Understanding medicalisation of female genital mutilation/cutting (FGM/C): A qualitative study of parents and health workers in Nigeria

Abstract Background: Female genital cutting/mutilation is a harmful traditional practice that violates women’s rights and has adverse health consequences. This paper presents the reasons for and circumstances of female genital mutilation/ cutting (FGM/C) in specific settings of three countries – Indonesia, Ethiopia and Kenya.Methods: Data were collected through a household survey with young people (15-24 years) and through focus group discussions, in-depth interviews and key informant interviews with youth and community stakeholders in 2016 and 2017. Descriptive statistics and thematic content analysis were conducted.Results: The study findings confirm some of the reasons for FGM/C documented by previous studies, noting that these reasons are strongly interconnected, and gender norms are the underlying driver. In all three settings, these reasons drive the alterations of female bodies to result in a ‘cultured’ body that is acceptable to the patriarchal status quo. This results in the ‘pure body’ in Indonesia, the ‘tame’ body in Ethiopia and the ‘adult body’ in Kenya. Health workers and parents play an important role in decision-making around FGM/C in all settings. In Kenya, in particular, young women negotiate their role in decision-making around FGM/C as they are older at the time of circumcision. The study reveals how the changing legal and social contexts in each setting bring about changes in the tradition of FGM/C resulting in medicalization of FGM/C in Indonesia, a lowered age of cutting for girls in Kenya and the increasingly underground practice of FGM/C in Ethiopia.Conclusions: The three cases demonstrate the huge variation in the practice of FGM/C and the social meaning attributed to it by young women and their communities. There is a need to further explore the role of parents in decision-making. Due to the links between the different drivers of FGM/C within each context, the study concludes that context-specific strategies need to be adopted by interventions to create long-lasting change.

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A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England

BMJ Open ◽

10.1136/bmjopen-2015-009846 ◽

2016 ◽

Vol 6 (1) ◽

pp. e009846 ◽

Cited By ~ 21

Author(s):

Jordan M Moxey ◽

Laura L Jones

Keyword(s):

Qualitative Study ◽

Female Genital Mutilation ◽

Intrapartum Care ◽

Genital Mutilation ◽

Somali Women ◽

Female Genital

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Exploring the views of female genital mutilation survivors, their male partners and healthcare professionals on the timing of deinfibulation surgery and NHS FGM care provision (the FGM Sister Study): protocol for a qualitative study

BMJ Open ◽

10.1136/bmjopen-2019-034140 ◽

2019 ◽

Vol 9 (10) ◽

pp. e034140

Author(s):

Laura Jones ◽

Emma Danks ◽

Joanne Clarke ◽

Lailah Alidu ◽

Benjamin Costello ◽

...

Keyword(s):

Qualitative Study ◽

Female Genital Mutilation ◽

Best Practice ◽

Healthcare Professionals ◽

Health Concern ◽

Care Provision ◽

Male Partners ◽

Genital Mutilation ◽

The Uk ◽

Female Genital

IntroductionFemale genital mutilation (FGM) is a significant global health concern and is likely to become an increasingly important healthcare challenge in destination countries such as the UK owing to rising levels of migration from FGM-affected countries. Currently, there is no consensus on the optimal timing of deinfibulation (opening) surgery for women who have experienced type 3 FGM and care provision remains suboptimal in the UK. This qualitative study aims to explore the views of survivors, male partners and healthcare professionals (HCPs) on the timing of deinfibulation and delivery of NHS FGM services.Methods and analysisA qualitative study, informed by the Sound of Silence conceptual framework, will be undertaken via two work packages (WPs). WP1 will explore views on timing preferences for deinfibulation and NHS FGM services through interviews and discussion groups with FGM survivors (n~50), male partners (n~10) and HCPs (n~50). WP2 will use established techniques via two workshops (community (n~20–25 participants) and national stakeholder (n~30–35 participants)) to synthesise qualitative research findings and inform best practice and policy recommendations around the timing of deinfibulation and NHS FGM care provision. Supported by trained interpreters, data collection will be audio recorded and transcribed. Data will be analysed using the framework method to facilitate a systematic mapping and exploration of qualitative data from multiple sources.Ethics and disseminationThe study has received ethical approval from the North West Greater Manchester East Research Ethics Committee (18/NW/0498). The outputs for this study will be recommendations for best practice and policy around FGM care provision that reflects the views and preferences of key stakeholders. The findings will be disseminated via conference presentations, peer-reviewed publications, patient groups, third sector organisations and social media.Trial registration numberISRCTN14710507.

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Health workers urged to identify women at risk of female genital mutilation

Primary Health Care ◽

10.7748/phc.25.2.6.s2 ◽

2015 ◽

Vol 25 (2) ◽

pp. 6-6

Author(s):

Jennifer Sprinks

Keyword(s):

At Risk ◽

Female Genital Mutilation ◽

Health Workers ◽

Genital Mutilation ◽

Female Genital

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Female genital mutilation (FGM) in Somaliland – why is change so slow?

10.36368/shaj.v1i1.254 ◽

2021 ◽

Author(s):

Annika Johansson ◽

Abdirahman Osman Gaas ◽

Amina Mahmoud Warsame

Keyword(s):

Female Genital Mutilation ◽

Health Workers ◽

Behavioural Change ◽

Small Scale ◽

Community Members ◽

Community Group ◽

Medical Reason ◽

Genital Mutilation ◽

Health Complications ◽

Female Genital

Female genital mutilation (FGM) is defined as any procedure involving the alteration or excision of external female genitalia for no medical reason. Somaliland has among the highest prevalence rates of FGM globally. In this article we describe how the Civil Society Organisation (CSO) ‘Network against female genital mutilation in Somaliland’ (NAFIS) has approached the challenge to reduce the high FGM prevalence. From its start in 2006, NAFIS has developed a multifaceted program to reach the overall goal: the elimination of all forms of FGM in Somaliland. Alone among the group of CSOs in the network, NAFIS introduced in its activities medical care and counselling for women who suffer from the consequences of FGM. From 2011 and onwards, thousands of women have been relieved of their FGM-related health complications and participated in counselling sessions at project centres. Shortly after this visit they have been invited to participate in community group meetings to share their experiences with other women who also have received FGM care and counselling, and other community members. The aim of the article is to describe this model of work - combining FGM care and counselling with community dialogues. The article is basically descriptive, using the authors’ own observations and encounters with project clients and staff over eight years. We have also used findings from three Master's theses on aspects of the process, and from other small scale studies to highlight people’s understanding, experiences and opinions in a context of an on-going health intervention. A lesson learnt from NAFIS project is that it has helped to open up communicative spaces in community dialogues where experiences are shared and understanding created of the harm caused by FGM, without the habitual stigma and shame. We discuss this process in a context of behavioural change theories. A major challenge during the process has been to involve men in the project’s FGM information and counselling activities. The role of nurses/midwives, being the first to meet women with FGM complications, is also discussed and the need emphasised to strengthen capacity of this category of health workers. One type of FGM gaining in usage is the poorly defined sunna, the health risks of which are unclear.

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