The use of peer referral incentives to increase demand for voluntary medical male circumcision in Zambia

Abstract

The International Initiative for Impact Evaluation (3ie) is an international grant-making NGO promoting evidence-informed development policies and programmes. We are the global leader in funding, producing and synthesising high-quality evidence of what works, how, why and at what cost. We believe that better and policy-relevant evidence will make development more effective and improve people's lives. 3ie impact evaluations3ie-supported impact evaluations assess the difference a development intervention has made to social and economic outcomes. 3ie is committed to funding rigorous evaluations that include a theory-based design, use the most appropriate mix of methods to capture outcomes and are useful in complex development contexts. About this report3ie accepted the final version of this report, The use of peer referral incentives to increase demand for voluntary medical male circumcision in Zambia, in November 2015 as partial fulfilment of requirements under grant TW3.16 issued under Thematic Window 3. The content has been copy edited and formatted for publication by 3ie. All of the content is the sole responsibility of the authors and does not represent the opinions of 3ie, its donors or its Board of Commissioners. Any errors and omissions are also the sole responsibility of the authors. Authors' affiliations listed in the title page are those that were in effect at the time the report was accepted. Any comments or queries should be directed to corresponding author Arianna Zanolini at azanolini@air.org. AcknowledgementsResearch discussed in this publication was funded by the International Initiative for Impact Evaluation (3ie).We thank the research assistants for this study, Bestone Munkombwe, Caren Siasimuna, Chimuka Siamatendu and Lweendo Muletambo, for their excellent research assistance. We also thank the male circumcision provision team at the Centre for Infectious Disease Research in Zambia (CIDRZ), in particular Christine Matoba, Bright Jere, Nelson Musonda, Inambao Ilubala, Gershom Mawele and all of the providers supported by CIDRZ for making male circumcision happen, and for working with us during the study and adapting their work to accommodate the study needs. We also thank Carol Njovu for administrative assistance and Dr Savory for help coordinating and advice along the way. Particular thanks go to Mr Maphiri, who helped us with the initial sensitisation meetings and has given us enthusiasm.We thank Society for Family Health for their collaboration and insights and for providing us with the data on male circumcisions.Finally, we thank all of the Southern Province Provincial Medical Office and the district health officers involved in the study, in particular Dr Musonda (Monze), Dr Habasimbi (Pemba), Dr Chilembo (Sinazongwe), Mr Mulengula (Mazabuka) and Dr Chibwe (Kalomo) for having welcomed the study in their districts. We also thank the participants in the Male Circumcision Technical Working Group for the initial feedback.ii Summary BackgroundMedical male circumcision is a promising HIV preventio...