MCHIP championed global guidance encompassing not only the initial startup of VMMC programs, but also their expansion. MCHIP worked in collaboration with PEPFAR and other agencies to design and assess programs, identify bottlenecks to service delivery, redesign programs for efficiency, and develop scale-up models to ensure that VMMC services are in the identified priority countries. MCHIP also developed key global guidance documents and supported meetings and webinars that provide country programs with the tools to navigate from policy/guideline development to actual implementation of high-quality services.
Development of key technical implementation documents and resources included:
- PEPFAR’s VMMC Best Practices for Site Operations
- PLoS VMMC Supplement
- VMMC Best Practice Video
- VMMC Webinars
- A Call to Action for Voluntary Medical Male Circumcision for HIV Prevention Satellite AIDS 2012 Conference
- Coordination of the Joint PEPFAR/WHO Meeting on Accelerating the Scale-up of VMMC for HIV Prevention in East and Southern Africa
- Continued provision of high level technical assistance to the 14 priority countries
- Posting of key technical documents to the WHO Male Circumcision Clearinghouse website
In addition, MCHIP’s PMTCT work was highlighted at international conferences including the Conference on Retrovirus and Opportunistic Infections (CROI 2013).
How did MCHIP HIV address scale?
MCHIP was committed to scaling up VMMC to create an HIV-free generation. Scale is defined as implementing VMMC services to reach “saturation levels” (80% of eligible men circumcised) in areas where HIV prevalence is high and male circumcision prevalence very low. MCHIP worked with the global VMMC community to reach scale in 14 priority countries. Activities included provision of global guidance documents, technical assistance related to scaling up services, and creating demand and forums for VMMC implementers to share best practices.
How did MCHIP HIV address community?
In Kenya and Ethiopia, PMTCT programs are only as successful if there is active community involvement. MCHIP in Kenya worked with the community to conduct assessment of needed services and to develop action plans to improve maternal health services. By engaging the community and having them identify gaps and provide solutions, not only did maternal and child health services improved, but the community had a committed interest in creating sustainable models to ensure this for the future.
How did MCHIP HIV address quality?
In all MCHIP programs, VMMC services met WHO‐defined standards. VMMC was is provided as part of the WHO minimum package of services, which included: HIV HTC; active exclusion of sexually transmitted infections; provision and promotion of condoms; risk reduction counseling; and circumcision surgery. MCHIP worked with countries to develop national VMMC standards to provide a benchmark for measuring VMMC services. The Program also spearhead the development of a generic quality improvement tool for VMMC for PEPFAR, and provided technical assistance in this area. MCHIP worked with programs to ensure that there are continuous quality improvement processes in place and that there is active engagement of all VMMC team members to maintain and improve quality.