The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa

Background: KwaZulu-Natal (KZN) remains the epicentre of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in South Africa. The incidence of HIV infection in KZN necessitates cost-effective strategies to curb the spread of infection. Voluntary medical male circu...

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Autores principales:	Celenkosini T. Nxumalo, Gugu G. Mchunu
Formato:	article
Lenguaje:	EN
Publicado:	AOSIS 2021
Materias:	explanatory model medical male circumcision primary health care voluntary medical male circumcision hiv prevention hiv/aids Medicine R
Acceso en línea:	https://doaj.org/article/91dd7c0d14af49ebbfb675150498cfa3
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spelling	oai:doaj.org-article:91dd7c0d14af49ebbfb675150498cfa32021-11-24T07:44:19ZThe development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa2078-61902078-620410.4102/safp.v63i1.5346https://doaj.org/article/91dd7c0d14af49ebbfb675150498cfa32021-11-01T00:00:00Zhttps://safpj.co.za/index.php/safpj/article/view/5346https://doaj.org/toc/2078-6190https://doaj.org/toc/2078-6204Background: KwaZulu-Natal (KZN) remains the epicentre of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in South Africa. The incidence of HIV infection in KZN necessitates cost-effective strategies to curb the spread of infection. Voluntary medical male circumcision (VMMC) has been adopted as an additional biomedical preventive strategy since 2010 in line with recommendations from the World Health Organization. Despite several attempts to scale-up VMMC to reach age specific targets to achieve immediate aversion of infections, the uptake of VMMC remains sub-optimal, particularly in KZN. The purpose of this study is to describe the processes that were followed in developing, describing and evaluating an explanatory model for VMMC in KZN, South Africa. Methods: A qualitative theory-generative phenomenographic study design was used to analyse the qualitative differences in primary healthcare stakeholders’ experiences, understanding and conceptions of VMMC in KZN, South Africa. The emerging results informed the development of the VMMC explanatory model for KZN, South Africa. The model development process followed four steps, namely (1) concept analysis, (2) construction of relational statements, (3) model description and (4) model evaluation. The criteria of relevance for the target audience – applicability, clarity, user friendliness and originality of work – were used to evaluate the model. Results: The model’s central premise is that the decision to undergo VMMC is shaped by a complex interplay of factors in the context or external environment of males (the extrinsic variable), which influences specific experiences, conceptions and understanding regarding VMMC (the influential/intrinsic variables). These collectively determine men’s responses to VMMC (the outcome variable). Conclusion: The model describes the process by which contextual, extrinsic and intrinsic variables interact to determine an individual male’s response to VMMC, thus providing a guide to primary healthcare providers on care, practice and policy interventions to support the uptake of VMMC in the rural primary healthcare context of KZN, South Africa.Celenkosini T. NxumaloGugu G. MchunuAOSISarticleexplanatory modelmedical male circumcisionprimary health carevoluntary medical male circumcisionhiv preventionhiv/aidsMedicineRENSouth African Family Practice, Vol 63, Iss 1, Pp e1-e9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	explanatory model medical male circumcision primary health care voluntary medical male circumcision hiv prevention hiv/aids Medicine R
spellingShingle	explanatory model medical male circumcision primary health care voluntary medical male circumcision hiv prevention hiv/aids Medicine R Celenkosini T. Nxumalo Gugu G. Mchunu The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa
description	Background: KwaZulu-Natal (KZN) remains the epicentre of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in South Africa. The incidence of HIV infection in KZN necessitates cost-effective strategies to curb the spread of infection. Voluntary medical male circumcision (VMMC) has been adopted as an additional biomedical preventive strategy since 2010 in line with recommendations from the World Health Organization. Despite several attempts to scale-up VMMC to reach age specific targets to achieve immediate aversion of infections, the uptake of VMMC remains sub-optimal, particularly in KZN. The purpose of this study is to describe the processes that were followed in developing, describing and evaluating an explanatory model for VMMC in KZN, South Africa. Methods: A qualitative theory-generative phenomenographic study design was used to analyse the qualitative differences in primary healthcare stakeholders’ experiences, understanding and conceptions of VMMC in KZN, South Africa. The emerging results informed the development of the VMMC explanatory model for KZN, South Africa. The model development process followed four steps, namely (1) concept analysis, (2) construction of relational statements, (3) model description and (4) model evaluation. The criteria of relevance for the target audience – applicability, clarity, user friendliness and originality of work – were used to evaluate the model. Results: The model’s central premise is that the decision to undergo VMMC is shaped by a complex interplay of factors in the context or external environment of males (the extrinsic variable), which influences specific experiences, conceptions and understanding regarding VMMC (the influential/intrinsic variables). These collectively determine men’s responses to VMMC (the outcome variable). Conclusion: The model describes the process by which contextual, extrinsic and intrinsic variables interact to determine an individual male’s response to VMMC, thus providing a guide to primary healthcare providers on care, practice and policy interventions to support the uptake of VMMC in the rural primary healthcare context of KZN, South Africa.
format	article
author	Celenkosini T. Nxumalo Gugu G. Mchunu
author_facet	Celenkosini T. Nxumalo Gugu G. Mchunu
author_sort	Celenkosini T. Nxumalo
title	The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa
title_short	The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa
title_full	The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa
title_fullStr	The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa
title_full_unstemmed	The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa
title_sort	development of an explanatory model for voluntary medical male circumcision in kwazulu-natal, south africa
publisher	AOSIS
publishDate	2021
url	https://doaj.org/article/91dd7c0d14af49ebbfb675150498cfa3
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The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa

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