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Health services and policy poster session 2: Circumcision
P5-S2.03 Phase 1 implementation of male circumcision as a comprehensive package of HIV prevention in Rwanda
  1. J Mbabazi
  1. TRACPlus, Kigali, Rwanda


Background Rwanda adopted Male Circumcision (MC) as part of a comprehensive package of HIV prevention strategies since 2007. In order to facilitate national roll out of MC, a Phase 1 campaign involving training of healthcare providers in Nyanza and Ruhengeri District Hospitals and their affiliated health centers targeting adolescents and adults was held from 30 August to 24 September 2010. The Center for Treatment and Research on AIDS, Malaria, Tuberculosis and Other Epidemics (TRAC Plus) provided MC kits and financial support (training, cost of MC procedure) to two selected districts hospitals (Nyanza and Ruhengeri) to implement phase 1. The aim of this training was to accelerate the implementation of safe, affordable and accessible male circumcision as an HIV prevention strategy while contributing in strengthening the existing programs. The quality of the MC services provided through routine data collection and formative supervision was ensured.

Methods The training provided covered both theoretical and practical aspects of MC as an HIV prevention strategy considering the WHO training modules. The training was conducted by a team of five National trainers (three doctors, two counsellors) and the selection criteria of participants (doctors and nurses) considered those with minimum surgical skills.

Results The training was for 10 days and 25 trainees (Medical doctors and nurses) from each District Hospital and health centers were trained in both theory and practical courses on Male Circumcision as an HIV prevention strategy and also provision of counselling on MC to the client before surgery. A 1-day training of community health workers on community sensitisation was done. Following the 2-week practical session in the two DH, 120 male circumcisions were performed and acceptability for HIV testing was 100%. Communication messages on male circumcision as an HIV prevention strategy and the other benefits of MC were provided to the communities. The follow-up visit of all people circumcised was done, and no adverse events were reported.

Conclusion The MC phase 1 was successfully implemented in two district hospitals of Nyanza and Ruhengeri and the evaluation will be done. Among the lessons learnt were mainly on the coordination of MC activities as it requires a focal point to facilitate the activity on a continuous basis.

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