Call number: LD2668 .T4 1979 B67 / Master of Science

The purpose of this study was to develop an intervention health promotion programme to prevent circumcision related health problem such as sepsis, botched circumcision, dehydration, penile amputation and reduce the number of deaths. The intervention programme was aimed at promoting a safe male circumcision practice affecting boys aged 12-18 years at Libode rural communities in Eastern Cape Province of South Africa. This was achieved through a mixed method design using both quantitative and qualitative approaches utilizing sequential transformative strategy to allow for the convergence of multiple perspectives of the traditional male circumcision in Libode. The study was conducted in 22 schools of the rural communities of Libode because most of the participants are still attending school. Frequencies and percentages were used to analyse the quantitative data, utilizing the Statistical Package for Social Sciences (SPSS). A total of 1036 participants, AmaXhosa circumcised young men (abafana) and uncircumcised boys (amakhwenkwe) participated in the cross-sectional survey, quantitative phase of the study. Qualitative phase of this study was composed of 7 focus group discussions with a total of 84 circumcised and uncircumcised male participants and 10 key informants’ interviews were conducted. In analysis qualitative data, the researcher found the most descriptive words for each topic and turned them into categories or sub-themes. Topics that related to each other were then grouped in order to reduce the number of categories and to create themes. The similar categories of data were grouped and analysed using Tesch’s method. Findings indicated that traditional circumcision is performed during winter and summer holidays in order to cater for the boys who are attending schools. The circumcision age at Libode ranges from 12 and 18 years of age which is against the Health Standards in Traditional Circumcision Act (Act No. 6 of 2001). Although the participants were aware of the complications of male circumcision in Libode, there was a high preference for traditional circumcision (92.3% of participants) to hospital circumcision. The participants were of the view that the benefits of traditional circumcision outweigh the complications or challenges related to traditional circumcision. They wanted to be socially accepted and wanted to learn about manhood values in the traditional circumcision which are values that cannot be achieved through the hospital based circumcision. As male circumcision initiation is seasonal and the intervention programme needed to be approved by different stakeholders, the testing of intervention programme could not happen before the programme was approved by all the stakeholders.

MPH / Department of Public Health

MPH / Department of Public Health / Male circumcision is being promoted in University of Venda presently due to the South African recent awareness that it is a method of preventing the transmission of the Human Immunodeficiency virus. However, for effective implementation, it is necessary that the students believe in the procedure and have a positive attitude towards the procedure. Purpose of study The objective of the study was to assess the University of Venda male student knowledge and perception regarding male circumcision. Methodology Method to achieve this was a cross sectional quantitative study using anonymous questionnaire among the male students in university of Venda after obtaining their consent. Data was captured and analyzed using SPSS. Result A total of 285 male students participated in the study. Most of them (77.2%) were undergraduate below 30years of age (91.2%) while others were post graduate (22.8%). Majority of them are Christians (97.9%), singles (85.9%) and married (12.6%).Result obtained showed that most of the respondent (87.9%) are circumcised, only a minority few (12.1%) are not circumcised. As regards the meaning of male circumcision (75.2%) said that male circumcision is the complete removal of theforeskin. Majority of the respondents (86.6%) responded that circumcision is better than uncircumcision, showing a relatively good knowledge of benefits of male circumcision, one-third of the respondent (39.9% ,37.8%) showed a good knowledge regarding the merits of male circumcision as per reducing the rate of STIs and the risk of HIV/AIDS. Conclusion Conclusively,most of the University of Venda students have a good knowledge of male circumcision, only a few are not knowledgeable about male circumcision. Also a positive attitude was shownon male circumcision with only a few students showing a negative attitude.While majority of the respondents practice male circumcision.They also encourage their siblings to do so. Recommendations The study made a number of recommendations that were intended to improve knowledge, attitude and practice of male circumcision, it calls for long campaign to reach more uncircumcised Univen students in order to scale up male circumcision and train more personnel to administer the ritual safely and under more hygienic conditions.

MAAS / Centre for African Studies / Zimbabwe launched the Voluntary medical male circumcision programme (VMMC) in November 2009, with the primary aim of curbing sexual transmitted infections (STI’s). In 2010, the district of Mazowe managed to adopt voluntary medical male circumcision programme to curb sexual transmitted infections. It is of concern that the voluntary medical male circumcision programme has been below expectations in Mazowe district. Hence, the aim of the study was to explore the effectiveness of the voluntary medical male circumcision programme among secondary school learners in Mazowe district. Furthermore, the primary goals of the study were firstly check the levels of understanding about the voluntary medical male circumcision programme among secondary school learners in Mazowe district. Secondly, explore the reasons behind the low rate of the voluntary medical male circumcision programme among secondary school learners. Thirdly, investigate whether cultural beliefs influence the learners’ choice. Lastly, recommend possible ways of improving the uptake of the voluntary medical male circumcision programme among secondary school learners in Mazowe district. A qualitative research method used in the study. Also, un-structured interviews and focused group discussions. The researcher conducted interviews using purposeful sampling method on three secondary schools in Mazowe district, Zimbabwe and about forty respondents participated in the study. The study adopted a planned behaviour and person/client centered approaches. The thesis’s conclusions deduced that most of the male respondents are not ready or willing to receive circumcision due to fear of being screened for HIV/AIDS, the cost of the procedure, pain, bleeding, to mention but a few. Furthermore, the researcher identified that in the Shona culture, medical male circumcision is rarely unknown. In addition, the Ministry of Health and Child Welfare must introduce new ways of circumcision to avoid bleeding, pain and must remove the screening of the HIV testing procedure before one is circumcise. Therefore, by these outcomes the Ministry of Child and Health Care Centre will try to find strategies in which they can scale the programme, since the study highlighted that most males are not going for circumcision, hence their lives are in predicament. More so, the study recommends v that researchers must obtain consent and ethical clearance from different relevant place so that data there will not be harm to respondents. Also, there is a need to look for policies in which the government will use to assess strategies to scale the programme, since it is of paramount importance to test the VMMC programme about the impact that it is giving to the community and to find out whether it is helpful or not. More so, in terms of future researchers, there is a need to reconnoiter barriers that hinders males from circumcised. Hence, fourth, this will motivate number of District schools to bring awareness towards males to take part in the programme and prevent males from being susceptible to the infections as recommended by the WHO in 2007. In addition, decentralizing the programme to the community, stakeholders would be able to work hand in hand with the District to make sure that the rate of the VMMC is up and those males take part in the programme willingly. Hence, this will create an efficacy of the programme since all stakeholders and the community will scale up the programme since the priority of all sides will be to scale the programme. Furthermore, clearing misconceptions associated with male learners (witchcraft, pain, bleeding, and religion, to mention but the few), providing them with right mentality about the good side of the programme. In addition, there is a need for the Ministry of Health and Child Welfare to amend new polices that allows free male circumcision, especially in public hospitals, hence, through these amendments, males might be willing to get the services. Lastly but not least, the Department of Education in Zimbabwe must set up tight mechanism for assessment for the programme, especially at secondary and high schools. This will in turn, develop an effective assessment system to see how effective the programme is in the districts. Finally, it is of paramount importance that the National HIV/AIDS council collaborates with the Ministry of Health and Child Welfare in decentralizing the service of the VMMC, since some respondents were concerned that the distance to the service centers were a hindrance for circumcision. / NRF