Systematic approach to improving six-week post voluntary medical male circumcision follow-up at Moroto Regional Referral Hospital in Uganda
Moroto Regional Referral Hospital (RRH) located in Uganda’s Karamoja Region had been struggling to improve the post-circumcision follow-up rate beyond seven days (six weeks) for some time. This would enable the circumcision team determine the final health status of their client and provide timely intervention when needed. During the USAID Applying Science to Strengthen and Improve Systems (ASSIST) project’s joint coaching and mentorship with SUSTAIN the Moroto RRH voluntary medical male circumcision (VMMC) quality improvement (QI) team was supported to systematically analyse the root causes and come up with various possible solutions to improve the six-week post-operative follow-up until the idea of making phone calls to remind clients was adopted and facilitated by SUSTAIN. The phone calls were mainly to remind clients to come for follow-up, however for those who could not come to the site, their wound healing status was obtained and action taken accordingly. Through these calls, two clients were identified with complications and managed in time when they would otherwise have been missed. The proportion of clients whose six-week post-operative follow-up status is known increased from as low as 0% in July 2015 to 100% in March 2016 and has been maintained above 80% for the last six months.