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Feasibility Assessment of Male Circumcision Volunteer Programme in Namibia

This assessment examines the feasibility of introducing a volunteer programme for male circumcision in Namibia, considering readiness of selected sites and identifying areas that need strengthening. Recommendations are provided based on key findings.

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Feasibility Assessment of Male Circumcision Volunteer Programme in Namibia

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  1. MALE CIRCUMCISION VOLUNTEER PROGRAMME:Feasibility Assessment InNamibiaDr. Justin K. NyatondoI-TECH NamibiaContributing Authors: Epafras Anyolo, MOHSS George Obita, WHO Dino Rech, WHO Alexis Ntumba, IntraHealth

  2. Presentation outline • Objectives of the assessment • Rationale for using volunteers • Methodology • Key findings • Recommendations • Progress to date

  3. Objectives of the Assessment • To assess selected sites for readiness to receive volunteers • To provide technical support to the male circumcision (MC) Task Force to develop a plan to introduce the volunteer programme in Namibia. • To provide recommendations on areas that need strengthening

  4. Rationale for use of volunteers • Despite significant steps in scaling up MC services in Namibia human resource constraints remain a major barrier • Lack of personnel • Trained MC providers overloaded with other duties • Current legal framework only allows doctors to perform MC • Use of volunteers has been used with success in other programmes in Namibia • Eye Camps (cataract surgery) • Operation Smile (cleft palate)

  5. Assessment team • Team led by two WHO consultants accompanied by representatives from: • Ministry of Health and Social Services • Development partners: • I-TECH Namibia • IntraHealth • USAID • CDC • Five hospitals visited: Windhoek Central, Oshakati, Onandjokwe, Rundu, and Nyangana

  6. Methodology • Methods used included • Interviews - management and staff using a standardised checklist • Observation - infrastructure, lay-out, equipments, and supplies • Document review • Key Areas considered: • Facility space • Staffing • Equipment and supplies • Current and future demand • Volunteer hosting logistics • Facility willingness to receive volunteers

  7. Findings • Facility space: • All facilities have dedicated surgical space for MC that can be made available full time • Staffing: • Doctors performing MC are available at all sites • Three sites have a team comprising of at least a doctor, nurse and counsellor trained on MC for HIV prevention • Very little time is dedicated to MC due to competing work demands hence low numbers of MCs done to date • Staff at Rundu and Nyangana hospitals not trained on MC for HIV prevention

  8. Findings (2) • Equipment and supplies: • Generally equipment and supplies are available, including medicines and consumables • A limited number of MC specific surgical kits • Current levels of MC kits capacity limited to a maximum of 5-10 cases a day

  9. Findings (3) • Current and future demand • Windhoek and Oshakati hospitals had waiting lists ~60 – 100 clients despite no active demand creation • Average waiting time up to 6 months • Average number of MCs done per week ranged from 0 – 5 across the five facilities • Indication from hospitals and partners is that potential demand could be high with mobilization

  10. Findings (4) • Volunteer hosting logistics: • All hospitals are easily accessible and have good nearby hotels/lodges • No logistics planning has been done yet. • Country experience in hosting eye camp volunteers is reassuring • Focal persons available at most sites • Facility willingness to receive volunteers: • All hospital teams expressed willingness and enthusiasm to receive volunteers • Demand Creation: • Ensure adequate demand prior to volunteers’ arrival

  11. Recommendations • Facility space: • Do lay out planning for waiting room and counselling space • Staffing: • Ensure availability of adequate trained support staff throughout the volunteer mission • Equipment and supplies: • Increase the number of MC kits to a minimum of 20 per hospital • Strongly recommend the introduction and training on diathermy • Consider use of MC disposable kits

  12. Progress….. • Formal invitation letter to WHO inviting volunteers to Namibia drafted • Ideal period for initial volunteer mission provisionally set for Aug - Sept 2010 • MoHSS and partners building capacity at sites through • MC dedicated staff recruited (Dr & nurses) • Training • Procuring instruments and consumables • Making necessary infrastructural adjustments at facilities • Good in country partner support available to address gaps

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