Combining Theory and Research to Validate a Social Norms Framework Addressing Female Genital Mutilation., (2022)

This study is a Descriptive research regarding All FGM/C with the following characteristics: Author(s): Suruchi S.,and Ramaiya A. FGM/C Type(s): All Health area of focus: None. Objective: In 2016,the United Nations Joint Program to Eliminate FGM,funded the development and subsequent validation of a monitoring and evaluation framework to understand the relationship between social norms and practicing FGM. Evidence on the framework was gathered through a pilot study in Ethiopia. This paper uses cross-sectional quantitative data from the pilot to operationalize the framework and determine what factors are associated with practicing FGM Study Population: Household eligibility criteria included that there was an adolescent girl 10–19 years old and a primary caregiver in the household and both provided consent to participating in the study. Both assent and consent procedures were followed for interviewing adolescent girls below 18 years of age. Apart from interviewing both the adolescent girls and their primary caregivers,these respondents were asked to nominate individuals who they considered as influential in matters associated with FGM,as well as,specific individuals in their social networks whose opinion around FGM mattered. Community influential and social network contacts were ranked based on the frequency they were mentioned in each enumeration area. These individuals were interviewed by the data collection team if they were available and consented to be interviewe Findings: A total of 554 and 481 participants answered the question “Have you undergone FGM?” and “Do you know a family member who has undergone FGM?” respectively. Overall,65% of participants said they had undergone FGM and 32% said they knew someone in their family who had undergone FGM. Predictors of not undergoing FGM included most progressive attitudes vs. less progressive attitudes about FGM and relationship to identity [OR: 1.9 (95% CI: 1.1–3.3)]; region [Afar vs. Addis Ababa: OR: 0.09 (95% CI: 0.02–0.5); Southern Nations Nationalities and People’s Regions vs. Addis Ababa: OR: 0.1 (95% CI: 0.05–0.3)],being 36 years old and above vs. 10–19 years (OR: 0.2 (95% CI: 0.1 to 0.7)) and being single,never married vs. married or engaged (OR: 2.8 (95% CI: 1.1–7.0)]. Predictors of knowing a family member who has not undergone FGM included: Higher knowledge vs. lower knowledge [OR: 0.3 (95% CI: 0.1–0.5)]; if the family expected you to abandon FGM,you had a greater odds of knowing a family member who had not undergone FGM [43.6 (95% CI: 2.7–687.8)]; coming from Southern Nations,Nationalities and People’s Region was associated with a lower odds of knowing a family member who had not undergone FGM [0.3 (95% CI: 0.1–0.6)]. Being a female influential vs. female caregiver was associated with a higher odds of knowing a family member who had not undergone FGM [2.9 (95% CI: 1.01–5.2)]. This paper has allowed us to validate a theory and research based social norms framework,specifically examining how social and behavior change communication can be used as a mechanism for shifting norms around a given harmful practice. Now that this model has been developed and validated,it is likely to provide a foundation to study the direct and indirect impacts of social norms programming on changing harmful practices,such as FGM.Many academics,researchers,and practitioners have remarked on the difficulty of measuring norms and linking norm change to exposure and involvement with communication interventions. Despite the limitations noted above,this paper has allowed us to operationalize a conceptual model on social norms measurement,specifically examining how social and behavior change communication can be used as a mechanism for shifting norms around a given harmful practice. Now that this model has been developed and validated,it is likely to provide a foundation to study the direct and indirect impacts of social norms programming on changing harmful practices,such as FGM. Plans are currently underway to incorporate the ACT framework into the FGM program in Sudan,which will allow us to use the pilot data to monitor and evaluate change.At a macro level,opportunities to reduce or to end the practice of FGM/C exist through legislation,policy,a public health approach grounded in gender equality and human rights. Using multi-sectoral actions that consider the social context and challenge social norms at macro,meso and micro levels appears more effective than individual-level interventions. Promoting advocacy and developing supportive environments to reduce GBV,enhance gender equality and empower communities is crucial for interventions to succeed and achieve the Sustainable Development Goal target of FGM/C abandonment by 2030. Geographical coverage Region(s):Western Africa,Eastern Africa Country(ies):Ethiopia,Guinea Source

September 8, 2023

Commentary: What should referral pathways have to improve healthcare experiences of women with female genital mutilation in Australia? (2021)

