Lesotho recently completed a situational analysis to determine whether it has the capacity to roll out a male circumcision service at public health facilities. The survey found that over 80 percent of Basotho were aware of the benefits of circumcision in preventing HIV, and many men were willing to be circumcised. The tiny mountainous kingdom has about five doctors per 100,000 patients, so health services are largely run by female nurses and most men regard it as “shameful to go to a woman and ask to be circumcised”, said Dr Mpolai Moteetee of the Ministry of Health and Social Welfare. Nurses are not authorised to perform male circumcisions but the country would consider allowing them to do so, “but I don’t know how many male nurses we will find in the system,” Moteetee remarked. Male circumcision is traditionally practiced in some parts of Lesotho, so any official policy would have to involve traditional leaders. Two task teams have been set up, one focused on addressing these concerns, and another focused on technical issues, but this had been a “protracted” process and there was still no resolution on how to move forward, Moteetee said. Cost is another major barrier. “I am not sure how we will manage, but this will have implications for access [to the procedure],” Moteetee added.
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