Voluntary medical male circumcision (VMMC) as an entry point for other male reproductive health services

Background: Given the efficacy of male circumcision the South African government set a target of circumcising 4, 3 million men in the next five years. Pilot projects and baseline surveys on male circumcision show high acceptability levels for these services. VMMC provides an opportunity to integrate other male reproductive health services including referrals. The objective of this paper is to assess integration of circumcision and other services and to facilitate a strong referral system for clients.
Methods: 2010-2011 monitoring data from a male circumcision clinic in KwaZulu Natal, South Africa were used to assess integration of male reproductive health services including referrals for CD4 count, TB diagnosis, STI management, and procedure abnormalities. Data were collated from consented individuals using telephone tracking and client referral forms and included HIV status.
Results: Out of 691 HIV positive men, 676 (96%) were referred for treatment, care and TB diagnosis as well as STI (Table 1). All the clients referred for STI and abnormal conditions were followed up and received services referred for. Out of 1027 referrals, 680(68.2%) were followed up through telephone tracking and the rest through tear-off slips placed in referral boxes at clinics. This reflects high levels of referral tracking though it could have been higher if all clients gave correct contact details and had cell phones.
Conclusions: Integration of VMMC strengthens referral to relevant services and offers men the opportunity to access health services specific to their needs. Telephone tracking of referrals is critical if tear-off slips are not available from referral points. One weakness in the referral tracking system is that self-reported telephonic data cannot be verified.

C. Nhlapo1, B. Ngcobo1, S. Molutsoane2
1Society for Family Health, Health Services, Johannesburg, South Africa, 2Society for Family Health, Medical Male Circumcision Clinic, Pietermaritzburg, South Africa