Urban Health Training Module I - Orientation %26 Induction HUP

Urban Health Training Module I - Orientation %26 Induction HUP



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Urban Health Training Module
Module I: Orientation and Induction
Health of the Urban Poor (HUP) Program

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Prepared for:
Health of the Urban Poor (HUP) Program
Population Foundation of India
B-28, Qutab Institutional Area, New Delhi-110016
Population Foundation of India is implementing Health of the Urban Poor (HUP) Program which is supported by
USAID/ India and working in 8 states and 5 demonstration cities – (Pune, Bhubaneswar, Jaipur, Delhi and Agra).
Plan India and Bhoruka Charitable Trust (BCT) are the implementing partners in Pune and Jaipur respectively.
Authors:
Dr. Jatin Dhingra (Consultant, City Demonstration)
Dr. Swati Mahajan (Demonstration Officer)
Special Inputs:
Mr. Partha Roy (City Coordinator, Bhubaneswar)
Dr. Mainak Chatterjee (Public Health Specialist)
Dr. Sainath Banerjee (Chief of Party)
Note: Replication of any content of the document should be done with consent from HUP

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Urban Health Training Module
Module I: Orientation and Induction
Health of the Urban Poor (HUP) Program

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CONTENTS
1.About Health of the Urban Poor (HUP) Program
7
a) Goal
8
b) Objectives
8
c) Strategies
8
d) Consortium Partners
8
e) Geographical Spread
8
2.About HUP City Demonstration Program
9
a) Objectives of City Demonstration
9
b) Components of City Demonstration
9
c) Steps of City Demonstration
10
d) Phases of City Demonstration
10
3.Field Human Resource Structure
11
a) Organogram
11
b) Individual roles & responsibilities of LW, CC & PC
11
c) Activities of LW, CC & PC
12
d) Qualities that make them effective
14
e) Values of field staff
14
f) Records to be maintained by LWs
14
4.HUP Reporting Formats
16
5.Communication Skills
26
a) Types of communication
26
b) Steps of effective communication
26
c) Interpersonal communication
27
d) Active listening
28
e) Gather approach
28
6.Other Skills Required:
29
a) Decision making
29
b) Negotiation skills
30
c) Coordination skills
30
7.Urban Specific Processes
32
a) Health Vulnerability Assessment
32
b) Household Mapping & Listing
33
c) Health Resource Mapping
36

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8.Constituting MAS
38
a) About Mahila Arogya Samiti (MAS)
38
b) Roles and Responsibilities of MAS
38
c) Composition and Structure of MAS
39
d) Process of formation of MAS
39
9.Organizing Urban Health & Nutrition Day (UHND)
42
Annexures:
47
I. Format for documentation of meeting minutes
47
II. Criteria of Health Vulnerability Assessment
48
III. Mapping Symbols
50
IV. Sample Slum Map
51
V. Sample Health Resource Map
51
VI. MAS Monitoring Matrix
52

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Session I
Objective of the session:
• By the end of the session, HUP frontline
worker will learn some important things
about HUP Program
Project period: Four years: October 1, 2009 to
September 30, 2013
Prime Recipient: Population Foundation of India
(PFI)
Supported by: USAID/India
About Health
of the Urban
Poor (HUP)
Program
Implementing Partners:
• PFI
• IIHMR, Jaipur
• PLAN India
• Bhorukha Charitable Trust (BCT)
Technical Partners:
• IIPS, Mumbai
• Micro Insurance Academy (MIA), Delhi
• Centre for Development and Population
Activities (CEDPA/India)
• CARE India
Sub Implementing Partners:
Agra
• CURE (Centre for Urban & Regional
Excellence)
• SNBS (Shri Nirotilal Buddha Sansthan)
Bhubaneswar
• FPAI (Family Planning Association of India)
• OVHA (Orissa Voluntary Health
Association)
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• Bhairabi Club
• GJS (Gopinath Juba Sangh)
• MY HEART (March of Youth for Health,
Education and Action for Rural Health)
Delhi
• Hope Worldwide
• Smile Foundation
Pune
• FPAI (Family Planning Association of India)
• CASP (Community Aid & Sponsorship
Programme)
Goal
To improve the health status of the urban poor
by adopting effective, efficient and sustainable
strategic intervention approaches, and the
principle of convergence for various development
programs.
1.2 Objectives
• Provide Quality Technical Assistance
to the GOI, states and cities for effective
implementation of the proposed National
Urban Health Mission (NUHM) or ongoing
Urban Health component of the NRHM
• Expand Partnerships in Urban Health
including engaging the commercial sector in
PPP activities
• Promote the convergence of different GOI
urban health and development efforts
• Strengthen urban planning initiatives by the
state through evidence-based city-level
demonstration and learning efforts
• Capacity building for high quality accessible
and sustainable health, nutrition and water
and sanitation services
• Leveraging resources
• Gender Equity and Male Engagement
• Empowering community for improved
negotiation and ownership
• Fostering strategic alliances and
partnership at all levels
• Demonstration, documentation, systematic
replication of successful urban health
intervention models
1.4 Geographical Spread
• 8 States: Madhya Pradesh, Chhattisgarh,
Rajasthan, Bihar, Jharkhand, Uttar Pradesh,
Uttarakhand and Orissa
• 5 Cities: Jaipur, Pune, Bhubaneswar, Delhi
and Agra
HUP Demonstration Cities
1.3 Strategies
• Need based Technical Assistance for
Operationalization of Urban Health Program
within the Public Health System at all levels
• Convergence at all levels for improved
health (MNCH), nutrition, water, sanitation
and hygiene through institutionalization
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Session II
Objectives of the session:
By the end of the session, HUP frontline workers
will learn about:
• Objectives of HUP City Demonstration
• Steps and Activities of City Demonstration
2.1 Objectives of City
Demonstration
• To produce documented models of urban
health programming which can be replicated
and scaled up by other governmental and
non-governmental programs
• Operations research studies conducted in
such sites would provide generate in-depth
learning about issues related to MNCHN and
WASH in urban poor areas
• Documentation of program experiences
and tool kits developed on various program
approaches would facilitate learning and
adaptation of similar approaches in other
cities of the country
• Develop IT enabled web based Monitoring &
Evaluation system which would capture key
process and outcome that can be replicated
for government and other programs
• Evolve program approaches for different
(size, capacity) types of public & private
stakeholders
2.2 Components of City
Demonstration
• Identification of program intervention area
with 1.5 lakh population
• Establishing/strengthening of service delivery
system to provide MNCHN, Birth Spacing
and WASH services through Urban Health
About
HUP City
Demonstration
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and Nutrition Day (UHND) and Urban Health
Centres
• Establishing /strengthening of referral services
• Promotion of activities at household or
community level to promote positive behavior
• Formation/strengthening of Mahila Arogya
Samitis (MAS)
• Engaging local NGOs for program
implementation & city based stakeholders for
program sustainability
2.3 Steps of City Demonstration:
Screening of field NGOS/implementing
partners based on criteria
2.4 Phases of City Demonstration:
There are two major phases–Preparatory Phase
and Implementation Phase
Preparatory Phase Implementation Phase
Listing and Mapping Household Visits
Household Survey
Formation of Mahila
Arogya Samiti (MAS)
Stakeholder
Consultations
(Group and Individual)
Service Delivery-
Through initiation
of Urban Health and
Nutrition Day and from
Urban Health Centres
Health Facility Mapping Linkages with referral
facilities
Short listing of NGOs based on field visit and
scoring
Proposal development and MoU signed with
the local implementing
Situation Analysis of the target area
Listing and Mapping (both listed & unlisted
slums)
Stakeholders’ consultations (Individual and
Groups)
Health Vulnerability assessment of Slums
Health Facility Assessment (Primary & Referral)
Assessment of MNCHN, Water and Sanitation
Development of Action plan & its
implementation
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Session III
Objectives of the session:
By the end of the session, HUP frontline workers
will learn about:
• Field HR structure of HUP City Demonstration
• Individual roles and responsibilities
• Values of field staff
• Qualities of an effective frontline worker
3.1 Organogram
Field Human
Resource
Structure
City Coordinator
One Project
Coordinator (PC)
for each NGO
partner
One Cluster
Coordinator
(CC) for every
12500-15000
population
One Link Worker
(LW) for every
2500-3000
population
NGO CBO Coordinator
PC (3-5 CCs)
1 CC
5-6 LWs
Mahila Arogya Samitis/Women’s
Groups
3.2 Individual Roles &
Responsibilities
Link Worker (LW):
Each Link Worker will cater to a population of
around 2500-3000 population (500-600 HHs).
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She would remain in charge of her area and
serve as an effective and demand generating
link between the service providers and the
community.
• Conducting regular
home visits for
promoting adoption of
healthy behaviors
• Create awareness on
MNCHN, Birth Spacing
and WASH related
issues
• Report on pregnancies,
births and deaths in her
area and maintenance
of Household registers,
individual level records
and other project
related documents
• Formation and
promotion of Mahila
Arogya Samiti (MAS) in
her area
• Organize regular
monthly meetings of MAS
• Build capacity of the MAS members on
various MNCHN and WASH interventions
• Support MAS members for establishing
Community Health Fund through risk
pooling
• Organize Urban Health and Nutrition day
(UHND) in collaboration with the Anganwadi
Worker
• Mapping and listing of all slum households
and preparation of Health Resource Map
with the help of community
• Provide all logistic support for conducting
Urban Health and Nutrition Day (UHND)
and outreach sessions
Cluster Coordinator (CC):
Each Cluster Coordinator will cater to a
population of around 12500-15000 (2500-3000
households). Each CC will supervise and co-
ordinate the activities of 5-6 link workers and in
turn report to the Project Coordinator.
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• Overall supervision and coordination of all
activities of Link Workers
• Build capacity of the Link Workers on various
MNCHN, WASH interventions and filling of
various HMIS formats
• Responsible for area demarcation of the link
workers
• Participate in the Ward Level Coordination
Committee meetings
• Facilitate organization of Urban Health and
Nutrition day (UHND) in his/her area
• Organize street plays, identification of sites
for wall paintings and conducting other
awareness generation activities
• Develop linkages with the neighboring Urban
Health Centre (UHC)
• Developing the capacity of ANM and AWW
in his/her area
• Complete all documentation related to MAS
meetings and Urban Health and Nutrition Days
• Compilation of and timely submission of all
program reports to Project Coordinator
Project Coordinator (PC):
The Project Coordinator is expected to be a
person from a social work background, and
having an understanding of cultural context
and experience in community mobilization
and promoting local participation. The Project
Coordinator will be a full time employee of HUP
Program. The role of the Project Coordinator in
the HUP Program with partner NGOs is in the
following contexts:
• Overall supervision and coordination of all
project activities and field staff
• Liaise and meeting with all the important
stake holders – Ward level officials, M.O.,
community leaders, members of MAS,
ANM, AWW, PHED officials and elected
representatives for preparing an action plan
• Formation/strengthening of Ward
Coordination Committee and organize its
regular monthly meetings
• Participation in City Level Coordination
Committee meetings

