effectiveness of neonatal male circumcision for prevention ... · effectiveness of neonatal male...
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Effectiveness of neonatal male circumcision for prevention of
UTI's in Balinese boys
Training Course in Sexual and Reproductive Health ResearchGeneva, 2 March 2009
Dr. Paolo FontanellaAss. AM.UR scholarship
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Circumcision and UTI’s
Reduction in UTI’s of 90%
High costs of UTI’s treatment/complications
Java circumcision prevalence: 92%
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Circumcision
Definition: ambiguities
Technical aspects- neonatal- adult
Aim: complete removal of the foreskin
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Circumcision in Bali: aims
Improving health status through reduction of:
UTI's, HIV, HPV in males and females
Penile and cervical cancers
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The Model Project
OVERVIEW
Feasibility- Human Resources- Costs
Efficacy in improving health conditions
Long-term multiplier effect
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The Model Project
Patients and Methods
Target population
Human Resources
Facilities
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_____________
WHO – SEARO, Provincial Reproductive Health & MPS Profile of Indonesia, 2008.
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The Model Project
Critical aspects
Acceptability- Religion- Social stigma
Education/information- Hospitals- Puskesmas/PHC
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The Model Project
Results and conclusions
Feasible
Effective in meeting the defined needs
Acceptable
Cost-effective?
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Spin-off and further proposals
Parallel adult program
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Acknowledgments
Tim Farley, Laura Guarenti, Bruce Dick
of WHO
Prof. Dewa N. Wirawan and Prof. Luh K. Suryaniof Universitas Udayana
Dr. H. El Shenoufy