Table 2

Preferred service delivery options for a male circumcision program for HIV prevention
Traditional penile-cutting communities
Location Service provider
Health facility Traditional house Health worker Traditional cutter
To increase safety and precision of cut To preserve culture. Health worker could be involved in traditional ceremony as a guest at traditional house If provided with skills and resources from the government
Initial procedure completed at health facility but all follow up and medication completed in traditional ways To strengthen the community Health worker to complete in health facility To increase ease of access for some communities
Completed at health facility but followed up with customary celebrations For the community to have more control of program.
For poor families who can’t afford customary celebrations. Because it defined customary practice
Completed only at traditional house to respect custom
For wealthy families to promote social standing
Financing Target population
Free Payment
Should be free if completed by government For traditional purposes only > 10 years as per traditional custom
Should be free if completed by government In kind or in gratitude, a part of cultural celebration School age
Communities that do not engage in traditional penile cutting
Location Service provider
Health facility Community location Health worker Peer/non-health worker
At health facility to increase safety of procedure Complete in secret community location Health worker to increase safety Use of local cutter due to loss of potential income if Health worker only involved
At health facility but it would need to be discrete For ease of access Health worker from outside community to increase secrecy and safety Accredited local cutter to alleviate human resource burden on health system
Not at major hospital as it is too public Going to health facility can be expensive and time consuming Male health worker as it would save embarrassment for patient and female health worker
Community outreach program to aid post level and if possible village level to assist in mitigating access issues for rural people
Financing Target population
Free Payment < 5 years >10 years
Because the government was promoting it To increase accountability for action Because many children are exposed to sex early Around time of sexual debut
A cost would be a barrier to service uptake In kind or in gratitude Other countries circumcise babies Older because boys they would be stronger physically and mentally to handle pain and procedure
Young men would not have access to cash due to poor employment options Older so that children would have a choice
If too high then this may impact on uptake

Tynan et al.

Tynan et al. BMC Public Health 2013 13:749   doi:10.1186/1471-2458-13-749

Open Data