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Background

Service Delivery and Facility Productivity during an Integrated Minor Surgery/Male Circumcision Pilot Program in Mozambique. Mahomed, M 1 ; Come, J 2 ; Bossemeyer , D 1 ; Nelson, L 3 ; Cummings, B 3 ; Félix, J 4 ; Necochea , E 1.

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Background

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  1. Service Delivery and Facility Productivity during an Integrated Minor Surgery/Male Circumcision Pilot Program in Mozambique Mahomed, M1; Come, J2; Bossemeyer, D1; Nelson, L3; Cummings, B3; Félix, J4; Necochea, E1 1Jhpiego, an Affiliate of John Hopkins University, 2Ministry of Health of Mozambique, 3CDC Mozambique, 4Ministry of Defense of Mozambique, Maputo Military Hospital

  2. Background Clients attending a group counseling session on MC and HIV • In Mozambique, 11.5% of adults live with HIV. • The Mozambican MC program was embedded within a broader effort of the Ministry of Health to strengthen minor surgery services. • With MOH approval and funding from PEPFAR/CDC, Jhpiego began to strengthen six pilot sites in high HIV/low MC provinces. • Interventions included minor renovations, provision of surgical equipment and supplies, and training on infection prevention, basic surgery skills including adult MC, and counseling. • Client flow was established to ensure provision of education, counseling, HIV testing and postoperative reviews. • Demand generation was not conducted to prevent what officials feared would be an overwhelming demand. Nurses doing MC Procedure

  3. Results • From November 2009 to April 2011, 10,829 minor surgeries (MS) were performed, of which 9,992 (92.3%) were MCs [in four pilot sites, using an adapted version of MOVE] • More than 60% of MC clients age 15–24 years old. • 93.6% of MC clients accepted HIV testing, with 4.6% testing positive. • The average of adverse event rate was 0.9% • The most frequent causes of moderate and severe adverse events are infection, excessive bleedingand pain • Client satisfaction was high, 95.7% of respondents would recommend services to their friends and family

  4. Conclusion • There is a latent demand for MC in Mozambique. • Word of mouth generated nearly 10,000 MC clients during the pilot. • Satisfied clients were key to the success of this pilot.

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