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Implementation of an infant male circumcision programme, Pakistan
Shazia Moosa1, Ammar Ali Muhammad1, Sohail Dogar2
1Center for Essential Surgical and Acute Care, Global Health Directorate, Indus Health Network, 5th Floor Woodcraft Building, Plot 3 & 3-A, Sector 47, Korangi Creek Road, Karachi, Pakistan.
Bulletin of the World Health Organization
|May 6, 2021
Summary
Health providers safely performed infant circumcisions in Pakistan using standardized training. Older infants had more adverse events, but major complications were rare, demonstrating program effectiveness.
Area of Science:
- Public Health
- Pediatric Surgery
- Global Health
Background:
- Infant circumcision is a common procedure with varying safety profiles globally.
- Implementing standardized, provider-led programs can improve access and outcomes.
Purpose of the Study:
- To evaluate the outcomes of a health provider-led infant circumcision program in Pakistan.
- To identify risk factors for adverse events in infant circumcision.
Main Methods:
- Trained non-physician health providers (surgical technicians, midwives) using the Plastibell device.
- Collected data on 2822 male infants (aged 1-92 days) over two years.
- Monitored adverse events via telephone follow-up and analyzed risk factors using logistic regression.
Main Results:
- A total of 2617 infants (92.7%) were followed up.
- Older infants (31-92 days) had a significantly higher risk of adverse events (aOR 2.03-2.14).
- Minor adverse events occurred in 3.8% of infants; major adverse events in 0.3%.
Conclusions:
- Standardized training and monitoring enabled safe infant circumcisions by non-physician providers.
- The program demonstrated a low rate of major adverse events.
- Age is a significant factor influencing adverse event risk in infant circumcision.
