scholarly journals Seeking culturally safe care: a qualitative systematic review of the healthcare experiences of women and girls who have undergone female genital mutilation/cutting

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027452 ◽  
Author(s):  
Catrin Evans ◽  
Ritah Tweheyo ◽  
Julie McGarry ◽  
Jeanette Eldridge ◽  
Juliet Albert ◽  
...  
Keyword(s):  
Systematic Review ◽  
Qualitative Research ◽  
Female Genital Mutilation ◽  
Oecd Countries ◽  
Genital Mutilation ◽  
Thematic Synthesis ◽  
Women And Girls ◽  
Synthesis Approach ◽  
Safe Care ◽  
Female Genital

ObjectiveTo explore the experiences of accessing and receiving healthcare related to female genital mutilation/cutting (FGM/C) across the life course from the perspective of women and girls who have undergone FGM/C.DesignA systematic review of qualitative research studies using a thematic synthesis approach.MethodsInclusion criteria were qualitative studies (including grey literature) of any design, from Organisation for Economic Co-operation and Development (OECD) countries, of any date and any language. Sixteen electronic databases were searched from inception to December 2017, supplemented by reference list searching. Papers were screened, selected and quality-appraised by two reviewers using established tools from the Joanna Briggs Institute. NVivo software was used to extract study characteristics and code study findings. An inductive thematic synthesis approach was undertaken to identify descriptive themes and interpret these into higher order analytical constructs. Confidence in the review findings was assessed using Grading of Recommendations, Assessment, Development and Evaluations-Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual).ResultsFifty-seven papers (from 55 distinct studies) from 14 different OECD countries were included (50% published within the last 8 years). One-third of studies focused exclusively on maternity care experiences, whereas others covered a range of foci. No studies reported explicitly on girls’ experiences or on experiences of health service-led safeguarding interventions. Only three studies addressed psychological care. The synthesis developed 17 descriptive themes, organised into 5 analytical constructs. These related to communication, access to care, experiences of cultural dissonance/integrity, disempowering care experiences and positive care encounters. The themes illuminate significant challenges to obtaining timely and holistic care (especially for deinfibulation), and highlight different ways in which women may experience care as disrespectful, unsafe and disempowering. Key elements of ‘culturally safe care’ are identified.ConclusionsThis review has highlighted key knowledge gaps, especially around (1) girls’/unmarried women’s experiences and (2) the impact of recent safeguarding interventions. There is an ongoing need for community engagement, service development and staff training.PROSPERO registration numberCRD420150300012015.

scholarly journals Consequences of Female Genital Mutilation on Women’s Sexual Health – Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Andy-Muller Nzinga ◽  
Stéphanie De Andrade Castanheira ◽  
Jessica Hermann ◽  
Véronique Feipel ◽  
Augustin Joseph Kipula ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sexual Health ◽  
Female Genital Mutilation ◽  
Meta Analysis ◽  
Genital Mutilation ◽  
Women’S Sexual Health ◽  
Female Genital

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 Estimating the indirect prevalence of Female Genital Mutilation/Cutting in Switzerland

2020 ◽  
Author(s):  
Sara Cottler-Casanova ◽  
Jasmine Abdulcadir
Keyword(s):  
At Risk ◽  
Female Genital Mutilation ◽  
Prevalence Data ◽  
Genital Mutilation ◽  
The Past ◽  
High Prevalence ◽  
Prevalence Estimates ◽  
Women And Girls ◽  
Using Data ◽  
Female Genital

Abstract ObjectiveTo update the indirect prevalence estimates for women and girls living with Female Genital Mutilation Cutting (FGM/C) in Switzerland, using data from the Swiss Federal Statistical Office of migrant women and girls born in one of the 30 high-prevalence FGM/C countries that are currently living in Switzerland. MethodsWe used Yoder and Van Baelen’s “Extrapolation of FGM/C Countries’ Prevalence Data” method, where we applied DHS and MICS prevalence figures from the 30 countries when FGM/C is practiced, and applied them to the immigrant women and girls living in Switzerland from the same 30 countries.ResultsIn 2010, the estimated indirect prevalence was 9,059 whereas in 2018, the estimated indirect prevalence was 21,706 women and girls living with or at risk of FGM/C.ConclusionOver the past decade, there have been significant increases in the number of estimated women and girls living with or at risk of FGM/C in Switzerland due to the increase in the total number of women and girls originally coming form the countries where the practice of FGM/C is traditional.

scholarly journals Review of Web-Based Toolkits for Health Care Practitioners Working With Women and Girls Affected by or at Risk of Female Genital Mutilation/Cutting

2020 ◽  
Vol 11 ◽  
pp. 215013272093529
Author(s):  
Hina Shaikh ◽  
Karen A. McDonnell
Keyword(s):  
At Risk ◽  
Health Professionals ◽  
Female Genital Mutilation ◽  
Service Providers ◽  
Health Sector ◽  
Skills Development ◽  
Genital Mutilation ◽  
Rich Diversity ◽  
Women And Girls ◽  
Female Genital