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• Assist ANM and Medical Officer of Urban
Heath Centre in micro planning of outreach
activities
• Prepare a local resource mobilization plan
• Plan and organize advocacy events for
celebration of various important days like
World Water Day, World Health Day, World
Population Day etc.
• Participation in monthly program review and
strategic planning meetings conducted by the
HUP city teams
• Build capacity of the link workers, cluster
coordinators and Govt. frontline workers
(ANM, AWW etc) on various MNCHN and
WASH related interventions.
• Responsible for area demarcation of the
cluster coordinators
• Ensure preparation and timely submission of
program reports
3.3 Values of field staff:
For every individual, values are the central guiding
force for all behavior and attitudes. Culture,
experience, education, religion, law, language
and media influence values. While working on
social issues, we are basically working with the
attitudes and behaviors of the community and
the programme implementers for a positive
and desired change. Hence, it becomes very
important to address the values of individuals for
social development.
Values shape our personality and identity and are
directly connected with our vision of life. They
guide us to decide our goal and act on it.
Some examples of values which are required for
social development include:
i. Value of Equality
• In a patriarchal society, women are viewed as
submissive, weak and soft and men as strong
and powerful. Due to this thinking men are
given more recognition, power and respect
in the family and society whereas women are
usually viewed in a supportive role. As a result,
girls and woman have less access to resources.
• Due to the caste structure, certain people
of our society do not get opportunities
to develop and get the benefits of the
mainstream.
As a HUP frontline worker, you have to
first understand problems of the poor and
marginalized communities. They need to be
educated about their rights and entitlements.
Empower them. Encourage them to share their
views and feelings. Treat each individual equally
irrespective of his or her class, caste, sex and
religion.
ii. Value of Responsibility
• Your behavior should be responsible. You
should promote your own health and that of
your family and community. You may keep
your own house clean and throw garbage in
the street, which is not responsible behavior..
iii. Believe in People’s Knowledge and
Experience
• All people have experience and knowledge.
It needs to be respected and valued while
making any decision.
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• They need to be active in sharing their views
while making decisions. For example, if
pregnant women are not coming forward to
get their names registered, you will need to
find out why they are not coming. Ask them
to suggest strategies to increase registration
of pregnant women and how they could
contribute to making the strategy work.
iv. Values of Trust
When people honour each other, there is
a trust established that leads to synergy,
interdependence and mutual respect. Gaining
the trust of those around you is not a difficult
or unachievable task. Trust can be created by
sharing feelings, thoughts, views and being
transparent. Trust is glue that holds people
together.
As a HUP frontline worker, your work is very
important. With that you should also value your
family and community. You also need to think
about what is more important to you and why. In
some situations the family may be important and
in some it may be the work. Understanding your
values enables you to move ahead and maintain
a balanced and fulfilling lifestyle.
3.4 Q ualities of an effective
Frontline worker:
• Possesses necessary knowledge and skills to
perform his/her job effectively
• Friendly and polite with the community
• Good communication skills
• Good facilitation skills
• Good coordination skills
• Management skills
• Good listener
• Decision maker
• Honest
• Knows the local
cultural context and
traditions
• Well dressed
• Self driven and committed to the well being
of the community
• Positive attitude
• Open to learning new skills
• Consistency and regular follow up
3.5 R ecords to be maintained by HUP
frontline staff:
By a Link Worker
• Household survey data indicating
▪ Number of currently married women of
reproductive age (15-49)
▪ Number of pregnant women
▪ Number of infants below one year of age
▪ Number of children between 1-5years of age
• Mother & Child Tracking Register
▪ Tracking of Pregnant women for Ante
natal & post natal care
▪ Tracking of infants for immunization up to
measles
• Birth Spacing Register
▪ Tracking of all currently married women
in the age group of 15-49 for use of birth
spacing methods
• Daily Diary: For keeping a record of daily
activities
• Vital Records: For keeping record of deaths,
births and marriages in the intervention area
• MAS Registers: Each LW is also supposed
to support the MAS members in maintaining
their records like the Meeting Register,
Beneficiary Register and Health Fund Register
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By a Cluster Coordinator
Each CC is required to maintain a track of the
community level activities in area of all his/her
LWs in a Community level Format.
This includes information on:
• No. of MAS meetings conducted in the area
• No. of Capacity building sessions organized
for MAS along with their topics
• No. of Urban Health and Nutrition Days
organized in the area
• No. of beneficiaries reached through Urban
Health and Nutrition Days
• No. of Ward Coordination Committee
meetings organized
• No. of advocacy events organized
*Also note that since in Delhi and
Bhubaneswar there are no LWs, so in these
two cities, the records to be maintained
normally by the LW will be maintained and
updated by the CCs.
Mother &
Child Tracking
Register
Household Survey
Daily Diary
Monthly Activity
Plan
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Session IV
HUP Reporting
Formats
Objectives of the session:
By the end of the session, HUP frontline workers
will learn about:
• All the HUP reporting formats
• How to capture the required information for
tracking progress of program interventions
4.1 Instruction Manual for filling the
Household format
1. City Code, Slum Code, Code of Link Worker
are not to be filled by the link workers.
2. Ward No. to be filled as per the ward list
available with the Municipal Corporation.
3. Serial No. - Please put the number in the
designated column.
4. Household ID- Please don’t fill in this column.
It will be computer generated. Household
refers to number of family members who
share a common kitchen.
5. House Number refers to the number of the
structure.
6. In case more than one HH lives in one
structure/ house – please use separate rows
for each HH. The computer will automatically
generate a unique ID for each HH.
7. Religion – Please fill in the name of the
religion- Whether Hindu, Muslim, Sikh etc.
8. Caste - Fill in the appropriate option- Whether
SC/ST/ OBC/ General.
9. BPL- Fill yes or no in this column depending
upon whether the HH has a BPL card or not.
10.Number of members in the HH- Please count
the children also.
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11. No. of currently married women, no. of
pregnant women, no. of infants below 1
year of age and no. of children between 1-5
years of age – Please fill in the appropriate
numbers in the respective columns.
12. Ownership of the house- Tick in the
appropriate column- whether own or rented
house.
13. Major source of drinking water- Fill in the
appropriate code from the options listed
below.
14. Access to toilet facility- Tick in the
appropriate column - For yes further ask,
whether the HH has access to an individual
or community toilet.
15. Utilization of toilet facility- This column will
help to understand the utilization of toilet
facility by all the members of the household
including children. Fill the number of
male and female members utilizing or not
utilizing the toilet facility separately. For the
households with no access to toilet facility
please don’t fill this column and write not
applicable.
4.2 Instruction Manual for Mother
and Child Tracking Format:-
Ask and Write:
1. Woman ID- Please don’t write anything in
this column, computer generated.
2. Name of woman- Write the name of the
woman.
3. Name of Husband- Write the name of her
husband.
4. No. of births (Para) - No. of total births by the
