Voluntary Medical Male Circumcision: A Framework Analysis of Policy and Program Implementation in Eastern and Southern Africa
Background:
Following confirmation of the effectiveness of voluntary medical male circumcision (VMMC) for HIV prevention, the World Health Organization and the Joint United Nations Programme on HIV/AIDS issued recommendations in 2007. Less than 5 y later, priority countries are at different stages of program scale-up. This paper analyzes the progress towards the scale-up of VMMC programs. It analyzes the adoption of VMMC as an additional HIV prevention strategy and explores the factors may have expedited or hindered the adoption of policies and initial program implementation in priority countries to date.
Methods and Findings:
VMMCs performed in priority countries between 2008 and 2010 were recorded and used to classify countries into five adopter categories according to the Diffusion of Innovations framework. The main predictors of VMMC program adoption were determined and factors influencing subsequent scale-up explored. By the end of 2010, over 550,000 VMMCs had been performed, representing approximately 3% of the target coverage level in priority countries. The “early adopter” countries developed national VMMC policies and initiated VMMC program implementation soon after the release of the WHO recommendations. However, based on modeling using the Decision Makers' Program Planning Tool (DMPPT), only Kenya appears to be on track towards achievement of the DMPPT-estimated 80% coverage goal by 2015, having already achieved 61.5% of the DMPPT target. None of the other countries appear to be on track to achieve their targets. Potential predicators of early adoption of male circumcision programs include having a VMMC focal person, establishing a national policy, having an operational strategy, and the establishment of a pilot program.
Conclusions:
Early adoption of VMMC policies did not necessarily result in rapid program scale-up. A key lesson is the importance of not only being ready to adopt a new intervention but also ensuring that factors critical to supporting and accelerating scale-up are incorporated into the program. The most successful program had country ownership and sustained leadership to translate research into a national policy and program.
: Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Voluntary Medical Male Circumcision: A Framework Analysis of Policy and Program Implementation in Eastern and Southern Africa. PLoS Med 8(11): e32767. doi:10.1371/journal.pmed.1001133
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1001133
Souhrn
Background:
Following confirmation of the effectiveness of voluntary medical male circumcision (VMMC) for HIV prevention, the World Health Organization and the Joint United Nations Programme on HIV/AIDS issued recommendations in 2007. Less than 5 y later, priority countries are at different stages of program scale-up. This paper analyzes the progress towards the scale-up of VMMC programs. It analyzes the adoption of VMMC as an additional HIV prevention strategy and explores the factors may have expedited or hindered the adoption of policies and initial program implementation in priority countries to date.
Methods and Findings:
VMMCs performed in priority countries between 2008 and 2010 were recorded and used to classify countries into five adopter categories according to the Diffusion of Innovations framework. The main predictors of VMMC program adoption were determined and factors influencing subsequent scale-up explored. By the end of 2010, over 550,000 VMMCs had been performed, representing approximately 3% of the target coverage level in priority countries. The “early adopter” countries developed national VMMC policies and initiated VMMC program implementation soon after the release of the WHO recommendations. However, based on modeling using the Decision Makers' Program Planning Tool (DMPPT), only Kenya appears to be on track towards achievement of the DMPPT-estimated 80% coverage goal by 2015, having already achieved 61.5% of the DMPPT target. None of the other countries appear to be on track to achieve their targets. Potential predicators of early adoption of male circumcision programs include having a VMMC focal person, establishing a national policy, having an operational strategy, and the establishment of a pilot program.
Conclusions:
Early adoption of VMMC policies did not necessarily result in rapid program scale-up. A key lesson is the importance of not only being ready to adopt a new intervention but also ensuring that factors critical to supporting and accelerating scale-up are incorporated into the program. The most successful program had country ownership and sustained leadership to translate research into a national policy and program.
