Introduction: According to figures released by UNICEF (United Nations Children’s Fund), more than 200 million girls and women have suffered female genital mutilation (FGM) in 30 African and Middle East countries. An increasing number of African women who come from ethnic groups where FGM is practised are arriving in Western countries. Healthcare professionals play a fundamental role in its prevention. Goals: To learn about the factors that healthcare professionals consider as facilitators for prevention and action when faced with female genital mutilation. Methods: A cross-sectional descriptive study developed on the basis of the qualitative methodological perspective, where 43 healthcare professionals participated. A series of analysis dimensions were established, based on which, the interview and discussion group scripts were designed. Results: Addressing FGM requires a series of structural adaptations of the healthcare system that facilitate the recording and monitoring of cases, both for treatment and for prevention. In addition, it is necessary to establish coordination between the healthcare, social services and education sectors. Conclusions: The existence of a protocol of action and training in its use is one of the key tools to take into account.
María Idoia Ugarte Gurrutxaga, Brígida Molina Gallego, Laura Mordillo‐Mateos et al.
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.
BACKGROUND: Transnational migratory movements make Spain a country with a very diverse population, including women and girls from countries where Female Genital Mutilation (FGM) is practiced. Given this reality, we set out to carry out a qualitative study to identify the knowledge, attitudes and skills of health professionals regarding FGM. METHOD: Qualitative study with a content analysis approach. Forty-seven health professionals with the profiles of Nursing, Family Medicine, Pediatrics, Midwifery and Gynecology and Obstetrics were purposively selected. Data were collected through semi-structured in-depth interviews and focus groups. The qualitative content analysis approach was used for data analysis. The study was conducted in the years 2019 and 2022. RESULTS: Although most professionals are aware of the current legislation on FGM in Spain, only a few of them are aware of the existence of the FGM prevention protocol in Castilla-La Mancha. This lack of knowledge together with the perception that FGM belongs to the private sphere of women, contributes to the loss of opportunities to identify and prevent FGM. CONCLUSION: Health professionals' training, especially midwives and pediatricians, is essential to the identification and action against Female Genital Mutilation.
María Idoia Ugarte Gurrutxaga, Victoria Mazoteras Pardo, Gonzalo Melgar de Corral et al.
Abstract This study examines how France's national asylum legislation has changed politically and ideologically from following a gender‐blind policy to recognizing gender‐based violence as a ground for asylum. Among European countries, France receives the largest number of female asylum seekers (FAS) from sub‐Saharan African (SSA) countries, where female genital mutilation/cutting (FGM/C) is practiced. Although France was one of the first countries to recognize FGM/C as a reason for granting asylum, it was reluctant to accept FAS as a “particular social group (PSG).” This article analyzes the increase in asylum claims based on FGM/C in the 2000s and examines the political discourses on changing asylum legislation up to the 2010s. Data from official reports of government organizations were examined to investigate the decisions on asylum applications involving FGM/C. France changed its policies in the 2000s to include gender equality in its republican identity due to ultra‐right party and social campaigns criticizing male members of minority groups for violence and discrimination against women. The then conservative government exploited these circumstances and enacted restrictive immigration laws that addressed FGM/C grievances partially; the succeeding socialist government recognized FGM/C as a ground for asylum. This study concludes by arguing that the 2011 European directive was a turning point for French asylum legislation to include gender‐sensitive interpretation of the grounds under the Convention on the Status of Refugees, in line with European policy. However, the status of SSA women and girls remains uncertain while they are subjected to medical examination and the application range of PSG could be reconsidered.
This article on the case of R v Noor (2024) discusses the second successful UK prosecution under the Female Genital Mutilation Act 2003, marking a significant legal precedent in addressing female genital mutilation. It underscores the critical role of midwives in detecting, reporting and caring for victims, highlighting the intersection of healthcare, law and ethics in combating this practice. By examining the case of Amina Noor, who took a child abroad for female genital mutilation, the article elucidates the legal ramifications of such acts. It stresses the importance of midwifery awareness, education and collaboration with legal entities to protect women and girls. The article advocates for continuous professional development, the use of legal tools such as female genital mutilation protection orders and a Commissioner to prevent female genital mutilation, emphasising the collective responsibility of healthcare professionals in eradicating this harmful practice and safeguarding vulnerable individuals.
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.
The paper aims to recall the most important works and theory of Alice Miller – the psychotherapist, who devoted her entire professional life to exposing violence hidden under the guise of upbringing. The study briefly introduces the biography of Alice Miller, which became available to readers only after her death, thanks to the book of her son. The next part discusses the views of Alice Miller regarding upbringing and the impact of children's experiences and suppressing feelings associated with them on violence in interpersonal relationships
The article emphasizes that in order to improve the protection of children’s rights during military conflicts and combat domestic violence, to identify facts of domestic violence against children, to improve and unify the forms of collecting, analyzing, summarizing and taking into account statistical data on cases of all forms of violence based on gender and domestic violence and the effectiveness of measures taken in these cases. Domestic violence is one such phenomenon that only worsens in the period of military aggression, while it can remain invisible or have an inadequate level of response from society due to many reasons. The problem of domestic violence is not new. This is especially true for children and teenagers. However, just as before the war, so now, children who are witnesses of domestic violence are not always recognized as victims. They are recognized as victims only if physical violence was directly directed against the child. Which, after all, a child who has witnessed domestic violence is obviously wrong, because the child who has witnessed domestic violence has at least already been harmed, in particular to his mental health. Different statistical forms in the subjects of prevention and counteraction to domestic violence, as well as their failure to take into account the features of today’s global challenges, make it impossible to qualitatively analyze data on the effectiveness of the system of prevention and counteraction to domestic violence / gender-based violence and lead to a lack of comprehensive scientific research on the impact of the pandemic and war on the situation of domestic violence / gender-based violence. At the same time, it is important to take into account in statistical forms vulnerable categories of affected persons, such as women, children, persons with disabilities, for the purpose of further analysis of such information and formation of effective assistance programs for such categories of persons based on the received data.
The situation of crisis produced by the Coronavirus (COVID-19) pandemic poses major challenges to societies all over the world. While efforts to contain the virus are vital to protect global health, these same efforts are exposing children and adolescents to an increased risk of family violence. Various criminological theories explain the causes of this new danger. The social isolation required by the measures taken in the different countries, the impact on jobs, the economic instability, high levels of tension and fear of the virus, and new forms of relationships have all increased levels of stress in the most vulnerable families and, therefore, the risk of violence. In addition, mandatory lockdowns imposed to curb the spread of the disease have trapped children in their homes, isolating them from the people and the resources that could help them. In general, the restrictive measures imposed in many countries have not been accompanied by an analysis of the access to the resources needed to reduce this risk. It is necessary to take urgent measures to intervene in these high-risk contexts so that children and adolescents can develop and prosper in a society which is likely to undergo profound changes, but in which the defense of their rights and protection must remain a major priority.
