Description of Session
Male circumcision confers a significant level of protection against heterosexual HIV acquisition among men. Since 2009, voluntary medical male circumcision (VMMC) has been a key HIV prevention intervention in Tanzania. With nationwide MC prevalence nearing 80% among males aged 15-29 years, it becomes increasingly difficult to reach eligible uncircumcised men with VMMC and achieve the 90% circumcision target. Thus, innovative approaches are needed in order to reach the remaining uncircumcised men in Tanzania. In late 2016, IntraHealth began triangulating quantitative (program, survey, census, and geographic) and qualitative data (key stakeholder interviews) to drive strategic planning of targeted VMMC service delivery in the five Lakes Region (i.e., Mwanza, Geita, Shinyanga, Mara, and Simiyu), and found significant geographic variability within these regions. IntraHealth generated ward-level circumcision estimates using census male population projections, circumcision prevalence estimates, and VMMC program performance data. This information was overlaid using geographic information system (GIS). This data coupled with information from community experts, enabled the identification of focused and accessible geographical areas with large numbers of uncircumcised men. Program performance increased by more than 200 percent once this approach was implemented across regions supported by IntraHealth, as well as achievement against targets. This success was sustained during 2018, when IntraHealth performed 305,718 MCs, contributing to 34 percent of all MCs conducted during a record-setting year of 905,313 MCs in Tanzania.
