کائڻ‬‫سرجري‬‫عزل‬‫مٿيان سڀ‬‫خبر نه آهي‬

‫‪.70‬‬‫توهان جي خيال ۾‪ ،‬حمل يا‬‫ويم دوران صحت جا‬‫ڪهڙا پيچيده مسئال ٿي‬‫سگهن ٿا‪ ،‬جيڪي هڪ‬‫عورت جي زندگي َء الء‬‫خطري جو باعث بڻجن ٿا؟‬‫‪.71‬‬‫توهان جي خيال ۾‪ ،‬هڪ‬‫عورت کي حمل دوران‬‫ڪيترا ڀيرا طبي معائنو‬‫ڪرائڻ گهرجي؟‬‫‪.72‬‬‫ڇا توهان ويم جي تياري‬‫جي باري ۾ ٻڌو آهي؟‬‫‪.73‬‬‫توهان جي خيال ۾ هڪ‬‫عورت کي ويم جي تياري‬‫الء ڇا ڪرڻ گهرجي؟‬‫‪.74‬‬‫توهان جي عالئقي ۾ هڪ‬‫حمل واري عورت ويم الء‬‫گهڻي ڀاڱي ڪٿي وڃي ٿي؟‬‫ڪنهن هڪ تي نشان لڳايو‬‫‪ .75‬تربيت حاصل ڪرڻ کان‬‫پوء‪ ،‬روزمره جي زندگي َء‬‫۾ توهان ڪهڙيون تبديليون‬‫آنديون؟‬‫‪36‬‬‫‪ .1‬ڪوبه نه‬‫‪ .2‬رت وهڻ‬‫‪ .3‬شديد مٿي جو سور‬‫‪ .4‬ڌنڌلو ڏسڻ‬‫‪ .5‬چڪر اچڻ‬‫‪ .6‬هٿن ۽ پيرن تي سوڄ‬‫‪ .7‬تيز بخار‬‫‪ .8‬غشي‬‫‪ .9‬ساه کڻڻ ۾ تڪليف‬‫‪ .10‬شديد ڪمزوري‬‫‪ .11‬شديد پيٽ جو سور‬‫‪ .12‬ٻار جي حرڪت گهٽ وڌ ٿيڻ‬‫‪ .13‬ويم ٿيڻ کان سواء ٿيلهي جو ڦاٽڻ ۽ پاڻي وهڻ‬‫‪ .14‬ڪو ٻيو‪ .‬وضاحت ڪريو ‪...........................................‬‬‫‪ .15‬خبر نه آهي‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫هر مهيني‬‫گهٽ ۾ گهٽ ٻه دفعا‬‫گهٽ ۾ گهٽ ٽي دفعا‬‫گهٽ ۾ گهٽ چار دفعا‬‫ڪي ٻيا وضاحت ڪريو ‪............................................‬‬‫خبر نه آهي‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫ڄمڻ واري ٻار الء خريداري‬‫نالو سوچڻ‬‫تربيت يافته دائي ۽ ويم جي جڳهه جي شناخت‬‫سڀ ڪجه وقت تي ڇڏڻ‬‫ٻيو (وضاحت ڪريو ‪)..................................................‬‬‫گهر (پنهنجو‪ ،‬مائٽن جو‪ ،‬دائي جو) وغيره‬‫پرائيويٽ اسپتال‬‫گورنمينٽ اسپتال‬‫ڪميونٽي مڊ وائيف جو گهر‬‫ڪو ٻيو (وضاحت ڪريو ‪)..........................................‬‬

