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SCALING UP MALE CIRCUMCISION PROGRAMMES IN THE EASTERN AND SOUTHERN AFRICA REGION TANZANIA 8 TH TO 10 TH JUNE 2010

SCALING UP MALE CIRCUMCISION PROGRAMMES IN THE EASTERN AND SOUTHERN AFRICA REGION TANZANIA 8 TH TO 10 TH JUNE 2010. Malawi Presentation. Introduction & Background. Malawi has 13.1 million people Adult HIV prevalence 12% (MDHS, 2004).

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SCALING UP MALE CIRCUMCISION PROGRAMMES IN THE EASTERN AND SOUTHERN AFRICA REGION TANZANIA 8 TH TO 10 TH JUNE 2010

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  1. SCALING UP MALE CIRCUMCISION PROGRAMMES IN THE EASTERN AND SOUTHERN AFRICA REGION TANZANIA 8TH TO 10TH JUNE 2010 Malawi Presentation

  2. Introduction & Background • Malawi has 13.1 million people • Adult HIV prevalence 12% (MDHS, 2004). • Among the sexually active population, the HIV prevalence is higher among females (13%) than males (10%) • Approximately 1 million people living with HIV • Approximately 85,000 new infections annually

  3. MC Background • MC is Concentrated in Southern Malawi mostly among the Yao(lakeshore area), mang’anja & Lhomwe with strong Muslim influence. • Not widely practiced in most parts of the country. • Religion and culture are main determinants of MC in Malawi. • The coming of Christianity and colonial administration influenced some Yao to stop MC. Viewed as genital mutilation.

  4. MC Current Situation • National MC Prevalence 21%(Respondent)-2004 Malawi DHS • 5% in the Northern region • 12.2% Central Regions • 33% in Southern region • MC situation analysis indicated 26.7% (Respondent) • WHO Standard definition 23.0 % Prevalence-(MC SITAN) • National HIV prevalence 12.1% with large regional variations (2007 Sentinel Surveillance) • 8.1% Northern, Centre 10.7%, & 17.6% South.

  5. MC Prevalence by Region

  6. Stratified Analysis Malawi DHS 2004

  7. Accomplishment • National MC consultative meeting held 2007. • National Task Force in place • MOH Chairing • NAC secretariat • MC included in the HIV Prevention strategy • MC activities in the HIV Prevention Strategy operational Plan • Situation analysis done and completed • Report accepted and adopted by MC subgroup

  8. Policy Environment • MC is recognized in the newly adopted 2009-2013 National HIV Prevention Strategy. • 2009 Operation Plan indicates development of an MC Policy and service delivery guidelines(Standard Operating Procedures) & communication strategy. • National MC taskforce formed, chaired by Ministry of Health and NAC secretariat. • Consultations with key social groups ongoing. • Situation analysis on MC done, report finalized & adopted.

  9. Challenges • MC Cultural & religious link very significant. • MC driven by experts and elders • Low involvement of young people in MC • Notable opposition to MC in the past. • Traditional leaders and Christian community • Cross sectional data presents a complicated picture ( High HIV prevalence among the circumcising community)

  10. Opportunities • Established link/referral system in the circumcising area between TMC & Hospitals for surgery. • MOH partnering with NGOs(BLM, PSI & Jhpiego) • BLM has 31 MC active sites • Culturally delinked (VMMC) • MC offered to drop in clients in public sector. • Rich ground for donor support & media readiness • Involvement of Academic Institutions in MC research. • Minimum pre-requisites in both rural and urban facilities to offer MC. (MC SITAN 2010)

  11. Next steps/ Areas that need support • Development of standard operating procedures(Guidelines) • Development of Communication Strategy • Development of operational plan on VMMC • Capacity building • Conducting Costing and needs assessment in the public sector.

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