woman- both live and still births.
5. No. of pregnancies (Gravida) - Total no. of
pregnancies of the woman (including the
present one), irrespective of the outcome
including abortion.
6. LMP- Date corresponding to the first day of
the last menstrual period (dd/mm/yy).
7.EDD- Expected date of delivery, EDD = LMP +
9 months + 7 days (dd/mm/yy).
Check from the Mother and Child Card
and write:
8. 1st ANC- Date of first ante-natal checkup,
corresponds to the date of registration of
pregnancy (dd/mm/yy).
9. 2nd ANC- Date of second ante-natal checkup
(dd/mm/yy).
10. 3rd ANC- Date of third ante-natal checkup
(dd/mm/yy).
11. TT 1- Date of first tetanus toxoid vaccination
for pregnant woman (dd/mm/yy).
12. TT 2- Date of second tetanus toxoid
vaccination for pregnant woman (dd/mm/yy),
to be given within 4-6 weeks of TT 1.
Ask and Write:
13. No. of IFA tablets consumed- The number
of IFA tablets actually consumed by her and
not the number of IFA tablets given to her.
Determine the appropriate code (1, 2, 3 or 4)
and insert in the box.
14. Planned location for delivery- Ask the woman
and her family about the planned location
for delivery and accordingly write the
appropriate code in the box. Example- If they
are planning to go to a Govt. hospital for
delivery then write 1 in the box.
15. Actual Date of delivery- Write the actual date
of delivery (dd/mm/yy).
16. Place of delivery- Depending upon the actual
place of delivery, please write the appropriate
code. Eg. If the delivery has occurred at
home then write 2 in the box.
17. Delivery conducted by a Skilled Birth
Attendant (SBA) - Specify whether the
delivery was conducted by a SBA or not.
Please write 1 for yes and 2 for no. Please
note that SBA includes ANM, LHV, Staff
Nurse and Medical Doctor. Anganwadi
Worker, Trained or untrained dai/ Traditional
Birth Attendant are not included in the
category of SBA.
18. Delivery Type- Whether it was a normal
delivery or Cesarean section and write the
appropriate code. In case of use of forceps
or a vacuum extractor to facilitate vaginal
delivery- the event is referred to as Assisted
Vaginal delivery and for it write code 3.
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19. Outcome of current pregnancy- Depending
upon whether it was a live birth or a still
birth please write the appropriate code, 1-
for live birth , 2- for still birth, 3-spontaneous
abortion and 4- induced abortion.
20. Number of children- In this column; write
the number of children born - 1 for a single
child, 2 for twins and so, on.
21. Post Natal visit 1 (within 48 hours) - Write
the date of 1st postnatal visit (dd/mm/yy).
22. Post Natal visit 2 (within 7 days) - Write the
date of 2nd postnatal visit (dd/mm/yy).
23. Post Natal visit 3 (within 8- 42 days) - Write
the date of 3rd postnatal visit (dd/mm/yy).
24. Child ID- Computer generated, do not fill
this column.
25. Name of the child- Write the name of the
child in the given space.
26. Date of Birth- Write the date of birth of the
child (dd/mm/yy).
27. Gender- Depending upon whether the child
is a male or a female – write the appropriate
code, 1 for male and 2 for female.
28. Weight at birth (in grams) - Please write the
birth weight of the child in grams. Source
of this information would be discharge
certificate from hospital, medical records
of SBA, AWW register or elicit information
from the mother or immediate care giver.
29. Colostrum feeding- If the child has been fed
colostrum, please write 1 and if not then
write 2 in the given space.
30. Birth Registration- If the birth has been
registered with municipality office, write 1
and if not then write 2 in the given space.
31. Age at which the complimentary feeding
was initiated (in months) – Mention the
number of completed months.
Check from the Mother and Child Card and
write:
Columns - 32-43- For each vaccine, write the
date on which vaccine was given to the child as
mentioned in the mother and child card
(dd/mm/yy).
44- Remarks – Any special information or
comments may be written in this column
(including reasons for left out and drop out from
any service).
4.3 Instruction Manual for filling
the Birth Spacing Format
This register will be filled for women of age
group 15-49 years, who are currently married
and living with their husband. This format will
exclude all women who are: Single/ Unmarried,
Divorced, Widow or Separated.
1. Woman ID- Please don’t write anything
in this column, it will be automatically
generated.
2. Name of woman- Write the name of the
woman.
3. Age – Specify the age of the woman in
completed years.
4. Name of Husband- Write the name of her
husband.
5. Mobile No. – Write the mobile number of the
woman or her husband in case she does not
have a mobile.
6. Number of living children – Write the
number of currently living children - male
and female in the respective columns.
7. Date of first visit – Specify the date of the
visit to the woman (dd/mm/yy).
8. Family Planning Method being used by
woman – Each column is to be used for
gathering information on the birth spacing
methods being used by the woman on a
monthly basis. Numbers 1-36 indicate the
number of months.
Mention the appropriate code for family planning
method being used by the woman, from the
options listed below. In case, she is using more
than one method in a single month, then
mention the code for the method which is used
more frequently than the other.
9. Reasons for not using or Stopping any
Method – In this, an Episode will include
cases which:
• Don’t use any method of Family Planning.
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• Used some method earlier but have now
stopped using any Family Planning method.
• Have switched from one method of family
planning to another.
Codes for Episodes:-
1. Became Pregnant
2. Want a child
3. Method Failed
4. Fear of side effects
5. Inconvenient to use
6. Family opposition to use of FP methods
7. Religious prohibition
8. Lack of access to FP methods
9. Hysterectomy done / Menopausal
10.Others (Please specify)
10. Remarks – Any remarks or comments can be written in this column.
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Session V
Communication
Skills
Objectives of the session
By the end of the session, HUP frontline workers
will learn about:
• Effective Communication skills
• How to improve their interpersonal skills
• GATHER approach
Communication is the process of sharing
ideas, thoughts, and feelings with self and
others. Communication is a two-way process
that involves getting your message across and
understanding what others have to say.
5.1 Kinds of Communication
1. Verbal Communication:
Verbal communication requires the use of:
• Words
• Vocabulary
• Language
How to improve Verbal Communication
• Using positive words
• Avoid careless language
• Reduce pauses
• Think and prepare before you speak
• Asking right questions
• Telling a story
2. Non Verbal Communication
It is usually understood as the process
of communication through sending and
receiving wordless messages. Such messages
can be communicated through:
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• Posture
• Facial expressions-anger, hate, fear, joy,
sadness and surprise
• Eyes – expression in your eyes
• Clothing
• Positioning within groups (face to face,
side)
• Shaking hands
• Voice tone
• Smile
3. Written Communication
As a frontline worker you may need to write
applications and letters to the authorities to
improve access to health care services. You
also need to document the processes and
decisions taken during meetings.
The process of communication
involves four basic elements:
Feedback
Sender
Receiver
Message
Sender: Person who sends information
Receiver: Person who receives the information sent
Message: Content of information sent by sender
Feedback: Response from receiver
Tips for effective communication:
• Accuracy
• Clarity
• Use of simple language
• Listen actively
• Break the barriers
• Use feedback
• Do not depend upon grapevine
• Be aware of others levels, feelings and
attitudes
• Do not act on assumptions
• Do not jump on conclusions
5.2 Interpersonal communication
It is the process of sending and receiving
information between two people using verbal
and non verbal language.
5.3 Improving your interpersonal
skills:
• Smile: People want to be around someone
who is always cheerful. Do your best to
be friendly and upbeat with your clients.
Maintain a positive, cheerful attitude about
work and about life. Smile often. The positive
energy you radiate will draw others to you.
