Delivery of male circumcision services: "Festina lente".
نویسندگان
چکیده
T HREE randomised clinical trials on the effects of male circumcision on HIV acquisition in men have been stopped by their data safety and management boards as the interim analyses showed a large protective effect, in the range of 50 to 60%. It is not only this large effect that makes male circumcision very appealing as an intervention for HIV prevention. Male circumcision is a one-time intervention, and unlike other prevention tools, such as use of condoms, vaginal microbicides and pre-exposure prophylaxis, it is not dependent on high compliance by the users for its effectiveness. However, this is the first time in the history of modern medicine that a surgical procedure has been recommended as an intervention to prevent a major public health problem and there are major challenges ahead in the design and implementation of male circumcision programmes. In this paper we will discuss issues in the delivery of male circumcision services, in particular services for adult men. We will try and identify the essential components of male circumcision services and examine which model of service delivery is likely to be the most cost-effective, and discuss some of the challenges involved.
منابع مشابه
Voluntary Medical Male Circumcision (VMMC) in Tanzania and Zimbabwe: Service Delivery Intensity and Modality and Their Influence on the Age of Clients
BACKGROUND Scaling up voluntary medical male circumcision (VMMC) to 80% of men aged 15-49 within five years could avert 3.4 million new HIV infections in Eastern and Southern Africa by 2025. Since 2009, Tanzania and Zimbabwe have rapidly expanded VMMC services through different delivery (fixed, outreach or mobile) and intensity (routine services, campaign) models. This review describes the moda...
متن کاملModifying the health system to maximize voluntary medical male circumcision uptake: a qualitative study in Botswana
Background In 2007, the World Health Organization and the Joint United Nations Programme on HIV/AIDS endorsed voluntary medical male circumcision (VMMC) as an add-on HIV-prevention strategy. Similar to many other sub-Saharan countries, VMMC uptake in Botswana has been low; as of February 2016, only 42.7% of the program target had been achieved. Previous work has examined how individual-level fa...
متن کاملEarly Infant Male Circumcision in Cameroon and Senegal: Demand, Service Provision, and Cultural Context
BACKGROUND Male circumcision is almost universal in North and West Africa, and practiced for various reasons. Yet there is little documentation on service delivery, clinical procedures, policies, and programmatic strategies. The United Nations Children's Fund (UNICEF) commissioned country program reviews in 2014 to shed light on the delivery of male circumcision services for infants in Cameroon...
متن کاملSafety of adult medical male circumcision performed by non-physician clinicians in Kenya: a prospective cohort study
BACKGROUND Male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. The Government of Kenya is rolling out voluntary medical male circumcision (VMMC) services, but struggles with health worker shortages, particularly with physician shortages. OBJECTIVE To evaluate the safety of male circumcision performed by non-physician clinicians in Kenya. ...
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ورودعنوان ژورنال:
- Reproductive health matters
دوره 15 29 شماره
صفحات -
تاریخ انتشار 2007