scholarly journals ‘Putting salt on the wound’: a qualitative study of the impact of FGM-safeguarding in healthcare settings on people with a British Somali heritage living in Bristol, UK

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035039 ◽  
Author(s):  
Saffron Karlsen ◽  
Natasha Carver ◽  
Magda Mogilnicka ◽  
Christina Pantazis
Keyword(s):  
At Risk ◽  
Service Providers ◽  
Healthcare Providers ◽  
Female Genital Cutting ◽  
Snowball Sampling ◽  
Genital Mutilation ◽  
Healthcare Settings ◽  
Alternative Sources ◽  
The Impact ◽  
Female Genital

ObjectivesThis research documents the experiences of people with Somali heritage with female genital mutilation (FGM)-safeguarding services in healthcare and whether such services are considered appropriate by the people who encounter them.DesignSix focus groups conducted with ethnic Somalis living in Bristol, during the summer of 2018, divided by gender and whether people had experienced FGM-safeguarding as adults or children.SettingParticipants experienced FGM-safeguarding in primary and secondary care.Participants30 people (21 women and 9 men), identified through local organisations or snowball sampling. All participants were of Somali heritage and aged over 18.ResultsGovernment priorities to support those who have experienced female genital cutting/mutilation (FGC/M) are being undermined by their own approaches to protect those considered at risk. Participants argued that approaches to FGM-safeguarding were based on outdated stereotypes and inaccurate evidence which encouraged health and other service providers to see every Somali parent as a potential perpetrator of FGC/M. Female participants described providers in a range of healthcare settings, including Accident and Emergency Departments (A&E), antenatal care and general practice, as ‘fixated’ with FGC/M, who ignored both their health needs and their experience as victims. Participants felt stigmatised and traumatised by their experience. This undermined their trust in health services, producing a reticence to seek care, treatment delays and reliance on alternative sources of care. Associated recommendations include developing more accurate evidence of risk, more appropriate education for healthcare providers and more collaborative approaches to FGM-safeguarding.ConclusionAll the participants involved in this study are committed to the eradication of FGC/M. But the statutory approaches currently adopted to enable this are considered ill-conceived, unnecessarily heavy-handed and ultimately detrimental to this. Recognising these common aims can enable the development of services better able to protect and support those at risk of FGC/M in ways which are culturally competent and sensitive.

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.

Exploring Beliefs and Attitudes Toward Female Genital Mutilation/Cutting Among Healthcare Providers in New York City

2021 ◽  
pp. 107780122110457
Author(s):  
Moonkyung Min ◽  
Tracy Wong ◽  
Adeyinka M. Akinsulure-Smith
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Healthcare Providers ◽  
Female Genital Cutting ◽  
Cultural Meanings ◽  
Genital Mutilation ◽  
Genital Cutting ◽  
Beliefs And Attitudes ◽  
Female Genital

Given the increase of African immigrants from countries with high female genital cutting (FGC) prevalence, this study explored U.S. healthcare providers’ beliefs and attitudes regarding FGC. A total of 31 professionals who have provided services to FGC-experienced women in New York City were interviewed; data were analyzed using grounded theory. Results indicated that, although a majority of respondents emphasized maintaining a nonjudgmental and open-minded attitude toward clients’ experiences, some only focused on the negative aspects of FGC. Also, multifaceted efforts by providers to understand the cultural meanings of FGC and resolve their own cultural dissonance were identified. The implications for practice were discussed.

Cultural Beliefs, Perceptions, and Experiences on Female Genital Mutilation Among Women and Men: A Qualitative Analysis

2021 ◽  
pp. 088626052110152
Author(s):  
Alba González-Timoneda ◽  
Antonio Cano Sánchez ◽  
Marta González-Timoneda ◽  
Vicente Ruiz Ros
Keyword(s):  
Female Genital Mutilation ◽  
Cultural Beliefs ◽  
Sampling Technique ◽  
Snowball Sampling ◽  
Traditional Practice ◽  
Genital Mutilation ◽  
The United Kingdom ◽  
Lack Of Information ◽  
Data Saturation ◽  
Female Genital

