Making HIV male circumcision programmes more sustainable
By Bedah Mengo
In some areas in the East African nation, the government partners are giving a token to those who come to be circumcised
NAIROBI (Xinhua) -- Kenya has stepped up efforts to increase access to Voluntary Medical Male Circumcision (VMMC) services in bid to make the programme sustainable.
Dr Athanasius Ochieng, VMMC Manager at National AIDS/STD Control Programme (Nascop) said ...The more people we circumcise, the more the costs go down because of economies of scale,” ...
Ochieng explained that Kenya is seeking to bring down the cost to 27 dollars per individual.
The VMMC expert noted that currently, the government and its partners are using about 40 U.S dollars to circumcise every man in the programme that has received praise across the world.
“This is too expensive for the government and donor partners. It is unsustainable. The costs can come down only if the number of people who are circumcised increases,” he said.
“This can come down further if the number of people increases. A huge number in every centre will ensure that the surgeons and other staff are effectively utilised,” he said. Currently, he noted that some centres do not achieve their targets, which makes costs go up because the surgeons, who are on salary, are paid yet they are not efficiently utilised.
To increase the number of people accessing the services, Ochieng said the government is targeting older men above 55 years and women. [???]
“Most of those people who have gone through VMMC are younger men below 25 years. This shows that there is a gap in the other age groups. We have initiated campaigns to reach out to the older men, who statistics indicate are exposed to HIV virus due to cultural practices, among other things,” he said. [So wouldn't it make more sense to address the cultural practices?]
Ochieng said they are holding more sensitisation [!] forums in the region and in the capital, where more people have also undergone the cut to create demand.
“Among old men, we found out that stigma and age is a great concern. Many old people believe that due to their advancing age, they do not need to undergo the cut since they may not be predisposed to HIV but this is not the case,” he said.
Fear of stigma is another concern for old men because many note they should not get circumcised at the same time with men young enough to be their children.
For women, Onchiri said that they are using them to reach out to men and their sons.
“Experience has shown that women are good agents, who can convince their men and sons to get circumcised,” he said.
Research indicates that male circumcision is beneficial to both men and women.
“VMMC reduces the risk of HIV infection among men and limits women’s exposure to the virus. This makes the procedure the best method in fighting HIV,” said Onchiri. [But condoms provide strong, directprotection tobothpartners.]
In some areas in the East African nation, Ochieng explained that government partners are giving a token to those who come to be circumcised.
“Those who come to VMMC centres are given some small amount of money, about 2 dollars so that this can encourage their colleagues to visit the centre for the minor surgery,” said Ochieng, who noted that the method is being used in Turkana.
Kenya, according to Nascop, is also considering introducing infant and early childhood VMMC to boost male cut for health reasons. [No infant has ever volunteered for circumcision. No study has ever shown any effect of infant circumcision on HIV transmission.]
According to Nascop, Kenya intends to circumcise 860,000 men by 2014. “If we achieve our target by that year, we would have averted about 2 million HIV infections by the year 2025,” he said.[That figure is Just Made Up.]