Percent of males circumcised who received counseling on risk reduction and who received condoms during the reporting period
The percent of males circumcised who received at least one age-appropriate risk-reduction/abstinence-during-wound-healing counseling session, according to national standards, and who received condoms, during the reporting period (typically annually).
This indicator is calculated for a reporting period as:
(Number of males circumcised who receive age-appropriate counseling and condoms / Total number of males circumcised) x 100
This indicator should be modified based on the age of the males circumcised and the cultural context. For instance, if the population of interest is males age 12 and under, the indicator calculation might be revised as follows:
(Number of males <13 circumcised, or parents of, who receive age-appropriate counseling / Total number of males <13 circumcised) x 100
In this calculation, the male infant, mother, and father, for example, would count as “one” in the numerator since they all represented one circumcision event.
Number of males circumcised during the reporting period and number receiving appropriate and adequate counseling based on the Male Circumcision Services Quality Assessment Toolkit and in accordance with national standards.
If targeting and/or linking to inequity, classify outlets where counseling is taking place by location (poor/not poor) and disaggregate by area served. Exit interviews can be conducted with clients to determine client’s poverty status.
Health facility records; observation checklists
This indicator assesses progress towards communicating safe sex behaviors and protection from HIV transmission in the postoperative period. Evidence of circumcision without standardized, age-appropriate counseling and provision of condoms indicates a lack of quality of the HIV prevention aspect of male circumcision services.
In this indicator, all males are included rather than men. Age-appropriate counseling is applicable to all clients, including parents of neonates. Programs may consider the counseling of parents of neonates being circumcised inappropriate or impossible. If so, it is reasonable to limit this indicator to men.
The provision of condoms is included because counseling includes the subject of abstinence from sexual activity until certified wound healing / six weeks post-surgery. If clients begin sexual activity before this period against the advice given in counseling, having condoms facilitates safe sex.
This indicator does not measure the quality of the counseling services: if it was accurate, comprehensive, and age-appropriate.
access, male circumcision, quality, HIV/AIDS, integration
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
WHO. Male Circumcision Services Quality Assessment Toolkit. 2009. http://www.who.int/hiv/pub/malecircumcision/qa_toolkit/en/