scholarly journals Development of a women empowerment framework to promote voluntary medical male circumcision uptake for HIV prevention in Zimbabwe

Author(s):  
Grace Danda ◽  
Thandisizwe Mavundla ◽  
Christina Mudokwenyu Rawdon

ABSTRACT Introduction: This study aimed to develop a women empowerment framework to promote Voluntary Medical Male Circumcision (VMMC) uptake for human immune-deficiency virus (HIV) prevention, guided by the following objectives: To explore relevant literature on the role of women in promoting male circumcision uptake; To develop a women empowerment framework to promote male circumcision uptake; To describe the women empowerment framework to promote male circumcision uptake. Methods: The study used a theory-generation design to explore, describe and develop a women empowerment framework from a broad literature review. Results: A three-phase approach suitable for the framework development emerged from the literature review. Phase one involved exploring relevant literature on role of women in male circumcision uptake, using the Population/problem, Intervention, Comparison and Outcome (PICO) method to identify and define the key concepts. Phase 2 adopted and adapted Maibvise and Mavundla model in identifying the following concepts: change agents as the health care providers, recipients as the women to influence men eligible for male circumcision, promoting male circumcision uptake and success of the male circumcision program. Phase 3 provided a detailed description of the framework including three key steps of empowerment of women, influencing positive perceptions of men and utilisation of male circumcision services. Conclusions: The identified concepts resulted in development of a women empowerment framework, which can be used as an education and advocacy tool in building the capacity of women in supporting the male circumcision programme to promote uptake. Further research is required to expand the utilisation of the framework in male circumcision healthcare services. KEY WORDS: Women empowerment, framework, voluntary medical male circumcision, male circumcision uptake, HIV prevention

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0139009 ◽  
Author(s):  
Haika Osaki ◽  
Gerry Mshana ◽  
Mwita Wambura ◽  
Jonathan Grund ◽  
Nyasule Neke ◽  
...  

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0209385 ◽  
Author(s):  
Katharine Kripke ◽  
Marjorie Opuni ◽  
Elijah Odoyo-June ◽  
Mathews Onyango ◽  
Peter Young ◽  
...  

2020 ◽  
pp. medethics-2020-106293
Author(s):  
Stuart Rennie ◽  
Adam Gilbertson ◽  
Denise Hallfors ◽  
Winnie K Luseno

The use of targets to direct public health programmes, particularly in global initiatives, has become widely accepted and commonplace. This paper is an ethical analysis of the utilisation of targets in global public health using our fieldwork on and experiences with voluntary medical male circumcision (VMMC) initiatives in Kenya. Among the many countries involved in VMMC for HIV prevention, Kenya is considered a success story, its programmes having medically circumcised nearly 2 million men since 2007. We describe ethically problematic practices in Kenyan VMMC programmes revealed by our fieldwork, how the problems are related to the pursuit of targets and discuss possible approaches to their management. Although the establishment and pursuit of targets in public health can have many benefits, assessments of target-driven programmes tend to focus on quantifiable outcomes rather than the processes by which the outcomes are obtained. However, in order to speak more robustly about programmatic ‘success’, and to maintain community trust, it is vital to ethically evaluate how a public health initiative is actually implemented in the pursuit of its targets.


2019 ◽  
Vol 23 (5) ◽  
pp. 1095-1103 ◽  
Author(s):  
Bernadette Hensen ◽  
Elizabeth Fearon ◽  
Ab Schaap ◽  
James J. Lewis ◽  
Helen A. Weiss ◽  
...  

2019 ◽  
Vol 10 (4) ◽  
pp. 970-977 ◽  
Author(s):  
Violeta J Rodriguez ◽  
Antonio Chahine ◽  
Aileen de la Rosa ◽  
Tae Kyoung Lee ◽  
Nicholas V Cristofari ◽  
...  

Abstract Voluntary medical male circumcision has been shown to provide a 50%–70% reduction in the risk of HIV infection without contributing to behavioral disinhibition of safer sexual practices. This study examined the interim implementation and dissemination data of Spear and Shield 2, an HIV risk-reduction program in Zambia. The purpose of this interim review was to identify contextual challenges to implementation and implement midcourse corrections associated with sustainability of program delivery. Using a mixed-methods design, quantitative evaluations of organizational functioning, barriers to implementation, burnout, and organizational readiness, as well as qualitative data utilizing the Consolidated Framework for Implementation Research (CFIR), were examined to evaluate program implementation. Participants were 184 health care providers from 46 clinics in Zambia. Successful implementation was associated with better community and leader support, and employee readiness and motivation. Quantitative assessments were not related to implementation and provided a limited picture of implementation outcomes. Results suggest that the qualitative data underlying the CFIR constructs provided a nuanced, contextual assessment of implementation, and dissemination outcomes. The CFIR may be valuable in informing the implementation of evidence-based interventions in other parts of Zambia.


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