Client Follow-up

VMMC clients are advised to return to a health care facility for post-circumcision follow-up visits to track progress on wound healing and to identify and manage possible adverse events. Many countries recommend three VMMC follow-up visits: at 48 hours, at seven days, and at six weeks relative to surgery.

Client follow-up requires facilities offering VMMC services to develop and maintain mechanisms encouraging all clients circumcised to return for follow-up. Facilities are expected to collect follow-up data, analyze and interpret results, and based on findings, make informed decisions to continuously improve follow-up rates.

VMMC post-procedure follow-up is important for assessing progress on wound healing and identifying and treating potential adverse events. Follow-up visits further provide the opportunity to reinforce messages on wound care, HIV prevention, and risk reduction measures.

In Uganda, ASSIST has worked with facilities to encourage female involvement in VMMC and found that clients who attend a group education session with their female partner are more likely to return for the 48-hour and seven-day follow-up visits.

  • Difficult to track clients due to poor data capturing and recording of client information.
  • Clients lost to follow-up due to tracking mechanisms that are not in place.
  • Assuring proper communication and referral systems between facilities and surrounding referral centers in cases where clients receive follow-up care at facilities other than the VMMC site where they were circumcised.
  • Insufficient and/or inconsistent messaging to clients regarding the importance of follow-up.
  • Challenges related to distance, transport and costs incurred to travel to a facility for follow-up services.


The document provides recommendations from the USAID ASSIST Project in South Africa for addressing challenges that are commonly experienced in VMMC programs.


This case study illustrates the need for facility-based improvement in standardized documentation of client forms and registers to increase and improve post-operative client follow-up.


These guidelines issued by the National Department of Health of the Republic of South Africa, provide comprehensive guidance for organizing and assuring the quality of VMMC service delivery.


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.


This excerpt from the Guide to Improving the Quality of Safe Male Circumcision in Uganda describes the successful changes tested by CQI team to improve client follow-up beyond 7 days after the procedure.