FACTORS ASSOCIATED WITH PARENTS' DECISION TO CIRCUMCISE MALE CHILDREN AGED 0-5 YEARS IN NANGABO SUB-COUNTY, WAKISO DISTRICT, UGANDA: A COMMUNITY SURVEY
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Introduction: Circumcision is the surgical removal of the foreskin from the penis. Various studies have demonstrated the impact of circumcision in reducing the transmission of Sexually Transmitted Diseases, including HIV, viruses like HPV and diseases like balanitis and UTIs, among others. The best age to carry out the procedure is still an issue of debate, with some suggesting the infancy period due to faster wound healing, parents being able to take care of the wound and less complicated procedure, while others suggested when the child is older/an adult because they can then make an independent decision and take care of the wound themselves. After various efforts to scale up the number of circumcised males in Uganda have reached a stagnant phase, efforts are now being turned towards promoting SMC in early childhood. However, there is paucity of data on the factors influencing parents’ decision to circumcise their children during this period, and this is what this study sought to address. Methodology: This was a cross-sectional study, involving both qualitative and quantitative components of data collection. The study was carried out in six parishes in Nangabo Subcounty, located in Wakiso District. Parents of male children aged 0-5 years were interviewed using a semi-structured questionnaire and a total of 4 FGDs with parents to circumcised and uncircumcised children were carried out. Results: The prevalence of circumcision among the male children aged 0-5 years was 53.8%. Health facility circumcision was the highest at 76.1% followed by home circumcision at 22%. The main reasons for the decision to circumcise during childhood included; reduced/less infections (28%), ensures health (17.1%) and heals fast (16.6%). Among those who had not circumcised the main reasons for this decision were; child is still young (24.4%), not aware of benefits of circumcision (20%) and lack of a nearby health facility (15%). Among all the respondents, 73.9% were aware of the benefits of circumcision. Parents who had circumcised cited cleanliness (31.5%) and less infections (31.5%) as benefits and complications as increased risk of infections (48.9%) and failed healing of the wound (37.3%). Parents of uncircumcised children cited benefits as cleanliness (30.5%) and less infections (27.3%) and main complications as failed healing of the wound (51.7%) and reduced sexual ability in adulthood. The major barrier to circumcision was the poor follow-up after circumcision was carried out at the health facility. These findings were backed up by the qualitative results. Circumcision status of the child’s father and siblings was the main influencer of the decision to circumcise the child. Education was found to have no effect on the decision to circumcise. Conclusion: The study found a relatively high prevalence of childhood circumcision, and that the major factor influencing parents’ decision to circumcise their children was the circumcision status of the child’s father. It further demonstrated that there is sufficient knowledge and a good attitude towards childhood circumcision. It is therefore possible to increase the prevalence of childhood circumcision if the few barriers are adequately addressed and proper sensitization on the complications of circumcision is properly done.