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自愿男性割礼:在坦桑尼亚伊林加地区的大规模运动中,以质量和效率匹配需求和供应。

Voluntary medical male circumcision: matching demand and supply with quality and efficiency in a high-volume campaign in Iringa Region, Tanzania.

机构信息

Jhpiego/Tanzania, Dar es Salaam, Tanzania.

出版信息

PLoS Med. 2011 Nov;8(11):e1001131. doi: 10.1371/journal.pmed.1001131. Epub 2011 Nov 29.


DOI:10.1371/journal.pmed.1001131
PMID:22140366
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3226544/
Abstract

The government of Tanzania has adopted voluntary medical male circumcision (VMMC) as an important component of its national HIV prevention strategy and is scaling up VMMC in eight regions nationwide, with the goal of reaching 2.8 million uncircumcised men by 2015. In a 2010 campaign lasting six weeks, five health facilities in Tanzania's Iringa Region performed 10,352 VMMCs, which exceeded the campaign's target by 72%, with an adverse event (AE) rate of 1%. HIV testing was almost universal during the campaign. Through the adoption of approaches designed to improve clinical efficiency-including the use of the forceps-guided surgical method, the use of multiple beds in an assembly line by surgical teams, and task shifting and task sharing-the campaign matched the supply of VMMC services with demand. Community mobilization and bringing client preparation tasks (such as counseling, testing, and client scheduling) out of the facility and into the community helped to generate demand. This case study suggests that a campaign approach can be used to provide high-volume quality VMMC services without compromising client safety, and provides a model for matching supply and demand for VMMC services in other settings.

摘要

坦桑尼亚政府已将自愿男性包皮环切术(VMMC)作为其国家艾滋病毒预防战略的一个重要组成部分,并在全国八个地区扩大 VMMC 规模,目标是到 2015 年使 280 万未割礼的男性接受 VMMC。在一次持续六周的 2010 年运动中,坦桑尼亚伊林加地区的五个卫生机构共实施了 10352 例 VMMC,超出了运动目标的 72%,不良事件(AE)发生率为 1%。在运动期间,艾滋病毒检测几乎是普遍的。通过采用旨在提高临床效率的方法,包括使用钳子引导的手术方法、手术团队在流水线上使用多个床位以及任务转移和任务共享,该运动使 VMMC 服务的供应与需求相匹配。社区动员和将客户准备工作(如咨询、检测和客户安排)从机构带到社区,有助于产生需求。这项案例研究表明,运动方法可用于提供大容量的优质 VMMC 服务,同时不影响客户的安全,并为在其他环境中匹配 VMMC 服务的供应和需求提供了一个模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/ed3d3b115f3e/pmed.1001131.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/086e7d4367a8/pmed.1001131.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/2d568d276466/pmed.1001131.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/5f81a22641cb/pmed.1001131.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/ed3d3b115f3e/pmed.1001131.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/086e7d4367a8/pmed.1001131.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/2d568d276466/pmed.1001131.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/5f81a22641cb/pmed.1001131.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b0/3226544/ed3d3b115f3e/pmed.1001131.g004.jpg

相似文献

[1]
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[7]
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引用本文的文献

[1]
Facilitators and barriers to voluntary medical male circumcision as an HIV prevention strategy in Kavango East, Namibia.

S Afr Fam Pract (2004). 2023-5-10

[2]
Key challenges to voluntary medical male circumcision uptake in traditionally circumcising settings of Machinga district in Malawi.

BMC Public Health. 2021-10-28

[3]
Circumcised men's perceptions, understanding and experiences of voluntary medical male circumcision in KwaZulu-Natal, South Africa.

S Afr Fam Pract (2004). 2020-5-19

[4]
Healthcare workers' perceptions and experiences of implementing voluntary medical male circumcision in KwaZulu-Natal, South Africa.

Afr J Prim Health Care Fam Med. 2020-3-30

[5]
Need for improved detection of voluntary medical male circumcision adverse events in Mozambique: a mixed-methods assessment.

BMC Health Serv Res. 2019-11-21

[6]
The relationship between management practices and the efficiency and quality of voluntary medical male circumcision services in four African countries.

PLoS One. 2019-10-3

[7]
Systematic review of the effect of economic compensation and incentives on uptake of voluntary medical male circumcision among men in sub-Saharan Africa.

AIDS Care. 2018-9

[8]
Implementing voluntary medical male circumcision using an innovative, integrated, health systems approach: experiences from 21 districts in Zimbabwe.

Glob Health Action. 2018

[9]
A prospective cohort study of safety and patient satisfaction of voluntary medical male circumcision in Botswana.

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[10]
The cost of demand creation activities and voluntary medical male circumcision targeting school-going adolescents in KwaZulu-Natal, South Africa.

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本文引用的文献

[1]
Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa.

PLoS Med. 2011-11-29

[2]
Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial.

Lancet. 2007-2-24

[3]
Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial.

Lancet. 2007-2-24

[4]
Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial.

PLoS Med. 2005-11

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