The use of circumcision for medical or health reasons is an issue that continues to be debated. The male circumcision rate in kenya is around 84%, with operations performed in hospitals and clinics. The american academy of pediatrics aap found that the health benefits of newborn male circumcision. Background we conducted quantitative and qualitative studies to explore barriers and motivating factors to vmmc for hiv prevention, and to assess utilization of existing vmmc communication channels. However, its uptake among traditionally circumcising communities, where male circumcision carries a cultural significance, has not been studied. Traditional male circumcision among young people service. Institute for social medicine, epidemiology and health economics, charite university medical centre, berlin, germany. Despite the awareness raised about the negative effects of circumcision, and despite the fact that there is a strong chinese and brazilian influence in africa neither nations generally practice. Traditional male circumcision in traditional male circumcision a practitioner with no formal medical training and whose coverage and safety precautions are unclear does the procedure w ilken et al. The tok mudim described the procedure in detail and was of the opinion that the. An exploration of the knowledge, attitudes and beliefs of. In traditional circumcisions, often the same knife is used for many initiates. Recently, the alarming rate of death and injury among initiates has led to the spotlight of media attention and government regulation being focused on traditional circumcision. Additional studies are needed of complication rates and male circumcision practices with specifically trained traditional surgeons and nurses in order to design the appropriate intervention for the safest traditional male circumcision possible.
Although mc has been demonstrated to reduce the risk of acquisition of several sexual transmitted. Donors like the us centers for disease control and prevention and africa comprehensive hivaids partnership funded by the gates foundation in collaboration with botswanas ministry of health have invested much to encourage hivnegative men to circumcise. Traditional male circumcision has an increased risk for complications. Pdf traditional male circumcision in a rural community in kedah. Mathematical modeling suggests that circumcising 80% of the male population aged 1549 in these countries by 2015 and sustaining this coverage level thereafter could avert 430,000 new hiv infections by. We systematically searched databases and reports for studies on the prevalence and complications of traditional male circumcision in youth 1024 years of age in eastern and southern africa, and also determined the ages at which traditional circumcision is most frequently performed. Botswana has been running safe male circumcision smc since 2009 and has not yet met its target. Medical vs traditional male circumcision debate rages. In south africa, where the initiation season is in full swing, there has been a varied response. In most ethnic communities, the traditional male circumcision is usually done in form of a staged. It also addresses broader issues of sexual and reproductive health of men and emphasizes that male circumcision must be set within the context of other strategies for reducing the risk of hiv infection. Voluntary medical male circumcision vmmc reduces chances of contracting hiv during heterosexual intercourse in males, and risk of cervical cancer in their female sexual partners. Ulwaluko, traditional circumcision and initiation into manhood, is an ancient initiation rite practised though not exclusively by the amaxhosa, and is commonly practised throughout south africa. So, if you still have some foreskin, then we cannot say your risk has been reduced or not says dr.
Analysis consisted of descriptive statistics and bivariate analysis between circumcision and. The 2012 policy statement says that not only should newborn circumcision be available to any parent who might wish, but it should be paid for by thirdparty payers. However, the aap doesnt recommend routine circumcision for all male newborns. Still one should emphasize the danger of the procedure, even with an intervention of additional training. The following underpinning factors have been identified to be a panacea. As part of a larger study, repeat semistructured interviews with 30 adult men from alexandra township were conducted. Traditional xhosa male circumcision rites need to be understood within a highly complex sociosexual context involving violence, family breakdown, resource scarcity and intergenerational conflict. Making the case for circumcision as a public health. Lucinda le roux a minithesis submitted in partial fulfillment of the requirements for the degree. Traditional circumcision during manhood initiation rituals in.
Adult male circumcision tool for use in traditional ceremonies. The global spread of islam from the 7th century ad necessitated,, knowledge, attitudes and practices of men towards voluntary male medical circumcision. Male circumcision initiation schools form part of the cultural practice in south africa and are protected by the south african constitution south. Traditional male circumcision open uct university of cape town. In 1999, a new policy on routine male circumcision states that the potential medical benefits of circumcision does not warrant performing it routinely. In uganda, it is practiced in the eastern parts on traditional or cultural justifications. Information for parents circumcision is a surgical procedure in which the skin covering the end of the penis is removed.
May 28, 2017 despite the awareness raised about the negative effects of circumcision, and despite the fact that there is a strong chinese and brazilian influence in africa neither nations generally practice. There is conclusive evidence from observational data and three randomized controlled. Identify and understand the interaction between the virus and traditional practices may lead to perform prevention programs and policies. Traditional circumcision during manhood initiation rituals. Jul 05, 2016 integrating medical male circumcision and traditional initiation is complicated. Challenges facing traditional male circumcision in the. Traditional male circumcision in eastern and southern africa.
