Malawi Voluntary Medical Male Circumcision Program Struggles with Infrastructure, Resource Challenges

Since its inception in 2012, the VMMC program in Malawi has aimed to circumcise 2.5 million males aged 10 to 49 years.

Malawi: Voluntary Medical Male Circumcision (VMMC) in Malawi is facing several challenges, including a lack of infrastructure and resources, according to Martin Kapito, National Program Manager for VMMC in the country, writes Esther Banda.

"We are struggling to reach some parts of the country because of these issues. The main challenge for us is actually space. Circumcision requires at least 3 or 4 rooms to be conducted, but our hospitals were built some time ago and it is difficult to secure these rooms," Kapito said.

Training providers to perform circumcision also require a two-week course.

Maziko Matemba, Executive Director of the Health and Rights Education program, emphasized the need for more resources and partners to support the VMMC program.

"It is important to view this program as part of HIV prevention efforts and to find ways to increase male circumcision resources, as well as improve infrastructure so that people can have private circumcision procedures," Matemba said.

The Ministry of Health in Malawi proposed several solutions to the challenges facing the VMMC program, including conducting circumcision procedures on weekends, integrating VMMC services with other routine services, and using reusable instruments instead of disposable ones.

The ministry also suggested task-shifting skills related to circumcision to lower-level healthcare workers and training providers in device-based circumcision methods that require minimal support.

Since its inception in 2012, the VMMC program in Malawi has aimed to circumcise 2.5 million males aged 10 to 49 years.

However, due to various challenges, the program had only circumcised between 600,000 and 700,000 males by 2017.

A second strategic plan was developed as part of the Combined Prevention Strategy for HIV Interventions, with a goal of circumcising 1.5 million males by 2025.

The annual target for the VMMC program has been 200,000 males since 2018, and to date, the program has circumcised approximately 1.3 to 1.4 million males. In 2022, the target was almost 196,000 males, but the program reached about 70% of this goal.

The target for 2023 is to circumcise 198,000 males.

Initially, the VMMC program targeted males aged 10 to 49 years, but the age range has since been expanded to include males aged 15 to 49 years.