scholarly journals The prevention of female genital mutilation in England: what can be done?

2018 ◽  
Vol 41 (3) ◽  
pp. e261-e266 ◽  
Author(s):  
E Plugge ◽  
S Adam ◽  
L El Hindi ◽  
J Gitau ◽  
N Shodunke ◽  
...  
Keyword(s):  
Public Health ◽  
Female Genital Mutilation ◽  
Public Health Issue ◽  
Global Public Health ◽  
Criminal Offence ◽  
Genital Mutilation ◽  
Awareness Raising ◽  
The Uk ◽  
The Impact ◽  
Female Genital

Abstract Background Female genital mutilation (FGM) is a global public health issue. Women in the UK are at risk of FGM and its adverse health consequences but little is known about its practice. Since 1985 it has been a criminal offence to perform FGM in the UK and further legislation has tightened the law but FGM continues. Methods Four community researchers from the Kenyan, Nigerian, Somalian and Sudanese communities in Oxford conducted focus groups and interviews with 53 people to understand the communities’ beliefs about how best to prevent FGM. Results Participants believed that the current UK legislation alone was not sufficient to tackle FGM and might in fact be counterproductive by alienating communities through its perceived imposition. They felt that there had been insufficient consultation with affected communities, awareness raising and education about the legislation. Community-led solutions were the most effective way to tackle FGM. Conclusions FGM adversely affects communities globally. In the UK, researchers from affected communities gathered data demonstrating the feasibility and importance of involving communities in FGM prevention work. Further research is needed to understand how best to prevent FGM in affected communities and, very importantly, to examine the impact of the UK legislation relating to FGM.

Female genital mutilation in the UK: considerations for best nursing practice

2019 ◽  
Vol 28 (12) ◽  
pp. 788-791
Author(s):  
Bethany Rose
Keyword(s):  
Public Health ◽  
Female Genital Mutilation ◽  
Nursing Practice ◽  
Health Concern ◽  
Public Health Concern ◽  
Genital Mutilation ◽  
Health Complications ◽  
The Uk ◽  
Female Genital

Female genital mutilation (FGM) is any process that injures or removes part or all of the external female genital organs for non-medical reasons. FGM is a growing public health concern in the UK because of an increase in migration from countries where it is widely practised. Education on FGM for nurses is key to supporting women who have undergone the practice, as well as safeguarding girls and women who are at risk. Nurses must understand the history and culture of FGM as well as the long-term health complications to be able to support affected women both professionally and sensitively.

scholarly journals Sexual Function in Women With and Without Female Genital Mutilation in Reproductive Age in South of Iran

2021 ◽  
Author(s):  
Mahshid Bokaie ◽  
Samaneh Hatefi ◽  
Shahnaz Mojahed ◽  
Nasibeh Roozbeh
Keyword(s):  
Sexual Function ◽  
Female Genital Mutilation ◽  
Reproductive Age ◽  
Public Health Issue ◽  
P Value ◽  
Women Of Reproductive Age ◽  
Genital Mutilation ◽  
Significant Difference ◽  
The Impact ◽  
Female Genital

Abstract Objectives: Female genital mutilation (FGM) is an important public health issue, especially in developing countries and it is still done in some parts of Iran. This study aimed to investigate the effect of FGM on the sexual function of women of reproductive age in Hormozgan province/IRAN.Study design: This study is a descriptive-analytical case-control study that was conducted in 2020 on 209 married women of reproductive age (15-49) in rural areas of Minab and Sirik counties in Hormozgan province/IRAN. Main outcome measures: The reliable and valid questionnaire FSFI for assessing female sexual function in the two groups was used after to obtain informed and voluntary consent from all participants and data with SPSS v: 16 software and with using descriptive/ Analytical statistics tests with a significant level of 0.05 were examined. Results: There is a significant difference between mutilated and non-mutilated women in the total score of sexual function(22.18±3.23 versus 23.41±2.52 respectively, p=0.023) and the domains of lubrication(3.04±0.62 versus 3.3±0.53 respectively, P=0.000), orgasm(3.81±0.63 versus 4.08±0.47 respectively, P=0.003), and sexual satisfaction(5.09±0.1 versus 5.37±0.87 respectively, P=0.017) But in the domains of desire, arousal, and pain in the two groups was no significant difference(P-value>0.05). Conclusion: FGM maybe leads to sexual dysfunction. Although most women were reluctant to perform mutilation on their daughters, more educational Actions are suggested to educate women about the impact of female mutilation on their sexual function. Counseling programs are also recommended to improve the sexual function of mutilated women.