Increased migration has given rise to more advocacy efforts against female genital mutilation or cutting (FGM/C), legislation that criminalizes the practice, and guidance to the health sector for managing care of affected groups. More women and girls who have been cut or who are at risk of FGM/C are migrating from regions where it is common to countries where it is not and interacting with health professionals and other community practitioners in these host countries. Despite numerous studies on the negative health impacts of FGM/C, little is known about toolkits on FGM/C that providers can use in their prevention and response efforts. We sought to explore the nature of Internet-based products referenced as toolkits and materials characteristic of toolkits aimed at different service providers who may interact with women and girls affected by FGM/C. Through an online search, we identified 45 toolkits and collected data about each one. We found that the toolkits targeted different audiences and offered a diverse set of information and resources. The majority of toolkits were aimed at health professionals and provided factual and epidemiological-focused content, yet many did not include research evidence, skills development application, or approaches for implementing the toolkit in practice. This review is the first completed in the area of FGM/C to show a rich diversity of online materials. Future toolkits can be improved with the provision of evidence-based information and practical skills development for use by health professionals in implementing best practices in working with women and girls affected by FGM/C.

scholarly journals Painful gynecologic and obstetric complications of female genital mutilation/cutting: A systematic review and meta-analysis

PLoS Medicine ◽  
2020 ◽  
Vol 17 (3) ◽  
pp. e1003088 ◽  
Author(s):  
Jacob Michael Lurie ◽  
Alessandra Weidman ◽  
Samantha Huynh ◽  
Diana Delgado ◽  
Imaani Easthausen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Female Genital Mutilation ◽  
Meta Analysis ◽  
Obstetric Complications ◽  
Genital Mutilation ◽  
Female Genital

scholarly journals Effects of COVID-19 Pandemic on Female Genital Mutilation/Cutting and Child, Early or Forced Marriages in Kenya, Uganda, Ethiopia and Senegal

2021 ◽  
Author(s):  
Tammary Esho ◽  
Dennis J. Matanda ◽  
Timothy Abuya ◽  
Sintayehu Abebe ◽  
Yeshitila Hailu ◽  
...  
Keyword(s):  
Female Genital Mutilation ◽  
Cross Sectional Study ◽  
Talk Shows ◽  
Cross Sectional ◽  
Genital Mutilation ◽  
Alternative Approaches ◽  
Women And Girls ◽  
Harmful Traditional Practices ◽  
Depth Interviews ◽  
Female Genital

Abstract Background The effects of COVID-19 on harmful traditional practices such Female Genital Mutilation/Cutting (FGM/C) and Child, Early or Forced Marriages (CEFM) have not been well documented. We examined how the COVID-19 pandemic has affected FGM/C and CEFM in Kenya, Uganda, Senegal, and Ethiopia. Methods A cross-sectional study design with a mixed methods approach was used. Household surveys targeting women and men aged 15–49 years in Kenya (n = 312), Uganda (n = 278), Ethiopia (n = 251), and Senegal (n = 208) were conducted. Thirty-eight in-depth interviews with programme implementers and policymakers were carried out in Kenya (n = 17), Uganda (n = 9), Ethiopia (n = 8), and Senegal (n = 4). Results In Kenya, the COVID-19 pandemic has contributed to the increase in both FGM/C and CEFM cases. Minimal increase of FGM/C cases was reported in Uganda and a significant increase in CEFM cases. In Ethiopia, the COVID-19 pandemic had a limited effect on changes in FGM/C and CEFM. In Senegal, there were minimal effects of COVID-19 on the number of FGM/C and CEFM cases. The pandemic has negatively affected implementation of interventions by the justice and legal system, the health system, and civil societies. Conclusions The pandemic has had varied effects on FGM/C and CEFM across the four countries. Across the four countries, the pandemic has negatively affected implementation of interventions by the various sectors that are responsible for preventing and responding to FGM/C and CEFM. This calls for innovative approaches in intervening in the various communities to ensure that women and girls at risk of FGM/C and CEFM or in need of services are reached during the pandemic. Evidence on how effective alternative approaches such as the use of call centres, radio talk shows and the use of local champions as part of risk communication in preventing and responding to FGM/C and CEFM amid COVID-19 is urgently required.

Female Genital Mutilation

2014 ◽  
Author(s):  
Fariyal Ross-Sheriff ◽  
Evalyne Kerubo Orwenyo
Keyword(s):  
Social Workers ◽  
Female Genital Mutilation ◽  
Severe Bleeding ◽  
Culturally Appropriate ◽  
Genital Mutilation ◽  
Risk Of Death ◽  
Human Rights Abuse ◽  
Women And Girls ◽  
Female Genital ◽  
Main Factor

Female genital mutilation (FGM) has been portrayed in the literature as an inhumane practice and a form of human rights abuse. Young women and girls who undergo FGM are subjected to the risk of developing infections as well as gynecological and psychological complications. Where severe bleeding occurs, the risk of death is imminent. Although FGM has been decried as an unnecessary and harmful ritual, it continues to be practiced in many parts of Africa, some parts of Asia, and the Middle East. Beliefs about the benefits of FGM are deeply entrenched in tradition and culture, making it a difficult practice to eradicate. This entry aims to portray the cultural embeddedness of FGM as the main factor in preventing its eradication. The information reviewed in this entry can be used to provide a framework for social workers to understand personal and societal reasons for FGM. Furthermore, this entry provides information that could be used to guide social workers in formulating culturally appropriate interventions with FGM practicing communities.

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