2012. 12 p.
Schenk, Katie
Friedland, Barbara A.
Apicella, Louis
Sheehy, Meredith
Munjile, Kelvin.
Hewett, Paul C.
Periodical title: 
Vulnerable Children and Youth Studies: An International Interdisciplinary Journal for Research, Policy and Care, Volume 7, Issue 2, 2012
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The authors present data from operations research into the introduction of male circumcision (MC) in Zambia, assessing informed consent (IC) procedures for adolescent MC clients. They administered a comprehension test among adult (n=311) and adolescent (n=115) clients at 10 clinics around Lusaka between the counseling and IC process. They conducted semi-structured interviews with adolescent (1317 years) MC clients 1 week post-surgery (n=28) and 13 key informants (service providers and stakeholders). They conducted six focus group discussions (FGDs) among 36 parents/guardians, half who had chosen MC for their sons, half who had not. Data reveal complex interactions between adolescent and parents/guardians regarding making and authorizing the decision to circumcise. Although comprehension was generally high, adolescents scored significantly (p < 0.05) lower than adult clients on two questions, reflecting their difficulty in understanding the key concepts associated with MC. Adolescent clients were significantly less likely than adult clients to report feeling comfortable with the decision to undergo MC (44% vs. 13%, p < 0.05). Qualitative data indicate that IC procedures for minors are poorly understood and inconsistently implemented at clinic sites, at a time when regulation was changing. The disparity between IC procedures for research and for surgery limits study findings; however, the authors underscore the importance of creating an environment in which human rights abuses are prevented. They recommend that service providers take steps to strengthen the IC process for minors, including training providers and publicizing consent requirements in community outreach activities.
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