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Systematic Approach to Improving Six-Week Post Voluntary Medical Male Circumcision Follow-up at Moroto Regional Referral Hospital in Uganda

The case study describes the experience of Moroto Regional Referral Hospital (RRH), located in Uganda’s Karamoja Region in applying CQI to improve post-operative follow-up. The hospital had been struggling to improve the post-circumcision follow-up rate beyond seven days (six weeks) for some time. This would enable the circumcision team to determine the final health status of their client and provide timely intervention when needed. During the USAID ASSIST Project’s joint coaching and mentorship with SUSTAIN, the Moroto RRH VMMC quality improvement team was supported to systematically analyze the root causes and come up with various possible solutions to improve the six-week post-operative follow-up until the idea of making phone calls to remind clients was adopted and facilitated by SUSTAIN. The phone calls were mainly to remind clients to come for follow-up, however, for those who could not come to the site, their wound healing status was obtained and action taken accordingly. Through these calls, two clients were identified with complications and managed in time when they would otherwise have been missed.