Features

Featured Tool: Safe Male Circumcision

NUMAT-trained surgeons perform SMC

NUMAT-trained surgeons perform safe male circumcision.

A 2005-6 survey conducted by the Uganda Ministry of Health (MOH) indicated that in Northern Uganda only 2.4% of males aged 15 – 49 years were circumcised. This made Northern Uganda the least circumcised population in the country.

The World Health Organization recommendations that safe male circumcision (SMC) become a component of the HIV prevention package for men, based on evidence that it has a protective effect upon HIV infection. In September 2011, the MOH launched its SMC policy, paving the way for the roll-out of this important HIV prevention intervention.

The NUMAT strategy has hinged on working within the existing health service delivery system, enlisting the support of specialist surgeons and lower cadre health workers to scale up SMC. A total of 56 health workers were oriented and trained in SMC in collaboration with the Rakai Health Science Project. 21 health facilities, including the two regional referral hospitals of Gulu and Lira, were given supplies and other equipment to undertake SMC and have started their own SMC activities. At the same time, SMC is being carried out in outreach camps after a radio campaign provided information about the service (location, dates, and also purpose of SMC), community mobilization, and sensitization by community resource persons.

 

NUMAT-Developed Data Monitoring Tools for Safe Male Circumcision

NUMAT has developed several tools as part of a monitoring system to track data on a SMC expansion activity for monitoring performance and effectiveness. The tools include hard copies and electronic forms for data collection, entry, and analysis, including:

  • pdf icon Client-Held Card – written in both English and local vernacular, this form provides client bio-data, consent, contact details of the surgeon, follow-up dates, and notes.

  • HCT Register – captures HCT services given to individuals that come to the units to access SMC services.
  • pdf icon SMC Register – captures details of individuals circumcised, including clients’ age, address, and adverse events on follow-up.

  • Summary Form – kept at NUMAT headquarters, this form summarizes activity outputs from the various SMC accredited facilities and provides required data for reporting to PEPFAR.


Orientation of SMC surgeons in SMC practice

Orientation of surgeons in safe male circumcision.

Successes

  • The HMIS register enables collation of SMC HCT data with that from other units in the health facility.

  • The data tools used also enable client follow-up and later evaluation of performance.

  • Since SMC is a one-time intervention, there is no possibility of double-counting.



Challenges

  • The tools add to the battery of documentation tools that health workers have to contend with.

  • The client-held cards are easily misplaced but the registration forms provide back-up information if appropriately updated at follow-up.

 

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