Female Genital Mutilation (FGM) is a harmful practice that affects millions of women worldwide and is recognized internationally as a violation of human rights. In an effort to combat this practice, the World Health Organization (WHO) and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), together with local partners, conducted a groundbreaking multi-country randomized cluster trial in Kenya, Guinea, and Somalia. The aim was to test the effectiveness of a complex intervention strategy to prevent FGM and provide comprehensive care for survivors.
According to the study findings, Kenya has shown a steady decline in the prevalence of FGM over the last three decades. However, there remains a pressing need to address the issue in 22 hotspot counties where FGM prevalence remains high. To address this, the WHO, in collaboration with the Ministry of Health (MoH) and the Africa Coordinating Centre for the Abandonment of Female Genital Mutilation/Cutting (ACCAF), based in the Faculty of Health Sciences, University of Nairobi, is taking proactive steps to disseminate the study’s results and plan the first phase of scale-up in Kenya.
The intervention package tested in the study aimed to empower nurses and midwives in antenatal care settings with the necessary tools and knowledge to provide effective FGM prevention and care services. The intervention package had two core components:
1. Health facility policies: This involved the implementation of policies directing healthcare providers’ involvement in FGM-related services as part of routine care, adopting a zero-tolerance approach to FGM practice. Posters with similar messages and relevant WHO guidelines and clinical handbooks were also made available in health facilities.
2. Person-Centred Approach: The second component, the study intervention, comprised a three-day training program that sensitized healthcare providers to be aware of their values that may affect service provision. It focused on building their knowledge and skills in applying a person-centered approach, known as the ABCD method, when communicating with their clients about FGM prevention. Person-centered care is a WHO-recommended approach that enhances the quality of clinical care by considering the perspectives of individuals, families, and communities in decision-making. It ensures that they have all the information they need and addresses their unique needs in a humane and holistic manner.
The results of the study have been highly promising. ANC providers at intervention sites were significantly more likely to use person-centred FGM prevention communication during routine antenatal care. They also exhibited greater knowledge and confidence in providing quality prevention and care services following the ABCD approach. As a result, ANC clients at intervention sites were twice as likely to report strong opposition to FGM practice and less likely to intend to subject their child to FGM or seek a healthcare worker to perform FGM. Additionally, they were more than two times as likely to be actively engaged in FGM prevention efforts. Video: Health workers communicating to end FGM(https://youtu.be/W5M6nJrbJus)
With these encouraging outcomes, the WHO, MoH, and ACCAF plan to disseminate the study findings widely and develop a comprehensive scaling-up strategy for all FGM prevalent counties. A workshop has been scheduled to discuss the study’s objectives and guide the implementation of the scale-up phase. This workshop will bring together key stakeholders, including healthcare professionals, policymakers, and representatives from civil society organizations, to collaborate on effective ways to combat FGM and protect the rights and health of women and girls. Video: WHO supporting the health sector to end FGM (https://www.who.int/multi-media/details/who-supporting-the-health-sector-to-end-fgm)
The WHO remains committed to working with partners and stakeholders to eliminate FGM, protect women’s rights, and promote the highest attainable standard of health for all. By adopting a person-centered approach, the prevention of FGM can become more effective and impactful, leading to positive change in communities across Kenya and beyond.
For more information and updates on the workshop and scaling-up strategy, please visit www.accaf.org
About WHO: The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. It works to ensure that everyone can achieve the highest possible level of health, regardless of their social or economic status.