Government takes over circumcision

THE Ministry of Health and Child Care has partnered Population Services International (PSI) to come up with a Voluntary Medical Male Circumcision (VMMC) Sustainability Transition Implementation Plan (STIP) which is set to see Government taking over implementation and programming of VMMC across the country.

In the newly adopted strategy, Government will take over financial responsibility of the programme, in a transition that will run until 2021. Previously, PSI was running the programme on behalf of the health ministry.

The ministry and PSI have been partners in the implementation of circumcision programmes in Zimbabwe since 2009. This new strategy will span from this year, 2019 to 2021.

Speaking at the launch of the new strategy National Voluntary Medical Male Circumcision Co-ordinator in the Ministry of Health and Child Care, Sinokuthemba Xaba said the ministry had the capacity to run the VMMC programme with Government support and called for channelling of more financial support towards the programmes. He said the country was on track to achieving VMMC targets as more than 1,4 million people had undergone VMMC in the country.

“HIV prevalence among adults aged 15–49 years has declined by more than half in the last two decades, from 32 percent in 1997 to 13 percent in 2017. Overall, new HIV infections have been declining, and currently stand at 0,47 percent among adults aged 15–64 years. Despite the decline in our HIV prevalence and incidence rates, there still remains the need for us to seriously continue to innovate as we seek to address this challenge in our nation,” said Xaba.

He said the previous strategy, known as the Accelerated Strategic Costed Operational Plan (ASCOP) which ended in 2018, contributed to the rapid scale-up of the programme, paving way for the new strategy.

“This new strategy that we are unveiling today will set the pace for the new focus in the programme which is geared on transitioning this initiative to sustainability. Sustainability in our HIV programmes is of critical importance as we need to make sure continued quality service provision, even in the light of dwindling donor funding.”

“We are excited that as Zimbabwe, we are one of the initial pioneers of this dialogue on sustainability. We have carried out pilot projects to see how different components and elements of sustainability will operate. A lot of consultations at various levels have been done and we have listened to the people, including the clients and potential clients themselves and what they said is what is contained in this document we are disseminating today. We are also looking forward to sharing our experiences, lessons and mistakes with other countries as we pioneer this progressive journey towards sustainability,” said Xaba.

He said the public must understand that communities were different and successes of the programme would be at different scales and levels.

“We have learnt that scale-up, sustainability and maintenance are not sequential phases in VMMC programming, but rather sustainability is a state or approach that is applicable in both phases of the programme. As our districts are still at different levels or phases of the programme, sustainability approach remains relevant even in the scale-up phase to ensure that limited resources are efficiently and effectively utilised allowing the programme to achieve more with the same resources in order to meet the underfunded scale-up targets.

“At the same time, in the districts that have met or are near to meeting saturation, there is a need to employ sustainable delivery strategies to continue maintaining VMMC coverage, despite a change in target population and significantly reduced funding that is expected following programme scale-up,” said Xaba.