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. 2017 Aug 29;17(1):185.
doi: 10.1186/s12887-017-0937-2.

The influence of socioeconomic factors on choice of infant male circumcision provider in rural Ghana; a community level population based study

Thomas Gyan  1   2 , Kimberley McAuley  3 , Natalie Strobel  3 , Sam Newton  4 , Seth Owusu-Agyei  5 , Karen Edmond  3   6
Affiliations

The influence of socioeconomic factors on choice of infant male circumcision provider in rural Ghana; a community level population based study

Thomas Gyan et al. BMC Pediatr. .

Abstract

Background: The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana.

Methods: The study investigated the effect of family income, distance to health facility, and cost of the circumcision on choice of infant male circumcision provider in rural Ghana. Data from 2847 circumcised infant males aged under 12 weeks and their families were analysed in a population-based cross-sectional study conducted from May to December 2012 in rural Ghana. Multivariable logistic regression models were adjusted for income status, distance to health facility, cost of circumcision, religion, maternal education, and maternal age.

Results: Infants from the lowest income households (325, 84.0%) were more likely to receive circumcision from an informal provider compared to infants from the highest income households (260, 42.4%) even after adjusting for religious affiliation (adjusted odds ratio [aOR] 4.42, 95% CI 3.12-6.27 p = <0.001). There appeared to be a dose response with increasing risk of receiving a circumcision from an informal provider as distance to a health facility increased (aOR 1.25, 95 CI 1.30-1.38 P = <0.001). Only 9.0% (34) of families in the lowest socio-economic quintile received free circumcision services compared to 27.9% (171) of the highest income families.

Conclusions: The Government of Ghana and Non-Government Organisations should consider additional support to poor families so they can access high quality free infant male circumcision in rural Ghana.

Keywords: Circumcision; Community; Ghana; Infant; Male; Population-based; Socio-economic.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approvals were obtained from Ghana Health Service Ethical Review Committee, the Institutional Ethics Committee of Kintampo Health Research Centre, the Research Ethics Committee of London School of Hygiene and Tropical Medicine, and the Human Research Ethics Committee of the University of Western Australia. Written informed consent was obtained from all the families of the circumcised male infants.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow diagram for the circumcision study. *Includes the 54 (18.6%) who died. These families were still interviewed and provided full information about circumcision thus their data were included
See this image and copyright information in PMC

References

    1. Alanis MC, Lucidi RS. Neonatal circumcision: a review of the world’s oldest and most controversial operation. Obstet Gynecol Surv. 2004;59(5):379–395. doi: 10.1097/00006254-200405000-00026. - DOI - PubMed
    1. Weiss H, Larke N, Halperin D, Schenker I. Neonatal and child male circumcision: a global review. UNAIDS Technical Bulletin. UNAIDS, Geneva Switzerland, UNAIDS/10.07E – JC1672E (English original, April 2010).
    1. Bailey RC, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369(9562):643–656. doi: 10.1016/S0140-6736(07)60312-2. - DOI - PubMed
    1. Bailey RC, Plummer FA, Moses S. Male circumcision and HIV prevention: current knowledge and future research directions. Lancet Infect Dis. 2001;1(4):223–231. doi: 10.1016/S1473-3099(01)00117-7. - DOI - PubMed
    1. Gyan, T., et al., Determinants of morbidity associated with infant male circumcision: community-level population-based study in rural Ghana. Trop Med Int Health. 2017. - PubMed