PSI Zimbabwe Internship Report

James Sengu r138798q
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UNIVERSITY
OF
ZIMBABWE
ATTACHMENT REPORT
NAME: JAMES SENGU
REG No: R138798Q
DEGREE PROGRAMME: BSc (HONS) DEGREE IN STATISTICS
COMPANY: POPULATION SERVICES INTERNATIONAL/ZIMBABWE
INSTITUTION: UNIVERSITY OF ZIMBABWE
SUPERVISORS: ROY DHLAMINI (INDUSTRIAL)
DR MATARISE (ACADEMIC)
This Industrial Attachment Report is in partial fulfillment of the requirements of the Bachelor of Science
Honours Degree in Statistics

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Contents
LIST OF ACRONYMS........................................................................................................................... 6
Acknowledgements................................................................................................................................. 9
Abstract.................................................................................................................................................10
Introduction ...........................................................................................................................................11
Organizational Background....................................................................................................................11
Organizational History...........................................................................................................................11
Heath Impact .........................................................................................................................................12
Organizational Mission ..........................................................................................................................12
Organizational Values............................................................................................................................12
ADDITIONAL VALUES ......................................................................................................................12
Organizational Partners..........................................................................................................................13
The Organizational Structure..................................................................................................................13
HIV and Sexually Transmitted Infection ................................................................................................13
Focus Areas...........................................................................................................................................13
Voluntary Medical Male Circumcision...................................................................................................14
Tuberculosis ..........................................................................................................................................14
Focus Area.............................................................................................................................................14
Contraception ........................................................................................................................................15
Focus areas............................................................................................................................................16
Non-Communicable Diseases.................................................................................................................16
Focus Areas...........................................................................................................................................16
Malaria ..................................................................................................................................................16
Focus Areas...........................................................................................................................................17
Child Health ..........................................................................................................................................17
Focus Area.............................................................................................................................................17
Attachment objectives............................................................................................................................17
Structure of the organization ..................................................................................................................18
Structure of the VMMC department .......................................................................................................19
The technical section..............................................................................................................................19
Developing and Building Program Database ..........................................................................................19
Program Indicators.................................................................................................................................20

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Challenges .............................................................................................................................................21
Collating data, Analyzing data and Report writing..................................................................................21
Challenges .............................................................................................................................................22
Data Quality Audits ...............................................................................................................................22
Methodology: ........................................................................................................................................22
Data for DHIS 2.....................................................................................................................................23
PEPFAR Data for Accountability Transparency Impact Monitoring( DATIM) ........................................24
Any Other Duties...................................................................................................................................27
Original Idea..........................................................................................................................................27
Data life Cycle and Data Management Support ......................................................................................27
Data Management Schedule...................................................................................................................27
Skills Acquired ......................................................................................................................................28
Communication Skills............................................................................................................................28
Analytical Skills ....................................................................................................................................28
Project Management ..............................................................................................................................29
Data Collection and Presentation Skills ..................................................................................................29
Time Management .................................................................................................................................29
Statistical Packages................................................................................................................................29
EpiData version 3.1................................................................................................................................29
How to work with EpiData.....................................................................................................................30
1. Define Data........................................................................................................................................30
4.Enter Data...........................................................................................................................................32
Files Saved: ...........................................................................................................................................33
5.Document Data ...................................................................................................................................33
6.Export for analysis and securing data. .................................................................................................34
Conclusion and Recommendations.........................................................................................................35
Recommendations to the University.......................................................................................................35
Recommendations to the PSI/ZIM..........................................................................................................35
CONCLUSION .....................................................................................................................................36
Appendix...............................................................................................................................................37
Questions on the CIR Form....................................................................................................................37
National Report Executive summary ......................................................................................................44

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Company, Partners and Funders logos....................................................................................................47
Company Costs and Expenses................................................................................................................47
Company Forms ....................................................................................................................................49

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LIST OF ACRONYMS
HIV Human Immune Virus
AIDS Acquired Immune Deficiency Virus
DAC District Aids Committee
IP Implementing Partner
IPC Interpersonal Communication
HIV Human Immune Virus
HPV Human Papilloma Virus
HTC HIV/AIDS Testing and Counseling
MoHCW Ministry of Health and Child Welfare
NAC National Aids Council
MC Male Circumcision
STIs Sexually Transmitted Infections
VMMC Voluntary Medical Male Circumcision
ART Anti-Retroviral Therapy
FP Family Planning
PLWHIV/AIDS People living with HIV/AIDS
IP’s Implementing Partners
PTSS Post Test Support Services
CMO Community Mobilizing Officer
PSI/Z Population Services International/Zimbabwe
W.H.O World Health Organization

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CBO’s Community Based Organizations
DATIM Data for Accountability Transparency Impact Monitoring
DHIS2 District Healthy Information System 2
DFID Department for International Development
PEPFAR President’s Emergency Plan for AIDS Relief
USAID United States Agency for International Development

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Acknowledgements
It is my proud privilege to release the feeling of my gratitude to several people who helped me directly or
indirectly to complete my industrial attachment. I express my heart full indebtness and owe a deep sense of
gratitude to my placement supervisor (Roy Dhlamini) and my attachment supervisor (Dr Matarise) for their
sincere guidance and inspiration in completing my internship.
I also thank all my friends and family members who have more or less contributed with their coordination and
cooperation and for their kind guidance and encouragement, l will be always indebted to them. Special mention
also goes to Population Service International Zimbabwe (PSI/ZIM) and the Voluntary Medical Male
Circumcision (VMMC) team for giving me the opportunity and support working with them to attain my
internship objectives.
I am extremely thankful to the Lord Almighty, Proverbs 3:6, in all thy ways acknowledge Him, and He shall
direct thy paths.
The study has indeed helped me to explore more knowledgeable avenues related to my statistical carrier and I
am sure it will help me in my future.

