Male circumcision: care practices and attitudes in a Muslim community of western Nepal

Abstract

Background: Male circumcision is a removal of the foreskin of the glans penis. There are medical, ritual
and religious reasons for male circumcision. The purpose of this study is to explore the current practices,
perceptions, future recommendations and health seeking behavior during and after performing male
circumcision in a Muslim community of western Nepal.
Method: A total of 64 households were sampled by a simple random sampling method. Information was
collected using semi-structured questionnaires and focus group discussions.
Result: Circumcision was practiced among all Muslim households and the main reason was religious rite
and ritual. It was the traditional circumciser, locally known as hazam, who circumcised all male children in
the community. Interestingly, in only 5 % of the household children had been circumcised using modern
medicines. The rest of the households, i.e. 95%, relied on traditional healing systems, the use of local herbs
and homemade ointments (mainly the suspension of ghee and ash). A Non-sterilized knife was the main
surgical instrument used during circumcision. The wound healing after circumcision was much longer, even
up to 90 days or more.
Conclusions: Circumcision is a practice that is still largely carried out outside the domain of the formal
health care system in this community. It demands a design of service delivery models from health policy
makers in the Ministry of Health, thus bringing circumcision within formal health care systems in those
communities. It deserves an urgent attention to provide safe, culturally acceptable and sustainable services
from health institutions.