SAFETY AND QUALITY OF CARE FOR MALE CIRCUMCISION

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SAFETY AND QUALITY OF CARE FOR MALE CIRCUMCISION

• Douglas Huber MD, MSc
• Management Sciences for Health
• September 18, 2002

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Overview

• Elements of Surgical Safety and Quality
• Counseling and Informed Choice/Consent
• Screening
• Preoperative and Postoperative Instructions
• Asepsis
• Anesthesia
• Competence of Provider/Surgical
  Training/Supplies/Setting
• Postoperative Care Managing Complications

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Complication Rates

• Accurate only in prospective studies
• Surgical complications 90-99 underreported in
  internationally supported service delivery
  settings
• Protected interviews useful in understanding
  causes of complications
• Expect complication rate of 2-3 (?) with
  clinical MC

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Contextual Issues of Surgical Safety for MC

• Clinical settingMC only
• Clinical settingMC plus training for
• responsible manhood
• Traditional MC practices
• 1. Need to know much more
• 2. Improve health care services through
• traditional practitioners?

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Conclusions

• Improve informed choice for MC now (quickly
• and with low cost)
• Encourage national programs to provide
• quality MC services
• Support clinical interventions with prospective
• follow-up
• Combine orientation for healthy manhood
• MC (Seize the Day)
• Engage private sector for MC services