• Be appreciative: Find one positive thing
about everyone you work with and let them
hear it. Be generous with praise and kind
words of encouragement. Say thank you
when someone helps you.
• Pay attention to others: Observe what’s
going on in other people’s lives. Acknowle-
dge their happy milestones, and express
concern and sympathy for difficult situations
such as an illness or death. Make eye contact
and address people by their first names.
• Practice active listening: To actively listen is
to demonstrate that you intend to hear and
understand another’s point of view.
• Bring people together: Create an
environment that encourages others to work
together. Treat everyone equally, and don’t
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play favorites. Follow up on other people’s
suggestions or requests.
• Resolve conflicts: Take a step beyond
simply bringing people together, and become
someone who resolves conflicts when they
arise. Learn how to be an effective mediator.
• Communicate clearly: Pay close attention
to both what you say and how you say it.
A clear and effective communicator avoids
misunderstandings with clients, coworkers
and associates.
• Humor: Don’t be afraid to be funny. Most
people are drawn to a person that can make
them laugh. Use your sense of humor as
an effective tool to lower barriers and gain
people’s affection.
• See it from their side: Empathy means
being able to put yourself in someone else’s
shoes and understand how they feel. Try to
view situations and responses from another
person’s perspective.
• Don’t complain: There is nothing worse
than a chronic complainer or whiner.
5.4 How to Be an Effective Listener
What You Think about Listening?
• Understand the complexities of listening
• Prepare to listen
• Adjust to the situation
• Focus on ideas or key points
• Capitalize on the speed differential
What You Feel about Listening?
• Want to listen
• Delay judgment
• Accept responsibility for understanding
• Encourage others to talk
What You Do about Listening?
• Establish eye contact with the speaker
• Take notes effectively
• Be a involved listener
• Avoid negative mannerisms and negative
body language
5.5 GATHER Approach: Six Steps
i. G- Greet: Greet the people politely
ii. A- Ask: Always ask the people about their
well being
iii. T-Tell: Tell the purpose of your visit
iv. H- Help: Help people in taking the decisions
judiciously
v. E- Explain: Explain the relevant
information clearly and properly
vi. R- Return: Return to the
community and follow up to see
whether people are sticking to
the advice given by you or not
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Session VI
Objectives of the session:
By the end of the session, HUP frontline workers
will learn about the importance of other skills
like:
• Decision Making
• Negotiation skills
• Coordination skills
Other skills
required
6.1 Decision making
Decision-making is a learned skill and must be
practiced consciously to strengthen it. As a HUP
frontline worker, you would often require to take
some decisions, which will affect the community
at large. Hence, it is very important for you to
master the skill of participatory decision-making
by involving the community at all levels.
There are some basic steps of decision-
making which need to be followed:
• Define the Problem
• Understand the situation carefully and
examine it from all perspectives
• Gather Information: Once the problem
is identified, collect all the necessary
information, seek advice from the appropriate
authority and involve the community.
• Think of Alternatives: At this stage of
decision-making, you need to arrange a
community meeting and discuss the situation
with people with whom you have worked
with to collect information regarding the
problem. In participatory decision-making, it
is very important that the community owns
the problem and feels responsible towards
solving it. Moreover, unless people accept
the solution, it cannot be achieved on a
permanent basis.
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• Choose an Alternative: Part of effective
decision-making is the ability to select one
good alternative from the various options
available. This can be done through consensus
of the community and approval, of the
authorities.
• Put the Decisions to Work: An effective
decision is one which can be put into action.
Thus, implementation is very important.
During this process, keep checking if it is
moving towards the expected solution, and
if there is something else which needs to be
addressed.
Decision-making skills can also be sharpened
through experience and practice. But one
needs to be confident and prepared to take
responsibility if the decision fails. This is part
of the learning process.
6.2 Negotiation skills:
Negotiation means dealing with differences
between two or more individuals or groups. As
a frontline worker, you will have to deal with
differences. Negotiation is the process by which
two or more people/parties with different needs
and goals work to find a mutually acceptable
solution to an issue.
Because negotiating is an inter-personal
process, each negotiating situation is different,
and is influenced by each party’s skills, attitudes
and style.
Steps of Successful Negotiation
• Ask for the other person’s perspective: In
a negotiating situation use questions to find
out what the other person’s concerns and
needs might be. When you hear the other
person express their needs or concerns, listen
to make sure you heard correctly.
• State your needs: In the process of
negotiation, the other person requires to
know your needs. It is very important to state
not only what you need but also why you
need it.
• Prepare options beforehand: Before
entering into a negotiating session, prepare
some options that you can suggest if
your preferred solution is not acceptable.
Anticipate why the other person may resist
your suggestion and be prepared to counter
the same with an alternative.
• Do not argue: Negotiating is about arriving
at solutions. Arguing is about trying to prove
the other person wrong. If during negotiation
each party tries to prove the other one wrong,
no progress will be made. Do not waste time
in arguing. If you disagree with something
state your disagreement in a gentle, but
assertive, way.
• Consider timing: There are good times to
negotiate and bad times. Bad times include
those situations where there is a high degree
of anger on either side, a preoccupation with
something else, a high level of stress or tiredness
on one side or the other. The best outcome for
almost all negotiations is a win/win situation
when both parties walk away with a positive
feeling about having achieved their goals.
6.3 Coordination skills:
As a HUP frontline worker, you are a link
between health care service providers and the
community. Therefore, you are expected to
regularly coordinate with various stakeholders
and the community.
• Anganwadi Worker & helper
• ANM
• Medical Officer/ Staff of the nearest UHC
• MAS members
• Community/Opinion leaders
You need to coordinate with the Health, ICDS
Deptt, PHED and Urban Local Bodies to:
• Share your concerns regarding the access to
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health care and nutrition services at the slum
level
• Jointly plan health activities to get optimum
outcome
• Micro Planning of outreach activities and
outreach immunization sessions
• Plan Urban Health & Nutrition Day (UHND) at
the slum level
• Improving access of your target population to
safe drinking water and sanitation facilities
There are different ways of coordination. The
most common way of coordination is to meet
the concerned person regularly and discuss the
issues or share information. Another way of
coordination is to call a meeting. You may need
special skills for effective coordination. Let us
understand them.
How to organize a meeting effectively?
Each meeting needs to be productive. A
productive meeting is well-planned and result-
oriented. Unproductive meetings are too
long, vague in purpose, poorly controlled and
frustrating.
• Decide the agenda of the meeting. Decide
who should be called. Invite only those
people who can contribute to the meeting
and take follow-up actions.
• Share the agenda with the concerned
persons. This is very critical. There may be no
need to send a written agenda; however you
need inform the invitees about the purpose
of the meeting and the points, to be
discussed.
• At the beginning of the meeting, welcome
all the participants.