Prosecution of female genital mutilation in the United Kingdom: Injustice at the intersection of good public health intentions and the criminal law

2019 ◽  
Vol 19 (4) ◽  
pp. 258-281 ◽  
Author(s):  
Marge Berer
Keyword(s):  
Public Health ◽  
United Kingdom ◽  
Criminal Law ◽  
Female Genital Mutilation ◽  
Public Health Issue ◽  
Traditional Practice ◽  
Genital Mutilation ◽  
The United Kingdom ◽  
Health Intentions ◽  
Female Genital

Female genital mutilation (FGM) is a harmful traditional practice and a serious public health issue in the countries where it is carried out. It is also a violation of the rights of the girls to whom it is done. The main action taken in the United Kingdom to stop FGM, has been to criminalise it. Public health measures, such as the provision of specialist clinics for those who experience complications of FGM have been implemented as well, and some education in schools is provided. This article is about the injustice that has arisen from the pursuit of prosecutions for FGM in the United Kingdom, in spite of good public health intentions. Since 2012, there have been four criminal cases, several arrests that never came to trial, and for reasons of safeguarding, an unknown number of investigations with the threat of girls being taken into care, and people stopped from travelling with girl children to visit their families in FGM-practising countries. To date, only one criminal case in 2019 – R v. N (FGM) – which is the main subject of this article, has resulted in a guilty verdict. This article outlines this history in relation to the criminal law and uses courtroom observation to analyse what happened in the 2019 case in detail. It argues that the conviction depended on medical opinion and the highly uncertain evidence of two children and was influenced by a spurious link to witchcraft that should never have been permitted in the courtroom. It argues that this conviction is unsafe and should be appealed. It further argues that to use protection orders only because a child’s mother had FGM, in the absence of any evidence of risk, is discriminatory and a form of impermissible racial/ethnic profiling. The article concludes that the United Kingdom should stop recording a history of FGM in women seeking healthcare. It calls for the current law against FGM to be reconsidered and replaced with positive measures for countering FGM which have the support and involvement of the community groups to whom they are addressed.

scholarly journals Ending female genital mutilation – a city’s coordinated effort

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Paixão ◽  
A Carmona ◽  
H Capelão ◽  
E Calé ◽  
A Silva
Keyword(s):  
Public Health ◽  
Primary Healthcare ◽  
Female Genital Mutilation ◽  
Healthcare Facility ◽  
Potential Health ◽  
Genital Mutilation ◽  
Specific Protocol ◽  
Entry Points ◽  
The Impact ◽  
Female Genital

Abstract Female genital mutilation (FGM) has short and long-term impacts on the health of girls/women. In Portugal, an estimated 5246 women were subjected to it, with 568 of them residing in the city of Amadora, in the metropolitan area of the capital Lisbon. As such, Amadora was considered a priority area for developing strategies to prevent female genital mutilation, under the coordination of the local public health unit. Our aim was to capacitate professionals to recognise and act on risk/danger and on minimising potential health impacts of FGM on the local institutions these girls/women might come into contact with. We created a task force that held meetings with different local actors: hospital, teams at the primary healthcare facility, city hall of Amadora, child protection services, a school, social inclusion projects, representatives of the justice system and a non-governmental organisation. We designed different scenarios for the different needs and entry points of these girls/women in the system and created appropriate procedures for all these actors. Within the primary healthcare facility, we created guidelines specifying criteria for referral to other specialties. This led to the development of a county protocol targeting FGM during the summer of 2019. We trained 160 healthcare professionals. In addition, we created a booklet for schools and held sessions in school groups targeting teachers, psychologists and operational assistants with a focus on risk and danger indicators and on how to proceed. Overall, 360 school professionals received training. During these sessions, we also presented resources on how to integrate FGM in discussions with students regarding gender violence and human rights. This intervention will be evaluated after one year (summer of 2020) through mixed-methods to understand the impact on the practice of the professionals in Amadora. We will conduct interviews and apply questionnaires to capture the implementation of this city-wide protocol. Key messages Given the complexity of FGM a wide societal and multidisciplinary approach should be used with a public health team coordinating the intervention. In Portugal there is a need for an organised and systematic response by professionals regarding FGM; our county-specific protocol aimed to create that response.

scholarly journals A cross-sectional study on pelvic floor symptoms in women living with Female Genital Mutilation/Cutting

