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 reduce the rate of pediatric HIV infection, particularly the Prevention of Mother-To-Child Transmission (PMTCT) of HIV.
In 2005 in Zimbabwe, it was estimated that 25% of pregnant mothers were HIV-positive, and that over 400,000 children had already been infected. Reducing these numbers, and making PMTCT a feature of routine prenatal care in Zimbabwe is major focus of the Trust's efforts. Largely through the efforts of the J.F. Kapnek Trust, by 2008, those numbers were reduced to 16% of pregnant women being HIV+, with less than 18% of infants born to HIV+ mothers contracting HIV at birth.

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 4000 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.

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. 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.

As national expansion goals are achieved, the Trust continues to improve the PMTCT program. In 2009, the J.F. Kapnek trust will begin to implement higher efficacy regimens such as nevirapine plus AZT combination therapy which will hopefully reduce mother-to-child transmission to less than 10%. 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.

The Trust has facilitated the provision of PMTCT services through technical support at 392 delivery centers in 26 districts around the country and provided PMTCT resources to an estimated 100,000 women. This is the largest donor supported PMTCT program in Zimbabwe. 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.

PRE-SCHOOL PROGRAM

SOCIALIZATION, EDUCATION, FOOD, & FAMILY SUPPORT

The J.F. Kapnek Trust is committed to ensuring the welfare of children, particularly those who are orphaned or affected by AIDS. 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 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 preschool and early childhood development programs to mitigate this increased burden on extended family networks that presently caring for over 95% of the AIDS orphans in Zimbabwe.

In 2008, the Trust opened 15 additional early childhood education centers, bringing the total of J.F. Kapnek-supported preschools to 36. Through this program, the Trust provides important early childhood education and support to nearly 1,800 children. The Trust continues to renovate classrooms, train and pay preschool teachers, and to provide their young students with lessons, a daily, large, nutritious, hot meal, fun and routine health care. Physician and nurse administered health and nutrition assessments are now available in all of our preschools. These preschools also provide much-needed relief for the extended families that care for many of these orphaned or vulnerable children. We continue to seek support from private donors to maintain these classrooms and to purchase preschool supplies.

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

ENHANCING THE LIVES OF CARETAKERS AND ORPHANS

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 care and health. Monthly meetings are taking place at each of the preschools where care givers can 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

SCHOOL FEES AND SCHOLARSHIPS

As our youngest students grow, the Trust continues to support their education. In partnership with The Herz Foundation, the Trust pays school fees for more than 3,300 orphaned and vulnerable children, including students in 25 elementary schools where the Kapnek Trust has established preschools. In addition, whereas most classrooms in Zimbabwe have only one text book for the teacher’s use, the J.F. Kapnek Trust has now supplied 38 elementary schools with enough school textbooks so that each pupil can have his/her own.

 
VIMBAINESU ORPHAN’S VILLAGE

FAMILY-BASED CARE

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 31 orphaned boys and girls left without an extended family to care for them. 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.