Voluntary Medical Male Circumcision Service Provision by Female Nurses: Assessing Locals’ Perceptions and Attitudes in Homa Bay County

Introduction: The Human Immune Deficiency Virus (HIV) pandemic is among the critical public health challenges facing the world especially the African continent today, and success in this setting remains critical in stemming this global epidemic. Kenya launched voluntary medical male circumcision (VMMC) programme in 2008 that proved successful in reaching a large population of uncircumcised men and is associated with substantial reduction in the transmission of HIV. However, Homa Bay County, Nyanza region still reports low circumcision rates and high HIV prevalence compared to the neighbouring counties like Migori at 52.6% and with Homa Bay at 26.7% of voluntary male circumcision rates Objectives: The study sought to determine the influence of locals’ perceptions and attitudes on the acceptability of female nurses in the provision of VMMC services in Rangwe Sub-County, Homa Bay County. Methodology: Study population was circumcised and uncircumcised men aged 18-50 years seeking services in eight selected health facilities in East Gem Ward, Rangwe Sub- County, Homa Bay County. The Fisher formula was used to sample respondents for the study. Descriptive study design was used. Both inferential and descriptive methods were used in the data management. Results: Revealed that MMC being freely discussed at the workplace or in the community had a statistically significant association with acceptability of female nurses in the provision of VMMC services (p = 0.000). This shows that a significant majority (89%) of the respondents whose places of work or community freely discussed VMMC, compared to 57% of the respondents whose places of work or community did not freely discuss VMMC, would recommend that female nurses be trained on VMMC and be allowed to provide the VMMC services. However, the attitude of the respondents’ workmates or community had no statistically significant association with acceptability of female nurses in the provision of VMMC services [c2(3) = 7.661, p = 0.054]. In other words, there is a significant difference in acceptability of female nurses in the provision of VMMC services between respondents whose places of work or community freely discussed VMMC and those whose places of work or community did not freely discuss VMMC. Conclusion: This is one among the few studies that focused on the acceptability of Female Nurses in the provision of voluntary medical male circumcision (VMMC) services despite the fact that male circumcision is one of the oldest and most common surgical procedures practiced worldwide performed by trained doctors, nurses and clinical officers, and traditional circumcisers in some communities. Many studies on male circumcision did not specifically dwell on acceptability of circumcisers based on their gender. Therefore, Ministry of Health and the County government of Homa Bay should develop appropriately tailored messages for communities to use as they engage in discussions on VMMC by female nurse at workplaces and in the community to help in decision making on policy change regarding the involvement of female nurses in VMMC service provision. That the study be replicated in other counties/regions in Kenya reporting low circumcision rates and high HIV prevalence; and on health workers to establish their perceptions and attitudes on the involvement of female nurses in VMMC service provision in the country.