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Abstract
This report is prepared in partial fulfillment of the requirements of B.Sc. Honors Degree in Statistics. It will
highlight my work related learning experience during placement at Population Service International
Zimbabwe(PSI/ZIM) as a Data Capture intern in the Voluntary Medical Male Circumcision(VMMC)
Department .The report will outline the work roles , responsibilities , achievements , activities and challenges
faced by student. The report also seeks to portray the organizational background of Population Service
International Zimbabwe (PSI/ZIM), its operations and the resulting products and services it offers, giving an
overview of how the theory l learnt at the university managed to simplify the assignments and duties I
performed during my internship period.

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Introduction
Organizational Background
Population Service International Zimbabwe (PSI/ZIM) is a global health organization dedicated to improve the
health of people in the developing world like Zimbabwe focusing serious challenges like a lack of family
planning, HIV and AIDS, barriers to maternal health, and the greatest threats to children under five years,
including malaria, diarrhea, pneumonia and malnutrition.
A hallmark of Population Service International Zimbabwe (PSI/ZIM) is a commitment to the principle that
health services and products are most effective when they are accompanied by robust communications and
distribution efforts that help ensure wide acceptance and proper use.
Population Service International Zimbabwe (PSI/ZIM) works in partnership with local government ministries of
health and local organizations to create health solutions that are built to last.
Organizational History
Population Service International Zimbabwe (PSI/ZIM) was founded in 1970 to improve reproductive health
using commercial marketing strategies. For its first 15 years, Population Service International Zimbabwe
(PSI/ZIM) worked mostly in the family planning (hence the name Population Service International).In 1985, it
started promoting oral rehydration therapy. Population Service International Zimbabwe’s first HIV prevention
project which promoted abstinence, fidelity and condoms began in 1988. Population Service International
Zimbabwe added malaria and safe water to its portfolio in the 1990’s and tuberculosis in 2004.
Population Service International Zimbabwe has been operating in the partnership with Ministry of Health and
Child Welfare(MoHCC) since 1996 , with an initial focus on HIV and AIDS prevention through the social
marketing of condoms , the program has now grown significantly to include numerous services such as HIV
testing and Counseling(HTC) , Sexually Transmitted Infections (STIs) treatments , Voluntary Medical Male
Circumcision (VMMC) , TB screening , ART provision , family planning and cervical cancer screening .
Population Service International Zimbabwe also supports the Ministry of Health and Child Care (MoHCC) with
long-lasting insecticide-treated nets distribution for the prevention of malaria and the social marketing of Water
Guard Sodium Hydrochloride solution for the prevention of Water-borne diseases.

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Heath Impact
Population Service International Zimbabwe has an uncompromising focus on, measurable health impact and
measures its effect on disease and death much like profit measures its profit, only last year 2014 Population
Service international saved the lives of 15,445 mothers, prevented 5,646,997 unintended pregnancies, stopped
254,792 new HIV infections and avoided 273,740 deaths due to disease like malaria, diarrhea and pneumonia
that most threaten young children.
Organizational Mission
Population Service International Zimbabwe makes it easier for people in the developing world to lead healthier
lives and plan the families the desire by marketing affordable products and services.
Organizational Values
 Measurement: Evidence , Research , Metrics and evaluation inform our choices
 Pragmatism: We strive for excellence , but useful and timely are better than perfect
 Honesty: We act with integrity , share what we achieve and admit when we fail
 Collaboration: Active partnering drives impact
 Trust: We have confidence in our people to make good decisions
 Commitment: We build local capacity and programs that last.
ADDITIONAL VALUES
 Flexibility
 Speed and efficiency
 Adaptation and innovation
 Measurable results
 Professionalism

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Organizational Partners
 Zimbabwe Ministry of Health and Child Care(MoHCC)
 National AIDS Council (NAC)
 Zimbabwe National Family Planning Council(ZNFPC)
 Community-based organizations
The Organizational Structure
The structure of the organization is subdivided into different programs namely:
1. HIV and Sexual transmitted infections
2. Tuberculosis
3. Contraception
4. Non Communicable Diseases
5. Malaria
6. Child Health
HIV and Sexually Transmitted Infection
Tremendous scientific advancements have been made in the last decade to prevent the transmission of HIV and
improve the lives of people living with HIV .Today the world can see the possibility of an AIDS-free generation
, but many challenges remain. In 2012 there were still 2.3 million new HIV infections and 35.3 million people
living with the virus worldwide. We are committed to taking an active role in creating an AIDS free generation
by implementing evidence-based, cost-effective interventions in collaboration with country governances and
other partners.
Focus Areas
Behavior change communications , combination prevention , condoms and lubricant , gender-based violence ,
HIV counseling and Testing , needle and springe distribution , prevention of Mother-to-Child transmission ,

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reproductive health/HIV integration , STI screening and diagnosis , stigma and discrimination , treatment care
and support , underserved populations , Voluntary Medical Male Circumcision(VMMC) and vulnerable
Populations.
Voluntary Medical Male Circumcision
It is an effective biomedical intervention that has been proven to reduce the risk of female-to -male HIV
transmission by up to 60 percent. In order to improve scale-up of Voluntary Medical Male
Circumcision(VMMC) services, with funding from the Bill and Melinda Gates Foundation and PEPFAR, we
have been actively involved in assessing the safety, feasibility, acceptability and cost of adult and infant male
circumcision devices that could potentially accelerates the scale up Voluntary Medical Male
Circumcision(VMMC) Services.
VMMC devices have the potential to make the male circumcision procedure safer , easier and quicker than
current methods .These devices may even be used safely by non-physician health care providers with a shorter
period of training, leading to a more cost-effective scale-up of male circumcision than standard surgical
methods.
Tuberculosis
According to the World Health Organization (WHO), one third of the world’s population has been infected with
tuberculosis .In 2012, nearly 9 million people fell ill due to TB and there were 1,3million TB deaths .In that
same year, national notification systems missed about 3 million people who developed TB. Today the illness
remains the leading cause of deaths for people living with HIV
Focus Area.
We began implementing TB programs in 2014 and have expanded our work to 22 countries in Latin America
,Asian and Africa .These programs include ;
 Working with the private and public sectors to strengthen health system’s ability to detect cases of TB ,
initiative and ensure completion of treatment and integrate HIV/TB services.
 Working with ministries of health to engage private-sector health workers in the provision of high
quality TB care