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Alzbeta Binkova ◽  
Marion Uebelhart ◽  
Patrick Dällenbach ◽  
Michel Boulvain ◽  
Angèle Gayet-Ageron ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Female Genital Mutilation ◽  
Cross Sectional Study ◽  
Background Information ◽  
Sectional Study ◽  
Cross Sectional ◽  
Genital Mutilation ◽  
Pelvic Floor Symptoms ◽  
The Impact ◽  
Female Genital

Abstract Background Female Genital Mutilation/Cutting (FGM/C) concerns over 200 million women and girls worldwide and is associated with obstetric trauma and long-term urogynaecological and psychosexual complications that are often under-investigated and undertreated. The aim of this study was to assess the pelvic floor distress and the impact of pelvic floor and psychosexual symptoms among migrant women with different types of FGM/C. Methods This cross-sectional study was conducted between April 2016 and January 2019 at the Division of Gynaecology of the Geneva University Hospitals. The participants were interviewed on socio-demographic and background information, underwent a systematic gynaecological examination to assess the presence and type of FGM/C and eventual Pelvic Organ Prolapse (POP), and completed six validated questionnaires on pelvic floor and psychosexual symptoms (PFDI-20 and PFIQ7 on pelvic floor distress and impact, FISI and WCS on faecal incontinence and constipation, PISQ-IR and FGSIS on sexual function and genital self-image). The participants’ scores were compared with scores of uncut women available from the literature. The association between selected variables and higher scores for distress and impact of pelvic floor symptoms was assessed using univariate and multivariable linear regression models. Results 124 women with a mean age of 31.5 (± 7.5), mostly with a normal BMI, and with no significant POP were included. PFDI-20 and PFIQ-7 mean (± SD) scores were of 49.5 (± 52.0) and 40.7 (± 53.6) respectively. In comparison with the available literature, the participants’ scores were lower than those of uncut women with pelvic floor dysfunction but higher than those of uncut women without such disorders. Past violent events other than FGM/C and forced or arranged marriage, age at FGM/C of more than 10, a period of staying in Switzerland of less than 6 months, and nulliparity were significantly associated with higher scores for distress and impact of pelvic floor symptoms, independently of known risk factors such as age, weight, ongoing pregnancy and history of episiotomy. Conclusions Women with various types of FGM/C, without POP, can suffer from pelvic floor symptoms responsible for distress and impact on their daily life. Trial registration. The study protocol was approved by the Swiss Ethics Committee on research involving humans (protocol n°15-224).

scholarly journals The Consequences of Female Genital Mutilation on Psycho-Social Well-Being: A Systematic Review of Qualitative Research

2021 ◽  
pp. 104973232110018
Author(s):  
Sarah O’Neill ◽  
Christina Pallitto
Keyword(s):  
Female Genital Mutilation ◽  
Social Impact ◽  
Well Being ◽  
Social Consequences ◽  
Health Consequences ◽  
Genital Mutilation ◽  
The Social ◽  
Women's Lives ◽  
The Impact ◽  
Female Genital

The health consequences of female genital mutilation (FGM) have been described previously; however, evidence of the social consequences is more intangible. To date, few systematic reviews have addressed the impact of the practice on psycho-social well-being, and there is limited understanding of what these consequences might consist. To complement knowledge on the known health consequences, this article systematically reviewed qualitative evidence of the psycho-social impact of FGM in countries where it is originally practiced (Africa, the Middle East, and Asia) and in countries of the diaspora. Twenty-three qualitative studies describing the psycho-social impact of FGM on women’s lives were selected after screening. This review provides a framework for understanding the less visible ways in which women and girls with FGM experience adverse effects that may affect their sense of identity, their self-esteem, and well-being as well as their participation in society.

scholarly journals Improving care for women and girls who have undergone female genital mutilation/cutting: qualitative systematic reviews

2019 ◽  
Vol 7 (31) ◽  
pp. 1-216 ◽  
Author(s):  
Catrin Evans ◽  
Ritah Tweheyo ◽  
Julie McGarry ◽  
Jeanette Eldridge ◽  
Juliet Albert ◽  
...  
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Pregnant Women ◽  
Systematic Reviews ◽  
Female Genital Mutilation ◽  
Genital Mutilation ◽  
Women And Girls ◽  
The Uk ◽  
Experienced Female ◽  
Female Genital

