PREVENTION MOTHER-TO-CHILD TRANSMISSION (PMTCT)

Since the late 1990s, the Trust has been working with leaders in AIDS research and other international NGOs to develop a program to reduce the rate of pediatric HIV infection, particularly the Prevention of Mother-To-Child Transmission (PMTCT) of HIV.

In Zimbabwe, it is estimated that 25% of pregnant mothers are HIV-positive, and that over 400,000 children have already been infected. Reducing these numbers, and making PMTCT a feature of routine prenatal care in Zimbabwe, has become a major focus of the Trust's efforts.

Following clinical trials in Uganda, researchers determined that the drug Nevirapine reduces HIV mother-to-child transmission by nearly 50%. Eager to begin pediatric AIDS prevention, the Kapnek Trust became the first non-governmental organization to deliver a Nevirapine-based intervention in Zimbabwe .

To initiate the program, the Trust joined forces with the Zimbabwe Ministry of Health (MOH) and other local stakeholders to set up a pilot program in Epworth, a low income suburb of Harare, Zimbabwe 's capital. Additionally, the trust identified the need for increased capacity within the Ministry of Health's National AIDS and Tuberculosis Unit. With grant support from the Elizabeth Glaser Pediatric AIDS Foundation, the Trust bolstered the capacity of the MOH by providing salary funding for six MOH staff positions, including a PMTCT National Program Manager.

Recognizing that training and education are both vital to the success of the program, the Trust coordinated the development of a comprehensive training manual for health workers, and funded monthly training workshops for stakeholders. Since beginning the program, more than 2,400 nurses, midwives and community health workers have received training in breast & infant feeding, HIV rapid testing, understanding PMTCT, and counseling sensitization.

The Trust has also been active in developing social marketing and public awareness campaigns to promote the benefits of PMTCT and related interventions.

On the heels of a successful pilot project, and with financial support from The Elizabeth Glaser Pediatric AIDS Foundation, the Trust established a collaborative relationship with Zimbabwe 's Ministry of Health to begin the national expansion of PMTCT intervention in Zimbabwe . The minimum PMTCT package includes antenatal care, voluntary counseling, HIV testing and Nevirapine drug intervention, which consists of a single dose to mothers during labor and to their newborns.

By 2006, the Trust has facilitated the provision of PMTCT services through technical support at 160 clinical sites around the country and provided PMTCT resources to over 35,000 women. The Trust's financial support of the sites provides salaries for District Coordinators, trained counselors and hundreds of community-based health workers. Presently, the expansion program continues with additional support from The United States Agency for International Development again in partnership with the Elizabeth Glaser Pediatric AIDS Foundation.

Comprehensive PMTCT care also includes attention to both psychosocial support and preparation for orphanhood. Psychosocial support addresses the wide range of economic, social and psychological factors facing HIV-infected parents, while preparation for orphanhood takes into account the prospects of children in families affected by AIDS.

As national expansion goals are achieved, the Trust continues to improve the PMTCT program. We are exploring the implementation of higher efficacy regimens such as nevirapine plus AZT combination therapy. In addition the program is developing links with family planning and PMTCT- plus , which supplements basic PMTCT care with antiretroviral (ARV) and opportunistic infection therapy. PMTCT- plus will extend the lives of HIV+ parents, which will in turn preserve the traditional family structure and address the issue of AIDS orphanhood at its source.

PRESCHOOLS & EARLY CHILDHOOD DEVELOPMENT

The Kapnek Trust is committed to ensuring the welfare of children, particularly those who are orphaned or affected by AIDS. As a result of success with the Prevention of Mother-to-Child Transmission of HIV Program, there is a growing challenge of caring for HIV-negative orphans. With this in mind the Trust has initiated preschool and early childhood development programs to mitigate this increased burden on the extended family network that is presently caring for over 95% of the AIDS orphans in Zimbabwe .

An enduring tragedy is that children continue to be innocent victims in the AIDS pandemic, with more than 1,000,000 AIDS orphans in Zimbabwe alone.

