Latest Updates

  • Improving Female Involvement in Voluntary Medical Male Circumcision in Uganda

    The USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project in Uganda has been working collaboratively with 10 implementing partners (IPs) to carry out voluntary medical male circumcision (VMMC) for HIV prevention programs since 2013. ASSIST’s objective was to build capacity of IP, district and health facility staff to improve the quality and safety of voluntary medical male circumcision services in Uganda. Initially, 30 health facilities were involved and progressively the activity was scaled up to additional health facilities. There were 19 health facilities in the first wave and 33 in the second.

    VMMC faces some challenges such as demand creation for services, adherence to six weeks abstinence after circumcision, return for post-operative review, and use of other HIV prevention methods after VMMC. Literature has shown that female involvement in VMMC can play a large role in addressing these challenges so QI teams set about to increase female partner involvement in VMMC.

    The tested changes section of this change package provide guidance to health facility teams on improving female involvement in VMMC, the authors recommend that to improve female involvement in VMMC, health unit teams should implement changes under the following four aims below, which were determined based on the gaps found to affect female involvement in VMMC at the health facilities:

    • Improving the competence of health providers to provide adequate and consistent information/messages on involving women in VMMC
    • Promoting the provision of female friendly services during VMMC services
    • Focus on community sensitization and mobilization on involving women in VMMC
    • Improving data capture of female participation in VMMC
  • Improving Management of Adverse Events Following Voluntary Medical Male Circumcision in Uganda

    The USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project in Uganda has been working collaboratively with 10 implementing partners (IPs) to carry out voluntary medical male circumcision (VMMC) for HIV prevention programs since 2013. ASSIST’s objective was to build capacity of IP, district and health facility staff to improve the quality and safety of voluntary medical male circumcision services in Uganda. One of the priorities was to improve the management of adverse events following circumcision. Initially, 30 health facilities were involved and progressively the activity was scaled up to additional health facilities. There were 19 health facilities in the first wave and 33 in the second.

    This change package focuses on actionable recommendations to reduce adverse events following VMMC based on the experiences of providers from the initial 30 facilities and all other waves. The change package describes the changes tested and implemented by the VMMC improvement teams to achieve the aims. It details the change ideas, the logic for their implementation and the steps taken to carry them out. The changes address the following aims:
    •    Build skills of health providers in prevention, identification and treatment of adverse events
    •    Improve the use of tools to capture and monitor adverse events following VMMC
    •    Improve follow up of clients after VMMC
    •    Improve referral of moderate and severe adverse events (as appropriate) following VMMC
    •    Improve wound care practices among circumcised clients and ability to recognize danger signs early.