From: Male circumcision for HIV prevention: current evidence and implementation in sub-Saharan Africa
Country | HIV prevalence (%) | Men circum-cised (%) | Policy framework | Implementation strategy, plan status | MC delivery structure | Potential infections averted by scaling up MC to 80% by 2015 and maintain rate through 2025* | Total Net Savings, 2009-2025 (US$) | Circum-cisions to date | Estimated number of MCs needed to reach 80% target | Achievement towards 80% target (%) |
---|---|---|---|---|---|---|---|---|---|---|
Botswana | 17.6 | 11.2 | MC as part of existing HIV prevention policy | In place | Services integrated in existing HIV prevention strategies | 62,773 | 248 million | 11,197 | 345,244 | 3.2 |
 |  |  |  | Phased scale-up goal, 80% of 0-49 years HIV-negative men by 2014 |  |  |  |  |  |  |
Ethiopia | 1.4 - National | 93 - National | MC as an additional HIV prevention strategy. Regional MC Task Force is to be established; draft regional MC strategic direction document under finalization. | Under development | MC to be provided in 100% of medical facilities in Gambella (one hospital and 25 health centres) | 1,479 | 5.8 million | 5,786 | 100,000 | 5.8 |
 | 6.0 - Gambella | 46 - Gambella |  | Target to provide services in 100% of healthcare facilities in Gambella Region |  |  |  |  |  |  |
Kenya | 7 - National | 86- National | MC policy in place: 'National Guidance' for MC | In place | Stand alone and integrated, mobile clinics; prison services | 73,420 | 247 million | 232,287 | 860,000 | 27 |
 | 15.4 - Nyanza | 48 - Nyanza |  | Target to reach 80% of 15-49 year old men (1.1 million men) and newborns by 2013 |  |  |  |  |  |  |
Lesotho | 24 | 52 | MC policy in place | In place | MC to be integrated in HIV prevention services focused in MNCH settings | 106,427 | 618 million | 4,000 | 376,795 | 1 |
 |  |  |  | Launched in 2010 |  |  |  |  |  |  |
Malawi | 11 | 21 | In place | National operational plan includes voluntary MC | Currently offered by free-standing clinics. Scale-up structure not yet developed | 240,685 | 1.2 billion | 3,119 | 2,101,566 | 0.1 |
Mozambique | 12 | 52 | Formal policy developed | MC included in operational plan for HIV prevention | MC services available on demand; adolescent and neonatal MC are planned. | 215,861 | 1.5 billion | 7,733 | 1,059,104 | 0.7 |
 |  |  |  | Rollout in pilot sites |  |  |  |  |  |  |
Namibia | 13 | 21 | MC policy approved | In place | Stand-alone, mobile services are being considered. Plans to integrate into hospital services. | 18,373 | 120 million | 1,987 | 330,218 | 0.6 |
 |  |  |  | Rollout in pilot sites |  |  |  |  |  |  |
Rwanda | 3 | 12 | Formal policy in development. Detailed operational plan in place | In place | Formal scale up started in the military. Plans to integrate into standard HIV prevention services. | 56,840 | 200 million | 1,694 | 1,746,052 | 0.1 |
 |  |  |  | Detailed operational plan being rolled out |  |  |  |  |  |  |
South Africa | 18 | 42 | Draft policy in place, under finalization | In place | Facility based, and stand-alone centres and camps, scale up from Orange Farm to 143 sites | 1,083,869 | 6.5 billion | 131,117 | 4,333,134 | 3.4 |
 |  |  |  | Currently being scaled up nationwide |  |  |  |  |  |  |
Swaziland | 26 | 8.2 | Policy adopted by cabinet | In place | Formal scale-up of integrated services started; dedicated "circumcision Saturdays' | 56,810 | 332 million | 18,869 | 183,450 | 13.3 |
Tanzania | 5.7 | 67 | Policy under way | Under development. Plans to target 8 regions with high HIV and low MC prevalence | Scale-up demonstration sites, MOVE strategy recommended in the public sector | 202,900 | 966 million | 18,026 | 1,373,271 | 1.4 |
Uganda | 6.4 | 25 | Policy in place | In place | Piloted in the military and a mobile site, plans to integrate into routine services | 339,524 | 2 billion | 9,052 | 4,145,184 | 0.2 |
Zambia | 14 | 12.8 | Cabinet approved MC as part of HIV prevention policy | In place | Multi-sectored approach focused on military, police, prisons, and neonatal services | 339,632 | 2.4 billion | 81,849 | 1,949,292 | 4.2 |
 |  |  |  | Target of 250,000 MCs a year; MC sites to increase to 300 by 2014 |  |  |  |  |  |  |
Zimbabwe | 14 | 10 | Policy in place | Under development (2010-2014) | Services offered through mobile and free-standing sites and in public health clinics. Nationwide neonatal MC planned | 565,751 | 3.8 billion | 13,977 | 1,912,595 | 0.7 |