As part of strategy to integrate Male circumcision service into the government health system, RHSP has worked with District Health Offices to establish 9 Circumcision satellite clinics at government health units in 6 of the 10 districts where RHSP serves as Implementing partner. These include 4 in Rakai (Kakuuto HCIV, Kacheera HCIII, Kyebe HCIII, Rakai Hospital); 1 in Lyantonde (Lyantonde Hospital); 1 in Lwengo (Kyazanga HCIV); 1 in Mpigi (Mpigi HCIV); 1 in Ssembabule (Sembabule HCIV); and 1 in Bukomansimbi. As at 2015, another satellite clinic could be started in Kalungu district at Kyamulibwa HCIII.
These Satellite clinics have flexible modes of operation such as adapting flexible duty schedules, specific Male circumcision days, and organizing 10-14 day circumcision camps in a way suitable to the local setting.
Clients are given a cell phone number that they can call in case of any problem after circumcision, and are advised on what to do and where to seek help. The most common adverse events are managed by the trained staff at the units. Clients with urological contraindications or adverse events that may not be managed by the unit staff are referred to RHSP for review by a program Urologist.
The government facilities are empowered to run the satellite clinics, in consideration of sustainability in the face of funding uncertainties. As at 2015, most have been handed over to the districts, but with continued reasonable logistical and technical support from RHSP. Only the satellite clinics in Rakai and Ssembabule districts remain actively run by RHSP.
Despite the challenges of competing for limited space at the units, occasional loss of some logistics, and the sometimes unavailable staff, the satellite centers are advantageous in that they enable the government health system to own the service. The service is closer, and more available to the people.
Quality in Male circumcision for HIV prevention means the ability to satisfy stated or implied needs, Performance according to standards, Conformance to requirements, Fitness for purpose or use, and Meeting the customer’s requirements
RHSP systematically improves the quality of the service by addressing the gaps between current practices and desired standards.