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 Training providers to offer high quality TB services, including screening, diagnosis and treatment .We
have extensive expertise training and supporting a variety of care providers, including general
practitioners, pharmacists and traditional healers.
 Providing ongoing supportive supervision so that providers continues to offer quality care and notify
cases to national TB programs
 Engaging small scale providers with social franchising.
Contraception
In many developing countries ,a large portion of the population lack access to family planning products
and services due to lack of products ,poor distribution systems ,high prices ,under-resourced public
health systems and lack of trained competent medical providers .Every year ,there are more than 70
million unintended pregnancies and every day more than 800 women die from preventable causes
related to pregnancies and child birth
Providing access to contraceptives prevents unintended, often high risk pregnancies those that come too
early ,too often or too late in life and reduces the number of abortions, saving lives .The benefit of
family planning also extend beyond a woman’s improved health ;
 Spaced births and fewer pregnancies improve child survival
 Women also have greater employment opportunities when they control their fertility ,which can
enhance their own and their families economic status
We promote short term contraceptives, long-acting reversible contraception and permanent methods by training
providers, assuring quality of care and social marketing for a wide range of products
To provide family planning products and services where they are most, we use a number of approaches and
strategies across our portfolio including:
 Creating franchised networks of medical providers to offer clinical services
 Working with health service providers through formal ,competency-based training programs and
rigorous quality assurance to ensure their ability to provide high quality family planning services
 Utilizing existing wholesale and retail distribution infrastructure to make products widely available

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 Expanding the reach of products and services through outreach events ,task shifting to lower level
providers where possible and engaging community based health workers
 Working with government and key stake holders to increase contraceptive security
 Advocacy for policy changes to reduce barriers to access and of contraception for youth, women and
couples.
Focus areas
Virginal ring ,diaphragm ,standard days methods and cycle beads ,oral contraception, emergency
contraception pills ,female condoms ,male condoms ,infect able contraception ,intra uterine
contraception device ,post-partum IDU ,contraception implants and permanent methods.
Non-Communicable Diseases
These are not passed from person to person. They are typically of long duration and progress slowly. The most
common NCDs include cardiovascular disease (such as heart attacks and stroke), cancers, chronic respiratory
diseases (such as chronic obstructive pulmonary diseases and asthma) and diabetes.
Focus Areas
Our organization plan for priority intervention areas in NCDs leverages over four decades of expertise in social
marketing, as well as organizational strengths in social franchising, behavior change communications and
service delivery. Currently we are focusing on diabetes, hypertension and cervical cancer.
Malaria
The World Health Organization (WHO) estimates that 3.4 billion people across the world are at risk of malaria,
with children under the age of five and pregnant women being most vulnerable. WHO also estimates that in
2013 there were 198 million cases of malaria which led to 584,000 deaths, mostly among African children.

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Focus Areas
We focus on a variety of interventions to improve the availability, affordability and use of effective malaria
treatment. Our interventions against malaria include the delivery of long-lasting insecticides-treated nets to
prevent malaria, rapid diagnostic tests to diagnose malaria, and artemisinia-based combination therapy to
effectively treat malaria. We also lead research programs to inform global malaria policy and national
programming decisions around the world.
Child Health
Nearly 9 million children less than five years old die each year from causes that are largely preventable ,
pneumonia , diarrhea and malaria , with malnutrition as an underlying cause of 35 percent of these deaths.
From pregnancy to birth and through a child’s first five years of life , the prospects for a healthy and bright
future are increasing thanks to the availability of more interventions with proven impact on the major causes of
child mortality . Through these various avenues , children can have a healthier start to life and a much greater
chance of celebrating their fifth birthday.
Our child survival efforts identify gaps in service and product delivery , and work through our global structure
of local network members to strengthen both public and private sector health markets for child heath.
We also use formative research to inform the design of marketing and communications campaigns that
stimulate demand for health products and services using a variety of channels such as mass media , community
level events and interpersonal communications.
Focus Area
Diarrheal disease, neonatal health, nutrition and pneumonia
Diarrhea-we educate individuals about purifying water in the home, practicing improved hygiene and offering
treatment i.e. oral rehydration solution (ORS) and zinc.
Attachment objectives
Contractor is engaged as a VMMC Data capture intern on past time basis to provide services for the VMMC
department and will report to the VMMC program manager (Roy Dhlamini).
Responsibilities include, but are not limited to the following tasks and activities;

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 Develop and build VMMC program database using program indicators from the current library.
 Collate and analyze data for regular and periodic reports as requested
 Carry out data quality audits for VMMC teams and make recommendations
 Prepare data and enter into DHIS2 system
 Create pivot tables for the generation of reports on a monthly basis
 Any other duties as assigned
Working together with the programs are the following departments
 Finance
 Marketing
 Procurement
 Human Resources
 Research metrics and information systems.
Structure of the organization

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Structure of the VMMC department
The technical section
Developing and Building Program Database
Since the program all the ten provinces of Zimbabwe, the VMMC were split by provinces , by month and by
age depending with the indicator used.

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Program Indicators
Indicators Where do you get the Statistics Comment
Q1.Total number of MCs
done by month
CIR form count and client register Include static and outreach
figures
Q2.Cumulative MCs done
to date and by site
Last Report and current
CIR/Register
Include static and outreach
figures
Q3.Total MCs done by
site by month
CIR form count and client register Report by static and outreach
sites and UF sites
Q4.Total number of MCs
by Type of site
(static/outreach)
CIR form and client register Disaggregate by
outreach/outreach
Q5.Total MCs by type of
MC by site
CIR form and client register PrePex/surgical for
outreach/static
Q6.Total MCs by province
and also by type of MC
Q7.Total number of AEs
(moderate to severe) by
site , by type of MC , by
Age group
CIR form , AE register and client
register
Disaggregate by AE type ,
static/outreach/type of MC
and Age group
Q8.Number of MCs by
age group by site by HIV
status
CIR form and client register Disaggregate by
static/outreach and by age
and by status
Q9.Number of clients
reviewed by visit (at least
one) by type of MC
CIR form and client register Count review once ,
disaggregate by
PrePex/surgical
tested for HIV by site
CIR form and client register Static/outreach
tested and opted out by
site and by HIV status
CIR form and client register
Q12.Number of MCs by CIR form and client register Disaggregate by HIV

