The work of Hand in Hand now rests on five key pillars: microfinance, education, health, information (Citizens' Centers), and the environment. Since 2004, their work has expanded substantially, both geographically and in terms of development interventions. From their base in just one district in Tamil Nadu, Hand in Hand now work sin 17 districts. They have also expanded into three other Indian states: Pondicherry, Karnataka, and Madhya Pradesh. In each new area, their work begins with the microfinance and self-help group program. Depending on local conditions, the group then introduces education, health, Citizens’ Centers, and environmental interventions.
While working with the poor and marginalized, Hand in Hand realized that a big reason for poverty and indebtedness was poor health. A sick person loses many days of wages and a malnourished child misses many days of school. Poor nutrition and low basic health standards also cause low immunity to diseases, and high child and female mortality rates. The organization's health pillar was therefore developed in order to take basic health care and hygiene services to the very poor.
Hand in Hand runs various health and hygiene awareness programs. Medical camps headed by qualified doctors are held regularly in all villages where the group has a presence. Serious cases are referred to the nearest government facility. Malnourished children are tracked and provided micro-nutrient supplements. Key component of the health program are listed below:
• Paid community clinic run by doctors recruited by the organization - This is a successful model that Hand in Hand hopes to replicate elsewhere.
• Sanitation program - This is a classic example of an integrated approach. Village women who form the self-help groups are motivated to build toilets in their own homes. Sanitation loans are then financed through the microfinance division.
• Awareness creation - This is a central part of the organization's work. Health mobilizers are recruited to motivate and mobilize the community. Additionally, the organization conducts health, hygiene, and sanitation camps.