Early infant male circumcision

Early infant male circumcision (EIMC) is medical male circumcision performed on healthy male newborns from 12 to 24 hours after birth and on young infants up to 60 days of age.  Circumcision is simpler, costs less, and has faster wound healing and less risk of complications in infants than in older males.  For these reasons, integrating EIMC services into routine services for newborns and infants is a long-term sustainability strategy for countries or regions with high HIV and STI prevalence and high coverage of VMMC among 15-29 year-old males.

In Tanzania, ASSIST has worked with the Ministry of Health and AIDSFree to apply CQI to the integration of EIMC in Reproductive and Child Health services, creating an EIMC CQI assessment tool and supporting sites in two regions to apply CQI to overcome operational challenges in integrating EIMC into routine care for eligible male infants.

Quality issues:

  • Assuring maternal and child health (MCH) service areas have infrastructure support for surgical procedures, appropriate space, appropriate supply chain management, and adverse events management capacity
  • Assuring that EIMC is delivered as part of a package of essential neonatal care (ENC) services, with linkages to other ENC services
  • Assuring eligibility requirements for EIMC are consistently followed in client screening (i.e., no EIMC of pre-term or low birth weight infants, no medical contraindications)
  • Assuring staff are trained in EIMC procedures
  • Assuring that accurate information on the protective effects, risks, and benefits associated with EIMC is provided to parents and caregivers to determine if EIMC is in the best interest of the individual infant to allow for informed consent
  • Assuring high post-operative (2-day, 7-day) follow-up of EIMC clients
  • Assuring the antenatal care services promote the risks and benefits of EIMC where EIMC services are available
  • Assuring that demand creation activities inform families and community of the benefits and risks of EIMC