Table 3

Summary of workshops from community groups
East Sepik Province workshops
Community leaders workshop Wewak n= 5
Review of current male circumcision program Advantages and Disadvantages
Advantages Disadvantages/challenges
1 Maintains the Sepik culture: (particularly if done in traditional way) Inadequate materials for the procedure so there is a tendency of reusing the same blades and materials if done in haus man
2 Influx of people for circumcision due to: Scarce human resources
a Prevention of STI (HIV) Shortage of testing materials
b Prevention of cervical cancer Funds
c Reduction of STI/HIV cases Lack of information
3 Entry point to VCT Having multiple sexual partners post circumcision
4 Referrals made to access proper medical services
5 Behavioral change due to increased involvement in VCT
Young women Wewak n=6
Factor Consensus vote Other description
Age > 5 years Children greater than 5 years are stronger (have higher levels of iron)
11 to early teens are able to understand MC and care for themselves
Cost Free Because it is for the prevention of HIV
Could be barrier to service delivery
Costs already incurred for transport to health facility
Who should cut Health Worker or Traditional cutter (if experienced) Health worker because they have medical expertise
Traditional cutter would need training, but could offer treatment with traditional medicine
Awareness MC program in ESP not well known to women
Young men Wewak n=8
Factor Consensus vote Other descriptions
Awareness For everyone Radio, television, peer group communication, newspaper, counsellor, general community awareness
Health and hygiene, to prevent HIV, for custom purposes
Age – 8 years
Location Range of options Health facility, Haus man or private doctor/traditional cutter
Treatment Combined health facility and traditional (to reduce costs) Health Facility for initial injections, medication, iodine and dressings
Traditional treatment for any follow up needs
Types of cut Circumferential cut and Dorsal Slit Both straight cut (dorsal slit or longitudinal incision only) and round cut (full circumferential cut) should be available
Access People should have choice Service brought to villages
Build health facility closer to rural people
Cutter Health worker or traditional cutter Either male or female
Cost Free
Eastern Highland Province workshops
Older women`s group (Village) n=9
Factors Consensus vote Other details
Age >15years
Cost Free
Location In Village
Service delivery barriers Shame (to go to health facility) and Cost Cost was seen as most significant barrier
Who should cut Health worker
Young women`s group (Village) n=12
Factors Consensus vote Other details
Location Aid post Prefer aid post over hospital due to ease of access
Age >13 years
Practitioner Health worker who is unknown
Cost Free Considered most important issue
Men`s group (Village) n=20
Factors Consensus vote Other details
Location In Village Build a House in the Community for procedure
Who should cut Local cutters To feel more comfortable
Continued employment of local cutter
Awareness For entire community
Timing Regular service
Community leaders (Lay) group Goroka n=7
Factors Consensus vote Other details
Awareness Explanation of what MC is to everyone To make informed decision
Use of community level representative appointed locally to be present in the community at all times, understands local language, to assist in breaking down shame.
Allowance for rep
Location Aid post To avoid all complications male circumcision must not be done outside of health facility
Urban Clinic Health facilities must be equipped with proper equipment
Hospital
Cutter Health Care worker only Doctors and nurses (must be trained certified medical practitioner)
Gender Sensitive for older population (i.e. male HW only)
Age >10years Foreskin easier to cut
Old enough to care for the treated wound
Preparation for prevention of HIV before sexual debut
Cost Free Free of charge for both procedure and medication because
-It is a government HIV strategy
-Higher attendance and number of males circumcised
Specialised community leaders Goroka (health workers, prison officers, department of health) n=11
Factors Consensus vote Other details
1. Location/access Local service
2. Who will cut Health worker or local cutter (with training) Limited human resources available
Male only
3. Age > 10 years (before sexually active) ∙Service should be available to a wide range of ages
∙Concern over consent and compliance
4. Cost Free ∙Incentives for men (bus fare/tea or coffee)
∙Incentive for local cutter or CHW to recruit
5. Training Relevant to PNG, Supervisor medical officer only
6. Compensation Potential for legal action due to complications
Would impact on community acceptance of program

Tynan et al.

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

Open Data