• Explain the purpose of the meeting again and
jointly fix how much time you need to spend
on the meeting.
• Give time to each person to share their views.
Avoid simultaneous discussions.
• If decisions need to be taken, discuss them
and articulate the outcome.
• If actions need to be taken after the
meeting, list down the actions along with
who is responsible for the action, which will
support it and a time-line for completion of
the action.
• At the end of the meeting prepare a
brief report and share it all the relevant
stakeholders.
• Within a few days after the discussion,
ensure that the decisions are put into action.
Also keep all the important stakeholders
informed about the progress.
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Session VII
Urban Specific
Processes
Objectives of the session:
By the end of the session, HUP frontline workers
will learn about processes of:
• Health Vulnerability Assessment
• Household Mapping and Listing
• Health Resource Mapping
7.1 H ealth Vulnerability Assessment
(HVA)
The vulnerability assessment of slums is a
simple procedure developed for mapping of all
poverty pockets in the city or a defined area,
and identifying the more vulnerable amongst
the identified slums by the application of a tool
developed through a participative technique.
The tool consists of a range of indicators,
developed with community members and/or
field-associated groups, to assess the vulnerability
situation in slums. It ensures that a fair and
appropriate assessment of the slums is done
using a ranking on the status of the indicators
in each slum. The purpose of HVA is to identify
and prioritize the slum areas which require more
attention than others.
Why:
• To understand magnitude of inequality within
the slums
• Proper targeting for investment and action
• Context specific interventions
• Most vulnerable deserve the most attention
How:
Applying a simple check list to cover:
• Land tenure rights
• House structure
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• Service provision ( water/drainage, toilet,
electricity etc)
• Employment pattern
• Occupational Hazards
• Health : Access to health care, Type of
facilities , Morbidity profile
• Credit facility (loan / saving)
• Education status
• Social institutions : NGOs, CBOs
• Gender
• Identity : Voter Card, BPL etc
Outcome of HVA:
After conducting HVA, slums can be categorized
into 3 categories:
• Most vulnerable (very low health indicators)-
Need greatest attention and resources
• Moderately vulnerable
• Least vulnerable – Need least attention and
resources
7.2 Household Listing and Mapping
Objectives of this activity:
• To identify the boundaries of the intervention
slum
• To determine the total no. of households and
the total population of the intervention slum
• To list the no. of beneficiaries in the
prescribed format
• To generate a map of the slum depicting
various resources like health facilities,
Community centres, Anganwadi centres,
schools, water resources, community toilet etc.
• To identify suitable locations for conducting
outreach immunization sessions and Urban
Health and Nutrition Days (UHNDs)
Process:
(i) To begin with, identify the boundaries
of the slum in consultation with the local
community. Then after consultation with the
local community, identify the most common
entrance to the slum. Do a transect walk
across the slum to understand the extent and
the layout of the slum
(ii) Starting Point
Always begin your travel at a logical starting
point. The starting point may be an intersection
of two boundaries usually a corner, which
seems most appropriate considering the types
of boundaries and the layout of streets. Exhibit
1 shows examples, with “s” representing the
starting point.
Exhibit 1- Examples of Marking the Starting
Point
(iii) Travel clockwise and follow the rule of
left
Always follow the rule of left, first covering and
numbering all the structures on the left hand
side. Within a given area, travel clockwise from
the starting point, draw arrows on the map to
indicate your path of travel. Marking your path
helps you while planning to be sure to cover
every street. The arrows help you to remain
focused while you are in the field and help other
survey staff later when they verify your path
of travel for quality control purposes. Simple
examples of marking the clockwise path of travel
are shown in Exhibit 2.
Exhibit 2 - Examples of Marking Clockwise
Path of Travel
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(iv) Make Left Turns
As you travel clockwise from the starting point,
make each possible left turn. When you come
to a road, street, or trail, make a left turn and
travel that road, mapping or listing structures on
the left side. If you travel on a road that comes
to a dead end, turn around so you travel in the
opposite direction on the same road and listing
units on your left.
(v) Make U-Turns at Segment Boundaries
When you reach a segment boundary, make
a U-turn and go back down the road you just
travelled looking for structures on the left.
This enables you to travel the other side of the
road. In most cases, U-turns will occur only on
streets that are intersected on both sides of the
street, streets that are dead ends, or streets that
terminate at the segment boundary.
Inclusions and Exclusions:
Inclusions
People live in many types of structures and
residences, such as single-family homes,
apartments, shelters and tents. Therefore, all the
residential structures should be numbered and
listed. Any structures that are under construction
or currently vacant but there is a chance that
they may get occupied in near future also need
to be numbered. Also if a family resides in the
premises of a structure like shop, Anganwadi,
school, temple etc. then it has to be numbered
and listed.
Exclusions
The exclusions include the following:-
• All non residential structures like temples,
mosque, shop, church, Anganwadi centre,
Community centre, School etc.
• Institutions like Homes for the aged, infirm,
or needy (children’s home, home or school
for the blind, orphanages, soldiers’ or sailors’
home), Correctional (jail, prison, penitentiary,
reformatory) and Mental facilities (hospital,
addiction treatment center, training school for
mentally handicapped)
• Collective living arrangements, such as
hostels, dormitories and military barracks
Always consult your supervisor if you are uncertain
whether a facility is to be numbered or not.
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Some Key Definitions:
Structure:
A structure is a free-standing building that can
have one or more rooms. Sometimes it is made
up of more than one component unit that are
used or likely to be used as dwellings (residences)
or establishment, places of worship, godowns,
stores etc.
Sometimes, a series of buildings may be found
along a street that is joined with one another
by common walls on either side looking like a
continuous structure. These different units are
practically independent of one another and each
portion should be treated as a separate structure.
On the other hand, multi-storied building having
several flats owned by different persons should
be treated as one structure. However, each wing
with separate entrance may be considered as
separate structure. Similarly, if there are more
than one building within an enclosed or open
compound (premises) belonging to the same
person e.g., the main house, the servants’
quarters, the garage etc., each of these buildings
separately constitutes a structure.
Household:
A household consists of all persons living
together in a housing unit and sharing a common
kitchen. Within one structure there may be
more than one household, depending upon the
number of kitchens used for cooking.
Numbering of structures and households:
In order to distinguish the HUP number from
other numbers that may exist already on the
door of the structure, write HUP in front of
the structure number (for example, HUP-001
where HUP represents the survey name and 001
represents the structure number).
The number should be written as HUP 001
1
Here, 001 is the structure number, the arrow
gives us the direction in which the mapping
listing has been done. Denominator indicates
number of households residing in the particular
structure. If more than household resides in a
structure then all the numbers have to be written
separated by commas. Eg. 1,2 means that within
structure number 1, two households 1 and 2
reside. For a locked house or empty house, “x” is