: Please see later in the article for the Editors' Summary
Zdroje
1. Joint United Nations Programme on HIV/AIDS 2010 Global report: UNAIDS report on global AIDS epidemic 2010. Geneva Joint United Nations Programme on HIV/AIDS
2. WellerSDavis-BeatyK 2002 Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev 2002 CD003255
3. DeCockKFowlerMMercierEdeVincenziISabaJ 2000 Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy practice. JAMA 9 1175 1182
4. World Health Organization 2010 Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: recommendations for a public health approach—2010 version. Geneva World Health Organization
5. World Health Organization 2009 WHO, UNODC, UNAIDS technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. Geneva World Health Organization
6. StoverK 2011 May 12 Treating HIV-infected people with antiretrovirals significantly reduces transmission to partners: findings result from NIH-funded international study. NIH News. Bethesda (Maryland) United States National Institutes of Health
7. PetersAJansenWvan DrielF 2010 The female condom: the international denial of a strong potential. Reprod Health Matters 18 119 128
8. AuvertBTaljaardDLagardeE 2005 Randomized controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med 2 e298 doi:10.1371/journal.pmed.0020298
9. GrayRHKogoziGSerwaddaDMakumbiFWatyaS 2007 Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 369 657 666
10. BaileyRMosesSParkerC 2007 Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 643 656
11. WeissHQuigleyMHayesR 2000 Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis. AIDS 14 2361 2370
12. TobianASerwaddaDQuinnTKigoziGGravittP 2009 Male circumcision for the prevention of HSV-2 and HPV infections and syphilis. New Engl J Med 13 1298 1309
13. AuvertBSobngwi-TambekouJCutlerENieuwoudtMLissoubaP 2009 Effect of male circumcision on the prevalence of high-risk human papillomavirus in young men: results of a randomized controlled trial conducted in Orange Farm, South Africa. J Infect Dis 199 14 19
14. GrayRSerwaddaDKongXMakumbiFKigoziG 2010 Male circumcision decreases acquisition and increases clearance of high-risk human papillomavirus in HIV-negative men: a randomized trial in Rakai, Uganda. J Infect Dis 201 1455 1462
15. SerwaddaDWawerMMakumbiFKongXKigoziG 2010 Circumcision of HIV-infected men: effects on high-risk human papillomavirus infections in a randomized trial in Rakai, Uganda. J Infect Dis 201 1463 1469
16. WawerMTobianAKigoziGKongXGravittP 2011 Effect of circumcision of HIV-negative women: a randomised trial in Rakai, Uganda. Lancet 377 209 218
17. WawerMMakumbiFKigoziGSerwaddaDWatyaS 2009 Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda. Lancet 374 229 237
18. WeissHHankinsCDicksonK 2009 Male circumcision and risk of HIV infection in women: a systematic review and meta-analysis. Lancet Infect Dis 9 669 677
19. World Health Organization/Joint United Nations Programme on HIV/AIDS 2007 WHO/UNAIDS technical consultation on male circumcision and HIV prevention: research implications for policy and programming. Conclusions and recommendations. Geneva World Health Organization
20. World Health Organization/Joint United Nations Programme on HIV/AIDS 2008 Operational guidance for scaling up male circumcision services for HIV prevention. Geneva World Health Organization
21. UNAIDS/WHO/SACEMA Expert Group on Modelling the Impact and Cost of Male Circumcision for HIV Prevention 2009 Male circumcision for HIV prevention in high HIV prevalence settings: what mathematical models contribute to informed decision making. PLoS Med 9 doi:10.1371/journal.pmed.1000109 e:1000109
22. NjeuhmeliEForsytheSReedJOpuniMBollingerL 2011 Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa. PLoS Med 8 e1001132 doi:10.1371/journal.pmed.1001132
23. GlaserEAbelsonHGarrisonK 1983 Putting knowledge to use: facilitating the diffusion of knowledge and the implementation of planned change. San Francisco Jossey-Bass
24. RogersE 1995 Diffusion of innovations, 4th ed. New York Free Press
25. SimmonsRFajansPGhironL 2007 Scaling up health service delivery: from pilot innovations to policies and programmes. Geneva World Health Organization
