Abstract
BackgroundThe influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana.MethodsThe study investigated the effect of family income, distance to health facility, and cost of the circumcision on choice of infant male circumcision provider in rural Ghana. Data from 2847 circumcised infant males aged under 12 weeks and their families were analysed in a population-based cross-sectional study conducted from May to December 2012 in rural Ghana. Multivariable logistic regression models were adjusted for income status, distance to health facility, cost of circumcision, religion, maternal education, and maternal age.ResultsInfants from the lowest income households (325, 84.0%) were more likely to receive circumcision from an informal provider compared to infants from the highest income households (260, 42.4%) even after adjusting for religious affiliation (adjusted odds ratio [aOR] 4.42, 95% CI 3.12–6.27 p = <0.001). There appeared to be a dose response with increasing risk of receiving a circumcision from an informal provider as distance to a health facility increased (aOR 1.25, 95 CI 1.30–1.38 P = <0.001). Only 9.0% (34) of families in the lowest socio-economic quintile received free circumcision services compared to 27.9% (171) of the highest income families.ConclusionsThe Government of Ghana and Non-Government Organisations should consider additional support to poor families so they can access high quality free infant male circumcision in rural Ghana.
Highlights
The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa
Male circumcision has been reported in a number of high quality trials to reduce human immunodeficiency virus (HIV) infection in adult males who live in communities with high HIV prevalence such as South and East Africa [3, 4]
To our knowledge, there have been no studies from rural Africa that have investigated the effect of these factors on choice of infant male circumcision provider
Summary
The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana. Other strategies to influence family’s care seeking patterns, improve use of health facilities, and improve use of trained circumcision providers are needed. This requires an understanding of the key factors which influence a family’s choice of circumcision provider. A recent systematic review reported that socio-economic factors such as income, location (rural and urban), and cost of the circumcision were key determinants of choice of health service provider for infant male circumcision [2]. To our knowledge, there have been no studies from rural Africa that have investigated the effect of these factors on choice of infant male circumcision provider
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