1. TANZANIA UPDATE ON MALE CIRCUMCISION ACTIVITIES Tuesday 8, 2010

2. Background Total population is 43 million,HIV prevalence 5.7% and Male circumcision prevalence is 70% Wide regional variations of both HIV and MC prevalence Key players Ministry of Health and Social Welfare (MOHSW) NIMR, WHO, CDC, UNICEF, USAID, Jhpiego, DOD, ICAP, UNAIDS

3. Comparison between HIV and MC

4. Key experiences 1/2 Formation of MC Task Force under MOHSW guidance in October 2007. Formation of MC Technical working group. Situation analysis of MC conducted between 2008-2009. Dissemination of results to all stake holders carried out in September 2009.

5. Key experiences 2/2 Development of the National Strategic Plan on MC December 2009. The National Strategic Plan to be operational by August 2010. Commencement of demonstration sites in three Regions (Mbeya, Iringa, Kagera) in September 2009.

6. Quality Assurance: Standards for MC under LA Site start-up guide Facility orientation Operations guide developed for demonstration Sites.

7. MOVE due to start at demonstration sites. M&E: Draft tools used by demonstration sites. Policy & Regulation: Policy and standards issues included in the just completed national strategy Innovations

8. Results of Situation analysis MC rate ranges between 20% and 98%, averaging to 70%. Males are willing to undergo MC even in areas where Traditional Male Circumcision is not practiced. TMC are ready to cooperate with MMC for safety improvement and referral system.

9. The MC services is being provided by Health Workers( Nurses and Clinicians) 94 providers trained. MC client pays between 1 and 3 dollars in the Demonstration sites. All clients receive VCT services before MC. Over 4700 male circumcision have been done and reported from the 3 sites since September 2009 to May 2010. Mc services in Tanzania

11. Lesson learnt Demonstration on sites have contributed to strategy development. No traditional/religious opposition to MC High demand with minimum mobilization.

12. Challenges Shortage of supplies and commodities for large scale MC activities Shortage of trained Health personnel Fund for scaling up MC activities Fund for getting the MC kits, materials and incentives.

13. Key next steps Scale up of MC activities in 8 Regions(Kagera, Mara, Mwanza, Tabora,Shinyanga, Rukwa, Mbeya & Iringa) Advocacy to the eight sited Regions Train staff for the sited Regions MC Costing exercises in the selected priority regions. Resource mobilization for sustainable services. The MC to be part of the CCHP.

14. Funds initial MC kits. advocacy to the eight priority Regions. Research. Supervision Technical Assistance Costing exercise Support needed

15. THANKS