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HIV status by site and by
type of site
positive/negative and
unknown
Challenges
The consolidated national monthly reports were all kept but some of the data was not there since it was
summarized and the field officers did not keep their own data storage so it was a bit challenging rather l
managed to find the data for some indicators
Collating data, Analyzing data and Report writing
At the end of each month the consolidated monthly report was written using all the VMMC program indicators
that is
1. Outreach by province and site against total number of outreach days, VMMC client and average number
of clients per day.
2. Age breakdown by province and by site against age breakdown.
3. Review follow up by province and site against % attendance per day.
4. HIV Testing by province and site against HIV status and VMMC uptake.
5. PrePex clients outputs by sites against age breakdown.
6. Adverse Events by site and type of AE against age.
7. Statistics table with the summary for the year and all cumulative figures by provinces and districts.
8. Referrals by Province and site against point of referral.
9. HIV Testing by Province and site against HIV Status and age.
10. VMMC clients by provinces, sites, types of circumcision i.e. forceps guided, PrePex and dorsal slit
against age breakdown.
After the collation of data from provincial narrative reports and sites reports then the data was
summarized by provinces for all the program indicators mentioned above. The VMMC National
Monthly report will include the executive summary of all indicators then the data was analyzed using
descriptive statistics i.e. graphs and charts.

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Challenges
Excel was too manual so it would need more care to avoid mistakes and errors and also the field officers
sometimes very late so that it would force you to work under pressure.
Data Quality Audits
Data quality refers to how well data meet the needs and expectations of the data users especially
decision makers. Good data quality:
 Increases programming efficiency and effectiveness
 Ensures stakeholders are satisfied with programming activities
 Enables accurate decision making based on accurate evidence and
 Improves confidence and trust with key stakeholders including donors
Data Quality Assessment refers to the process of triangulating reported data against the primary sources
of that information at site level where the data and reports are generated, DQA also verifies
completeness of documentation.
Methodology:
Step1
Assemble the following major documents: Client Register , Client Intake Record Forms and Monthly
report.
Step 2
Decide on period to be sample (Normally beginning, mid and towards end of period) .Select a month
and then pull all major docs as in step 1.
Step 3
Select and indicator to be tracked e.g.
 Number of clients circumcised on a particular month for MC
 Number of AEs reported that month.

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Step 4
Do a physical verification of all clients (entries) on the 2 documents (Client register and CIR Forms),
pay attention to clients who opted out.
Step 5
Compare the totals of an indicator from the 2 data sources (CIR and register) and the monthly, note
discrepancies among the 3 and find out why? Some of the reasons could be as a result of outreach
registers missing, not updated client or lab register or even omissions.
NB Also checks AEs and management of such.
Step 6
Address the discrepancies of any. Decide which documents is correctly completed and updated, use it to
update and correct other docs noting that the report must be the final since the figures have been
reported.
I did a DQA on two provinces that is Mashonaland East and Mashonaland West provinces.
Data for DHIS 2
The District Health Information Software (DHIS) is a computer programme that allows health services to enter,
validate, and analyse routine data (monthly, quarterly and annually), semi-permanent data (population
estimates, equipment, personnel numbers) and survey data (ad-hoc surveys, regular surveys, sentinel surveys,
One common
Figure

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client satisfaction surveys). A prototype Special Patient Module is available for capturing special types of
patient data and automatically analysing and/or aggregating it into routine data.
The DHIS has several methods for analysing data and produce reports and other outputs:
 The system enables users to add or modify Indicators and their component Data Elements as they see
fit.
 A standalone but interfaced Data Dictionary provides easy access to (national) Data Elements and
Indicators.
 Data can be automatically processed and exported to Excel Pivot Table Files, which the user can
generate automatically using the Pivot Generator Tool.
 A highly flexible Report Generator is available for designing complex but compact tabular or chart
reports that combine indicators and raw data at user-definable levels of aggregation.
 The Report Generator enables users to extract and format data for export to Geographical Information
Systems (GIS) and other software like Epi Info 2002 or SPSS.
 A web-enabled Query Master, which uses a Pivot Table like interface, is available for enabling access
to data via Intranet or Internet servers.
Note that the DHIS is not an Electronic Health/Medical Record (EHR/EMR) system oriented towards
clinical management of patients – it is fundamentally a action-oriented Health Management Information
System (HMIS) designed to support Health Sector Reform, decentralised decision-making, and local use of
information.
DHIS 2 is an electronic database at PSI/ZIM entered figures on monthly bases. Figures for the system are
prepared using proportions and inferential statistics since the reported data does not match exactly to the
requirements of DHIS 2.
PEPFAR Data for Accountability Transparency Impact Monitoring (DATIM)
The Data Approval application is a function within DATIM that facilitates the process of submitting facility,
community, and national indicator data for review and approval from the Implementing Partner through the
OGAC HQ level.

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The image below illustrates the overall workflow process of the Data Approval application:
User roles within DATIM have been broadly defined across three levels: Implementing Partner, Activity
Manager (Agency level), and Country SI Team (Interagency level).
Implementing Partner users can view, enter, and edit site-level MER data associated with their mechanism(s).
In addition, Implementing Partners may also use DATIM’s analytic and visualization tools to review data
and/or run reports associated with their entered data. Implementing Partner users also have the ability to
“submit” data to their respective Activity Manager for review and approval in DATIM.

