Female genital mutilation/cutting and birthing: Enhanced education and training is critical for health care providers

Lurie, Jacob; Kaur, Gunisha

doi:10.7189/jogh.12.03059

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…These socio-cultural factors shape the norms, values and experiences of women and could be incorporated in the development of woman-centred care guidelines ( 38 ). Moreover, the model does not explicitly address trauma-informed care, an approach that recognises the impact of trauma on the health and wellbeing of patients, particularly relevant in the context of FGM ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

Strengthening woman-centred care for pregnant women with female genital mutilation in Australia: a qualitative muti-method study

Turkmani,

Dawson

2024

Front. Glob. Womens Health

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Woman-centred care is a collaborative approach to care management, where the woman and her health provider recognise one another's expertise and interact based on mutual respect to provide adequate information and individualised care. However, woman-centred care has not been fully achieved, particularly for women who have experienced female genital mutilation in high-income countries. A lack of clear guidelines defining how to implement woman-centred care may negatively impact care provision. This study sought to explore the quality of point-of-care experiences and needs of pregnant women with female genital mutilation in Australia to identify elements of woman-centred care important to women and how woman-centred care can be strengthened during consultations with health professionals. This multi-method qualitative study comprised two phases. In phase one, we conducted interviews with women with female genital mutilation to explore their positive experiences during their last pregnancy, and in phase two, a workshop was held where the findings were presented and discussed to develop recommendations for guidelines to support woman-centred care. The findings of the first phase were presented under three distinct categories of principles, enablers, and activities following a framework from the literature. In phase two, narrative storytelling allowed women to share their stories of care, their preferences, and how they believe health providers could better support them. Their stories were recorded visually. This study highlights the importance of a comprehensive approach to woman-centred care involving experts, clinicians, community members, and women in designing education, tools, and guidelines.

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Section: Discussionmentioning

confidence: 99%

Strengthening woman-centred care for pregnant women with female genital mutilation in Australia: a qualitative muti-method study

Turkmani,

Dawson

2024

Front. Glob. Womens Health

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“…Service user outcomes detailed in our evaluation show the value of NHS services offering holistic, women-centred support in primary care. The relational methods used by the NHS staff in the pilot clinics formed the mechanisms by which trust is promoted, an essential component when working in a trauma-informed manner (Covington, 2007;Warwick-Booth & Cross, 2020;Lurie et al, 2022). However, the timing of deinfibulation remains a complex matter for survivors, with services needing to recognise that women require agency and choice in relation to procedures and their bodies (The FGM Sister Study 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the survivors interviewed in this evaluation all noted that they had not disclosed their FGM to anyone until they attended health appointments, indicating the prevalence of stigma as an ongoing challenge. Therefore, health care services need to operate carefully to ensure that they do no further stigmatise survivors and communities, nor retraumatise women seeking their support (Karlsen & Mogilincka, 2019;Lurie et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…Clinics were to be located in community settings for ease of access. The remit of the clinics was gender-specific focusing upon treating survivors only, and the model of care was trauma-informed, with a focus on holistic support, working in patient-centred ways, as well as the prevention of re-traumatisation (Lurie et al, 2022). The service specification (NHS England, 2018) drawn up by NHS England stated that women should expect to receive the following:…”

Section: Nhs Service Specification (Pilot Clinics)mentioning

confidence: 99%

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FGM (Female Genital Mutilation) Health Support for Non-Pregnant Women: Evaluation Findings From the NHS Pilot Programme

Warwick-Booth¹,

Starks²

2023

icgr

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There has been little progress in meeting the needs of non-pregnant women with FGM, who might seek medical help in the UK. The NHS funded eight FGM clinics for non-pregnant women across England, 2019-2021. The aim of our evaluation was to test how effective/capable these clinics were in meeting the health and wellbeing needs of women who are not pregnant but have experienced FGM. Our evaluation documented each of the various models of service delivery across the eight commissioned delivery sites, capturing evidence of what works to improve the health and wellbeing of women using these services. Within this we explored the importance of delivering clinics within community settings. We also examined the effectiveness of various staff roles (lead clinician, health advocate and therapist) across each clinic to understand the holistic approach used to deliver services. We captured the views of a small number of service users through individual interviews, to include their lived experiences of FGM and attending the clinic in our data. The main aim of the evaluation was to determine whether the clinics improved the health outcomes of non-pregnant survivors of FGM. This paper presents findings from the qualitative research component of the evaluation. Drawing upon interview data from 42 professionals as well as 12 service users, we summarise our key findings here. We detail the model of support (community service delivery, with trusted professionals, creating a safe space) and the learning gained from the pilot implementation. Positive outcomes include improved health and well-being for women (mental and physical health improvements). Challenges in service delivery included language barriers, how professionals reach into communities, the stigma associated with FGM as an experience, and mental health problems arising from FGM.

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“…Torture is associated with a wide range of chronic health conditions [ 3 , 4 ]. Pain and pain-related disabilities are the most common physical sequelae [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Treatments and interventions addressing chronic somatic pain in torture survivors: A systematic review

Oren,

Ercanli,

Maayan

et al. 2024

PLOS Glob Public Health

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Torture survivors experience chronic, somatic pain that may be exacerbated by environmental, social, and structural factors that extend beyond immediate traumatic events and diagnoses. We conducted a systematic review of research describing the types and efficacy of treatments for chronic somatic pain in a global population of torture survivors. In this systematic review, we searched Ovid MEDLINE, Ovid EMBASE (1974 to present), and PubMed. We used all appropriate controlled vocabulary and keywords for interventions and treatments for chronic somatic pain in torture survivors. The population included survivors of torture of any age and in any country. Outcomes included pain relief, pain intensity, distress level, and quality of life. Four authors participated in screening, full-text review, and quality assessment, with each title and abstract being independently reviewed by two authors. This study is reported according to the PRISMA guidelines and registered in PROSPERO. We included six pre-post intervention studies and four pilot or modified randomized controlled trials (RCTs), for a total of ten studies included in the analysis. Different combinations of interventions targeted pain reduction in refugees, the majority of whom were torture survivors as the primary (n = 1) or secondary (n = 9) outcome. Sample sizes varied from eight to 470 participants. We identified three main types of interventions: multimodal combined, manual therapy, and specific types of talk therapy. Five studies demonstrated positive outcomes on pain and its intensity, three reported no effect, and two had mixed outcomes. Pain in torture survivors is often considered a symptom secondary to mental health illness and not targeted directly. Instead, combined interventions are mainly directed at posttraumatic stress disorder (PTSD), depression, and anxiety. Most studies noted promising preliminary results and plans to conduct RCTs to increase the reproducibility and quality of their pilot data.

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Female genital mutilation/cutting and birthing: Enhanced education and training is critical for health care providers

Cited by 4 publications

References 7 publications

Strengthening woman-centred care for pregnant women with female genital mutilation in Australia: a qualitative muti-method study

Strengthening woman-centred care for pregnant women with female genital mutilation in Australia: a qualitative muti-method study

FGM (Female Genital Mutilation) Health Support for Non-Pregnant Women: Evaluation Findings From the NHS Pilot Programme

Treatments and interventions addressing chronic somatic pain in torture survivors: A systematic review

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