Percent of males circumcised who had at least one postoperative follow-up visit (routine or emergency), during the reporting period
The percent of males circumcised who had at least one follow-up visit following the circumcision procedure for routine or emergency matters, during the reporting period (typically annually). Data should be collected continuously at the facility level and should be aggregated periodically, preferably monthly or quarterly, for use at the local level.
This indicator is calculated for a reporting period as:
(Number of males circumcised who received one or more postoperative follow-up visits / Total number of males circumcised) x 100
Number of males circumcised during the reporting period, number returning for a postoperative follow-up visit, and number of visits per client recorded. Data should be disaggregated by location, type of facility (e.g. urban vs. rural, public, private, non-governmental, community-based), and single or repeat visits.
Health facility records
Accurate assessment of the safety of male circumcision program requires assessment of the client for adverse events. Optimizing safe sex behaviors following male circumcision and achieving the degree of protection male circumcision offers against HIV infection found in randomized trials likely requires repeated counseling sessions, including as part of each postoperative visit. Thus, not only does this indicator measure ongoing quality of care, like the previous indicator, Percent of males circumcised who received counseling on risk reduction and who received condoms, during the reporting period, it also assesses progress towards communicating safe sex behaviors and protection from HIV transmission in the postoperative period.
A similar indicator has been added under a new Prevention sub-area on male circumcision in the PEPFAR Next Generation Indicators Reference Guide (2009), “Number of males circumcised within the reporting period who return at least once for post-operative follow-up care (routine or emergent) within 14 days of surgery”.
Clients receiving surgery at one location but follow-up at another pose a challenge to data linkage and no single successful approach to linking the data has been devised. Also, this indicator does not measure if the client received counseling on safe sex behavior or the quality of the counseling services.
male circumcision, access, quality, HIV/AIDS
WHO & UNAIDS. A guide to indicators for male circumcision programmes in the formal health care system. 2009. http://www.who.int/hiv/pub/malecircumcision/hiv_mc_me.pdf
PEPFAR, 2009, The President’s Emergency Plan for AIDS Relief: Next Generation Indicators Reference Guide, Washington, DC: USAID/PEPFAR. http://pdf.usaid.gov/pdf_docs/Pcaac330.pdf