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; Jackson Lija

doi:10.9745/GHSP-D-15-00210

Figures & Tables

Figures

Tables

Download figure
Open in new tab
Download powerpoint
FIGURE 1
Facilities in the EIMC Pilot Project, Iringa Region, Tanzania
Abbreviations: EIMC, early infant male circumcision; FGD, focus group discussion.
Download figure
Open in new tab
Download powerpoint
FIGURE 2
Percentage Distributions of EIMCs by Infant’s Age at Circumcision and Mother’s Residence
Abbreviation: EIMC, early infant male circumcision.
Download figure
Open in new tab
Download powerpoint
FIGURE 3
Where Parents/Guardians Heard About EIMC
Abbreviation: EIMC, early infant male circumcision.
Download figure
Open in new tab
Download powerpoint
Providers in Iringa, Tanzania, perform early infant male circumcision using the Mogen clamp.

Tables

Figures

View popup

TABLE 1 Overview of EIMC Study Participants

EIMC Acceptors				EIMC Non-Acceptors
	No. of FGDs	Total No. of Participants	Range per FGD	No. of FGDs	Total No. of Participants	Range per FGD	Total No. of Participants
Men	4	28	4–10	4	24	4–7	52
Women	8	63	5–10	8	50	4–10	113
Total	12	91	4–10	12	74	4–10	165

Abbreviations: EIMC, early infant male circumcision; FGD, focus group discussion.

View popup

TABLE 2 Characteristics of Clients in the Iringa EIMC Pilot Project, April 2013–December 2014

	Iringa Regional Referral Hospital	Ipogolo Health Centre	Tosamaganga District Hospital	Ilula Lutheran Hospital	Frelimo Hospital	Igumbilo Dispensary	Mafinga District Hospital	Kidabaga Health Centre	Total
No. of male infants born during pilot project	5,175	851	2,203	1,674	174	54	2,442	105	12,678
EIMC uptake among male infants, No. (%)	483 (9.3)	268 (31.5)	303 (13.7)	263 (15.7)	66 (36.9)	36 (66.7)	86 (3.5)	24 (22.9)	2084 (16.4)
Age at circumcision, days, median (range)	32 (1–74)	27 (1–72)	4 (1–78)	14 (1–78)	28 (1–60)	30 (1–71)	14 (1–73)	3 (1–34)	22 (1–78)
No. of EIMC performed	528	503	326	297	179	125	99	27	2,084
EIMCs by mother’s place of delivery, No. (%)
This facility	450 (85.2)	216 (42.9)	297 (91.1)	252 (84.9)	54 (30.2)	20 (16.0)	85 (85.9)	24 (88.9)	1,398 (67.1)
Another facility not offering EIMC services	45 (8.5)	235 (46.7)	23 (7.1)	34 (11.4)	113 (63.1)	89 (71.2)	13 (13.1)	3 (11.1)	555 (26.6)
Home	33 (6.3)	52 (10.3)	6 (1.8)	11 (3.7)	12 (6.7)	16 (12.8)	1 (1.0)	0 (0.0)	131 (6.3)
EIMCs by place of residence,^a No. (%)
Urban	477 (90.3)	409 (81.3)	22 (6.7)	169 (56.9)	172 (96.1)	47 (37.6)	43 (43.3)	0 (0.0)	1,339 (64.2)
Rural	42 (8.0)	93 (18.5)	303 (92.9)	122 (41.1)	6 (3.3)	78 (62.4)	56 (56.6)	27 (100.0)	727 (34.9)
Infants brought for day 2 follow-up,^a No. (%)	510 (98.3)	495 (98.6)	210 (64.6)	289 (99.3)	172 (96.6)	125 (100)	91 (91.9)	27 (100.0)	1,919 (92.9)
Infants brought for day 7 follow-up,^a No. (%)	455 (87.7)	424 (84.5)	34 (10.5)	214 (73.5)	148 (83.2)	114 (91.2)	59 (59.6)	16 (59.3)	1,464 (70.9)
Circumcised infants with HIV+ mothers, No. (% of all circumcised infants)	34 (6.4)	27 (5.4)	28 (8.6)	34 (11.4)	14 (7.8)	8 (6.4)	13 (13.1)	1 (3.7)	159 (7.6)

Abbreviation: EIMC, early infant male circumcision.
↵a 18 mothers reported residence outside of the region and were excluded from this analysis.

View popup

TABLE 3 Place of Delivery and Follow-up Attendance by Urban or Rural Residence of Mother, Iringa EIMC Pilot Project, April 2013–December 2014

Indicator	Urban-Dwelling Mothers (N = 1,339)	Rural-Dwelling Mothers (N = 727)	P Value	Total (N = 2,066)^a
Indicator	% (95% CI)	% (95% CI)	P Value	% (95% CI)
Mother’s place of delivery			<.001
This facility	63.4 (60.9, 65.9)	73.7 (70.4, 76.8)		67.0 (65.0, 69.1)
Another facility not offering EIMC services	29.6 (27.2, 32.1)	21.3 (18.5, 24.4)		26.7 (24.8, 28.6)
Home	7.0 (5.8, 8.5)	5.0 (3.6, 6.8)		6.3 (5.3, 7.4)
Returned for day 2 follow-up visit	97.4 (96.4, 98.1)	84.6 (81.8, 87.0)	<.001	92.9 (91.7, 93.9)
Returned for day 7 follow-up visit	82.2 (80.1, 84.2)	49.9 (46.3, 53.6)	<.001	70.9 (68.9, 72.8)
Attended with the infant for circumcision			<.001
Mother/female guardian	82.3 (80.2, 84.3)	68.8 (65.3, 72.0)		77.5 (75.7, 79.2)
Both parents	17.7 (15.7, 19.8)	31.2 (27.9, 34.7)		22.5 (20.7, 24.3)

Abbreviations: CI, confidence interval; EIMC, early infant male circumcision.
↵a 18 mothers reported residence outside of the region and were excluded from this analysis.

View popup

TABLE 4 Age at Circumcision by Level of Health Facility in the Iringa EIMC Pilot Project, April 2013–December 2014

	Age at Circumcision
Facility Level (No. of EIMCs performed)	≤2 Days % (95% CI)	3–7 Days % (95% CI)	8–28 Days % (95% CI)	29–42 Days % (95% CI)	43–60 Days % (95% CI)	61–78 Days % (95% CI)
Hospitals (1,429)	12.0 (10.4, 13.8)	19.3 (17.3, 21.4)	29.2 (26.9, 31.7)	18.1 (16.1, 20.1)	20.6 (18.5, 22.7)	0.8 (0.4, 1.4)
Health centers (530)	3.8 (2.4, 5.8)	9.3 (7.1, 12.0)	41.9 (37.7, 46.1)	22.5 (19.1, 26.2)	21.7 (18.4, 25.4)	0.9 (0.4, 2.2)
Dispensaries (125)	12.8 (7.9, 20.0)	9.6 (5.5, 16.2)	22.4 (15.8, 30.6)	38.4 (30.2, 47.3)	16.0 (10.5, 23.6)	0.8 (0.1, 5.6)
Total (2,084)	9.9 (8.8, 11.3)	16.2 (14.6, 17.8)	32.1 (30.1, 34.1)	20.4 (18.7, 22.2)	20.6 (18.9, 22.4)	0.8 (0.5, 13.1)