Latest Articles
- Scaling Up Early Infant Male Circumcision: Lessons From the Kingdom of Swaziland
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.
- Early Infant Male Circumcision in Cameroon and Senegal: Demand, Service Provision, and Cultural Context
Despite the absence of national policies and strategies, early infant male circumcision is routinely offered at all levels of the health care system in Cameroon and Senegal, mainly because of community demand. Improving medical male circumcision will require service guidelines, preservice training, investigation of surgical and nonsurgical devices, supply chains, data collection tools, engaged communities to raise awareness, and communication strategies for men.
- Comparative Cost of Early Infant Male Circumcision by Nurse-Midwives and Doctors in Zimbabwe
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.
- Sustaining Gains Made in Voluntary Medical Male Circumcision
Introducing early infant male circumcision (EIMC) can sustain voluntary medical male circumcision (VMMC) programs. This Global Health: Science and Practice supplement presents lessons learned, research findings on demand creation, and cost comparisons of various models of EIMC introduction.
- Scaling Up and Sustaining Voluntary Medical Male Circumcision: Maintaining HIV Prevention Benefits
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.
- Fertility Awareness Methods Are Not Modern Contraceptives: Defining Contraception to Reflect Our Priorities
A recent article in GHSP calls for classifying fertility awareness methods as “modern contraceptives” despite their inferiority. We believe in a rights-based approach, which considers the real-world conditions that many women face, including constrained sexual agency and low baseline reproductive health literacy. We must demonstrate true commitment to increasing access to the most effective and reliable contraceptive methods.
- Leading With LARCs in Nigeria: The Stars Are Aligned to Expand Effective Family Planning Services Decisively
Despite years of family planning effort in Nigeria, the modern contraceptive prevalence (mCPR) has reached only 10%. Yet a few recent seminal, well-executed programs have been outstandingly successful providing long-acting reversible contraceptives (LARCs)—both in the public and private sector, and in the North and South. Remarkably, the LARCs they provided were equivalent to 2% mCPR in 2015 alone.
Accordingly, we advocate markedly increased support for: (1) private-sector approaches such as social franchising, particularly in the South, (2) mobile outreach, and (3) support to public clinical facilities, including expanding access through community health extension workers (CHEWs), particularly in the North. Success will require system support, quality, and concerted engagement from a variety of partners including the Government of Nigeria.
Without significant progress in Nigeria, the global FP2020 goal appears unattainable. Fortunately, leading with LARCs along with wide choice of other methods provides a clear avenue for success.
- Response to Austad: Offering a Range of Methods, Including Fertility Awareness Methods, Facilitates Method Choice
When selecting a contraceptive method, women and men consider various attributes in addition to effectiveness, such as side effects, return to fertility, level of medical intervention, and interference with sexual activity. Offering a range of methods, including fertility awareness methods that meet the standard to be considered modern, helps to address these considerations, facilitating method choice.