5th World Congress on Virology
Rwanda Biomedical Center/HIV Division, Rwanda
Title: Modeling implementation of Early Infant Male Circumcision in Rwanda: Lessons learnt
Biography: Chaste Karangwa
Background Medical male circumcision (MMC) has been proven to reduce the risk of HIV infection in men. Rwanda does not traditionally circumcise, after sensitization campaigns through community people were interested in MMC, to meet this demand adult MMC is provided since 2008, in addition Rwanda is modeling Newborn male circumcision (performed between births to 2 months) as long term strategy. Methodology A steering committee was established to oversee implementation and to review progress regularly. Steps in establishing the services followed the classical program cycle of assessment, planning, implementation and monitoring. Medical Staff from maternity and surgical department were trained on Mogen device use for 3 days, sites were selected, supplies were procured, and clients were sensitized and enrolled. Data and adverse events was collected routinely and reviewed for uptake improvement. Results A total of 85 circumcisions were performed, 6% of these consented at the ANC, 35% after delivery and 59 % during routine child welfare clinic visits. The average birth weight was 3.3 kilos and age was 41 days. Majority (n/N) did not experience any adverse events (AE), five experienced AE such as bleeding and 8 had incomplete removal of the foreskin. Lessons learned and next steps Integration of newborn male circumcision in MNCH setting is feasible. Mogen clamp is simple to use. Selection of health care workers with surgical experience, extended and adequate training using infant penis models and supervision on the job are critical to minimize AE and to achieve better outcome of Newborn male circumcision procedures.
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