Srithanaviboonchai Kriengkrai, Srirak Namtip, Pruenglampoo Boonlure, Thaikla Kanittha, Suwanteerangkul Jiraporn, Khorana Jiraporn, Danthamrongkul Vipa, Paileeklee Suchada, Pattanasattayavong Uraiwan, Grimes Deanna E, Grimes Richard M
Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
BMC Health Serv Res. 2018 Apr 11;18(1):275. doi: 10.1186/s12913-018-3093-y.
Neonatal male circumcision (NMC) is an alternative approach to adult male circumcision for HIV prevention. Recent studies found that NMC was rarely performed in Thailand and that most Thai health professionals did not recognize that NMC could reduce the risk of HIV infection and would not want NMC services in their hospitals. This study explored the thoughts and concerns of Thai government health staff regarding the introduction of NMC in government health facilities as a public health measure.
In-depth interviews with physicians, nurses and physician administrators from four different levels of government hospitals in four provinces representing 4 regions of Thailand were conducted after provision of education regarding the benefits and risks of NMC. Interviews were audio recorded and analyzed using Atlas.ti software to develop themes.
Six themes emerged from the data of 42 respondents: understanding of the benefits of NMC; risks of NMC; need for a pilot project; need for staff training and hospital readiness; need for parental/family education; and need for public awareness educational campaign. Major concerns included possible medical complications of NMC, infringement of child rights, and lack of understanding from staff and parents. The respondents emphasized the need for a clear policy, proper training of staff, financial and equipment support, and piloting NMC rollout before this measure could be fully implemented.
Thai health professionals who took part in this study expressed several concerns if NMC had to be performed in their health care facilities. There is significant preparation that needs to be done before NMC can be introduced in the country.
新生儿男性包皮环切术（NMC）是一种用于预防艾滋病病毒的成人男性包皮环切术替代方法。近期研究发现，泰国很少开展新生儿男性包皮环切术，且大多数泰国卫生专业人员并不认为该手术可降低感染艾滋病病毒的风险，也不希望在其医院提供此类服务。本研究探讨了泰国政府卫生工作人员对于在政府卫生机构引入新生儿男性包皮环切术作为一项公共卫生措施的想法和担忧。
在提供了有关新生儿男性包皮环切术的益处和风险的教育后，对来自泰国4个地区4个省份4个不同层级政府医院的医生、护士和医生管理人员进行了深入访谈。访谈进行了录音，并使用Atlas.ti软件进行分析以确定主题。
42名受访者的数据产生了6个主题：对新生儿男性包皮环切术益处的理解；该手术的风险；开展试点项目的必要性；工作人员培训和医院准备情况的需求；对家长/家庭教育的需求；以及开展公众意识教育活动的需求。主要担忧包括新生儿男性包皮环切术可能出现的医疗并发症、侵犯儿童权利以及工作人员和家长缺乏理解。受访者强调，在全面实施这项措施之前，需要有明确的政策、对工作人员进行适当培训、提供资金和设备支持，并开展新生儿男性包皮环切术推广试点。
参与本研究的泰国卫生专业人员表示，如果必须在其医疗机构开展新生儿男性包皮环切术，他们存在诸多担忧。在该国引入该手术之前，需要进行大量准备工作。
