Female Genital Mutilation/Cutting: sharing data and experiences to accelerate eradication and improve care: part 2

Ahmed, Wisal; Denholm, Nikki; Dawson, Angela; Essén, Birgitta; Johnsdotter, Sara; Bukuluki, Paul; Naeema, Al Gasseer H.; Eltayeb, Dalya; Shell‐Duncan, Bettina; Njue, C; Muteshi, Jacinta Khasiala; Lamy, Clotilde; Neyrinck, Pascale; Verduyckt, Peter; Alexander, Sophie; Kimani, Samuel; Esho, Tammary; Kimani, Violet; Kigondu, Christine; Karanja, Joseph; Guyo, Jaldesa; Touré, Moustapha; Guindo, Yacin Gackou; Samaké, Djibril; Camara, Ladji; Traoré, Youssouf; Traoré, Alassane; Samaké, Alou; Jordal, Malin; Jirovsky, Elena; Wu, Samantha; Fitzgerald, Kevin T.; Mishori, Ranit; Reingold, Rebecca B.; Ismail, Edna Adan; Say, Lale; Uebelhart, Marion; Boulvain, Michel; Dällenbach, Patrick; Irion, Olivier; Petignat, Patrick; Farina, Patrizia; Ortensi, Livia Elisa; Pecorella, Claudia; Novak, Lindsey; Cuzin, B.; Delmas, Florence Brunel; Papingui, Albertine; Bader, Dina; Wahlberg, Anna; Selling, Katarina Ekholm; Källestål, Carina; Ibraheim, Abdalla Hisham Hussein Imam; Elawad, Nasr A. M.; Gasseer, Al; Naeema, H.; Maison, Elamin; Hussein, HM; Albagir, Altayyeb Mohammed; Albirair, Mohamed; Salih, Sarah A. Salam; Muniu, Samuel; Nyamongo, Isaac K.; Ndavi, P M; Hedley, Holly; Kuenzi, Rachel; Malavé-Seda, Laura; Clare, Camille A.; Greenfield, Jacqueline; Augustus, Praise; Ukatu, Nneamaka; Manu, Eugene; Altonen, Brian; Caillet, Martin; Földes, P; Vital, Mathilde; Dugast, S.; Hanf, Matthieu; Winer, Norbert; Seifeldin, Amr; Villani, Michela; Seinfeld, Rebecca; Earp, Brian D.; Cappon, Sien; L’Ecluse, C.; Clays, Els; Tency, Inge; Leye, Els; Johansen, R. Elise B.; Ouédraogo, Charlemagne; Madzou, S.; Simporé, A.; Combaud, Vanessa; Ouattara, A.; Millogo, F.; Ouédraogo, Abdoulaye; Kiemtoré, Sibraogo; Zamané, Hyacinthe; Sawadogo, Youssouf; Kaien, P.; Dramé, B.; Thiéba, Blandine; Lankoandé, J.; Descamps, P.; Catania, Lucrezia; Mastrullo, R.; Caselli, Antonella; Cecere, Renzo; Abdulcadir, Omar; Abdulcadir, Jasmine; Vogt, Sonja; Efferson, Charles; O’Neill, Suzanne C.; Dubour, D.; Florquin, Sandrine; Bos, Michael; Zewolde, S.; Richard, Fabienne; Varol, Nesrin; Dawson, Andrew W.; Turkmani, Sabera; Hall, Janet; Nanayakkara, Susie; Jenkins, Gwynne L.; Homer, Caroline; McGeechan, Kevin; Vital, Misliza; Visme, Sophie de; Hanf, Maria; Philippe, Henri-Jean; Winer, Nathaniel; Wylomanski, S.; Johnson‐Agbakwu, Crista; Warren, Nicole; Macfarlane, Ann; Dorkenoo, W.; Lien, Inger-Lise; Schultz, James

doi:10.1186/s12978-017-0362-x

Cited by 14 publications

(8 citation statements)

References 2 publications

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“…Nevertheless, we had not expected this to be such a pervasive conviction among our research participants. Male involvement has been reported to increase negotiations of abandonment [5,65,66], which was confirmed in this study through the stories of two informants who claimed to have escaped FGC mainly due to interference from their fathers. There are also several studies that have identified significant changes in gender roles in the diaspora [30,[67][68][69].…”

Section: Negative Attitude and Disengagementsupporting

confidence: 77%

Blurred transitions of female genital cutting in a Norwegian Somali community

Johansen

2019

PLoS ONE

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While diaspora communities have become more critical of Female Genital Cutting (FGC), there are also trends of continuity. To explore the interplay between continuity and change, I designed a study among Somali migrants in Norway. A team of six Somali research assistants collected data from 72 male and female research participants between 16 and 57 years of age through in-depth interviews and focus group discussions. The aim of the study was to gather knowledge that could improve interventions among migrant populations. The study findings indicate that the experience of FGC as a practice in transition implies that people have to maneuver between different and partly contradictory social norms. The paper first discusses the contradiction between a strong negative attitude toward FGC and very low engagement. The lack of engagement is explained by the increased privatization of FGC and insecurities due to the transition and disempowerment with regard to challenging the FGC practices of relatives based in countries of origin. Second, the paper explores the contradiction between perceptions of FGC as a disappearing practice and the recognition of trends of continuation. Trends of continuation include those related to perceptions of risk during travel to countries of origin, resistance to defibulation, support for sunna circumcision and insecurities regarding the significance of FGC for marriageability. Thus, despite an almost universally negative attitude toward FGC in the form of infibulation, ongoing changes can, to some extent, hamper further change. This suggests that to ensure further progress in the abandonment of the practice, these complex and interconnected expectations must be addressed.