The limited data available on the safety of traditional male circumcision point to high rates of complications and adverse events. But those who undergo medical male circumcision are rejected even by their friends at school and in the community, if one has undergone traditional male circumcision. The male circumcision rate in ivory coast is around 95%, with operations conducted in hospitals and health clinics. So cleanliness is the main benefit for male circumcision and also medical male circumcision is said to prevent the spread of hivaids and other sexually transmitted diseases. In the eastern cape the application of health standards in traditional circumcision act. Medical vs traditional male circumcision debate rages living. Male circumcision policy, practices and services in the. Male circumcision under local anaesthesia version 3. During the circumcision procedure, the traditional sur geon uses an assegai umdlanga to cut the foreskin of the penis without any anesthesia in the circumcision initiation school mavundla et al. Opinions and perceptions regarding traditional male. Chinese, simplified mandarin dialect bilingual pdf health information translations chinese, traditional cantonese dialect. Abstract hispanics in the united states have lower rates of male circumcision and higher rates of hiv. Standards in the traditional circumcision act act no. Opinions and perceptions regarding traditional male circumcision.
From the traditional music and cultures of kenya, a multimedia encyclopaedia dedicated to all kenyan tribes, including music and dance, history, culture, society, religion and beliefs, rituals and daily life, fables, legends, riddles and proverbs. The tribe uses the zhou elephant totem and claims to have a strong jewish traditional background upon which their practice of circumcision is anchored. According to the zimbabwe national aids council, male circumcision is the surgical removal of the fold. Traditional male circumcision clearinghouse on male. Complications of traditional circumcision amongst young xhosa. Within africa, male circumcision is widely practiced and almost universal in the north and west africa. This study focuses on the vitality of the shangani traditional initiation ritual of male circumcision mc practice in the context of hiv and aids epidemic. The complications of traditional male circumcision were studied in 48 boys seen between january 1981 and december 1995. In the past decade, traditional male circumcision, known as ulwaluko among the. Scientific studies show some medical benefits of circumcision. Pdf ulwaluko traditional male circumcision researchgate.
National strategy aims to reach 80% of males aged 1549 with circumcision services by 2016 that is 4. Circumcision of the male child starts way back in history as far as the biblical times. Eastern cape is the preferred location for traditional male circumcision. Zimbabwe mixes medicine and tradition for safer circumcision. In the newborn period less than 2 months of age, almost all circumcisions are done by generalist physicians using one of three surgical instruments. Randomised controlled trials of male circumcision proved that circumcision was up to 60% protective against the acquisition of hiv among men national strategy aims to reach 80% of males aged 1549 with. Making the case for circumcision as a public health strategy. Is traditional male circumcision effective as an hiv. The ritual is traditionally intended as a teaching institution, to prepare young males for the responsibilities of manhood. Pdf on sep 11, 2015, asithandile diveti and others published ulwaluko traditional male circumcision find, read and cite all the research. South african national guidelines for medical male circumcision.
This research seek to look at the culture of traditional male circumcision in south africa and the impact this tradition has on the lives and health of the people who practice it. Action is required to improve male circumcision practices in many regions and to ensure that health care providers and the public have uptodate information on the health risks as well as the benefits of safe male circumcision. Randomized clinical trials have shown that medical male circumcision substantially reduces the risk of contracting hiv, 1,2 leading many to espouse this practice as a means to combat hiv on a large scale. Circumcision surgical procedure in males involves either a conventional cut and stitch surgical procedure or use of a circumcision instrument or device. A mass circumcision ceremony is traditionally practiced.
Getting circumcision is the right thing to do for your health and the health of your partner and loved ones because it has many health benefits. Key legislation governing regulation of traditional circumcision in the. The aap leaves the circumcision decision up to parents and supports use of anesthetics for infants who have the procedure. Male circumcision policy, practices and services in the eastern. In the eastern cape the application of health standards in traditional circumcision act of 2001 makes it. Manual for male circumcision under local anaesthesia. Many boys and men wishing to be circumcised do not have. Graphic before and after photos of patients receiving a traditional circumcision procedure. Removing this skin, called the foreskin, fully exposes the head of the penis. She further explained that there is a difference between traditional and medical circumcision. Traditional practices are important in maintaining cultural identity and continuity, but some have harmful aspects and voices have been raised to discontinue such. Traditional male circumcision in eastern and southern. Integrating medical male circumcision and traditional initiation is complicated. Methods and findings a populationbased survey was conducted with 2350 respondents aged 1549.
Voluntary medical adult male circumcision for hiv prevention. Medical male circumcision mmc is the surgical removal of the thin layer of skin that covers the head of the penis. Mortality related to traditional male circumcision was 0. Therefore, initiates are called abakhwetha in isixhosa. There are several important differences between traditional procedures and the clinical procedures adopted in the randomised controlled trials of male circumcision for hiv prevention. Circumcision amongst the xhosa people of south africa represents a rite of passage to manhood. In pondoland in the eastern cape, for example, there has been strong resistance to surgical intervention. There has been the notion that, especially with traditional male circumcision, that not the entire foreskin is removed. Ulwaluko, traditional circumcision and initiation into manhood, is an ancient initiation rite practised though not exclusively by the amaxhosa.
Mar 31, 2020 the american academy of pediatrics aap says the benefits of circumcision outweigh the risks. Here, men can opt for one of two types of circumcision. The present study considers male circumcision in lesotho, where hiv prevalence is among the highest in the world 23%. Conclusion published studies on traditional male circumcision in eastern and southern africa are limited. Thirteen eastern and southern african countries are currently scalingup voluntary medical male circumcision vmmc as part of a comprehensive hiv prevention strategy.
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