‫‪ .76‬ڇا ان ڏس ۾ توهان ٻيو‬‫ڪنهن کي آماده ڪيو؟‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪ .3‬جيڪڏهن ها ته ڪنهن کي آماده ڪيو وضاحت ڪريو‬‫‪.............................................................................................‬‬‫‪Section 6:Neonatal Care‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.7‬‬‫‪.8‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.77‬‬‫توهان جي خيال ۾ تازي ڄاول ٻار‬‫۾ ڪهڙيون خطرناڪ عالمتون‬‫ظاهر ٿي سگهن ٿيون؟‬‫‪.78‬‬‫توهان جي خيال ۾ هڪ تازيڄاول‬‫ٻار جي سار سنڀال الء ڪهڙي‬‫خاص شيء جو خيال رکڻ گهرجي؟‬‫(وهنجارڻ‪ ،‬ٿڃ‪ ،‬حفاظتي ٽڪا)‬‫‪.79‬‬‫توهان جي خيال ۾ خصوصي کير‬‫پيارڻ ڇا آهي؟‬‫‪.80‬‬‫‪.81‬‬‫توهان جي خيال ۾ هڪ ٻار کي‬‫ڪيتري عرصي تائين فقط ما ُء جو‬‫کير پيارڻ گهرجي؟‬‫ساه نه کڻڻ‬‫ٿڃ نه وٺڻ‬‫گهڻو روئڻ‬‫حرڪت نه ڪرڻ‬‫ڪو ٻيو (وضاهت ڪريو ‪)...................................‬‬‫وهنجارڻ‬‫ڪمبل يا چادر سان ڍڪڻ‬‫صفائي‬‫خاندان جي ماڻهن کي ڏيکارڻ‬‫کاڌو ۽ دوائون کارائڻ‬‫حفاظتي ٽڪا‬‫خاص طور ٿڃ‬‫ڪو ٻيو (وضاحت ڪريو ‪)...................................‬‬‫ٿڃ ۽ ٻيو کير جيڪڏهن ما ُء جو کير گهٽ آهي‬‫ٿڃ ۽ ٻيو کاڌو جيڪڏهن ما ُء جو کير گهٽ آهي‬‫ٿڃ ۽ پاڻي‬‫ڇهن مهينن تائين فقط ما ُء جو ٿڃ‬‫ڪو ٻيو (وضاحت ڪريو ‪)...................................‬‬‫ڪڏهن به نه‬‫ڇهن مهينن کان گهٽ‬‫ڇهه مهينا‬‫خبر نه آهي‬‫تربيت حاصل ڪرڻ کان پوء‪،‬‬‫روزمره جي زندگي َء ۾ توهان‬‫ڪهڙيون تبديليون آنديون؟‬‫‪.82‬‬‫ڇا ان ڏس ۾ توهان ٻيو ڪنهن کي‬‫آماده ڪيو؟‬‫‪ .4‬ها‬‫‪ .5‬نه‬‫جيڪڏهن ها ته ڪنهن کي آماده ڪيو وضاحت ڪريو‬‫‪.............................................................................................‬‬‫‪Section 7. Health Facilities‬‬‫‪.83‬‬‫گهرجي سطح تي صحت بابت تعليم جي سيشن کان‬‫پهرين؛ عام طور تي بيماري َء جي حالت ۾ توهان جي‬‫خاندان جا فرد ڪيڏانهن ويندا هئا؟ (فلو‪ ،‬ٿڌ‪ ،‬اتفاقي سڙڻ)‬‫ڪنهن به هڪ خاص جواب تي نشان لڳايو‪.‬‬‫‪37‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫بنيادي صحت مرڪز )‪(BHU‬‬‫ڳوٺاڻو صحت مرڪز )‪(RHC‬‬‫پبلڪ اسپتال‬‫پرائيويٽ اسپتال‬‫حڪيم‬‫روايتي عالج ڪندڙ‪/‬پير‬‫‪.84‬‬‫تربيت يا پروجيڪٽ کان پهرين‪ ،‬شديد بيماري َء جي‬‫حالت ۾ توهان جي خاندان جا فرد ڪيڏانهن وڃن ٿا؟‬‫‪.85‬‬‫گهرجي سطح تي صحت بابت تعليم جي پروگرام کان‬‫پوء خاندان جا فرد يا مٽ مائٽ عام بيماري َء جي‬‫صورت ۾ ڪيڏانهن وڃڻ کي ترجيح ڏين ٿا؟‬‫‪.86‬‬‫گهرجي سطح تي صحت بابت تعليم جي پروگرام کان‬‫پوء خاندان جا فرد يا مٽ مائٽ شديد بيماري َء جي‬‫صورت ۾ ڪيڏانهن وڃڻ کي ترجيح ڏين ٿا؟