Thematic Window 3 Award Winners

3ie is pleased to announce seven awards for implementing pilot interventions and conducting impact evaluations of interventions to increase demand for Voluntary Medical Male Circumcision.

The awards have been made under 3ie’s Thematic Window 3.

This is the first time that 3ie is funding pilot interventions alongside impact evaluations. The aim here is to encourage ideas for new programmes that, once studied through rigorous impact evaluation, can add to the broader base of knowledge of what works. 

The pilot interventions that are being evaluated are all aimed at increasing demand for Voluntary Medical Male Circumcision (VMMC).

To read more about 3ie’s Thematic Window 3, click here.

Awards

Optimising the use of economic incentives to increase male circumcision demand: a randomized trial to compare fixed vs. lottery-based incentives in Kenya

Principal Investigators: Kawango Agot, Harsha Thirumurthy
Organisation: University of North Carolina at Chapel Hill

The study will use individual-level random assignment to test whether offering lottery-based incentives can increase VMMC uptake. Study participants will be uncircumcised men and will be visited at their homes or workplaces, informed about the study, and then randomly assigned to receive either a scratch card for a lottery with high-value prizes (lottery-based incentive); or a food voucher of KES 50 (US$ 0.60) (control group) -- if they come for VMMC. The sample size of the study is 900 uncircumcised men, 21-49 years of age.

Mobile phone short-text (SMS) platform ‘Zambia U-Report’ to increase demand for voluntary medicalized male circumcision among adolescents and young adults

Principal Investigators: Landry Tsague, Paul Wang
Organisation: Comprehensive HIV/AIDS Management Programme (CHAMP) and IDInsight

The study will randomly assign at least 2,500 existing 1,360 existing and newly recruited uncircumcised male participants between the ages of 15 and 30 into three arms: Routine (control), Conventional, and Tailored. An equal number of participants will be assigned to each arm. In the ‘conventional’ SMS intervention, promotional and educational messages will be sent to participants encouraging enrolees (called Ureporters) to undergo VMMC. In the ‘tailored’ SMS intervention, VMMC messages will be tailored to individual participant needs based on information received via SMS polls. All Ureporters will be able to ask questions to HIV counsellors via SMS at any time. The study participants will be recruited in Lusaka and Chongwe districts. The choice of districts will help in investigating how this programme works in both urban and peri-urban settings.

MCUTS II: Male Circumcision Uptake through Soccer in Zimbabwe

Principal Investigators: David A. Ross, Methembe Ndlovu, Jeff DeCelles
Organisation: Grassroots Soccer

This study seeks to pilot test the Make the Cut (MTC) intervention with adolescent males in government schools. The intervention involves a 60 minute, interactive, soccer-themed learning experience promoting male circumcision led by a trained, circumcised coach. This intervention has been previously implemented as a trial with an older target group. Based on qualitative research from the this Male Circumcision Uptake through Soccer (MCUTS) trial, the study will tailor the intervention for adolescent males as MTC+. The intervention will target adolescent males aged 14-19. In addition to the learning session and print material, it will introduce a small soccer-related incentive as well as phone based follow-up to the intervention. MCUTS II seeks to enrol 26 government secondary schools and approximately 1280 male students in Bulawayo to assess the effectiveness of MTC+. The schools will be randomized to either receive early (intervention group) or delayed (control group) delivery of the MTC+ intervention.

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

Principal Investigators: Harsha Thirumurthy, Arianna Zanolini, Carolyn Bolton, David Linyama, Lane-Lee Lyabola
Organisations: Centre for Infectious Disease Research in Zambia and University of North Carolina

The intervention to be implemented is a peer-referral incentive programme to increase VMMC uptake in Southern Province, Zambia. The intervention will allow men undergoing male circumcision in randomly selected intervention clinics to refer up to five uncircumcised men in their social network for male circumcision. The men will receive a monetary reward of 10 Kwacha (approximately US$ 2) for each person they refer who comes to the clinic for the male circumcision procedure.
To assess the impact of the intervention, the study will use a cluster randomized design in which clinics will be randomly selected to have a peer referral incentive programme or not. Seven clinics will be randomly assigned in the intervention group and seven clinics will be assigned in the control group. In each catchment area covered by one clinic, uncircumcised men will be selected for inclusion in the sample of the study.

Advertising for demand creation for Voluntary Medical Male Circumcision in South Africa

Principal Investigators: Nicholas Wilson, Sasha Frade, Dino Rech and Willa Friedman
Organisation: The Centre for HIV and AIDS Prevention Studies (CHAPS) and Reed College, USA

 

This study will evaluate the impacts on take-up of VMMC of four different postcard-based VMMC recruitment mechanisms relative to a basic VMMC postcard by using an individual randomised controlled trial. 

The four main VMMC recruitment mechanisms are: (i) a voucher for US$10 conditional on completing a VMMC consultation, (ii) a voucher for US$10 conditional on completing the VMMC procedure, (iii) information that 2 out of 3 partners of uncircumcised men prefer circumcised men, and (iv) information that 2 out of 3 partners of uncircumcised men prefer circumcised men framed by the statement, “Are you tough enough?”. 

With 9 different treatment arms, this would imply a needed total sample size of 5589, requiring 5589 postcards to be sent

Innovative demand creation for voluntary medical male circumcision amongst potentially high-impact male populations in Uganda

Principal Investigators: Alex Muganzi and Andrew Kambugu
Organisation: Infectious Diseases Institute

This study will seek to increase demand for VMCC services among potentially high-impact male populations (partners of pregnant women in the third trimester) in Uganda by involving their intimate female partners to deliver a customised behaviour change communication (BCC) message package to them. The pregnant women in the third trimester will be approached through three antenatal clinics which have a high number of clients.

The implementation of the intervention will comprise two phases. The initial phase will involve the delivery of a standard BCC message package by women to their intimate male partners . This will be followed by a second phase where a customised BCC message package that addresses barriers faced by men while seeking VMMC services will be delivered by their female intimate partners. The impact of these interventions will be assessed through a quasi-experimental approach to see if they result in increased demand for VMMC services among the targeted male populations.

Using smart phone raffles as a method to increase demand for male circumcision in Tanzania

Principal Investigators: Hally Mahler and Eva Bazant
Organisation: Jhpiego,Tanzania

The Bwana Mkubwa (big man) study is an experimental study that will be carried out in 14 health facilities—seven intervention facilities and seven control facilities, which draws upon the health belief model, where the barrier to action (social stigma associated with seeking VMMC as an adult) can be overcome through the use of a motivational incentive. In this case, the incentive would be a smart phone raffle, open to clients who are 20 years and above to achieve a 25 per cent increase in the number of adult men receiving VMMC services at routine service delivery sites. The study posits that the social boost of becoming a Bwana Mkubwa or a big man who owns a fancy phone, will overcome the short-term social stigma of seeking circumcision services. Additionally, health providers and peer promoters who successfully refer clients to the intervention sites will be entered into a separate monthly smart phone raffle—and the number of successful referrals to all Bwana Mkubwa sites both before and during the intervention period will be assessed to determine if the intervention affects the number of referrals.

Photo © Francesco, hdptcar, whiteafrican, Neil Rankin, Raising Voices/Cedovip, Nell Freeman, Naomi Key-Field

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