Safe Male Circumcision.

Safe male circumcision (SMC; also known as voluntary medical male circumcision is a scientifically proven biomedical intervention that substantially reduces the risk of female-to-male transmission of HIV. The World Health Organization and the United Nations Program on HIV/ AIDS recommend SMC for countries with a high prevalence of HIV and low prevalence of male circumcision. According to the Uganda Demographic and Health Survey conducted in 2006, only 25% of adults were circumcised and HIV prevalence among uncircumcised males was higher (6.7%) than in circumcised males (4.5%). 

By 2014, the 2014 Uganda HIV and AIDS Country progress report showed that 35% of adult men had undergone safe medical circumcision. 

USAID/SUSTAIN currently supports seven regional referral hospitals to scale-up SMC interventions. The target is to circumcise at least 12,881 men this funding year. SUSTAIN supports SMC services at hospitals and outreaches in surrounding communities, which began in April 2013. These activities include circumcision by surgical method and device (PrePex) circumcision.

Key Activities

1.     Supported the MOH to conduct a rapid assessment of SMC-specific needs (i.e. infrastructure, equipment and training) at each of the hospitals and developed hospital-specific action plans;

2.     Identified and trained hospital-based SMC teams;

3.     Working with individual hospitals to renovate and repair minor theaters or identify appropriate spaces for hospital-based circumcision activities;

4.     Supporting hospital teams to quantify and distribute SMC kits and sundries to hospitals; 

5.     Supporting hospital teams to mobilize communities for circumcision;

6.     Supporting hospitals to conduct VMMC onsite and through outreach camps;

7.     Supporting hospitals implement proper waste disposal and infection prevention measures; and

8.     Conducting regular external quality assessments and mentorships to ensure provision of quality VMMC services.

Achievements 

1.     Circumcised a total of 123,509 men from April 2013 to September 2017 at supported hospitals.

2.     Trained and equipped over 132 service providers with the required skills to deliver SMC services at their respective hospitals by September 2017. Each team includes a circumciser, a circumcision assistant and a counselor. Of these, 15 health workers were trained in offering SMC using the PrePex method.

3.     Worked with USAID/Uganda to ensure the collection and disposal of over three tons of metallic waste.

4.     Supported some hospitals, such as Gulu Regional Referral Hospital to renovate and functionalize the hospital incinerator. 

5.     Mentorships, quality assessment and promotion of QI initiatives enabled supported hospitals to improve their performance against Ministry of Health quality standards.