‬‫‪.87‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.7‬‬‫بنيادي صحت مرڪز )‪(BHU‬‬‫ڳوٺاڻو صحت مرڪز )‪(RHC‬‬‫پبلڪ اسپتال‬‫پرائيويٽ اسپتال‬‫حڪيم‬‫روايتي عالج ڪندڙ‪/‬پير‬‫ڪو ٻيو‪ ،‬وضاحت ڪريو ‪....................................‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.7‬‬‫بنيادي صحت مرڪز )‪(BHU‬‬‫ڳوٺاڻو صحت مرڪز )‪(RHC‬‬‫پبلڪ اسپتال‬‫پرائيويٽ اسپتال‬‫حڪيم‬‫روايتي عالج ڪندڙ‪/‬پير‬‫ڪو ٻيو‪ ،‬وضاحت ڪريو ‪....................................‬‬‫گذريل ٽن مهينن ۾‪ ،‬گهڻا دفعا ليڊي هيلٿ ورڪر توهان‬‫جي گهر آئي ۽ صحت جي مسئلن تي گفتگو ڪئي؟‬‫‪.88‬‬‫پروگرام کان پهرين توهان جي ڳوٺ ۾ حامله عورتون‬‫چڪاس ۽ ويم الء ترجيهن ڪٿي وينديون هيون؟‬‫‪.89‬‬‫‪.7‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.7‬‬‫ڪو ٻيو‪ ،‬وضاحت ڪريو ‪....................................‬‬‫بنيادي صحت مرڪز )‪(BHU‬‬‫ڳوٺاڻو صحت مرڪز )‪(RHC‬‬‫پبلڪ اسپتال‬‫پرائيويٽ اسپتال‬‫حڪيم‬‫روايتي عالج ڪندڙ‪/‬پير‬‫ڪو ٻيو‪ ،‬وضاحت ڪريو ‪....................................‬‬‫پروگرام کان پوء توهان جي ڳوٺ ۾ حامله عورتون‬‫چڪاس ۽ ويم الء ترجيهن ڪٿي وينديون آهن؟‬‫‪38‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.7‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫بنيادي صحت مرڪز )‪(BHU‬‬‫ڳوٺاڻو صحت مرڪز )‪(RHC‬‬‫پبلڪ اسپتال‬‫پرائيويٽ اسپتال‬‫حڪيم‬‫روايتي عالج ڪندڙ‪/‬پير‬‫ڪو ٻيو‪ ،‬وضاحت ڪريو ‪....................................‬‬‫بنيادي صحت مرڪز )‪(BHU‬‬‫ڳوٺاڻو صحت مرڪز )‪(RHC‬‬‫پبلڪ اسپتال‬‫پرائيويٽ اسپتال‬‫حڪيم‬‫روايتي عالج ڪندڙ‪/‬پير‬‫‪ .7‬ڪو ٻيو‪ ،‬وضاحت ڪريو ‪....................................‬‬‫‪Section 8: Community support for emergency services‬‬‫‪.90‬‬‫توهان جي خيال ۾‪ ،‬ڳوٺ‪/‬برادري َء ۾‬‫ايمرجنسي َء ۾ اهل خاندانن جي حامله‬‫عورتن جي سار سنڀال الء مدد‪ /‬رهنمائي‬‫جو طريقه ڪار آهي؟‬‫جيڪڏهن ها ته ايمرجنسي َء ۾ اهڙي‬‫عورت کي ڪهڙي مدد ملي سگهي ٿي؟‬‫‪.92‬‬‫ويم گهر يا اسپتال تائين مفاصلو‬‫‪.93‬‬‫دائي َء وٽ پهچڻ تائين مفاصلو‬‫‪.91‬‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫‪.1‬‬‫‪.2‬‬‫‪.3‬‬‫‪.4‬‬‫‪.5‬‬‫‪.6‬‬‫گاڏي ڪرڻ الء رقم‬‫گاڏي َء جي سهولت‬‫عالج الء رقم‬‫(وضاحت‬‫ٻي‬‫ڪا‬‫‪).........................................‬‬‫خبر نه آهي‬‫هڪ ڪلوميٽر تائين‬‫‪ 1‬کان ‪ 2‬ڪلوميٽر تائين‬‫‪ 2‬کان ‪ 3‬ڪلوميٽر تائين‬‫‪ 3‬کان ‪ 4‬ڪلوميٽر تائين‬‫‪ 4‬کان ‪ 5‬ڪلوميٽر تائين‬‫‪ 5‬ڪلوميٽر کان مٿي‬‫هڪ ڪلوميٽر تائين‬‫‪ 1‬کان ‪ 2‬ڪلوميٽر تائين‬‫‪ 2‬کان ‪ 3‬ڪلوميٽر تائين‬‫‪ 3‬کان ‪ 4‬ڪلوميٽر تائين‬‫‪ 4‬کان ‪ 5‬ڪلوميٽر تائين‬‫‪ 5‬ڪلوميٽر کان مٿي‬‫‪Section 9: Community Impact‬‬‫‪.94‬‬‫‪39‬‬‫اين آر ايس پي مان تربيت حاصل ڪرڻ‬‫کان پوء عملي طور ڪهڙيون تبديليون‬‫آيون؟‬‫‪ .1‬ها‬‫صحت ۽ صفائي؟‬‫ابتدائي طبي امداد؟‬‫کاڌ خوراڪ کائڻ؟‬‫ڪريو‬