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Section: Negative Attitude and Disengagementsupporting

confidence: 77%

Blurred transitions of female genital cutting in a Norwegian Somali community

Johansen

2019

PLoS ONE

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“…Women with acute FGM/C-related complications faced additional fear that presenting for care exposed them to legal sanctions because the practice is illegal in Kenya [42]. This is consistent with evidence that fear of criminalization limits access to much needed health services [79,80]. Healthcare providers have a responsibility to take the legislative framework into consideration and may be required to report FGM/C cases; thus, facing an ethical dilemma.…”

Section: Discussionmentioning

confidence: 59%

Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study

Kimani

Kabiru

Muteshi

et al. 2020

BMC Int Health Hum Rights

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Background: Female genital mutilation/cutting (FGM/C) is a cultural practice associated with health consequences, women rights and deprivation of dignity. Despite FGM/C-related health consequences, circumcised women may encounter additional challenges while seeking interventions for reproductive health problems. Experiences of women/girls while accessing health services for reproductive health problems including FGM/C-related complications in poor, remote and hard to reach areas is poorly understood. We sought to explore barriers to care seeking among Somali women with complications related to FGM/C in public health facilities in Kenya. Methods: We drew on qualitative data collected from purposively selected women aged 15-49 years living with FGM/C, their partners, community leaders, and health providers in Nairobi and Garissa Counties. Data were collected using in-depth interviews (n = 10), key informant interviews (n = 23) and 20 focus group discussions. Data were transcribed and analyzed thematically using NVivo version 12.Results: Barriers were grouped into four thematic categories. Structural barriers to care-seeking, notably high cost of care, distance from health facilities, and lack of a referral system. Concerns regarding perceived quality of care also presented a barrier. Women questioned health professionals' and health facilities' capacity to offer culturallysensitive FGM/C-specific care, plus ensuring confidentiality and privacy. Women faced socio-cultural barriers while seeking care particularly cultural taboos against discussing matters related to sexual health with male clinicians. Additionally, fear of legal sanctions given the anti-FGM/C law deterred women with FGM/C-related complications from seeking healthcare. Conclusion: Structural, socio-cultural, quality of service, and legal factors limit health seeking for reproductive health problems including FGM/C-related complications. Strengthening health system should consider integration of FGM/C-related interventions with existing maternal child health services for cost effectiveness, efficiency and quality care. The interventions should address health-related financial, physical and communication barriers, while ensuring culturally-sensitive and confidential care.

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“…It has also been considered to be a potential intervention for preventing FGM/C. There are some studies which have reported successful health education interventions in preventing FGM/C globally, but there is need for more exploration of the interventions including their effects in different communities [ 25 ]. To our knowledge, there is no systematic review that has synthesised the evidence and ensured understanding of the effectiveness of health education interventions as discrete interventions for FGM/C.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of health education as an intervention designed to prevent female genital mutilation/cutting (FGM/C): a systematic review

et al. 2018

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BackgroundFemale Genital Mutilation/Cutting (FGM/C) is a harmful practice that violates the human rights of women and girls. Despite global efforts to restrict the practice, there have been few reports on major positive changes to the problem. Health education interventions have been successful in preventing various health conditions and promoting service use. They have also been regarded as promising interventions for preventing FGM/C. The objective of this systematic review is to synthesise findings of studies about effectiveness of health education as an intervention to prevent FGM/C.MethodsThe electronic databases searched were MEDLINE, EMBASE, Cochrane library, Web of Science, Psych INFO, CINAHL and ASSIA. Our search included papers published in the English language without date limits. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). A predesigned data recording form was used to extract data from the included studies which were summarised by comparing similar themes.ResultsTwelve out of 359 individual studies met our inclusion criteria. Seven studies were quantitative, three were qualitative and two used mixed methods. Six studies tested before and after the interventions, four studies assessed the effectiveness of previous interventions used by different research teams and two studies endorsed the intervention. Four main factors emerged and were associated with facilitating or hindering the effectiveness of health education interventions: sociodemographic factors; socioeconomic factors; traditions and beliefs; and intervention strategy, structure and delivery.ConclusionsIt is vital to target factors associated with facilitating or hindering the effectiveness of health education for FGM/C. This increases the possibility of effective, collective change in behaviour and attitude which leads to the sustainable prevention of FGM/C and ultimately the improved reproductive health and well-being of individuals and communities.Electronic supplementary materialThe online version of this article (10.1186/s12978-018-0503-x) contains supplementary material, which is available to authorized users.

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Female Genital Mutilation/Cutting: sharing data and experiences to accelerate eradication and improve care: part 2

Cited by 14 publications

References 2 publications

Blurred transitions of female genital cutting in a Norwegian Somali community

Blurred transitions of female genital cutting in a Norwegian Somali community

Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study

Effectiveness of health education as an intervention designed to prevent female genital mutilation/cutting (FGM/C): a systematic review

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