Acceptability of medical male circumcision among men in Engela district of the Ohangwena region, Namibia
This study focused on acceptability of medical male circumcision (MMC) in Ohangwena region, Namibia. Since the scaling up of this program in public hospitals, no study was done with a specific focus on men who are the target population for this intervention. This study aimed at exploring the role of masculinities in MMC acceptance and specifically focused on circumcised men. To understand this context, I initially focused on general constructions of masculinity as well as the historical background of ritual circumcision which used to be practiced in this region. I spent three months at Engela District Hospital working with the male circumcision (MC) regional coordinator who is also the MC Nurse at the same hospital. Data collection process utilised an ethnographic study design involving qualitative research methods namely participant observation, formal and informal interviews and the use of field notes. Participants included men who visited the hospital for circumcision procedure, health workers and community elders. Findings indicate that, circumcision that is now offered in hospital settings is not a recognised marker of masculinity in Ohangwena. There is also paucity of information regarding traditional circumcision. Since its abolishment in the eighteenth century, little is known about the history of this practice. Contemporary means of being a man in this setting are situated in everyday circumstances and include work, being strong, independent and ability to fulfil family responsibilities. Thus, in this context notions of masculinity do not determine men’s responses to MMC. Instead, men are motivated by health benefits in accepting MMC. MMC’s proven ability to reduce HIV transmission by 60% is the primary reason why most men are willing to be circumcised. Other reasons include genital hygiene and correction of medical conditions related to the foreskin such as ulcers and lacerations. Men’s knowledge and understanding of the relationship between MC and HIV prevention also plays a role in MMC acceptance. Some concerns that were raised by men in relation to this intervention are pain and discomfort, fear of complications, decreased penile sensitivity, transfer of untruthful information and gender of circumciser. I regard these concerns as barriers to MMC acceptance. This thesis also argues that, the manner in which MMC is performed out in public health facilities in not gender sensitive since it is mostly done by women. This act in my view is likely to make men feel emasculated and thus discourage other men from taking up this voluntary service. This study therefore recommends similar research in other contexts to challenge speculations made about the likely impact of MMC on masculinity, because, in my research, uptake of MMC has nothing to do with constructions of manhood. I further recommend provision of standardised equipments and resources including human resources for efficient provision of this program countrywide.