Implementation of an infant male circumcision programme, Pakistan, Bull World Health Organ, 2021
Shazia Moosa, Ammar Ali Muhammad, Sohail Dogar, Sundus Iftikhar, Walter Johnson, Asad Latife & Lubna Samada
Objective To retrospectively review outcomes of a health provider-led infant circumcision programme in Pakistan.
Methods Based on World Health Organization guidelines, we trained surgical technicians and midwives to perform circumcisions using the Plastibell device at two Indus Health Network facilities. Programme tools include a training manual for health providers, information brochures for families, an enrolment form and standardized forms for documenting details of the procedure and outcomes. Infants aged 1–92 days were eligible for the study. Health workers contacted families on days 1 and 7 after the procedure to record any adverse events. We compared the characteristics of infants experiencing adverse events with infants facing no complications using multivariate logistic regression.
Findings Between August 2016 and August 2018, 2822 circumcised male infants with mean age 22.8 days were eligible for the study. Of these, 2617 infants (92.7%) were followed up by telephone interviews of caretakers. Older infants were more likely to experience adverse events than infants circumcised between 1–30 days of age []
Conclusion Standardized training protocols and close monitoring enabled nonphysician health providers to perform safe circumcisions on infants aged three months or younger.