Overcoming Seasonality in Scaling up Voluntary Medical Male Circumcision

A Case Study from Tanzania

Due to client beliefs, the agricultural calendar, and other factors, seasonality has posed a perennial challenge to those responsible for generating demand for VMMC services in Tanzania----as it has in South Africa, Zambia, and many other priority countries where VMMC is being scaled up. In the early years of Tanzania's VMMC program, 75 to 80 percent of circumcisions were performed in the high-demand "winter" months due to local beliefs that wounds heal better during the cold season. This case study examines the VMMC program launched in 2009 in Iringa and Njombe. Managers of this program believe that seasonality, once considered a key barrier to meeting ambitious targets and running efficient, productive programs, no longer limits the success of VMMC programs. Through a combination of structural and behavioral measures, the VMMC program in Iringa and Njombe saw a significant change between 2010 to 2014 in the distribution of VMMCs throughout the year.