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used to denote the no. of household, so in that
case, the numbering may be done as HUP 077
x
The numbering of household has to be
cumulative, so that the mapping and listing
exercise clearly generates the total number
of structures and households residing in the
intervention slum.
Use a permanent marker to write on the entrance
to the structure, the number that has been
assigned to the structure. Remember that this is
the serial number of the structure as assigned on
the household listing form, which is the same as
the number indicated on slum map.
Listing:
The listing of the households has to be done
in the prescribed format. For listing, the HUP
frontline worker will visit each structure and do
the listing till all the allotted households in their
area are covered.
The following information has to be gathered
from each household:-
• Name of the household head
• No. of households residing within the
structure (depending upon the no. of
kitchens)
• Religion
• Caste
• BPL status
• Ownership status
• Total no. of family members including children
The frontline worker must be careful to locate
any hidden structures. In some areas, structures
have been built so haphazardly that they may
easily be missed. If there is a pathway leading
from the listed structure, check to see whether
the pathway leads to another structure. Persons
living in the area may help to identify hidden
structures.
The listing assignment is complete when all
streets and other areas within the slum have been
covered and the numbers representing structures
and households observed for each street or area
have been entered in the Household Listing Form.
Mapping:
This section describes the process of
mapping the slum. The first task of the frontline
worker is to draw the boundaries of the slum
and a few landmarks to identify the slum.
Thereafter, the worker is supposed to plot
each structure on the map, indicating the route
covered through arrows in the appropriate
directions.
The map will generate a complete layout of
the slum with all the structures mapped and
numbered. Special symbols will be used to depict
landmarks within the slum.
All the resources like health facilities, community
centres, anganwadi centres, schools, water
resources, community toilet etc. would be
mapped. The slum map would be a useful tool
for planning, especially for outreach services like
immunization sessions and Urban Health and
Nutrition Days (UHNDs).
Be sure to cover the entire slum, entering a
sequential number for each structure. The
mapping assignment is complete when all
streets and other areas within the slum have
been covered and the numbers representing
structures have been depicted on the
slum map.
The final presentation of the map should be
in a proper layout with the name of the slum
and ward number on top, the directions on
right hand side top corner and legend on the
right hand side bottom. The number of total
households and the total population of the slum
should be written below the map.
Also pay attention to the proper branding and
marking of the map.
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7.3 Health Resource Mapping
Health Resource (HR) Map is the map produced
by the Mahila Arogya Samiti (MAS) for tracking
of beneficiaries for various Maternal and Child
Health services.
Objectives of this activity:
• To identify all the resources available in the
intervention slum
• To allocate the households among the
members of MAS for effective tracking, follow
up and promotive positive behavior change
• To track drop out and left out cases for
immunization
• To help in identifying suitable locations for
conducting outreach immunization sessions,
health camps, health education sessions and
Urban Health and Nutrition Days (UHNDs)
Process:
To begin with, identify the boundaries of the
area in consultation with the members of the
MAS. Thereafter plot the various roads, lanes
and landmarks on the map. Also plot the various
resources of the community like Anganwadi
36 OriEntation and Induction Training ModulE - hup
Centre, Community Centre, any health facility,
school etc.
For distinguishing the households allocated to
different members of the MAS, different colors
are used. Therefore, the number of colors used,
depends upon the no. of members in the MAS.
Remember, the health resource map is a
snapshot of the slum/ part of the slum to
which the MAS members belong. It may not be
indicative of the entire slum, so it should not be
thought of as an alternative to the slum map.
The process of mapping may have to be repeated
a couple of times before the final version is
generated. The final map should be laminated for
use in tracking of beneficiaries for immunization
on a day to day basis.
Use of Health Resource Map in tracking of
beneficiaries for immunization:
Health Resource map is used for tracking the
pregnant women and children below one year
of age for immunization. MAS members divide
the slum households among themselves and
identify pregnant women and children below
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denoted by sticking bindis on the map. The
smaller bindi denotes the vaccination status of
pregnant woman and the larger bindi denotes
the vaccination status of the child.
As soon as the pregnancy is diagnosed, a small
bindi is put on the map on the structure denoting
the house of the pregnant women. A pregnant
woman is supposed to get 2 TT injections during
her pregnancy. The status of TT vaccination is
indicated by further putting smaller dots on the
bindi using a marker/whitener. One dot on the
bindi, indicates that one dose of TT has been
administered and hence, the woman has to
be followed up for the second dose within the
coming 4-6 weeks. Two dots indicate that the
pregnant woman has received both the doses of
TT vaccination.
Once the delivery takes place, the smaller bindi
is replaced by a larger bindi. For denoting
the vaccination of child, a larger bindi is used
because a child is supposed to receive vaccination
five times during the first year of life.
• At Birth- BCG, Oral Polio-zero dose, Hepatitis
B - zero dose
• At 6 weeks- DPT-1, OPV-1, Hepatitis B -1
• At 10 weeks- DPT-2, OPV-2, Hepatitis B -2
• At 14 weeks- DPT-3, OPV-3, Hepatitis B -3
• At 9-12 months- Measles and Vitamin -A
Therefore, each time when the child receives
the age appropriate vaccines, a small dot is
put over the bindi using a marker or whitener.
Hence, the number of dots on the bindi helps
the MAS members to keep a track of the
immunization status of the child and also to
follow up for the vaccines due to the child.
Once the child completes one year of age, the
bindi is removed. Health Resource Map is a
useful tool for tracking drop out and left out
cases of immunization.
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Session VIII
Mahila Arogya
Samiti (MAS)
Objectives of the session:
By the end of the session, HUP frontline workers
will learn:
• About Mahila Arogya Samiti (MAS)
• Roles and Responsibilities of MAS
• Composition and Structure of MAS
• Process of constitution of MAS
• Records to be maintained by the MAS
8.1 Introduction & Goals
MAS will act as the focal community group in
each slum area for implementation of the HUP
Program interventions. Specifically, the MAS will
facilitate the HUP Program to fulfill the following
goals:
1. Organize or facilitate community level health
