Knowledge, attitudes and practices of primary healthcare professionals to female genital mutilation in Valencia, Spain: are we ready for this challenge?

Abstract

BackgroundThe practice of Female Genital Mutilation (FGM) is a deeply-rooted tradition in 30 Sub-Saharan and Middle-East countries which affects approximately 200 million women and girls worldwide. The practice leads to devastating consequences on the health and quality of life of women and girls in both the short and long term. Globalizing processes and migration flows have recorded cases of this practice worldwide representing for healthcare professionals an emerging challenge on how to approach their healthcare in a transcultural, ethical and respectful way. No survey to assess knowledge, attitudes and practices on FGM among primary healthcare professionals has been conducted in the Valencian region of Spain to date.MethodsThe main purpose of this study is to assess the perceptions, knowledge, practices and attitudes of the primary healthcare professionals in relation to FGM in the Clínic-Malvarrosa healthcare area of Valencia. A cross-sectional descriptive study was conducted based on a self-administered questionnaire to general practitioners, paediatricians, nurses, midwives, gynaecologists, social workers and others.ResultsA total of 321 professionals answered the questionnaire. Less than 5% of professionals answered that they had ever found a case of FGM during their professional practice and 21.8% answered that they had ever worked with population at risk of FGM. Almost 15% of professionals answered that they had received training on FGM but of those who had received training, only 22.7% correctly identified the typology of FGM and less than 5% correctly identified the geographical area. Only 6.9% of the respondents admitted to know some protocol of action, being midwives, paediatricians and social workers the most aware professionals of such protocols.ConclusionThis study demonstrates that FGM is a problem present in the population attending primary healthcare services in Valencia. However, the professionals showed a profound lack of knowledge around concept, typology, countries of prevalence of FGM and existent protocols of action. It is healthcare professional duty to recognize this situation and to follow the right protocols of action, refer these women and their families to the most appropriate services and professionals that fit their needs, ensuring a multidisciplinary, positive and transcultural care for these families.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3396-z) contains supplementary material, which is available to authorized users.

Crossing cultural divides: A qualitative systematic review of factors influencing the provision of healthcare related to female genital mutilation from the perspective of health professionals

“…The majority of healthcare professionals (65.3%) had not read any guidelines relating to FGM/C [126]. Other recent studies in the UK, Spain and Australia provide further evidence that substantive training needs remain [112, 121, 127, 128].…”

Exploring the capacity of the Somaliland healthcare system to manage female genital mutilation / cutting-related complications and prevent the medicalization of the practice: a cross-sectional study

“…In high-income countries, especially those with immigrant communities from high FGM/C-prevalent countries, health systems' challenges in addressing the needs of those affected are widely reported [34]. Examples include limited staff knowledge around the concept, typology, and prevalence of FGM/C and the protocols for remedial action [33][34][35][36][37][38][39][40][41]. Similar FGM/C healthcare capacity limitations have been found in low-income settings.…”

Female Genital Mutilation/Cutting (FGM/C) coding capacities in Swiss University Hospitals using the International Classification of Diseases (ICD)

“…Certi ed interpreters and coders should also receive training. Finally, professionals in obstetrics, pediatrics, primary care, and travel medicine should be able to identify children at risk and discuss prevention, national laws on FGM/C and child's rights [21][22][23][24]31 . Sensitizing and teaching about FGM/C in existing pre-graduate classes, such as anatomy, gynecology and obstetrics, urology, infectious disease, pediatrics, psychiatry and primary care could improve standard training.…”

“…However, insu cient screening and routine genital examinations among pediatricians, or absent documentation can also explain the low numbers 22 . A speci c code for "risk of FGM/C" might facilitate screening and prevention 16 .…”

“…Furthermore, hospital data represents an opportunity to study access and quality of care for patients who underwent FGM/C, providing guidance for health interventions [14][15][16] . [17][18][19][20][21][22] . Pediatricians also lack training on FGM/C and rarely perform external genital examinations 23,24 .…”