Client follow-up

VMMC clients are advised to return to a health care facility for post-circumcision follow-up visits to track progress on wound healing and to identify and manage possible adverse events. Many countries recommend three VMMC follow-up visits: at 48 hours, at seven days, and at six weeks relative to surgery.

Client follow-up requires facilities offering VMMC services to develop and maintain mechanisms encouraging all clients circumcised to return for follow-up. Facilities are expected to collect follow-up data, analyze and interpret results, and based on findings, make informed decisions to continuously improve follow-up rates.

VMMC post-procedure follow-up is important for assessing progress on wound healing and identifying and treating potential adverse events. Follow-up visits further provide the opportunity to reinforce messages on wound care, HIV prevention, and risk reduction measures.

In Uganda, ASSIST has worked with facilities to encourage female involvement in VMMC and found that clients who attend a group education session with their female partner are more likely to return for the 48-hour and seven-day follow-up visits.

Quality issues:

  • Difficult to track clients due to poor data capturing and recording of client information.
  • Clients lost to follow-up due to tracking mechanisms that are not in place.
  • Assuring proper communication and referral systems between facilities and surrounding referral centers in cases where clients receive follow-up care at facilities other than the VMMC site where they were circumcised.
  • Insufficient and/or inconsistent messaging to clients regarding the importance of follow-up.
  • Challenges related to distance, transport and costs incurred to travel to a facility for follow-up services.