services and referral linkages for Maternal,
Newborn, Child Health and Nutrition
(MNCHN),and Water Sanitation and Hygiene
(WASH) services including private health care
providers for increased access to services.
2. Generate community awareness on MNCHN,
WASH and locally relevant health issues.
3. Develop community based monitoring of
MNCHN services using a Health Resource
Map.
4. Promote the acceptance of best practices
in MNCHN and WASH by the community
members.
5. Promote community level awareness on
safe drinking water, effective sanitation and
hygiene behaviors for promoting preventive
health.
6. Facilitate the promotion of health risk pooling
by the community members.
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8.2 C omposition and structure
of MAS
Each MAS will cover approximately 1000 slum
population or 200 – 250 households. However,
this can be modified based on the ground
realities in each slum area, e.g., small slum of less
than 1000 population or presence of disparate
groups within each slum. In case of existing
Anganwadi Centres in the slum, the coverage of
each MAS should be aligned with the coverage
area of the Anganwadi Centre. In any case, it
has to be ensured that each slum area has at
least one MAS constituted from among the
community members.
Each MAS will comprise of 10 – 15 members
depending on the size of the slum, but, the
group size should not be less than 8 members
and more than 20 members. In case of MAS
formed in a slum community with different social
groups, representation should be ensured from
all groups and from all pockets of the slum.
There are no absolute criteria for inclusion or
exclusion for any MAS member. However, the
following parameters can be used for preferential
inclusion of members:
1. Desire to contribute to ‘well-being of
the community’ with a sense of social
commitment and leadership skills.
2. Past experience or membership of collective
efforts like Self Help Groups (SHG), DWCUA
group, Neighborhood Group under SJSRY,
thrift and credit group, etc.
3. Socially acceptable women like Anganwadi
Worker (AWW), Anganwadi Helper (AWH),
Accredited Social Health Activist (ASHA) or
Urban Social Health Activist (USHA).
4. HUP frontline worker may or may not be a
member of the group, but would definitely
play a facilitator’s role.
the agenda of Community video call sessions,
representing the group in Ward Coordination
Committee meetings and other advocacy events,
planning any awareness generation activities by
the group and taking a decision on to whom
the loan has to be given in consultation with the
group.
Secretary- Secretary is responsible for making
all arrangements related to the monthly meeting
including venue selection and logistics, recording
and circulation of meeting minutes, maintenance
and updating all the group’s records and
registers, coordinating group’s community
mobilization efforts, logistics and other
arrangements for UHND and outreach sessions,
and has all the administrative responsibility of the
group.
Treasurer- Treasurer is responsible for
maintaining all records and registers related
to risk pooling, operating the bank account of
the group, keeping a track of all the financial
transactions, follow up of the loan given to the
community and keeping some cash in hand for
meeting contingency expenses.
8.4 Process of MAS formation:
A. Initial Meetings with slum women:
• The LW and CC would act as a facilitator and
explain the purpose and role of MAS. They
conduct a series of meetings with women
from the slum to understand the health
conditions and to orient them on health,
nutrition and WASH issues.
• Persistent follow up is required and expected
time of formation of a group may be
between 3-4 months, depending upon the
response from the community.
8.3 Office Bearers and their roles
President- The president is responsible for
allocation of household to each MAS member,
finalizing the agenda of monthly meeting
and its minutes, supporting the HUP frontline
worker in coordinating with the AWW and
ANM for organizing Urban Health and Nutrition
Day (UHND) and outreach sessions, finalizing
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B. Identification of potential MAS members:
• An intervening period of 1-2 weeks will be
provided to the community members who
have participated in the initial meetings to
reflect and discuss on the issues brought
forward during the meetings.
• An idea of the commitment levels of
individual participants will need to be formed
through a review of their participation and
involvement in successive meetings.
• The MAS will be ready for formation once
a core group of 10-15 members have been
identified.
• Drop outs of women would be there and this
should be taken as a natural phenomenon.
• Social acceptance should be ensured by
talking to family members.
C. Formation of the MAS:
• The identified core group should then be
sensitized on the following:
▪ MNCHN and WASH issues
▪ Benefits of group formation for access to
health services and other entitlements
▪ Community risk pooling
▪ Group strengthening
▪Existing resources
▪Existing groups in other areas
▪ Personal, family and environmental
hygiene
Encourage the group to do a health resource
mapping exercise for complete understanding
of the slum/lanes, health facilities, schools,
water sources, Anganwadi Centres,
Community toilets etc.
D. Institutional strengthening of the MAS:
• Encourage the group to meet at least once in
a month.
• Ensure setting of rules related to regular
meetings, maintenance of records and
keeping minutes of the meeting.
• Facilitate selection of office bearers and
division of roles among them.
40 OriEntation and Induction Training ModulE - hup
• Provide necessary assets to the group like
Mat, Registers, Iron Box (small for collecting
money and large for keeping all assets), IEC/
BCC materials, banner etc.
• Help the group to open a bank account,
which should be a joint account in the name
of President, Secretary and Treasurer of the
MAS.
• Establish a system for fund management- Help
the group to decide its lending rates and norms,
reasons for lending, records to be maintained,
mechanism of tracking of loans etc.
E. Capacity building for implementing
interventions:
• Develop their understanding on RCH,
Nutrition and WATSAN issues, tracking left
out cases, drop outs and counseling skills for
tracking of beneficiaries.
• Develop the understanding among MAS
members about support to be provided to LW
in listing and depicting beneficiaries of their
assigned lanes on the health resource map.
• Encourage involvement of group members
in participatory community health planning
and responsibilities for implementation of the
plan.
• Support group members to discuss about
health, water, sanitation and hygiene issues
during their meetings.
• Facilitate linkages of MAS with the
neighboring public sector health facilities,
government hospitals, accredited private
hospitals and charitable hospitals for referral
and diagnostic services.
• Encourage to be the interface between
service providers and community.
• Develop coordination between UHC service
providers (public, private and charitable) and
MAS members for receiving regular supplies
of all components of the RCH, Immunization
and Disease Control programs under NRHM.
• Encourage the group members to give
prior information to community about
organization of outreach camps and ensuring
the mobilization of beneficiaries during these
camps.

