HIGH VOLUME MALE CIRCUMCISION, IRINGA REGION, TANZANIA

Saturday, 9th of June 2012 Print
  • HIGH VOLUME MALE CIRCUMCISION, IRINGA REGION, TANZANIA

Voluntary Medical Male Circumcision: Matching Demand and Supply with Quality and Efficiency in a High-Volume Campaign in Iringa Region, Tanzania

Summary points and abstract below; full text, http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001131

Related article is at

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001127

Summary Points

The government of Tanzania has adopted voluntary medical male circumcision (VMMC) as an important component of its HIV prevention strategy and aims to reach 2.8 million uncircumcised men within the next three years.

In June and July 2010, a six-week VMMC campaign in Tanzania's Iringa Region performed 10,352 circumcisions.

Strategies adopted by the campaign to generate demand included the widespread dissemination of messages focused on the provision of free VMMC by specially trained health care providers and on the HIV prevention benefits of VMMC.

Clinical efficiency was improved through, for example, the use of multiple beds in an assembly line, and the efficient use of staff time through task shifting and task sharing.

The experiences of this campaign suggest that high-volume VMMC can be performed without compromising client safety, and provide a model for matching supply and demand for VMMC services elsewhere.

Abstract 

The government of Tanzania has adopted voluntary medical male circumcision (VMMC) as an important component of its national HIV prevention strategy and is scaling up VMMC in eight regions nationwide, with the goal of reaching 2.8 million uncircumcised men by 2015. In a 2010 campaign lasting six weeks, five health facilities in Tanzania's Iringa Region performed 10,352 VMMCs, which exceeded the campaign's target by 72%, with an adverse event (AE) rate of 1%. HIV testing was almost universal during the campaign. Through the adoption of approaches designed to improve clinical efficiency—including the use of the forceps-guided surgical method, the use of multiple beds in an assembly line by surgical teams, and task shifting and task sharing—the campaign matched the supply of VMMC services with demand. Community mobilization and bringing client preparation tasks (such as counseling, testing, and client scheduling) out of the facility and into the community helped to generate demand. This case study suggests that a campaign approach can be used to provide high-volume quality VMMC services without compromising client safety, and provides a model for matching supply and demand for VMMC services in other settings.

 

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