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PERIOPERATIVE NURSES CHAPTER� 43RD ANNUAL SCIENTIFIC CONFERENCE.

THEME: HARMONIZING KNOWLEDGE AND EXPERTISE IN PERIOPERATIVE NURSING.

SUB THEME: INNOVATION AND TECHNOLOGY IN PERIOPERATIVE PRACTICE.

DATE: 9th to 11 September 2026.

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Beyond the Cut: Primary Health Care and Community-Based Interventions to Prevent Adverse Outcomes of Cultural Circumcision Practices

Presented By: AMON KIPKIRUI BITE,

CO -author DR. TITUS KOECH MOD.

Institution: BURNT FOREST SUB-COUNTY HOSPITAL,UASIN GISHU COUNTY.

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Introduction

  • Globally, male circumcision is a rite of passage among communities.
  • In African communities, Kenya included, it occupies a significant cultural space.
  • However, adverse outcomes have led to preventable morbidity and mortality in Uasin Gishu county
  • 2023 – 24 deaths
  • 2024 – 8 deaths
  • 2025 – 1 death
  • Uasin Gishu County Department of health adopted primary healthcare and community-based intervention to prevent and address these adverse outcomes.
  • We report on these practical culturally sensitive interventions that were adopted and their effectiveness.
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Methodology

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  • The study was a mixture of qualitative and quantitative research using interviews and case reviews.

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  • The study was conducted in four Uasin Gishu County health facilities.

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  • Purposely selected based on their capacity to handle complicated post circumcision cases.

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  • All medical records of initiates admitted in the hospitals between November 2022 and January 2023 were sampled and reviewed.

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  • Focus was on causes of admission and outcomes.

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  • Confidentiality was observed among subjects.

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Map of Uasin-Gishu County

Sub County Hospitals

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Results

  • A total of 52 medical records were reviewed and 32 health workers interviewed.
  • The affected boys ranged from 14 to 20 years with standard deviation 0.75.
  • Median age of 16 years and a mean of 17 years ..
  • The causes of admission were septicemia, cellulitis, urethritis, anemia, pneumonia, wound infections, dehydration, psychological trauma.
  • Post treatment 37 recoveries were recorded .
  • A total of 8 mortalities at sub-county hospitals.
  • A total of 7 were referred to MTRH for advanced care.

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Findings

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Discussion

  • Key contributing factors identified were poor hygiene and use of non-sterile instruments and unskilled personnel.

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  • Also inadequate postoperative care ,lack of postoperative treatment with antibiotics, dehydration from traditional fasting practices.

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  • Notable emotional or physical abuse during the initiation.

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Conclusion

  • Post circumcision morbidities and mortalities is of great health concern.

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  • There is an urgent need to regulate the practice.

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  • Community training and sensitization on safe practices.

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  • A hybrid model that blends cultural rites with professional medical support.

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  • Protection of cultural customs.

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Recommendation

  • Strengthen community awareness and education on unsafe circumcision practices .

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  • Enforce regulatory frameworks to ensure only trained providers perform circumcisions.

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  • Integrate safe circumcision services within primary healthcare and universal health coverage.

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  • Protection of cultural customs and build partnerships which promote healthy behaviors.

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  • Conduct continuous training on safe circumcision procedures

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  • Establish surveillance and reporting system to respond and track complications.

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recomendations

  • County to develop Policy on male circumcision .
  • County to set aside resources for capacity building, follow up and management .
  • There is need to strengthen partnerships with all stakeholders.
  • Comprehensive screening for potential candidates and intensive community education .

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Acknowledgements

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Reference

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  • 1. Kimani, J., Otieno, P., & Mutai, S. (2023). Complications of traditional male circumcision among adolescents in western Kenya. African Journal of Urology, 29(4), 241–249.
  • 2. Kigozi, G., Nalugoda, F., Musoke, R., & Wawer, M. J. (2022). Long-term impact of male circumcision on HIV and STI prevention in Rakai, Uganda. PLOS Medicine, 19(2).
  • 3. Mavundla, T. R., Mbatha, N., & Ngcobo, N. (2024). Unsafe traditional circumcision practices: Public health challenges in Eastern Cape. BMC Public Health, 24(1), 1132.
  • 4. Hakizimana, D., Uwizeye, P., & Niyibizi, E. (2023). Voluntary medical male circumcision uptake and determinants in Rwanda: A cross-sectional study. Frontiers in Reproductive Health.
  • 5. Taye, A., & Biru, S. (2023). Prevalence and predictors of circumcision complications among Ethiopian males. Ethiopian Journal of Health Sciences, 33(1), 45–53.
  • 6. Murenje, V., Chirwa, T., & Dube, N. (2024). Programmatic outcomes of national voluntary medical male circumcision implementation in Zimbabwe (2015–2022). Global Health Research and Policy, 9(3), 87.
  • 7. Mwashambwa, M., Mwampagatwa, I., & Lusingu, J. (2022). Cultural significance and medical implications of male circumcision among Tanzanian tribes. Pan African Medical Journal, 41, 144.
  • 8. Balogun, F. O., & Olowookere, S. A. (2024). Male circumcision practices in southwestern Nigeria: Health and cultural implications. African Health Sciences, 24(2), 335–344.

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“Lets be the generation that ends unsafe circumcision-every life is a victory to humanity”

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THANK YOU