Globally, over 200 million women and girls have been subjected to Female Genital Mutilation (FGM). This practice, illegal in most countries, often happens in unsanitary conditions and without clinical supervision with consequent bleeding and infection. However, little is known about its contribution to the global epidemiology of child mortality. We matched data on the proportion of girls of a given age group subject to FGM to age-gender-year specific mortality rates during 1990-2020 in 15 countries where FGM is practised. We used fixed-effects regressions to separate the effect of FGM on mortality-rates from variation in mortality in that country in that year. Using our estimated effect, we calculated total annual excess mortality due to FGM. Our estimates imply that a 50% increase in the number of girls subject to FGM increases their 5-year mortality rate by 0.075 percentage point (95% CI [Formula: see text]-[Formula: see text]). This increased mortality rate translates into an estimated 44,320 excess deaths per year across countries where FGM is practised. These estimates imply that FGM is a leading cause of the death of girls and young women in those countries where it is practised accounting for more deaths than any cause other than Enteric Infections, Respiratory Infections, or Malaria.
Arpita Ghosh, Heather D. Flowe, James Charles Rockey
During human history we found several procedures which can be considered as strong attacks on the physical and psychological integrity of human communities. Amongst these procedures are male and female genital mutilation. We have selected for this manuscript female genital mutilation (FGM) because we have personal knowledge of this practice in Africa and as there is today a growing perception on the necessity of to stop FGM, we want to share our experience of the knowledge of FGM. Effectively, some years ago, when we were working in research projects in Angola (West Africa) we were present at ceremonies (not the act) of female genital mutilation (FGM, whose popular name in Angola is “fanado”) by invitation of the community where the FGM was carried out, and we can transmit the following : (i) the images then seen remain in our memory -men, women and the young had vestments with many colors and adornments of metal, straw etc, were singing and dancing with strong energy ; (ii) the girls were stressed and fearful, thinking of their future suffering. Then, in this context, here we have as:1) general objective: to give our modest contribution to reinforce the necessity to end with the FGM practice, in that the dignity and rights of all girls are not respected; 2) particular objectives: (i) to show the negative repercussion of the FGM on girls concerning their physical and psychological health, since we are convinced that a genuine awareness of the gravity of the problems is an essential pre-condition for the implementation of any tangible measures for its end; (ii) to transmit the actual hope for the end of this procedure, considering, principally, that on 6 February 2019, WHO joins individuals, organizations, and UN partners worldwide in marking the International Day of Zero Tolerance for FGM [1]. To reach our objectives, we have selected information that we have considered as more relevant in the context of an edital.
Performing female genital mutilation (FGM) is prohibited within the UK by the FGM Act of 2003. A mandatory reporting duty for FGM requires regulated health and social care professionals and teachers in England and Wales to report known cases of FGM in under 18-year-olds to the police. An application to the court for an FGM protection order (FGMPO) can be made to keep individual women and girls safe from FGM. This paper reveals the significant disconnect between the number of FGMPO applications and known recorded cases of FGM. The introduction of FGMPOs requires critical exploration as there is insufficient evidence to show that FGMPOs are effective in protecting women and girls from FGM. It is therefore unclear what impact, if any, FGMPOs are having upon the protection of women and girls at risk of FGM. The barriers to the implementation of FGMPOs and possible solutions are discussed.
Joseph Home, Andrew Graeme Rowland, Felicity Gerry et al.
Female circumcision or female genital mutilation (FGM) is a traditional and cultural practice among Africans including some tribes in Nigeria. Its origin dates back to antiquity. FGM is the amputation and mutilation of the sex organ of girls and women for various cultural, medical and traditional reasons. The practice is inimical and dangerous to the health of the victims. It also violates rights of women. This paper discussed how the practice can be eradicated through the legal framework of legislation, education, enlightenment, and human rights norms.
Abstract The ‘global prohibition regime’ against ‘female genital mutilation’ (FGM) remains understudied within criminology. Zemiology, with its raison d’être to locate the source and nature of harm, opens up analytical potential. Bringing zemiology together with decolonial feminist approaches for the first time, we analyse data from focus group interviews with people of Somali heritage living in Bristol, England, to consider the unacknowledged harms created by anti-FGM legal and policy developments in the UK context. We argue that the racialized criminalization of ‘FGM’ gives rise to considerable harm: in particular, harms of misrecognition, autonomy and psychological well-being. We conclude by considering the wider relevance of our findings to debates on state responses to violence against women and girls.
Christina Pantazis, Natasha Carver, Saffron Karlsen et al.
