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Structural Biology 2018 & STD AIDS 2018
Journal of Genetics and Molecular Biology
|
Volume 2
S e p t e m b e r 0 3 - 0 4 , 2 0 1 8 | B a n g k o k , T h a i l a n d
allied
academies
STD-AIDS AND INFECTIOUS DISEASES
STRUCTURAL BIOLOGY AND PROTEOMICS
&
International Conference on
International Conference on
Joint Event on
Suzi Joel, J Genet Mol Biol 2018, Volume 2
THE IMPACTS OF A DEMAND-SIDE VMMC
INCENTIVES PROGRAM ON THE MALE
CIRCUMCISION RATE IN 2 DISTRICTS
IN MALAWI: A SYNTHETIC CONTROL
APPROACH
Suzi Joel
National AIDS Commission, Malawi
Background:
The study aimed to evaluate the effect of incentives on
improving the uptake of VMMC. The primary research question sought to find
out whether provision of incentives can significantly increase VMMC uptake
among in-school and out-of-school boys and young men aged 10 to 34 in
Malawi. Uptake of VMMC among eligible 10-34 years old males has been
slow and Malawi Government sought to identify evidence-based innovative
solutions to increase VMMC uptake. In this light, the Malawi National AIDS
Commission undertook a study of using incentives to create VMMC demand
in Mchinji and Rumphi districts from October 2015 to April 2016. School
heads and community-based mothers’ groups offered vouchers to potential
circumcision clients and their caretakers and a second set to hand out to their
friends and caregivers – that covered the cost of transport for them and their
caregiver for the procedures and two follow-up visits.
Methods:
Synthetic control methods were used to estimate the causal
effect of the program on the circumcision rate of males 10-34 years old.
Information on VMMC rates for the two years before study onset, as well as
district-level socio-demographic and health information, inform the synthetic
counterfactual for each of the study districts. Permutation tests establish the
robustness of the impact estimates.
Findings:
The program led to a substantial increase in circumcisions: an
additional 16.05 male circumcisions per 1,000 adult males in Rumphi, and an
additional 9.15 in Mchinji. Overall, an individual who received a voucher was
seven timesmore likely to be circumcised than someonewho had not received
one. Complementary qualitative findings suggest that mothers’ groups were
more effective in motivating young men due to personal attention and that
caregivers and informal networks play an important supportive function in
the circumcision decision.
Conclusions:
Despite implementation challenges, the demand-side VMMC
program is highly effective in increasing the circumcision rate from low
baseline levels.
Suzi Joel is behavior change specialist currently head-
ing HIV combination prevention and social and behav-
ior change programmes for the Malawi National AIDS
Commission. He holds a Master of Arts degree in
Communication in Development from the University
of Malawi and a first degree in Humanities Minoring
in Demography from the same university. He has over
13 years of experience in HIV and health program and
policy development and management, research and
evaluation. He has conducted research and published
five papers on non-biomedical HIV and integrated
health programming. He has previously worked with
Johns Hopkins University Center for Communication
Programs in Malawi on several projects coordinating
integrated health communication programmes.
joel.suzi@gmail.comBIOGRAPHY