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. 2018 Apr 4;18(1):240.
doi: 10.1186/s12913-018-3033-x.

Health sector involvement in the management of female genital mutilation/cutting in 30 countries

R Elise B Johansen  1 , Mai Mahgoub Ziyada  2 , Bettina Shell-Duncan  3 , Adriana Marcusàn Kaplan  4 , Els Leye  5
Affiliations

Health sector involvement in the management of female genital mutilation/cutting in 30 countries

R Elise B Johansen et al. BMC Health Serv Res. .

Abstract

Background: For the last decades, the international community has emphasised the importance of a multisectoral approach to tackle female genital mutilation (FGM/C). While considerable improvement concerning legislations and community involvement is reported, little is known about the involvement of the health sector.

Method: A mixed methods approach was employed to map the involvement of the health sector in the management of FGM/C both in countries where FGM/C is a traditional practice (countries of origin), and countries where FGM/C is practiced mainly by migrant populations (countries of migration). Data was collected in 2016 using a pilot-tested questionnaire from 30 countries (11 countries of origin and 19 countries of migration). In 2017, interviews were conducted to check for data accuracy and to request relevant explanations. Qualitative data was used to elucidate the quantitative data.

Results: A total of 24 countries had a policy on FGM/C, of which 19 had assigned coordination bodies and 20 had partially or fully implemented the plans. Nevertheless, allocation of funding and incorporation of monitoring and evaluation systems was lacking in 11 and 13 of these countries respectively. The level of the health sectors' involvement varied considerably across and within countries. Systematic training of healthcare providers (HCP) was more prevalent in countries of origin, whereas involvement of HCP in the prevention of FGM/C was more prevalent in countries of migration. Most countries reported to forbid HCP from conducting FGM/C on both minors and adults, but not consistently forbidding re-infibulation. Availability of healthcare services for girls and women with FGM/C related complications also varied between countries dependent on the type of services. Deinfibulation was available in almost all countries, while clitoral reconstruction and psychological and sexual counselling were available predominantly in countries of migration and then in less than half the countries. Finally, systematic recording of FGM/C in medical records was completely lacking in countries of origin and very limited in countries of migration.

Conclusion: Substantial progress has been made in the involvement of the health sector in both the treatment and prevention of FGM/C. Still, there are several areas in need for improvement, particularly monitoring and evaluation.

Keywords: Countries of migration; Countries of origin; Female circumcision; Female genital mutilation/cutting; Health policy; Healthcare; Prevention.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the ethical committee at the Norwegian Centre for Research Data (NSD). Consistent with the ethical clearance, return of filled questionnaire after being informed about the project, the voluntary nature of participation and treatment of data is to be considered as informed consent. Collected data concerns national policies and practices in the different countries and does not include personal data. Identifying markers, such as names and e-mail addresses of respondents were removed.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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