26. BollingerLStoverJ 2009 The potential cost and impact of expanding male circumcision in 14 countries. Geneva World Health Organization
27. World Health Organization 2009 Male circumcision: situation analysis toolkit. Geneva World Health Organization
28. BalasEBorenS 2000 Managing clinical knowledge for health care improvement. BemmelJMcCrayA Yearbook of medical informatics Stuttgart Schattauer Publishing 65 70
29. World Health Organization 2009 Practical guidance for scaling up health service innovations. Geneva World Health Organization
30. HalperinDTBaileyRC 1999 Male circumcision and HIV infection: 10 years and counting. Lancet 354 1813 1815
31. MuulaAS 2006 On evidence in support of male circumcision in HIV prevention: what next? PLoS Med 3 e66 doi:10.1371/journal.pmed.0030066
32. Joint United Nations Programme on HIV/AIDS 2006 Report on the male circumcision and HIV prevention country consultation meeting. Geneva Joint United Nations Programme on HIV/AIDS Esibayeni Lodge, Matsapha. 26-27 September 2006
33. Joint United Nations Programme on HIV/AIDS 2006 Male circumcision and HIV prevention: Tanzania country stakeholder consultation. Geneva Joint United Nations Programme on HIV/AIDS Dar es Salaam Protea Hotel. 14-15 September 2006
34. Joint United Nations Programme on HIV/AIDS 2006 Male circumcision consultative meeting report. Geneva Joint United Nations Programme on HIV/AIDS Protea in Lusaka, Zambia. 11-12 September 2006
35. Joint United Nations Programme on HIV/AIDS 2006 Kenya stakeholder consultation on male circumcision in the context of HIV prevention. Geneva Joint United Nations Programme on HIV/AIDS Mayfair Holiday Inn, Nairobi, Kenya. 7-8 September 2006
36. Joint United Nations Programme on HIV/AIDS 2006 Male circumcision and HIV prevention: Lesotho country consultation meeting report. Geneva Joint United Nations Programme on HIV/AIDS Lesotho Sun Hotel, Lesotho. 25 July 2006
37. DicksonK 2010 Male circumcision for HIV prevention: progress in scale-up [presentation]. 17th Conference on Retroviruses and Opportunistic Infections; San Francisco, California; 16–19 February 2010
38. DuggerCW 2009 December 2 Breaking with past, South Africa issues broad AIDS policy. The New York Times A6
39. SmithD 2009 December 1 South Africa's Jacob Zuma promises to take HIV test in AIDS policy reversal. The Guardian 16
40. National AIDS and STI Control Programme 2010 Progress report on Kenya's voluntary medical male circumcision programme, 2008-09: summary. Nairobi Government of Kenya, Ministry of Public Health and Sanitation, National AIDS and STI Control Programme
41. Herman-RoloffALlewellynEObieroWAgotKNdinya-AcholaJ 2011 Implementing voluntary medical male circumcision for HIV prevention in Nyanza Province, Kenya: lessons learned during the first year. PLoS ONE 6 e18299 doi:10.1371/journal.pone.0018299
42. CurranKNjeuhmeliEMirelmanADicksonKAdamuT 2011 Voluntary medical male circumcision: strategies for meeting the human resource needs of scale-up in southern and eastern Africa. PLoS Med 8 e1001129 doi:10.1371/journal.pmed.1001129
43. EdgilDStankardPSForsytheSReedJRechD 2011 Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services. PLoS Med 8 e1001128 doi:10.1371/journal.pmed.1001128
Štítky
Interné lekárstvoČlánok vyšiel v časopise
PLOS Medicine
2011 Číslo 11
- Statinová intolerance
- Monoklonální protilátky v léčbě hyperlipidemií
- Statiny indukovaná myopatie: Jak na diferenciální diagnostiku?
- Parazitičtí červi v terapii Crohnovy choroby a dalších zánětlivých autoimunitních onemocnění
- Význam hydratace při hojení ran
Najčítanejšie v tomto čísle
- Evidence-Based Guidelines for Mental, Neurological, and Substance Use Disorders in Low- and Middle-Income Countries: Summary of WHO Recommendations
- Voluntary Medical Male Circumcision: Strategies for Meeting the Human Resource Needs of Scale-Up in Southern and Eastern Africa
- Voluntary Medical Male Circumcision: Translating Research into the Rapid Expansion of Services in Kenya, 2008–2011
- Physical Activity Attenuates the Influence of Variants on Obesity Risk: A Meta-Analysis of 218,166 Adults and 19,268 Children