HARARE, (PlusNews) - Providing male circumcision as an HIV prevention measure in Zimbabwe's state hospitals is off to a very slow start, and experts cite the country's crippled health sector as the main reason for the delay. Although about 140 circumcisions were successfully performed at four hospitals as part of a training exercise, health officials told IRIN/PlusNews the government was not yet ready to roll out the programme. The money is there: Zimbabwe has received funding from donors for the male circumcision programme, which is being administered by Population Services International (PSI), a social marketing NGO. But the health workers are not ready. Government intended implementing the initiative by August this year but has had to train more health personnel. "We don't want any hiccups when we open the doors to the public; that is why we are proceeding with caution," Dr Owen Mugurungi, National Tuberculosis and HIV/AIDS coordinator in the ministry of health and child welfare, told IRIN/PlusNews. "We want to make sure that when we make the announcement that rollout has begun, people can come and get quality service, and that nothing will go wrong. We want to make sure that we have adequate staff, and that they are also knowledgeable about how to conduct the operation safely."The government, working with AIDS service organizations, has embarked on an awareness campaign to educate people about the benefits of the procedure. "We want men to understand that male circumcision is part of the prevention package, and that this procedure works with other aspects in our prevention campaigns, otherwise we will have a huge disaster on our hands if this is not carefully understood," Mugurungi said.
We don't want any hiccups when we open the doors to the public; that is why we are proceeding with caution Is the public health sector ready?Health minister Henry Madzorera said it would be some time before male circumcision was offered at all hospitals and clinics. "We want to do this in the same manner that was done with national antiretroviral therapy programme. It started at four hospitals in Harare [the capital] and Bulawayo [the second city] and then the programme was decentralized to smaller hospitals throughout the provinces."Zimbabwe's public health facilities were starved of resources, drugs and equipment for years, but a health worker strike that began in November 2008 shut down health services completely for several months. The loss of qualified nurses and doctors would make it even more difficult to deliver the service. "I am sure the ministry is aware of the scale of collapse in the public health sector ... there is just no staff to do this kind of thing," said Itai Rusike, director of the Community Working Group of Health (CWGH), a local NGO operating in 25 districts. Zimbabwe has one of the highest HIV prevalence rates in the world - 15.6 percent, or at least 1.7 million people living with HIV, according to UNAIDS - and could not afford to delay introducing the new prevention method. Rusike called on government to use communities already practising male circumcision to drive the process, so as to alleviate pressure on public hospitals. An estimated 10 percent of Zimbabwean men are circumcised for religious and traditional reasons. "There are communities already doing male circumcision, such as the Muslims, and this could be a good entry point. The ministry can offer technical support and monitor to see that the exercise is done under the most hygiene standards," Rusike suggested. According to the only study on the acceptability of male circumcision, undertaken in Harare in 2000 by UNAIDS, at least 45 percent of respondents expressed a wish to be circumcised if the practice was "affordable, safe and was confirmed to reduce the risk of contracting HIV or sexually transmitted infections". st/kn/he
Theme(s): (PLUSNEWS) Care/Treatment - PlusNews, (PLUSNEWS) Gender Issues, (PLUSNEWS) HIV/AIDS (PlusNews), (PLUSNEWS) Prevention - PlusNews [ENDS]