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Male Circumcision for HIV Prevention in Kenya: Service Delivery beyond Nyanza

Male Circumcision for HIV Prevention in Kenya: Service Delivery beyond Nyanza. Dr Peter Cherutich, MD, MPH Deputy Director National AIDS/STD Control Programme (NASCOP). Male Circumcision Meeting, Arusha 2010. 2007 KAIS: Male circumcision and HIV. National HIV Prevalence: 7.1%

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Male Circumcision for HIV Prevention in Kenya: Service Delivery beyond Nyanza

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  1. Male Circumcision for HIV Prevention in Kenya: Service Delivery beyond Nyanza Dr Peter Cherutich, MD, MPH Deputy Director National AIDS/STD Control Programme (NASCOP) Male Circumcision Meeting, Arusha 2010

  2. 2007 KAIS: Male circumcision and HIV National HIV Prevalence: 7.1% National MC Prevalence: 85 % Province with the highest HIV prevalence (Nyanza) has the lowest MC level Province with the second highest HIV prevalence (Nairobi) has second lowest MC level

  3. 1st Kenya HIV Prevention Summit, Kisumu results shared Kisumu trial stopped, DMS gives press statement 1st Kenya MC stakeholder meeting DMS approves Policy on Male Circumcision MC Taskforce recommends to DMS Policy on Male Circumcision WHO/UNAIDS endorse MC at Montreux Kisumu results published in the Lancet 2007; 396:643–656. ESA Africa Consultation Meeting on MC in Nairobi The VMMC Journey….. Sept 07 Feb 07 Mar 07 May 07 Aug 07 Sept 06 Nov 06 Dec 06 Dr. Mores & the MCC team

  4. … The VMMC Journey MC RRI in 11 districts Over 35,000 men circumcised in 30 days Policy for MC in Kenya published Task force reconvenes on 30th January Consultation meeting with LCE in Oyugis Letter from LCE to DMS 2nd Kenya Prevention Summit 2nd Stakeholder meeting in Nyanza Announcement by GOK of National MC Programme Jan 08 Mar 08 April 08 Jul 08 Sept 08 Oct 08 Nov 08 Jun 09 Nov 09 Ministry allows nurses to perform MC Nyanza health facility assessment completed Mbagathi: working meeting for subcommittees Creation of Nyanza Provincial MC Taskforce 1st Stakeholder meeting in Nyanza

  5. VMMC policies and Guidelines MC policy guidance Clinical Manual for MC under LA MC 5 year strategy in line with KNASP III MC communication strategy MC M&E tools 5

  6. MC Scale up – Need

  7. MC TARGETS BY REGION AND TIMELINE (TO REACH 80% AMONG CURRENTLY NON-CIRCUMCISED AND 94% NATIONALLY)

  8. Cosmopolitan-high demand for VMMC Facility assessments done Engagement of various stakeholders Technical Political More partnerships are being established Nairobi Metropolitan

  9. Pockets of non-circumcising communities bordering Uganda-Teso and Samia GoK through support from World Bank Plan to offer 5000 MCs by end 2010 Preparatory activities and training ongoing Service delivery to start July 2010 Western Province

  10. Around Lake Turkana and diaspora of non-circumcising communities Very encouraging support from political, religious and government officials Plans underway for a dedicated partners to start routine service delivery Various partners are already working among circumcising communities e.g Walter Reed Rift-Valley Province

  11. MC Achievements versus Targets in VMMC strategy Cumulatively 120,000 MCs have been done

  12. Quality assurance • 2 EQA visits-April and November 2009 • National government led Quality Improvement Team established • Local Training done, domestication in process • QI teams in 3 districts

  13. Key Challenges • Coordination and mobilization of partners • Rationalization of partners, no new partners • Targeting resources to those in greatest need • Potential replacement of out-of-pocket MCs service • Matching supply and demand • Ensuring efficiency is the guiding principle • Vertical versus integrated approach • Reaching older men!

  14. Opportunities • World Cup 2010 • Revitalization of male reproductive health • Community health strategy • Improves access • Synergies with other programmese.g HIV testing and counselling • Sustained political and technical leadership • MC now widely accepted across communities

  15. Ahsante!

  16. Acknowledgements • VMMC Taskforce • Male Circumcision Consortium • FHI • NRHS • Engender Health • USG • Gates Foundation • UN family

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