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FIELD ACTION REPORT
Open Access

Incorporating Voluntary Medical Male Circumcision Into Traditional Circumcision Contexts: Experiences of a Local Consortium in Zimbabwe Collaborating With an Ethnic Group

Joseph Hove, Lewis Masimba, Vernon Murenje, Simon Nyadundu, Brian Musayerenge, Sinokuthemba Xaba, Brian Nachipo, Vuyelwa Chitimbire, Batsirai Makunike, Marrianne Holec, Takarubuda Chinyoka, John Mandisarisa, Shirish Balachandra, Mufuta Tshimanga, Scott Barnhart and Caryl Feldacker
Global Health: Science and Practice March 2019, 7(1):138-146; https://doi.org/10.9745/GHSP-D-18-00352
Joseph Hove
aZimbabwe Association of Church-Related Hospitals (ZACH), Harare, Zimbabwe.
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Lewis Masimba
aZimbabwe Association of Church-Related Hospitals (ZACH), Harare, Zimbabwe.
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Vernon Murenje
bInternational Training and Education Center for Health (I-TECH), Harare, Zimbabwe.
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Simon Nyadundu
cMinistry of Health and Child Care, Harare, Zimbabwe.
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Brian Musayerenge
cMinistry of Health and Child Care, Harare, Zimbabwe.
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Sinokuthemba Xaba
cMinistry of Health and Child Care, Harare, Zimbabwe.
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Brian Nachipo
cMinistry of Health and Child Care, Harare, Zimbabwe.
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Vuyelwa Chitimbire
aZimbabwe Association of Church-Related Hospitals (ZACH), Harare, Zimbabwe.
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Batsirai Makunike
bInternational Training and Education Center for Health (I-TECH), Harare, Zimbabwe.
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Marrianne Holec
dInternational Training and Education Center for Health (I-TECH), Seattle, WA USA.
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Takarubuda Chinyoka
eRepresentative of the VaRemba ethnic group, Harare, Zimbabwe.
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John Mandisarisa
fU.S. Centers for Disease Control and Prevention, Harare, Zimbabwe.
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Shirish Balachandra
fU.S. Centers for Disease Control and Prevention, Harare, Zimbabwe.
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Mufuta Tshimanga
gCommunity Health Intervention Project (ZiCHIRe), Harare, Zimbabwe.
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Scott Barnhart
dInternational Training and Education Center for Health (I-TECH), Seattle, WA USA.
hDepartment of Global Health, University of Washington, Seattle, WA, USA.
iDepartment of Medicine, University of Washington, Seattle, WA, USA.
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Caryl Feldacker
dInternational Training and Education Center for Health (I-TECH), Seattle, WA USA.
hDepartment of Global Health, University of Washington, Seattle, WA, USA.
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  • For correspondence: cfeld@uw.edu
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The successful collaboration resulted in a male circumcision camp where 98% of the 672 boys and men ages 10 and up chose voluntary medical male circumcision (VMMC) while traditional practices were respected. Such collaborations may improve patient safety and increase VMMC uptake in sub-Saharan Africa.

ABSTRACT

Employing voluntary medical male circumcision (VMMC) within traditional settings may increase patient safety and help scale up male circumcision efforts in sub-Saharan Africa. In Zimbabwe, the VaRemba are among the few ethnic groups that practice traditional male circumcision, often in suboptimal hygienic environments. ZAZIC, a local consortium, and the Zimbabwe Ministry of Health and Child Care (MoHCC) established a successful, culturally sensitive partnership with the VaRemba to provide safe, standardized male circumcision procedures and reduce adverse events (AEs) during traditional male circumcision initiation camps. The foundation for the VaRemba Camp Collaborative (VCC) was established over a 4-year period, between 2013 and 2017, with support from a wide group of stakeholders. Initially, ZAZIC supported VaRemba traditional male circumcisions by providing key commodities and transport to help ensure patient safety. Subsequently, 2 male VaRemba nurses were trained in VMMC according to national MoHCC guidelines to enable medical male circumcision within the camp. To increase awareness and uptake of VMMC at the upcoming August–September 2017 camp, ZAZIC then worked closely with a trained team of circumcised VaRemba men to create demand for VMMC. Non-VaRemba ZAZIC doctors were granted permission by VaRemba leaders to provide oversight of VMMC procedures and postoperative treatment for all moderate and severe AEs within the camp setting. Of 672 male camp residents ages 10 and older, 657 (98%) chose VMMC. Only 3 (0.5%) moderate infections occurred among VMMC clients; all were promptly treated and healed well. Although the successful collaboration required many years of investment to build trust with community leaders and members, it ultimately resulted in a successful model that paired traditional circumcision practices with modern VMMC, suggesting potential for replicability in other similar sub-Saharan African communities.

  • Received: September 17, 2018.
  • Accepted: February 12, 2019.
  • Published: March 22, 2019.
  • © Hove et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-18-00352

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Global Health: Science and Practice: 7 (1)
Global Health: Science and Practice
Vol. 7, No. 1
March 22, 2019
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Incorporating Voluntary Medical Male Circumcision Into Traditional Circumcision Contexts: Experiences of a Local Consortium in Zimbabwe Collaborating With an Ethnic Group
Joseph Hove, Lewis Masimba, Vernon Murenje, Simon Nyadundu, Brian Musayerenge, Sinokuthemba Xaba, Brian Nachipo, Vuyelwa Chitimbire, Batsirai Makunike, Marrianne Holec, Takarubuda Chinyoka, John Mandisarisa, Shirish Balachandra, Mufuta Tshimanga, Scott Barnhart, Caryl Feldacker
Global Health: Science and Practice Mar 2019, 7 (1) 138-146; DOI: 10.9745/GHSP-D-18-00352

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Incorporating Voluntary Medical Male Circumcision Into Traditional Circumcision Contexts: Experiences of a Local Consortium in Zimbabwe Collaborating With an Ethnic Group
Joseph Hove, Lewis Masimba, Vernon Murenje, Simon Nyadundu, Brian Musayerenge, Sinokuthemba Xaba, Brian Nachipo, Vuyelwa Chitimbire, Batsirai Makunike, Marrianne Holec, Takarubuda Chinyoka, John Mandisarisa, Shirish Balachandra, Mufuta Tshimanga, Scott Barnhart, Caryl Feldacker
Global Health: Science and Practice Mar 2019, 7 (1) 138-146; DOI: 10.9745/GHSP-D-18-00352
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