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User examples: IP M&E Staff, Data Clerks, Country Director and/or Senior Leadership
Activity Manager (Agency level) users are responsible for “accepting” data submissions from Implementing
Partners, reviewing these submissions, and then “submitting” data up to the interagency space in country. While
Activity Managers have the ability to accept and submit any Implementing Partner data associated with their
“home” agency (i.e., USAID, CDC, DoD, Peace Corps, etc.), it is important to establish clear approval
workflow protocols outside of DATIM to minimize confusion and ensure accountability within and across
teams. Typically, country teams assign IP data approval duties to relevant AORs/CORs or Activity Managers
during planning and reporting cycles. However, in the event of staff travel or access issues, other agency-level
users will be able to accept and submit data on behalf of the assigned Activity Manager.
User examples: Agency AORs/CORs, SI/M&E Staff, in-country Agency Lead(s)
Country SI Team (Inter-agency level) users “accept” Agency submissions, review data that will aggregate to
the inter-agency technical area totals, and potentially take action to deduplicate data across partners/agencies.
Once the inter-agency reviews have been completed, the PEPFAR Coordination Office and/or SI Liaison then
“submits” these site-level data to OGAC HQ for final review. Please note that DATIM users with a formal
agency role (i.e., as an Activity Manager) will not receive direct access to the inter-agency dataset; to view this
data, your DATIM User Administrator will need to create “read-only” inter-agency accounts for all those
associated with the inter-agency review process.
User examples: PEPFAR Coordination Office stakeholders, Senior Management, Agency SI Advisors, inter-
agency TWG reviewers, and the SI Liaison

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Note: The data approval workflow enables DATIM users to submit and approve mechanisms through the
workflow after a reporting period has expired. Additionally, if a data set is locked for data entry, approval
workflow still allows users to submit and approve mechanisms.
Any Other Duties
There was also another electronic database called DATIM which was entered data on quarterly bases so there
was need to combine the data for the three months. I also provide the VMMC manager and director with data as
per their requisites.
Original Idea
Data life Cycle and Data Management Support
Data Management Schedule
1. Description of the project
2. Description of the data to be collected
3. Standards to be applied for formats , metadata etc
4. Plans for short term storage and data management e.g. file formats, local storage, back up procedures
and security.
5. Legal and ethics issues e.g. intellectual property and confidentiality of study participants
6. Access polices and provisions
7. Provisions for long term archiving and preservation e.g. in a data archive
8. Assigned data management responsibility.
As a measure to data problems l introduced my email signature in form of a picture of a data life cycle so that
the field officers will keep in mind the idea of archiving their data.

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Skills Acquired
The skills I acquired during my internship include:
 Communication skills
 Analytical Skills
 Project Management
 Data collections and presentation skills
 Time management
 Statistical Packages.
Communication Skills
Communication is an invaluable tool to any organization. In fact it is critical to such an extent that it is the life
blood of the organization. In my first days during the placement this was actually a challenge because of my
quiet conduct. However I managed to overcome this by trying to be a socialite and attending PSI/Zimbabwe
social functions such as meetings, workshops and presentations.
Analytical Skills
Our daily work entailed analysis and writing detailed reports on observations. Writing these reports required
one to be very analytical and objective in their observations. I managed to equip myself with the current
information and events through reading widely constant researches and surveys.

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Project Management
On joining the VMMC department, this opened me up on the practical implementation of the modules Survey
Methods and sampling techniques. I learnt how to develop a study design, which includes defining project goals
and objectives, specifying tasks or how goals will be achieved, what resources are needed, and associating
budgets and timelines for completion. Also this included implementing the project plan, along with careful
controls to stay on the "critical path", that is, to ensure the plan is being managed according to plan. More
importantly I learnt team building and the power of teamwork for successful completion of a project
Data Collection and Presentation Skills
In VMMC department, l learnt that the quality of program goals depends also on the data collection methods
used and the quality of that data. Due to time and monetary constraints we used cost cutting methods such as
using excel report templates. I also got the opportunity to be involved in the designing of these reports templates
and of note was the need to maintain uniformity in the templates.
Time Management
Due to my zealous approach early in the placement I had a challenge with time management. I used to spend
my days in a frenzy of activity, but achieve very little because I was not concentrating my effort on the things
that matter the most. However I was quick to shift focus; “Concentrate on results, not on being busy”. Due to
timelines on most of our tasks I had to learn how to prioritize and plan ahead. I found this to be effective in
achieving results. I also learnt flexibility among tasks as requested by management.
Statistical Packages
At the organization I had the opportunity to familiarize with the Ms Excel package which is mostly used for
data analysis and data entry. I also learnt new data entry software, Epidata.
EpiData version 3.1
EpiData is a program for entering and document data.

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It is used when you have collected data on paper and you want to do statistical analyses or tabulation of
data.Basic frequency tables and lists of data can be made , but other than that Epidata is focused on data entry
and documentation of data.
During data entry calculation of summary scales or restrictions to values can be defined. You can choose an
item from a list and save the corresponding numerical code (1=No 2=Yes), the text lists are exported as value
labels for statistical programs.Dates are easily entered eg 2301 will be formated as 23/01/2003 if entered in the
year 2003 in a dd/mm/yyyy field.
Epidata is suitable for simple datasets where you have one source of data eg one questionaire or one laboratory
registration form as well as datasets with many or branching data forms. The idea is that you write simple text
lines and the program converts this to a dataentry form for which you can add further control of entry ,
conditional jumping to other fields or calculations.
Downloading and installing EpiData is free of charge .EiData did not interfere with the setup of your computer .
It also consists of one program file and help files. EpiData comes as a few files and does not depend on install .
EpiData has got no limits on the number of observation and specification of data file structure must fit within
999 lines of text.
How to work with EpiData
The EpiData screen has a standard windows layout with one menu line and toolbars. This work process toolbar
guides you from “1.Define data” to “6.Export data” for analysis.
1. Define Data
Define data by writing three types of information for each variable:
A..Name of input field (variable, e.g. v1 or exposure).
B..Text describing the variables. (E.g. sex or day of birth)

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C..A field definition, e.g. ## for two digit numerical.
Other field types are Boolean (yes-no), encrypted or soundex fields.
Setting options (file menu) it is important that the user decides on one of two principles for naming variables.
With first word the name of the input fields will be taken as first word on the definition line. With automatic a
combination of the first 10 characters in the line. The example would give:
a. v1sex (10 first characters in sentence) ‘automatic’ field name is v1sex
b. v1 (first word of the sentence). ‘first word’ field name is v1
Other options: e.g. colour of background and fields, line height etc. Users of e.g. Stata or SPSS use the first
word principle; field names will be variable names. Users of Stata should choose lowercase fields names.
2. Make data file.
After writing the definition you can preview your data form or create the actual data file.
3. Add/Revise Checks-at Entry of Data
A strong part of EpiData is the possibility to specify rules and calculations during data entry.
 Restricting data entry to certain values and give text descriptions to the numerical codes entered.
 Specify sequence of data entry E.g. fill out certain questions for males only , (jumps)
 Apply calculations during data entry E.g. age at visit based on date of visit and date of birth. But
typically most calculations are done at the analysis stage.
 Help messages and other extended definitions of computations, if...then...endif structures.

