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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Implementing voluntary medical male circumcision for HIV prevention in Nyanza Province, Kenya: Lessons learned during the first year
PLoS ONE, Volume 6, No. 4, Article e18299, Year 2011
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Description
Background: In 2007, the World Health Organization endorsed male circumcision as an effective HIV prevention strategy. In 2008, the Government of Kenya (GoK) launched the national voluntary medical male circumcision (VMMC) program in Nyanza Province, the geographic home to the Luo, the largest non-circumcising ethnic group in Kenya. Currently, several other African countries are in the early stages of implementing this intervention. Methods and Results: This paper uses data from a health facility needs assessment (n = 81 facilities) and a study to evaluate the implementation of VMMC services in 16 GoK facilities (n = 2,675 VMMC clients) to describe Kenya's experience in implementing the national program. The needs assessment revealed that no health facility was prepared to offer the minimum package of services as outlined by the national guidelines, and partner organizations were called upon to fill this gap. The findings concerning human resource shortages facilitated the GoK's decision to endorse trained nurses to provide VMMCs, enabling more facilities to offer the service. Findings from the evaluation study resulted in replacing voluntary counseling and testing (VCT) with provider-initiated testing and counseling (PITC) and subsequently doubling the proportion of VMMC clients tested for HIV. Conclusions: This paper outlines how certain challenges, like human resource shortages and low HIV test rates, were addressed through national policy changes, while other challenges, like large fluctuations in demand, were addressed locally. Currently, the program requires significant support from partner organizations, but a strategic plan is under development to continue to build capacity in GoK staff and facilities. Coordination between all parties was essential and was facilitated through the formation of national, provincial, and district VMMC task forces. The lessons learned from Kenya's VMMC implementation experience are likely generalizable to other African countries. © 2011 Herman-Roloff et al.
Authors & Co-Authors
Herman-Roloff, Amy
United States, Chicago
University of Illinois at Chicago
Kenya, Kisumu
Nyanza Reproductive Health Society
Llewellyn, Emma
Kenya, Kisumu
Nyanza Reproductive Health Society
Obiero, Walter Obungu
Kenya, Kisumu
Nyanza Reproductive Health Society
Agot, Kawango E.
Kenya, Kisumu
Impact Research and Development Organization
Ndinya-Achola, Jeckoniah O.
Kenya, Nairobi
University of Nairobi
Muraguri, Nicholas M.
Kenya, Nairobi
National Aids and Sti Control Programme
Bailey, Robert C.
United States, Chicago
University of Illinois at Chicago
Kenya, Kisumu
Nyanza Reproductive Health Society
Statistics
Citations: 65
Authors: 7
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pone.0018299
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Study Locations
Kenya
Participants Gender
Male