Index by author

July 2016 | Volume 4 | Supplement 1

Introducing Early Infant Male Circumcision for HIV Prevention: Considerations for Policy, Safety, Cost, Acceptability and Demand

  1. Adamu, Tigistu

    1. Open Access
      Scale-Up of Early Infant Male Circumcision Services for HIV Prevention in Lesotho: A Review of Facilitating Factors and Challenges
      Virgile Kikaya, Rajab Kakaire, Elizabeth Thompson, Mareitumetse Ramokhele, Tigistu Adamu, Kelly Curran and Emmanuel Njeuhmeli
      Global Health: Science and Practice July 2016, 4(Supplement 1):S87-S96; https://doi.org/10.9745/GHSP-D-15-00231

      Key elements of Lesotho’s phased introduction of early infant male circumcision were strong commitment from the Ministry of Health and donors; adequate training and supervision; integration with maternal, newborn, and child health; and appropriate communication. Challenges around cultural acceptance, the availability of health care providers, and task sharing will need to be addressed.

    2. Open Access
      Scaling Up Early Infant Male Circumcision: Lessons From the Kingdom of Swaziland
      Laura Fitzgerald, Wendy Benzerga, Munamato Mirira, Tigistu Adamu, Tracey Shissler, Raymond Bitchong, Mandla Malaza, Makhosini Mamba, Paul Mangara, Kelly Curran, Thembisile Khumalo, Phumzile Mlambo, Emmanuel Njeuhmeli and Vusi Maziya
      Global Health: Science and Practice July 2016, 4(Supplement 1):S76-S86; https://doi.org/10.9745/GHSP-D-15-00186

      Swaziland is the first country to introduce national early infant male circumcision (EIMC) into voluntary medical male circumcision (VMMC) programming for HIV prevention. With more than 5,000 EIMCs performed between 2010 and 2014, Swaziland learned that EIMC requires inclusion of stakeholders within and outside of HIV prevention bodies; robust support at the facility, regional, and national levels; and informed demand. Expansion of EIMC and VMMC has the potential to avert more than 56,000 HIV infections in Swaziland over the next 20 years.

  2. Ahanda, Kim Seifert

    1. Open Access
      Scaling Up and Sustaining Voluntary Medical Male Circumcision: Maintaining HIV Prevention Benefits
      Emmanuel Njeuhmeli, Marelize Gorgens, Elizabeth Gold, Rachel Sanders, Jackson Lija, Alice Christensen, Francis Ndwiga Benson, Elizabeth Mziray, Kim Seifert Ahanda, Deborah Kaliel, Tin Tin Sint and Chewe Luo
      Global Health: Science and Practice July 2016, 4(Supplement 1):S9-S17; https://doi.org/10.9745/GHSP-D-16-00159

      To maintain high circumcision prevalence, voluntary medical male circumcision programs in East and Southern Africa need to plan for sustainability and conduct transition assessments early on, rather than waiting until the saturation of priority targets at the end of the program.

  3. Amuri, Mbaraka

    1. Open Access
      Bringing Early Infant Male Circumcision Information Home to the Family: Demographic Characteristics and Perspectives of Clients in a Pilot Project in Tanzania
      Mbaraka Amuri, Georgina Msemo, Marya Plotkin, Alice Christensen, Dorica Boyee, Hally Mahler, Semakaleng Phafoli, Mustafa Njozi, Augustino Hellar, Erick Mlanga, Aisha Yansaneh, Emmanuel Njeuhmeli and Jackson Lija
      Global Health: Science and Practice July 2016, 4(Supplement 1):S29-S41; https://doi.org/10.9745/GHSP-D-15-00210

      During a pilot project in Tanzania’s Iringa region, more than 2,000 male infants were circumcised in less than 2 years in 8 facilities, representing 16.4% of all male births in those facilities. The age of the infant at circumcision and the time of return for follow-up visits varied significantly between urban and rural dwellers. Early infant male circumcision (EIMC) outreach activities and use of health outposts for follow-up visits should be explored to overcome these geographic barriers. EIMC programs will also require targeted investments in demand creation, especially among fathers, to expand and thrive in traditionally non-circumcising settings such as Iringa.

  4. Bellhouse, Lauren

    1. Open Access
      Long-Term Investment for Infants: Keys to a Successful Early Infant Male Circumcision Program for HIV Prevention and Overall Child Health
      Tin Tin Sint, Lauren Bellhouse and Chewe Luo
      Global Health: Science and Practice July 2016, 4(Supplement 1):S3-S8; https://doi.org/10.9745/GHSP-D-15-00229

      Countries where adult male circumcision has reached high coverage should consider national early infant male circumcision (EIMC) programs where EIMC is feasible and culturally acceptable. Ministries of health that intend to set up a routine offer of EIMC should put systems in place to ensure that its introduction (1) does not compromise adult male circumcision programs, (2) does not weaken routine service delivery platforms, (3) is done safely, and (4) adheres to the rights of the child.

  5. Benson, Francis Ndwiga

    1. Open Access
      Scaling Up and Sustaining Voluntary Medical Male Circumcision: Maintaining HIV Prevention Benefits
      Emmanuel Njeuhmeli, Marelize Gorgens, Elizabeth Gold, Rachel Sanders, Jackson Lija, Alice Christensen, Francis Ndwiga Benson, Elizabeth Mziray, Kim Seifert Ahanda, Deborah Kaliel, Tin Tin Sint and Chewe Luo
      Global Health: Science and Practice July 2016, 4(Supplement 1):S9-S17; https://doi.org/10.9745/GHSP-D-16-00159

      To maintain high circumcision prevalence, voluntary medical male circumcision programs in East and Southern Africa need to plan for sustainability and conduct transition assessments early on, rather than waiting until the saturation of priority targets at the end of the program.

