Evidence map›Paper›PMID 40638679›Full record

ArticlePLOS global public health2025

Integration of a vertical voluntary medical male circumcision program into routine health services in Zimbabwe: A solution for sustainable HIV prevention.

Amanda Marr Chung, Joseph Murungu, Precious Chitapi, Rudo Chikodzore, Peter Case, Jonathan Gosling, Roly Gosling, Sinokuthemba Xaba, Getrude Ncube, Owen Mugurungi and 3 more

Abstract read
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Amanda Marr ChungDepartment of Medicine, Stanford University, Stanford, California, United States of America.ORCID https://orcid.org/0000-0003-4443-9616
Joseph MurunguInstitute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America.
Precious ChitapiPrecious Innovations, Ubuntu Global Charitable Trust, Harare, Zimbabwe.
Rudo ChikodzoreUNICEF, Harare, Zimbabwe.
Peter CaseCollege of Business, Law and Governance, James Cook University, Townsville, Australia.ORCID https://orcid.org/0000-0003-1214-8371
Jonathan GoslingBristol Business School, University of West of England, Bristol, United Kingdom.ORCID https://orcid.org/0000-0003-2613-4237
Roly GoslingInstitute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America.
Sinokuthemba XabaHIV and TB Programme, Ministry of Health and Child Care, Harare, Zimbabwe.
Getrude NcubeHIV and TB Programme, Ministry of Health and Child Care, Harare, Zimbabwe.
Owen MugurungiHIV and TB Programme, Ministry of Health and Child Care, Harare, Zimbabwe.
Patience KunakaHIV and TB Programme, Ministry of Health and Child Care, Harare, Zimbabwe.
Stefano M BertozziSchool of Public Health, University of California, Berkeley, California, United States of America.
Caryl FeldackerDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The global health community has recognized the importance of integrating and sustaining health programs within national health systems rather than managing stand-alone 'vertical' interventions. Corresponding with these objectives, international aid donors are embracing the principle of localization. Voluntary Medical Male Circumcision (VMMC) in Zimbabwe is a large vertical HIV prevention program that was primarily funded through development assistance for health. Program stakeholders want to sustainably integrate VMMC into routine health services so that the program will continue to be a cost-effective HIV prevention strategy. The research team studied the effectiveness of a district-level intervention to empower local stakeholders in this integration effort. To evaluate this intervention, the research team conducted a document review of district-level work plans, combined with a survey administered to district teams assessing sustainability capacity of the program. Over a two-year period, Task Teams in all five intervention districts successfully integrated the VMMC program by reducing barriers and leveraging opportunities in other parts of the health system. Key outcomes impacted all WHO health system building blocks, including enhanced leadership and governance, improved service delivery through better access and acceptability, an expanded health workforce through training, more efficient use of medical technologies, improved data quality, and the mobilization of local funds to support program financing and sustainability. The sustainability survey showed a reduction in funding stability but a significant increase in communications, program adaptation, and organizational capacity. By institutionalizing participatory work planning, fostering local ownership, and mobilizing resources, the project demonstrated a successful model for integrating, scaling, and sustaining VMMC services. Other health programs in low- and middle-income countries seeking to integrate and sustain health services at subnational levels should consider this diagonal, bottom-up model to promote local leadership development and health system strengthening.

Identifiers

PMID40638679
PMCPMC12244533

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.