The practice of female genital mutilation (FGM) is a deeply-rooted tradition that affects predominantly regions of Africa and Asia. Because of migration flows, FGM is an issue of increasing concern worldwide. FGM is now carried out in Europe, North America, Australia and New Zealand, and more specifically among immigrant communities from countries where it is common. This study aims to assess the experience, knowledge, attitudes, and beliefs related to FGM of migrant women and men from FGM-affected countries residing in Spain and the United Kingdom. A phenomenological qualitative approach was used. Participants (n=23) were recruited by using the snowball sampling technique until data saturation was reached. Data were collected through 18 open-ended interviews and a focus group. Of the 23 participants, 20 women had undergone FGM. The following five themes were generated from interviews: (a) FGM practice development, (b) knowledge about the practice, (c) reasons for performing FGM, (d) attitudes toward continuing or abandoning the practice, and (e) criminalization of FGM. The study here presented identifies a lack of information, memory, and knowledge about the practice of FGM and typology among women with FGM. The justification of the practice seems to be based on a multifactorial model, where sociocultural and economic factors, sexual factors, hygienic-esthetic factors, and religious-spiritual factors take on a greater role in the analysis of the interviews carried out. The participants practically unanimously agree to advocate the abandonment and eradication of this harmful traditional practice. The knowledge displayed in this study may provide a basis for improving awareness and healthcare in such collectives, aiming the eradication of this harmful traditional practice.

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.

The impact of child maltreatment on the mental and physical health of child victims: a review of the evidence

2021 ◽  
pp. 1-11
Author(s):  
Eileen Vizard ◽  
Jenny Gray ◽  
Arnon Bentovim
Keyword(s):  
Child Maltreatment ◽  
Physical Health ◽  
Child Victims ◽  
Physical And Mental Health ◽  
Children And Young People ◽  
Genital Mutilation ◽  
Health And Development ◽  
The Impact ◽  
Mental And Physical Health ◽  
Female Genital

SUMMARY This article gives a general overview of the current situation in relation to a range of widely recognised and also newly identified types of child maltreatment. The academic and clinical evidence relating to the impact of child maltreatment on the mental and physical health of child victims is substantial and steadily increasing in volume. New types of abuse are being identified, and changing environmental circumstances, which exacerbate the possibility of widely recognised types of child maltreatment occurring, are also being described. These include multi-type maltreatment, female genital mutilation and online child maltreatment. Serious questions may arise regarding neglect of the moral and social development of children and young people who become addicted to online gaming and pornography. Multiple national and local definitions of each of these existing and new forms of maltreatment have been created, some of which are covered here. The impact of these abuses on the physical and mental health and development of child victims in families or settings where abuse or neglect has occurred is discussed.

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.

scholarly journals Understanding Low-value Care and Associated De-implementation Processes: A Qualitative Study of Choosing Wisely Interventions Across Canadian Hospitals

2021 ◽  
Author(s):  
Gillian Parker ◽  
Monika Kastner ◽  
Karen Born ◽  
Nida Shahid ◽  
Whitney Berta
Keyword(s):  
Process Model ◽  
Healthcare Providers ◽  
Implementation Process ◽  
Choosing Wisely ◽  
Structured Interviews ◽  
Team Members ◽  
Implementation Processes ◽  
Healthcare Settings ◽  
National Campaigns ◽  
The Impact

Abstract Background:Choosing Wisely (CW) is an international movement comprised of national campaigns in more than 20 countries to reduce low-value care (LVC). Hospitals and healthcare providers are examining existing practices and putting interventions in place to reduce practices that offer little to no benefit to patients or may cause them harm. De-implementation, the reduction or removal of a healthcare practice is an emerging field of research. Little is known about the factors which (i) sustain LVC; and (ii) the magnitude of the problem of LVC. In addition, little is known about the processes of de-implementation, and if and how these processes differ from implementation endeavours. The objective of this study was to explicate the myriad factors which impact the processes and outcomes of de-implementation initiatives that are designed to address national Choosing Wisely campaign recommendations.Methods:Semi-structured interviews were conducted with individuals implementing Choosing Wisely Canada recommendations in healthcare settings in four provinces. The interview guide was developed using concepts from the literature and the Implementation Process Model (IPM) as a framework. All interviews were conducted virtually, recorded, and transcribed verbatim. Data were analysed using thematic analysis.Results:Seventeen Choosing Wisely team members were interviewed. Participants identified numerous provider factors, most notably habit, which sustain LVC. Contrary to reporting in recent studies, the majority of LVC in the sample was not ‘patient facing’; therefore, patients were not a significant driver for the LVC, nor a barrier to reducing it. Participants detailed aspects of the magnitude of the problems of LVC, specifically the impact of harm and resources. Unique factors influencing the processes of de-implementation reported were: influence of Choosing Wisely campaigns, availability of data, lack of targets and hard-coded interventions.Conclusions: This study explicates factors ranging from those which impact the maintenance of LVC to factors that impact the success of de-implementation interventions intended to reduce them. The findings draw attention to the significance of unintentional factors, highlight the importance of understanding the impact of harm and resources to reduce LVC and illuminate the overstated impact of patients in de-implementation literature. These findings illustrate the complexities of de-implementation.

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.

Sign in / Sign up

Export Citation Format

Share Document