This study is a Descriptive research regarding All FGM/C with the following characteristics: Author(s): Njue,C.,Ameyaw,E.K.,Ahinkorah,B.O. et al FGM/C Type(s): All Health area of focus: Biological and psychological consequences of FGM. Objective: Examination of the evidence derived from healthcare professionals’ interfacing with women with female genital mutilation (FGM) to comprehend the referral pathways available to these women in Australia. Study Population: N/A Findings: Clinicians encountered FGM-related complications that included ruptured bladder and total urinary incontinence. Midwives and paediatricians indicated a lack of referral pathways for FGM,but used their discretion to refer such cases to social work departments,obstetric/gynaecological units,child protection service providers,psychological counsellors and surgeons. The continuum of care for women with FGM is characterised by inadequate and lack of clear referral pathways. This underscores the need to develop and strengthen referral pathways in response to physical,birthing and psychological complications of women with FGM to improve their care experiences in Australia.Capacity building initiatives on FGM-prevention and care for trainees and practising health providers and community involvement in high burden areas/populations should be implemented to promote uptake and utilization of the referral services. Provision of infrastructural support,including clinical management tools,job aids,posters,referral algorithms and electronic patient records with “drop-down menus” for referral sites for health complications of FGM to reinforce the providers’ efforts are critical. Geographical coverage Region(s):Australia and New Zealand Country(ies):Australia Source

Communication for abandonment of female genital cutting: an approach based on human rights principles (2006)

This study is a Exploratory research regarding All FGM/C with the following characteristics: Author(s): Ford Neil FGM/C Type(s): All Health area of focus: None. Objective: To explore approaches to communication that is based on community dialogue and the development of shared understanding,rather than on the dominant model of health communication: the design and delivery of messages that direct individuals to preferred behaviours Study Population: None Findings: A programming approach that combines non-directive community discussion with public declarations against FGC may lead to mass abandonment of this practice Geographical coverage Region(s):Not specified Country(ies):Not specified Source

Community Education Matters: Representations of Female Genital Mutilation in Guineans Immigrant Women (2015)

This study is a Descriptive research regarding All FGM/C with the following characteristics: Author(s): Wilson Abreu and Margarida Abreu  FGM/C Type(s): All Health area of focus: None. Objective: 1. To explore the experiences of Guineans immigrant women that lived in communities where the practice was performed, 2. To describe how,where,and who was usually involved,to identify the effects of the mutilation,and 3. To evaluate the effectiveness of the educational programs developed to eradicate the practice Study Population: Immigrant women from Guinea Bissau living in the North of Portugal Findings: Findings show that Type II was the most common form of mutilation. It was shaped by a complex interplay of cultural factors related to the initiation into womanhood,the status of woman and the need to be accepted by men. Study did not find a direct relation between religion and mutilation. Educational programs offered an alternative to the ritual (“symbolic fanado”). The educational programs were in general inclusive and culturally-sensitive. They contributed to the reduction of the prevalence of female mutilation,involving the community and respecting the local culture. Instead of imposition,the programs developed a cultural action for freedom. As a result,in these programs emergeed an alternative to the cutting,well accepted by the population. Geographical coverage Region(s):Southern Europe Country(ies):Portugal Source

Community Influences on Female Genital Mutilation/ Cutting in Kenya: Norms,Opportunities,and Ethnic Diversity (2019)

This study is a Exploratory research regarding All FGM/C with the following characteristics: Author(s): Grose,R. G.,Hayford,S. R.,Cheong,Y. F.,Garver,S.,Kandala,N. B.,& Yount,K. M. FGM/C Type(s): All Health area of focus: None. Objective: We propose an integrated theory about contextual factors and test it using multilevel discrete-time hazard models in a nationally representative sample of 7,535 women with daughters who participated in the 2014 Kenya Demographic and Health Survey Study Population: The 2014 KDHS collected FGMC information in two ways: (1) reports from all women about their attitudes about and experiences with FGMC and (2) reports from women with daughters aged 0 to 15 about daughters’ experiences with FGM Findings: A daughter’s adjusted hazard of FGMC was lower if she had an uncut mother who disfavored FGMC,lived in a community that was more opposed to FGMC,and lived in a more ethnically diverse community. Unexpectedly,a daughter’s adjusted FGMC hazard was higher if she lived in a community with more extrafamilial opportunities for women. Other measures of women’s opportunities warrant consideration,and interventions to shift FGMC norms in more ethnically diverse communities show promise to accelerate abandonment Geographical coverage Region(s):Eastern Africa Country(ies):Kenya Source

Community Participation and Challenges in controlling Female Genital Mutilation in A Rural Community of Southwest Ethiopia: A Mixed Study (2021)

This study is a Descriptive research regarding All FGM/C with the following characteristics: Author(s): Melsew S.A FGM/C Type(s): All Health area of focus: None. Objective: This study was aimed to assess the role of community participation and challenges in controlling the female genital mutilation in rural community of southwest Ethiopia Study Population: A community based cross sectional study was conducted from November 1–30,2020 in southwest Ethiopia among 403 study participants Findings: The response rate of the study was 91.3% of them completed the interview. From this as the total response rate indicated that 65.8% females and 34.2% male responded. The result indicated that among participant females 79.27% circumcised. From the participant,70.1% of respondents not support community participating in control of female genital mutilation. The result of this study indicates that majority,92.2% of the respondents believe (M = 4.48,SD = 0.639) that community participation can help the actors to left female genital mutilation practice in the community. The influence of community participation in making decision to left circumcision of once daughter in the future. The result revealed that 45.0% and 44.4% of respondents perceive (M = 4.34,SD = 0.661) community participation influence the future actions of an individual can be high and very high respectively. The challenges identified in the current study were changing tradition of female circumcision from public to secrecy,lack of decision making among local people,lack of open discussion among rural community,submissive participation by women in FGM controlling process,intervention of local administration and preference of donors’ problems.The practice of FGM in the study are high since the goal of sustainable development goal is zero. Lowe attitude and perception towards female genital mutilation is study area. Majority of FGM practice was done health professionals in secret way. This implies that more intervention is needed for the reduction of its practice. The government should work with the community and should consider culturally appropriate and socially acceptable policies and strategy to reduce the practice. Geographical coverage Region(s):Eastern Africa Country(ies):Ethiopia Source

