Center for Health Market Innovations (CHMI)

Programs

Mobile Male Circumcision Clinic

last updated May 10, 2012
  • Rural
  • Men

Overview

Implementing organization: 
Makerere University Walter Reed Project (UWRP)
Legal Status: 
Year Launched: 
2010
Stage: 
Pilot/startup stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Donor

Scale

Number of Clients Served: 
6,000 circumcisions during 2011
Summary: 

The Mobile Medical Male Circumcision clinic is a modern, safe, and practical mobile surgical van that expands access to circumcision services to previously unreached areas of Uganda.

Program goals/rationale: 

The World Health Organisation, the Uganda Ministry of Health, and scientists worldwide endorse safe male medical circumcision (MMC) as an effective HIV prevention strategy based on research findings that safe MMC reduces the risk of HIV acquisition among males by 60 percent. Safe MMC thus protects both men and women by reducing the transmission of HIV, sexually transmitted diseases, and some cancers.

Key program components: 

The Mobile Medical Male Circumcision clinic is being implemented by Makerere University Walter Reed Project (MUWRP) in partnership with the Kayunga and Mukono districts. The mobile clinic was customized in South Africa and is designed to offer MMC services to underserved communities, such as fishing villages, with a full-time staff 5 days a week.

The mobile MMC clinic comprises a self-contained surgical unit and two surgical beds. To supplement the medical procedure, the program also emphasized preventive measures such as abstinence, being faithful, and using proper contraception. HIV testing and counseling is provided to every patient, as well as pre and post-operative sexual risk reduction counseling, assessment and/or treatment of STIs, strong promotion of consistent use of condoms, counseling on the need for abstinence from sexual activity during wound healing, wound care instructions, and post-operative clinical assessments and care. The program's additional activities include training local health care workers, renovating clinics, and educating the community about the medical benefits of safe MMC.

Based on data from the basic program evaluation, MUWRP developed a clinical ledger tool to improve operational efficiency. The aim of this tool is to greatly reduce paperwork for clinicians by allowing them to record all (WHO recommended) surgical, pre- and post-clinical information in one book.

This program is the first of its kind to bring safe MMC services to remote areas. It is also the only mobile clinic in East Africa for MMC aimed at preventing HIV infection.

Program history: 

In July 2009 MUWRP implemented Uganda's first non-research safe medical male circumcision (MMC) program at the Kayunga District Hospital. In 2010, an additional surgical theatre was renovated at the Kojja Health Center IV in Mukono and MUWRP supported the launch of the MMC program for Mukono District. Additionally, with funding from PEPFAR, the program establish a second Uganda MMC training center, specifically to help roll out MMC services in Eastern Ugandan clinics. Finally, in order to offer MMC services to hard-to-reach, high-risk men, MUWRP launched a mobile MMC clinic in December 2010.

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