‫‪.95‬‬‫(ڪن به ٽن تبديلين بابت معلومات وٺو)‬‫وضاحت‬‫ڪا‬‫ٻي‬‫‪...........................................‬‬‫‪ .2‬نه‬‫‪ .3‬خبر نه آهي‬‫عملي تبديلي الء توهان پنهنجي خاندان‬‫کي ڪهڙي ڄاڻ‪/‬پيغام ڏنا؟‬‫‪ .1‬ها‬‫‪ .2‬نه‬‫‪ .3‬خبر نه آهي‬‫(مهرباني فرمائي ڪي به ٻه اهم پيغام‬‫ٻڌايو)‬‫‪.96‬‬‫‪ .4‬ها‬‫عملي تبديلي َء الء جيڪڏهن توهان‬‫‪ .5‬نه‬‫پنهنجي مائٽن يا پاڙي وارن کي ڄاڻ ڏني‬‫خبر نه آهي‬‫آهي ته بيان ڪريو؟‬‫(جيڪڏهن سيشن ورتو آهي ته وضاحت‬‫ڪريو)‬‫‪.97‬‬‫‪.98‬‬‫‪40‬‬‫مهرباني فرمائي پروگرام کان پوء‬‫ڳوٺ‪/‬برادري جي سطح تي ورتل‬‫حفاظتي اپا َء‪ ،‬بيان ڪريو؟‬‫‪ ‬حفاظتي ٽڪا‬‫‪ ‬مڇرداني َء جو استعمال‬‫‪ ‬بيٺل پاڻي َء جي نيڪالي‬‫‪ ‬آيوڊين جو استعمال‬‫‪ ‬پيدائش ۾ وقفي جي طريقن جو‬‫استعمال‬‫طريقا ‪:‬پوليو جا ڦڙا‬‫مهرباني ڪري وضاحت ڪريو ته‬‫تربيتون حاصل ڪرڻ کان پوء توهان‬‫پنهنجي ڳوٺ ۽ برادري َء ۾ ڪهڙيون‬‫تبديليون آنديون‪.‬‬‫ڪريو‬

