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Voluntary Medical Male Circumcision (VMMC) service model rebranding amidst novel corona virus-19 (COVID-19) pandemic in meeting set targets in Zambia

Title
Voluntary Medical Male Circumcision (VMMC) service model rebranding amidst novel corona virus-19 (COVID-19) pandemic in meeting set targets in Zambia
Presenter
Joseph Masiye
Authors
J. Masiye * (1), R. Kamboyi (1), A. Kaonga (1), P. Lukonde (2), P. Lungu (1), B. Musonda (1), A. Silumesii (1), R. Mwanza (3), J. Chinyonga (4), D. Phiri (5), M. Siame (6), O. Chituwo (7), G. Lingenda (8), T. Mwamba (9), L. Kasonka (10)
Institutions
(1) Ministry of Health, Public Health, Lusaka, Zambia, (2) Ministry of Health, Clinical Care and Diagnostics, Lusaka, Zambia, (3) Ministry of Health, Quality Assurance and Improvement, Lusaka, Zambia, (4) Ministry of Health, Performance Improvement, Lusaka, Zambia, (5) Ministry of Health, Public Management Unit, Lusaka, Zambia, (6) Ministry of Health, Monitoring and Evaluation, Lusaka, Zambia, (7) Centres for Diseases Control and Prevention, CDC, Biomedical Prevention, Lusaka, Zambia, (8) USAID, Biomedical Prevention, Lusaka, Zambia, (9) Clinton Health Access Initiative, HIV Program, Lusaka, Zambia, (10) Ministry of Health, Permanent Secretary - Technical Services, Lusaka, Zambia

BACKGROUND: Zambia's Voluntary Medical Male Circumcision (VMMC) program had significant scale-up success in recent years. The national operational plan of 2016-2020 had a target to circumcise 2 million males in five years. Operational plan focused two service delivery models; conducting national wide campaigns accounted 75% of annual performance and routine model accounted for 30%. During campaigns, massive demand generation activities were done such as road shows, public announcements and community mobilizers were recruited to conduct interpersonal communication in the communities. Program met its annual targets from 2017 to 2019. In March 2020, Zambia recorded its first COVID-19 case, guidelines were given to all programs to remodel service delivery, and that focused on prevention of COVID-19 pandemic. VMMC technical working group changed the service delivery models to get numbers
METHODS: In 2020, the program opened up more static sites from 1,715 to 2,200 across the country. Outreach sites were upgraded to offer minimum routine services, more health workers were trained in VMMC skills through conventional training method and blended learning. Measures implored helped cushion workload in the static sites. Coordinated supply management system with implementing partners was established to ensure adequate supplies reached the sites on time. sites with adequate staffing adopted moonlighting and weekend schedules. Scheduling of clients helped to avoid crowding at the sites. Demand generation was done through posters, social media platforms and community radio stations. Seats were provided in the sites to enable social distance to clients as they waited for the services. Coordination meetings with provinces and districts were conducted virtually on a weekly basis. Rebranded the program from 'a man who cares is circumcised to 'a man who cares; mask up. get circumcised'.
RESULTS: The strategies employed helped the program achieve 125% performance against the target for 2020 and is already at 51% by end of 1st quarter 2021.
CONCLUSIONS: Despite the effects of COVID-19 pandemic on HIV prevention programs. Program successfully increased the uptake of VMMC among boys and men. The COVID-19 has helped to remodel our service delivery into sustainable models. The program continued with strategies that worked in meeting the set targets for the country.

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