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When you start the add/revise part a new screen appears: At the top the variable name (v8) is shown.
Range, Legal defines which data can be entered.
Jumps specifies where to go to after entry (here on value 1 jump to field v10)
Must enter: If set to Yes a value must be given. (otherwise leaving the blank is accepted)
Repeat: Repeat value from previous record, e.g. if data are from groups a value will repeat until next group.
The value can still be changed.
Value label: For categorical data this defines the meaning of the values e.g. 1=man 2=woman. The values
are edited via the ‘+’.The drop-down list lets you pick an existing label definition.
Edit: Many other aspects can be defined here as “free hand” editing for this field , see the collection of
commands in the help file.
Save: Save current definitions.
4.Enter Data
Open the file and enter , add or search data. The blue explanatory text to the right of the input fields is added
by EpiData after entry of data based on labels I check file. An example of calculated fields is the Body mass
index and age.

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Files Saved:
A.Dataform definition files e.g. first.qes
Actual data file containing the data e.g. first.rec
C.A file with the defined checks e.g. first.chk
Supplementary files , e.g. first. Not with notes taken during data entry or first.log with documentation.
5.Document Data
After creating the data file you can document file structure.

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And after entering data you may list values for some or all records or you could view the data with or without
labels in a spreadsheet .
A code book can include raw frequency tables.
6.Export for analysis and securing data.
Export the data for analyses or back up all files associated with a data set to a selected user defined back up
folder. When exporting data to Stata you should select Export’s lowercase option.

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Conclusion and Recommendations
Recommendations to the University
The B. Sc. Honors Degree in Statistics program should cover more practical work to brace the students for
challenging tasks in the actual research and statistical world.
There is need for the department to liaise more with industry in sourcing placements for students going for
work-related learning .This has to be so as it is rather difficult to secure a place for attachment purposes.
The university should allow for greater diversity for most programs like for example a statistics program should
allow for flexibility of shopping in commerce, sciences, health and arts faculties. Most researches now include
economic and health substance and this requires knowledge of economic business and health modules. This
will also go a long way in marketing the University for producing professionally competent personnel.
Most of the modules done in the statistics department are more theoretical than they are practical. I would
recommend more practical modules be introduced in order to brace the students on the practical aspect of
mathematics. This makes it easier for students when they go for attachment. If possible, more statistical
packages should be taught since different organizations have different packages that they use and if the student
is accustomed to one or two packages it might be a challenge.
Recommendations to the PSI/ZIM
My stay at PSI/Z has been much appreciated as I have managed to gain professional experience that will go a
long way in the nurturing of business and leadership skills.

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I understand this was the first time the organization took interns who are still students in local university, I
would recommend for this to continue as I have seen the platform to be very effective in acquiring professional
experience.
CONCLUSION
I managed to settle down with much ease at the Population Services International/Zimbabwe and experience
gained is worth the stay at the organization. I now have knowledge about the statistical field and my future
carrier is to be based on this informed decision. It has been a pleasure for me to attain numerous skills and
contemporaries during the period of my work-related learning period at this wonderful organization.
There are a lot of theories that I found myself constantly referring to with what I learnt in Statistical inference,
Applied Statistics, Survey Methods and Sampling theory , Time Series , Statistical Computing and Regression
Analysis. I was in a better position to quickly adapt to the statistical processes and techniques applied here at
PSI/Z since l was writing the Program reports.
Work-related learning is meant to expose students to activities in the industry, at the same time preparing them
to the working environment. My industrial attachment at the Population Services International/Zimbabwe was
an eye opener. It went a long way in enriching my knowledge of the application of statistics in both the local
and international markets.

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Appendix
Questions on the CIR Form
VMMC Client Intake Form
Date of Visit: _______________________Facility: _____________________________ Facility Code: _________________________
MC Client Number (year/prog/5 digit number)______________________ District: ________________________Province:
________________________
PERSONAL DETAILS
Client Name: _____________________________________________
National ID: _____________________________________________
D.O.B: __________ Age: _________(years)
dd/mm/yy
Client’s Physical Address (Residence/Village):
________________
________________
Client Tel: Home: ______________________________________
Mobile: ______________________________________
Work: ______________________________________
Alternate Address:
Work School Friend/next of kin
Address: ________________________________________________
Alternate Tel: ___________________________________________
Name of friend/next of kin:__________________________
FACILITY
Type of Site/Service (tick appropriate):
Static site Outreach Site
Mobile______________________________________
How did client learn about the service?(Tick all that apply)
Friend/family Partner/Spouse
Health worker Poster/newspaper/leaflet
Other client Community mobilizer
TV/radio Other (Specify) _________________
INDIVIDUAL COUNSELING
Primary reason for circumcision:
Partial HIV protection Sexual pleasure
STI protection Medical
HIV Status
Known HIV+:
If HIV positive client indicate WHO HIV clinical stage (I- IV)

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Appearance Hygiene
Cultural/social/religious Other (specify) _______
……………………………………………….
If HIV positive indicate CD4 cell count……………………….
HIV Test done for MC: HIV Test
result:
Positive Negative Unknown
MEDICAL SCREENING/PHYSICAL EXAMINATION
Any allergies?
Yes No
If yes, specify:____________________________________________
________________________________________________
Have you ever been diagnosed with any of the following?
Cancer
Hypertension Hemophilia/bleeding disorder
Diabetes Mellitus Peripheral vascular disease
Heart condition
Lung condition
Thyroid
Any other(Specify)…………………………………
Are you currently taking any medications
If yes, specify:____________________________________________
________________________________________________________
Have you ever had an operation?
If yes, specify:____________________________________________
________________________________________________________
Do you have any of the following complaints?
Urethral discharge
Genital sore
Painful/weak erection
Swelling of the scrotum
Pain on urination
Difficulty in retracting the foreskin
Others:(specify)_________________________________________
General condition:
Healthy Ill looking
Yes No
Pallor
Lymphadenopathy
Wasting
Jaundice
Dehydration