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5.1 Page 41

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8.5 R ecords and Registers to be
maintained by the MAS:
• Beneficiary Register- Depicting all pregnant
women and children below one year of age in
their intervention area.
• Community Health Fund register- Keeping
record of all transactions and risk pooling
activities.
• Meeting register- For recording the meeting
minutes.
Beneficiary
Register
Meeting
Register
Community
Health
Fund
Register
8.6 O perational details of MAS
meetings:
• Frequency: Once in a month or a week,
depending upon the respective group’s
agenda.
• Timings: Generally group meets for one
hour.
• Venue: Common meeting place decided by
the respective group.
• Facilitator: One of the HUP frontline staff,
mostly a Link worker.
• Minutes of the meetings are recorded in the
register and are signed by all the members
attending the meeting.
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Session IX
Organizing
Urban Health &
Nutrition Day
(UHND)
Objectives of the session:
By the end of the session, HUP frontline workers
will learn:
• Objectives of UHND
• Services to be provided at each UHND
• Requirements for organizing UHND
• Their roles and responsibilities in organizing
UHND
9.1 Objectives of UHND:
• To provide health, nutrition and WASH
(water, sanitation and hygiene) services to
the target community from an identified
point through a convergent mechanism.
• To generate awareness among the target
population about preventive and promotive
aspects of health care.
• To improve the health seeking behavior of
the target population.
9.2 Operational Details:
Frequency- Once a month at a fixed post on
fixed day of the month for a population of
approx. 1000 slum dwellers.
Venue- Anganwadi Centre (AWC)/ Community
Centre/ School premises/ Any other appropriate
place provided by the ULB/ Any appropriate place
suggested by the community.
9.3 Services provided:
1. Supplementary Nutrition#
2. Immunization*
3. Health Check-up*
4. Referral Services*
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5. Pre – School Education#
6. Nutrition & Health Education#
7. Water, Sanitation and Hygiene (WASH)
* Three of the seven services namely
Immunization, Health Check-up and
Referral Services are delivered through
the Ministry of Health & Family Welfare.
#Three of the seven services namely
Supplementary Nutrition, Pre – School
Education, Nutrition & Health Education are
mandated under the Ministry of Women and
Child Development.
In addition, HUP Program has incorporated the
WASH component since in the urban areas the
non-health determinants have a direct implication
on disease burden and morbidity.
9.4 Details of the Service Package:
i. MNCHN services:
Target Group
Pregnant Women
Lactating mothers
Services
• Early Registration of pregnancies
• Antenatal Checkup (ANC)
• Tetanus Toxoid Injections
• Weight Monitoring
• Iron Folic Acid (IFA) Tablet distribution
• Identification & Referral for women with signs of complications during
pregnancy
Counsel on the following:
• Diet during pregnancy
• Importance of rest
• Danger Signs during pregnancy
• Personal Hygiene
• IFA tablets- Counseling on dose and side effects to improve
compliance
• Birth Preparedness and Complication Readiness
• Registration for JSY
• Importance of institutional delivery
• Post natal care
• Essential Newborn Care
• Exclusive Breast Feeding for first six months
Counsel on the following:
• Post natal care
• Birth Spacing
• Exclusive Breast Feeding for first six months
• Complimentary feeding
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Children below 1 year (Infants)
Children between 1-5 years of age
Currently married
women in the age
group of 15-49 years
• Registration of new births
• Complete routine immunization against the six vaccine preventable
diseases and Hepatitis B
• Immunization for dropout and left out cases
• Weighing and Growth Monitoring
• Counseling for care of newborn and feeding
• Booster doses of DPT/OPV
• Tracking and vaccination of drop outs and left out cases
• Case Management of those suffering from Diarrhea and Acute
Respiratory Infections (ARIs)
• Referral of complicated cases of Diarrhea and ARIs
• Weighing and Growth Monitoring
• Provision of supplementary nutrition for grades of mild malnutrition
• Referral for cases of severe malnutrition
Counsel mothers on the following:
• Home management of childhood diseases and referral for
complications
• Hygienic and correct cooking practices
• Balanced diet
• Counseling on delaying the first birth and spacing between births
• Distribution and provision of non-clinic contraceptives such as
condoms and OCPs
• Referral of cases opting for other methods of Family Planning
• Referral of cases for diagnosis and treatment of RTIs/STIs
ii. WASH Services:
Water
Sanitation
Services
Counsel on the following:
• Importance of safe drinking water
• Treatment of drinking water at the point of use
• Safe handling of drinking water
Counsel on the following:
• Construction of individual sanitary latrines
• Usage of toilet facilities – Individual toilets, community toilets or
shared latrines .
• Safe disposal of child Feaces
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Hygiene
Counsel on the following:
• Hand washing at critical times – before cooking, before eating, before
feeding the child, after defecation and after handling child feaces
• Proper menstrual hygiene
• Avoidance of breeding sites for mosquitoes
9.5 R equirements for organizing
UHND
a) Staff:
• ANM
• AWW
• HUP Frontline Worker (LW/CC)
• MAS members
b) Instruments, Equipments, and Furniture:
• Weighing scale – Adult & Child
• Examination table
• Bed screen
• Hemoglobin meters
• Urine examination kits
• Gloves
• Stethoscope and blood pressure instrument
• Measuring tape
• Foetoscope
• Vaccine carrier with ice packs
• AD Syringes and syringe cutter
c) Drugs and Contraceptive Supplies:
• Iron Folic Acid (IFA) tablets- Adult and Child
• Deworming tablets like Albendazole
• Paracetamol tablets
• Chloroquine tablets
• Condoms
• Oral Contraceptive Pills
• Oral Rehydration Solution (ORS) packets
d) Vaccines:
• Tetanus Toxoid
• Hepatitis B
• Oral Polio Vaccine (OPV)
• DPT
• BCG
• Measles
• Vitamin A solution
e) IEC materials for communication and
counseling and Registration (MCH) cards
TT
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9.6 R oles & Responsibilities of HUP
frontline worker:
1. Increasing Demand for services on the
community side:
• Conduct regular household visits for
identifying and mobilizing the pregnant
women for ANC (first time or repeat visits)
• Tracking of infants who need immunization,
were left out or drop-out cases
• Generation of a due list – list of all pregnant
women and children whose vaccinations are
due
• Identifying and listing women requiring post
natal care
• Listing and creating awareness in eligible
couples on birth spacing methods
• Identifying and listing of children who need
care for malnutrition
• Creating demand to avail services from AWC
at the community level
• Ensure maximum participation from the
target groups (pregnant women, children and
eligible couples) on the day of UHND
2. Mobilizing resources from the
Supply Side:
• Coordinate with AWW and ANM for ensured
supply of services on UHND
• Ensure the supply of medicines, vaccines and
other related supplies
• Liasioning with government to appoint
designated staff on UHND for uninterrupted
supply of services
R oles & Responsibilities of Mahila
Arogya Samiti (MAS) members:
• To assist the HUP frontline workers in
identification and listing of beneficiaries for
UHND
• Tracking of left out and drop out
cases for vaccination from their allocated
households
• To assist the HUP frontline workers in
mobilizing the community on the day of
UHND
• Help in logistic arrangements at the AWC/any
other identified point
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Annexures
ANNEXURE I: Format for documentation of a meeting/ MAS meeting
Date:
Time:
Venue:
Purpose of the meeting:
Members present during the meeting:
1)
2)
3)
4)
Brief Proceedings of the meeting:
Decisions taken:
1)
2)
3)
Actions to be taken:
1)
2)
3)
Signatures of all the members present:
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48 OriEntation and Induction Training ModulE - hup

5.9 Page 49

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ANNEXURE III: Mapping Symbols
Mapping Items
Orientation To The North
Slum Boundary
Residential House
Non-Residential House
Vacant Dwelling Unit
Pucca Road
Kachcha Road
Footpath
Broad Gauge Railway Line
Meter Gauge Railway Line
River
Dry River Bed
Mountain Hill
Canal
Pond
Well, Water Tap
Market
Temple
Mosque
Church
School
Dispensary
Panchayat Ghar/Administrative Building
Post Office
Bridge
Railway Station
Electric Pole
Tree, Bush
50 OriEntation and Induction Training ModulE - hup
Standard Symbols
N
M
S
AB
PO
R

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6.1 Page 51

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ANNEXURE IV: Sample Slum Map
ANNEXURE V: Sample Health Resource Map
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6.3 Page 53

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6.4 Page 54

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6.6 Page 56

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For more information please contact:
Health of the Urban Poor (HUP) Program
Population Foundation of India
B-28, Qutab Institutional Area, New Delhi-110016, Tel: 91-11-43894166, Fax: 91-11-43894199
Email: info_hup@populationfoundation.in, www.populationfoundation.in
This document is made possible by the support of the American people through the United States Agency for International Development (USAID). The
contents are the responsibility of the Population Foundation of India and do not necessarily reflect the views of USAID or the United States Government.