Background: Namibia''s Ministry of Health and Social Services (MOHSS) prioritizes voluntary medical male circumcision (VMMC) as a core intervention to avert new HIV infections. To achieve this goal, the country set out to conduct 330,218 procedures among men by 2021. Khomas Region, where the capital Windhoek is situated, has a population of 386,000 and a set VMMC target of 47,000. However, the region has only one public VMMC site. Uptake of VMMC services was therefore low, and innovative approaches to reach targets, including partnership with the private sector, were required.
The USAID-funded Strengthening High Impact for an AIDS-free Generation (AIDSFree) Project provides assistance to private for-profit health providers and stakeholders to increase access to and affordability and quality of HIV services, with an emphasis on VMMC.
Description: AIDSFree had a network of 32 private health facilities in Windhoek. These facilities were providing VMMC services only to clients with health insurance or those who could afford to pay out of pocket. To increase VMMC coverage in Windhoek, AIDSFree partnered with the Khomas VMMC regional team to pilot and introduce free VMMC services for uninsured males at private health facilities. The free services were introduced in October 2016 and are funded by USAID.
A service-level agreement was reached to reimburse facilities for the provision of the VMMC service package. Additionally, the facilities were supported with disposable kits, recordkeeping, and reporting. Finally, the Khomas regional VMMC team and AIDSFree undertook joint demand creation activities to encourage clients to access services.
Between October 2016 and September 2017, Khomas Region conducted 8,846 circumcisions; of these, 81% (7,172) were in private sector facilities.
Lessons learned:
· Private clinics reported providing more VMMCs to clients on the free program than to clients with insurance.
· The free VMMC program currently meets the needs of uninsured males.
· Engaging the private sector through a free VMMC program accelerates the achievement of national targets.
Conclusions/Next steps: Namibia has a well-developed, robust private health sector whose potential is not fully utilized. Private facilities are well-positioned to partner with the government to provide VMMC services beyond their regular health insurance clients.

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