Community-based interventions can change detrimental social norms: Experience from the Navrongo Female Genital Mutilation Experiment (2005)

This study is a Explanatory research regarding All FGM/C with the following characteristics: Author(s): Philip B. Adongo,Elizabeth Jackson,Livesy Abokyi,Reshma Naik,Ellie S. Feinglass ,James F. Phillips FGM/C Type(s): All Health area of focus: None. Objective: To presents results from a multifaceted qualitative study examining the social consequence of the intervention,including the impact on circumcised women and girls,the transition to adulthood,traditional sexuality education,gender identity,and changes relating to cultural and religious practices,with a particular focus on funeral and marital customs. Study Population: Findings: Focus group discussions and in-depth interviews conducted with communities indicate that participants are willing to change their practices if programs are culturally sensitive and carefully implemented. Geographical coverage Region(s):Western Africa Country(ies):Ghana Source

Community-based study of circumcision practices in Nigeria (2012)

This study is a Descriptive research regarding All FGM/C with the following characteristics: Author(s): Abdur-Rahman Lukman Olajide,Musa Omotoso,Oshagbemi Gordon K FGM/C Type(s): All Health area of focus: None. Objective: To determine the pattern of circumcision practice and identify factors affecting the practice in Ilorin community Study Population: Mothers,Fathers,Caregivers Findings: Circumcision is an inherent part of life of people in Ilorin; hence,using mothers/ parents of under-5 children gave a quick and reliable recall of the practice of circumcision and the events surrounding it. The prevalence of female circumcision among mothers was 65.6%. This prevalence rate is higher than what is generally quoted as an average,in Nigeria (25.1- 40%). Female circumcision is still being practiced in the community as reflected in the incidence rate of 73.9% Geographical coverage Region(s):Western Africa Country(ies):Nigeria Source

Community-Based Survey on Female Genital Excision in Faranah District,Guinea (2001)

This study is a Descriptive research regarding All FGM/C with the following characteristics: Author(s): Daman Keita and David Blankhart FGM/C Type(s): All Health area of focus: None. Objective: To study the beliefs and practices of people in Faranah District,Guinea regarding female genital excision (FGE) Study Population: Women of reproductive age,older women,married men,community and religious leaders,traditional practitioners and health workers Findings: The study found that female genital excision (FGE) was being carried out on girls aged 6-14,mostly using a traditional knife and involving total excision of the clitoris and partial removal of the external genitals,in conjunction with instruction on how young women should behave when they are married. Despite the practice being illegal under national laws,few people were aware of this. There was a tendency towards taking girls for medical care to avoid complications,and some people suggested that FGE should be done by medical professionals,but this was a minority. More than 60 per cent of respondents thought FGE was harmful to health and supported its abolition. Many more men than women took this view; women felt under pressure to maintain the tradition. To stop FGE,the study notes that local organizations needed to support a process of change within the community,including awareness-raising about the law and the negative health effects of FGE,promoting alternative ceremonies,educating practitioners and supporting education and improvements in the status of women Geographical coverage Region(s):Western Africa Country(ies):Guinea Source

Comparative study level of parent education of women circumcised and uncircumcised women in Qeshm (2014)

This study is a Correlation research regarding All FGM/C with the following characteristics: Author(s): Zarei,Eghbal,Seyed Reza Fallahchai,and Yahya Bazyarizadeh.  FGM/C Type(s): All Health area of focus: N/A. Objective: To answer the question on whether the level of education for circumcised and uncircumcised women in Queshm creates any differences in female circumcision of their female children. Study Population: Women Findings: Results showed that between parent education group,circumcised women and uncircumcised women in Qeshm city,there was significant difference. The parental education of circumcised women was lower than parental uncircumcised women. Low education and lack of prerequisite awareness of the necessary information on the impact of female circumcision by the mothers resulted in the decline of effective and responsible role in relation to their female children circumcision. Due to the significant differences in parents’ educational levels of women circumcised and uncircumcised women and a lower level of circumcised parents education than parents of uncircumcised women Promotion of education and literacy levels of parents and the knowledge derived from it can be a deterrent to prevent and reduce the prevalence of female genital mutilation along with other factors cited. Key words: comparison,female genital mutilation/cutting,education’s level of parents. Geographical coverage Region(s):Southern Asia Country(ies):Iran Source