  6. Benzerga, Wendy

    1. Open Access
      Scaling Up Early Infant Male Circumcision: Lessons From the Kingdom of Swaziland
      Laura Fitzgerald, Wendy Benzerga, Munamato Mirira, Tigistu Adamu, Tracey Shissler, Raymond Bitchong, Mandla Malaza, Makhosini Mamba, Paul Mangara, Kelly Curran, Thembisile Khumalo, Phumzile Mlambo, Emmanuel Njeuhmeli and Vusi Maziya
      Global Health: Science and Practice July 2016, 4(Supplement 1):S76-S86; https://doi.org/10.9745/GHSP-D-15-00186

      Swaziland is the first country to introduce national early infant male circumcision (EIMC) into voluntary medical male circumcision (VMMC) programming for HIV prevention. With more than 5,000 EIMCs performed between 2010 and 2014, Swaziland learned that EIMC requires inclusion of stakeholders within and outside of HIV prevention bodies; robust support at the facility, regional, and national levels; and informed demand. Expansion of EIMC and VMMC has the potential to avert more than 56,000 HIV infections in Swaziland over the next 20 years.

  7. Biddle, Andrea K

    1. Open Access
      Comparative Cost of Early Infant Male Circumcision by Nurse-Midwives and Doctors in Zimbabwe
      Collin Mangenah, Webster Mavhu, Karin Hatzold, Andrea K Biddle, Getrude Ncube, Owen Mugurungi, Ismail Ticklay, Frances M Cowan and Harsha Thirumurthy
      Global Health: Science and Practice July 2016, 4(Supplement 1):S68-S75; https://doi.org/10.9745/GHSP-D-15-00201

      Early infant male circumcision (EIMC) conducted by nurse-midwives using the AccuCirc device was safe and less costly per procedure than when conducted by doctors: for nurse-midwives, US$38.87 in vertical programs and US$33.72 in integrated programs; for doctors, US$49.77 in vertical programs.

  8. Bitchong, Raymond

    1. Open Access
      Scaling Up Early Infant Male Circumcision: Lessons From the Kingdom of Swaziland
      Laura Fitzgerald, Wendy Benzerga, Munamato Mirira, Tigistu Adamu, Tracey Shissler, Raymond Bitchong, Mandla Malaza, Makhosini Mamba, Paul Mangara, Kelly Curran, Thembisile Khumalo, Phumzile Mlambo, Emmanuel Njeuhmeli and Vusi Maziya
      Global Health: Science and Practice July 2016, 4(Supplement 1):S76-S86; https://doi.org/10.9745/GHSP-D-15-00186

      Swaziland is the first country to introduce national early infant male circumcision (EIMC) into voluntary medical male circumcision (VMMC) programming for HIV prevention. With more than 5,000 EIMCs performed between 2010 and 2014, Swaziland learned that EIMC requires inclusion of stakeholders within and outside of HIV prevention bodies; robust support at the facility, regional, and national levels; and informed demand. Expansion of EIMC and VMMC has the potential to avert more than 56,000 HIV infections in Swaziland over the next 20 years.

  9. Boyee, Dorica

    1. Open Access
      Bringing Early Infant Male Circumcision Information Home to the Family: Demographic Characteristics and Perspectives of Clients in a Pilot Project in Tanzania
      Mbaraka Amuri, Georgina Msemo, Marya Plotkin, Alice Christensen, Dorica Boyee, Hally Mahler, Semakaleng Phafoli, Mustafa Njozi, Augustino Hellar, Erick Mlanga, Aisha Yansaneh, Emmanuel Njeuhmeli and Jackson Lija
      Global Health: Science and Practice July 2016, 4(Supplement 1):S29-S41; https://doi.org/10.9745/GHSP-D-15-00210

      During a pilot project in Tanzania’s Iringa region, more than 2,000 male infants were circumcised in less than 2 years in 8 facilities, representing 16.4% of all male births in those facilities. The age of the infant at circumcision and the time of return for follow-up visits varied significantly between urban and rural dwellers. Early infant male circumcision (EIMC) outreach activities and use of health outposts for follow-up visits should be explored to overcome these geographic barriers. EIMC programs will also require targeted investments in demand creation, especially among fathers, to expand and thrive in traditionally non-circumcising settings such as Iringa.

  10. Chatora, Kumbirai

    1. Open Access
      Perspectives of Parents and Health Care Workers on Early Infant Male Circumcision Conducted Using Devices: Qualitative Findings From Harare, Zimbabwe
      Webster Mavhu, Karin Hatzold, Getrude Ncube, Shamiso Fernando, Collin Mangenah, Kumbirai Chatora, Owen Mugurungi, Ismail Ticklay and Frances M Cowan
      Global Health: Science and Practice July 2016, 4(Supplement 1):S55-S67; https://doi.org/10.9745/GHSP-D-15-00200

      Parents who opted for early infant male circumcision (EIMC) and health care workers felt EIMC was a safe and acceptable procedure that would likely become more widely adopted over time. Barriers to EIMC uptake such as parental fears of harm and cultural beliefs are potentially surmountable with adequate education and support.

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