What interventions are effective to prevent or respond to female genital mutilation? A review of existing evidence from 2008–2020

Abstract

As the final decade of acceleration towards zero new cases of Female Genital Mutilation (FGM, SDG Target 5.3) by 2030 has begun, increasing the rigour, relevance, and utility of research for programming, policy development and resource allocation is critical. This study aimed to synthesize and assess the quality and strength of existing evidence on interventions designed to prevent or respond to FGM between 2008 and 2020.The study drew on a Rapid Evidence Assessment of the available literature on FGM interventions. The quality of studies was assessed using the ‘How to Note: Assessing the Strength of Evidence’ guidelines published by the Foreign, Commonwealth and Development Office (FCDO) and strength of evidence using a modified Gray scale developed by the What Works Association. Of the 7698 records retrieved, 115 studies met the inclusion criteria. Of the 115 studies, 106 were of high and moderate quality and were included in the final analysis. This review shows that at the system level, legislation-related interventions must be multifaceted to be effective. Whilst all levels would benefit from more research, for the service level especially more research is needed into how the health system can effectively prevent and respond to FGM. Community-level interventions are effective for changing attitudes towards FGM, but more must be done to innovate with these interventions so that they move beyond affecting attitudes alone to creating behaviour change. At the individual level, formal education is effective in reducing FGM prevalence among girls. However, the returns of formal education in ending FGM may take many years to be realized. Interventions targeting intermediate outcomes, such as improvement in knowledge and change in attitudes and beliefs towards FGM, are equally needed at the individual level.

Contextual determinants of generational continuation of female genital mutilation among women of reproductive age in nigeria: analysis of the 2018 demographic and health survey

“…This is consistent with previous studies that reported the influence of media exposure on FGM practice [ 47 , 48 ]. This is because several interventions, including the National Policy and Plan of Action for the Elimination of FGM that are committed to eradicating FGM have leveraged on using the media to change the narratives of pro-FGM beliefs, opinions and perceptions [ 12 , 49 ]. Where women are exposed to such anti-FGM media campaigns, they may save their daughters from FGM, even if they themselves were mutilated.…”

Amref Alternative Rites of Passage (ARP) model for female genital mutilation/cutting, teenage pregnancies, and child, early and forced marriages in Kenya: a stepped-wedge cluster randomised controlled trial protocol

“…There is a dearth of knowledge regarding the effectiveness of the ARP intervention. 14 An impact evaluation study revealed that ARP played a role in increasing the years of schooling for girls and reduces the prevalence of FGM/C in Kajiado and Narok. 15 Nonetheless, the data used in this study was derived from the Demographic and Health Survey (DHS)-a secondary dataset not specifically collected for the purpose of evaluating the effectiveness of the ARP model.…”