Abstract
Background: Early Infant Male Circumcision (EIMC) is part of sustainable HIV prevention strategies in Kenya. The goals of the national EIMC program are to circumcise at least 40% of all newborn male infants delivered at hospitals offering the service and keep the rate of moderate and adverse events below 2%.
 Objectives: To determine the proportion of early male infants (age less than 60 days) born at hospitals in four counties of western Kenya who got circumcised and document the prevalence of adverse events (AEs) among those circumcised.
 Methods: A retrospective descriptive study involving all records for EIMC from 1st March 2014 through 31st March 2018 in four counties of western Kenya. Data analysis was done using EXEL to document proportion of facilities offering EIMC and compare EIMC uptake and outcomes in the four counties against the national goals for the program.
 Results: A mean of 4.3% of total health facilities offer EIMC in the region. Siaya had the highest proportion of facilities offering EIMC while Migori had the lowest proportion. Uptake of EIMC was low at 17.4% for all male infants born, far less than the anticipated target of 40%. Average adverse event rates were 0.3%.
 Conclusion: EIMC uptake remains low in this region of Kenya due to small number of health facilities offering the service. The proportion of circumcised early male infants born at the target health facilities is below the national target of 40% even though the rate of adverse events among those circumcised is acceptable.
 Keywords: Adverse event; circumcision; early male infant; uptake; western Kenya.
Highlights
Voluntary Male Medical Circumcision (VMMC) was introduced as a component of the national HIV prevention program in Kenya in the year 2008 after three randomized controlled trials in African men demonstrated that male circumcision reduces the risk of HIV acquisition by approximately 60%1, 2, 3
The long-term aspiration of Early Infant Male Circumcision (EIMC) in Kenya was to implement the service in all Maternal-Newborn-Child Health (MNCH) facilities in the high priority VMMC counties of Nyanza region of western Kenya so as to eventually make male circumcision the norm in all Kenyan communities in this region, regardless of cultural background[17, 18, 19]
Prior pilot studies conducted by Nyanza Reproductive Health Services (NRHS) in the focus Nyanza region of western Kenya to assess safety and acceptability of EIMC showed that EIMC is safe and acceptable in the region[19]
Summary
Voluntary Male Medical Circumcision (VMMC) was introduced as a component of the national HIV prevention program in Kenya in the year 2008 after three randomized controlled trials in African men demonstrated that male circumcision reduces the risk of HIV acquisition by approximately 60%1, 2, 3. African Health Sciences ing this VMMC rollout and in effort to come up with sustainable models for VMMC, United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) endorsed the Early Infant Male Circumcision (EIMC), which prompted Kenya to start piloting this program in 2014 before to progressively rolling it out across the country[17, 18]. A similar study showing high acceptability of EIMC was done in Botswana in 2013 20 Based on these results, EIMC services were gradually rolled out in four high-priority counties of western Kenya as an integral component of Maternal, Newborn Child Health (MNCH) services[18]. The proportion of circumcised early male infants born at the target health facilities is below the national target of 40% even though the rate of adverse events among those circumcised is acceptable.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