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Genital: Yes No Yes No Yes No
Phimosis Paraphimosis Epispadias
Hypospadias Genital Ulcers Genital warts
Balanitis Torsion of the penis Adhesions
Posthitis Urethral discharge Others:
If Other, describe: _____________________________________________________________________________________________________
CIRCUMCISION METHOD ELIGIBILITY
Informed Consent Granted (with parental signature if under age 18):
No
Client is eligible for which circumcision method (check all that apply):
Surgical circumcision PrePex circumcision Neither: Reason:_______________________________
Of the appropriate methods, the circumcision method chosen by client (check one):
Surgical circumcision PrePex circumcision
If PrePex, complete PrePex Circumcision Section. If surgical VMMC, complete Surgical Male Circumcision Section
CIRCUMCISION PROCEDURE:
Date of Procedure/Placement/Removal: ________________
Circumciser’s Name(Dr, Nurse): ________________
Assistant’s Name: (Dr , Nurse) ______ _____________
Vital signs: Weight (kg)____________ Blood Pressure______ /______ mmHg Pulse ________________b/min
Surgical Male Circumcision PrePex Male Circumcision
Procedure Type:
-guided Other (specify): ___________________
Anaesthesia: ________ Time given:_____________
Local anaesthetic ………………..mls 1% lignocaine plus …………….mls
0.5% Marcaine
Start of Operation (time): ___________________________
End of Operation (time): ____________________________
Device Size
Device Batch ID #:
Placement of ring :Date……………………….Time…………………………….
Removal of ring; Date……………………… .Time…………………….………..

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Clinical Notes: _______________________________________________________________________________________________________
____________________________________________________________________________________________________________________
Adverse Events During Procedure
Client had NO adverse event(s) diagnosed during placement visit (skip to post-procedure assessment)
Client had adverse event(s) diagnosed during placement visit (prior to discharge):
Mild Moderate Severe Severity not Classified
Pain(A-PA)
Bleeding(A-BL)
Anesthetic-related problem(A-AN)
Damage to penis(A-SD)
Excess skin removal(A-SD)
Difficulty with placement
Device malfunction
If any AEs occurred, describe AE management: ____________________________________________________________________________
____________________________________________________________________________________________________________________
Post-Procedural Assessment (before discharge)
Vital signs:
Blood Pressure______ /______ mmHg
Pulse ________________b/minDressing or PrePex device
appropriately placed:
Yes No
Client provided post-procedure written instructions:
Oral analgesia given:
Yes, Drug:___________________ No
General condition: _________________________________
Date of next scheduled visit: ________________________________
Discharged by:____________________________________________

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Yes No, explain: ____________________________
Client given MC Client Card and instructed to return for next follow-
up visit:
Yes No
Signature: _______________________________________________

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Day two post-op visit(For surgical male circumcision)
Indicate Date
Indicate name of nurse/doctor
. Any complication Yes NO
If yes, indicate grade of adverse event ( mild, moderate, severe)
Additional review date(For surgical male circumcision)
Indicate Date
Any complication Yes NO
Seven days post-op visit(For surgical and PrePex)
Indicate Date
.If yes, indicate grade of adverse event ( mild, moderate, severe)
.Additional review date (For surgical and PrePex)
Indicate Date
Forty two days(Surgical) post-op visit or forty nine days(PrePex)
Indicate Date
If yes, indicate grade of adverse event ( mild, moderate,
severe).
Indicate if wound healing is complete Yes No
Patient started sexual activity Yes No
If Yes, indicate since when post op

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STANDARD MEDICAL PROCEDURE
VMMC
PREPARATION
1. Gathers all needed equipment
2. Greets the client and/or parent(s) respectfully and with kindness.
3. Describes his/her role in the male circumcision procedure
4. Asks the client or parent(s) if they have any questions they wish to ask about the procedure
5. Reviews the client’s records (history, examination findings, laboratory reports)
6. verifies the client’s identity and checks that informed consent was obtained
7. Checks that the client has recently washed and rinsed his genital areas
PREOPERATIVE TASKS
1. Prepares instrument tray and open sterile instrument pack without touching items
2. Asks the client to lie on his back in a comfortable position
3. Covers the patient to maintain dignity
4. Washes hands thoroughly and dry them with a clean dry towel
5. Puts on a sterile gown or apron.
6. Puts on two pairs of sterile gloves
7. Applies antiseptic solution (e.g. Betadine solution) twice to the genital area.
8. Retracts the foreskin and cleans with antiseptic appropriately
9. Removes the outer pair of gloves
10. Applies a center “O” drape to the genital area and pulls the penis through the “O” drape
11. Performs a gentle examination of the external genitalia
12. Performs a subcutaneous ring block or a dorsal penile nerve as per protocol
13. Checks the anaesthetic effect of the nerve block and tops up as needed
14. Throughout the procedure reassures the client

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SURGICAL PROCEDURE
1. Performs surgical procedure as per protocol
POST-OPERATIVE TASKS
1. Correctly performs infection prevention procedures
2. Washes hands thoroughly and dries them with a clean dry towel
3. Observes the client’s vital signs and record the findings
4. Answers the client’s questions and concerns
5. Advises the client on postoperative care of the penis
6. Observes the client’s vital signs and record the findings
7. Once stable, discharges patient on mild analgesic
8. Completes operation notes and other client record forms
References
1. WHO, Male Circumcision Services: QA Toolkit 2009
National Report Executive summary
Zimbabwe Voluntary Medical Male Circumcision Program Monthly Report for December 2015
1. VMMC Service Delivery Highlights
 A total of 14,045 clients accessed VMMC service this month. This represents a 11% decrease as
compared to November (15,745 clients) and a 3% increase as compared to the same period last year

