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Models to increase Volumes and Efficiency in Zimbabwe’s Male Circumcision program

Models to increase Volumes and Efficiency in Zimbabwe’s Male Circumcision program . K. Hatzold 1 , C. Samkange 2 , E. Fusire 3 , G.S. Dendere 4 , K. Kaseke 1 , D. Rech 5 , R. Dhlamini 1 , G. Ncube 6 , O. Mugurungi 6

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Models to increase Volumes and Efficiency in Zimbabwe’s Male Circumcision program

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  1. Models to increase Volumes and Efficiency in Zimbabwe’s Male Circumcision program • K. Hatzold1, C. Samkange2, E. Fusire3, G.S. Dendere4, K. Kaseke1, D. Rech5, R. Dhlamini1, • G. Ncube6, O. Mugurungi6 • Institutes:1Population Services International Zimbabwe, Harare, Zimbabwe, 2University of • Zimbabwe College of Health Sciences, 3Zimbabwe Republic Police, Medical Department 4Air • Force of Zimbabwe, Medical Department, 5Population Services International, 6Ministry of • Health and Child Welfare Zimbabwe

  2. Background • Adult HIV prevalence 13.7% • MC prevalence 10.3% • 750,000 HIV infections could be averted if 80% of males are circumcised • Goal to circumcise 80% of 15-29 year old males by 2015 (1.3 million) • Policy only allows doctors to conduct MCs • Completed 12 months pilot phase to test models of service delivery, 6500 males circumcised over 12 months • High latent demand for MC

  3. MOVE Components • Forceps guided method • Cost-effective, Safe, High outputs • Diathermy for hemostasis • Team of 2 doctors & 3 nurses serving 4 clients at one time • Open plan operating room with several cubicles • Client flow • Quick movement between cubicles • Communication among team • Disposable MC kits, hand scrub between clients

  4. MC Client Flow Surgical Team A A Doctor 1 Client 3 Client 5 Client 1 S S Doctor 2 Client 4 Client 2 N S S A A N N

  5. Results

  6. Next Steps • Multi-country operational research to evaluate MC MOVE. • Efficiency models used for expansion of MC services. • Policy change towards task shifting of surgical components of MC to nurses.

  7. Acknowledgments Partners • MOHCW Zimbabwe • O. Mugurungi, G. Ncube • C. Samkange, University of Zimbabwe • D. Rech, PSI Donors: • USAID • UKAID Implementers: • PSI MC team • E. Fusire, G.S. Dendere, K. Kaseke, R.Dhlamini

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