Voluntary Medical Male Circumcision in Nyanza Province, Kenya

This case traces the development of a voluntary medical male circumcision (VMMC) campaign into national policy in Kenya. Beginning with background information on the cultural, political, and scientific context surrounding male circumcision, the case then traces advances in a United States President's Emergency Plan for AIDS Relief (PEPFAR)-funded implementation effort to deliver male circumcision in Nyanza Province in Kenya, and the progression from randomized clinical trial to national policy. The case examines the various delivery models used in Nyanza how relationships evolved between those parties involved in its implementation into practice, and the development of the national strategic plan for VMMC released in 2009. The case ends with the implementers having come together successfully for two rapid, aggressive, 30-day implementation campaigns, as the head of Kenya's National AIDS and Sexually Transmitted Infections Control Programme wrestles with how to make such campaigns sustainable and what lessons from the campaign to pass on to the national program.

Learning Objectives: To understand how a randomized controlled trial may be translated into a large-scale public health program; how a surgical campaign was designed and implemented for rapid impact; the role of national and international collaboration in large-scale health delivery; and the ethical tradeoffs that arise in large-scale public health programs.

The Global Health Delivery (GHD) Project, an interdisciplinary collaboration between Harvard Business School, Harvard Medical School, and Brigham and Women’s Hospital, investigates the management decisions behind disease treatment and prevention globally. The Global Health Delivery (GHD) Case Collection is a set of teaching case studies that are available for all at no cost online through Harvard Business Publishing, GHDonline, and The Case Centre.