Background In a context of high migration, there are growing numbers of women living in the UK who have experienced female genital mutilation/cutting. Evidence is needed to understand how best to meet their health-care needs and to shape culturally appropriate service delivery. Objectives To undertake two systematic reviews of qualitative evidence to illuminate the experiences, needs, barriers and facilitators around seeking and providing female genital mutilation-/cutting-related health care from the perspectives of (1) women and girls who have experienced female genital mutilation/cutting (review 1) and (2) health professionals (review 2). Review methods The reviews were undertaken separately using a thematic synthesis approach and then combined into an overarching synthesis. Sixteen electronic databases (including grey literature sources) were searched from inception to 31 December 2017 and supplemented by reference list searching. Papers from any Organisation for Economic Co-operation and Development country with any date and in any language were included (Organisation for Economic Co-operation and Development membership was considered a proxy for comparable high-income migrant destination countries). Standardised tools were used for quality appraisal and data extraction. Findings were coded and thematically analysed using NVivo 11 (QSR International, Warrington, UK) software. Confidence in the review findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation – Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. All review steps involved two or more reviewers and a team that included community-based and clinical experts. Results Seventy-eight papers (74 distinct studies) met the inclusion criteria for both reviews: 57 papers in review 1 (n = 18 from the UK), 30 papers in review 2 (n = 5 from the UK) and nine papers common to both. Review 1 comprised 17 descriptive themes synthesised into five analytical themes. Women’s health-care experiences related to female genital mutilation/cutting were shaped by silence and stigma, which hindered care-seeking and access to care, especially for non-pregnant women. Across all countries, women reported emotionally distressing and disempowering care experiences. There was limited awareness of specialist service provision. Good care depended on having a trusting relationship with a culturally sensitive and knowledgeable provider. Review 2 comprised 20 descriptive themes synthesised into six analytical themes. Providers from many settings reported feeling uncomfortable talking about female genital mutilation/cutting, lacking sufficient knowledge and struggling with language barriers. This led to missed opportunities for, and suboptimal management of, female genital mutilation-/cutting-related care. More positive experiences/practices were reported in contexts where there was input from specialists and where there were clear processes to address language barriers and to support timely identification, referral and follow-up. Limitations Most studies had an implicit focus on type III female genital mutilation/cutting and on maternity settings, but many studies combined groups or female genital mutilation/cutting types, making it hard to draw conclusions specific to different communities, conditions or contexts. There were no evaluations of service models, there was no research specifically on girls and there was limited evidence on psychological needs. Conclusions The evidence suggests that care and communication around female genital mutilation/cutting can pose significant challenges for women and health-care providers. Appropriate models of service delivery include language support, continuity models, clear care pathways (including for mental health and non-pregnant women), specialist provision and community engagement. Routinisation of female genital mutilation/cutting discussions within different health-care settings may be an important strategy to ensure timely entry into, and appropriate receipt of, female genital mutilation-/cutting-related care. Staff training is an ongoing need. Future work Future research should evaluate the most-effective models of training and of service delivery. Study registration This study is registered as PROSPERO CRD420150300012015 (review 1) and PROSPERO CRD420150300042015 (review 2). Funding The National Institute for Health Research Health Services and Delivery Research programme.

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

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249662
Author(s):  
Samuel Muhula ◽  
Anthony Mveyange ◽  
Samuel Oji Oti ◽  
Martha Bande ◽  
Hellen Kayiaa ◽  
...  
Keyword(s):  
Female Genital Mutilation ◽  
Secondary Data ◽  
Sub Saharan Africa ◽  
Rite Of Passage ◽  
Genital Mutilation ◽  
Community Stakeholders ◽  
Quasi Experimental ◽  
Sub Saharan ◽  
The Impact ◽  
Female Genital

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.

Failure to Protect Girls from Female Genital Mutilation

2015 ◽  
Vol 79 (5) ◽  
pp. 344-357
Author(s):  
Theodora A. Christou ◽  
Sam Fowles
Keyword(s):  
Female Genital Mutilation ◽  
Criminal Liability ◽  
Responsibility To Protect ◽  
Parental Responsibility ◽  
Genital Mutilation ◽  
International Obligations ◽  
The Law ◽  
Failure To Protect ◽  
The Uk ◽  
Female Genital

Whilst FGM had been a crime in the UK for over 2 decades, over 60, 000 girls continued to be mutilated. In 2015 the UK took its international obligations to protect girls from such physical harm more seriously and enacted new legislation. This article focuses on the parental responsibility to protect their daughter from harm and their criminal liability if they fail to take adequate action to prevent the mutilation occurring. We explore the socio-legal setting, the gaps in the law, the state's international obligations and finally the newly introduced rebuttable presumption.

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