Presentation on theme: "SCALING UP MALE CIRCUMCISION PROGRAMMES IN THE EASTERN AND SOUTHERN AFRICA REGION TANZANIA 8 TH TO 10 TH JUNE 2010 Malawi Presentation."— Presentation transcript:
SCALING UP MALE CIRCUMCISION PROGRAMMES IN THE EASTERN AND SOUTHERN AFRICA REGION TANZANIA 8 TH TO 10 TH JUNE 2010 Malawi Presentation
Introduction & Background Malawi has 13.1 million people Adult HIV prevalence 12% (MDHS, 2004). Among the sexually active population, the HIV prevalence is higher among females (13%) than males (10%) Approximately 1 million people living with HIV Approximately 85,000 new infections annually
MC Background MC is Concentrated in Southern Malawi mostly among the Yao(lakeshore area), mang’anja & Lhomwe with strong Muslim influence. Not widely practiced in most parts of the country. Religion and culture are main determinants of MC in Malawi. The coming of Christianity and colonial administration influenced some Yao to stop MC. Viewed as genital mutilation.
MC Current Situation National MC Prevalence 21%(Respondent)-2004 Malawi DHS 5% in the Northern region 12.2% Central Regions 33% in Southern region MC situation analysis indicated 26.7% (Respondent) WHO Standard definition 23.0 % Prevalence-(MC SITAN) National HIV prevalence 12.1% with large regional variations (2007 Sentinel Surveillance) 8.1% Northern, Centre 10.7%, & 17.6% South.
Stratified Analysis Ethnic GroupHIV among circumcised HIV among uncircumcised Yao9.513.4 Hlomwe13.816.4 Malawi DHS 2004
Accomplishment National MC consultative meeting held 2007. National Task Force in place MOH Chairing NAC secretariat MC included in the HIV Prevention strategy MC activities in the HIV Prevention Strategy operational Plan Situation analysis done and completed Report accepted and adopted by MC subgroup
Policy Environment MC is recognized in the newly adopted 2009-2013 National HIV Prevention Strategy. 2009 Operation Plan indicates development of an MC Policy and service delivery guidelines(Standard Operating Procedures) & communication strategy. National MC taskforce formed, chaired by Ministry of Health and NAC secretariat. Consultations with key social groups ongoing. Situation analysis on MC done, report finalized & adopted.
Challenges MC Cultural & religious link very significant. MC driven by experts and elders Low involvement of young people in MC Notable opposition to MC in the past. Traditional leaders and Christian community Cross sectional data presents a complicated picture ( High HIV prevalence among the circumcising community)
Opportunities Established link/referral system in the circumcising area between TMC & Hospitals for surgery. MOH partnering with NGOs(BLM, PSI & Jhpiego) BLM has 31 MC active sites Culturally delinked (VMMC) MC offered to drop in clients in public sector. Rich ground for donor support & media readiness Involvement of Academic Institutions in MC research. Minimum pre-requisites in both rural and urban facilities to offer MC. (MC SITAN 2010)
Next steps/ Areas that need support Development of standard operating procedures(Guidelines) Development of Communication Strategy Development of operational plan on VMMC Capacity building Conducting Costing and needs assessment in the public sector.