Hrvatin I1, Šćepanović D11University Medical Center Ljubljana, Gynaecological Clinic, Ljubljana, SloveniaBackground: FGM represents a global concern as 63 million more girls could be subjected to FGM by 2050. It is a deeply embedded cultural tradition that holds a symbolic meaning in numerous communities and is practiced in rural and urban areas. While the exact number of girls and women worldwide who have undergone FGM procedure remains unknown, at least 200 million girls and women in 30 countries have been subjected to the practice. The practice of FGM is highly concentrated in Africa, in the Middle East and in some Asian countries, but can also be found in Europe, Australia and North America, due to displacement caused by civil wars, globalization and migration.Purpose: The objective of this paper was to review the current literature on female genital mutilation and its consequences, to describe and critically assess the theoretical and methodological approaches to treatment options and to describe and assess different methods that aim to stop or reduce the continuation of FGM.Methods: We carried out a literature review of articles published in the last 10 years. Included articles studied consequences following FGM, treatment options and different methods to stop or reduce the continuation of FGM. Literature search was conducted on the following databases PubMed, PEDro, Cochrane database, CINAHL and Medline.Results: Globally the prevalence is declining, as many actions from legal to community based programmes are being proposed. There are many known consequences that can be divided in to two groups: short and long term. Treatment options are well documented in the literature, but published studies are of poor quality. Nevertheless, there are many treatment options and guidelines on how to treat women with FGM. Health care professional should be well informed and sensitive to properly treat women with FGM. They should also inform women about possible consequences and legal aspects. Recent literature review of student's and health care professionals' knowledge and attitudes regarding FGM showed that there is a strong need for education and training, since health care professionals are the key persons in the care for complications and prevention of FGM. Studies show that there is a huge lack of knowledge regarding this subject. Society should be informed about this procedure and should encourage open communication within the society, especially between men and women, since their opinion usually matches, but because the lack of communication in the community the practice continues.Conclusion(s): This article offers a new and recent prospective of FGM, consequences and treatment options as well as what we can do to stop this practice. Limitations of this review include the risk of bias, because it is not possible to identify and retrieve all studies. Future research should be of better quality and should focus especially on treatment options.Implications: As health care professionals we should have some knowledge of the subject and especially about how to address and inform possible future patients that have been submitted to the practice.Keywords: female genital mutilation, consequences, preventionFunding acknowledgements: This study was unfunded.Topic: Women's & men's pelvic health; Globalisation: health systems, policies & strategies; Professional practice: otherEthics approval required: NoInstitution: NoneEthics committee: NoneReason not required: This was a literature review, therefore ethics approval was not needed.All authors, affiliations and abstracts have been published as submitted.
Basically, as a result of her huge population and the most populous African nation, Nigeria has the most noteworthy outright number of Female Genital Mutilation (FGM) around the world, representing around one-fourth of the assessed 116132 million circumcised women globally. The aim of this analytical review is mainly to establish the present status of the Female Genital Mutilation in Nigeria. Relevant literature pertaining to FGM recovered from internet providers such as Google search, online journals, books, magazines, diaries and libraries. All these were chosen for implicit comprehension of the discourse. In Nigeria, the pervasiveness rate of Female Genital Mutilation among women is 43%. Proof proliferates that; statistically, the pervasiveness of the Female Genital Mutilation is drastically declining. The continuous drive and crusade to extirpate FGM is undertaken by bodies like United Nations, World Health Organization, International Children Emergency Fund, African Union and numerous women associations. Nonetheless, there is never any government law forbidding FGM in Nigeria. There is urgent need to annihilate Female Genital Mutilation Africa and specifically in Nigeria. Persistent education and training of the overall population at every level with accentuation on the risks and nuisance of the Female Genital Mutilation is foremost.
Purpose: We aim to provide a comprehensive overview of the health consequences of female genital mutilation/cutting (FGM/C), with a particular focus on the psychosexual implications of this practice and the overall impact of reconstructive plastic surgery. Methods: A MEDLINE search through PubMed was performed to identify the best quality evidence published studies in English language on long-term health consequences of FGM/C. Results: Women with FGM/C are more likely to develop psychological disorders, such as post-traumatic stress disorder, anxiety, somatization, phobia, and low self-esteem, than those without FGM/C. Most studies showed impaired sexual function in women with FGM/C. In particular, women with FGM/C may be physiologically less capable of becoming sexually stimulated than uncut women. Reconstructive surgery could be beneficial, in terms of both enhanced sexual function and body image. However, prospective studies on the impact of reconstructive surgery are limited, and safety issues should be addressed. Conclusion: Although it is clear that FGM/C can cause devastating immediate and long-term health consequences for girls and women, high-quality data on these issues are limited. Psychosexual complications need to be further analyzed to provide evidence-based guidelines and to improve the health care of women and girls with FGM/C. The best treatment approach involves a multidisciplinary team to deal with the multifaceted FGM/C repercussions.
Laura Buggio, Federica Facchin, Laura Chiappa et al.
PURPOSE OF REVIEW: Female genital cutting/mutilation (FGM/C) performed by health care professionals (medicalization) and reduced severity of cutting have been advanced as strategies for minimizing health risks, sparking acrimonious ongoing debates. This study summarizes key debates and critically assesses supporting evidence. RECENT FINDINGS: While medicalization is concentrated in Africa, health professionals worldwide have faced requests to perform FGM/C. Whether medicalization is hindering the decline of FGM/C is unclear. Factors motivating medicalization include, but are not limited to, safety concerns. Involvement of health professionals in advocacy to end FGM/C can address both the supply and demand side of medicalization, but raises ethical concerns regarding dual loyalty. Ongoing debates need to address competing rights claims. SUMMARY: Polarizing debates have brought little resolution. We call for a focus on common goals of protecting the health and welfare of girls living in communities where FGM/C is upheld and encourage more informed and open dialog.
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.
R. Elise B. Johansen, Mai Mahgoub Ziyada, Bettina Shell‐Duncan et al.
