Improving the quality of voluntary medical male circumcision: A case study from uganda

Abstract

Voluntary medical male circumcision (VMMC) is an intervention that has the potential to significantly reduce HIV transmission in Uganda. Modeling estimates suggest that if implemented to reach a coverage of 80% of males aged 15-49 years, it would prevent 300,000 new HIV infections between 2011 and 2025. But to reach such an outcome, services need to be of high quality, meeting and exceeding minimum quality standards. This case study describes the journey of 30 pilot health units in Uganda to address gaps in VMMC service delivery and the kind of support that they received. The 30 health units consisted of 29 health facilities and one mobile van, spread across all regions of Uganda. They represented high-volume sites chosen by USAID’s 10 VMMC implementing partners-three sites chosen by each implementing partner. The case describes how baseline assessments were conducted to identify quality gaps and how quality improvement (QI) teams were trained and organized at each site to make changes in care processes and track their results through the review of client forms and registers. The case presents the results achieved across the 30 sites and describes how the key learning from these sites was shared with new sites which in turn improved care at an even faster rate, due the knowledge transferred about successful practices to improve VMMC service quality.