Background: Evidence shows that a large number of males would have to undergo VMMC in order to have a population level impact on HIV prevalence in South Africa. The challenge lies in increasing VMMC uptake in South Africa, especially in marginalised communities with limited healthcare facilities. Mobile clinics offering free VMMC services aim to increase uptake in hard-to-reach areas.
Description: The mobile clinic is a basic medical clinic inside a container van that travels directly to the community and remains static for a limited period of time, before moving to another area. The mobile clinic site was first located in Shoshanguve, Gauteng (October 2013-March 2014). After identifying areas where there was little to no VMMC coverage, the team moved to Mathibestad, Northwest Province (April 2014), and Parys, Free State, (July 2014). In Mathibestad, the mobile clinic is situated next to a public clinic.
Lessons learned: From 2013 to present, the mobile clinics program cumulatively circumcised 8151 males (see figure). The advantage of the mobile clinic is its mobility to move to and within communities. However, the mobile clinic remains static in the community as a result of the large size of the mobile clinic. This requires the outreach team to travel within the community and recruit clients, as well as offer transportation to bring clients to the mobile clinic site.

VMMC Procedures Performed Using Mobile Clinics
[VMMC Procedures Performed Using Mobile Clinics]

Conclusions/Next steps: Although mobile clinics have contributed to VMMC uptake, the effectiveness of the mobile clinics would increase by using smaller mobile clinics that can move within the area, compared to large mobile clinics that remain static and therefore require transportation for clients. The relationship between the public healthcare facilities and mobile clinics is critical in ensuring that clients feel safe knowing that the public clinic is associated with the mobile clinic; as well as for referrals to the mobile clinic.