Improving Female Involvement in Voluntary Medical Male Circumcision in Uganda

The USAID Applying Science to Strengthen and Improve Systems (USAID ASSIST) project provided technical support to 29 static health units and one mobile unit, with the goal of improving the quality of VMMC services. The CQI approach focuses on process improvement, recognizing both internal and external customers, and promoting the use of objective data to analyze and improve processes. The CQI approach was implemented in the VMMC program to address several challenges, including improving compliance to the six-week abstinence period after VMMC, improving return for post-operative follow-up among circumcised clients, increasing uptake of VMMC services, and promoting the use of other HIV prevention methods after VMMC. The approach also aimed to improve female involvement in VMMC service delivery, which is critical for achieving the program's goals. The CQI approach involves a continuous cycle of planning, implementing, evaluating, and improving processes. In the context of VMMC, this means identifying areas for improvement, testing changes, and evaluating their impact. The approach also involves engaging stakeholders, including health providers, community members, and women, to ensure that their needs and concerns are addressed. The USAID ASSIST project worked with 29 health facilities to implement the CQI approach, with a focus on improving female involvement in VMMC services. The project aimed to increase the percentage of married or cohabiting men attending VMMC with their partners, which is critical for achieving the program's goals. The project also aimed to improve the competence of health providers to integrate gender in VMMC activities, provide female-friendly services alongside VMMC services, focus on community sensitization and mobilization on female involvement in VMMC services, and improve data capture of women attending VMMC services with their male partners. The project achieved several results, including improving the competence of health providers to integrate gender in VMMC activities, increasing the percentage of married or cohabiting men attending VMMC with their partners, and improving data capture of women attending VMMC services with their male partners. The project also identified several lessons learned, including the importance of engaging stakeholders, including health providers, community members, and women, to ensure that their needs and concerns are addressed. The change package for improving female involvement in VMMC services is organized into four aims: improving the competence of health providers to integrate gender in VMMC activities, providing female-friendly services alongside VMMC services, focusing on community sensitization and mobilization on female involvement in VMMC services, and improving data capture of women attending VMMC services with their male partners. The change package provides a summary of strategies and interventions that have been tested and proven to improve care in the context of VMMC. The project's recommendations include engaging stakeholders, including health providers, community members, and women, to ensure that their needs and concerns are addressed, improving the competence of health providers to integrate gender in VMMC activities, providing female-friendly services alongside VMMC services, focusing on community sensitization and mobilization on female involvement in VMMC services, and improving data capture of women attending VMMC services with their male partners. The project's lessons learned highlight the importance of engaging stakeholders, including health providers, community members, and women, to ensure that their needs and concerns are addressed.