Appendix II
List of Participants
S.#
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34

Name Of ParticipantsAgeVillage Name

Pass OR Fail

Nahida18

Muhammad Khan Gabol

pass

Imam Khatoon

18

Muhammad Khan Gabol

pass

Khaldida

18

Muhammad Khan Gabol

pass

Sain

18

Muhammad Khan Gabol

pass

Reman

18

Muhammad Khan Gabol

pass

Jamilan17

Muhammad Khan Gabol

pass

Anila

17

Muhammad Khan Gabol

pass

Meharnisa

17

Muhammad Khan Gabol

pass

Zulekhan

18

Muhammad Khan Gabol

pass

Farzana16

Muhammad Khan Gabol

pass

Ameer Bano

16

Mohammad Khan Gbaol

pass

Kasma

16

Mohammad Khan Gbaol

pass

Reshman18

Abdullah Kodan

Fail

Nawabzadi

19

Abdullah Kodan

pass

Meerzadi

16

Abdullah Kodan

pass

Amina

21

Abdullah Kodan

pass

Gul Bhar

18

Abdullah Kodan

pass

Shaila18

Abdullah Kodan

pass

Aneeta17

Abdullah Kodan

pass

Shaheen16

Abdullah Kodan

pass

Gul Naz

18

Izat Khan Lashari

pass

shereen

17

Izat Khan Lashari

pass

Amna

17

Abdullah Kodan

pass

Salama17

Mohammad Ishaque Lasharipass

Zeenat18

Mohammad Ishaque Lashari

pass

Noor Bano

18

Ahmed Khan Kalmati

pass

Suraiya22

Ahmed Khan Kalmati

pass

Turna

16

Ahmed Khan Kalmati

pass

Tasleem

20

Ahmed Khan Kalmati

pass

Ganwa

16

Ahmed Khan Kalmati

pass

Nusrat17

Ahmed Khan Kalmati

pass

Noor Bano

18

Ahmed Khan Kalmati

pass

Rozeena17

Ahmed Khan Kalmati

pass

Noshab18

Ahmed Khan Kalmati

pass

41

35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75

Arzana16

Ahmed Khan Kalmati

pass

Husna

17

Ahmed Khan Kalmati

pass

Neelam18

Ahmed Khan Kalmati

pass

Soohn

18

Sahib Khanpass

Sherbano

16

Sahib Khanpass

Akeela16

Sahib Khanpass

Mandam18

Sahib Khan

pass

Noor Khatoon

17

Sahib Khan

Fail

Kalsoom

16

Sahib Khan

pass

Zeenat16

Sahib Khan

pass

Robena18

Ahmed Khan Kalmati

pass

Gulzaran

19

Ahmed Khan Kalmati

pass

Saima

18

Ahmed Khan Kalmati

pass

Salma

19

Ahmed Khan Kalmati

pass

Laila

18

Ahmed Khan Kalmati

pass

Nashab18

Ahmed Khan Kalmati

pass

Zareena19

Ahmed Khan Kalmati

pass

Mariya17

Ahmed Khan Kalmati

pass

Noor Bano

18

Ahmed Khan Kalmati

pass

Saran

18

Ahmed Khan Kalmati

pass

Reshma18

Ahmed Khan Kalmati

pass

Azeeman

18

Ahmed Khan Kalmati

pass

Amna

17

Sahib Khan

pass

Murk

16

Izat Khan Lashari

pass

Akeela17

Izat Khan Lashari

Fail

Shahida18

Izat Khan Lashari

pass

Aneeta18

Izat Khan Lashari

pass

Sanghar

16

Izat Khan Lashari

pass

Bakhtawar

19

Izat Khan Lashari

pass

Zubida16

Izat Khan Lashari

pass

Zahida18

Basham Khan Lashari

pass

Mardi

17

Mohammad Ishaque Lashari

pass

Husna

18

Sahib Khan

Fail

Temeena17

Mubarak Lashari

pass

Naheeda17

Mubarak Lashari

pass

Sumera17

Mubarak Lasharipass

Waqaran18

Mubarak Lashari

pass

Shahnaz18

Mubarak Lasharipass

Humairan17

Mubarak Lashari

pass

Shaheen18

Abdul Qadir Lashari

pass

Samreen16

Abdul Qadir Lashari

pass

42

76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116

Abida

17

Abdul Qadir Lashari

pass

Noorbano

17

Pairan Lashari

pass

Najma

18

Abdul Qadir Lashari

pass

Tahmeena

17

Abdul Qadir Lashari

pass

Ameena18

