Circumcision practice among trained circumcisers in Ghana

Abstract

Background: In Ghana, circumcision is performed by both formal and informal health service providers (traditional circumcisers). Although circumcision-related morbidities are common with both formal and informal providers, they are more common among the formal health service circumcisers. This study evaluates circumcision practice by formal circumcision providers in Ghana.

Materials and methods: This was a cross-sectional study of circumcision practised by medical circumcisers in Ghana. A questionnaire was developed using Google forms and the link sent by email to trained medical circumcisers from all over Ghana. The questionnaire surveyed the demographics of respondents and their circumcision practice. Data was analysed with PASW Statistics for Windows, Version 28.0. Chicago: SPSS Inc.

Results: A total of 361 circumcisers completed the questionnaire, 80.5% females and 19.5% males. Most (69.8%) were 30 39 years old and the majority (73.3%) were midwives. Three hundred and fifty-eight (99.2%) of them offer pre circumcision counselling and 315 (87.3%) offer post-circumcision counselling. Only 44 (12.2%) circumcisers obtain informed consent, and 333 (92.2%) administer anaesthesia for circumcision. Penile block with Lidocaine was the most common (352; 97.5%) form of anaesthesia administered. The Gomco clamp technique was the most common circumcision technique used by 238 (65.9%) circumcisers, followed by the dorsal slit technique (190; 52.6%). Bleeding was the most common post-circumcision complication encountered.

Conclusion: Among healthcare personnel in Ghana, midwives perform the majority of circumcisions and there is a high rate of anaesthesia for circumcision. However, the circumcisers need to be encouraged to obtain informed consent for circumcision.