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MC MOVE Models for optimizing the volume and efficiency of MC services

MC MOVE Models for optimizing the volume and efficiency of MC services. By Dr Dino Rech. MC MOVE. Evolution of efficiency principles in surgery and MC Efficiency principles used in MC Progress to date New sites and programs Research Ongoing evolution.

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MC MOVE Models for optimizing the volume and efficiency of MC services

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  1. MC MOVEModels for optimizing the volume and efficiency of MC services By Dr Dino Rech

  2. MC MOVE • Evolution of efficiency principles in surgery and MC • Efficiency principles used in MC • Progress to date • New sites and programs • Research • Ongoing evolution. • Efficiency challenges • Balancing demand and supply/ seasonality • Counselling and communications • Part time MC providers vs specialised teams

  3. Evolution of efficiency principles in surgery and MC…e.g. Aravind Eye Hospital India Orange Farm South Africa

  4. Evolution of efficiency principles in surgery and MCMOVEWHO pilot initiative:Aims to maximise Surgical results and minimising time and resources needed to perform high volumes of surgery. Facilitates cost effective solutions to MC scale up in high volume/demand settings

  5. Efficiency Principles used in MC Techniques - Forceps-guided - Cautery (monopolar) for haemostasis - Fewer stitches (8-12) for foreskin apposition - Collective wrap of surgical items - Pre-assembled surgical kits • Theatre layout for faster patient turnover • DEVICES/ SHANG RING ?? Surgical Efficiency Techniques Task-Shifting - Training / certification of entire MC procedure to lower health cadres, e.g., clinical officers, nurses. Task-Shifting Task-Sharing

  6. The Fourth Efficiency Principle Adequate Client flow and demand for services • Communications • Mobilization • Counselling and testing services

  7. Surgical layout

  8. Efficiency focused MC Kits & Electrocautery

  9. Surgical Methods * Times depicted are based on time-motion observations at Orange Farm, South Africa

  10. Results * Note Graph with initial impact and results from Tanzania.

  11. Progress to date • Efficiency focused( use of MOVE) implementation (PSI MOVE Implementation) • South Africa PSI • Swaziland PSI • Zimbabwe PSI • Tanzania • Botswana • Zambia PSI • Kenya • Research:MOVE Evaluation or Systematic Monitoring & Evaluation of Male Circumcision Scale up

  12. Aggregate Numbers – Four Pilot Sites. Tanzania MOVE Begins 13

  13. Challenges to implementing efficient high volume services • Balancing demand and supply / managing seasonality of demand • Counselling and communications: How to keep up? • Part time MC providers VS specialised teams: Pros and Cons

  14. Thank You!

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