Abdul Qadir Lashari

pass

Shabana17

Mubarak Lashari

pass

Sughran16

Mubarak Lashari

pass

Seema

17

Mubarak Lashari

pass

Sajida16

Mubarak Lashari

pass

Shahida17

Mubarak Lasharipass

Kainat18

Abdul Qadir Lashari

pass

Saltanati

17

Pairan Lashari

pass

Kanwal18

Abdul Qadir Lashari

pass

Shahida17

Abdul Qadir Lashari

Fail

Nagma

17

Abdul Qadir Lashari

pass

Sindhu17

Abdul Qadir Lashari

pass

Shariya18

Abdul Qadir Lashari

pass

Sajida17

Abdul Qadir Lashari

pass

Noorbano

17

Abdul Qadir Lashari

pass

Raheela16

Abdul Qadir Lashari

pass

Ruksana18

Abdul Qadir Lashari

pass

Sahwat16

Abdul Qadir Lashari

pass

Aneela18

Abdul Qadir Lashari

pass

Roshna17

Mubarak Lashari

pass

Soomal16

Murad Manghnhar

passNoor Bano

19

Haroon Lashari

pass

Wasai

16

Haroon Lashari

pass

Nazeeran

18

Haroon Lasharipass

Jabbari

16

Haroon Lashari

pass

Zaiboo19

Haroon Lashari

pass

Hasina22

Haroon Lashari

pass

Zahida22

Murad Maghhar

pass

Pini

18

Murad Maghhar

pass

Hafizan18

Murad Maghhar

pass

Noorjhan

17

Haroon Lashari

pass

Perveen18

Haroon Lashari

pass

Naseiat19

Haroon Lashari

pass

Khairi22

Haroon Lashari

pass

Pathani

18

Haroon Lasharipass

Abida Perveen

18

Mubarak Lashari

pass

Sukhan18

Mubarak Lashari

pass

43

117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157

Sanam

17

Mubarak Lashari

pass

Saima

18

Murad Manghnhar

pass

Sajida22

Ahmed Khan Kalmati

pass

Rahima19

Ahmed Khan Kalmati

pass

Ramda

22

Ata Muhammad Unar

Fail

Zahara19

Ata Muhammad Unar

pass

Bushra22

Ata Muhammad Unar

pass

Feroza19

Ata Muhammad Unar

pass

Shazia19

Ata Muhammad Unar

pass

Sajida18

Ata Muhammad Unar

pass

Amna

18

Ahmed Khan Kalmati

pass

Hajran22

Ahmed Khan Kalmati

pass

Budhi

20

Haji Arab Lashari

pass

Azima

19

Haji Arab Lashari

pass

Najma

18

Haji Arab Lashari

pass

Nasreen

19

Haji Arab Lashari

pass

Nasiba17

Haji Arab Lasharipass

Samina17

Haji Arab Lashari

pass

Hizaroona

18

Haji Arab Lashari

pass

Nasima19

Haji Arab Lashari

pass

Basaran

20

Haji Arab Lashari

pass

Zubaida17

Haji Arab Lashari

pass

Nusrat21

Ahmed Khan Kalmati

FailShazia21

Achar Mallah

pass

Sabira19

Achar Mallah

pass

Sanam

19

Achar Mallah

pass

Rabia

18

Achar Mallah

FailParveen18

Achar Mallah

pass

Priya

22

Achar Mallah

pass

Sajida19

Abdul Qadir Lashari

pass

Saima

16

Abdullah Kodan

pass

Asiya

16

Abdullah Kodan

pass

Wasima16

Abdullah Kodan

pass

Farzana19

Abdullah Kodan

pass

Khan Zadi

18

Sahib Khan Lashari

pass

Noor Jaan

18

Sahib Khan Lashari

pass

Laila

18

Sahib Khan Lashari

pass

Nasreen

16

Sahib Khan Lashari

pass

Gul pari

17

Sahib Khan Lashari

pass

Sharifan

16

Sahib Khan Lashari

pass

Anita

19

Ahmed Khan Kalmati

pass

44

158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198

Rozina17

Ahmed Khan Kalmati

pass

Shaida17

Ahmed Khan Kalmati

pass

Zahida18

Muhammad Ishaque Lashari

pass

Salma

18

Muhammad Ishaque Lashari

pass

Sonari21

Muhammad Ishaque Lashari

pass

Pars

16

Muhammad Ishaque Lashari

pass

Sher Khan

17

Babo Khan Lashari

pass

