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The AIDS Support Organisation (TASO)

Using Non Physician Surgeons in Scaling up Safe M edical Circumcision (SMC) in Uganda: TASO Mbale Experience . Tumuheki M , Fomum E, Logose B, Babirye J; Okoboi S. The AIDS Support Organisation (TASO). Founded in 1987 by 16 individuals personally affected by HIV and AIDS

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The AIDS Support Organisation (TASO)

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  1. Using Non Physician Surgeons in Scaling up Safe Medical Circumcision (SMC) in Uganda:TASO Mbale Experience. Tumuheki M, Fomum E, Logose B, Babirye J; Okoboi S

  2. The AIDS Support Organisation (TASO) • Founded in 1987 by 16 individuals personally affected by HIV and AIDS • Vision: “A world without HIV and AIDS” • Mission: To contribute to the process of preventing HIV, restoring hope & improving the quality of life of PLWHA & their families.

  3. Background • Uganda adopted Safe Male Circumcision as part of the broader strategies for HIV prevention in 2010 after; • Several randomized clinical trials have proven that SMC prevents HIV transmission from females to males by 60% • Uganda developed SMC implementation guidelines for enrollment and scale up of SMC services • Uganda targets to circumcise 4.2 million (80%) adult males by 2015

  4. Background cont; • Uganda has an estimated 4000 registered medical doctors (UMDPC, 2013) • Doctor patient ratio is about 1:24,000 (HRHA Report, 2012) • Scaling up SMC by Physicians to meet the target was challenging without task sharing and shifting. • M.O.H-Uganda guided the training and use of non physician surgeons ( clinical officers, Nurses) to carry out SMC

  5. Description • TASO SMC program was initiated in 2013 after trainings by; • Rakai Health Science Program (RHSP) in Rakai district • Makerere University WALTER REED project in Kanyunga • 2 weeks training involving both theories and much intensive supervised practicum • Trained staff observed and practiced in hospitals under technical supervision by trainers

  6. Description cont… • The teams were trained to handle emergency and resuscitation • Mapping of all potential SMC camping sites and assessment of eligible site suitable for camping

  7. Monthly SMC outputs in Uganda

  8. TASO Bi-annual SMC outputs

  9. RESULTS Total number of 4679 males were circumcised (Jan 2013 to Dec 2013)

  10. SMC in progress in community theatres

  11. Lessons learnt. • Non –physician surgeons can scale up safe male circumcision in settings with inadequate physician surgeons to meet the set targets • Non physician surgeons are available and willing to carryout SMC in rural communities compared to physician surgeons • No major adverse events during and after surgeries were experienced

  12. Next Steps • HIV implementing partners can adopt this model to scale SMC to Public Health Facilities. • Optimizing use of non-physicians to contribute to Uganda’s SMC targets

  13. In Partnership With;

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