Abstract
Background
Kenya’s VMMC program needed to transition from donor-funded scale-up to sustainable, domestically supported maintenance.
Methods
Three models (static, mobile, mixed) were piloted in Siaya and Migori counties targeting boys aged 10–14. Metrics included service uptake, unit costs, and stakeholder perceptions.
Results
Mixed models outperformed others in both uptake and cost efficiency. Community engagement declined, while domestic financing for service provision remained low.
Conclusion
Sustainability-focused models can maintain high circumcision coverage at reduced cost. However, securing local financing remains a major challenge.
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