Nusrat16

Babo Khan Lashari

pass

Malooka18

Babo Khan Lashari

pass

Hamida17

Muhammad Ishaque Lasharipass

Samina18

Babo Khan Lashari

pass

Sharifan18

Babo Khan Lashari

pass

Bakhtawar

17

Babo Khan Lashari

pass

Ganwa

18

Babo Khan Lashari

pass

Gul Pari

18

Babo Khan Lashari

pass

Basheera

18

Babo Khan Lashari

pass

Salma

18

Babo Khan Lashari

pass

Noorjhan19

Haji Arab Lashari

pass

Rani

17

Haji Arab Lashari

pass

Allah Dini

21

Haji Arab Lashari

pass

Zaiba

18

Haji Arab Lasharipass

Gul Bano

17

Haji Arab Lashari

pass

Rozia

22

Haji Arab Lashari

pass

Nasreen

16

Haji Abdul Karim Lashari

pass

Safooran

18

Haji Abdul Karim Lashari

pass

Razia

21

Haji Abdul Karim Lashari

pass

Sharifan

22

Haji Abdul Karim Lashari

pass

Asima

18

Haji Abdul Karim Lashari

pass

Zaharan

21

Haji Abdul Karim Lashari

pass

Noojhan

16

Haji Abdul Karim Lashari

pass

Noor Bano

18

Haji Abdul Karim Lashari

pass

Sahib Zadi

22

Haji Abdul Karim Lashari

pass

Zaib Nisa

20

Haji Abdul Karim Lashari

pass

Nahida21

Haji Abdul Karim Lashari

pass

Noor Bano

22

Haji Abdul Karim Lashari

pass

Khairan

20

Haji Abdul Karim Lashari

pass

Naheeda20

Haji Abdul Karim Lashari

pass

Shabana21

Sache Dino Shaikh

pass

Ajeeban17

Sache Dino Shaikh

pass

Rahmat21

Sache Dino Shaikh

pass

Zahida18

Sache Dino Shaikh

pass

45

199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239

Safia

19

Sache Dino Shaikh

pass

Hakim Zadi

20

Haji Mir khan Lashari

pass

Noor jahan

22Haji Mir khan Lashari

pass

Nasiman

20

Haji Mir khan Lashari

pass

Zuriat18

Haji Mir khan Lashari

pass

Ameer Zadi

19

Haji Mir khan Lashari

pass

Rubina18

Haji Mir khan Lashari

pass

Kamila17

Haji Mir khan Lashari

pass

Sara

20

Haji Mir khan Lashari

pass

Zarina18

Haji Mir khan Lasharipass

Shehzadi

18

Haji Mir khan Lashari

pass

Gulli

18

Haji Mir khan Lashari

pass

Asima

18

Haji Mir khan Lashari

pass

Basheera

18

Talib Khan Bolch

pass

Aminat16

Talib Khan Bolch

pass

Ruqiat20

Talib Khan Bolch

pass

Rukhsana

18

Talib Khan Bolch

pass

Nawab Zadi

17

Talib Khan Bolch

pass

Gulbano18

Talib Khan Bolch

pass

Sumera18

Talib Khan Bolch

pass

Zarbano19

Murad Khaskheli

pass

Razi

19

Talib Khan Bolch

pass

Aminat17

Talib Khan Bolch

pass

Zahida17

Talib Khan Bolch

pass

Qazbano18

Talib Khan Bolch

pass

Shabnam19

Sache Dino Shaikh

Fail

Laila

19

Sache Dino Shaikh

pass

Zulekha19

Sache Dino Shaikh

pass

Shama

19

Sache Dino Shaikh

Fail

Sooni

18

Sache Dino Shaikhpass

Kainat18

Sache Dino Shaikh

pass

Gul Naz Ahmed

18

Saleh Kodan

pass

Rahila16

Sache Dino Shaikh

pass

Nazia

18

Sache Dino Shaikh

passsharifan17

Sache Dino Shaikh

pass

Benazir

17

Talib Khan Bolch

pass

Jamal khatoon

17

Talib Khan Bolch

pass

Sheerin18

Talib Khan Bolch

pass

Abida

17

Talib Khan Bolch

pass

Seema

17

Murad Khaskheli

FailNoor Bibi

17

Murad Khaskheli

pass

46

240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280

Khair Zadi

18

Murad Khaskheli

pass

bibi

18

Murad Khaskheli

pass

Zahra

17

Murad Khaskheli

FailRahila17

