Background: The WHO and UNICEF recommend early infant male circumcision (EIMC) as a strategy to maintain male circumcision coverage in areas with high HIV prevalence. he USAID-funded AIDSFree Project and the Tanzania Ministry of Health Community Development Gender Elderly and Children scaled up EIMC services integrated into existing reproductive health services.
The home delivery rate of infants are 2%, 3% and 12% in Iringa, Njombe and Tabora, respectively. Parents who give birth at home may not be educated on the benefits of EIMC which generally occurs in facilities. Therefore, through project volunteers, parents are educated on the benefits (and risks) of EIMC. We explored the uptake of EIMC services on women who delivered at home, who were educated in the community, and whose infants accessed postnatal care within 60 days post-delivery.
Methods: We conducted chat review of the client-level EIMC database from October 2016 to September 2018 from 38 EIMC facilities and 38 non-EIMC facilities was conducted to determine the effect of EIMC program on increasing number of PNC visits out of home deliveries. We used two-population z-test to compare the increase of PNC services between VMM facilities and non-VMMC facilities.
Results: Out of 8748 Infants attending PNC, (3.4%) 298 were delivered at home and came for PNC through EIMC and out of 61,931 Infants attending non-EIMC (1%) 713 were delivered at home. Therefore, Infants delivered at home from EIMC communities were 3.4 times more likely to come for PNC visits compared to Infants delivered at home from non-EIMC communities (p< 0.0001, z=18.97). Infants born at home that came for EIMC received the missed PNC services.
Conclusions: The opportunity provided by EIMC services enabled 298 women who delivered at home to access postnatal care services that may have been missed. Postnatal care services are vital to mitigate risks of maternal and neonatal mortality in Tanzania. Therefore, advocating and scaling up EIMC services and ensuring them are linked to reproductive health services can be a catalyst to attract and subsequently offer, postnatal care services.