Medical Male Circumcision in KZN

12 October 2010

Objectives Support KZN DOH in rapid scale up of MMC in all 11 districts Support delivery of comprehensive, safe, affordable,

accessible MMC services Increase skills and capacity of health providers in provision of

MMC Strengthen community structures that support implementation

of an integrated MMC Service delivery model Develop standardized guidelines, SOPs, tools, methods and

equipment for MMC service delivery Disseminate correct and consistent messaging around MMC Scale-up innovative and successful models of MMC service

delivery in other districts and provinces.

Training MatCH team of 4 doctors and 20 nurses trained in

forceps guided/MOVE model 3 sessional doctors trained @ OF 6 DOH staff (doctors & nurses) trained @ OF 20 M&E support staff eThekwini:

3 one-day trainings for 24 doctors and 300 nurses 292 counselors trained on MMC counseling 43 DOH M&E staff trained

On-site training @ camps/fixed sites 104 doctors & 345 nurses observed/participated in surgical

procedures*

* Data from 17 camps

Camps

2-day camps for males aged 14-25 during school holidays/long weekends

Recruitment through traditional leaders, local media, schools and HCWs

Screened at PHC (CT, STI, medical screening to determine eligibility & informed consent obtained)

Day 1: procedure Day 2: social and cultural program & follow up

assessment Day 7: follow up @ PHC

Results 23 camps in 11 districts since

June 2010 Supported by CHAPS, St

Mary’s, SFH, Africa Centre, Zuzimpilo, BRHC

Circumcised 3648 males 80% 15-24 years *Adverse Events (all 2%;

mod/severe < 0.5%) Mild - 42 Moderate -9 Severe -2

Age Number %

10-14 199 5

15-19 1928 53

20-24 987 27

25-34 349 10

35-49 50 1

50+ 9 0

Unknown age 126 3

* Data for 17 camps

Fixed Sites

eThekwini sites (Addington, St Aidens, PMMH, R K Khan, Wentworth, Osindisweni in process; still to set up MG, and KEH VIII, St Mary’s already functional) Providing equipment & supplies Support with M&E Mentoring & HR support

All KZN Districts - Diathermies, TA, IEC

Technical Assistance

Support to province in developing MMC implementation plan, including target setting

TA to facilities and all district offices in setting up fixed clinics and camps

SOPs for camps and fixed clinics in process

Challenges

National-Provincial communication Parallel roll-out of Tara Klamp Multiple requests for support of camps Set up & logistics for camps Limited by # diathermies & kits Power failures during camps DOH staff availability Data submission via DHIS & tracking follow up Impact of strike on fixed site set up Changes in leadership @ provincial level

Plans S2S vehicles, diathermies & kits Proposal for discretionary funds (R400 per circumcision)

from treasury Massive scale up at fixed sites in all districts – target

60,000 in 6 months Printing & distribution of national guidelines/IEC

materials MMC program manager & staff M&E support in all districts Tracking 7 day follow-up Integration of MMC into HCT program including linking

with schools MMC Train in partnership with Metrorail

NGIYABONGA

THANK YOU