Despite the fact that the VMMC procedure is highly effective, there are some common complications associated with it at circumcision clinic. Fortunately, the cost of circumcision has decreased in the recent years, compared to the costs associated with the treatment in the 1960s.
Cost declines from 83% in the 1960s to 77% in the 2010s
Using the National Hospital Discharge Survey, Johns Hopkins researchers looked at the cost of circumcision. Using the findings, they are hoping to convince the federal government to make it compulsory for private health insurance to cover circumcision.
The results were alarming. In the 1960s, circumcision rates were at an all-time high, but today they are less than half that. Almost a quarter of newborn boys are not circumcised.
The benefits of circumcision are relatively minor. For example, circumcision is effective in preventing urinary tract infections and herpes. However, it is also painful.
The benefits are also not worth pursuing for every male. And the cost of circumcision is putting financial strain on the medical system.
In the US, male circumcision rates have decreased from an all-time high of eighty-three percent in the 1960s to seventy-seven percent in the 2010s. Some doctors think more needs to be done to educate the public about the benefits of circumcision. But some parents disagree, arguing that it is their choice.
Researchers at Hopkins believe that the decline in coverage has contributed to the rise in medical costs. For example, an intact foreskin can cause adverse medical conditions in half of uncircumcised men.
The Hopkins study is the first to look at the cost of male circumcision. The American Academy of Pediatrics has recently changed its position on male circumcision. While the Academy believes that infant circumcision is a medically necessary procedure, it is not necessary for all children.
VMMC is a cost-effective intervention
VMMC is an effective intervention for circumcision that helps reduce HIV infection. It has also been a proven strategy to increase protection against female-to-male sexual transmission of HIV. Currently, the World Health Organization (WHO) recommends VMMC as a method to reduce the risk of HIV.
The cost of the procedure is low, as compared to other surgical procedures. In addition, reusable surgical instruments contribute to the savings. The cost of VMMC is much lower than previous estimates. In Uganda, the average cost was $34-$61.
In Kenya, the cost was $108 per individual. The cost was based on an average of 30 days of intervention. The direct clinical cost of the circumcision was less than $10 per procedure.
The results of the VMMC study suggest that a circumcision at age 20 is a cost-effective intervention. The financial return of a circumcision at this age is 14.5% per year. The financial return of a circumcision performed at age 20 is the highest for males between the ages of 20-25.
In South Africa, VMMC has been effective in reducing the financial cost of HIV prevention. It has also helped increase coverage of adolescent boys. By 2021, South Africa will reach 80% of 10- to 29-year-olds with VMMC coverage.
VMMC can be done at any age
VMMC is a health service that helps to reduce the risk of HIV transmission and prevent high risk HPV transmissions. The World Health Organization recommends a comprehensive package of services for VMMC, including linkages to other male reproductive health services, STI management, and condom distribution.
If all countries with “high coverage” of VMMCs were to meet this target, it would reduce the number of new HIV infections by nearly 1 million by 2030.
Currently, countries with “high coverage” of VMMCs have 18.6 million circumcised males. However, there are disparities in circumcision coverage across countries.
One key barrier to VMMC is a lack of awareness about the benefits of circumcision and the risks associated with VMMC. The study found that a majority of participants were not aware of the risks and limitations of VMMC.
Another barrier was a lack of belief that circumcision would reduce the risk of HIV acquisition. However, a study in Uganda found that HIV prevalence was low among circumcised males. During VMMC counseling, messages are provided about the benefits of Circumcision ShangRing Device and the limitations of VMMC.
Adolescents make up half of the total population reached by VMMC efforts in priority countries. Therefore, it is important to understand how the adolescent experience of VMMC influences the message delivered during VMMC counseling. This study was conducted in three countries to explore the messages used during adolescent VMMC counseling.
Common complications
Various complications can occur after circumcision, including infection, bleeding, and necrotizing fasciitis. These complications can be prevented through proper pre-operative assessment and treatment. Other less common complications include urethral fistula, pubic hair strangulation, Fournier gangrene, osteomyelitis, and denudation of the penis.
Infection is the most common complication. This can be attributed to the fact that the procedure involves genital cutting. It can also be a result of excessive bleeding at the surgical site. The most common types of infection include bacterial and viral. The most common bacterial infection is Chlamydia. Chlamydia is transmitted through sexual contact. A bacterial binding of the host receptors can initiate the infection.
Penile adhesions are relatively common. They occur more frequently in obese patients, and may require surgery. Other complications include gangrene, acute renal failure, and tetanus. Septicemia may cause amputation of the glans penis.
Necrotizing fasciitis is a more severe complication that can lead to tissue death. Surgical treatment is necessary. It is also associated with slower healing. A study from Nigeria found a 12.7% incidence of necrotizing fasciitis after circumcision.
Another study found an increased risk of UTI among uncircumcised males. The authors calculated an odds ratio of 0.07 to 0.23. After adjusting for multiple factors, uncircumcision was associated with an increased risk of UTI. However, this was not enough to justify routine circumcision in the first year of life. Other complications include septicemia, gangrene, and acute renal failure.
One-way sensitivity analysis
Until now, there has been no comprehensive study on the cost-effectiveness of male circumcision. A recent study from Rwanda, however, has made this possible. In fact, it has helped to inform policy decisions in the country.
In order to assess the cost-effectiveness of circumcision, researchers used the Decision-Makers’ Program Planning Tool developed by UNAIDS. The tool breaks costs into direct and indirect costs. It also includes a list of ‘ingredients’ that go into the cost of circumcision. The cost per male circumcised was calculated using the ‘ingredients’ approach, which takes into account the costs of each individual component. The costs of consumables were also abstracted from invoices.
Using the same tool, researchers also calculated the cost-effectiveness of different intervention strategies. The strategy with the lowest cost per client was the Exclusive Intervention Strategy (EIS). It targeted a higher conversion rate, provided greater scope for efficiency and was more cost-effective than standard care.
The cost-effectiveness of neonatal circumcision was also analysed. In addition to the cost of the procedure itself, the study also considered the savings in future health care costs. For each 200 dollars of future health care costs that are avoided, an offset of 183 dollars is generated. The calculation is based on a sensitivity analysis of 47 different variables. In addition, the study also shows the value of low-cost recruiting methods for men in the age group 25-49 years.
