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Male Circumcision for HIV Prevention in Tanzania’s Iringa Region

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This public health campaign to prevent the transmission of HIV in the Iringa region of Tanzania provides free male circumcision (MC-for-HIV) services through a government-supported, United States Agency for International Development (USAID)-funded programme.

The project was developed through collaboration with the Tanzania Ministry of Health and Social Welfare and with funding from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the USAID’s global Maternal and Child Health Integrated Program (MCHIP), which is implemented by Jhpiego in Tanzania.

Communication Strategies

Radio advertising is used to promote the free MC services and publicise how to access the services. Services are coupled with free HIV counselling and testing services. Services are accessible at 24 sites across the region during the advertised campaign periods. Target goals are set to increase the numbers of men who take advantage of the MC services. Advertising promotes health and hygiene benefits of MC, including prevention of HIV/AIDS, when combined with other prevention methods. The radio campaigns are focused on women as partners as well as men.

 

The programme developed "demand efficiencies" to bring in and manage clients, in part through behaviour change communication (BCC). The project de-congested service delivery sites by preparing/following up with clients in their communities (providing education, counselling, pre-op exams, and follow-up exams) using tents and other structures. It hired additional counsellors during campaign periods to remove this "typical bottleneck point." The preparation included advance scheduling of clients in order to better match supply and demand of providers and commodities. This was done in part through developing a "live" database and hiring data clerks for each site so that real-time data were available. Local government officials were recruited as leaders, conducting supervision during the campaign.

Development Issues

HIV/AIDS.

Key Points

In 2010, Jhpiego/Tanzania implemented a high-volume MC campaign - circumcising 10,352 clients at five sites in 36 days - and providing a model that other countries in the region are now following. The programme in Iringa is an attempt to scale up those services. Of the men who were circumcised, 99% were also tested for HIV and learned their HIV status. Since MC-for-HIV-prevention activities began in Iringa in October 2009, more than 25,000 circumcisions have been performed, as of May 2011, helping to avert nearly 6,000 new infections, according to programme managers. In June, July, and August of 2011, the Iringa region embarked upon a campaign with the aim of providing MC services for an additional 20,000 adolescent boys and men.

Partners

Ministry of Health and Social Welfare, the White Ribbon Alliance for Safe Motherhood in Tanzania, T-MARC Social Marketing, USAID, Centers for Disease Control and Prevention (CDC).

Sources

Jhpiego website, September 8 2011.