Scaling Safe Circumcisions in Communities

Male circumcision (MC), although a common and simple procedure, is not available to a majority of the population as a safe, sterile intervention. The con-vincing evidence of the protective role of circumcision towards the spread of STDs (particularly HIV) led to the establishment of voluntary, adult male circumcision programmes in high-HIV-burden countries. In low- and middle-income Muslim countries, where the need for circumcision is high, there is an evident gap in access to, and delivery of, this procedure. Large-scale programmes aimed at circumcising male babies in settings where circumcision is a religious requirement, as opposed to a medical indication, have not been established. This chapter would draw upon current guidelines and literature, review existing programmes that have attempted to establish community-based safe circumcision initiatives and discuss strategies for sustainable scale-up to meet this huge public health need. We believe it is important to translate existing clinical knowledge into a population-based healthcare intervention.