Brothers For Life Medical Male Circumcision (MMC) Social Mobilisation and Summer Campaign

Introduction

Brothers For Life, the national men’s campaign, is being undertaken in partnership with SANAC: Men’s Sector and the Department of Health, USAID/PEPFAR, Johns Hopkins Health and Education in South Africa and Sonke Gender Justice to drive demand and promote the uptake of medical male circumcision in South Africa.

The Brothers For Life partners will implement a concerted campaign to promote the demand for MMC services in communities with existing USAID funded MMC service-provision sites. This campaign will support the national media campaign to promote MMC, HIV counselling and testing (HCT) and condom use to be launched in February.

The mass-media component of the MMC Scale-up strategy will comprise:

• A television commercial
• Outdoor media and commuter advertising promoting specific MMC service-provision sites
• A 30-part radio talk show on 11 SABC radio stations promoting MMC, HIV prevention and healthy lifestyles
• Bi-monthly four-page Daily Sun features on HIV prevention (MMC, condom use, HCT ) and related topics including gender and family planning

Social Mobilisation for MMC

The Brothers For Life Social Mobilisation campaign for MMC implementation is implemented in partnership with Sonke Gender Justice in 15 communities that have existing service-provision sites supported by government and USAID/PEPFAR in Gauteng, Free State, Mpumalanga and Northern Cape.

The key objectives of the Social Mobilisation campaign are to:

• • • Promote the uptake/create demand for MMC and HCT services in the USAID sites
    • Increase knowledge on MMC and HIV Prevention for clients and community
    • Build Capacity for Social Mobilisation partners and their social mobilisation teams

Social Mobilisation Sites for MMC

The following 15 sites will be supported with the implementation of a comprehensive MMC social mobilisation package.

Support and Material

Sonke and JHHESA provide continuous technical support as well as limited material support to the Community Action Teams (CAT). These include material support for the first major CAT community blitz, and where there is an absolute need and where resources are available other CAT social mobilisation activities.

The following materials will be provided to the CAT (all based on availability and active involvement of partners):

• • • Brothers For Life Toolkits for the CAT
    • Provision of 4 flipcharts for the service-provision site and up to 6 for the CAT stakeholders who work on social mobilisation
    • MMC brochures
    • MMC post-procedure brochure

Strategy for the Make Summer Even Hotter Campaign:

The campaign on medical male circumcision undertaken under the Brothers for Life banner started in February 2012 and focused primarily on increasing the knowledge of the benefits of medical male circumcision and increasing people’s awareness of the availability of services for medical male circumcision.

This campaign included the broadcast of a television commercial, a radio talkshow, the use of outdoor media, an SMS service locator system that uses GPS technology and a searchable website through which clients can search for their nearest MMC site.

Rationale

South Africa has a traditional seasonal norm around medical male circumcision in South Africa. Data from the Department of Health and USAID/PEPFAR clinics show that while there is a significant demand for MMC in the winter months that demand decreases in summer months and thus places significant pressure on health-care providers and clinics in winter.

Purpose

The purpose of the Make Summer Even Hotter Circumcision campaign is to address the social norms around the seasonality of circumcision, while at the same time continuing to increase knowledge and address attitudes and social norms relating to the health benefits of circumcision in South Africa and promoting the uptake of services.

The strategy

This strategy has as its central tenet the use of radio supported by television, print media with social mobilisation and discussions with men and women, in communities, tertiary institutions and schools.

The mass media campaign for the Make Summer Even Hotter campaign is structured around the use of radio and trying to encourage a national discussion around MMC in summer.

The television campaign will continue to use the existing television commercial with the tag line: “The Time is Now: Get Circumcised for Free this Summer”. The television commercial commenced in November and continued in January.

Outdoor Campaign – outdoor media are refreshed along the lines of the Make Summer Even Hotter Campaign. Messages promote the uptake of MMC in summer and the use of condoms.

Evidence for the Campaign behind the Make Summer Even Hotter Campaign

What is the evidence to show that circumcision reduces the risk of HIV infection

• • • Three randomised studies undertaken in South Africa, Uganda and Kenya show that male circumcision reduces the risk of HIV infection by 60%.

What do we mean by the “lovecut”?

• • • The “lovecut” refers to MMC that is done in a clean and hygienic clinical setting.
    • Why are we calling it the “love cut”? Men who are circumcised reduce their and their partners’ risk of HIV infection, STIs and help protect their partner from cervical cancer.
    • Men who choose to be circumcised show they love their partner by taking the pain for a lifetime of gain to their health and that of their partner.

Why the emphasis on getting circumcised in Summer?

• • • In South Africa there is a myth that the wound from circumcision heals quicker in winter than in summer. This results in queues, waiting lists and frustration for medical personnel and clients.
    • Over 96 522 men got medically circumcised in the period May – August 2012 in 28 districts serviced by a combination of mobile and fixed services funded by the South African Government, USAID and PEPFAR. This demand on services places a huge burden on the clinical services, and in some instances even results in instability and violence. Encouraging men to circumcise in the summer months will help to ensure that more efficient services are provided to men, meaning they do not have to queue.
    • Just under 1 million men have indicated that they want to be circumcised in the next 12 months. Given that there is a predisposition to circumcision in winter, this may place a huge burden on the existing clinical services. To beat the queues, circumcise in summer.
    • There is no evidence to show that men who are circumcised in summer heal any slower than men who get circumcised in winter.
    • Getting circumcised in summer may be more comfortable because a man has to wear less clothing making it more comfortable than during winter, where heavier clothing is preferred to keep warm.