Peer-reviewed article
Health sector involvement in the management of female genital mutilation/cutting in 30 countries
R. Elise B. Johansen, Mai Mahgoub Ziyada, Bettina Shell‐Duncan, Adriana Kaplan Marcusán, Els Leye ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how health sectors in 30 countries manage female genital mutilation/cutting (FGM/C), comparing countries where it is traditionally practised with countries where it occurs mainly among migrant populations. Researchers found that while 24 countries had policies on FGM/C, implementation varied widely, with limited funding and weak monitoring systems in many places. Health worker training was more common in countries of origin, while prevention efforts were stronger in countries of migration. However, systematic recording of FGM/C cases was almost entirely absent in countries of origin and very limited elsewhere.
Key points
- 24 of 30 countries had FGM/C policies, but only 20 had partially or fully implemented plans
- Allocation of funding and monitoring and evaluation systems were lacking in 11 and 13 countries respectively
- Healthcare providers in most countries were forbidden from conducting FGM/C, but restrictions on re-infibulation were inconsistent
- Deinfibulation services were available in almost all countries, but psychological counselling and clitoral reconstruction were available in less than half the countries of migration
- Systematic recording of FGM/C in medical records was completely absent in countries of origin and very limited in countries of migration
Limitations
The study provides a snapshot of health sector involvement across countries at a single point in time (2016-2017) and does not assess the quality or effectiveness of policies and services implemented. The document does not detail the specific characteristics or contexts of the 30 countries studied beyond dividing them into countries of origin and countries of migration.
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.