Table 3 Summary of workshops from community groups
East Sepik Province workshops | ||
|---|---|---|
Community leaders workshop Wewak n= 5 | ||
Review of current male circumcision program Advantages and Disadvantages | ||
Advantages | Disadvantages/challenges | |
1 Maintains the Sepik culture: (particularly if done in traditional way) | Inadequate materials for the procedure so there is a tendency of reusing the same blades and materials if done in haus man | |
2 Influx of people for circumcision due to: | Scarce human resources | |
a Prevention of STI (HIV) | Shortage of testing materials | |
b Prevention of cervical cancer | Funds | |
c Reduction of STI/HIV cases | Lack of information | |
3 Entry point to VCT | Having multiple sexual partners post circumcision | |
4 Referrals made to access proper medical services | ||
5 Behavioral change due to increased involvement in VCT | ||
Young women Wewak n=6 | ||
Factor | Consensus vote | Other description |
Age | > 5 years | Children greater than 5 years are stronger (have higher levels of iron) |
11 to early teens are able to understand MC and care for themselves | ||
Cost | Free | Because it is for the prevention of HIV |
Could be barrier to service delivery | ||
Costs already incurred for transport to health facility | ||
Who should cut | Health Worker or Traditional cutter (if experienced) | Health worker because they have medical expertise |
Traditional cutter would need training, but could offer treatment with traditional medicine | ||
Awareness | MC program in ESP not well known to women | |
Young men Wewak n=8 | ||
Factor | Consensus vote | Other descriptions |
Awareness | For everyone | Radio, television, peer group communication, newspaper, counsellor, general community awareness |
Health and hygiene, to prevent HIV, for custom purposes | ||
Age | – 8 years |  |
Location | Range of options | Health facility, Haus man or private doctor/traditional cutter |
Treatment | Combined health facility and traditional (to reduce costs) | Health Facility for initial injections, medication, iodine and dressings |
Traditional treatment for any follow up needs | ||
Types of cut | Circumferential cut and Dorsal Slit | Both straight cut (dorsal slit or longitudinal incision only) and round cut (full circumferential cut) should be available |
Access | People should have choice | Service brought to villages |
Build health facility closer to rural people | ||
Cutter | Health worker or traditional cutter | Either male or female |
Cost | Free | Â |
Eastern Highland Province workshops | ||
Older women`s group (Village) n=9 | ||
Factors | Consensus vote | Other details |
Age | >15years | Â |
Cost | Free | Â |
Location | In Village | Â |
Service delivery barriers | Shame (to go to health facility) and Cost | Cost was seen as most significant barrier |
Who should cut | Health worker | Â |
Young women`s group (Village) n=12 | ||
Factors | Consensus vote | Other details |
Location | Aid post | Prefer aid post over hospital due to ease of access |
Age | >13 years | |
Practitioner | Health worker who is unknown | |
Cost | Free | Considered most important issue |
Men`s group (Village) n=20 | ||
Factors | Consensus vote | Other details |
Location | In Village | Build a House in the Community for procedure |
Who should cut | Local cutters | To feel more comfortable |
Continued employment of local cutter | ||
Awareness | For entire community | Â |
Timing | Regular service | Â |
Community leaders (Lay) group Goroka n=7 | ||
Factors | Consensus vote | Other details |
Awareness | Explanation of what MC is to everyone | To make informed decision |
Use of community level representative appointed locally to be present in the community at all times, understands local language, to assist in breaking down shame. | ||
Allowance for rep | ||
Location | Aid post | To avoid all complications male circumcision must not be done outside of health facility |
Urban Clinic | Health facilities must be equipped with proper equipment | |
Hospital | ||
Cutter | Health Care worker only | Doctors and nurses (must be trained certified medical practitioner) |
Gender Sensitive for older population (i.e. male HW only) | ||
Age | >10years | Foreskin easier to cut |
Old enough to care for the treated wound | ||
Preparation for prevention of HIV before sexual debut | ||
Cost | Free | Free of charge for both procedure and medication because |
-It is a government HIV strategy | ||
| Â | Â | -Higher attendance and number of males circumcised |
Specialised community leaders Goroka (health workers, prison officers, department of health) n=11 | ||
Factors | Consensus vote | Other details |
1. Location/access | Local service | Â |
2. Who will cut | Health worker or local cutter (with training) | Limited human resources available |
Male only | Â | |
3. Age | > 10 years (before sexually active) | ∙Service should be available to a wide range of ages |
∙Concern over consent and compliance | ||
4. Cost | Free | ∙Incentives for men (bus fare/tea or coffee) |
∙Incentive for local cutter or CHW to recruit | ||
5. Training | Relevant to PNG, Supervisor medical officer only | |
6. Compensation | Potential for legal action due to complications | |
| Â | Would impact on community acceptance of program | |