As a complement to its ongoing work with the Vimbainesu Children's Home in Zvimba district the Trust is working to address the needs of young children by establishing community-based, rural preschools and centers for early childhood development.

Through this program, the Trust provides important early childhood education and support to nearly 1,000 children, a significant number of whom are orphans and vulnerable children from aunt, uncle or grandparent-headed households. In addition to the proven benefits of early childhood education to a child's social integration and later academic achievement, the sites offer psycho-social support and serve other support functions, including offering much-needed respite for hundreds of primary caregivers.

In 2006 we have opened 4 new preschools. With a total of 12 preschools in operation, we are now providing support for hundreds of orphans and the extended family members who care for them. We are also expanding the breadth of our Preschool Teacher's Training curriculum in partnership with the Ministry of Education. This sets the stage for our effort to expand this to what we hope will soon become a national preschool program, giving support to hundreds of thousands of orphans and children made vulnerable by HIV/AIDS.

The early childhood education and development project is an integral component of the Trust's effort to address the needs of children, particularly those orphaned and affected by AIDS, while weaving a seamless continuum of care for families and communities.

PARENT/CARETAKER EDUCATION

We have added an important new parent's group program that educates mothers, fathers, aunts, uncles and grandparents. Topics include important issues regarding children's ace and health. Monthly meetings are taking place at each of the preschools where care giverscan learn about early childhood development, parenting skills, nutrition, family planning and education topics, such as an introduction to the prevention of mother to child HIV/AIDS transmission.

ORPHAN EDUCATION

With the support of the Herz Foundation, we have expanded our primary school fee program to include over 2,500 children, orphaned or otherwise impacted by the loss of relatives, resulting from HIV/AIDS.

DISASBLED CHILDREN'S CARE

More than 1,500 children with disabilities and their families continue to receive support through our Children's Rehabilitation Unit. In addition, this year we coordinated an orthopedic surgical team visit from the Kaiser Permanente Hospital System. The team operated on 17 children with physical disabilities, allowing many of them to walk for the first time in their lives.

VIMBAINESU CHILDREN'S HOME

Ensuring the welfare of orphans and vulnerable children, particularly those affected by AIDS, is one of the Kapnek Trust's top priorities in Zimbabwe. Through its work with the Vimbainesu Children's home, located in Zvimba district, Mashonaland West Province, the Trust is playing a role in shaping the lives of dozens of children.

The community-based Vimbainesu Children's Home cares for 45 AIDS orphans. In keeping with current national and international practice, Vimbainesu promotes community-based orphan care. As a rural, family-based home, Vimbainesu benefits from strong community integration, which is essential to providing a safe, supportive and nurturing environment for children to grow and develop.

The Trust is committed to helping each child reach his or her potential, and is developing support programs that offer opportunities and support for every child. These new and ongoing programs include:

•  permaculture and drip irrigation gardens

•  carpentry training

•  computer education

•  small business management

•  cultural awareness activities and field trips

•  psychosocial support & personal empowerment

These activities are designed to respond to the interests of the children while also offering valuable skills and important lessons about teamwork, planning and responsibility.

The Trust's work at the Vimbainesu home helped to highlight the need for preschools and early childhood education in Zvimba, and the first of several preschools managed by the Kapnek Trust is located here. Creation of a youth group and ongoing work with teenagers at the home is also helping to create a model for a potential youth program in the area that would address the needs of teenage boys and girls, a particularly vulnerable group in the spread of HIV/AIDS.

The Trust's work at the Vimbainesu Children's Home represents one more link in efforts to provide integrated care for children, youth, families and communities in Zimbabwe , as well as ongoing efforts to address preparation for orphanhood as it relates to Kapnek's PMTCT activities.

COMMUNITY-BASED HIV/AIDS CARE & SUPPORT

As part of ongoing efforts to support women, children and families in rural districts, the Trust is working in collaboration with community leaders and other non-governmental organizations to develop a holistic approach to community-based orphan care.

By capitalizing on existing programs at the Vimbainesu Children's Home, and the rapidly expanding preschool and early childhood development in the area, efforts are being made to support traditional community interdependence in Zvimba District.