Demand Creation for Voluntary Medical Male Circumcision in Tanzania: an Impact Evaluation (Bwana Mkubwa)

2021 ◽  
Author(s):  
Hally Mahler ◽  
Eva Bazant
2018 ◽  
Author(s):  
Taurai Matikiti ◽  
Tsitsi P Juru ◽  
Notion Gombe ◽  
Peter Nsubuga ◽  
Mufuta Tshimanga

AbstractZimbabwe is one of the 14 countries in eastern and southern Africa that have adopted Voluntary Medical Male Circumcision (VMMC) as an HIV prevention intervention in response to WHO’s recommendation for countries with generalised high HIV epidemics and low VMMC prevalence. However, since 2013 when VMMC was scalled up in Zimbabwe, there was a general low uptake of the VMMC programme particularly on the target age group 20-29 years which has an immediate reduction in the HIV burden. The failure of VMMC uptake in the priority age group prompted the need to analyse the effectiveness of demand creation promotions and personnel used in creating demand for VMMC in Chitungwiza district, Zimbabwe. We employed judgmental sampling, a non-probability sampling technique where we interviewed VMMC clients (n=50) and service providers (n=10) using self administered questions, and community mobilisers (n=10) and demand creation teams (n=3) using face-to-face interviews based on their experience, knowledge and professional judgment. We also randomly analysed client records in the form of 50 Client Intake Forms (CIF) books. We found out that Community mobilisers and Demand creation officers were effective in mobilising clients in the age group 10-15 years and 16-30 years respectively. The use of clinicians (nurses) was also found to be useful in creating demand for VMMC. We also found out that intensifying campaigns during school holidays, the use of tent-based/caravan campaigns and the door to door campaigns were most effective strategies under demand creation promotions. We concluded that there is need to increase demand creation officers and qualified community mobilisers. To regulary train and motivate current community mobilisers as well as increasing the use of clinicians(nurses) in demand creation. We recommended the need to increase the number of mobile caravans and intensifying on the door to door campaigns in the district.


2016 ◽  
Vol 72 ◽  
pp. S278-S284 ◽  
Author(s):  
Aggrey S. Semeere ◽  
Barbara Castelnuovo ◽  
Denis S. Bbaale ◽  
Agnes N. Kiragga ◽  
Joanita Kigozi ◽  
...  

2021 ◽  
Vol 6 (Suppl 4) ◽  
pp. e006141
Author(s):  
Webster Mavhu ◽  
Melissa Neuman ◽  
Karin Hatzold ◽  
Stephen Buzuzi ◽  
Galven Maringwa ◽  
...  

IntroductionReaching men aged 20–35 years, the group at greatest risk of HIV, with voluntary medical male circumcision (VMMC) remains a challenge. We assessed the impact of two VMMC demand creation approaches targeting this age group in a randomised controlled trial (RCT).MethodsWe conducted a 2×2 factorial RCT comparing arms with and without two interventions: (1) standard demand creation augmented by human-centred design (HCD)-informed approach; (2) standard demand creation plus offer of HIV self-testing (HIVST). Interpersonal communication (IPC) agents were the unit of randomisation. We observed implementation of demand creation over 6 months (1 May to 31 October 2018), with number of men circumcised assessed over 7 months. The primary outcome was the number of men circumcised per IPC agent using the as-treated population of actual number of months each IPC agent worked. We conducted a mixed-methods process evaluation within the RCT.ResultsWe randomised 140 IPC agents, 35 in each arm. 132/140 (94.3%) attended study training and 105/132 (79.5%) reached at least one client during the trial period and were included in final analysis. There was no evidence that the HCD-informed intervention increased VMMC uptake versus no HCD-informed intervention (incident rate ratio (IRR) 0.87, 95% CI 0.38 to 2.02; p=0.75). Nor did offering men a HIVST kit at time of VMMC mobilisation (IRR 0.65, 95% CI 0.28 to 1.50; p=0.31). Among IPC agents that reported reaching at least one man with demand creation, both the HCD-informed intervention and HIVST were deemed useful. There were some challenges with trial implementation; <50% of IPC agents converted any men to VMMC, which undermined our ability to show an effect of demand creation and may reflect acceptability and feasibility of the interventions.ConclusionThis RCT did not show evidence of an effect of HCD-informed demand intervention or HIVST on VMMC uptake. Findings will inform future design and implementation of demand creation evaluations.Trial registration numberPACTR201804003064160.


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