The impact of community led alternative rite of passage on eradication of female genital mutilation/cutting in Kajiado County, Kenya: A quasi-experimental study

Abstract

Introduction In Kenya, Female Genital Mutilation/Cutting (FGM/C) is highly prevalent in specific communities such as the Maasai and Somali. With the intention of curtailing FMG/C prevalence in Maasai community, Amref Health Africa, designed and implemented a novel intervention—community-led alternative rite of passage (CLARP) in Kajiado County in Kenya since 2009. The study: a) determined the impact of the CLARP model on FGM/C, child early and forced marriages (CEFM), teenage pregnancies (TP) and years of schooling among girls and b) explored the attitude, perception and practices of community stakeholders towards FGM/C. Methods We utilised a mixed methods approach. A difference-in-difference approach was used to quantify the average impact of the model with Kajiado as the intervention County and Mandera, Marsabit and Wajir as control counties. The approach relied on secondary data analysis of the Kenya Demographic and Health Survey (KDHS) 2003, 2008–2009 and 2014. A qualitative approach involving focus group discussions, in-depth interviews and key informant interviews were conducted with various respondents and community stakeholders to document experiences, attitude and practices towards FGM/C. Results The CLARP has contributed to: 1) decline in FGM/C prevalence, CEFM rates and TP rates among girls by 24.2% (p<0.10), 4.9% (p<0.01) and 6.3% (p<0.01) respectively. 2) increase in girls schooling years by 2.5 years (p<0.05). Perceived CLARP benefits to girls included: reduction in teenage marriages and childbirth; increased school retention and completion; teenage pregnancies reduction and decline in FGM/C prevalence. Community stakeholders in Kajiado believe that CLARP has been embraced in the community because of its impacts in the lives of its beneficiaries and their families. Conclusion This study demonstrated that CLARP has been positively received by the Maasai community and has played a significant role in attenuating FGM/C, CEFM and TP in Kajiado, while contributing to increasing girls’ schooling years. CLARP is replicable as it is currently being implemented in Tanzania. We recommend scaling it up for adoption by stakeholders implementing in other counties that practice FGM/C as a rite of passage in Kenya and across other sub Saharan Africa countries.

Empowering Communities against Harmful Social Practices through Integrated Water Hygiene and Sanitation and Alternative Rites of Passage Model in Kajiado County, Kenya

“…In Kenya, the ARP model was first rolled out in Kajiado County in 2009 in line with Amref's vision to eradicate widespread FGM/C practices across the African continent by 2030 (Muhula et al, 2021). The model also targets to reduce and eventually eliminate child, early, and forced marriage (CEFM) and pregnancies and improve girls' or women's levels of educational attainment (Olenja et al, 2019).…”

“…The model also targets to reduce and eventually eliminate child, early, and forced marriage (CEFM) and pregnancies and improve girls' or women's levels of educational attainment (Olenja et al, 2019). Efforts made through the ARP model have resulted in positive impacts including a reduction in the prevalence of FGM/C (24.2%), Child and Early Forced marriages (4.9%), and Teenage pregnancies (6.3%) (Muhula et al, 2021). However, more needs to be done to bridge the gap.…”

“…In Kajiado County, Amref Health Africa in Kenya has been implementing community Led alternative rite of passage (CLARP), whose aim is to curb high FGM/C prevalence in the country (Muhula et al, 2021). The intervention entails changing social norms by engaging community stakeholders including cultural leaders, Morans, traditional birth attendants, county Governments, and religious leaders.…”

“…After the training, a graduation ceremony blessed and attended by the community, cultural elders and leaders, and key stakeholders are held for the girls who successfully complete the training and are able to publicly denounce the practice. An impact evaluation conducted in the county showed that the ARP model had had positive impact including a reduction in the prevalence of FGM/C (24.2%), Child and Early Forced marriages (4.9%) and Teenage pregnancies (6.3%) (Muhula et al, 2021). Despite the impact of the ARP Model, there is a need to continue bridging the FGM/C and other harmful practices gap among young girls and women in the county through exploring other integrated models that will be more effective.…”

“…Access to safe water and improved sanitation and hygiene is still a great challenge, with women, girls and children forced to walk over 5 kilometres to fetch the essential commodity (Mbogo et al, n.d.). (Graamans et al, 2019;Muhula et al, 2021). These interventions have always been implemented in isolation.…”