Country: ZIMBABWE Programme update - 31 JULY 2009

PROGRAMME UPDATE I 2009

Summary:

The overall strategy of ZRCS in combating the HIV and AIDS pandemic is through the community based approach. This is hinged on social and psycho-social support to people living with HIV & AIDS and OVC and prevention. Subsequently, the National Society has adopted the following five key strategic initiatives:

? Strengthening the capacity of families to care for the family members living with HIV and AIDS and to protect and care for their OVC

? Mobilize and strengthen social support systems and community based responses for HIV and AIDS).

? Strengthen the capacity of children and young people to meet their own needs

? Raise awareness within communities to create an environment that enables support for children and adults affected by HIV and AIDS).

The National Society has reached a cumulative figure of 19 091 home based care clients and 54 818 orphans and vulnerable children by June 2009.

The situation

Zimbabwe is among the countries most affected by HIV and AIDS. The last National Demographic Health Survey conducted in 2005-2006 period by the Ministry of Health and Child Welfare (MoHCW) show that the country’s prevalence rates are decreasing from 20.1% in 2005 (UNAIDS) to 18.1% in 2006. Antenatal Surveillance by the MoHCW show that the prevalence rate further declined in 2007-2008 to an official figure of 15.6%. The ZDHS results also show that HIV prevalence is higher among women than men in both urban and rural populations.

• Estimated number of PLHIV in need of ART = 500 000 including children.

• PLHIV on ART = 152 474

• Children on ART = 14 526

• Note: The above given numbers are those people on the public (Government) register, excluding clients under private practitioners.

• The Min. of Health and Child Welfare is currently scaling up prevention of further transmission of HIV and impact mitigation of HIV & AIDS to those infected and affected.[Source: MOHCW]

Progress towards objectives

SECTION A

General analysis of Progress and Challenges:

• The HIV and AIDS Programme is one of ZRCS major programme whose main objective is to improve the lives of the chronically and terminally ill patients particularly PLHIV. This programme has been doing well in the past to such an extent that it has been regarded as one of the Best Practices for the NS. However, because of the funding challenges the programme is not achieving the set targets.

• Under the Prevention component a strategy was developed and launched in a bid to create an environment for fundraising for the component. The component has reached 21% of its 5 year target and this comes up as a result of funding gap.

• Under the ART programme 66.6% % (500 patients initiated on ARVs) of the set target has been achieved however, the remaining 33% can be achieved when more funding is availed by December 2009.

• A 50% school fees support has been achieved however the other 50% can be achieved when more funding is availed for 3rd and 4th quarter

SECTION B

Prevention of further HIV infection

• A total of 333 951 beneficiaries with 163 920 males and 170 031 females against targeted 326 687 were reached through information, education and communication (IEC) materials distributed during sensitization, coordination and stakeholders meetings, sporting activities, Youth Friendly Centres and Social Clubs.

Achievements:

• Peer Educators, Care facilitators and other ZRCS volunteers distributed IEC materials during their day to day work and other health related campaigns such as cholera awareness campaigns.

• A total of 7759 people were referred for VCT and PMTCT during the period under review compared to 642 in December 2008.

• 8094 PLHIV were supported on positive prevention.

• Two peer education T.O.T trainings were conducted at Westwood training Centre. The trainings were conducted in two groups. The Zonal Prevention Officer also attended this training.

• Peer education training in Sexual and Reproductive Health and life skills for youth peer educators was conducted in 8 provinces and a total of 291 peer educators were trained. The Prevention officer technically supported provincial follow up trainings.

• The NS developed an HIV prevention strategy which was successfully launched on the 7th of May 2009 at the Red Cross HQ offices.

• The National Society received 25 copies of Minimum Standards for HIV Peer Education Programmes from IFRC Zonal Office.

Constraints or challenges:

• There is an increased demand for IEC materials. The NS has resorted to other approaches of disseminating information through edutainment. These efforts are marred by Shortage of sporting equipment, drama equipment, transport problems, penile models, female dooms and a variety of video tapes.

Expanding Care Treatment and Support

2.1 Assisting Children and Orphans (OVC) made vulnerable by HIV and AIDS

Progress

• Grannies/guardians clubs needs assessment was conducted in April using 2008 COW funds. The report highlighted the need to establish these clubs so as to reduce information gaps between OVC and the guardians. The grannies would also use the clubs for information sharing, PSS, peer education and economic empowerment to continue supporting OVC under their care. The actual establishment and revival of the Grannies/Guardians clubs will be done during the third quarter.

• A total of 5 155 OVC received their educational support and their tuition fees have been paid in full to date.).

• 40 OVC underwent vocational training at the Gwanda Youth Centre (A ZRCS Vocational training centre).

• ZRCS procured OVC PSS camp equipment through IFRC including a 4X4 Toyota vehicle. The equipment was handed over to ZRCS in March and a National Test run camp was successfully conducted in June .The camp equipment, vehicle and a trailer mounted generator was officially commissioned during the test run camp.

• The day of the African Child was celebrated by organisations working with children including ZRCS under the theme “Africa fit for children - a call for accelerated action towards their survival”

• ZRCS entered into US 41 770 partnership with the country UNICEF to scale up Birth registration of OVC in two of the project areas ZRCS is working from i.e. Mt Darwin and Mudzi Districts. A total of more than 500 OVC are expected to acquire Birth certificates during the period of implementation from 1st June to 31 December 2009. ZRCS is also piloting scaled up Birth registration exercise in another project area of Matobo district.

