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Review
. 2022 Dec;19(6):491-500.
doi: 10.1007/s11904-022-00644-8.

VMMC Programmatic Successes and Challenges: Western Kenya Case Study

Kawango Agot  1 , Jacob Onyango  2 , Marylyn Ochillo  2 , Elijah Odoyo-June  3
Affiliations
Review

VMMC Programmatic Successes and Challenges: Western Kenya Case Study

Kawango Agot et al. Curr HIV/AIDS Rep. 2022 Dec.

Abstract

Purpose of review: The Nyanza region of western Kenya is lauded for impressive coverage of voluntary medical male circumcision (VMMC) and remains the bedrock of the VMMC program in Kenya. We conducted literature review on programmatic successes and challenges of implementing VMMC program in the region.

Recent findings: Responsive stakeholders' engagement, robust policy environment, effective technical working groups, prompt capacity building of health facilities, government support, flexible implementation strategies, and sustained donor funding contributed to the successes of the program that saw circumcision prevalence in Nyanza reach between 75.6 and 85.3% among 15-29-year-olds by 2019. However, the lack of support for early infant circumcision, inadequate domestic financing, and slow pace of service integration into government health facilities continue to undermine the progress towards sustainability. While local ownership of the VMMC program has been demonstrated through its inclusion in county annual health workplans and progressive integration into routine health care, continued dependence on declining external funding threatens its sustainability. Furthermore, Kenya is experiencing a youth bulge with a projected high demand for VMMC which calls for increased resource inputs into the program. Strategies are therefore needed to increase domestic resource inflows into VMMC.

Keywords: HIV prevention; Kenya; VMMC sustainability; Voluntary medical male circumcision.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLOS Med [Internet]. 2005;2(11):e298. https://doi.org/10.1371/journal.pmed.0020298 . - DOI
    1. Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369(9562):643–56. - DOI
    1. Gray RH, Li X, Kigozi G, Serwadda D, Nalugoda F, Watya S, et al. The impact of male circumcision on HIV incidence and cost per infection prevented: a stochastic simulation model from Rakai. Uganda Aids. 2007;21(7):845–50.
    1. World Health Organization and Joint United Nations Programme on HIV/AIDS. New data on male circumcision and HIV prevention: policy and program implications. [Internet]. Geneva, Switzerland; 2007. Available from: http://www.who.int/hiv/pub/malecircumcision/research_implications/en/ind...
    1. National AIDS/STI Control Programme (NASCOP). National guidance for voluntary male circumcision in Kenya. Nairobi, Kenya; 2008.

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