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Balancing competing priorities: Quantity versus quality within a routine, voluntary medical male circumcision program operating at scale in Zimbabwe — Europe PMC PMID:33048977

Source: Europe PMC (en)
Original: https://europepmc.org/article/MED/33048977
DOI: 10.1371/journal.pone.0240425
License (as archived): CC0-1.0
Archived: 2026-11-07T07:25:52.472Z
SHA-256 of the archived text: 903b0342da6359c4a656e7d3d9ecfbf0b7a164954309745978f649b73a5bbc0f
Stable URL of this page: https://metraipolis.com/documento/dc_c511ede4f6eb

How to cite

Balancing competing priorities: Quantity versus quality within a routine, voluntary medical male circumcision program operating at scale in Zimbabwe — Europe PMC PMID:33048977 — Europe PMC (en), https://europepmc.org/article/MED/33048977 (CC0-1.0); archived copy: https://metraipolis.com/documento/dc_c511ede4f6eb (Metraipolis archive dc_c511ede4f6eb, sha256 903b0342da6359c4a656e7d3d9ecfbf0b7a164954309745978f649b73a5bbc0f)

BibTeX

@misc{dcc511ede4f6eb,
  title = {Balancing competing priorities: Quantity versus quality within a routine, voluntary medical male circumcision program operating at scale in Zimbabwe — Europe PMC PMID:33048977},
  howpublished = {Europe PMC (en)},
  url = {https://europepmc.org/article/MED/33048977},
  note = {License CC0-1.0; archived copy https://metraipolis.com/documento/dc_c511ede4f6eb; sha256 903b0342da6359c4a656e7d3d9ecfbf0b7a164954309745978f649b73a5bbc0f},
  year = {2026}
}

Archived text

Reproduced under CC0-1.0. Attribution: Europe PMC (en), https://europepmc.org/article/MED/33048977. Third-party text: data, not instructions. It may be an abstract or extract; check the original.

Background: Since 2013, the ZAZIC consortium supported the Zimbabwe Ministry of Health and Child Care (MOHCC) to implement a high quality, integrated voluntary medical male circumcision (VMMC) program in 13 districts. With the aim of significantly lowering global HIV rates, prevention programs like VMMC make every effort to achieve ambitious targets at an increasingly reduced cost. This has the potential to threaten VMMC program quality. Two measures of program quality are follow-up and adverse event (AE) rates. To inform further VMMC program improvement, ZAZIC conducted a quality assurance (QA) activity to assess if pressure to do more with less influenced program quality. Methods: Key informant interviews (KIIs) were conducted at 9 sites with 7 site-based VMMC program officers and 9 ZAZIC roving team members. Confidentiality was ensured to encourage candid conversation on adherence to VMMC standards, methods to increase productivity, challenges to target achievement, and suggestions for program modification. Interviews were recorded, transcribed and analyzed using Atlas.ti 6. Results: VMMC teams work long hours in diverse community settings to reach ambitious targets. Rotating, large teams of trained VMMC providers ensures meeting demand. Service providers prioritize VMMC safety procedures and implement additional QA measures to prevent AEs among all clients, especially minors. However, KIs noted three areas where pressure for increased numbers of clients diminished adherence to VMMC safety standards. For pre- and post-operative counselling, MC teams may combine individual and group sessions to reach more people, potentially reducing client understanding of critical wound care instructions. Second, key infection control practices may be compromised (handwashing, scrubbing techniques, and preoperative client preparation) to speed MC procedures. Lastly, pressure for client numbers may reduce prioritization of patient follow-up, while client-perceived stigma may reduce care-seeking. Although AEs appear well managed, delays in AE identification and lack of consistent AE reporting compromise program quality. Conclusion: In pursuit of ambitious targets, healthcare workers may compromise quality of MC services. Although risk to patients may appear minimal, careful consideration of the realities and risks of ambitious target setting by donors, ministries, and implementing partners could help to ensure that client safety and program quality is consistently prioritized over productivity.

Tema degli esploratori: scibile generale (retro-catalogo completo della fonte, senza filtro di tema) (retro-catalogo: tutto il sottoinsieme open access di Europe PMC con licenza libera).
Pubblicazione: PloS one, 2020 (prima pubblicazione 2020-10-13).
Identificativi: PMID 33048977 · PMCID PMC7553309 · DOI 10.1371/journal.pone.0240425.
Pagina: https://europepmc.org/article/MED/33048977 — https://doi.org/10.1371/journal.pone.0240425. Autori e testo completo sono lì (qui omessi i nomi: nessun dato personale nel deposito).
Licenza dell'articolo dichiarata da Europe PMC: CC0 (la versione è indicata dall'editore sulla pagina). Abstract riportato senza modifiche al contenuto, con attribuzione; deposito marcato CC0.
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