Leadership and Learning

Global Leadership
To date, MCHIP has championed global guidance encompassing not only the initial startup of VMMC programs, but also their expansion. MCHIP has 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 has 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. These guidance documents will remain important resources for years to come.

Development of key technical implementation documents and resources includes:

In addition, our PMTCT work has been highlighted at international conferences including the Conference on Retrovirus and Opportunistic Infections (CROI 2013).

Program Learning Achievements
MCHIP continues to focus on program learning. In the HIV field, the Program is focused on answering key questions regarding HIV HTC and VMMC service provision. Currently three assessments are underway that will answer:

  • What is the current role of Voluntary Counseling and Testing (VCT) given that PITC services have become standard of care? What are the current needs for VCT?
  • How can VMMC programs attract older clients? Provision of comprehensive male sexual and reproductive health services integrated with medical services is believed to get older clients to access services.

How does MCHIP HIV address scale?
MCHIP is 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 is working with the global VMMC community to reach scale in 14 priority countries. Activities include 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 does 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 have maternal and child health services improved, but the community has a committed interest in creating sustainable models to ensure this for the future.

How does MCHIP HIV address quality?
In all MCHIP programs, VMMC  services meet WHO‐defined standards. VMMC is provided as part of the WHO minimum package of services, which includes: HIV HTC; active exclusion of sexually transmitted infections; provision and promotion of condoms; risk reduction counseling; and circumcision surgery.  MCHIP has 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 is working 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.