Hundreds of men have been flocking Gasabo’s Kibagabaga hospital to undergo circumcision for free.
The program which started in June with training, the actual circumcision starting October intends to cover 2 million men by the year 2013.
Kibagabaga Hospital carries circumcision every weekend but this time it carried it on Monday, the boxing day due to Christmas feastive.
Circumcision has been recognized as one of the tools to reduce risks of acquiring HIV.
In 2009, the Minister of Health Dr Agnes Binagwaho published a paper on PLoS Medicine website to show Male Circumcisions (MC) cost effectiveness. It is also said that Binagwaho is a board member PLoS Medicine.
PLoS Medicine is an open-access, peer-reviewed medical journal that publishes outstanding human studies that substantially enhance the understanding of human health worldwide.
According to the paper now on the PLoS medicine website, MC is one of the oldest and most common surgical procedures with approximately 30% of men circumcised worldwide.
While MC is almost universal in North Africa and most of West Africa, it is less common in Southern Africa where HIV prevalence is much higher.
In Rwanda, MC is not a traditional procedure and it is estimated that only about 15% of men are circumcised. Nonetheless, due to the ongoing debate about MC in the country, demand for the service is increasing according to the Ministry of Health.
Conclusive evidence from three randomised control trials conducted in Uganda, Kenya, and South Africa showed that MC reduces the risk of HIV infection by about 55%: 51% in Uganda , 53% in Kenya , and 60% in South Africa.
Studies also report a substantially reduced risk of other sexually transmitted infections (STIs) among circumcised men, such as syphilis (summary risk ratio (RR) = 0.67, 95% confidence interval (CI) 0.54–0.83) and chancroid (RR 0.12–1.11).
There is also evidence that MC protects against urinary tract infections (RR = 0.13, CI 0.01–2.63) [8]; invasive penile cancer and reduces prevalence of human papillomavirus (HPV) (adjusted RR 0.65, 95% CI 0.46–0.90; p = 0.009).
Most studies report a reduced risk of gonorrhoea and chlamydia trachomatis infection in female partners Moreover, MC protects against balanitis, posthitis, phimosis, and paraphimosis.
The paper presented by Dr Binagwaho indicate that infant MC, total costs (US$2,250,000) are lower than discounted total savings (US$3,808,523) meaning the intervention is cost-saving.
For adolescents and adults, total costs (US$8,850,000) are higher than total savings, for net costs of US$2,940,180 and US$3,407,951, respectively.
The cost-effectiveness ratio (net cost per infection averted) is US$3,932 and US$4,949 for adolescents and adults, respectively.
The findings from the analysis in Rwanda show that neonatal MC is less expensive than adolescent and adult MC (US$15 instead of US$59 per procedure) and is cost-saving; even though savings from infant circumcision will be realized later in time.
The fact that MC of infants in Rwanda is a cost-saving intervention means that for each MC performed, the government of Rwanda will save money.
Simoni Kanyaruhango who is heading the program through Rwanda Biomedical Center (RBC), noted that there’re efforts to enhance the program which for the past four years of its existence hasn’t shown much progress.
“So far we’re equipping all District hospitals countrywide with necessary tools, we also have plans to take similar services in rural areas,”
A report by the Ministry of Health show that only 12% of men were circumcised by the year 2007. Kanyaruhango noted that the idea was to reduce the risks of men acquiring HIV/AIDS and other sexual transmitted diseases.
Also this report shows that 50 to 60% of circumcision men in the region had lesser risks of acquiring HIV/AIDs.
Fabien Kalisa aged 25 was among hundreds of male lining up to undergo the minor surgery done in three theater rooms, decided to be circumcised after learning from one of the RBC campaign.
“I commend the initiative of this hospital in giving out free circumcision since many are reluctant to pay the amount while others don’t fully understand the advantages, the doctor has told us that after seven days I will be fine and ready to get back to work and my genital hygiene will improve too,” he remarked.
Due to the big number of people interested for the free service, the Director of Kibagabaga hospital Christian Ntizimira noted that the exercise intends to end its first phase by February followed by evaluation then continue till 2013.
He says that every weekend between 80 and 90 men are circumcised and that between 300-400 men have been circumcised so far and all operations have been successful, Ntizimira said.
Acquired immunodeficiency syndrome (AIDS) has killed more than 25 million people since 1981 and more than 31 million people (22 million in sub-Saharan Africa alone) are now infected with the human immunodeficiency virus (HIV), which causes AIDS.
ENDS
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