Murad Khaskheli

pass

Najma

18

Murad Khaskheli

pass

Rehana17

Murad Khaskheli

pass

Amina

18

Murad Khaskheli

pass

Lakhma18

Sache Dino Shaikhpass

Mehjabeen

16

Sache Dino Shaikh

pass

Gul Naaz

17

Sache Dino Shaikhpass

Nagina19

Sache Dino Shaikh

pass

Mithi

17

Sache Dino Shaikhpass

Bakhtawar

17

Sache Dino Shaikhpass

Safiya19

Sache Dino Shaikh

pass

Shanila18

Sache Dino Shaikh

pass

Rubina18

Sache Dino Shaikh

pass

Sitara19

Saleh Kodan

FailSamina22

Saleh Kodan

Fail

Samreen18

Saleh Kodan

pass

Sohni

17

Saleh Kodan

pass

Gul Khatoon

18

Amir Bux Kalmati

pass

Fatima18

Amir Bux Kalmati

pass

Husna

20

Amir Bux Kalmati

pass

Zulaikha

19

Amir Bux Kalmati

pass

Khadija

18

Amir Bux Kalmati

pass

Najma

17

Nisar Lashari

pass

Salmi

22

Sidho Maghnar

pass

Razia

23

Sidho Maghnar

Fail

Naz Bano

16

Nisar Lashari

pass

Shahida16

Nisar Lashari

Fail

Aamina20

Nisar Lashari

Fail

Rani

22

Amir Bux Kalmati

Fail

Hasina17

Nisar Lashari

pass

Shabira18

Amir Bux Kalmati

pass

Sakina18

Amir Bux Kalmati

Fail

Farzana18

Amir Bux Kalmati

Fail

Najma

19

Amir Bux Kalmati

pass

Bakhtawar

18

Amir Bux Kalmati

pass

Saima

20

Amir Bux Kalmati

pass

Fareeda22

Abdullah Denyo

FailMariyat18

Abdullah Denyo

Fail

47

281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305

Chhatal22

Abdullah Denyo

pass

Amira

17

Murad Khaskheli

pass

Bhan Bhai

22

Abdullah Denyo

pass

Ishrat Fatima

18

Talib Khan Bolch

pass

Imam Zadi

17

Talib Khan Bolch

pass

Khursheen

17

Talib Khan Bolch

pass

Parveen18

Talib Khan Bolch

pass

Zahida18

Talib Khan Bolch

pass

Sabira18

Talib Khan Bolch

pass

Banazir

18

Talib Khan Bolch

pass

Saima

18

Talib Khan Bolch

pass

Bakhtawar

18

Talib Khan Bolch

pass

Aisha

18

Gul Mohammad Shoro

pass

Saira

20

Gul Mohammad Shoro

FailFarzana19

Gul Mohammad Shoro

pass

Safra

21

Gul Mohammad Shoro

pass

Hasina19

Gul Mohammad Shoro

pass

Kahira18

Aachar Shoro

Fail

Khato

19

Gul Mohammad Shoro

pass

Marvi

19

Gul Mohammad Shoro

pass

Saleha19

Aachar Shoro

pass

Kari

21

Haji Mir Khan Lashari

FailBachai18

Haji Mir Khan Lashari

Fail

Hawa

23

Haji Mir Khan Lashari

pass

Nagina19

Haji Mir Khan Lashari

pass

48

Appendix III
List of Interviewers

S.#

1

2

3

4

5

6

7

Name Of Enumerators

Gull Khatoon

Gull Pari

GulshanRehanaSaima

ZarinaZahida

Age

25

24

28

24

21

28

21

Qualification

Experience

Forms Filled

CoveredVillages

B.A

2 years Marlin project healthand NRSP Trainer HHEP project
and Nursing course

23

5

14

4

Inter

1 years Agha Khan Healthproject Safcow and Marlin
health project

46

10

M.A

6 month agha khan center as anurse and 5 year Teaching
Experience

48

5

Inter

Agha khan , safcow and Marlin
health and nutration and NRSP
trainer Under HHEP project

56

12

metricAgha khan , safcow and Marlin
health and nutration and NRSP
trainer Under HHEP project

52

11

B.A

Agha khan , safcow and Marlin
health and nutration and NRSP
trainer Under HHEP project

12

1

B.A

5years Agha Khan Healthproject NRSP Trainer under
HHEP project and Nursing
course49