Exploring factors influencing integration of traditional and medical male circumcision methods at Ingquza Hill Local Municipality, Eastern Cape: A socio-ecological perspective.

Sandile Prusente,Yandisa Sikweyiya,Nelisiwe Khuzwayo

doi:10.4102/phcfm.v11i1.1948

Abstract

BackgroundMedical male circumcision (MMC) and traditional male circumcision (TMC) are reportedly having negative and positive outcomes in the Eastern Cape province. Researchers show contradictory remedies; some advocate for abolishment of TMC and others call for the integration of both methods.AimThis study aimed to explore factors influencing the integration of TMC and MMC at different socio-ecological levels.SettingThe study was conducted at Ingquza Hill Local Municipality in the Eastern Cape province.MethodsAn explorative qualitative study design, using in-depth interviews (IDIs) and focus group discussions (FGDs), was employed in this study. Purposive sampling was used to select the participants. A framework analysis approach was used to analyse the data, and the themes were developed in line with the socio-ecological model.ResultsFour main themes emerged from the data as important in influencing the integration of TMC and MMC methods. These included: (1) individual factors, related to circumcision age eligibility and post-circumcision behaviour; (2) microsystem factors, related to alcohol and drug abuse, peer pressure, abuse of initiates, and family influence; (3) exosystem factors, related to financial gains associated with circumcision and the role of community forums; and (4) macrosystem factors, related to stigma and discrimination, and male youth dominance in circumcision practices.ConclusionMale circumcision in this area is influenced by complex factors at multiple social levels. Interventions directed at all of these levels are urgently needed to facilitate integration of the TMC and MMC methods.

Highlights

In South Africa, male circumcision (MC) is one of the oldest traditions practised by various black African ethnic groups
Our findings confirm those of other studies conducted in the Eastern Cape province, which suggested that the role traditional circumcision schools once played in the socialisation of young AmaXhosa males has been eroded over the years,[20,21] and that the teachings that are currently given to initiates, especially in Traditional male circumcision (TMC) schools, are at odds with the dignity and self-respect expected from circumcised men.[22]
We argue that this may undermine the integration of the TMC and male circumcision (MMC) methods, as some elderly participants doubted the value of TMC in producing respectful and productive men who can contribute in building their communities

Summary

Introduction

In South Africa, male circumcision (MC) is one of the oldest traditions practised by various black African ethnic groups. It involves the surgical removal of all or part of the foreskin of the penis. Studies[3] have found that men in the Eastern Cape province largely prefer TMC over medical male circumcision (MMC), there is no strong scientific evidence showing its health benefits compared to MMC. Medical male circumcision (MMC) and traditional male circumcision (TMC) are reportedly having negative and positive outcomes in the Eastern Cape province. Researchers show contradictory remedies; some advocate for abolishment of TMC and others call for the integration of both methods

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Discussion

Conclusion