• An OVC PSS Life skills training documentary was produced and distributed to partners and stakeholders.

• The Danish Red Cross (DRC) supports the OVC activities of ZRCS’s HIV and AIDS programme through the fundraising project “Barnelandet” which produces a fundraising magazine “Nyt fra Barnelandet” in Denmark. The DRC communication team visited ZRCS to document some of the success stories of OVC who have excelled in high school and are ready for university education. They also focused on the OVC receiving food aid and livelihoods as well as the impact of Hero work, a PSS concept being used for OVC.

Challenges

• The government policy on school fees has been shifting since the introduction of a multicurrency economy and this resulted in discrepancies in the school fees structure from school to school.

• There is growing need for support for vocational and tertiary education for OVC who would have excelled at high school but normally they turn 19yrs upon registration and or during second year whilst our strategy only supports up to 18 yrs.

Overall key Considerations

• The ZRCS OVC life skills PSS Documentary has indicated to be a good resource mobilisation tool although it will need to be reduced from 18 minutes to an 8 minute documentary according to feedback from some of the partners and potential local sponsors.

• Feedback from community leaders, schools and stakeholders indicate that the HERO work and PSS camps have a positive life changing effect on OVC and adults who would have attended. There is need to develop a more systematic impact assessment and monitoring indicators so that these good practices can be documented and shared.

• The demand for school fees continues to rise against a background of economic recession, there is need to carry out an assessment or an operational research in block granting as an option to payment of school fees tuition in cash.

2.2 Providing HBC Treatment, and Support for PLWHA

Progress

• National AIIDS Council requested ZRCS to share the ART Training Package with ZRCS with Hospitality industry as well as IOM. This was done.

• ZRCS coordinated with other external and internal stakeholders in ensuring smooth flow of the HIV and AIDS implementation. An HIV and AIDS Coordination meeting was held at Westwood Training Centre with all partners who included IFRC, DRC, JRCS and the hosts ZRCS. The meeting aimed at reviewing progress, financial gaps and general challenges in the HIV and AIDS programming particularly the paradigm shift in HBC.

• ZRCS conducted a Mid Term evaluation of the HIV and AIDS programme and the ART programmes which started on the 29 May 2009 and was completed in June.

• CF meetings continue to be held in all provinces once quarterly due to financial constraints.

• CFs continued to do home visits to 55 031 OVC and 19 560 HBC clients in which they provided counselling and health education.

• ARVs and OI drugs were procured and distributed to the ART districts of Mt. Darwin and Chivi.

• The re- introduction of food distribution to clients was most welcome by most clients especially those on ART or chronically ill.

• Procurement of volunteer uniforms was achieved through support from IFRC. However, the distribution is still going on.

Challenges

• The paradigm shift of HBC still needs to be discussed at all levels so that all stakeholders will brace up for the changes.

• Funding for this programme continues to dwindle hence quality of care and support for clients is compromised

Overall Key Considerations

• The rapid assessment of the HIV and AIDS programme is expected to inform the future of the programme. ZRCS has made it a point to involve all stakeholders so as to ensure the best scenario for the NS is adopted.

2.3 ART

Progress

• The ART outreach programme continues in the two pilot project areas Chivi and Mt Darwin districts.

• The client treatment initiation started in November 2008.

• A total of 890 clients are on the waiting list and are eligible for antiretroviral therapy.

• A total of 516 clients have been started on antiretroviral therapy (ART) in the two districts.

• The people are coming in large numbers for voluntary counseling and testing

Reducing Stigma and Discrimination

Achievements:

• The NS through the HIV & AIDS prevention programme spearheaded the training and support of 102 ambassadors of hope. Gender based violence, stigma and discrimination topics are included in SRH peer education training manual hence easy to disseminate the information during trainings and peer education activities.

Constraints or challenges:

The economic environment in the country has impacted negatively on: -

• Production of IEC material to support ambassadors of hope and peer education activities.

• Shortage of, and high costs of transport hinder ambassadors of hope’s mobility.

Building National Society Capacity

Progress:

General management issues

• The National Society has continued to receive support from the partners for the implementation for this programme. The programme coordination mechanism agreed in the first quarter is being implemented as partners met for the second quarter programme review.

• Generally the programme performance continued on a good note due to the increased integration with other programmes like Watsan and Food Security and Livelihoods, networking and coordination with other partners.

• The programme volunteers continued to receive their monthly incentives and new uniforms which was a good motivation to their work.

• The continued technical support from the partners and guidance from ZRCS board and senior management also contributed positively to the process.

• The financial support base continue to dwindle thus the need to explore new funding opportunities, find more partners, explore targeted resource mobilisation in line with the funding opportunities available provided they answer the priorities of the National Society and the targeted populations. This has directly affected the reach and quality of service.

• The general late disbursement of funds by some partners has continued to negatively affect the smooth implementation of the programme compounded by the shortage of adequate transport to effectively implement the programme. A good example could be the core costs where salaries are apportioned and other ongoing programme activities and administrative issues which need continual flow of funds.

• The late approval of the 2009 operational plan which affected the first quarter activities still had a negative bearing in the second quarter.

The NS therefore looks forward to continued support in resource mobilisation to maintain and expand timely and quality service delivery to the most vulnerable communities.

Looking ahead:

• The NS will continue to strive to ensure that the vulnerable communities are served, through the integrated approach