Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
Chapter 9
MANAGING A CIRCUMCISION SERVICE
Summary
• The manager of a clinic circumcision service has a number of
roles. These include ensuring quality of services, making sure that
good quality records are kept, monitoring and evaluating the
programme, and carrying out supportive supervision.
• To meet these responsibilities, the clinic manager must set the
desired levels of performance for the services provided, assess
current levels of performance, work with other clinic staff to
analyse the causes of inadequate performance and find solutions
for identified problems.
RECORD-KEEPING, MONITORING AND EVALUATION
The clinic manager should ensure that the health care providers
maintain adequate records on all clients. Records should include
information on the identity of the client, the type of service provided,
and any special circumstances associated with it. Sample record
forms to assist this task are given in Appendices 9.1 (stock card), 9.2
(stock-taking card for consumables), 9.3 (adverse event form) and 9.4
(register).
A more detailed account of indicators and monitoring and evaluation
of male circumcision programmes is given in the WHO/UNAIDS
publication A guide to indicators for male circumcision programmes in
the formal health care system, which can be downloaded from the
Clearinghouse on Male Circumcision for HIV prevention
(www.malecircumcision.org).
Indicators
Health care facility managers need detailed information to allow them
to make decisions about how best to use scarce resources. They
might want to know the answers to questions such as:
• Are we reaching our target audience
• Can we provide the necessary services (for example, do we have
the appropriate equipment, staff and medications)
• Are our services of high quality (for example, do they meet national
and international standards)
• Do our services meet the needs of our clients
• Are we referring clients who need it
For each question, managers should develop one or more indicators
to monitor the services or the impact of changes. For example, to
assess the quality of the circumcision service provided, an appropriate
Record keeping, monitoring, evaluation and supervision Chapter 9-1