Cost comparison of the ShangRing device versus Mogen clamp for early infant male circumcision in Sub-Saharan Africa.
Nahid Punjani, Tenny R Zhang, Spyridon P Basourakos et al.
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In 30 seconds
This cost comparison alongside a randomized controlled trial assessed early infant male circumcision using the ShangRing (SR) versus the Mogen clamp (MoC) among infants aged 0–60 days in Kenya, Tanzania, and Uganda. Among 1,378 infants, 689 received each device. Per-procedure costs varied by country: SR cost $61.30, $47.14, and $64.59 in Kenya, Tanzania, and Uganda, respectively; MoC cost $56.38, $50.43, and $58.57. Overall, the authors judged costs comparable. Modeling found infant circumcision less costly than circumcision at age 15 in Kenya, but not in Tanzania or Uganda.
Key findings
- The trial included 1,378 infants: 689 underwent circumcision with the ShangRing and 689 with the Mogen clamp.
- In Kenya, Tanzania, and Uganda, ShangRing costs were $61.30, $47.14, and $64.59 per procedure; Mogen clamp costs were $56.38, $50.43, and $58.57.
- In 2023 nominal costs, infant circumcision was less expensive than waiting until age 15 in Kenya; the comparison was reversed in Tanzania and Uganda.
Why it matters
Cost is relevant to planning early infant circumcision programmes intended to contribute to HIV prevention. These findings suggest that the relative costs of the two devices are broadly comparable, while the economic case for circumcision in infancy versus adolescence differs across the three countries. Local costs and the timing of service delivery therefore matter when assessing programme options.
What to keep in mind
The cost estimates come from three countries and may not represent costs in other settings. The comparison with adolescent circumcision was modeled rather than a direct comparison of observed adolescent procedures.