American People Partner with Tanzania on Effective HIV Prevention Strategy

The visiting members observe surgical efficiencies for HIV prevention intervention that help Tanzanian male circumcision providers serve up to 150 clients per day. PHOTO/COURTESY OF AMERICAN EMBASSY

 

 

Iringa, Tanzania – A group of 26 program managers and health care providers from different countries and sponsored by the American people through USAID, visited a voluntary medical male circumcision campaign in Iringa to observe the successful implementation of high volume services in rural and remote health facilities.

The visitors from Kenya, Malawi, South Africa, Uganda,  Zambia and the United States toured sites in Iringa region from August 10-13, where a campaign to provide this important HIV prevention intervention was underway. 

 

The campaign, which ended on Saturday, August 13, provided safe and efficient male circumcision for HIV prevention services to nearly 31,000 adolescent and adult males over eight weeks, exceeding the campaign’s original target by 150%. 

 

The program was implemented by the Iringa Regional Medical Office with support from the U.S. President’s Emergency Plan for AIDS Relief through the U.S. Agency for International Development’s global, flagship Maternal and Child Health Integrated Program (MCHIP), which is implemented by Jhpiego—an affiliate of Johns Hopkins University.

Male circumcision is an effective HIV prevention strategy, reducing female-to-male acquisition of HIV as much as 60%. When used in combination with other HIV prevention measures—including condoms, partner reduction and abstinence—circumcision is an important addition to men’s HIV-prevention options.  

 

The HIV prevalence in Iringa is estimated at nearly sixteen percent—three times the national average and currently the highest in Tanzania. Unlike other parts of the country, male circumcision is not a routine health practice in the region with only one-third of men being circumcised.

“The Iringa male circumcision campaign is an excellent example of a program implemented well and has been very successful in getting quality services to where it matters—the people,” said Dr. Delivette Castor, Epidemiology and Statistics Advisor at USAID. “This campaign is also a good example of doing a lot with little.”

As part of the circumcision program, clients received services that included a health check, counseling and testing for HIV, screening for sexual transmitted infections and treatment, risk reduction counseling and condom promotion.

 The visiting male circumcision program officers toured six sites, including hospitals, small health centers and larger health facilities. They also participated in a day of topic-specific briefings and discussions on: demand creation, monitoring and evaluation, data management, finance, procurement, transportation and quality assurance.

“I have learned a lot and I am very impressed with what I saw. What I liked most is how facilities are implementing task-shifting and task-sharing among the team for increased efficiency”, said Luwiza Puleni, MCHIP/MNH Specialist from Malawi. “This is also the first time I am seeing MOVE in action”, she added. MOVE stands for Model for Optimizing the Volume and Efficiency of male circumcision services.

“We will soon be launching campaigns in Malawi and the experience gained here will be vital” said Ms Puleni

 The group was able to see facilities serving more than 100 – and in one case, up to 150 -- clients a day. The objective was to show them how, with the right planning and partners, even very rural, distant and small health facilities can be turned into highly-efficient  male circumcision (MC) sites.

“The Iringa MC Program is doing fantastic work. There is a lot of experience to take from this campaign”, said  Dr. John Sehlangu Kekana, Chief of Party for the Nkangala Male Circumcision Program in South Africa, whose team will be launching a male circumcision services next month.

What impressed the visitors was observing a program owned by the regional authority, with full involvement of village/community leaders, dedicated service providers and a highly supportive and enthusiastic public.