Male circumcision in Rwanda Presented by Background l
Male circumcision in Rwanda Presented by:
Background l l l Population: 9. 3 M HIV Prevalence : 3% MC Prevalence: 15% (15 -49 years) MC integrated in the national HIV prevention policy since 2007 MC Partnerships: WHO, UNAIDS, UNICEF, USG, Jhpiego, Civil Society Organizations
Figure 1: Scenario for MC Service Expansion in Rwanda - Adult, Adolescent (10 -19 yrs) and Neonatal MC Programme Sources: Rwanda NIS 2009; Rwanda NSP 2009 -2012
Implementation Status l Leadership: v NAC (CNLS) coordination of MC activities v MOH responsible for MC in health facilities v TRAC Plus responsible for development of MC tools v Technical Working Group (TWG) since 2008(National and Partners) v MC focal person in TRAC Plus & CNLS.
Implementation Status… l Situation Analysis: *3 studies: -Cost & effectiveness of MC -Facility readiness assessment (data analysis: Ongoing) -MC KAP study (data analysis) *DMPPT Model (ongoing)
Accomplishment l l l Policy & Regulation : -MC integrated in National HIV prevention Policy; -MC guidelines under approval. Advocacy with civil society umbrellas (with support from AVAC/IHV) QA , M&E framework under discussion
Accomplishment… l Training: 2 Programme Managers ; 6 National trainers; 50 MC service providers, 91 MC counselors (military HF) l Service Delivery: MC in 9 Military sites (542 circumcised men since 10/2009 to 04/2010), l MC pilot project is planned in 2 districts hospitals (Musanze & Nyanza)
Lessons Learnt l l Political engagement / commitment of stakeholders. Community acceptability is likely to be high Existing of certain cultural/sexual practices that could undermine MC impact and or acceptability Willingness of women to be involved in MC rollout
Challenges l l l l The operational plan under discussion with technical support of UNAIDS; Insufficient medical staff and mobility of trained staff Insufficiency of MC kits High cost of the MC / Funding availability Task shifting Communication plan Service coverage and M&E framework
Way Forward l l l Finalize DMPPT model: Operational Plan Evidence based policies Capacity building Development of communication plan and tools Modeling effective service delivery at district level
Support need to scale up l Technical expertise: q Operational plan; q BCC; q Capacity Building;
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