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(13,697 clients). The month’s total of 14,045 clients circumcised represents a 76% achievement against
a target of 18,600.
 A cumulative total of 183,592 clients have been circumcised so far this year and this represents 102% to
the annual national target of 180,000.
 This month's contribution brings PSI supported district's contribution to the national total to 541,092
clients since program inception. Harare province recorded 1,271 (9% of month's total), Bulawayo
circumcised 543 (4% of month’s total), Matebeleland North recorded 1,635 (12% of month's total),
Matebeleland South circumcised 1,044 clients (7% of month's total), Mashonaland Central recorded
2,233 (16% of month’s total), Mashonaland West circumcised 1,941 (14% of month’s total).
Mashonaland East recorded 1,587 clients (11% of month's total), Manicaland circumcised 914 clients
(7% of month’s total), Midlands circumcised 1,204 clients (9% of month's total) while Masvingo
recorded 1,673 clients (12% of the month's total).
 Uniformed forces VMMC teams: Ten uniformed services teams contributed a total of 2,150 clients
(15% of month's total) to the national total this month. Manyame in Harare circumcised 173 clients
(8% of UF month's contribution); Imbizo Barracks in Matebeleland North circumcised 217 clients (10%
of UF total); Whawha Prison(Midlands) circumcised 143 clients (7% of UF total) ; Thornhill in
Midlands recorded 389 clients (18% of UF total); 3 Field Ambulance in Manicaland circumcised 57
(3%of UF total); 2 Brigade in Harare circumcised 101 clients (5% of UF total) ; ZPS Harare Central
circumcised 301 clients (14% of UF total) ; while 4 Bridgade in Masvingo circumcised 196 clients (9%
of UF’s total ) ; Gwanda prison (Mat South) and Khami Maximum circumcised 281 clients (13% 0f
UF’s total).
 PrePex: Of the 14,045 clients circumcised this month, 2,214clients (16% of month's total) opted for the
PrePex MC method. This is a 19% decrease as compared to the previous month when 2,746 clients were
circumcised using the PrePex method and brings the cumulative total to 17,624 clients. The increase can
be attributed to more teams being trained and the delivery of commodities to sites. The Bulawayo MC
Clinic circumcised 156clients (7% of PrePex total) client, Harare City Centre circumcised 260 clients
(12% of PrePex total), Lobengula 41 clients (2% of PrePex total), Shurugwi circumcised 45 clients (2%
of PrePex total), Gweru Provincial Hospital circumcised 37 clients (2% of PrePex total), ZNFPC
Spilhaus circumcised 51 clients (2% of PrePex total). The Mutare Provincial Hospital circumcised 49
clients (2% of PrePex total), Beitbridge Hospital circumcised 186 clients (9% of PrePex total), Kadoma
Hospital circumcised 51 clients (2% of PrePex total), Gwanda Prison circumcised 156 clients (7% of
PrePex total) ; Harare City Health circumcised 69 clients (3% of PrePex total) ; Mt Darwin Hospital

46 | P a g e
circumcised 251 clients (12% of PrePex total) ; Bindura Provincial Hospital circumcised 47 clients (2%
of PrePex total) ; Marondera Provincial Hospital circumcised 103 clients (5% of PrePex total) ; Karoi
District Hospital circumcised 18 clients (0.8% of PrePex total) ; Mtshabezi Mission Hospital
circumcised 2 clients (0.1% of PrePex total) , Concession Hospital circumcised 32 clients(2% of prepex
total) , Mvurwi Hospital circumcised 64 Clients (3% of prepex total) , Kwekwe General Hospital
circumcised 31 clients (1.4% of prepex total) , Chipinge Hospital circumcised 44 clients(2% of prepex
total) , Rusape Hospital circumcised 29 clients (1% of prepex total) ,Esigodini Hospital circumcised 6
Clients(0.3% of prepex total) ,Father O’hea Hospital circumcised 12 clients(0.6% of prepex total)
,Chivhu District Hospital circumcised 22 clients (1% of PrePex total) , Nkayi circumcised 58 clients
(3% of PrePex total) , Murehwa Hospital circumcised 59 clients (3% of PrePex total) ,
Khami(Umguza) circumcised 188 client (9% of PrePex total) , Shamva circumcised 47 clients (2% of
PrePex total) , St Michaels Hospital circumcised 4 clients (0.2% of PrePex total) , Nhowe Hospital
circumcised 13 clients (0.6% of PrePex total), Ruwa Rehabilitation Hospital circumcised 10 clients
(0.5% of PrePex total) , Howard Hospital(Mazowe) circumcised 10 clients (0.5% of PrePex total) ,
Chinhoyi Provincial Hospital circumcised 1 client (0.01% of PrePex total), Masvingo Provincial
Hospital circumcised 12 clients (0.6% of PrePex total), Manama Provincial Hospital circumcised 6
clients (0.3% of PrePex total), and 3 field Ambulance Hospital circumcised 10 clients (0.5% of
PrePex total) .
 A total of 6,385clients (45% of total) were circumcised using the forceps guided method; 5,446 clients
(39% of total) were circumcised using the dorsal slit method and 2,214 clients (16% of total) opted to
be circumcised using the PrePex method this month.
 VMMC Training:
No trainings were done this month.
 Demand creation:
Of the 14,045 clients who accessed VMMC services in December, implementing partners (IPs)
mobilized and recruited 10,398 clients and this is 74% of the month's total. PSI Community Mobilizing
Officers (CMOs) and district service delivery teams contributed 3,111 clients (22% of month's total
clients circumcised). A total of 447 (3% of month's total) clients were circumcised and reported as walk-
in clients. Village health workers recruited a total of 218 clients (1% of month’s total clients

47 | P a g e
circumcised). During the month the following activities were conducted in order to reach care givers and
potential VMMC clients: Community dialogues, Sensitisation meetings, IPC sessions and Community
soccer. Benefits of VMMC and availability were discussed during these sessions with the objective of
recruiting clients for VMMC as well as community buy in. A total of 90,469 individuals (52% target
achievement) were reached with VMMC messages during community mobilization activities and the
conversion rate is at 1:6. Cumulatively January to date a total of 646,714individuals was reached with
key messages on VMMC.
Company, Partners and Funders logos
Company Costs and Expenses

48 | P a g e

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